Regardless of the dose and duration of treatment to 18% of the administered dose tsefditorena excreted unchanged by the kidneys.
Studies labeled tsefditorena in healthy volunteers showed that nevsosavsheysya of the drug is excreted through the intestine, and a large proportion of tsefditorena transformed into inactive deca durabolin cycle. During hydrolysis tsefditorena pivoxil formed pivalate that excreted by the kidneys in the form pivaloilkarnitina conjugate.
Special patient groups
Pharmacokinetics tsefditorena pivoxil does not have significant differences in humans, depending on the floor.
When assigning identical doses tsefditorena concentration in elderly patients (age over 65 years), slightly higher compared to middle-aged adult population; parameters in these patients above about 26% and 33% respectively. Except in cases of severe renal and / or hepatic failure patients older dose adjustment is required.
Treatment of infections caused by susceptible microorganisms tsefditorenu:
- upper respiratory tract infections: acute tonzillofaringit, acute sinusitis;
- Lower respiratory tract infections: acute exacerbations of chronic bronchitis, community-acquired pneumonia;
- uncomplicated infections of the skin and subcutaneous fat: abscess, infected skin wounds, abscesses, folliculitis, impetigo and furunculosis.
- Hypersensitivity to tsefditorenu, other cephalosporins or to any other component of the drug;
- severe allergic reaction to penicillin and other beta-lactam antibiotics;
- hepatic insufficiency deca durabolin cycle;
- patients on hemodialysis;
- hypersensitivity reaction to the protein casein in history;
- Primary carnitine deficiency;
- Children up to age 12 years;
- simultaneous use tsefditorena pivoxil and blockers H2-histamine receptors.
Patients with hypersensitivity to other beta-lactam antibiotics because of the possibility of cross-allergic reactions.
The simultaneous use of aminoglycosides and diuretics (furosemide).
Patients with disorders of the gastrointestinal tract, including colitis history.
Pregnancy and lactation
Clinical data on the use tsefditorena pivoxil in pregnant women have not received. Although studies in animals have shown no embryotoxic or teratogenic effects of the drug, should not be used during pregnancy unless the expected benefit to the mother outweighs the potential risk to the fetus.
Data on penetration tsefditorena into breast milk is not enough. Therefore, when using the drug Spektratsef breast-feeding should be discontinued.
Dosage and administration:
The tablets should be swallowed whole, drinking plenty of water, preferably after a meal.
The recommended dose depends on the severity of the infection, the initial state of the patient and potential pathogens.
Adults and children over 12 years
- Acute faringotonzillit, acute sinusitis and deca durabolin cycle uncomplicated infections of the skin and subcutaneous fat: 200 mg every 12 hours for 10 days.
- Exacerbation of chronic bronchitis: 200 mg every 12 hours for 5 days.
- Community-acquired pneumonia: 200 mg every 12 hours for 14 days. In severe cases the recommended dose of 400 mg every 12 hours for 14 days.
For elderly patients, except in cases of severe violations of the liver and / or renal impairment, dose adjustment is required.
For patients with mild impairment of renal function dose adjustment is required. In patients with renal insufficiency moderate (creatinine clearance of 30-50 ml / min), the recommended dose should not exceed 200 mg twice a day. In patients with severe renal impairment (creatinine clearance less than 30 ml / min) the maximum daily dose should not exceed 200 mg.
In patients on hemodialysis, the recommended dose has not been established.
Abnormal liver function
in patients with mild or moderate hepatic impairment dose adjustment is required (class A or B on the Child-Pugh). In severe hepatic insufficiency data to assign the recommended dose is not obtained.
On the part of metabolism and nutrition
From the upper respiratory tract
Very rare: pharyngitis, rhinitis, sinusitis, tinnitus.
The respiratory system, thorax and mediastinum
Very rare: bronchospasm.
On the part of the gastro-intestinal tract
Very common:. Diarrhea
Common: nausea, abdominal pain, dyspepsia.
Rare: constipation, flatulence, vomiting, oral candidiasis, belching, pseudomembranous colitis, dry mucous membranes deca durabolin cycle of the mouth, dysgeusia.
Very rare: aphthous stomatitis.
On the part of the liver and biliary tract
Rare: abnormal liver function.
With the skin side and the subcutaneous fat
Rare: rash, pruritus, urticaria.
On the part of the musculoskeletal system and connective tissue disorders
Very rare: myalgia.
With the genitourinary system
Common: Candida vaginitis.
Rare: vaginitis, leucorrhoea.
Rare: Fever, fatigue, generalized pain, excessive sweating.
From the laboratory parameters
Sometimes: leukopenia, thrombocytosis, increased concentrations of alanine aminotransferase (ALT).
Rare: increase in blood clotting time, hyperglycemia, hypokalemia, bilirubinemia, increasing the concentration of aspartate aminotransferase (the ACT), alkaline phosphatase, albuminuria.
In addition, the described isolated cases of eosinophilia, trombotsitopenii, reducing the thromboplastin time, thrombocytopathy, increasing the concentration of lactate dehydrogenase (LDH), gapoproteinemii and increasing creatinine concentration.
: Isolated reports of the following adverse events have also been at the side of hematopoiesis – haemolytic anemia, lymphadenopathy; – from the water-electrolyte metabolism: dehydration; – the part of the psyche: dementia, depersonalization, emotional lability, euphoria, hallucinations, thought disorder, increased libido, collapse; – the part of the nervous system: amnesia, impaired coordination, muscular hypertonicity, meningitis, tremor; – by the organ of vision: impaired vision, disorders of the organ of vision, eye pain, blepharitis; – on the part of the cardiovascular system : atrial fibrillation, congestive heart failure, tachycardia, ventricular arrythmia, postural hypotension; – the part of the gastrointestinal tract: hemorrhagic colitis, ulcerative colitis, gastro-intestinal bleeding, glossitis, hiccups, change the language of color; – by mochevydelitelnoy system: dysuria, pain in the kidneys, nephritis, nocturia, polyuria, urinary incontinence, urinary tract infection; – the part of the genitourinary system: pain in the breast, menstrual disorders, metrorrhagia, erectile dysfunction; – other reactions: bad body odor, chills. The following adverse reactions have not been recorded as adverse events after administration tsefditorena, however, they are characteristic of the cephalosporins: – allergic reactions: allergic reactions, including Stevens-Johnson syndrome, erythema multiforme exudative, serum sickness, toxic epidermal necrolysis; – by mochevydelitelnoy system: violation kidney function, toxic nephropathy; – from the liver and biliary tract: cholestasis; – the part of hematopoiesis: aplastic anemia.
If overdose the patient may appear symptoms such as nausea, vomiting, diarrhea.
With the development of clinical drug overdose shown symptomatic therapy.
Interaction with other drugs
Joint application tsefditorena pivoxil and antacids containing magnesium hydroxide, aluminum, after meals reduces Cmax and AUC figures tsefditorena 14% and 11%, respectively. Although the clinical significance of this fact is not known, it is recommended that the period between the administration of antacids and tsefditorena pivoxil is 2 hours.
combined use of probenecid and tsefditorena pivoxil antibiotic reduces excretion by the kidneys, increasing the ratio Cmax by 49%, the AUC by 122% and increasing the half-life tsefditorena 53%.
Blockers H2-histamine receptors
Simultaneous administration of intravenous famotidine and tsefditorena pivoxil inside leads to a decrease in Cmax and AUC figures of 27% and 22%, respectively. Thus, the simultaneous use tsefditorena pivoxil blockers and H2-histamine receptors are not recommended.
With the development of hypersensitivity reactions treatment should be discontinued and appropriate treatment to the patient.
As with other broad-spectrum antibiotics, tsefditorenom treatment can lead to overgrowth of resistant organisms. For this reason it is recommended for monitoring patients receiving the drug, especially in the case of prolonged treatment.
In patients with severe renal impairment is recommended to periodically monitor renal function.
During the course of treatment with cephalosporins may reduce prothrombin activity. For this reason, in patients at risk (with renal or hepatic insufficiency or in the case of prior anticoagulants destination) is necessary to monitor the prothrombin time. The development of diarrhea during or after treatment, especially when it is severe, persistent character and the presence of blood impurities, may be indicative of pseudomembranous colitis. In mild cases of diarrhea only enough discontinuation of the drug, in more severe shown antibiotic therapy, which shows the sensitivity of Clostridium difficile, and the appointment of infusion therapy. As with other cephalosporins, tsefditoren can lead to false positive results of direct Coombs test, the detection of glucose in the urine using a copper recovery of the test, but not using the enzyme test. Because of the high risk of false-negative test results ferricyanide glucose determination in plasma or blood it is recommended that the background on tsefditorenom treatment to determine the concentration of glucose in the blood or plasma of patients used the glucose oxidase or glyukozogeksokinazny methods. With the combination of cephalosporins with aminoglycosides and / or loop diuretics, particularly in patients with impaired renal function may increase the risk of nephrotoxicity. Spektratsef contains approximately 13.1 mg (tablet dose of 200 mg), and 26.2 mg (tablet dose of 400 mg) of sodium per dose, which should be considered when appointing the drug to patients who are on a diet low in sodium.
Effects on ability to drive and / or other mechanisms
Reported impact tsefditorena pivoxil on the ability to drive and / or other mechanisms. At the same time it should be noted that taking deca durabolin cycle drug may be accompanied by undesirable phenomena such as vomiting, headache. steroide musculation achat winstrol prix achat steroide france