оксипропилметилцеллюлоза; тальк; титана двуокись; пропиленгликоль; полиэтиленоксид 4000 или опадрай II
Фармакологические свойства
Противомикробный препарат широкого спектра действия из группы фторхинолонов. Действует на бактериальный фермент ДНК-гиразу, обеспечивающую сверхспирализацию и, таким образом, стабильность ДНК бактерий (дестабилизация цепей ДНК приводит к их гибели). Оказывает бактерицидный эффект.
Препарат активен в отношении микроорганизмов, продуцирующих β-лактамазы и быстрорастущих атипичных микобактерий.
Препарат неактивен в отношении Treponema pallidum.
Показания к применению
инфекционно-воспалительные заболевания дыхательных путей (бронхит, пневмония);
инфекционно-воспалительные заболевания ЛОР-органов (синусит, фарингит, средний отит, ларингит);
инфекционно-воспалительные заболевания кожи и мягких тканей;
инфекционно-воспалительные заболевания костей и суставов;
инфекционно-воспалительные заболевания брюшной полости (включая инфекции ЖКТ) и желчевыводящих путей;
инфекционно-воспалительные заболевания почек (пиелонефрит) и мочевыводящих путей (цистит, уретрит);
инфекционно-воспалительные заболевания органов малого таза (эндометрит, сальпингит, оофорит, цервицит, параметрит, простатит) и половых органов (кольпит, орхит, эпидидимит);
гонорея;
хламидиоз;
менингит;
профилактика инфекций у больных с нарушением иммунного статуса (в т.ч. при нейтропении).
Противопоказания
дефицит глюкозо-6-фосфатдегидрогеназы;
эпилепсия (в т.ч. в анамнезе);
снижение судорожного порога (в т.ч. после черепно-мозговой травмы, инсульта или воспалительных процессов в ЦНС);
возраст до 18 лет (т.к. не завершен рост скелета);
беременность;
лактация (грудное вскармливание);
повышенная чувствительность к компонентам препарата.
С осторожностью следует назначать препарат при атеросклерозе сосудов головного мозга, нарушениях мозгового кровообращения (в анамнезе), хронической почечной недостаточности, органических поражениях ЦНС.
Способ применения и дозы
Внутрь, до или во время еды, целиком, запивая водой. Дозы подбираются индивидуально в зависимости от локализации и тяжести течения инфекции, а также чувствительности микроорганизмов, общего состояния больного и функции печени и почек.
Взрослым — по 200–800 мг в сутки, курс лечения — 7–10 дней, кратность применения — 2 раза в день. Дозу до 400 мг — в 1 прием, предпочтительно утром. При гонорее — 400 мг однократно.
У пациентов с нарушением функции почек (при Cl креатинина 50–20 мл/мин) разовую дозу следует принять 1 раз в сутки или по 50% от средней дозы 2 раза в сутки. При Cl креатинина менее 20 мл/мин разовая доза — 200 мг, затем — по 100 мг в сутки через день.
При гемодиализе и перитонеальном диализе — по 100 мг каждые 24 ч. Максимальная суточная доза при печеночной недостаточности — 400 мг.
Длительность курса лечения определяется чувствительностью возбудителя и клинической картиной; лечение следует продолжать еще не менее 3 дней после исчезновения симптомов заболевания и полной нормализации температуры. При лечении сальмонеллезов курс лечения составляет 7–8 дней, при неосложненных инфекциях нижних мочевыводящих путей — 3–5 дней.
Детям — только по жизненным показаниям, при невозможности замены другими препаратами. Средняя суточная доза — 7,5 мг/кг, максимальная — 15 мг/кг.
Побочное действие
Со стороны органов ЖКТ: гастралгия, анорексия, тошнота, рвота, диарея, метеоризм, абдоминальные боли, повышение активности печеночных трансаминаз, гипербилирубинемия, холестатическая желтуха, псевдомембранозный энтероколит.
Со стороны нервной системы и органов чувств: головная боль, головокружение, неуверенность движений, тремор, судороги, онемение и парестезии конечностей, интенсивные сновидения, «кошмарные» сновидения, психотические реакции, тревожность, состояние возбуждения, фобии, депрессия, спутанность сознания, галлюцинации, повышение внутричерепного давления; нарушение цветовосприятия, диплопия, нарушение вкуса, обоняния, слуха и равновесия. При применении мази — ощущение жжения и дискомфорта в глазах, гиперемия, зуд и сухость конъюнктивы, светобоязнь, слезотечение.
Со стороны опорно-двигательного аппарата: тендинит, миалгии, артралгии, тендосиновит, разрыв сухожилия.
Со стороны сердечно-сосудистой системы и крови (кроветворение, гемостаз): тахикардия, снижениеАД (при в/в введении; при резком снижении АД введение прекращают), васкулит, коллапс; лейкопения, агранулоцитоз, анемия, тромбоцитопения, панцитопения, гемолитическая и апластическая анемия.
Аллергические реакции: кожная сыпь, зуд, крапивница, аллергический пневмонит, аллергический нефрит, эозинофилия, лихорадка, отек Квинке, бронхоспазм, синдром Стивенса-Джонсона и Лайелла, фотосенсибилизация, мультиформная эритема, редко — анафилактический шок.
Со стороны кожных покровов: точечные кровоизлияния (петехии), дерматит буллезный геморрагический, папулезная сыпь с коркой, свидетельствующие о поражении сосудов (васкулит).
Со стороны мочеполовой системы: острый интерстициальный нефрит, нарушение функции почек, гиперкреатининемия, повышение содержания мочевины.
Прочие: дисбактериоз, суперинфекция, гипогликемия (у больных сахарным диабетом), вагинит.
Пищевые продукты, антациды, содержащие Al3+, Ca2+, Mg2+ или соли железа, снижают всасывание офлоксацина, образуя нерастворимые комплексы (интервал между приемами этих препаратов должен быть не менее 2 ч).
Снижает клиренс теофиллина на 25% (при одновременном применении следует уменьшить дозу теофиллина).
Циметидин, фуросемид, метотрексат и препараты, блокирующие канальцевую секрецию, повышают концентрацию офлоксацина в плазме.
Увеличивает концентрацию глибенкламида в плазме.
При одновременном приеме с антагонистами витамина K необходимо осуществлять контроль свертывающей системы крови.
При назначении с НПВС, производными нитроимидазола и метилксантина повышается риск развития нейротоксических эффектов.
При одновременном назначении с глюкокортикоидами повышается риск разрыва сухожилий, особенно у пожилых людей.
При назначении с препаратами, ощелачивающими мочу (ингибиторы карбоангидразы, натрия бикарбонат), увеличивается риск кристаллурии и нефротических эффектов.
Особые указания
Не является препаратом выбора при лечении пневмонии, вызываемой пневмококками, не показан для лечения острого тонзиллита.
В период лечения необходимо воздерживаться от вождения транспорта и занятий потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций. Нельзя употреблять алкоголь.
На фоне лечения препаратом не следует использовать гигиенические тампоны типа Тампакс, в связи с повышенным риском развития молочницы.
На фоне лечения возможно ухудшение течения миастении, учащение приступов порфирии у предрасположенных пациентов.
Возможны ложноотрицательные результаты при бактериологической диагностике туберкулеза (препятствует выделению Mycobacterium tuberculosis).
Условия хранения
Список Б. Препарат следует хранить в сухом, защищенном от света, недоступном для детей месте, при температуре не выше 25°С.
Срок годности
2 года.
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картофельный;"}},{"type":"paragraph","data":{"text":"МКЦ;"}},{"type":"paragraph","data":{"text":"тальк;"}},{"type":"paragraph","data":{"text":"поливинилпирролидон низкомолекулярный;"}},{"type":"paragraph","data":{"text":"магния или кальция стеарат;"}},{"type":"paragraph","data":{"text":"аэросил"}},{"type":"paragraph","data":{"text":"\u003ci\u003eСостав оболочки:\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"оксипропилметилцеллюлоза; тальк; титана двуокись; пропиленгликоль; полиэтиленоксид 4000 или опадрай II"}}]},{"id":7,"name":"Фармакологические свойства","slug":"pharmacologic_effects","body":[{"type":"paragraph","data":{"text":"Противомикробный препарат широкого спектра действия из группы фторхинолонов. Действует на бактериальный фермент ДНК-гиразу, обеспечивающую сверхспирализацию и, таким образом, стабильность ДНК бактерий (дестабилизация цепей ДНК приводит к их гибели). Оказывает бактерицидный эффект."}},{"type":"paragraph","data":{"text":"Препарат активен в отношении микроорганизмов, продуцирующих β-лактамазы и быстрорастущих атипичных микобактерий."}},{"type":"paragraph","data":{"text":"К препарату чувствительны: Staphylococcus aureus, Staphylococcus epidermidis, Neisseria gonorrhoeae, Neisseria meningitidis, Escherichia coli, Citrobacter spp., Klebsiella spp. (включая Klebsiella pneumoniae), Enterobacter spp., Hafnia spp., Proteus spp. (включая Proteus mirabilis, Proteus vulgaris - индол-положительные и индол-отрицательные штаммы), Salmonella spp., Shigella spp. (включая Shigella sonnei), Yersinia enterocolitica, Campylobacter jejuni, Aeromonas hydrophila, Plesiomonas aeruginosa, Vibrio cholerae, Vibrio parahaemolyticus, Haemophilus influenzae, Chlamydia spp., Legionella spp., Serratia spp., Providencia spp., Haemophilus ducreyi, Bordetella parapertussis, Bordetella pertussis, Moraxella catarrhalis, Propionibacterium acnes, Brucella spp."}},{"type":"paragraph","data":{"text":"Различной чувствительностью к препарату обладают: Enterococcus faecalis, Streptococcus pyogenes, Streptococcus pneumoniae, Streptococcus viridans, Serrratia marcescens, Pseudomonas aeruginosa, Acinetobacter spp., Mycoplasma hominis, Mycoplasma pneumoniae, Mycobacterium tuberculosis, Mycobacteriurn fortuitum, Ureaplasma urealyticum, Clostridium perfringens, Corynebacterium spp., Helicobacter pylori, Listeria monocytogenes, Gardnerella vaginalis."}},{"type":"paragraph","data":{"text":"К препарату устойчивы Nocardia asteroides, анаэробные бактерии (Bacteroides spp., Peptococcus spp., Peptostreptococcus spp., Eubacterium spp., Fusobacterium spp., Clostridium difficile)."}},{"type":"paragraph","data":{"text":"Препарат неактивен в отношении Treponema pallidum."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"инфекционно-воспалительные заболевания дыхательных путей (бронхит, пневмония);"}},{"type":"paragraph","data":{"text":"инфекционно-воспалительные заболевания ЛОР-органов (синусит, фарингит, средний отит, ларингит);"}},{"type":"paragraph","data":{"text":"инфекционно-воспалительные заболевания кожи и мягких тканей;"}},{"type":"paragraph","data":{"text":"инфекционно-воспалительные заболевания костей и суставов;"}},{"type":"paragraph","data":{"text":"инфекционно-воспалительные заболевания брюшной полости (включая инфекции ЖКТ) и желчевыводящих путей;"}},{"type":"paragraph","data":{"text":"инфекционно-воспалительные заболевания почек (пиелонефрит) и мочевыводящих путей (цистит, уретрит);"}},{"type":"paragraph","data":{"text":"инфекционно-воспалительные заболевания органов малого таза (эндометрит, сальпингит, оофорит, цервицит, параметрит, простатит) и половых органов (кольпит, орхит, эпидидимит);"}},{"type":"paragraph","data":{"text":"гонорея;"}},{"type":"paragraph","data":{"text":"хламидиоз;"}},{"type":"paragraph","data":{"text":"менингит;"}},{"type":"paragraph","data":{"text":"профилактика инфекций у больных с нарушением иммунного статуса (в т.ч. при нейтропении)."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"дефицит глюкозо-6-фосфатдегидрогеназы;"}},{"type":"paragraph","data":{"text":"эпилепсия (в т.ч. в анамнезе);"}},{"type":"paragraph","data":{"text":"снижение судорожного порога (в т.ч. после черепно-мозговой травмы, инсульта или воспалительных процессов в ЦНС);"}},{"type":"paragraph","data":{"text":"возраст до 18 лет (т.к. не завершен рост скелета);"}},{"type":"paragraph","data":{"text":"беременность;"}},{"type":"paragraph","data":{"text":"лактация (грудное вскармливание);"}},{"type":"paragraph","data":{"text":"повышенная чувствительность к компонентам препарата."}},{"type":"paragraph","data":{"text":"С осторожностью следует назначать препарат при атеросклерозе сосудов головного мозга, нарушениях мозгового кровообращения (в анамнезе), хронической почечной недостаточности, органических поражениях ЦНС."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Внутрь, до или во время еды, целиком, запивая водой. Дозы подбираются индивидуально в зависимости от локализации и тяжести течения инфекции, а также чувствительности микроорганизмов, общего состояния больного и функции печени и почек."}},{"type":"paragraph","data":{"text":"Взрослым — по 200–800 мг в сутки, курс лечения — 7–10 дней, кратность применения — 2 раза в день. Дозу до 400 мг — в 1 прием, предпочтительно утром. При гонорее — 400 мг однократно."}},{"type":"paragraph","data":{"text":"У пациентов с нарушением функции почек (при Cl креатинина 50–20 мл/мин) разовую дозу следует принять 1 раз в сутки или по 50% от средней дозы 2 раза в сутки. При Cl креатинина менее 20 мл/мин разовая доза — 200 мг, затем — по 100 мг в сутки через день."}},{"type":"paragraph","data":{"text":"При гемодиализе и перитонеальном диализе — по 100 мг каждые 24 ч. Максимальная суточная доза при печеночной недостаточности — 400 мг."}},{"type":"paragraph","data":{"text":"Длительность курса лечения определяется чувствительностью возбудителя и клинической картиной; лечение следует продолжать еще не менее 3 дней после исчезновения симптомов заболевания и полной нормализации температуры. При лечении сальмонеллезов курс лечения составляет 7–8 дней, при неосложненных инфекциях нижних мочевыводящих путей — 3–5 дней."}},{"type":"paragraph","data":{"text":"Детям — только по жизненным показаниям, при невозможности замены другими препаратами. Средняя суточная доза — 7,5 мг/кг, максимальная — 15 мг/кг."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Со стороны органов ЖКТ: гастралгия, анорексия, тошнота, рвота, диарея, метеоризм, абдоминальные боли, повышение активности печеночных трансаминаз, гипербилирубинемия, холестатическая желтуха, псевдомембранозный энтероколит."}},{"type":"paragraph","data":{"text":"Со стороны нервной системы и органов чувств: головная боль, головокружение, неуверенность движений, тремор, судороги, онемение и парестезии конечностей, интенсивные сновидения, «кошмарные» сновидения, психотические реакции, тревожность, состояние возбуждения, фобии, депрессия, спутанность сознания, галлюцинации, повышение внутричерепного давления; нарушение цветовосприятия, диплопия, нарушение вкуса, обоняния, слуха и равновесия. При применении мази — ощущение жжения и дискомфорта в глазах, гиперемия, зуд и сухость конъюнктивы, светобоязнь, слезотечение."}},{"type":"paragraph","data":{"text":"Со стороны опорно-двигательного аппарата: тендинит, миалгии, артралгии, тендосиновит, разрыв сухожилия."}},{"type":"paragraph","data":{"text":"Со стороны сердечно-сосудистой системы и крови (кроветворение, гемостаз): тахикардия, снижениеАД (при в/в введении; при резком снижении АД введение прекращают), васкулит, коллапс; лейкопения, агранулоцитоз, анемия, тромбоцитопения, панцитопения, гемолитическая и апластическая анемия."}},{"type":"paragraph","data":{"text":"Аллергические реакции: кожная сыпь, зуд, крапивница, аллергический пневмонит, аллергический нефрит, эозинофилия, лихорадка, отек Квинке, бронхоспазм, синдром Стивенса-Джонсона и Лайелла, фотосенсибилизация, мультиформная эритема, редко — анафилактический шок."}},{"type":"paragraph","data":{"text":"Со стороны кожных покровов: точечные кровоизлияния (петехии), дерматит буллезный геморрагический, папулезная сыпь с коркой, свидетельствующие о поражении сосудов (васкулит)."}},{"type":"paragraph","data":{"text":"Со стороны мочеполовой системы: острый интерстициальный нефрит, нарушение функции почек, гиперкреатининемия, повышение содержания мочевины."}},{"type":"paragraph","data":{"text":"Прочие: дисбактериоз, суперинфекция, гипогликемия (у больных сахарным диабетом), вагинит."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Симптомы: головокружение, спутанность сознания, заторможенность, дезориентация, сонливость, рвота."}},{"type":"paragraph","data":{"text":"Лечение: промывание желудка, симптоматическая терапия."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Совместим со следующими инфузионными растворами: изотоническим раствором натрия хлорида, раствором Рингера, 5% раствором фруктозы, 5% раствором декстрозы (глюкозы)."}},{"type":"paragraph","data":{"text":"Не смешивать с гепарином (риск преципитации)."}},{"type":"paragraph","data":{"text":"Пищевые продукты, антациды, содержащие Al3+, Ca2+, Mg2+ или соли железа, снижают всасывание офлоксацина, образуя нерастворимые комплексы (интервал между приемами этих препаратов должен быть не менее 2 ч)."}},{"type":"paragraph","data":{"text":"Снижает клиренс теофиллина на 25% (при одновременном применении следует уменьшить дозу теофиллина)."}},{"type":"paragraph","data":{"text":"Циметидин, фуросемид, метотрексат и препараты, блокирующие канальцевую секрецию, повышают концентрацию офлоксацина в плазме."}},{"type":"paragraph","data":{"text":"Увеличивает концентрацию глибенкламида в плазме."}},{"type":"paragraph","data":{"text":"При одновременном приеме с антагонистами витамина K необходимо осуществлять контроль свертывающей системы крови."}},{"type":"paragraph","data":{"text":"При назначении с НПВС, производными нитроимидазола и метилксантина повышается риск развития нейротоксических эффектов."}},{"type":"paragraph","data":{"text":"При одновременном назначении с глюкокортикоидами повышается риск разрыва сухожилий, особенно у пожилых людей."}},{"type":"paragraph","data":{"text":"При назначении с препаратами, ощелачивающими мочу (ингибиторы карбоангидразы, натрия бикарбонат), увеличивается риск кристаллурии и нефротических эффектов."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Не является препаратом выбора при лечении пневмонии, вызываемой пневмококками, не показан для лечения острого тонзиллита."}},{"type":"paragraph","data":{"text":"В период лечения необходимо воздерживаться от вождения транспорта и занятий потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций. Нельзя употреблять алкоголь."}},{"type":"paragraph","data":{"text":"На фоне лечения препаратом не следует использовать гигиенические тампоны типа Тампакс, в связи с повышенным риском развития молочницы."}},{"type":"paragraph","data":{"text":"На фоне лечения возможно ухудшение течения миастении, учащение приступов порфирии у предрасположенных пациентов."}},{"type":"paragraph","data":{"text":"Возможны ложноотрицательные результаты при бактериологической диагностике туберкулеза (препятствует выделению Mycobacterium tuberculosis)."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Список Б. 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К препарату чувствительны: Staphylococcus aureus, Staphylococcus epidermidis, Neisseria gonorrhoeae, Neisseria meningitidis, Escherichia coli, Citrobacter spp., Klebsiella spp. (включая Klebsiella pneumoniae), Enterobacter spp., Hafnia spp., Proteus spp. (включая Proteus mirabilis, Proteus vulgaris - индол-положительные и индол-отрицательные штаммы), Salmonella spp., Shigella spp. (включая Shigella sonnei), Yersinia enterocolitica, Campylobacter jejuni, Aeromonas hydrophila, Plesiomonas aeruginosa, Vibrio cholerae, Vibrio parahaemolyticus, Haemophilus influenzae, Chlamydia spp., Legionella spp., Serratia spp., Providencia spp., Haemophilus ducreyi, Bordetella parapertussis, Bordetella pertussis, Moraxella catarrhalis, Propionibacterium acnes, Brucella spp. Различной чувствительностью к препарату обладают: Enterococcus faecalis, Streptococcus pyogenes, Streptococcus pneumoniae, Streptococcus viridans, Serrratia marcescens, Pseudomonas aeruginosa, Acinetobacter spp., Mycoplasma hominis, Mycoplasma pneumoniae, Mycobacterium tuberculosis, Mycobacteriurn fortuitum, Ureaplasma urealyticum, Clostridium perfringens, Corynebacterium spp., Helicobacter pylori, Listeria monocytogenes, Gardnerella vaginalis. К препарату устойчивы Nocardia asteroides, анаэробные бактерии (Bacteroides spp., Peptococcus spp., Peptostreptococcus spp., Eubacterium spp., Fusobacterium spp., Clostridium difficile). 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