Remedy

Remedia is an antimicrobial substance from the category of fluoroquinolones - ofloxacin isomer of levogyrate. Shows a wide range of antimicrobial activity.

Levofloxacin contributes to the blocking of DNA gyrase (type 2 topoisomerase), as well as type 4 topoisomerase; also disrupts the processes of stitching 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 the effect of a relatively large number of microbial strains in in vitro studies, and in addition in vivo.

Indications Remedies

It is used in diseases with infectious and inflammatory etiology, triggered by bacteria that are sensitive to levofloxacin:

• infecting the lower part of the respiratory tract infections (non-hospital pneumonia or exacerbation of chronic bronchitis );
• maxillary sinusitis in the acute stage;
• lesions associated with the work of the urethra (without complications);
• occurring with complications of the urinary tract (among them acute pyelonephritis);
• infections associated with the subcutaneous layer and the epidermis (abscess, atheroma with suppurations and boils);
• bacteremia or septicemia;
• bacterial nature of prostatitis of a chronic nature;
• infection affecting the abdominal area;
• combined treatment of drug-resistant types of tuberculosis.

[1], [2], [3], [4]

Release form

The release of the drug component is produced in tablets, 5 or 10 pieces inside the pack.

[5]

Pharmacodynamics

The level of bacterial exposure to levofloxacin is determined by the ratio of the serum indicator Сmax or AUC values with the IPC.

The main mechanism of resistance is the result of the gyr-A gene mutation. In vitro tests demonstrate the cross-resistance of levofloxacin with other fluoroquinolones.

The principle of the therapeutic effect of Remedia often avoids cross-resistance between levofloxacin, as well as other categories of antibacterial agents.

[6], [7], [8], [9], [10]

Pharmacokinetics

Suction.

After ingestion, levofloxacin is absorbed at high speed and almost fully absorbed, reaching plasma Cmax values after 60 minutes. Its bioavailability values are approximately 100%.

Food has almost no effect on the intensity of absorption of the drug.

Distribution processes

About 30-40% of the drug is synthesized with blood serum protein. The cumulative effect after multiple administration of drugs in a portion of 0.5 g, 1 time per day is almost absent. In theory, an insignificant cumulation is possible after taking the above dosage 2-fold per day. Stable values of the drug reaches after 3 days.

Exchange processes.

Levofloxacin is involved in metabolic processes only slightly; its metabolic components are levofloxacin N-oxide with dismethyl-levofloxacin. These elements make up less than 5% of the volume of drugs excreted in the urine.

Excretion.

The applied levofloxacin is excreted from the blood plasma rather slowly (the term half-life equals 6-8 hours). Excretion processes mainly occur through the kidneys (85% of the portion taken).

Parameters of drug linearity.

Levofloxacin has linear pharmacokinetic properties using dosages in the range of 0.05-0.6 g.

[11], [12], [13], [14], [15], [16], [17], [18], [19]

Dosing and administration

Per day pills must be used 1-2 times.

The size of the dose portion is determined by the intensity and type of infection, and with it the sensitivity of the identified or suspected bacteria that cause the disease.

The duration of therapy varies depending on the type of pathology, but usually lasts a maximum of 2 weeks (although with prostatitis of a bacterial nature, the duration can be up to 1 month).

Observing the general scheme of antibacterial treatment, Remedy should be continued for at least 48-72 hours after establishing a normal temperature or receiving a negative response in bacteriological testing.

It is necessary to take medication orally, do not chew the tablets, drink some liquid. If the dosage requires it, the tablet can be divided according to the fault line present on it. It is necessary to apply medicine with food or between the use of food.

The drug should be used 2 hours before the introduction of antacids, iron salts or sucralfate - because of the risk of weakening the absorption.

[35], [36], [37], [38],

Use Remedies during pregnancy

Do not prescribe levofloxacin during breastfeeding or pregnancy.

Contraindications

The main contraindications:

• epilepsy;
• tendon disease associated with earlier quinolone therapy;
• severe intolerance against levofloxacin, any other elements of the drug or other substances from the fluoroquinolone category.

Caution is needed when used in such cases:

• the elderly (high risk of concomitant deterioration of renal activity);
• lack of G6FD component;
• a history of a cerebrospinal lesion (due to severe injury or stroke);
• combined use with substances that lower the threshold of cerebral convulsive activity (seizures may occur);
• myasthenia pseudo-paralytic;
• diagnosed risk factors for prolongation of QT-interval indicators.

[20], [21], [22], [23], [24], [25], [26], [27], [28]

Side effects Remedies

Among the side effects are:

• lesions of the digestive tract: vomiting, indigestion, diarrhea (also bloody), loss of appetite, nausea, pain affecting the abdominal area, and in addition, hepatitis, colitis of pseudomembranous nature, dysbiosis, increased transaminase liver and hyperbilirubinemia;
• abnormalities in the work of the cardiovascular system: tachycardia, a decrease in blood pressure values, atrial fibrillation, vascular collapse and prolongation of the QT interval on the cardiogram;
• problems with metabolism: hyperglycemia or hypoglycemia (hyperhidrosis, increased appetite, nervousness and trembling);
• Disorders of the function of the National Assembly: drowsiness, marked headaches, anxiety, dizziness, insomnia and weakness, and in addition, fear, paresthesias affecting the hands, confusion, and with it 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);
• lesions of the sense organs: problems with smell, hearing and sight, disorders of tactile or taste sensations;
• disorders of the musculoskeletal structure: myalgia or arthralgia, ruptures affecting tendons, muscle weakness, rhabdomyolysis, or tendonitis;
• disorders of the urinary system: OPN, hypercreatininemia, or tubulointerstitial nephritis;
• problems affecting the blood-forming organs: neutro-, thrombocyto-, leuko- or pancytopenia, eosinophilia, hemorrhage, agranulocytosis or hemolytic anemia;
• signs of allergy: skin hyperemia or itching, urticaria, TEN or SSD, swelling of mucous membranes and the epidermis, anaphylaxis, bronchial spasm, vasculitis and pneumonitis of an allergic nature;
• others: photosensitivity, asthenia, persistent fever, exacerbation of existing porphyria, the emergence of superinfection or leukocytoclastic form of vasculitis.

[29], [30], [31], [32], [33], [34]

Overdose

Signs of poisoning are mainly associated with the central nervous system (dizziness, disorder of consciousness or confusion, as well as seizures similar to epileptic seizures).

Along with this, violations affecting the gastrointestinal tract (for example, nausea) and erosion in the area of the mucous GIT may be observed; prolongation of the QT-interval values is also possible.

Corresponding symptomatic measures are carried out; there is no antidote to the drug. Dialysis procedure will be ineffective.

[39]

Interactions with other drugs

Levofloxacin prolongs the term half-life of cyclosporine.

Using GCS increases the likelihood of tendon rupture (especially in older people).

Cimetidine and drugs that block the secretion of tubules inhibit the excretion of levofloxacin.

The infusion fluid is compatible with 0.9% NaCl, 5% dextrose liquid, 2.5% Ringer's dextrose solution, and complex fluids used in parenteral nutrition (carbohydrates with amino acids and electrolytes).

Theophylline with NSAIDs increase the likelihood of seizures.

It is forbidden to combine the drug with heparin, as well as liquids that provide an alkaline reaction (for example, a solution of bicarbonate sodium).

In diabetics who ingest insulin or antidiabetic drugs, when using levofloxacin, hyper- or hypoglycemic states may occur, which is why blood sugar levels should be monitored.

Remedia potentiates the anticoagulant properties of warfarin.

Alcohol is able to potentiate the negative manifestations associated with the central nervous system (feeling of stupor, dizziness or drowsiness).

[40], [41],

Storage conditions

Remedia must be kept in a dark place, closed from the penetration of small children. Temperature values range from 10-25 ° C.

[42], [43], [44],

Shelf life

Remedia can be applied for a 24-month term from the date the drug was manufactured.

[45], [46], [47]

Application for children

Admission Remedia at the age of less than 18 years is prohibited.

[48],

Analogs

Analogs of drugs are means Elefloks and Tavanic.

[49], [50], [51],