Гиперчувствительность к левофлоксацину, другим фторхинолонам или компонентам препарата, эпилепсия, поражение сухожилий при ранее проводившемся лечении хинолонами, беременность, период лактации, детский и подростковый возраст (до 18 лет). Непереносимость лактозы или недостаточность лактазы, а также глюкозо-галактозная мальабсорбция. С осторожностью лицам ...
Эколевид – синтетический антибактериальный препарат широкого спектра действия из группы фторхинолонов, содержащий в качестве активного вещества левовращающий изомер офлоксацина. Левофлоксацин блокирует ДНК-гиразу, нарушает суперспирализацию и сшивку разрывов ДНК, ингибирует синтез ДНК, вызывает глубокие морфологические изменения в цитоплазме, клеточной стенке и мембранах бактерий. Левофлоксацин действует бактерицидно, активен в отношении большого количества возбудителей бактериальных инфекций как в условиях in vitro, так и in vivo.
Фармакологические свойства
Противомикробное средство, фторхинолон.
Показания к применению
Инфекционно-воспалительные заболевания, вызванные чувствительными к препарату микроорганизмами:
Нижних дыхательных путей (обострение хронического бронхита, внебольничная пневмония),
ЛОР-органов (в т.ч. острый гайморит),
Мочевыводящих путей и почек (в т.ч. острый пиелонефрит),
Кожи и мягких тканей (абсцессы, фурункулез),
Хронический бактериальный простатит,
Интраабдоминальные инфекции,
Лекарственно-устойчивые формы туберкулеза - в составе комплексной терапии
Противопоказания
Гиперчувствительность к левофлоксацину, другим фторхинолонам или компонентам препарата, эпилепсия, поражение сухожилий при ранее проводившемся лечении хинолонами, беременность, период лактации, детский и подростковый возраст (до 18 лет). Непереносимость лактозы или недостаточность лактазы, а также глюкозо-галактозная мальабсорбция. С осторожностью лицам пожилого возраста, при дефиците глюкозо-6-фосфатдегидрогеназы.
Применение при беременности и в период грудного вскармливания
Препарат противопоказан при беременности.
Способ применения и дозы
Внутрь, до еды или в перерыве между приемами пищи, не разжевывая, запивая достаточным количеством жидкости. Острый гайморит: по 500 мг 1 раз в сутки в течение 10-14 дней, Внебольничная пневмония: по 500 мг 1-2 раза в сутки, 7-14 дней, Обострение хронического бронхита: по 250-500 мг 1 раз в сутки в течение 7-10 дней, Неосложненные инфекции мочевыводящих путей- 250 мг 1 раз в сутки в течение 3 дней, Осложненные инфекции мочевыводящих путей (в т.ч. пиелонефрит): 250 мг 1 раз в сутки (при тяжелом течении заболевания дозу следует увеличить) в течение 7-10 дней, Хронический бактериальный простатит - 500 мг 1 раз в сутки, курс лечения – 28 дней, Инфекции кожи и мягких тканей: по 250-500 мг 1-2 раза в сутки в течение 7-14 дней, Интраабдоминальная инфекция – по 500 мг 1 раз в сутки, курс лечения 7-14 дней (в комбинации с антибактериальными препаратами, действующими на анаэробную микрофлору), Комплексная терапия лекарственно-устойчивых форм туберкулеза: по 500 мг 1-2 раза в сутки, курс лечения - до 3 месяцев, Длительность лечения зависит от вида и тяжести заболевания. После купирования симптомов острого воспаления и нормализации температуры рекомендуется продолжать терапию левофлоксацином в течение 48-72 часов. Дозирование препарата у пациентов с нарушенной функцией почек (клиренс креатинина менее 50 мл/мин): 50-20 мл/мин: - Первоначальная доза 250 мг/24 ч: далее 125 мг/24 ч, - Первоначальная доза 500 мг/24 ч: далее 250 мг/24 ч, - Первоначальная доза 500 мг/12 ч: далее 250 мг/12 ч,19-10 мл/мин: - Первоначальная доза 250 мг/24 ч: далее 125 мг/48 ч, - Первоначальная доза 500 мг/24 ч: далее 125 мг/24 ч, - Первоначальная доза 500 мг/12 ч: далее 125 мг/12 ч,10* мл/мин: - Первоначальная доза 250 мг/24 ч: далее 125 мг/48 ч, - Первоначальная доза 500 мг/24 ч: далее 125 мг/24 ч, - Первоначальная доза 500 мг/12 ч: далее 125 мг/24 ч,* в т.ч. при гемодиализе и постоянном амбулаторном перитоне-альном диализе После гемодиализа или постоянного амбулаторного перитонеального диализа не требуется введения дополнительных доз. Не требуется коррекции дозы у пациентов с нарушениями функции печени.
Побочное действие
Со стороны пищеварительной системы: тошнота, рвота, диарея (в т.ч. с кровью), нарушение пищеварения, снижение аппетита, боль в животе, псевдомембранозный колит, повышение активности "печеночных" трансаминаз, гипербилирубинемия, гепатит, дисбактериоз. Со стороны сердечно-сосудистой системы: снижение артериального давления, сосудистый коллапс, тахикардия, удлинение интервала QT, мерцательная аритмия. Со стороны нервной системы: боль, головокружение, слабость, сонливость, бессонница, тремор, беспокойство, парестезии, страх, галлюцинации, спутанность сознания, депрессия, двигательные расстройства, судороги. Со стороны органов чувств: нарушения зрения, слуха, обоняния, вкусовой и тактильной чувствительности. Со стороны опорно-двигательного аппарата: артралгия, мышечная слабость, миалгия, разрыв сухожилий, тендинит, рабдомиолиз. Со стороны мочевыделительной системы: гиперкреатининемия, интерстициальный нефрит, острая почечная недостаточность. Со стороны органов кроветворения: эозинофилия, гемолитическая анемия, лейкопения, нейтропения, агранулоцитоз, тромбоцитопения, панцитопения, геморрагии. Со стороны обмена веществ: гипогликемия (повышение аппетита, повышенное потоотделение, дрожь). Аллергические реакции: зуд и гиперемия кожи, отек кожи и слизистых оболочек, крапивница, злокачественная экссудативная эритема (синдром Стивенса-Джонсона), токсический эпидермальный некролиз (синдром Лайелла), бронхоспазм, удушье, анафилактический шок, аллергический пневмонит.
Передозировка
Симптомы передозировки препарата левофлоксацин проявляются на уровне центральной нервной системы (спутанность сознания, головокружение, нарушение сознания и судороги). Кроме того, могут отмечаться желудочно-кишечные расстройства (например, тошнота, рвота) и эрозивные поражения слизистых оболочек желудочно-кишечного тракта. В исследованиях, проведенных с использованием сверхвысоких доз левофлоксацина, было показано удлинение интервала QT. Левофлоксацин не выводится посредством гемодиализа или перитонеального диализа. Специфического антидота (противодействующего вещества) не существует. Лечение – промывание желудка и симптоматическая терапия.
Особые указания
При лечении больных пожилого возраста следует иметь в виду, что они часто страдают нарушениями функции почек. Несмотря на то, что фотосенсибилизация на фоне лечения левофлоксацином отмечается достаточно редко, больным не рекомендуется подвергаться сильному солнечному или искусственному ультрафиолетовому облучению. При подозрении на псевдомембранозный колит следует немедленно отменить левофлоксацин и начать соответствующее лечение. В таких случаях нельзя применять лекарственные средства, угнетающие моторику кишечника. Больные с недостаточностью глюкозо-6-фосфатдегидрогеназы (наследственное нарушение обмена веществ) могут реагировать на фторхинолоны разрушением эритроцитов (гемолиз). В связи с этим, лечение левофлоксацином следует проводить с осторожностью. Такие побочные эффекты левофлоксацина, как головокружение или сонливость, а также расстройства зрения (см. раздел «Побочное действие»), могут ухудшать реакционную способность и затруднять управление автомобилем, обслуживание машин и механизмов.
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Непереносимость лактозы или недостаточность лактазы, а также глюкозо-галактозная мальабсорбция. С осторожностью лицам пожилого возраста, при дефиците глюкозо-6-фосфатдегидрогеназы."}}]},{"id":6,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Препарат противопоказан при беременности."}}]},{"id":7,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Внутрь, до еды или в перерыве между приемами пищи, не разжевывая, запивая достаточным количеством жидкости. Острый гайморит: по 500 мг 1 раз в сутки в течение 10-14 дней, Внебольничная пневмония: по 500 мг 1-2 раза в сутки, 7-14 дней, Обострение хронического бронхита: по 250-500 мг 1 раз в сутки в течение 7-10 дней, Неосложненные инфекции мочевыводящих путей- 250 мг 1 раз в сутки в течение 3 дней, Осложненные инфекции мочевыводящих путей (в т.ч. пиелонефрит): 250 мг 1 раз в сутки (при тяжелом течении заболевания дозу следует увеличить) в течение 7-10 дней, Хронический бактериальный простатит - 500 мг 1 раз в сутки, курс лечения – 28 дней, Инфекции кожи и мягких тканей: по 250-500 мг 1-2 раза в сутки в течение 7-14 дней, Интраабдоминальная инфекция – по 500 мг 1 раз в сутки, курс лечения 7-14 дней (в комбинации с антибактериальными препаратами, действующими на анаэробную микрофлору), Комплексная терапия лекарственно-устойчивых форм туберкулеза: по 500 мг 1-2 раза в сутки, курс лечения - до 3 месяцев, Длительность лечения зависит от вида и тяжести заболевания. 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Со стороны опорно-двигательного аппарата: артралгия, мышечная слабость, миалгия, разрыв сухожилий, тендинит, рабдомиолиз. Со стороны мочевыделительной системы: гиперкреатининемия, интерстициальный нефрит, острая почечная недостаточность. Со стороны органов кроветворения: эозинофилия, гемолитическая анемия, лейкопения, нейтропения, агранулоцитоз, тромбоцитопения, панцитопения, геморрагии. Со стороны обмена веществ: гипогликемия (повышение аппетита, повышенное потоотделение, дрожь). 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