Противомикробное средство группы фторхинолонов широкого спек... Инструкция
Показания к применению
Инфекционно-воспалительные заболевания, вызванные чувствительными к офлоксацину микроорганизмами, в том числе: нижних дыхательных путей (обострение хронического бронхита, пневмония), почек и мочевыводящих путей, в том числе пиелонефрит, уретрит, половых органов и органов малого таза, в том числе, цервицит, простатит, кожи и мягких тканей.
Противопоказания
Повышенная чувствительность к офлоксацину, другим хинолонам или другим компонентам препарата. возраст до 18 лет. беременность. период грудного вскармливания. дефицит глюкозо-6-фосфат-дегидрогеназы. эпилепсия, в том числе в анамнезе. снижение судорожного порога, в том числе после инсульта. при черепно-мозговой травме, остром нарушении мозгового кровообращения, ...
Противомикробное средство группы фторхинолонов широкого спектра действия. Бактерицидное действие офлоксацина связано с блокадой фермента ДНК-гиразы в бактериальных клетках. Высокоактивен в отношении большинства грамотрицательных бактерий: Escherichia coli, Salmonella spp., Shigella spp., Proteus spp., Morganella morganii, Klebsiella spp. (в т.ч. Klebsiella pneumoniae), Enterobacter spp., Serratia spp., Citrobacter spp., Yersinia spp., Providencia spp., Haemophilus influenzae, Neisseria gonorrhoeae, Neisseria meningitidis, Mycoplasma spp., Legionella pneumophila, Acinetobacter spp., а также Chlamydia spp. Активен в отношении некоторых грамположительных микроорганизмов (в т.ч. Staphylococcus spp., Streptococcus spp., особенно бета-гемолитических стрептококков). К офлоксацину умеренно чувствительны Enterococcus faecalis, Streptococcus pneumoniae, Pseudomonas spp. К офлоксацину не чувствительны анаэробные бактерии (кроме Bacteroides ureolyticus). Устойчив к действию β-лактамаз.
Показания к применению
Инфекционно-воспалительные заболевания, вызванные чувствительными к офлоксацину микроорганизмами, в том числе: нижних дыхательных путей (обострение хронического бронхита, пневмония), почек и мочевыводящих путей, в том числе пиелонефрит, уретрит, половых органов и органов малого таза, в том числе, цервицит, простатит, кожи и мягких тканей.
Противопоказания
Повышенная чувствительность к офлоксацину, другим хинолонам или другим компонентам препарата. возраст до 18 лет. беременность. период грудного вскармливания. дефицит глюкозо-6-фосфат-дегидрогеназы. эпилепсия, в том числе в анамнезе. снижение судорожного порога, в том числе после инсульта. при черепно-мозговой травме, остром нарушении мозгового кровообращения, воспалительных заболеваниях центральной нервной системы. поражения сухожилий на фоне ранее проводившегося приема фторхинолонов. непереносимость лактозы, недостаточность лактазы, глюкозо-галактозная мальабсорбция, периферическая нейропатия.
Применение при беременности и в период грудного вскармливания
Противопоказан к применению при беременности и в период лактации. В экспериментальных исследованиях не выявлено отрицательного влияния на фертильность у крыс.
Способ применения и дозы
Внутрь. Дозу офлоксацина следует подбирать в зависимости от типа и тяжести инфекции, а также общего состояния пациента и функции печени и почек. Таблетки принимают целиком, запивая водой, до или во время еды. По 200-800 мг в сутки в 2 приема через равные интервалы времени. Дозу до 400 мг в сутки можно принимать в один прием, лучше в первой половине дня. Пациентам с нарушением функции почек (КК менее 50 мл/мин) требуется коррекция режима дозирования в зависимости от величины КК. У пациентов пожилого возраста коррекция дозы не требуется. Продолжительность лечения определяется чувствительностью возбудителя, тяжестью инфекционного заболевания и ответом на терапию. Лечение следует продолжать еще минимум 3 дня после полной нормализации температуры тела или после подтверждения эрадикации бактериального агента. Обычно продолжительность лечения составляет 7-10 дней, за исключением лечения гонореи, и не должно превышать 2 месяца.
Побочное действие
Со стороны пищеварительной системы часто - тошнота, рвота, диарея, боль в животе. нечасто - снижение аппетита, запор, метеоризм. редко - повышение активности печеночных трансаминаз, гипербилирубинемия, холестатическая желтуха, колит (в том числе геморрагический), сухость слизистой оболочки полости рта. очень редко - гепатит, псевдомембранозный колит. Со стороны нервной системы нечасто - головная боль, головокружение, бессонница, беспокойство, нервозность. редко - кошмарные сновидения, интенсивные сновидения, психотические реакции, тревожность, состояние возбуждения, фобии, депрессия, спутанность сознания, галлюцинации, суицидальные попытки, сонливость, тремор, судороги, онемение и парестезии конечностей, неуверенность движений, повышение внутричерепного давления. очень редко - экстрапирамидные расстройства, сенсорная или сенсорно-моторная нейропатия, периферическая нейропатия. Со стороны органов чувств нечасто - конъюнктивит. редко - нарушение цветовосприятия, диплопия, нарушения вкуса, обоняния, равновесия. очень редко - шум в ушах, нарушение слуха, в том числе глухота в исключительных случаях. Со стороны опорно-двигательного аппарата очень редко - тендинит, миалгии, мышечная слабость у пациентов с миастенией, артралгии, тендосиновит, разрыв сухожилий, мышечные и суставные симптомы рабдомиолиза, боль в конечностях. Со стороны сердечно-сосудистой системы нечасто - ощущение сердцебиения. редко - сердечная недостаточность, гипотония. очень редко - желудочковая аритмия, в том числе пароксизмальная желудочковая тахикардия типа пируэт, удлинение интервала QT, гипертензия. Со стороны дыхательной системы нечасто - сухой кашель, ринофарингит. редко -одышка, бронхоспазм. неизвестная частота - аллергический пневмонит. Со стороны кожи и подкожных тканей очень редко - петехии, буллезный геморрагический дерматит, папулезная сыпь с коркой, свидетельствующие о поражении сосудов (васкулит). Со стороны системы крови и органов кроветворения очень редко - лейкопения, включая агранулоцитоз, анемия (в том числе гемолитическая и апластическая), тромбоцитопения, панцитопения, обострение порфирии. Со стороны мочевыделительной системы очень редко - острый интерстициальный нефрит, нарушения функции почек, гиперкреатининемия, повышение концентрации мочевины, дизурия, задержка мочи, острая почечная недостаточность. Аллергические реакции нечасто - кожная сыпь, зуд, крапивница. очень редко -мультиформная экссудативная эритема (в том числе синдром Стивенса-Джонсона), токсический эпидермальный некролиз (синдром Лайелла), фотосенсибилизация, аллергический пневмонит, аллергический нефрит, эозинофилия, лихорадка, ангионевротический отек, бронхоспазм. гипотония, гипертония, анафилактический шок, зуд наружных половых органов у женщин. Прочие очень редко - дисбактериоз кишечника, суперинфекция, боль в груди, гипер- или гипогликемия (у пациентов с сахарным диабетом на фоне приема антидиабетических препаратов), носовое кровотечение, жажда, снижение массы тела, вагинит, выделения из влагалища, утомляемость, астения, общая слабость.
Особые указания
С осторожностью применять у пациентов с нарушениями функции почек и печени. В период лечения требуется проводить контроль уровня глюкозы в крови. При длительной терапии необходимо периодически контролировать функции почек, печени, картину периферической крови. При применении офлоксацина следует обеспечить достаточную гидратацию организма, пациент не должен подвергаться ультрафиолетовому облучению. В экспериментальных исследованиях мутагенный потенциал не выявлен. Длительные исследования по определению канцерогенности офлоксацина не проводились. В исследованиях на молодых животных нескольких видов офлоксацин вызывал артропатию и остеохондроз. Безопасность и эффективность у детей и подростков в возрасте до 18 лет не установлена. Влияние на способность к вождению автотранспорта и управлению механизмами С осторожностью применять у пациентов, деятельность которых связана с необходимостью высокой концентрации внимания и быстроты психомоторных реакций.
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