Cipgen-TZ

Cipgen-TZ

Ciprofloxacin, Tinidazole

Treatment of mixed infections caused by sensitive anaerobic and aerobic microorganisms:

chronic sinusitis,

lung abscess,

empyema,

intra-abdominal infections,

inflammatory gynecological diseases,

postoperative infections (with the possible presence of aerobic and anaerobic bacteria),

chronic osteomyelitis,

skin and soft tissue infections,

ulcers on the diabetic foot,

bedsores,

infection of the oral cavity (including periodontitis and periodontitis).

Treatment of diarrhea or dysentery of amoebic or mixed (amoebic and bacterial) etiology.

Inside, after eating, drink plenty of water.

It should not be broken, chewed or in any other way to destroy the pill.

Recommended dose for adults

Tsifran^® ST 250/300 mg — 2 tables. 2 times a day.

Tsifran^® ST 500/600 mg — 1 table. 2 times a day.

hypersensitivity to any derivatives of fluoroquinolone or imidazole,

hematological diseases,

organic neurological lesions,

suppression of bone marrow hematopoiesis,

porphyria,

children's age (up to 18 years).

With caution: severe atherosclerosis of the cerebral vessels, impaired cerebral circulation, mental illness, epilepsy, epileptic syndrome, severe renal and / or liver failure.

When using the drug in the elderly, there were no significant problems. However, in elderly patients, there may be an age-dependent decrease in kidney function, so caution should be exercised when using the drug in such patients.

From the digestive system: decreased appetite, dryness of the oral mucosa, "metallic" taste in the mouth, nausea, vomiting, diarrhea, abdominal pain, flatulence, cholestatic jaundice (especially in patients with previous liver diseases), hepatitis, hepatonecrosis.

From the central nervous system: headache, dizziness, increased fatigue, impaired coordination of movements (including locomotor ataxia), dysarthria, peripheral neuropathy, rarely convulsions, weakness, tremor, insomnia, increased sweating, increased intracranial pressure, confusion, depression, hallucinations, as well as other manifestations of psychotic reactions, migraine, fainting, cerebral artery thrombosis.

On the part of the senses: disorders of taste and smell, visual impairment (diplopia, change in color perception), tinnitus, hearing loss.

From the cardiovascular system: tachycardia, heart rhythm disorders, decreased blood pressure.

From the hematopoietic system: leukopenia, granulocytopenia, anemia, thrombocytopenia, leukocytosis, thrombocytosis, hemolytic anemia.

On the part of laboratory parameters: hypoprothrombinemia, increased activity of hepatic transaminases and alkaline phosphatase, hypercreatinemia, hyperbilirubinemia, hyperglycemia.

From the urinary system: hematuria, crystalluria (with alkaline urine and low diuresis), glomerulonephritis, dysuria, polyuria, urinary retention, decreased nitrogen-releasing kidney function, interstitial nephritis.

Allergic reactions: skin itching, urticaria, blistering, accompanied by bleeding, and the appearance of small nodules forming scabs, drug fever, spot hemorrhages on the skin (petechiae), swelling of the face or larynx, shortness of breath, eosinophilia, increased photosensitivity, vasculitis, erythema nodosum, erythema multiforme (including Stevens-Johnson syndrome), toxic epidermal necrolysis (syndrome Lyell).

Other: arthralgia, arthritis, tendovaginitis, tendon tears, asthenia, myalgia, superinfections (candidiasis, pseudomembranous colitis), flushes of blood to the face.

Treatment: therapy for overdose of the drug Tsifran^® CT should be symptomatic and include the following measures:

- induction of vomiting or gastric lavage,

- carrying out measures for adequate hydration of the body (infusion therapy),

- maintenance therapy.

There is no specific antidote.

A combined drug intended for the treatment of mixed infections caused by anaerobic and aerobic microorganisms, as well as gastrointestinal infections, such as diarrhea or dysentery, amoebic or mixed (amoebic and bacterial) nature.

Tinidazole it is effective against anaerobic microorganisms, such as Clostridium difficile, Clostridium perfringens, Bacteroides fragilis, Peptococcus and Peptostreptococcus anaerobius. Anaerobic microorganisms cause mainly diseases of the abdominal cavity, small pelvis, lungs or organs of the oral cavity. In anaerobic infections, a mixture of anaerobic and aerobic bacteria is most often present. Therefore, in case of mixed anaerobic infection, an antibiotic active against aerobic bacteria is added to the therapy.

Ciprofloxacin - broad-spectrum antibiotic, active against most aerobic gram-positive and gram-negative microorganisms, such as E.coli, Klebsiella spp., S.typhi and other strains Salmonella, P.mirabilis, P.vulgaris, Yersinia enterocoilitica, Ps.aeruginosa, Shigella flexneri, Shigella sonnei, H.ducreyi, H.influenzae, N.gonorrhoeae, M.catarrhalis, V.cholerae, B.fragilis, St.aureus (including methicillin-resistant strains), St.epidermidis, S.pyogenes, S.pneumoniae, Chlamidia, Mycoplasma, Legionella and Mycobacterium tuberculosis.

Both ciprofloxacin and tinidazole are well absorbed in the gastrointestinal tract. C_max each component is achieved within 1-2 hours. The total bioavailability of tinidazole is 100%, and the binding of plasma proteins is 12%. T_1/2 - about 12-14 hours. The drug quickly penetrates into the tissues of the body, reaching high concentrations there.

Tinidazole creates concentrations in the cerebrospinal fluid equal to its plasma concentrations, and undergoes reabsorption in the renal tubules. Tinidazole is excreted in the bile at concentrations slightly below 50% of its plasma concentration. About 25% of the dose is excreted unchanged in the urine. The metabolites make up 12% of the administered dose and are also excreted in the urine. Along with this, there is a slight excretion of tinidazole in the feces.

Ciprofloxacin it is well absorbed after oral administration. The bioavailability of ciprofloxacin is about 70%. When combined with food, the absorption of ciprofloxacin slows down. 20-40% of the drug is bound by plasma proteins. Ciprofloxacin penetrates well into liquid media and body tissues: lungs, skin, fat, muscle and cartilage tissues, as well as into bone tissue and organs of the urinary system, prostate. The drug is found in high concentrations in saliva, nasal mucus and bronchial secretions, semen, lymph, peritoneal fluid, bile and prostate secretions. Ciprofloxacin is partially metabolized by the liver. About 50% of the dose is excreted unchanged in the urine,15% - in the form of active metabolites, such as oxyciprofloxacin. The rest of the dose is excreted in the bile, partially reabsorbed. About 15-30% of ciprofloxacin is excreted in the feces. T_1/2 - about 3.5-4.5 h. T_1/2 it can be prolonged in severe renal insufficiency and in elderly patients.

• Quinolones/fluoroquinolones in combinations
• Other synthetic antibacterial agents in combinations

Tinidazole

Increases the effect of indirect anticoagulants (to reduce the risk of bleeding, the dose is reduced by 50%) and the effect of ethanol (disulfiram-like reactions).

It is compatible with sulfonamides and antibiotics (aminoglycosides, erythromycin, rifampicin, cephalosporins).

It is not recommended to prescribe with ethionamide.

Phenobarbital accelerates the metabolism.

Ciprofloxacin

Due to a decrease in the activity of microsomal oxidation processes in hepatocytes, it increases the concentration and lengthens the T_1/2 theophylline (and other xanthines, such as caffeine), oral hypoglycemic drugs, indirect anticoagulants, helps to reduce the prothrombin index.

When combined with other antimicrobial drugs (beta-lactam antibiotics, aminoglycosides, clindamycin, metronidazole), synergy is usually observed.

Increases the nephrotoxic effect of cyclosporine, there is an increase in serum creatinine, in such patients, it is necessary to monitor this indicator 2 times a week.

When taken simultaneously, it increases the effect of indirect anticoagulants.

Oral administration together with iron-containing drugs, sucralfate and antacid drugs containing Mg² , Ca² , A1³ it leads to a decrease in the absorption of ciprofloxacin, so it should be prescribed 1-2 hours before or 4 hours after taking the above drugs.

NSAIDs (excluding acetylsalicylic acid) increase the risk of seizures.

Didanosine reduces the absorption of ciprofloxacin due to the formation of complexes with Mg contained in didanosine² , A1³ .

Metoclopramide accelerates absorption, which reduces the time to reach its maximum concentration.

Co-administration of uricosuric drugs leads to a slowdown in the elimination (up to 50%) and an increase in the plasma concentration of ciprofloxacin.