Инфекционно-воспалительные заболевания у взрослых, вызванные чувствительными к препарату микроорганизмами:- внебольничная пневмония; - осложненные инфекции мочевыводящих путей (включая пиелонефрит); - неосложненные инфекции мочевыводящих путей; - хронический бактериальный простатит; - септицемия/бактериемия, связанные с указанными выше Показания к применениюми; ...
эпилепсия; - поражения сухожилий при применении фторхинолонов в анамнезе; - детский и подростковый возраст до 18 лет (в связи с незавершенностью роста скелета, т.к. нельзя полностью исключить риск поражения хрящевых точек роста); - беременность (нельзя полностью исключить риск поражения хрящевых точек роста у плода); - период лактации (нельзя полностью исключить риск поражения хрящевых точек роста костей у грудного ребенка); - повышенная чувствительность к левофлоксацину или к другим хинолонам. С осторожностью:- у пациентов, предрасположенных к развитию судорог (у пациентов с предшествующими поражениями ЦНС, у пациентов, одновременно получающих препараты, снижающие порог судорожной готовности головного мозга, такие как фенбуфен, теофиллин); - у пациентов с латентным или манифестированным дефицитом глюкозо-6-фосфатдегидрогеназы (повышенный риск гемолитических реакций при лечении хинолонами); - у пациентов с нарушением функции почек (требуется обязательный контроль за функцией почек, а также коррекция режима дозирования); - у пациентов с известными факторами риска удлинения интервала QT: у пациентов пожилого возраста; 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; - у пациентов с сахарным диабетом, получающих пероральные гипогликемические средства, например, глибенкламид или инсулин (возрастает риск развития гипогликемии); - у пациентов с тяжелыми нежелательными реакциями на другие фторхинолоны, такими как тяжелые неврологические реакции (повышенный риск возникновения аналогичных нежелательных реакций при применении левофлоксацина); - у пациентов с псевдопаралитической миастенией (myasthenia gravis).
В 1 мл содержится: Левофлоксацина гемигидрат 5.1246 мг, что соответствует содержанию левофлоксацина 5 мгВспомогательные вещества: натрия хлорид - 9 мг, хлористоводородная кислота - 1.2-1.6 мг, натрия гидроксид - 0-0.3 мг, вода д/и - до 1 мл.
Фармакологические свойства
Противомикробное средство широкого спектра действия, фторхинолон. Действует бактерицидно. Блокирует ДНК-гиразу (топоизомеразу II) и топоизомеразу IV, нарушает суперспирализацию и сшивку разрывов ДНК, ингибирует синтез ДНК, вызывает глубокие морфологические изменения в цитоплазме, клеточной стенке и мембранах. Активен в отношении Enterococcus faecalis, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Streptococcus pyogenes и Streptococcus agalactiae, Viridans group streptococci, Enterobacter cloacae, Enterobacter aerogenes, Enterobacter agglomerans, Enterobacter sakazakii, Escherichia coli, Haemophilus influеnzае, Haemophilus parainfluenzae, Klebsiella pneumoniae, Klebsiella oxytoca, Legionella pneumoniae, Moraxella catarrhalis, Proteus mirabilis, Pseudomonas aeruginosa, Pseudomonas fluorescens, Chlamydia pneumoniae, Mycoplasma pneumoniae, Acinetobacter anitratus, Acinetobacter baumannii, Acinetobacter calcoaceticus, Bordetella pertussis, Citrobacter diversus, Citrobacter freundii, Morganella morganii, Proteus vulgaris, Providencia rettgeri, Providcncia stuartii, Serratia marcescens, Clostridium perfringens.
Показания к применению
Инфекционно-воспалительные заболевания у взрослых, вызванные чувствительными к препарату микроорганизмами:- внебольничная пневмония; - осложненные инфекции мочевыводящих путей (включая пиелонефрит); - неосложненные инфекции мочевыводящих путей; - хронический бактериальный простатит; - септицемия/бактериемия, связанные с указанными выше Показания к применениюми; - инфекции брюшной полости; - для комплексного лечения лекарственно-устойчивых форм туберкулеза.
Противопоказания
эпилепсия; - поражения сухожилий при применении фторхинолонов в анамнезе; - детский и подростковый возраст до 18 лет (в связи с незавершенностью роста скелета, т.к. нельзя полностью исключить риск поражения хрящевых точек роста); - беременность (нельзя полностью исключить риск поражения хрящевых точек роста у плода); - период лактации (нельзя полностью исключить риск поражения хрящевых точек роста костей у грудного ребенка); - повышенная чувствительность к левофлоксацину или к другим хинолонам. С осторожностью:- у пациентов, предрасположенных к развитию судорог (у пациентов с предшествующими поражениями ЦНС, у пациентов, одновременно получающих препараты, снижающие порог судорожной готовности головного мозга, такие как фенбуфен, теофиллин); - у пациентов с латентным или манифестированным дефицитом глюкозо-6-фосфатдегидрогеназы (повышенный риск гемолитических реакций при лечении хинолонами); - у пациентов с нарушением функции почек (требуется обязательный контроль за функцией почек, а также коррекция режима дозирования); - у пациентов с известными факторами риска удлинения интервала QT: у пациентов пожилого возраста; 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; - у пациентов с сахарным диабетом, получающих пероральные гипогликемические средства, например, глибенкламид или инсулин (возрастает риск развития гипогликемии); - у пациентов с тяжелыми нежелательными реакциями на другие фторхинолоны, такими как тяжелые неврологические реакции (повышенный риск возникновения аналогичных нежелательных реакций при применении левофлоксацина); - у пациентов с псевдопаралитической миастенией (myasthenia gravis).
Применение при беременности и в период грудного вскармливания
Противопоказан к применению при беременности и в период лактации (грудного вскармливания).
Способ применения и дозы
Препарат принимают внутрь или вводят в/в по 250-500 мг 1-2 раза/сут. Дозы определяются характером и тяжестью инфекции, а также чувствительностью предполагаемого возбудителя. Пациентам с нормальной или умеренно нарушенной функцией почек (КК >50 мл/мин) препарат рекомендуется назначать в следующих дозах. Внебольничная пневмония: по 500 мг 1-2 раза/сут (суточная доза - 500-1000 мг левофлоксацина). Курс лечения - 7-14 дней. Неосложненные инфекции мочевыводящих путей: 250 мг 1 раз/сут (суточная доза - 250 мг левофлоксацина). Курс лечения - 3 дня. Осложненные инфекции мочевыводящих путей (включая пиелонефрит): 250 мг 1 раз/сут. При тяжелых инфекциях возможно увеличение дозы. Курс лечения - 7-10 дней. Хронический бактериальный простатит: 500 мг 1 раз/сут (суточная доза - 500 мг левофлоксацина). Курс лечения - 28 дней. Септицемия/бактериемия: по 500 мг 1-2 раза/сут (суточная доза - 500-1000 мг левофлоксацина). Курс лечения - 10-14 дней. Инфекция брюшной полости: по 500 мг 1 раз/сут. Курс лечения - 7-14 дней в комбинации с антибактериальными препаратами, действующими на анаэробную флору. Инфекции кожи и мягких тканей: внутрь по 1 таб. 250 мг (250 мг левофлоксацина) 1 раз/сут, или по 2 таб. 250 мг или по 1 таб. 500 мг (500 мг левофлоксацина) 1-2 раза/сут (соответственно 500-1000 мг левофлоксацина в сут). Курс лечения - 7-14 дней. В составе комплексной терапии лекарственно-устойчивых форм туберкулеза Таваник назначают по 500 мг 1-2 раза/сут (500-1000 мг левофлоксацина/сут) до 3 мес. Пациентам с нарушением функции почек требуется коррекция режима дозирования в зависимости от величины КК.
Побочное действие
Со стороны средечно-сосудистой системы: часто - флебит; редко - синусовая тахикардия, снижение АД; неизвестная частота (постмаркетинговые данные) - удлинение интервала QT. Со стороны системы кроветворения: нечасто - лейкопения, эозинофилия ; редко - нейтропения, тромбоцитопения; неизвестная частота (постмаркетинговые данные) - панцитопения, агранулоцитоз, гемолитическая анемия. Со стороны нервной системы: часто - головная боль, головокружение; нечасто - сонливость, тремор, дисгевзия (извращение вкуса); редко - парестезия, судороги; неизвестная частота (постмаркетинговые данные) - периферическая сенсорная невропатия, периферическая сенсорно-моторная невропатия, дискинезия, экстрапирамидные расстройства, потеря вкусовых ощущений, паросмия (расстройство ощущения запаха, особенно субъективное ощущение запаха, объективно отсутствующего), включая потерю обоняния. Со стороны психики: часто - бессонница; нечасто - чувство беспокойства, спутанность сознания; редко - психические нарушения (например, с галлюцинациями), депрессия, ажитация (возбуждение), нарушения сна, кошмарные сновидения; неизвестная частота (постмаркетинговые данные) - нарушения психики с нарушениями поведения с причинением себе вреда, включая суицидальные мысли и суицидальные попытки. Со стороны органа зрения: очень редко - нарушения зрения, такие как расплывчатость видимого изображения. Со стороны органа слуха и лабиринтные нарушения: нечасто - вертиго (чувство отклонения или кружения или собственного тела или окружающих предметов); редко - звон в ушах; неизвестная частота (постмаркетинговые данные) - снижение слуха. Со стороны дыхательной системы: нечасто - одышка; неизвестная частота (постмаркетинговые данные) - бронхоспазм, аллергический пневмонит. Со стороны пищеварительной системы: часто - диарея, рвота, тошнота; нечасто - боли в животе, диспепсия; неизвестная частота (постмаркетинговые данные) - геморрагическая диарея, которая в очень редких случаях может быть признаком энтероколита, включая псевдомембранозный колит. Со стороны печени и желчевыводящих путей: часто - повышение активности АЛТ, АСТ; нечасто - повышение концентрации билирубина в крови; неизвестная частота (постмаркетинговые данные) - тяжелая печеночная недостаточность, включая случаи развития острой печеночной недостаточности, особенно у пациентов с тяжелым основным заболеванием (например, при сепсисе); гепатит. Со стороны мочевыводящих путей: нечасто - повышение концентрации креатинина в сыворотке крови; редко - острая почечная недостаточность (например, вследствие развития интерстициального нефрита). Дерматологические реакции: нечасто - сыпь, зуд, крапивница; неизвестная частота (постмаркетинговые данные) - токсический эпидермальный некролиз, синдром Стивенса-Джонсона, экссудативная многоформная эритема, реакции фотосенсибилизации (повышенной чувствительности к солнечному и ультрафиолетовому излучению), лейкоцитокластический васкулит. Реакции со стороны кожи и слизистых оболочек могут иногда развиваться даже после введения первой дозы препарата. Аллергические реакции: нечасто - крапивница; редко - ангионевротический отек; неизвестная частота (постмаркетинговые данные) - анафилактический шок, анафилактоидный шок. Анафилактические и анафилактоидные реакции могут иногда развиваться даже после введения первой дозы препарата. Со стороны костно-мышечной системы: нечасто - артралгия, миалгия; редко - поражение сухожилий, включая тендинит (например, ахиллова сухожилия), мышечная слабость, которая может быть особенно опасна у пациентов с псевдопаралитической миастенией (myasthenia gravis); неизвестная частота (постмаркетинговые данные) - рабдомиолиз, разрыв сухожилия (например, ахиллова сухожилия). Этот побочный эффект может наблюдаться в течение 48 ч после начала лечения и может носить двусторонний характер. Со стороны обмена веществ: нечасто - анорексия; редко - гипогликемия, особенно у пациентов с сахарным диабетом (возможные симптомы гипогликемии: волчий аппетит, нервозность, испарина, дрожь). Инфекционные и паразитарные заболевания: нечасто - грибковые инфекции, развитие резистентности патогенных микроорганизмов. Общие реакции: нечасто - астения; редко - пирексия (повышение температуры тела). Местные реакции: часто - реакция в месте введения (болезненность, гиперемия кожи). Другие возможные нежелательные эффекты, относящиеся ко всем фторхинолонамОчень редко: приступы порфирии (очень редкой болезни обмена веществ) у больных, уже страдающих этим заболеванием.
Передозировка
Симптомы: исходя из данных, полученных в токсикологических исследованияхпроведенных у животных, важнейшими ожидаемыми симптомами острой передозировки препарата Таваник являются симптомы со стороны ЦНС (нарушения сознания, включая спутанность сознания, головокружение и судороги). При постмаркетинговом применении препарата при передозировке наблюдались эффекты со стороны ЦНС, включая спутанность сознания, судороги, галлюцинации и тремор. Возможно развитие тошноты и возникновение эрозий слизистой оболочки ЖКТ. В клинико-фармакологических исследованиях, проведенных с дозами левофлоксацина, превышающими терапевтические, было показано удлинение интервала QT. Лечение: в случае передозировки требуется тщательное наблюдение за пациентом, включая ЭКГ-мониторирование. Лечение симптоматическое. В случае острой передозировки таблеток Таваник показано промывание желудка и введение антацидов для защиты слизистой оболочки желудка. Левофлоксацин не выводится посредством диализа (гемодиализа, перитонеального диализа и постоянного амбулаторного перитонеального диализа). Специфического антидота не существует.
Особые указания
С осторожностью применяют пациентам пожилого возраста (высокая вероятность наличия сопутствующего снижения функции почек). После нормализации температуры рекомендуется продолжать лечение не менее 48-78 ч. Длительность в/в вливания 500 мг (100 мл инфузиоиного раствора) должна составлять не менее 60 мин. Во время лечения необходимо избегать солнечного и искусственного УФ облучения во избежание повреждения кожных покровов (фотосенсибилизация). При появлении признаков тендинита левофлоксацин немедленно отменяют. Следует иметь в виду, что у больных с поражением головного мозга в анамнезе (инсульт, тяжелая травма) возможно развитие судорог, при недостаточности глюкoзo-6-фосфатдeгидpoгeназы - риск развития гемолиза. Влияние на способность к вождению автотранспорта и управлению механизмамиВ период лечения необходимо воздерживаться от занятий потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций.
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Информация предоставляется в справочных целях. Не занимайтесь самолечением. При первых признаках заболевания обратитесь к врачу.
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Дозы определяются характером и тяжестью инфекции, а также чувствительностью предполагаемого возбудителя. Пациентам с нормальной или умеренно нарушенной функцией почек (КК \u003e50 мл/мин) препарат рекомендуется назначать в следующих дозах. Внебольничная пневмония: по 500 мг 1-2 раза/сут (суточная доза - 500-1000 мг левофлоксацина). Курс лечения - 7-14 дней. Неосложненные инфекции мочевыводящих путей: 250 мг 1 раз/сут (суточная доза - 250 мг левофлоксацина). Курс лечения - 3 дня. Осложненные инфекции мочевыводящих путей (включая пиелонефрит): 250 мг 1 раз/сут. При тяжелых инфекциях возможно увеличение дозы. Курс лечения - 7-10 дней. Хронический бактериальный простатит: 500 мг 1 раз/сут (суточная доза - 500 мг левофлоксацина). Курс лечения - 28 дней. Септицемия/бактериемия: по 500 мг 1-2 раза/сут (суточная доза - 500-1000 мг левофлоксацина). Курс лечения - 10-14 дней. Инфекция брюшной полости: по 500 мг 1 раз/сут. Курс лечения - 7-14 дней в комбинации с антибактериальными препаратами, действующими на анаэробную флору. Инфекции кожи и мягких тканей: внутрь по 1 таб. 250 мг (250 мг левофлоксацина) 1 раз/сут, или по 2 таб. 250 мг или по 1 таб. 500 мг (500 мг левофлоксацина) 1-2 раза/сут (соответственно 500-1000 мг левофлоксацина в сут). Курс лечения - 7-14 дней. В составе комплексной терапии лекарственно-устойчивых форм туберкулеза Таваник назначают по 500 мг 1-2 раза/сут (500-1000 мг левофлоксацина/сут) до 3 мес. Пациентам с нарушением функции почек требуется коррекция режима дозирования в зависимости от величины КК."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Со стороны средечно-сосудистой системы: часто - флебит; редко - синусовая тахикардия, снижение АД; неизвестная частота (постмаркетинговые данные) - удлинение интервала QT. Со стороны системы кроветворения: нечасто - лейкопения, эозинофилия ; редко - нейтропения, тромбоцитопения; неизвестная частота (постмаркетинговые данные) - панцитопения, агранулоцитоз, гемолитическая анемия. Со стороны нервной системы: часто - головная боль, головокружение; нечасто - сонливость, тремор, дисгевзия (извращение вкуса); редко - парестезия, судороги; неизвестная частота (постмаркетинговые данные) - периферическая сенсорная невропатия, периферическая сенсорно-моторная невропатия, дискинезия, экстрапирамидные расстройства, потеря вкусовых ощущений, паросмия (расстройство ощущения запаха, особенно субъективное ощущение запаха, объективно отсутствующего), включая потерю обоняния. Со стороны психики: часто - бессонница; нечасто - чувство беспокойства, спутанность сознания; редко - психические нарушения (например, с галлюцинациями), депрессия, ажитация (возбуждение), нарушения сна, кошмарные сновидения; неизвестная частота (постмаркетинговые данные) - нарушения психики с нарушениями поведения с причинением себе вреда, включая суицидальные мысли и суицидальные попытки. Со стороны органа зрения: очень редко - нарушения зрения, такие как расплывчатость видимого изображения. Со стороны органа слуха и лабиринтные нарушения: нечасто - вертиго (чувство отклонения или кружения или собственного тела или окружающих предметов); редко - звон в ушах; неизвестная частота (постмаркетинговые данные) - снижение слуха. Со стороны дыхательной системы: нечасто - одышка; неизвестная частота (постмаркетинговые данные) - бронхоспазм, аллергический пневмонит. Со стороны пищеварительной системы: часто - диарея, рвота, тошнота; нечасто - боли в животе, диспепсия; неизвестная частота (постмаркетинговые данные) - геморрагическая диарея, которая в очень редких случаях может быть признаком энтероколита, включая псевдомембранозный колит. Со стороны печени и желчевыводящих путей: часто - повышение активности АЛТ, АСТ; нечасто - повышение концентрации билирубина в крови; неизвестная частота (постмаркетинговые данные) - тяжелая печеночная недостаточность, включая случаи развития острой печеночной недостаточности, особенно у пациентов с тяжелым основным заболеванием (например, при сепсисе); гепатит. Со стороны мочевыводящих путей: нечасто - повышение концентрации креатинина в сыворотке крови; редко - острая почечная недостаточность (например, вследствие развития интерстициального нефрита). Дерматологические реакции: нечасто - сыпь, зуд, крапивница; неизвестная частота (постмаркетинговые данные) - токсический эпидермальный некролиз, синдром Стивенса-Джонсона, экссудативная многоформная эритема, реакции фотосенсибилизации (повышенной чувствительности к солнечному и ультрафиолетовому излучению), лейкоцитокластический васкулит. Реакции со стороны кожи и слизистых оболочек могут иногда развиваться даже после введения первой дозы препарата. Аллергические реакции: нечасто - крапивница; редко - ангионевротический отек; неизвестная частота (постмаркетинговые данные) - анафилактический шок, анафилактоидный шок. Анафилактические и анафилактоидные реакции могут иногда развиваться даже после введения первой дозы препарата. Со стороны костно-мышечной системы: нечасто - артралгия, миалгия; редко - поражение сухожилий, включая тендинит (например, ахиллова сухожилия), мышечная слабость, которая может быть особенно опасна у пациентов с псевдопаралитической миастенией (myasthenia gravis); неизвестная частота (постмаркетинговые данные) - рабдомиолиз, разрыв сухожилия (например, ахиллова сухожилия). Этот побочный эффект может наблюдаться в течение 48 ч после начала лечения и может носить двусторонний характер. Со стороны обмена веществ: нечасто - анорексия; редко - гипогликемия, особенно у пациентов с сахарным диабетом (возможные симптомы гипогликемии: волчий аппетит, нервозность, испарина, дрожь). Инфекционные и паразитарные заболевания: нечасто - грибковые инфекции, развитие резистентности патогенных микроорганизмов. Общие реакции: нечасто - астения; редко - пирексия (повышение температуры тела). Местные реакции: часто - реакция в месте введения (болезненность, гиперемия кожи). Другие возможные нежелательные эффекты, относящиеся ко всем фторхинолонамОчень редко: приступы порфирии (очень редкой болезни обмена веществ) у больных, уже страдающих этим заболеванием."}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Симптомы: исходя из данных, полученных в токсикологических исследованияхпроведенных у животных, важнейшими ожидаемыми симптомами острой передозировки препарата Таваник являются симптомы со стороны ЦНС (нарушения сознания, включая спутанность сознания, головокружение и судороги). При постмаркетинговом применении препарата при передозировке наблюдались эффекты со стороны ЦНС, включая спутанность сознания, судороги, галлюцинации и тремор. Возможно развитие тошноты и возникновение эрозий слизистой оболочки ЖКТ. В клинико-фармакологических исследованиях, проведенных с дозами левофлоксацина, превышающими терапевтические, было показано удлинение интервала QT. Лечение: в случае передозировки требуется тщательное наблюдение за пациентом, включая ЭКГ-мониторирование. Лечение симптоматическое. В случае острой передозировки таблеток Таваник показано промывание желудка и введение антацидов для защиты слизистой оболочки желудка. Левофлоксацин не выводится посредством диализа (гемодиализа, перитонеального диализа и постоянного амбулаторного перитонеального диализа). Специфического антидота не существует."}}]},{"id":9,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"С осторожностью применяют пациентам пожилого возраста (высокая вероятность наличия сопутствующего снижения функции почек). После нормализации температуры рекомендуется продолжать лечение не менее 48-78 ч. Длительность в/в вливания 500 мг (100 мл инфузиоиного раствора) должна составлять не менее 60 мин. Во время лечения необходимо избегать солнечного и искусственного УФ облучения во избежание повреждения кожных покровов (фотосенсибилизация). При появлении признаков тендинита левофлоксацин немедленно отменяют. Следует иметь в виду, что у больных с поражением головного мозга в анамнезе (инсульт, тяжелая травма) возможно развитие судорог, при недостаточности глюкoзo-6-фосфатдeгидpoгeназы - риск развития гемолиза. Влияние на способность к вождению автотранспорта и управлению механизмамиВ период лечения необходимо воздерживаться от занятий потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций."}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"Противомикробное средство широкого спектра действия, фторхинолон. Действует бактерицидно. 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