Левофлоксацин Таблетки, 10 шт, 750 мг, для взрослых, в пленочной оболочке

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Enterococcus faecalis), Listeria monocytogenes, Staphylococcus coagulase-negative methi-S(I), Staphylococcus aureus methi-S, Staphylococcus epidermidis methi-S, Staphylococcus spp. (CNS), Streptococcus группы С и G, Streptococcus agalactiae, Streptococcus pneumoniae peni I/S/R, Streptococcus pyogenes, Streptococcus viridans peni-S/R."}},{"type":"paragraph","data":{"text":"\u003ci\u003eАэробные грамотрицательные микроорганизмы:\u003c/i\u003e Acinetobacter spp. (в т.ч. Acinetobacter baumannii), Actinobacillus actinomycetemcomitans, Citrobacter freundii, Eikenella corrodens, Enterobacter spp. (в т.ч. Enterobacter aerogenes, Enterobacter cloacae), Escherichia coli, Gardnerella vaginalis, Haemophilus ducreyi, Haemophilus influenzae ampi-S/R, Haemophilus parainfluenzae, Helicobacter pylori, Klebsiella spp. (в т.ч. Klebsiella oxytoca, Klebsiella pneumoniae), Moraxela catarrhalis (β+/β-), Morganella morganii, Neisseria gonorrhoeae non-PPNG/PPNG, Neisseria meningitidis, Pasteurella spp. (в т.ч. Pasteurella dagmatis, Pasteurella multocida, Pasteurella canis), Proteus mirabilis, Proteus vulgaris, Providencia spp. (в т.ч. Providencia rettgeri, Providencia stuartii), Pseudomonas aeruginosa, Pseudomonas spp. (в т.ч. Pseudomonas aeruginosa), Salmonella spp., Serratia spp. (в т.ч. Serratia marcescens)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eАнаэробные микроорганизмы:\u003c/i\u003e Bacteroides fragilis, Bifidobacterium spp., Clostridium perfringens, Fusobacterium spp., Peptostreptococcus, Propionibacterum spp., Veilonella spp."}},{"type":"paragraph","data":{"text":"\u003ci\u003eДругие микроорганизмы:\u003c/i\u003e Bartonella spp., Chlamydia pneumoniae, Chlamydia psittaci, Chlamydia trachomatis, Legionella spp. (в т.ч. Legionella pneumophila), Mycobacterium spp. (в т.ч. Mycobacterium leprae, Micobacterium tuberculosis), Mycoplasma hominis, Mycoplasma pneumoniae, Ricketsia spp., Ureaplasma urealyticum."}},{"type":"paragraph","data":{"text":"\u003ci\u003eУмеренно чувствительные микроорганизмы:\u003c/i\u003e аэробные грамположительные микроорганизмы - Corynebacterium urealyticum, Corynebacterium xerosis, Enterococcus faecium, Staphylococcus epidermidis methi-R, Staphylococcus liaemolyticus methi-R; аэробные грамотрицательные микроорганизмы - Campylobacter jejuni, Campylobacter coli; анаэробные микроорганизмы - Prevotella spp., Porphyromonas spp."}},{"type":"paragraph","data":{"text":"\u003ci\u003eРезистентные к левофлоксацину микроорганизмы:\u003c/i\u003e аэробные грамположительные микроорганизмы - Staphylococcus aureus methi-R, Staphylococcus coagulas e-negative methi-R, Corynebacterium jeikeium; аэробные грамотрицательные микроорганизмы - Alcaligenes xylosoxidans; анаэробные микроорганизмы - Bacteroides thetaiotaomicron; другие микроорганизмы - Mycobacterium avium."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Бактериальные инфекции у взрослых чувствительные к левофлоксацину:"}},{"type":"paragraph","data":{"text":"-острый бактериальный синусит;"}},{"type":"paragraph","data":{"text":"- обострение хронического бронхита;"}},{"type":"paragraph","data":{"text":"- внебольничная пневмония;"}},{"type":"paragraph","data":{"text":"- неосложненные инфекции мочевыводящих путей;"}},{"type":"paragraph","data":{"text":"- осложненные инфекции мочевыводящих путей (включая острый пиелонефрит);"}},{"type":"paragraph","data":{"text":"- хронический бактериальный простатит;"}},{"type":"paragraph","data":{"text":"- инфекции кожных покровов и мягких тканей (в том числе нагноившиеся атеромы абсцесс фурункулез);"}},{"type":"paragraph","data":{"text":"- туберкулез (в составе комплексной терапии лекарственно-устойчивых форм);"}},{"type":"paragraph","data":{"text":"- профилактика и лечение сибирской язвы при воздушно-капельном пути заражения."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"- повышенная чувствительность к левофлоксацину другим фторхинолонам или другим компонентам препарата в анамнезе;"}},{"type":"paragraph","data":{"text":"- эпилепсия;"}},{"type":"paragraph","data":{"text":"- псевдопаралитическая миастения (myasthenia gravis);"}},{"type":"paragraph","data":{"text":"- поражения сухожилий связанные с приемом фторхинолонов в анамнезе;"}},{"type":"paragraph","data":{"text":"- детский и подростковый возраст до 18 лет (в связи с незавершенностью роста скелета так как нельзя полностью исключить риск поражения хрящевых точек роста);"}},{"type":"paragraph","data":{"text":"- беременность (нельзя полностью исключить риск поражения хрящевых точек роста у плода);"}},{"type":"paragraph","data":{"text":"- период лактации (нельзя полностью исключить риск поражения хрящевых точек роста костей у ребенка)."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"- предрасположенность к судорожным реакциям (у пациентов с предшествующими поражениями центральной нервной системы (ЦНС) у пациентов одновременно получающих препараты снижающие порог судорожной готовности головного мозга (фенбуфен теофиллин));"}},{"type":"paragraph","data":{"text":"- латентный или манифестированный дефицит глюкозо-6-фосфатдегидрогеназы (повышенный риск гемолитических реакции при лечении хинолонами);"}},{"type":"paragraph","data":{"text":"- нарушение функции почек (требуется контроль за функцией почек а также коррекция режима дозирования см. \"Способ применения и дозы\");"}},{"type":"paragraph","data":{"text":"- у пациентов с известными факторами риска удлинения интервала QT: у пациентов пожилого возраста (старше 65 лет) у пациентов женского пола у пациентов с нескорректированными электролитными нарушениями (гипокалиемия гипомагниемия); с синдромом врожденного удлинения интервала QT; у пациентов с сердечной недостаточностью инфарктом миокарда брадикардией; при одновременном приеме лекарственных препаратов удлиняющих интервал QT (антиаритмические IA и III классов трициклические антидепрессанты нейролептики макролиды);"}},{"type":"paragraph","data":{"text":"- у пациентов с сахарным диабетом получающих пероральные гипогликемические препараты (возрастает риск гипогликемии);"}},{"type":"paragraph","data":{"text":"- у пациентов с тяжелыми нежелательными реакциями на другие фторхинолоны такими как тяжелые неврологические реакции (повышенный риск возникновения аналогичных нежелательных реакций при применении левофлоксацина);"}},{"type":"paragraph","data":{"text":"- у пациентов с психозами или у пациентов имеющих в анамнезе психические заболевания."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Левофлоксацин противопоказан для применения у беременных женщин и женщин в период грудного вскармливания."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Внутрь. Режим дозирования определяется характером и тяжестью инфекции, а также чувствительностью предполагаемого возбудителя. Разовая доза - 250-500 мг, кратность приема 1-2 раза/сут. Продолжительность лечения варьирует в зависимости от течения заболевания."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Указанные ниже побочные эффекты представлены в соответствии со следующими градациями частоты их возникновения: очень часто (≥ 1/10) часто (≥ 1/100 до < 1/10) нечасто (≥ 1/1000 до < 1/100) редко (≥ 1/10000 до < 1/1000) очень редко (< 1/10000) неуточненная частота (по имеющимся данным определить частоту встречаемости не представляется возможным)."}},{"type":"paragraph","data":{"text":"Со стороны нервной системы: часто - головная боль головокружение; нечасто - сонливость тремор дисгевзия (извращение вкуса); редко - парестезия судороги (см. раздел \"Особые указания\"); неуточненная частота - периферическая сенсорная нейропатия периферическая сенсорно-моторная нейропатия дискинезия экстрапирамидные расстройства потеря вкусовых ощущений паросмия (расстройство ощущения запаха особенно субъективное ощущение запаха объективно отсутствующего) включая потерю обоняния обморок доброкачественная внутричерепная гипертензия."}},{"type":"paragraph","data":{"text":"Психические расстройство: часто - бессонница; нечасто - чувство беспокойства тревога спутанность сознания; редко - психические нарушения (например галлюцинации паранойя) депрессия ажитация нарушение сна ночные кошмары; неуточненная частота - нарушение психики с нарушением поведения с причинением себе вреда включая суицидальные мысли и суицидальные попытки."}},{"type":"paragraph","data":{"text":"Со стороны органа зрения: очень редко - нарушения зрения такие как расплывчатость видимого изображения; неуточненная частота - преходящая потеря зрения."}},{"type":"paragraph","data":{"text":"Со стороны органа слуха и лабиринтные нарушения: нечасто - верти го (чувство отклонения или кружения собственного тела или окружающих предметов); редко - звон в ушах; неуточненная частота - снижение слуха потеря слуха."}},{"type":"paragraph","data":{"text":"Со стороны сердечно-сосудистой системы: редко - синусовая тахикардия ощущение сердцебиения снижение артериального давления; неуточненная частота - удлинение интервала QT желудочковые нарушения ритма желудочковая тахикардия желудочковая тахикардия типа \"пируэт\" которые могут приводить к остановке сердца (см. разделы \"Передозировка\" \"Особые указания\")."}},{"type":"paragraph","data":{"text":"Со стороны крови и лимфатической системы: нечасто - эозинофилия лейкопения; редко - нейтропения тромбоцитопения; неуточненная частота - панцитопения агранулоцитоз гемолитическая анемия."}},{"type":"paragraph","data":{"text":"Со стороны желудочно-кишечного тракта: часто - тошнота рвота диарея; нечасто - боль в животе диспепсия метеоризм запор; неуточненная частота - геморрагическая диарея которая в очень редких случаях может быть признаком энтероколита включая псевдомембранозный колит (см. раздел \"Особые указания\") панкреатит."}},{"type":"paragraph","data":{"text":"Со стороны печени и желчевыводящих путей: часто - повышение активности аланинаминотрансферазы аспартатаминотрансферазы щелочной фосфатазы гамма- глутамилтрансферазы; нечасто - повышение концентрации билирубина; неуточненная частота - тяжелая печеночная недостаточность включая случаи развития острой печеночной недостаточности иногда с фатальным исходом особенно у пациентов с тяжелым основным заболеванием (например у пациентов с сепсисом); гепатит желтуха."}},{"type":"paragraph","data":{"text":"Со стороны дыхательной системы органов грудной клетки и средостения: нечасто - одышка; неуточненная частота - бронхоспазм аллергический пневмонит."}},{"type":"paragraph","data":{"text":"Со стороны обмена веществ и питания: нечасто - анорексия; редко - гипогликемия (повышение аппетита испарина дрожь нервозность); неуточненная частота - гипергликемия гипогликемическая кома (ем. раздел \"Особые указания\")."}},{"type":"paragraph","data":{"text":"Со стороны костно-мышечной системы и соединительной ткани: нечасто - артралгия миалгия; редко - поражение сухожилий (например ахиллова сухожилия) включая тендинит мышечная слабость которая может быть опасна у пациентов с псевдопаралитической миастенией (см. раздел \"С осторожностью\"); неуточненная частота - рабдомиолиз разрыв сухожилия (например ахиллова сухожилия). Этот побочный эффект может наблюдаться в течение 48 часов после начала лечения и может носить двусторонний характер) разрыв связок разрыв мышц артрит (см. раздел \"Особые указания\")."}},{"type":"paragraph","data":{"text":"Со стороны почек и мочевыводящих путей: нечасто - гиперкреатининемия; редко - острая почечная недостаточность (например вследствие развития интерстициального нефрита)."}},{"type":"paragraph","data":{"text":"Со стороны кожи и подкожных тканей: нечасто - сыпь зуд крапивница гипергидроз; неуточненная частота - злокачественная экссудативная эритема (синдром Стивенса-Джонсона) токсический эпидермальный некролиз (синдром Лайелла) реакции фотосенсибилизации лейкоцитокластический васкулит стоматит экссудативная многоформная эритема. Реакции со стороны кожи и слизистых оболочек анафилактические и анафилактоидные реакции могут иногда развиваться даже после приема первой дозы препарата."}},{"type":"paragraph","data":{"text":"Инфекционные и паразитарные заболевания: нечасто - грибковые инфекции развитие резистентности патогенных микроорганизмов."}},{"type":"paragraph","data":{"text":"Со стороны иммунной системы: редко - ангионевротический отек; неуточненная частота - анафилактический шок анафилактоидный шок."}},{"type":"paragraph","data":{"text":"Анафилактические и анафилактоидные реакции могут иногда разминаться даже после приема первой дозы препарата."}},{"type":"paragraph","data":{"text":"Общие расстройства: нечасто - астения; редко - пирексия (повышение температуры тела); неуточненная частота - боль (включая боль в спине груди и конечностях)."}},{"type":"paragraph","data":{"text":"Другие возможные нежелательные эффекты относящиеся ко всем фторхинолонам: очень редко - приступы порфирии у пациентов с порфирией."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Симптомы: нарушения сознания включая спутанность сознания головокружение судороги возможно развитие тошноты эрозивных поражений слизистых оболочек желудочно-кишечного тракта удлинение интервала QT галлюцинации тремор."}},{"type":"paragraph","data":{"text":"В случае передозировки требуется тщательное наблюдение за пациентом включая ЭКГ - мониторирование."}},{"type":"paragraph","data":{"text":"Лечение: симптоматическое. В случае острой передозировки показано промывание желудка и введение антацидов для защиты слизистой оболочки желудка. Специфического антидота не существует диализ неэффективен."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Взаимодействия требующие соблюдения осторожности"}},{"type":"paragraph","data":{"text":"С препаратами содержащими магний алюминий железо и цинк диданозином"}},{"type":"paragraph","data":{"text":"Препараты содержащие двухвалентные или трехвалентные катионы такие как соли цинка или железа (лекарственные препараты для лечения анемии) магний и/или алюминий-содержащие препараты (такие как антациды) диданозин (только лекарственные формы содержащие в качестве буфера алюминий или магний) рекомендуется принимать не менее чем за 2 часа до или через 2 часа после приема препарата Левофлоксацин."}},{"type":"paragraph","data":{"text":"Соли кальция оказывают минимальный эффект на абсорбцию левофлоксацина при его приеме внутрь."}},{"type":"paragraph","data":{"text":"С сукральфатом"}},{"type":"paragraph","data":{"text":"Действие левофлоксацина значительно ослабляется при одновременном применении сукральфата. Пациентам получающим левофлоксацин и сукральфат рекомендуется принимать сукральфат через 2 часа после приема левофлоксацина."}},{"type":"paragraph","data":{"text":"С теофиллином фенбуфеном или подобными лекарственными препаратами из группы нестероидных противовоспалительных препаратов снижающими порог судорожной активности головного мозга."}},{"type":"paragraph","data":{"text":"Фармакокинетического взаимодействия левофлоксацина с теофиллином не выявлено. Однако при одновременном применении хинолонов и теофиллина нестероидных противовоспалительных препаратов и других препаратов снижающих порог судорожной готовности головного мозга возможно выраженное снижение порога судорожной готовности мозга. Концентрация левофлоксацина при одновременном приеме фенбуфена повышается только на 13 %."}},{"type":"paragraph","data":{"text":"С непрямыми антикоагулянтами"}},{"type":"paragraph","data":{"text":"У пациентов получавших лечение левофлоксацином в комбинации с непрямыми антикоагулянтами (например варфарином) наблюдалось повышение протромбинового времени/международного нормализованного отношения и/или развитие кровотечения в том числе и тяжелого. Поэтому при одновременном применении непрямых антикоагулянтов и левофлоксацина необходим регулярный контроль показателей свертывания крови."}},{"type":"paragraph","data":{"text":"С пробенецидом и циметидином"}},{"type":"paragraph","data":{"text":"При одновременном применении лекарственных препаратов нарушающих почечную канальцевую секрецию таких как пробенецид и циметидин и левофлоксацина следует соблюдать осторожность особенно у пациентов с почечной недостаточностью. Циметидин и пробенецид замедляют выведение левофлоксацина на 24 % и 34 % соответственно. Маловероятно что это может иметь клиническое значение при нормальной функции почек."}},{"type":"paragraph","data":{"text":"С циклоспорином"}},{"type":"paragraph","data":{"text":"Левофлоксацин увеличивает период полувыведения циклоспорина на 33 %. Гак как это увеличение является клинически незначимым коррекции дозы циклоспорина при его одновременном применении с левофлоксацином не требуется."}},{"type":"paragraph","data":{"text":"С глюкокортикостероидами"}},{"type":"paragraph","data":{"text":"Одновременный прием глюкокортикостероидов повышает риск разрыва сухожилий."}},{"type":"paragraph","data":{"text":"С лекарственными препаратами удлиняющими интервал ОТ"}},{"type":"paragraph","data":{"text":"Левофлоксацин как и другие фторхинолоны должен применяться с осторожностью у пациентов получающих препараты удлиняющие интервал QT (например антиаритмические средства класса IA и III трициклические антидепрессанты макролиды нейролептики)."}},{"type":"paragraph","data":{"text":"Прочие"}},{"type":"paragraph","data":{"text":"Результаты проведенных клинико-фармакологических исследований но изучению возможных фармакокинетических взаимодействий левофлоксацина с дигоксином глибенкламидом ранитидином варфарином показали что фармакокинетика левофлоксацина при одновременном применении с этими препаратами нс изменяется в достаточной степени чтобы ото имело клиническое значение."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Госпитальные инфекции вызванные синегнойной палочкой (Pseudomonas aeruginosa) могут потребовать комбинированной терапии."}},{"type":"paragraph","data":{"text":"Распространенность приобретенной резистентности высеваемых штаммов микроорганизмов может изменяться в зависимости от географического региона и с течением времени. В связи е этим требуется информация о резистентности к препарату в конкретной стране. Для терапии тяжелых инфекций или при неэффективности лечения должен быть установлен микробиологический диагноз с выделением возбудителя и определением его чувствительности к левофлоксацину."}},{"type":"paragraph","data":{"text":"Метициллин-резистентный золотистый стрептококк"}},{"type":"paragraph","data":{"text":"Имеется высокая вероятность того что метициллин-резистентный золотистый стрептококк будет резистентным к фторхинолонам включая левофлоксацин. Поэтому левофлоксацин не рекомендуется для лечения установленных или предполагаемых инфекций вызываемых метициллин-резистентным золотистым стрептококком в случае если лабораторные анализы не подтвердили чувствительности этого микроорганизма к левофлоксацину."}},{"type":"paragraph","data":{"text":"Пациенты предрасположенные к развитию судорог"}},{"type":"paragraph","data":{"text":"Как и другие хинолоны левофлоксацин должен с большой осторожностью применяться у пациентов е предрасположенностью к судорогам. К таким пациентам относятся пациенты с предшествующими поражениями ЦНС такими как инсульт тяжелая черепно-мозговая травма; пациенты одновременно получающие препараты снижающие порог судорожной готовности головного мозга такие как фенбуфен и другие подобные ему нестероидные противовоспалительные препараты или другие препараты понижающие порог судорожной готовности такие как теофиллин (см. раздел \"Взаимодействие с другими лекарственными средствами\")."}},{"type":"paragraph","data":{"text":"Псевдомембранозный колит"}},{"type":"paragraph","data":{"text":"Развившаяся во время или после лечения левофлоксацином диарея особенно тяжелая упорная и/или с кровью может быть симптомом псевдомембранозного колита вызываемого Clostridium difficile. В случае подозрения на развитие псевдомембранозного колита лечение левофлоксацином следует немедленно прекратить и сразу же начать специфическую антибиотикотерапию (ванкомицин тейкопланин или метронидазол внутрь). Препараты тормозящие перистальтику кишечника противопоказаны."}},{"type":"paragraph","data":{"text":"Тендинит"}},{"type":"paragraph","data":{"text":"Редко наблюдаемым тендинит при применении хинолонов включая левофлоксацин может приводить к разрыву сухожилий включая ахиллово сухожилие. Этот побочный эффект может развиться в течение 48 часов после начала лечения и может быть двусторонним. Пациенты пожилого возраста в большей степени предрасположены к развитию тендинита. Риск разрыва сухожилий может повышаться при одновременном приеме глюкокортикостероидов. При подозрении на тендинит следует немедленно прекратить лечение препаратом Левофлоксацин и начать соответствующее лечение пораженного сухожилия например обеспечив ему достаточную иммобилизацию (см. разделы \"Противопоказания\" и \"Побочпое действие\")."}},{"type":"paragraph","data":{"text":"Реакции гиперчувствительности"}},{"type":"paragraph","data":{"text":"Левофлоксацин может вызывать серьезные потенциально фатальные реакции гиперчувствительности (ангионевротический отек анафилактический шок) даже при применении начальных доз (см. раздел \"Побочное действие\"). Пациентам следует немедленно прекратить прием препарата и обратиться к врачу."}},{"type":"paragraph","data":{"text":"Тяжелые буллезные реакции"}},{"type":"paragraph","data":{"text":"При приеме левофлоксацина наблюдались случаи тяжелых буллезных кожных реакций таких как синдром Стивенса-Джонсона или токсический эпидермальный некролиз (см. раздел \"Побочное действие\"). В случае развития каких-либо реакций со стороны кожи или слизистых оболочек пациент должен немедленно обратиться к врачу и не продолжать лечение до его консультации."}},{"type":"paragraph","data":{"text":"Нарушения со стороны печени и желчевыводящих путей"}},{"type":"paragraph","data":{"text":"Сообщалось о случаях развития печеночного некроза включая развитие фатальной печеночной недостаточности при применении левофлоксацина главным образом у пациентов с тяжелыми основными заболеваниями например с сепсисом (см. раздел \"Побочное действие\"). Пациенты должны быть предупреждены о необходимости прекращения лечения и срочного обращения к врачу в случае появления признаков и симптомов поражения печени таких как анорексия желтуха потемнение мочи зуд и боли в животе."}},{"type":"paragraph","data":{"text":"Пациенты с почечной недостаточностью"}},{"type":"paragraph","data":{"text":"Так как левофлоксацин экскретируется главным образом почками у пациентов с нарушением функции ночек требуется обязательный контроль функции почек а также коррекция режима дозирования (см. раздел \"Способ применения и дозы\"). При лечении пациентов пожилого возраста следует иметь в виду что больные этой группы часто страдают нарушениями функции почек."}},{"type":"paragraph","data":{"text":"Предотвращение развития реакций фотосенсибилизации"}},{"type":"paragraph","data":{"text":"Хотя фотосенсибилизация при применении левофлоксацина встречается очень редко для предотвращения ее развития пациентам не рекомендуется во время лечения и в течение 48 часов после окончания лечения левофлоксацином подвергаться без особой необходимости сильному солнечному или искусственному ультрафиолетовому облучению (например посещать солярии)."}},{"type":"paragraph","data":{"text":"Суперинфекция"}},{"type":"paragraph","data":{"text":"Как и при применении других антибиотиков применение левофлоксацина особенно в течение длительного времени может приводить к усиленному размножению нечувствительных к нему микроорганизмов (бактерии и грибов) что может вызывать изменения микрофлоры которая в норме присутствует у человека что может приводить к развитию суперинфекции. Поэтому в ходе лечения обязательно проводить повторную оценку состояния пациента и в случае развития во время лечения суперинфекции следует принимать соответствующие меры."}},{"type":"paragraph","data":{"text":"Удлинение интервала QT"}},{"type":"paragraph","data":{"text":"Сообщалось об очень редких случаях удлинения интервала QT у пациентов получавших фторхинолоны включая левофлоксацин. При применении фторхинолонов включая левофлоксацин следует соблюдать осторожность у пациентов с известными факторами риска удлинения интервала QT: у пациентов с нескорректированными электролитными нарушениями (с гипокалиемией гипомагниемией); с синдромом врожденного удлинения интервала QT; с заболеваниями сердца (сердечная недостаточность инфаркт миокарда брадикардия); при одновременном приеме лекарственных средств способных удлинять интервал QT таких как антиаритмические средства IA и III класса трициклические антидепрессанты макролиды нейролептики."}},{"type":"paragraph","data":{"text":"Пациенты пожилого возраста и пациенты женского пола могут быть более чувствительны к препаратам удлиняющим интервал QT. Поэтому следует с осторожностью применять у них фторхинолоны включая левофлоксацин (см. разделы \"С осторожностью\" \"Способ применения и дозы\" \"Побочное действие\" \"Передозировка\" и \"Взаимодействие с другими лекарственными средствами\")."}},{"type":"paragraph","data":{"text":"Пациенты с недостаточностью глюкозо-6-фосфатдегидрогеназы"}},{"type":"paragraph","data":{"text":"У пациентов с латентным или манифестированным дефицитом глюкозо-6-фосфатдегидрогеназы имеется предрасположенность к гемолитическим реакциям при лечении хинолонами ч то следует принимать во внимание при лечении левофлоксацином."}},{"type":"paragraph","data":{"text":"Гипо- и гипергликемия (дисгликемия)"}},{"type":"paragraph","data":{"text":"Как и при применении других хинолонов при применении левофлоксацина наблюдались случаи развития гипо- и гипергликемии обычно у пациентов е сахарным диабетом получающих одновременно лечение пероральными гипогликемическими препаратами (например глибенкламидом) или препаратами инсулина. Сообщалось о случаях развития гипогликемической комы. У пациентов е сахарным диабетом требуется тщательный мониторинг концентрации глюкозы в крови (см. раздел \"Побочное действие\")."}},{"type":"paragraph","data":{"text":"Периферическая невропатия"}},{"type":"paragraph","data":{"text":"У пациентов получающих фторхинолоны включая левофлоксацин отмечалась сенсорная и сенсорно-моторная периферическая невропатия начало которой может быть быстрым. Если у пациента появляются симптомы невропатии применение левофлоксацина должно быть прекращено. Это минимизирует возможный риск развития необратимых изменений."}},{"type":"paragraph","data":{"text":"Обострение псевдо паралитической миастении (myastheniagravis)"}},{"type":"paragraph","data":{"text":"Фторхинолоны включая левофлоксацин характеризуются блокирующей нервно- мышечное проведение активностью и могут усиливать мышечную слабость у пациентов с псевдопаралитической миастенией. В пострегистрационном периоде наблюдались неблагоприятные реакции включая легочную недостаточность потребовавшую проведение искусственной вентиляции легких и смертельный исход которые ассоциировались с применением фторхинолонов у пациентов с псевдопаралитической миастенией. Применение левофлоксацина у пациента с установленным диагнозом псевдопаралитической миастении не рекомендуется (см. раздел \"Побочное действие\")."}},{"type":"paragraph","data":{"text":"Применение при воздушно-капельном пути заражения сибирской язвой"}},{"type":"paragraph","data":{"text":"Применение левофлоксацина у человека по этому показанию основано на данных чувствительности к нему Bacillus anthracis полученных в исследованиях in vitro и в экспериментальных исследованиях проведенных на животных а также на ограниченных данных применения левофлоксацина у человека. Лечащие врачи должны обращаться к национальным и/или международным документам которые отражают выработанную общими усилиями точку зрения по лечению сибирской язвы."}},{"type":"paragraph","data":{"text":"Психотические реакции"}},{"type":"paragraph","data":{"text":"При применении хинолонов включая левофлоксацин сообщалось о развитии психотических реакций которые в очень редких случаях прогрессировали до развития суицидальных мыслей и нарушений поведения с причинением себе вреда (иногда после приема разовой дозы левофлоксацина (см. раздел \"Побочное действие\")). При развитии таких реакций лечение левофлоксацином следует прекратить и назначить соответствующую терапию. Следует с осторожностью назначать препарат пациентам с психозами или пациентам имеющим в анамнезе психические заболевания."}},{"type":"paragraph","data":{"text":"Нарушения зрения"}},{"type":"paragraph","data":{"text":"При развитии любых нарушении зрения необходима немедленная консультация офтальмолога (см. раздел \"Побочпое действие\")."}},{"type":"paragraph","data":{"text":"Влияние и а лабораторные тесты"}},{"type":"paragraph","data":{"text":"У пациентов принимающих левофлоксацин определение опиатов в моче может приводить к ложноположительным результатам которые следует подтверждать более специфическими методами."}},{"type":"paragraph","data":{"text":"Левофлоксацин может ингибировать рост Mycobacterium tuberculosis и приводить в дальнейшем к ложноотрицательным результатам бактериологического диагноза туберкулеза."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Следует соблюдать осторожность при управлении транспортными средствами и занятиями другими потенциально опасными видами деятельности так как некоторые побочные эффекты левофлоксацина такие как головокружение сонливость и расстройства зрения могут отрицательно влиять на способность управления транспортными средствами и выполнения потенциально опасных видов деятельности требующих повышенной концентрации внимания и быстроты психомоторных реакций."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки покрытые пленочной оболочкой 750 мг."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"При температуре не выше 25 \u003csup\u003e0\u003c/sup\u003eС."}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"2 года. Не использовать по истечении срока годности указанного на упаковке."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту"}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"Открытое акционерное общество \"Фармстандарт-Лексредства\" (ОАО \"Фармстандарт-Лексредства\")"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"ОАО \"Фармстандарт-Томскхимфарм\""}}]}],"source":null},"description_toggle":false,"short_description":"Синтетическое антибактериальное средство широкого спектра действия из группы фторхинолонов, левовращающий изомер офлоксацина. Левофлоксацин блокирует ДНК-гиразу и топоизомеразу IV, нарушает суперспирализацию и сшивку разрывов ДНК, ингибирует синтез ДНК, вызывает глубокие морфологические изменения в цитоплазме, клеточной стенке и мембранах микробных клеток. Левофлоксацин активен в отношении большинства штаммов микроорганизмов как в условиях in vitro так и in vivo.Аэробные грамположительные микроорганизмы:Bacillus anthracis, Corynebacterium diphtheriae, Corynebacterium jeikeium, Enterococcus spp. (в т.ч. Enterococcus faecalis), Listeria monocytogenes, Staphylococcus coagulase-negative methi-S(I), Staphylococcus aureus methi-S, Staphylococcus epidermidis methi-S, Staphylococcus spp. (CNS), Streptococcus группы С и G, Streptococcus agalactiae, Streptococcus pneumoniae peni I/S/R, Streptococcus pyogenes, Streptococcus viridans peni-S/R.Аэробные грамотрицательные микроорганизмы:Acinetobacter spp. (в т.ч. Acinetobacter baumannii), Actinobacillus actinomycetemcomitans, Citrobacter freundii, Eikenella corrodens, Enterobacter spp. (в т.ч. Enterobacter aerogenes, Enterobacter cloacae), Escherichia coli, Gardnerella vaginalis, Haemophilus ducreyi, Haemophilus influenzae ampi-S/R, Haemophilus parainfluenzae, Helicobacter pylori, Klebsiella spp. (в т.ч. Klebsiella oxytoca, Klebsiella pneumoniae), Moraxela catarrhalis (β+/β-), Morganella morganii, Neisseria gonorrhoeae non-PPNG/PPNG, Neisseria meningitidis, Pasteurella spp. (в т.ч. Pasteurella dagmatis, Pasteurella multocida, Pasteurella canis), Proteus mirabilis, Proteus vulgaris, Providencia spp. (в т.ч. Providencia rettgeri, Providencia stuartii), Pseudomonas aeruginosa, Pseudomonas spp. (в т.ч. Pseudomonas aeruginosa), Salmonella spp., Serratia spp. (в т.ч. Serratia marcescens).Анаэробные микроорганизмы:Bacteroides fragilis, Bifidobacterium spp., Clostridium perfringens, Fusobacterium spp., Peptostreptococcus, Propionibacterum spp., Veilonella spp.Другие микроорганизмы:Bartonella spp., Chlamydia pneumoniae, Chlamydia psittaci, Chlamydia trachomatis, Legionella spp. (в т.ч. Legionella pneumophila), Mycobacterium spp. (в т.ч. 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