Острый синусит, обострение хронического бронхита, неосложненные инфекции кожи и подкожных структур, внебольничная пневмония, включая внебольничную пневмонию, возбудителями которой являются штаммы микроорганизмов с множественной резистентностью к антибиотикам⃰, осложненные инфекции кожи и подкожных структур (включая инфицированную диабетическую стопу), ...
Гиперчувствительность к моксифлоксацину, другим хинолонам и любому другому компоненту препарата, Возраст до 18 лет, Беременность, период грудного вскармливания, Наличие в анамнезе патологии сухожилий, развившейся вследствие лечения антибиотиками хинолонового ряда, Врожденные или приобретенные удлинения интервала QT на кардиограмме, Нарушения электролитного ...
Мегафлокс - противомикробное средство из группы фторхинолонов, действует бактерицидно. Применяется при лечении заболеваний верхних и нижних дыхательных путей и кожных инфекций.
Фармакологические свойства
Моксифлоксацин - фторхинолоновый антибактериальный препарат IV поколения, ингибирует ДНК-гиразу и топоизомеразу IV, которые в бактериальной клетке осуществляют репликацию, рекомбинацию и репарацию ДНК.
Показания к применению
Острый синусит, обострение хронического бронхита, неосложненные инфекции кожи и подкожных структур, внебольничная пневмония, включая внебольничную пневмонию, возбудителями которой являются штаммы микроорганизмов с множественной резистентностью к антибиотикам⃰, осложненные инфекции кожи и подкожных структур (включая инфицированную диабетическую стопу), осложненные интраабдоминальные инфекции, включая полимикробные инфекции, в том числе внутрибрюшинные абсцессы, неосложненные воспалительные заболевания органов малого таза (в том числе сальпингиты и эндометриты).
Противопоказания
Гиперчувствительность к моксифлоксацину, другим хинолонам и любому другому компоненту препарата, Возраст до 18 лет, Беременность, период грудного вскармливания, Наличие в анамнезе патологии сухожилий, развившейся вследствие лечения антибиотиками хинолонового ряда, Врожденные или приобретенные удлинения интервала QT на кардиограмме, Нарушения электролитного баланса, особенно некоррегированная гипокалиемия, Острая ишемия миокарда, Клинически значимая брадикардия, Клинически значимая сердечная недостаточность со сниженной фракцией выброса левого желудочка, Наличие в анамнезе нарушений ритма, сопровождавшихся клинической симптоматикой, Одновременное применение с другими препаратами, удлиняющими интервал QT, В связи с ограниченным количеством клинических данных применение моксифлоксацина противопоказано пациентам с нарушением функции печени (класс С по классификации Чайлд-Пью) и пациентам с повышением трансаминаз более, чем в пять раз выше верхней границы нормы.
Применение при беременности и в период грудного вскармливания
Противопоказано
Способ применения и дозы
Внутрь, не разжевывая, запивая достаточным количеством воды, вне зависимости от приема пищи. Рекомендуемый режим дозирования моксифлоксацина: одна таблетка (400 мг) 1 раз в день при инфекциях, указанных выше. Не следует превышать рекомендованную дозу.
Побочное действие
Инфекционные и паразитарные заболевания: часто - грибковые суперинфекции. Со стороны системы кроветворения: нечасто - анемия, лейкопения, нейтpопения, тромбоцитопения, тромбоцитемия, удлинение пpотpомбинового вpемени/увеличение международного нормализованного отношения (МНО), редко - изменение концентрации тpомбопластина, очень редко - повышение концентрации пpотpомбина/уменьшение МНО. Со стороны иммунной системы: нечасто - аллергические реакции, зуд, сыпь, крапивница, эозинофилия, редко - анафилактические/анафилактоидные реакции, ангионевротический отек, включая отек гортани (потенциально угрожающий жизни), очень редко - анафилактический/анафилактоидный шок (в том числе потенциально угрожающий жизни). Со стороны обмена веществ: нечасто - гиперлипидемия, редко - гипергликемия, гиперурикемия. Психические расстройства: нечасто - тревожность, психомоторная гиперактивность/ажитация, редко - эмоциональная лабильность, депрессия (в очень редких случаях возможно поведение с тенденцией к самоповреждению, такое как суицидальные мысли или суицидальные попытки), галлюцинации, очень редко - деперсонализация, психотические реакции (потенциально проявляющиеся в поведении с тенденцией к самоповреждению, таком как суицидальные мысли и суицидальные попытки). Со стороны нервной системы: часто - головная боль, головокружение, нечасто - парестезии/дизестезии, нарушения вкусовой чувствительности (включая в очень редких случаях агевзию), спутанность сознания и дезориентация, нарушения сна, тремор, вертиго, сонливость, редко - гипестезия, нарушения обоняния (включая аносмию), атипичные сновидения, нарушение координации (включая нарушения походки вследствие головокружения или вертиго, в очень редких случаях ведущие к травмам в результате падения, особенно у пожилых пациентов), судороги с различными клиническими проявлениями (в том числе "grand mal" припадки), нарушения внимания, нарушения речи, амнезия, периферическая нейропатия и полинейропатия, очень редко - гиперестезия. Со стороны органа зрения: нечасто - нарушения зрения (особенно при реакциях со стороны ЦНС), очень редко - преходящая потеря зрения (особенно на фоне реакций со стороны ЦНС). Со стороны органа слуха и лабиринтные нарушения: редко - шум в ушах, ухудшение слуха, включая глухоту (обычно обратимое). Со стороны сердечно-сосудистой системы: часто - удлинение интервала QT у пациентов с сопутствующей гипокалиемией, нечасто - удлинение интервала QT, ощущение сердцебиения, тахикардия, вазодилятация, редко - желудочковые тахиаритмии, обмороки, повышение артериального давления, снижение артериального давления, очень редко - неспецифические аритмии, полиморфная желудочковая тахикардия (Torsade de Pointes), остановка сердца (преимущественно у лиц с предрасполагающими к аритмиям состояниями, такими как клинически значимая брадикардия, острая ишемия миокарда). Со стороны дыхательной системы, органов грудной клетки и средостения: нечасто - одышка (включая астматическое состояние). Со стороны желудочно-кишечного тракта: часто - тошнота, рвота, боли в животе, диарея, нечасто - сниженный аппетит и сниженное потребление пищи, запор, диспепсия, метеоризм, гастроэнтерит (кроме эрозивного гастроэнтерита), повышение активности амилазы, редко - дисфагия, стоматит, псевдомембранозный колит (в очень редких случаях ассоциированный с угрожающими жизни осложнениями). Нарушения со стороны печени и желчевыводящих путей: часто - повышение активности "печеночных" трансаминаз, нечасто - нарушения функции печени (включая повышение активности лактатдегидрогеназы), повышение концентрации билирубина, повышение активности гамма-глутамил-трансферазы, повышение в крови активности щелочной фосфатазы, редко - желтуха, гепатит (преимущественно холестатический), очень редко - фульминантный гепатит, потенциально приводящий к жизнеугрожающей печеночной недостаточности (включая фатальные случаи). Со стороны кожи и мягких тканей: очень редко - буллезные кожные реакции, например, синдром Стивенса-Джонсона или токсический эпидермальный некролиз (потенциально опасный для жизни). Со стороны скелетно-мышечной и соединительной ткани: нечасто - артралгия, миалгия, редко - тендинит, повышение мышечного тонуса и судороги, мышечная слабость, очень редко - разрывы сухожилий, артрит, нарушения походки вследствие повреждения опорно-двигательной системы, усиление симптомов миастении gravis. Со стороны почек и мочевыводящих путей: нечасто - дегидратация (вызванная диареей или уменьшением приема жидкости), редко - нарушение функции почек, почечная недостаточность (в результате дегидратации, что может привести к повреждению почек, особенно у пожилых пациентов с ранее существовавшими нарушениями функции почек.
Передозировка
Симптомы. Имеются ограниченные данные о передозировке моксифлоксацина. Не отмечено каких-либо побочных эффектов при применении моксифлоксацина в дозе до 1200 мг однократно и по 600 мг в течение 10 дней и более. Лечение. В случае передозировки следует ориентироваться на клиническую картину и проводить симптоматическую поддерживающую терапию с ЭКГ-мониторингом. Применение активированного угля сразу после приема препарата Мегафлокс может помочь предотвратить чрезмерное системное воздействие моксифлоксацина в случаях передозировки.
Особые указания
В некоторых случаях уже после первого применения препарата может развиться гиперчувствительность и аллергические реакции, о чем следует немедленно информировать врача. Очень редко, даже после первого применения препарата, анафилактические реакции могут прогрессировать до угрожающего жизни анафилактического шока. В этих случаях лечение препаратом Мегафлокс следует прекратить и немедленно начать проводить необходимые лечебные мероприятия (в том числе противошоковые). При применении моксифлоксацина у некоторых пациентов может отмечаться удлинение интервала QT. Препарат Мегафлокс следует применять с осторожностью у женщин и пациентов пожилого возраста. Поскольку женщины по сравнению с мужчинами имеют более длинный интервал QT, они могут быть более чувствительны к препаратам, удлиняющим интервал QT. Пожилые пациенты также более подвержены действию препаратов, оказывающих влияние на интервал QT. Степень удлинения интервала QT может нарастать с повышением концентрации препарата, поэтому не следует превышать рекомендованную дозу. Удлинение интервала QT сопряжено с повышенным риском желудочковых аритмий, включая полиморфную желудочковую тахикардию. Однако у пациентов с пневмонией корреляция между концентрацией моксифлоксацина в плазме крови и удлинением интервала QT отмечено не было. Ни у одного из 9000 пациентов, получавших моксифлоксацин, не отмечалось сердечно-сосудистых осложнений и летальных случаев, связанных с удлинением интервала QT. При применении моксифлоксацина может увеличиваться риск развития желудочковых аритмий у пациентов с предрасполагающими к аритмиям состояниями.
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микрокристаллическая целлюлоза, повидон, кроскармеллоза натрия, коллоидный диоксид кремния, стеарат магния."}}]},{"id":2,"name":"Описание","slug":"common_description","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Мегафлокс - противомикробное средство из группы фторхинолонов, действует бактерицидно. Применяется при лечении заболеваний верхних и нижних дыхательных путей и кожных инфекций."}}]},{"id":3,"name":"Фармакологические свойства","slug":"pharmacologic_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Моксифлоксацин - фторхинолоновый антибактериальный препарат IV поколения, ингибирует ДНК-гиразу и топоизомеразу IV, которые в бактериальной клетке осуществляют репликацию, рекомбинацию и репарацию ДНК."}}]},{"id":4,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Острый синусит, обострение хронического бронхита, неосложненные инфекции кожи и подкожных структур, внебольничная пневмония, включая внебольничную пневмонию, возбудителями которой являются штаммы микроорганизмов с множественной резистентностью к антибиотикам⃰, осложненные инфекции кожи и подкожных структур (включая инфицированную диабетическую стопу), осложненные интраабдоминальные инфекции, включая полимикробные инфекции, в том числе внутрибрюшинные абсцессы, неосложненные воспалительные заболевания органов малого таза (в том числе сальпингиты и эндометриты)."}}]},{"id":5,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Гиперчувствительность к моксифлоксацину, другим хинолонам и любому другому компоненту препарата, Возраст до 18 лет, Беременность, период грудного вскармливания, Наличие в анамнезе патологии сухожилий, развившейся вследствие лечения антибиотиками хинолонового ряда, Врожденные или приобретенные удлинения интервала QT на кардиограмме, Нарушения электролитного баланса, особенно некоррегированная гипокалиемия, Острая ишемия миокарда, Клинически значимая брадикардия, Клинически значимая сердечная недостаточность со сниженной фракцией выброса левого желудочка, Наличие в анамнезе нарушений ритма, сопровождавшихся клинической симптоматикой, Одновременное применение с другими препаратами, удлиняющими интервал QT, В связи с ограниченным количеством клинических данных применение моксифлоксацина противопоказано пациентам с нарушением функции печени (класс С по классификации Чайлд-Пью) и пациентам с повышением трансаминаз более, чем в пять раз выше верхней границы нормы."}}]},{"id":6,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Противопоказано"}}]},{"id":7,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Внутрь, не разжевывая, запивая достаточным количеством воды, вне зависимости от приема пищи. Рекомендуемый режим дозирования моксифлоксацина: одна таблетка (400 мг) 1 раз в день при инфекциях, указанных выше. Не следует превышать рекомендованную дозу."}}]},{"id":8,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Инфекционные и паразитарные заболевания: часто - грибковые суперинфекции. Со стороны системы кроветворения: нечасто - анемия, лейкопения, нейтpопения, тромбоцитопения, тромбоцитемия, удлинение пpотpомбинового вpемени/увеличение международного нормализованного отношения (МНО), редко - изменение концентрации тpомбопластина, очень редко - повышение концентрации пpотpомбина/уменьшение МНО. Со стороны иммунной системы: нечасто - аллергические реакции, зуд, сыпь, крапивница, эозинофилия, редко - анафилактические/анафилактоидные реакции, ангионевротический отек, включая отек гортани (потенциально угрожающий жизни), очень редко - анафилактический/анафилактоидный шок (в том числе потенциально угрожающий жизни). Со стороны обмена веществ: нечасто - гиперлипидемия, редко - гипергликемия, гиперурикемия. Психические расстройства: нечасто - тревожность, психомоторная гиперактивность/ажитация, редко - эмоциональная лабильность, депрессия (в очень редких случаях возможно поведение с тенденцией к самоповреждению, такое как суицидальные мысли или суицидальные попытки), галлюцинации, очень редко - деперсонализация, психотические реакции (потенциально проявляющиеся в поведении с тенденцией к самоповреждению, таком как суицидальные мысли и суицидальные попытки). Со стороны нервной системы: часто - головная боль, головокружение, нечасто - парестезии/дизестезии, нарушения вкусовой чувствительности (включая в очень редких случаях агевзию), спутанность сознания и дезориентация, нарушения сна, тремор, вертиго, сонливость, редко - гипестезия, нарушения обоняния (включая аносмию), атипичные сновидения, нарушение координации (включая нарушения походки вследствие головокружения или вертиго, в очень редких случаях ведущие к травмам в результате падения, особенно у пожилых пациентов), судороги с различными клиническими проявлениями (в том числе \"grand mal\" припадки), нарушения внимания, нарушения речи, амнезия, периферическая нейропатия и полинейропатия, очень редко - гиперестезия. Со стороны органа зрения: нечасто - нарушения зрения (особенно при реакциях со стороны ЦНС), очень редко - преходящая потеря зрения (особенно на фоне реакций со стороны ЦНС). Со стороны органа слуха и лабиринтные нарушения: редко - шум в ушах, ухудшение слуха, включая глухоту (обычно обратимое). Со стороны сердечно-сосудистой системы: часто - удлинение интервала QT у пациентов с сопутствующей гипокалиемией, нечасто - удлинение интервала QT, ощущение сердцебиения, тахикардия, вазодилятация, редко - желудочковые тахиаритмии, обмороки, повышение артериального давления, снижение артериального давления, очень редко - неспецифические аритмии, полиморфная желудочковая тахикардия (Torsade de Pointes), остановка сердца (преимущественно у лиц с предрасполагающими к аритмиям состояниями, такими как клинически значимая брадикардия, острая ишемия миокарда). Со стороны дыхательной системы, органов грудной клетки и средостения: нечасто - одышка (включая астматическое состояние). Со стороны желудочно-кишечного тракта: часто - тошнота, рвота, боли в животе, диарея, нечасто - сниженный аппетит и сниженное потребление пищи, запор, диспепсия, метеоризм, гастроэнтерит (кроме эрозивного гастроэнтерита), повышение активности амилазы, редко - дисфагия, стоматит, псевдомембранозный колит (в очень редких случаях ассоциированный с угрожающими жизни осложнениями). Нарушения со стороны печени и желчевыводящих путей: часто - повышение активности \"печеночных\" трансаминаз, нечасто - нарушения функции печени (включая повышение активности лактатдегидрогеназы), повышение концентрации билирубина, повышение активности гамма-глутамил-трансферазы, повышение в крови активности щелочной фосфатазы, редко - желтуха, гепатит (преимущественно холестатический), очень редко - фульминантный гепатит, потенциально приводящий к жизнеугрожающей печеночной недостаточности (включая фатальные случаи). Со стороны кожи и мягких тканей: очень редко - буллезные кожные реакции, например, синдром Стивенса-Джонсона или токсический эпидермальный некролиз (потенциально опасный для жизни). Со стороны скелетно-мышечной и соединительной ткани: нечасто - артралгия, миалгия, редко - тендинит, повышение мышечного тонуса и судороги, мышечная слабость, очень редко - разрывы сухожилий, артрит, нарушения походки вследствие повреждения опорно-двигательной системы, усиление симптомов миастении gravis. Со стороны почек и мочевыводящих путей: нечасто - дегидратация (вызванная диареей или уменьшением приема жидкости), редко - нарушение функции почек, почечная недостаточность (в результате дегидратации, что может привести к повреждению почек, особенно у пожилых пациентов с ранее существовавшими нарушениями функции почек."}}]},{"id":9,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Симптомы. Имеются ограниченные данные о передозировке моксифлоксацина. Не отмечено каких-либо побочных эффектов при применении моксифлоксацина в дозе до 1200 мг однократно и по 600 мг в течение 10 дней и более. Лечение. В случае передозировки следует ориентироваться на клиническую картину и проводить симптоматическую поддерживающую терапию с ЭКГ-мониторингом. Применение активированного угля сразу после приема препарата Мегафлокс может помочь предотвратить чрезмерное системное воздействие моксифлоксацина в случаях передозировки."}}]},{"id":10,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"В некоторых случаях уже после первого применения препарата может развиться гиперчувствительность и аллергические реакции, о чем следует немедленно информировать врача. Очень редко, даже после первого применения препарата, анафилактические реакции могут прогрессировать до угрожающего жизни анафилактического шока. В этих случаях лечение препаратом Мегафлокс следует прекратить и немедленно начать проводить необходимые лечебные мероприятия (в том числе противошоковые). При применении моксифлоксацина у некоторых пациентов может отмечаться удлинение интервала QT. Препарат Мегафлокс следует применять с осторожностью у женщин и пациентов пожилого возраста. Поскольку женщины по сравнению с мужчинами имеют более длинный интервал QT, они могут быть более чувствительны к препаратам, удлиняющим интервал QT. Пожилые пациенты также более подвержены действию препаратов, оказывающих влияние на интервал QT. Степень удлинения интервала QT может нарастать с повышением концентрации препарата, поэтому не следует превышать рекомендованную дозу. Удлинение интервала QT сопряжено с повышенным риском желудочковых аритмий, включая полиморфную желудочковую тахикардию. Однако у пациентов с пневмонией корреляция между концентрацией моксифлоксацина в плазме крови и удлинением интервала QT отмечено не было. Ни у одного из 9000 пациентов, получавших моксифлоксацин, не отмечалось сердечно-сосудистых осложнений и летальных случаев, связанных с удлинением интервала QT. 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