Furamag for cystitis

Non-specific (and not only) inflammation of the urinary tract has long been effectively treated with drugs belonging to the group of nitrofurans. They are active against most bacteria infecting the lower urinary tract. Resistance to 5-nitrofuran derivatives in pathogenic microorganisms develops slowly and usually does not have time even for a long course of treatment to reach a clinically significant value. And short courses of nitrofurans can be administered countless times. Relatively new and often recently prescribed drug Furamag for cystitis - also represents this drug group. It has some advantages over its predecessors, which relate to the fundamentally new structure of the drug, contributing to its higher bioavailability and expanding the degree of activity, which makes Furamag more effective in the treatment of acute and chronic inflammatory diseases of the bladder.

Indications Furamaga for cystitis

Acute cystitis of bacterial, fungal, protozoal origin caused by microorganisms sensitive to the active ingredient of the drug - furazidine. Relief comes as soon as 20 minutes after taking the drug, however, this does not mean that the treatment is over, it is necessary to drink the entire course of the drug prescribed by the doctor.

Also helps furamag in chronic cystitis, the duration of the course in this case a little longer, with frequent relapses helps to cope with the daily intake of the drug once before bedtime for several months.

Often prescribed furamag for the prevention of cystitis in patients who will be invasive diagnosis of genitourinary organs, surgery, catheterization, as well as - for prophylactic purposes after unprotected sex.

Release form

The drug is available in the form of powder, encapsulated in gelatin capsules with a dosage of 25 or 50mg.

Pharmacodynamics

The powdery contents of the capsule is a compound in equal proportions of soluble furazidine potassium salt and magnesium hydroxycarbonate. The two-component composition prevents the transformation of furazidine into poorly soluble furagin. In addition, the capsule does not dissolve in the stomach, but reaches the small intestine, where dissolution and absorption occurs. Thanks to this, several positive effects are achieved at once. Bioavailability of furazidine increases compared to its other forms (2.5-3 times), which allows faster reaching the required concentration in the urine, providing suppression of pathogenic microorganisms activity and their death. In addition, the effect of the drug is prolonged, the therapeutically effective dose is halved and the risk of gastrointestinal side effects typical for nitrofurans is minimized. The results of comparative studies of clinical efficacy showed that Furamag has such superiority not only to drugs of nitrofuran class, but also antibiotics used in urology (ciprofloxacin, amoxicillin/clavulanate, cefazolin, nalidixic acid and others). Particularly sensitive to the action of Furamag were the causative agents of common nonspecific cystitis in women: Escherichia coli, Enterococcus faecalis, Staphylococcus saprophyticus, other staphylococci, Morgan's proteins and Myribilis.

Like other nitrofurans, furazidine binds oxygen molecules, and pathogens experience hypoxia. During treatment, the key stage of cellular respiration of bacteria - the Krebs cycle - is affected. In addition, microbes under the influence of the drug stop synthesizing nucleic acids, which leads to the destruction of their cell membranes, cessation of vital activity and death. As a result of taking the first doses of the drug almost immediately reduces the concentration of toxic products of microbial activity, and the patient's condition improves significantly. Unlike antibiotics, nitrofurans do not have an immunosuppressive effect, but, on the contrary, stimulate leukopoiesis and, consequently, phagocytosis, which also contribute to the destruction of microorganisms.

Pharmacokinetics

A study comparing the pharmacokinetics of furazidine derivatives - furamag and furagin showed that the concentration of the active substance in the urine is much higher (5-6 times) after the use of furamag capsule than in case of taking furagin tablet, i.e. Bacteriostatic/bactericidal effects are more powerful in the first drug. The dosage of the active ingredient was the same in both the preparations. This is due to the fact that the capsule dissolves in the small intestine, its contents do not come into contact with the acid in the stomach and do not turn into a difficult to dissolve furagin.

Passive diffuse absorption increases as the drug moves through the small intestine and is most intense in the distal part. In the large intestine, absorption is almost non-existent.

High clinically significant concentration of furazidine is found in lymph, which prevents the spread of infection by lymphogenic route, not bad - in bile, lower - in blood plasma, saliva and liquor. The highest content of the active substance is in urine, where it reaches a maximum three to four hours after taking the drug. In blood plasma, the highest content may persist for 3-8 hours. Absorption of furamag increases if it is taken after a meal.

Excreted by kidneys up to 85%, the rest is metabolized in the liver. In case of impaired renal excretory function, the metabolism process is more intensive.

Dosing and administration

Furamag for cystitis in adults is prescribed by a doctor depending on the form and stage of the disease. The standard single dose recommended for adult patients is from 50 to 100mg of the drug. The frequency of intake - three times a day after meals. To avoid overdose, the daily dose should not exceed 300mg and it is impossible to take a double dose to compensate for missed intake.

For children weighing more than 30 kg, that is, from three to ten years of age, the daily dose is calculated in the proportion of 5mg per kilogram of weight. The obtained result is divided into three doses.

Children weighing more than 30kg (approximately over ten years of age) are given 50mg three times a day.

The standard duration of treatment is from five to ten days. After taking a ten-day or two-week break, it is possible to repeat the drug if necessary and, after agreeing with the doctor, to take it again.

After treatment of chronic recurrent cystitis in order to prevent exacerbations prescribe a long-term course (3-6 months) to take a third to a quarter of the daily dose once a day before bedtime.

For prophylactic purposes to prevent the development of cystitis due to surgery and other invasive interventions the single dose for adult patients is 50mg, for children - 25mg three times a day.

When taking the drug, it is necessary to drink water well.

Furamag capsules have very good reviews in cystitis. They are recommended to adult patients as a means of first and emergency aid. However, it should be taken into account that instant relief does not indicate that the disease has passed. It is necessary to finish the prescribed course. Furamag is especially relevant for cystitis in women. Anatomical features of the external female genital organs make the weaker sex predisposed to frequent nonspecific cystitis. In this case, the drug of choice is furamag.

In males, cystitis is usually caused by specific infections and requires different treatment. In addition, clinical studies have shown that drugs of the nitrofuran group can affect the quality and quantity of sperm produced, reduce the motility of spermatozoa and lead to pathomorphological changes in them. Therefore, although there is no direct contraindication to the use of furamag in men, it is not worth treating with it without extreme necessity.

• Application for children

Based on the experience of clinical use, in pediatric practice, it is allowed to use the drug for the treatment of infants who are already one full month old. Low toxicity and practical absence of common side effects of nitrofurans make furamag a drug of choice for treatment of children.

The official instruction stipulates the age of reception - from three years of age.

Use Furamaga for cystitis during pregnancy

Furazidine derivatives, including Furamag, are not certified for risks in pregnancy, as no authoritative studies have been conducted in this population. There is no evidence that it is safe for expectant mothers and during lactation. It is compared to certified nitrofurantoin (Furadonin), which belongs to the same class, has similar properties and is used in the same cases. It is believed that until the 38th week of pregnancy, the drug is safe, and in later weeks - is not recommended because of the possible development of hemolytic jaundice in the newborn. Also by analogy with nitrofurantoin, furamag is exceptionally allowed to be used for the treatment of cystitis in nursing mothers.

Given that such recommendations are not based on sound research evidence, great caution should be exercised when treating these populations with Furamag.

The official instruction does not recommend taking the drug for pregnant and lactating women.

Contraindications

Permanent: anamnesis of allergic reactions to drugs of nitrofuran class, directly to furazidine and auxiliary components of the drug.

Severe hepatic and renal dysfunction (creatinine clearance ˂30ml/s).

Porphyria, G6FD deficiency, polyneuropathy of any etiology.

Temporary contraindication is hemodialysis at any age, urosepsis, lung disease, iron-deficiency and B-deficiency anemia, renal parenchyma infections.

Side effects Furamaga for cystitis

Allergic reactions of all kinds from banal small itchy hives to Quincke's edema.

Gastrointestinal disorders, the most characteristic consequences of treatment with drugs of the nitrofuran group, occurring in about 50% of cases, from furamag occur ten times less often (5%), nevertheless this possibility is not excluded.

Hematopoiesis disorders, somnolence, headache, slight hypertension, subfebrile, dizziness, localized peripheral and generalized neuritis and neuralgia, visual impairment, hearing impairment, hoarseness, reversible alopecia, myalgia and arthralgia may occur.

Respiratory effects are most commonly manifested by pulmonary hypersensitivity. The reaction may be acute, at the first administration of the drug. Its symptoms are fever, cough, chest pain, dyspnea simultaneously with skin allergic manifestations - rash, itching, swelling, redness. In the blood at the same time, the number of eosinophils increases. Chronic reactions occur with more subdued symptomatology and develop gradually after prolonged use of the drug, sometimes after the end of the course of treatment. If their symptoms are ignored, they may lead to pneumonia or pulmonary fibrosis.

Undesirable effects from the hepatobiliary system may develop.

All side effects are reversible and pass after the drug is discontinued. In the development of neuropathies and for their prevention it is recommended to take B vitamins in parallel.

Overdose

Symptomatology of excess dose is characterized by clinical picture of neurointoxication - discoordination of movements, trembling of limbs.

Help with overdose includes immediate withdrawal of the drug, abundant drinking. In acute intoxication, you can take anti-allergic drugs and B vitamins to stabilize the nervous system.

Interactions with other drugs

Drugs that oxidize urine (vitamin C, calcium chloride and others) increase the concentration of furazidine in the urine, increasing the effectiveness of treatment and at the same time the risk of increased side effects. Drugs that alkalize urine, level the therapeutic effect of the drug, as they accelerate its elimination with urine.

Increased side effects on the side of hematopoiesis (suppression) are observed when furamag is combined with drugs of sulfonamides group and antibiotics chloramphenicol and ristomycin.

In laboratory studies it has been established that it is not worth combining the above drug with other urologic antibiotics of the class of fluoroquinolones, since they mutually counteract each other.

Concomitant use with sulfinpyrazone and probenecid reduces the rate of elimination of furazidine and increases the risk of toxic events, and with antacids, which include magnesium, reduces the absorption of the active substance furamag from the small intestine.

Patients with renal dysfunction should not be administered furamag in combination with antibiotics of the aminoglycoside class.

Furamag is well combined with penicillins and cephalosporins (mutual enhancement of action), it can also be combined with erythromycin and tetracycline.

During treatment with nitrofurans it is forbidden to consume alcohol-containing drinks and medicinal tinctures.

During treatment with Furamag it is not worthwhile to conduct a urine test for glucose content by copper recovery method - the result may be false positive.

The storage conditions specified by the manufacturer should be observed: store at room temperature not more than 25℃ in places protected from direct sunlight and inaccessible to children and animals. It is also worth paying attention to the expiration date indicated on the package. After the expiry date the drug should not be used.

Analogs

There are a lot of drugs. What is better for cystitis? The answer depends on what caused the inflammation. Patients with cystitis do a urine culture for bacterial flora, however, the result is not known immediately, so prescribe treatment with a drug with a broad spectrum of action, and then, after receiving the analysis, the appointment can be adjusted.

So, Furamag or Furadonin. Both drugs have the same spectrum of action and are used in the same cases. Furamag has some features that make it more effective (described above). Therefore, if there are no other reasons, for example, intolerance to the auxiliary components of the capsule contents or the active substance - furazidine, preference should be given to the more effective drug.

The same applies to the choice of furagin or furamag, especially since the active ingredient of the drugs is the same. But the soluble form gives furagin great advantages, in particular, it is taken in a smaller dose with the same effect.

Furamag or nolicin. The first is an antimicrobial drug, the second is an antibiotic from the group of fluoroquinolones. In comparative studies, as mentioned above, Furamag in nonspecific cystitis showed higher efficacy than fluoroquinolones. In addition, antibiotics of the above group have many side effects. For example, they are prohibited for people with a tendency to epileptiform seizures.

The same applies to the choice of furamag or monural. The second drug is used once, at most twice. This is great, but each of the drugs has a spectrum of action, and each patient has an individual tolerance. Therefore, the question of choice is primarily a question of tolerability and effectiveness of treatment. It is best to solve it together with the attending physician.

Reviews of Furamag are very good. Only it seems that it is often used not quite correctly, once or twice, relieved the symptoms - and that's it. Such self-medication is fraught with chronicization of the process. To give yourself an ambulance and alleviate the condition - it is good, but even better - to take, albeit later, analyze the causative agent, cure cystitis definitively and forget about it.