Instructions for Norfloxacin
Dosage form Norfloxacin:
Film-coated tablets of white or almost white color, round, biconvex; two layers are visible at the break - the core is from white to light yellow in color and the film shell. Composition 1 tab. norfloxacin 400 mg Excipients: lactose monohydrate - 85 mg, microcrystalline cellulose - 98 mg, croscarmellose sodium - 37 mg, water - 10 mg, povidone K25 - 24 mg, magnesium stearate - 6 mg. The composition of the film membrane: hypromellose - 11 mg, macrogol-4000 - 3 mg, titanium dioxide - 6 mg.
Pharmacodynamic Norfloxacin:
Antimicrobial agent from the group of fluoroquinolones. It has a bactericidal effect. It acts on the bacterial enzyme DNA gyrase, which provides supercoiling and, thus, the stability of bacterial DNA. Destabilization of the DNA chain leads to the death of bacteria.
It has a wide spectrum of antibacterial action and is active against most strains of microorganisms, both in vitro and in vivo. Sensitive in vivo: gram-positive aerobes - Enterococcus faecalis, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus aprophyticus, Streptococcus agalactiae; gram-negative aerobes - Citrobacter freundii, Enterobacter aerogenes, Enterobacter cloacae, Escherichia coli, Klebsiella pneumoniae, Neisseria gonorrhoeae, Proteus mirabilis, Proteus vulgaris, Pseudomonas aeruginosa, Serratia marcescens, Salmonella spp.
Indications Norfloxacin:
Infectious and inflammatory diseases caused by microorganisms sensitive to norfloxacin. For oral administration: diseases of the urinary tract, prostate, gastrointestinal tract, gonorrhea, prevention of relapse of urinary tract infections, bacterial infections in patients with granulocytopenia, "diarrhea of travelers."
For topical use: conjunctivitis, keratitis, keratoconjunctivitis, corneal ulcers, blepharitis, blepharoconjunctivitis, acute inflammation of the meibomian glands and dacryocystitis, prevention of eye infections after removal of a foreign body from the cornea or conjunctiva, after surgery and after chemical damage; external otitis media, acute otitis media, chronic otitis media, prevention of infectious complications during surgical interventions on the organ of hearing
Pharmacokinetics Norfloxacin:
When ingested, about 30-40% is absorbed, food intake reduces the rate of absorption. Plasma protein binding is 14%. Norfloxacin is well distributed in the tissues of the urogenital system. Penetrates through the placental barrier. About 30% is excreted in the urine unchanged.
Side effects Norfloxacin:
From the digestive system: nausea, heartburn, anorexia, diarrhea, abdominal pain. From the side of the central nervous system: headache, dizziness, feeling tired, sleep disturbances, irritability, anxiety. Allergic reactions: skin rash, itching, Quincke's edema. Co side of the urinary system: interstitial nephritis
Special conditions Norfloxacin:
It should be used with caution in patients with epilepsy, convulsive syndrome of another etiology, with severe impaired renal and hepatic function. During treatment, patients should receive a sufficient amount of fluid (under the control of diuresis). Norfloxacin should be taken at least 2 hours before or 2 hours after taking antacids or preparations containing iron, zinc, magnesium, calcium or sucralfate.
Contraindications Norfloxacin:
Pregnancy, lactation (breastfeeding), childhood and adolescence (up to 15 years), glucose-6-phosphate dehydrogenase deficiency, hypersensitivity to norfloxacin and other quinolone drugs.
Drug Interactions Norfloxacin:
With the simultaneous use of norfloxacin with warfarin, the anticoagulant effect of the latter is enhanced. With the simultaneous use of norfloxacin with cyclosporine, an increase in the concentration of the latter in blood plasma is noted.
With the simultaneous administration of norfloxacin and antacids or preparations containing iron, zinc, magnesium, calcium or sucralfate, the absorption of norfloxacin is reduced due to the formation of complexons with metal ions (the interval between their intake should be at least 4 hours).
With the simultaneous administration of norfloxacin reduces theophylline clearance by 25%, therefore, with simultaneous use, the dose of theophylline should be reduced.
The simultaneous administration of norfloxacin with drugs with the potential ability to lower blood pressure can cause a sharp decrease in blood pressure. In this regard, in such cases, as well as with the simultaneous introduction of barbiturates, anesthetics, heart rate, blood pressure, ECG indicators should be monitored.
Concomitant use with drugs that lower the epileptic threshold can lead to the development of epileptiform seizures. Reduces the effect of nitrofurans.
Dosage Norfloxacin Antimicrobial 400 mg:
Inside on an empty stomach (at least 1 hour before or 2 hours after eating) and drink plenty of fluids. In the absence of specific doctor's prescriptions, the following doses are recommended: a tablet (400 mg) 2 times a day.
The duration of treatment is from 7 to 14 days, if necessary, a longer treatment is carried out. In case of urinary tract infections - 400 mg 2 times a day, for 7-10 days; with uncomplicated cystitis - 3-7 days; with chronic recurrent urinary tract infection - up to 12 weeks; in acute bacterial gastroenteritis (shigellosis, salmonellosis) - 5 days; in acute gonococcal urethritis, pharyngitis, proctitis, cervicitis - once 800 mg.
For the prevention of infections (in patients with neutropenia) - 400 mg 2 times a day; for the prevention of bacterial gastroenteritis - 400 mg / day. For the prevention of diarrhea of travelers - 400 mg / day 1 day before departure and during the entire period of the trip (no more than 21 days). For the prevention of relapse of urinary tract infections - 200 mg / day. With bacterial prostatitis (acute and chronic) - 400 mg 2 times a day for 28 days. In patients with impaired renal function with creatinine clearance (CC) of more than 30 ml / min, dosage adjustment is not required. With CC below 30 ml / min and patients undergoing hemodialysis, 1/2 therapeutic dose is prescribed 2 times a day or the full dose 1 time per day.
