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Remedy
Last reviewed: 04.07.2025
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Remedy is an antimicrobial substance from the fluoroquinolone category - ofloxacin isomer of levorotatory nature. It demonstrates a wide range of antimicrobial activity.
Levofloxacin helps block DNA gyrase (topoisomerase type 2), as well as topoisomerase type 4; it also disrupts the processes of cross-linking DNA breaks and supercoiling, and at the same time slows down DNA binding and provokes profound morphological changes in the area of cell membranes, cytoplasm and bacterial walls.
Levofloxacin demonstrates an effect on a relatively large number of microbial strains in in vitro studies, as well as in vivo.
Indications Remedies
It is used for diseases of infectious and inflammatory etiology, caused by bacteria sensitive to levofloxacin:
- infections affecting the lower respiratory tract (community-acquired pneumonia or exacerbation of chronic bronchitis );
- maxillary sinusitis in the acute stage;
- lesions associated with the functioning of the urethra (without complications);
- complicated lesions of the urinary tract (including acute pyelonephritis);
- infections associated with the subcutaneous layer and epidermis (abscesses, atheromas with suppuration and furuncles);
- bacteremia or septicemia;
- chronic prostatitis of bacterial origin;
- infection affecting the abdominal area;
- combination treatment of drug-resistant types of tuberculosis.
Release form
Pharmacodynamics
The level of bacterial exposure to levofloxacin is determined by the ratio of serum Cmax or AUC values to MIC.
The main mechanism of resistance is the result of a gene mutation gyr-A. In vitro tests demonstrate cross-resistance of levofloxacin with other fluoroquinolones.
The principle of therapeutic influence of Remedia often allows to avoid cross-resistance between levofloxacin and other categories of antibacterial substances.
Pharmacokinetics
Suction.
After oral administration, levofloxacin is rapidly and almost completely absorbed, reaching plasma Cmax values after 60 minutes. Its bioavailability values are approximately 100%.
Food has little effect on the rate of drug absorption.
Distribution processes.
About 30-40% of the drug is synthesized with blood serum protein. The cumulative effect after repeated administration of the drug in a dose of 0.5 g, 1 time per day is almost absent. In theory, insignificant cumulation is possible after taking the above dosage 2 times per day. The drug reaches stable values after 3 days.
Exchange processes.
Levofloxacin participates in metabolic processes only slightly; its metabolic components are levofloxacin N-oxide with desmethyl-levofloxacin. These elements make up less than 5% of the volume of the drug excreted in urine.
Excretion.
The applied levofloxacin is excreted from the blood plasma rather slowly (the half-life term is 6-8 hours). The excretion processes mainly occur through the kidneys (85% of the dose taken).
LS linearity parameters.
Levofloxacin has linear pharmacokinetic properties when using dosages in the range of 0.05-0.6 g.
[ 11 ], [ 12 ], [ 13 ], [ 14 ], [ 15 ], [ 16 ], [ 17 ], [ 18 ], [ 19 ]
Dosing and administration
The tablets should be used 1-2 times per day.
The size of the portion dose is determined by the intensity and type of infection, and along with this, the sensitivity of the identified or suspected causative bacteria.
The duration of therapy varies depending on the type of pathology, but usually lasts a maximum of 2 weeks (although in the case of bacterial prostatitis the duration can reach 1 month).
In accordance with the general antibacterial treatment regimen, Remedia should be continued for at least 48-72 hours after the temperature has returned to normal or a negative result has been obtained in bacteriological testing.
The medication should be taken orally, the tablets are not chewed, they are washed down with some liquid. If the dosage requires it, the tablet can be divided along the break line on it. The medication should be taken with food or between meals.
The drug should be taken 2 hours before the administration of antacids, iron salts or sucralfate due to the risk of decreased absorption.
Use Remedies during pregnancy
Levofloxacin should not be administered during breastfeeding or pregnancy.
Contraindications
Main contraindications:
- epilepsy;
- tendon disease associated with previous quinolone therapy;
- severe hypersensitivity to levofloxacin, any other components of the drug or other substances from the fluoroquinolone category.
Caution is required when using in the following cases:
- elderly people (high risk of concomitant deterioration of renal function);
- G6PD deficiency;
- history of brain damage (due to severe trauma or stroke);
- combined use with substances that lower the threshold of cerebral convulsive activity (convulsions may occur);
- pseudoparalytic myasthenia;
- diagnosed risk factors for prolongation of QT interval indicators.
[ 20 ], [ 21 ], [ 22 ], [ 23 ], [ 24 ], [ 25 ], [ 26 ], [ 27 ], [ 28 ]
Side effects Remedies
Side effects include:
- gastrointestinal tract lesions: vomiting, indigestion, diarrhea (also bloody), loss of appetite, nausea, pain affecting the abdominal area, as well as hepatitis, pseudomembranous colitis, dysbacteriosis, increased activity of liver transaminases and hyperbilirubinemia;
- disturbances in the functioning of the cardiovascular system: tachycardia, decreased blood pressure, atrial fibrillation, vascular collapse and prolongation of the QT interval on the cardiogram;
- metabolic problems: hyperglycemia or hypoglycemia (hyperhidrosis, increased appetite, nervousness and tremors);
- disorders of the nervous system: drowsiness, severe headaches, anxiety, dizziness, insomnia and weakness, as well as fear, paresthesia affecting the hands, confusion, and convulsions and hallucinations. In addition, sensory polyneuropathy, depression, sensory-motor polyneuropathy, movement disorders and mental disorders with behavioral problems (self-harm - for example, suicide attempts and thoughts about it);
- damage to the senses: problems with smell, hearing and vision, disorders of tactile or taste sensations;
- disorders of the musculoskeletal system: myalgia or arthralgia, ruptures affecting tendons, muscle weakness, rhabdomyolysis or tendonitis;
- disorders associated with the function of the urinary system: acute renal failure, hypercreatininemia or tubulointerstitial nephritis;
- problems affecting the hematopoietic organs: neutro-, thrombocyto-, leukopenia- or pancytopenia, eosinophilia, hemorrhage, agranulocytosis or hemolytic anemia;
- signs of allergy: skin hyperemia or itching, urticaria, TEN or SJS, swelling of the mucous membranes and epidermis, anaphylaxis, bronchial spasm, vasculitis and pneumonitis of allergic origin;
- others: photosensitivity, asthenia, persistent fever, exacerbation of existing porphyria, occurrence of superinfection or leukocytoclastic vasculitis.
Overdose
Signs of poisoning are mainly related to the central nervous system (dizziness, disturbances of consciousness or confusion, as well as seizures similar to epileptic seizures).
Along with this, disturbances affecting the gastrointestinal tract (for example, nausea) and erosions in the area of the gastrointestinal mucosa may be observed; prolongation of the QT interval values is also possible.
Appropriate symptomatic measures are taken; the drug has no antidote. Dialysis will be ineffective.
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Interactions with other drugs
Levofloxacin prolongs the half-life of cyclosporine.
The use of GCS increases the risk of tendon rupture (especially in older people).
Cimetidine and drugs that block tubular secretion inhibit the excretion of levofloxacin.
The infusion fluid is compatible with 0.9% NaCl, 5% dextrose fluid, 2.5% Ringer's dextrose solution and complex fluids used in parenteral nutrition (carbohydrates with amino acids and electrolytes).
Theophylline and NSAIDs increase the likelihood of seizures.
It is prohibited to combine the drug with heparin, as well as liquids that have an alkaline reaction (for example, sodium bicarbonate solution).
In diabetics who take insulin or antidiabetic drugs orally, hyper- or hypoglycemic conditions may occur when using levofloxacin, which is why blood sugar levels need to be monitored.
Remedy potentiates the anticoagulant properties of warfarin.
Alcoholic beverages can potentiate negative manifestations associated with the central nervous system (feeling of numbness, dizziness or drowsiness).
Attention!
To simplify the perception of information, this instruction for use of the drug "Remedy" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.