Tsiprinol instructions for use tablets. Application instruction tsiprinol ® (ciprinol ®). Pregnancy and breastfeeding

Pills Tsiprinol have in their composition ciprofloxacin hydrochloride monohydrate , silicon dioxide, croscarmellose sodium, sodium carboxymethyl starch, magnesium stearate, povidone, microcrystalline cellulose, propylene glycol, titanium dioxide, talc.

In the solution Tsiprinol contains the following substances: ciprofloxacin lactate , sodium chloride, hydrochloric acid, water,

Release form

The drug is available as an infusion solution. It is a clear liquid with a yellowish-green hue.

A concentrate is also sold, which is used to prepare the solution. It is a clear or yellowish-greenish solution.

Tablets Tsiprinol 250 mg are biconvex, have a round shape, white color, bevelled edges. They are covered with a film shell, on one side of the tablet there is a notch.

Tablets Tsiprinol 500 mg biconvex, oval-shaped, white. The tablet is covered with a film shell, on the one hand there is a notch.

Tablets Tsiprinol 750 mg are oval in shape, have a white film shell, there is a notch on both sides of the tablet.

pharmachologic effect

Cyprinol (ciprofloxacin) has an antibacterial effect on the body. It is a second generation monofluorinated fluoroquinolone. Under its influence, topoisomerase II, an enzyme that determines the replication and biosynthesis of bacterial deoxyribonucleic acid, is inhibited. It takes an active part in the process of bacterial cell division and in the biosynthesis of proteins.

Tsiprinol has a bactericidal effect, it is most effective against gram-negative bacteria. Therefore, the drug is used in the treatment of diseases caused by these bacteria.

Also, a number of gram-positive bacteria are sensitive to Tsiprinol: Staphylococcus spp., Streptococcus spp. It also affects a number of intracellular microorganisms.

The high efficiency of the drug is noted in the treatment of infectious diseases provoked by Pseudomonas aeruginosa. Tsiprinol is inactive against chlamydia, anaerobes, mycoplasmas. Mushrooms, viruses, protozoa generally show resistance to the action of the drug.

Pharmacodynamics and pharmacokinetics

Ciprinol in the form of tablets is rapidly absorbed from the gastrointestinal tract. Its absorption is not affected by food intake, and its bioavailability is not reduced. Bioavailability is 50-85%. The maximum concentration of the active substance in the patient's blood is observed approximately 1-1.5 hours after taking the tablets. After absorption, the active substance is distributed in the tissues of the urogenital and respiratory tract, in synovial fluid, muscles, skin, fatty tissues, saliva, sputum, cerebrospinal fluid. It also enters cells (macrophages, neutrophils), which determines its effectiveness in the treatment of infectious diseases, in which pathogens are localized intracellularly.

As a result of biotransformation occurring in the liver, inactive metabolites appear. The drug is excreted from the body through the kidneys, as well as through the action of extrarenal mechanisms (with feces, with bile). The half-life of the drug from the body is from 5 to 9 hours. Therefore, for effective therapy, it is enough to take the drug twice a day.

After an intravenous infusion of a solution of Tsiprinol, the maximum concentration is reached after 1 hour. When administered intravenously, there is an active distribution in the tissues of the body, in which there is a higher concentration of the active substance compared to blood plasma. Ciprofloxacin crosses the placenta well.

In people with normal renal function, the half-life of the drug is 3 to 5 hours. In patients with renal insufficiency, the half-life increases to 12 hours.

After the infusion, the drug is excreted through the kidneys. Approximately 50-70% of the drug is excreted unchanged, another 10% is excreted as metabolites, the rest is through the digestive tract. A small percentage of the active substance is excreted in breast milk.

Indications for use Tsiprinol

Ciprinol is prescribed when it is necessary to treat infections that were provoked by microorganisms with high sensitivity to ciprofloxacin, from which a person develops a certain disease. Therefore, the indications for the use of the drug are as follows:

• infectious diseases of the respiratory tract: , cystic fibrosis, bronchiectasis, etc.;
• infectious ENT diseases :, mastoiditis, ;
• infectious diseases of the urinary tract and kidneys : , ;
• infectious diseases of the genital organs, as well as other organs of the small pelvis :, epididymitis, salpingitis, etc .;
• infectious diseases of the abdominal cavity : , cholangitis, intraperitoneal abscess, developing due to infection, etc .;
• skin and soft tissue infections : ulcers, burns and wounds of infectious origin, phlegmon,;
• infectious diseases of the musculoskeletal system : septic arthritis, ;
• the development of sepsis, infections in people with impaired;
• preventive measures to prevent the development of infections during surgical and orthopedic operations;
• therapy and prevention of pulmonary anthrax.

Contraindications

Do not prescribe Tsiprinol for the following diseases and conditions:

• a high level of sensitivity to ciprofloxacin, other drugs belonging to the group of fluoroquinolones or to any other components of the drug.
• and feeding time
• age up to 18 years (with the exception of the treatment of complications caused by Pseudomonas aeruginosa in children from 5 to 17 years old who suffer from cystic fibrosis of the lungs; also used for the treatment and prevention of anthrax in children);
• you can not use the drug at the same time with.

With caution, Ciprinol is prescribed to patients with severe cerebral vessels, impaired blood flow in the brain, as well as to people suffering from mental illness, renal or hepatic insufficiency. The condition of the elderly who are being treated with the drug, as well as those who have a deficiency of glucose-6-phosphate dehydrogenase, should be closely monitored.

Side effects

• Digestive system : a complex of dyspeptic phenomena, hepatonecrosis, cholestatic jaundice, pseudomembranous colitis.
• Central nervous system: , high level and , fainting, convulsions, agitation, increased ICP, impaired consciousness, hallucinations, other psychotic reactions.
• Sense organs: impaired vision, smell, hearing, periodic appearance of tinnitus.
• The cardiovascular system : problems with heart rhythm, lowering blood pressure, periodic flushing of blood to the face.
• Hematopoietic system : anemia, leukopenia, thrombocytopenia, granulocytopenia, thrombocytosis, leukocytosis.
• urinary system : crystalluria, hematuria, , polyuria, dysuria, albuminuria, bleeding, nephritis, decreased nitrogen excretion of the kidneys.
• Allergy manifestations :, skin itching, blistering and bleeding, pinpoint hemorrhages, drug fever, edema, vasculitis, exanthema, etc.
• Musculoskeletal system : , arthralgia, tendon ruptures, tendovaginitis, myalgia, .
• Other manifestations : , sensitivity to light, a state of general weakness.
• According to laboratory parameters : increased activity of hepatic transaminases and alkaline phosphatase, hypoprothrombinemia, hyperuricemia, hypercreatininemia, hyperbilirubinemia, hyperglycemia.
• With infusion, local reactions may occur.

Application instruction of Tsiprinol (Way and dosage)

Both intravenous injection of a solution of Ciprinol and Ciprinol 500 mg (tablets) are administered twice a day. In mild forms of infectious diseases of the urinary or respiratory tract, as well as when a single dose of the drug is prescribed 250 mg. In severe forms of diseases or complicated infections, the patient should take 500 or 750 mg of the drug.

The instruction for Tsiprinol 500 mg provides that for gonorrhea the drug is taken in this dose once. If intravenous administration of the drug is practiced, it is necessary to carry out a slow infusion, while the dose of the drug is 200-400 mg. If the patient is diagnosed with acute, 100 mg of Tsiprinol is injected intravenously once. In order to prevent postoperative infectious complications, approximately 1 hour before the start of surgery, the patient is administered 200-400 mg of Tsiprinol.

If the patient has a violation in the work of the kidneys, then the daily dose of drugs for oral administration is reduced by half.

You should drink the tablets before meals, while it is important to drink the drug with plenty of water.

Overdose

In case of an overdose, a number of symptoms may occur: headache, vomiting, nausea, diarrhea. In case of a severe overdose, disturbances of consciousness, tremor, convulsions, and manifestation of hallucinations are possible.

Symptomatic therapy is carried out, it is important to ensure that the patient receives a sufficient amount of fluid, to carry out gastric lavage. Laxatives, activated charcoal are also prescribed.

Interaction

If treated simultaneously Tsiprinol And Didanosine, then there is a decrease in the absorption of ciprofloxacin.

Under the influence of ciprofloxacin, the concentration increases and the half-life of theophylline and other xanthines from the body increases.

With parallel treatment with ciprofloxacin and oral hypoglycemic agents, as well as indirect anticoagulants, the prothrombin index decreases.

It is possible to develop seizures while taking ciprofloxacin and NSAIDs.

The absorption of ciprofloxacin may decrease with parallel treatment with antacids, drugs that contain aluminum, iron, zinc, and magnesium ions. It is important to ensure that the interval between taking these drugs is at least 4 hours.

If ciprofloxacin and are used simultaneously, then the nephrotoxic effect of the latter is enhanced.

With alcohol

It is forbidden to take alcoholic beverages during treatment with Tsiprinol.

children

The drug can be prescribed for the treatment of children and adolescents under 18 years of age only if it is necessary to treat and prevent anthrax, as well as in the treatment of complications caused by Pseudomonas aeruginosa in children with cystic fibrosis of the lungs.

During pregnancy and lactation

Do not prescribe Tsiprinol for the treatment of pregnant women, as well as nursing mothers. Breastfeeding should be stopped immediately.

Tsiprinol - a new description of the drug, you can see the pharmacological action, side effects, dosage of the drug Tsiprinol. Useful reviews about Tsiprinol -

A broad-spectrum antimicrobial drug from the group of fluoroquinolones.
Preparation: CYPRINOL®
The active substance of the drug: ciprofloxacin
ATX encoding: J01MA02
CFG: Antibacterial drug of the fluoroquinolone group
Registration number: P No. 014323/02
Date of registration: 22.07.08
The owner of the reg. credit: KRKA d.d. (Slovenia)

Release form Tsiprinol, drug packaging and composition.

Tablets, film-coated, white, round, biconvex, with bevelled edges and a notch on one side. Film-coated tablets 1 tab. ciprofloxacin (as hydrochloride monohydrate) 250 mg
Excipients: sodium carboxymethyl starch, anhydrous colloidal silicon dioxide, sodium croscarmellose, magnesium stearate, povidone, microcrystalline cellulose, propylene glycol, talc, titanium dioxide (E171).


Tablets, film-coated, white, oval, biconvex, notched on one side. Film-coated tablets 1 tab. ciprofloxacin (as hydrochloride monohydrate) 500 mg
Excipients: sodium carboxymethyl starch, anhydrous colloidal silicon dioxide, croscarmellose sodium, magnesium stearate, povidone, microcrystalline cellulose.
The composition of the film shell: hypromellose, propylene glycol, talc, titanium dioxide.
10 pieces. - blisters (1) - packs of cardboard.
Tablets, coated white or almost white, oval, with a notch on both sides. Coated tablets 1 tab. ciprofloxacin (as hydrochloride monohydrate) 750 mg
Excipients: microcrystalline cellulose, sodium starch glycolate, povidone, sodium carboxymethylcellulose, colloidal silicon dioxide, magnesium stearate, hydroxypropylmethylcellulose (hypromellose), propylene glycol, talc, titanium dioxide (E171).
10 pieces. - blisters (1) - packs of cardboard.
10 pieces. - blisters (2) - packs of cardboard.
Concentrate for solution for infusion in the form of a clear, colorless or slightly greenish-yellow solution, without mechanical impurities. Concentrate for solution for infusions 1 ml 1 amp. ciprofloxacin (as lactate) 10 mg 100 mg
Excipients: lactic acid, hydrochloric acid, disodium edetate, water for injections.
10 ml - ampoules (5) - blister packs (1) - cardboard packs.
Solution for infusion transparent, yellowish-greenish color. Solution for infusion 1 ml 1 vial. ciprofloxacin (as lactate) 2 mg 100 mg

50 ml - bottles (1) complete with bottle holder - packs of cardboard.
Solution for infusion transparent, yellowish-greenish color. Solution for infusion 1 ml 1 vial. ciprofloxacin (as lactate) 2 mg 200 mg
Excipients: sodium lactate, sodium chloride, hydrochloric acid, water for injection.
100 ml - bottles (1) complete with bottle holder - packs of cardboard.
Solution for infusion transparent, yellowish-greenish color. Solution for infusion 1 ml 1 vial. ciprofloxacin (as lactate) 2 mg 400 mg
Excipients: sodium lactate, sodium chloride, hydrochloric acid, water for injection.
200 ml - bottles (1) complete with bottle holder - cardboard packs.
The description of the drug is based on the officially approved instructions for use.

Pharmacological action Tsiprinol

A broad-spectrum antimicrobial drug from the group of fluoroquinolones. Acts bactericidal. It inhibits the enzyme DNA-gyrase of bacteria, as a result of which DNA replication and the synthesis of cellular proteins of bacteria are disrupted. Ciprofloxacin acts both on multiplying microorganisms and on microorganisms that are in the resting phase.
The drug is active against gram-negative bacteria: Escherichia coli, Salmonella spp., Shigella spp., Citrobacter spp., Klebsiella spp., Enterobacter spp., Proteus mirabilis, Proteus vulgaris, Serratia marcescens, Hafnia alvei, Edwardsiella tarda, Providencia spp., Morganella morganii, Vibrio spp., Yersinia spp., Haemophilus spp., Pseudomonas aeruginosa, Moraxella catarrhalis, Aeromonas spp., Pasteurella multocida, Plesiomonas shigelloides, Campylobacter jejuni, Neisseria spp.; intracellular microorganisms: Legionella pneumophila, Brucella spp., Chlamydia trachomatis, Listeria monocytogenes, Mycobacterium tuberculosis, Mycobacterium kansasii, Mycobacterium avium-intracellulare; Gram-positive bacteria: Streptococcus spp. (including Streptococcus pyogenes, Streptococcus agalactiae), Staphylococcus spp. (including Staphylococcus aureus, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus saprophyticus). Most methicillin-resistant staphylococci are also resistant to ciprofloxacin.
Streptococcus pneumoniae, Enterococcus faecalis are moderately sensitive to the drug.
Corynebacterium spp., Bacteroides fragilis, Pseudomonas cepacia, Pseudomonas maltophila, Ureaplasma urealyticum, Clostridium difficile, Nocardia asteroides are resistant to the drug.
The effect of the drug against Treponema pallidum has not been studied enough.
When taking Tsiprinol, there is no development of parallel resistance to other antibiotics that do not belong to the group of gyrase inhibitors, which makes it highly effective against bacteria that are resistant to aminoglycosides, penicillins, cephalosporins, tetracyclines.

Pharmacokinetics of the drug.

Suction
After oral administration, ciprofloxacin is rapidly absorbed from the gastrointestinal tract. Eating slows down absorption, but does not affect the value of Cmax and bioavailability. Bioavailability varies from 50% to 85%. Cmax in the blood serum of healthy volunteers after oral administration of the drug at a dose of 250 mg, 500 mg, 750 mg and 1000 mg is achieved after 1-1.5 hours and is 0.76 mg / ml, 1.6 mg / ml, 2.5 mg / ml and 3.4 mg / ml respectively.
Distribution
Ciprofloxacin is well distributed in tissues and body fluids, with high concentrations found in bile, lungs, kidneys, liver, gallbladder, uterus, seminal fluid, prostate tissue, tonsils, endometrium, fallopian tubes and ovaries. The concentration of ciprofloxacin in these tissues is higher than in the blood serum. Ciprofloxacin also penetrates well into the liquid media of the eye, bones, bronchial secretions, saliva, skin, muscles, pleura, peritoneum and lymph. It penetrates into the cerebrospinal fluid in a small amount, the concentration of ciprofloxacin in non-inflamed meninges is 6-10% of that in the blood serum, in inflamed meninges - 14-37%. The concentration of ciprofloxacin in neutrophils is 2-7 times higher than in blood serum.
Vd is 2-3.5 l / kg.
Plasma protein binding - 30%.
Penetrates through the placental barrier.
Metabolism and excretion
Biotransformed in the liver (15-30%) with the formation of inactive metabolites (diethylciprofloxacin, sulfocyprofloxacin, oxyciprofloxacin, formylciprofloxacin). It is excreted mainly in the urine (50-70%); 15-30% - with feces. T1 / 2 is 3-5 hours.

Pharmacokinetics of the drug.

in special clinical situations
In chronic renal failure, T1 / 2 increases to 12 hours.

Indications for use:

Infectious and inflammatory diseases caused by microorganisms sensitive to the drug, including:
- respiratory tract infections;
- infections of the ear, throat and nose;
- infections of the kidneys and urinary tract;
- infections of the genital organs (gonorrhea, prostatitis, adnexitis, postpartum infections);
- infections of the digestive system (including the mouth, teeth, jaws), gallbladder and biliary tract;
- infections of the skin, mucous membranes and soft tissues;
- infections of the musculoskeletal system;
- sepsis;
- peritonitis;
- prevention and treatment of infections in patients with reduced immunity (against the background of immunosuppressant therapy).

Dosage and method of application of the drug.

set individually, depending on the location and severity of the infection, the state of the body, age, body weight, kidney function of the patient.
For uncomplicated diseases of the kidneys and urinary tract, the drug is prescribed 250 mg 2 times / day, for complicated ones - 500 mg 2 times / day.
In diseases of the lower respiratory tract - 250 mg 2 times / day, in severe cases - 500 mg 2 times / day.
In the treatment of gonorrhea, the drug is prescribed once at a dose of 250-500 mg.
With enteritis, severe colitis, gynecological infections, prostatitis, osteomyelitis - 500 mg 2 times / day.
For the treatment of diarrhea - 250 mg 2 times / day.
The duration of treatment depends on the severity of the disease.
For patients with impaired renal function, a single dose of the drug for oral administration is half the average daily dose.
In chronic renal failure, the drug is prescribed depending on creatinine clearance. Creatinine clearance (ml/min) Dose >50 usual

Dosage and method of application of the drug.

30-50 250-500 mg once every 12 hours 5-29 250-500 mg once every 18 hours
For patients on hemodialysis or peritoneal dialysis, the drug is prescribed after dialysis at a dose of 250-500 mg 1 time per 24 hours.
Tablets should be taken on an empty stomach with a sufficient amount of liquid.
Perhaps in / in the introduction of the drug. The dose of Tsiprinol is determined depending on the severity of the disease, type of infection, body condition, age, body weight, kidney function of the patient.
The average recommended single dose is 200 mg (for severe infections - 400 mg), the frequency of administration is 2 times / day; duration of treatment - 1-2 weeks, if necessary, and more.
The drug can be administered in / in a stream, but more preferably in / in a drip for 30 minutes (200 mg) and 60 minutes (400 mg).
In acute gonorrhea, 100 mg of the drug is administered once.
For the prevention of postoperative infections - 30-60 minutes before surgery, 200-400 mg of Tsiprinol are administered intravenously.

Side effects of Tsiprinol:

On the part of the digestive system: nausea, vomiting, diarrhea, pseudomembranous colitis, flatulence, loss of appetite, cholestatic jaundice (especially in patients with previous liver diseases), hepatitis, hepatonecrosis, increased activity of hepatic transaminases, alkaline phosphatase, LDH, bilirubin.
From the side of the central nervous system and peripheral nervous system: headache, dizziness, fatigue, anxiety, tremor, increased intracranial pressure, peripheral paralgesia, insomnia, nightmares, confusion, depression, hallucinations and other manifestations of psychotic reactions (occasionally progressing to states, in which the patient may harm himself), fainting, migraine, cerebral artery thrombosis.
On the part of the senses: taste and smell disorders, visual impairment (diplopia, change in color perception), tinnitus, hearing loss.
From the side of the cardiovascular system: tachycardia, cardiac arrhythmias, arterial hypotension, hot flashes (with intravenous administration).
From the hemopoietic system: eosinophilia, leukopenia, thrombocytopenia, neutropenia; with intravenous administration, granulocytopenia, anemia, thrombocytosis, hemolytic anemia are also possible.
From the musculoskeletal system: rarely - arthritis, tendovaginitis, tendon rupture; arthralgia, myalgia (with intravenous administration).
From the urinary system: crystalluria, interstitial nephritis, glomerulonephritis, dysuria, polyuria, albuminuria, hematuria, increased levels of urea, creatinine; urinary retention, decreased nitrogen excretion by the kidneys.
Allergic reactions: pruritus, urticaria, angioedema, Stevens-Johnson syndrome, arthralgia; vasculitis, erythema nodosum, exudative erythema multiforme, Lyell's syndrome (with intravenous administration).
Adverse reactions associated with chemotherapeutic action: candidiasis.
Others: general weakness, photosensitivity; increased sweating, hyperglycemia (with intravenous administration).
Local reactions: with a / in the introduction - pain and burning, phlebitis.

Contraindications to the drug:

Pseudomembranous colitis (for intravenous administration);
- deficiency of glucose-6-phosphate dehydrogenase (for intravenous administration);
- pregnancy;
- lactation period (breastfeeding);
- children and adolescents up to 18 years;
- hypersensitivity to ciprofloxacin or other drugs from the group of fluoroquinolones.
With caution, the drug is prescribed for atherosclerosis of cerebral vessels, cerebrovascular accidents, mental illness, epilepsy, convulsive syndrome, severe renal or hepatic insufficiency, elderly patients.

Use during pregnancy and lactation.

The drug is contraindicated for use during pregnancy and lactation (breastfeeding).

Special instructions for the use of Tsiprinol.

If severe and prolonged diarrhea develops during or after treatment with ciprofloxacin, the diagnosis of pseudomembranous colitis should be excluded, which requires immediate discontinuation of the drug and the appointment of appropriate treatment.
If pain occurs in the tendons or when the first signs of tendovaginitis appear, treatment should be discontinued due to the fact that isolated cases of inflammation and even rupture of the tendons during treatment with fluoroquinolones have been described.
During the treatment period, in order to avoid the development of crystalluria, it is unacceptable to increase the recommended daily dose. Patients should receive plenty of fluids to maintain normal diuresis and acid urine.
Due to possible photosensitivity during treatment with Tsiprinol, contact with direct sunlight should be avoided.
Influence on the ability to drive vehicles and control mechanisms
When using the drug, one should refrain from engaging in potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions.

Drug overdose:

Treatment: specific antidote is unknown. Gastric lavage is indicated, monitoring of the patient's condition, if necessary, symptomatic therapy is carried out. It is necessary to ensure sufficient fluid intake in the body. With the help of hemodialysis or peritoneal dialysis, a small amount of ciprofloxacin (less than 10%) can be removed.

Interaction of Tsiprinol with other drugs.

With the simultaneous use of Tsiprinol with didanosine, the absorption of ciprofloxacin is reduced due to the formation of complexes of ciprofloxacin with magnesium and aluminum salts contained in didanosine.
Due to a decrease in the activity of microsomal oxidation processes in hepatocytes, ciprofloxacin increases the concentration and increases the half-life of theophylline and other xanthines.
With the simultaneous use of ciprofloxacin and oral hypoglycemic drugs, indirect anticoagulants, a decrease in the prothrombin index is noted.
With the simultaneous use of ciprofloxacin and NSAIDs (excluding acetylsalicylic acid), the risk of convulsions increases.
Simultaneous administration of antacids, as well as preparations containing aluminum, zinc, iron and magnesium ions, can cause a decrease in the absorption of ciprofloxacin, so the interval between the appointment of these drugs should be at least 4 hours.
With the simultaneous use of ciprofloxacin and cyclosporine, the nephrotoxic effect of the latter is enhanced.
Metoclopramide accelerates the absorption of ciprofloxacin, which leads to a decrease in the time to reach its maximum plasma concentration.
Co-administration of uricosuric drugs leads to a slowdown in excretion (up to 50%) and an increase in the plasma concentration of ciprofloxacin.
When combined with other antimicrobials (beta-lactam antibiotics, aminoglycosides, clindamycin, metronidazole), synergism is usually observed. Cyprinol can be used in combination with azlocillin and ceftazidime for infections caused by Pseudomonas spp.; with mezlocillin, azlocillin and other beta-lactam antibiotics - for streptococcal infections; with isoxazolpenicillins and vancomycin - with staphylococcal infections; with metronidazole and clindamycin - for anaerobic infections.

Conditions of sale in pharmacies.

The drug is dispensed by prescription.

Terms of storage conditions of the drug Tsiprinol.

The drug should be stored in a place protected from light and moisture, out of the reach of children, at a temperature not exceeding 25°C. Shelf life - 5 years.

Latin name: Ciprinol
ATX code: J01MA02
Active substance: Ciprofloxacin
hydrochloride monohydrate
Manufacturer: Krka, Slovenia
Pharmacy leave condition: On prescription
Price: from 70 to 130 rubles.

"Ciprinol" is an antimicrobial drug, it belongs to the fluoroquinolones. It is active in relation to a number of microbes, both during their division and at rest. It acts on gram-positive bacteria and non-gram-staining bacteria. It is effective against microorganisms that are resistant to penicillin, sulfonamides, nitrofurans and a number of other antibiotics. The drug is ineffective against anaerobic species, mycoplasma and chlamydia. Mushrooms, viral forms and most of the simplest organisms are resistant to the effects of "Ciprinol". Due to the wide spectrum of action and rapid absorption, it has a strong therapeutic effect.

Indications for use

Tablets "Ciprinol" are prescribed to patients with infectious and inflammatory diseases with the presence of complications and uncomplicated, caused by pathogens sensitive to the effects of ciprofloxacin. An antibiotic is used to treat the following inflammations and infectious diseases:

• Respiratory systems: various pneumonias (except pneumococcal type), acute and chronic bronchitis at the time of deterioration, bronchiectasis, tuberculosis, cystic fibrosis (pulmonary form)
• Throat, ear and nose: inflammatory processes in the frontal and maxillary sinuses, inflammation of the middle ear, palatine tonsils, throat mucosa, mastoid process

• Abdominal cavity, digestive system and bile ducts: inflammation of the peritoneum, intraperitoneal abscess, salmonellosis, shigellosis, typhoid fever, cholangitis, campylobacteriosis, cholera and yersiniosis
• Urinary system: inflammation of the urethra and bladder, as well as the renal pelvis
• Organs of the reproductive system and other organs located in the small pelvis: inflammation of the prostate gland, testes and their appendages, ovaries, endometrial layer of the uterus, fallopian tubes, uterine appendages, pelvic peritoneum; tubular abscess, chancroid, chlamydia, gonorrhea
• Bone and joint tissues: osteomyelitis, septic inflammation of the joints
• Muscle tissue, epithelium and dermis: suppuration, wounds and ulcers with infection, phlegmon, burns
• Infections with a reduced immune response (as a result of treatment with immunosuppressants or due to neutropenia).

Compound

Tablet "Ciprinol" contains: active substance - ciprofloxacin hydrochloride monohydrate; auxiliary components - anhydrous colloidal silicon oxide IV, povidone sorbent, MCC, magnesium stearate salt, cellulose sodium salt, sodium carboxymethylcellulose. The shell contains: titanium oxide IV, 1,2-dioxypropane, talc, hydroxypropyl methylcellulose.

The solution for infusion contains: active substance - ciprofloxacin, represented by lactate salts; auxiliary components - sodium lactate, hydrochloric acid, saline.

Medicinal properties

"Ciprinol" has a bactericidal effect. It has an inhibitory effect on one of the main bacterial enzymes, DNA gyrase, which makes it impossible to duplicate and synthesize the DNA molecule. This disrupts the synthesis of bacterial protein, as a result of which the cell is unable to multiply and function.

"Ciprinol" as tablets is well absorbed in the stomach and reaches its highest content in the blood 1-1.5 hours after ingestion, if the instructions are followed. The presence of food in the stomach does not reduce the bioavailability of the drug, although it slows down the absorption process.

Biotransformation occurs in the liver, after which metabolites with low activity are formed. The drug is excreted both with the help of the kidneys and through the gastrointestinal tract (excreted with bile and feces). The elimination half-life is 4.5 to 9 hours.

The average price is from 50 to 130 rubles.

"Ciprinol", tablets

Tablets in a light film:

1. 250 mg of ciprofloxacin, contained in a 291 g tablet. Round-shaped discs with a bevelled edge and a notch on one of the surfaces, No. 10, packed in a blister and a cardboard box
2. 500 mg ciprofloxacin, contained in a 582 g tablet. Oval-shaped convex discs with a notch on the surface on one side, No. 10, packed in a blister and a carton
3. 750 mg of ciprofloxacin, contained in a tablet weighing 873 g. Oval-shaped discs with a notch on two surfaces, No. 10 and No. 20, packed in a blister and a cardboard box.

Mode of application

These tablets are recommended to be taken orally on an empty stomach, swallowed whole with water. The dosage is selected individually, taking into account the type of infection and its severity, depending on the age, weight and constitution, as well as the functional state of the patient's urinary system, in particular the kidneys, so the instruction in this case is advisory. If renal insufficiency is detected, the daily dose is calculated based on the analysis of creatinine clearance.

The average price is from 90 to 120 rubles.

Solution for infusion and concentrate "Ciprinol"

The solution for infusion is green-yellow, transparent, contains 2 mg of ciprofloxacin in the form of lactate per 1 ml, is available in the following forms:

• 50 ml in a vial in a carton, equivalent to 100 mg of ciprofloxacin
• 100 ml in a vial in a carton, equivalent to 200 mg of ciprofloxacin
• 200 ml in a vial in a carton, equivalent to 400 mg of ciprofloxacin.

And there is also a concentrated form for obtaining solutions: a colorless or green-yellow transparent solution containing ciprofloxacin lactate 10 mg per 1 ml. Produced in 10 ml ampoules, which is equivalent to the content of 100 mg of ciprofloxacin per 1 ampoule; 5 ampoules in cells in a pack of cardboard, instructions for proper dilution are attached.

Mode of application

You can inject the drug into the bloodstream, but it is more rational to administer it with a dropper: 200 mg per half hour and 400-500 mg per hour.

• 125 mg twice a day for diseases of the reproductive and urinary systems, not complicated by anything
• 250–500 mg twice daily for lung infection and 500 mg for airway and ENT inflammation
• 500–700 mg to prevent possible infection one and a half hours before surgery
• 500-750 mg twice a day for severe infections, sepsis, inflammation of the peritoneum, complicated course of cystic fibrosis, infections of the joint and bone tissues.

Elderly patients, as a rule, are prescribed a dosage lower than the recommended one. In the treatment of children, the drug is prescribed only after a detailed analysis of the ratio of benefits and risks due to possible side effects.

The duration of therapy depends on the severity of the disease and its dynamics, on the results of bacteriological tests. It is recommended to continue therapy for at least three more days after the main clinical manifestations have been eliminated and the temperature has returned to normal.

Contraindications

Elderly people, children and people with renal insufficiency are prescribed an antibiotic, having previously assessed the possible risk. Treatment with "Ciprinol" is contraindicated in:

• Pregnancy and lactation
• High sensitivity to various quinolones
• Pseudomembranous colitis (infusion only)
• Glucose-6-phosphate dehydrogenase deficiency (infusion only)
• Simultaneous reception of tizanidine.

During pregnancy and breastfeeding

There are insufficient data on the use of ciprofloxacin during pregnancy. Fetotoxicity was not detected, but the possibility that the drug may lead to changes in the articular cartilage of the fetus cannot be ruled out. Therefore, it is categorically not recommended to use the drug during pregnancy, if there is an alternative replacement.

Ciprofloxacin passes into the mother's milk, so during the period of feeding it should not be taken because of the risk of disorders in the articular cartilage of the child.

Precautionary measures

Therapy should be carried out under the supervision of a specialist and monitor the dynamics of the disease. The instruction contains special instructions:

During treatment, an increase in the prothrombin index is possible, therefore, it is necessary to monitor the state of the blood coagulation system, especially when performing surgical interventions

Persons suffering from seizures, epilepsy, mental disorders or liver dysfunction should be prescribed the drug with caution.

During therapy, it is necessary to ensure the supply of a sufficient volume of fluid to maintain normal diuresis and maintain an acidic urine reaction.

Cross-drug interactions

"Ciprinol" can be combined with antibiotics from the group of penicillins, cephalosporins, aminoglycosides. It potentiates blood sugar-lowering agents, which can lead to hypoglycemia. Antagonistic action is seen with tetracycline and chloramphenicol.

Preparations for lowering the level of acidity in the stomach with magnesium or aluminum make it difficult for the absorption of "Ciprinol".

With the simultaneous administration of ciprofloxacin and cyclosporine, the toxic effect of the latter on the kidneys is enhanced.

The absorption of the antibiotic worsens while taking funds containing zinc or iron.

Simultaneous administration with warfarin reduces the concentration of "Ciprinol" in the blood.

"Ciprinol" reduces the rate of metabolism of xanthine drugs in the liver, which may be the cause of their increased concentration in the blood.

Side effects

In the process of admission, some patients will have to deal with:

• From the side gastrointestinal tract: abdominal pain, nausea, vomiting, flatulence, cholestasis, hepatitis (rare)
• From the side sense organs: ringing in the ears, impaired hearing and vision, disorders of smell and taste
• From the side CNS: headache, dizziness, fatigue, sleep disturbance, anxiety, hallucinations, depressive states, psychotic reactions, migraine, impaired clarity of consciousness
• From the side PNS: trembling of the limbs, increased sweating, convulsions, altered pain perception
• From the side hematopoietic organs: anemia, hemolytic anemia, decrease in the number of granulocytes and platelets or increase in the number of leukocytes and platelets
• From the side of cardio-vascular system: arrhythmia, tachycardia, hypotension, syncope, cerebral artery thrombosis
• From the side genitourinary system: crystalluria, blood in the urine, increased diuresis, protein in the urine, urethral bleeding, glomerulonephritis, interstitial nephritis
• From the side musculoskeletal system: inflammation and pain in the joints, inflammation of the tendons, muscle pain, swelling of the joints, ruptures in the tendons
• Allergic manifestations: itching, blisters, rash, swelling of the larynx or facial tissues, an increase in the number of eosinophils in the blood, arteritis, shortness of breath, exudative erythema, toxic epidermal necrolysis, anaphylactic shock.

Overdose

Symptoms: nausea, vomiting, loose stools, dizziness, headaches, trembling, convulsive states, impaired clarity of consciousness, delirium.

Treatment: symptoms should be treated because no specific antidote has been found. With a slight overdose, you need to adjust the consumption of sufficient volumes of water. In severe poisoning, it is necessary to wash the stomach, take sorbents and laxatives. Hemodialysis in this case is ineffective.

Terms and conditions of storage

Store at temperatures not exceeding 25°C and relative humidity not exceeding 75%. Avoid direct exposure to UV rays. Keep away from children. Shelf life - 60 months. Do not use if instructions say expired.

Analogues

“ ”

Dr Reddy's, India
Price from 40 to 200 rubles.

It is produced in the form of tablets, infusion solution and as eye drops.

pros

• Combined drug, two active ingredients - ciprofloxacin and tinidazole
• Approved for local use

Minuses

• Do not use contact lenses while taking eye drops
• Side effects on the digestive organs are strongly pronounced.

“ ”

Bayer, Germany
Price from 180 to 500 rubles.

Round-shaped disc-shaped tablets 250 mg and capsule-shaped 500 mg with "Bayer" embossing, solution for IV infusions 50 ml and 100 ml.

pros

• Fast action
• High therapeutic effect

Minuses

• Solutions are very photosensitive
• The solutions are incompatible with many drugs that change the pH to the alkaline side, which creates restrictions on the use.

TEVA Pharmaceutical Industries, Hungary
Price from 60 to 150 rubles.

Antimicrobial agent with bactericidal action. Available in tablets of 250 and 500 mg.

pros

• Affordable price
• High efficiency

Minuses

• Pronounced side effects on the nervous system and intestines
• Contraindicated under the age of 15 years.

Photo of the drug

Latin name: Ciprinol

ATX Code: J01MA02

Active substance: Ciprofloxacin (Ciprofloxacin)

Analogues: Tsiprolet, Tsiprobay, Tsiprinol SR, Quintor, Tseprova

Producer: KRKA (Slovenia)

The description applies to: 03.10.17

Tsiprinol is an antibacterial drug from the group of fluoroquinolones. In medical practice, this antibiotic is used to treat infectious and inflammatory processes provoked by microorganisms sensitive to it. Active against intracellular microorganisms, gram-negative and gram-positive bacteria.

Active substance

Ciprofloxacin (Ciprofloxacin).

Release form and composition

Available in several dosage forms: in tablets, as a solution for infusion and concentrate for the preparation of an infusion solution.

Film-coated tablets are sold in packs of 10 and 20.

The concentrate for the preparation of an infusion solution is available in 10 ml ampoules.

In the form of a ready solution for infusion, it is sold in 50, 100 and 200 ml bottles.

Indications for use

Assign for the treatment of complicated and uncomplicated infectious diseases provoked by microorganisms sensitive to ciprofloxacin:

• Infections of the abdominal organs, peritonitis, bacterial infections of the gastrointestinal tract, biliary tract and gallbladder.
• Pneumonia, respiratory infections.
• Infections of the pelvic organs.
• Infectious diseases of the paranasal sinuses and middle ear.
• Infections of the kidneys and urinary tract.
• Infectious diseases of the joints and bones.
• Soft tissue and skin infections.
• Eye infections.
• sepsis.

The drug can be used for the prevention and treatment of infectious and inflammatory diseases in patients with reduced immunity.

Contraindications

Do not prescribe in case of hypersensitivity to fluoroquinolones, pregnant and lactating women, as well as children and adolescents under the age of 18 years.

Intravenous administration of an antibiotic is contraindicated in glucose-6-phosphate dehydrogenase deficiency and pseudomembranous enterocolitis.

With great care used for mental illness, epilepsy, cerebrovascular accident, severe renal or hepatic insufficiency. Not recommended for use by the elderly.

Instructions for use Tsiprinol (method and dosage)

The dosage of the antibiotic depends on the localization of the infection, the clinical picture of the disease, the general condition of the body, the age and body weight of the patient. Tablets should be taken before meals and with plenty of water.

• For infections of the respiratory and urinary tract, 250 mg is prescribed twice a day. With a complicated course of the disease, a single dosage is increased to 500-750 mg.
• For the treatment of uncomplicated gonorrhea, take a single dose of 500 mg. For gynecological infections, prostatitis, osteomyelitis and severe enterocolitis, an antibiotic is prescribed at a dosage of 500-750 mg every 12 hours.

It is also possible to / in the introduction of the drug. The average single dose in this case will be 200 mg with a frequency of administration 2 times a day. The duration of the course of treatment is 1-2 weeks or more.

Side effects

May cause the following side effects:

• From the side of the central nervous system - headaches, insomnia, dizziness, fatigue, tinnitus, increased intracranial pressure, diplopia, hallucinations, psychosis.
• From the digestive tract - lack of appetite, abdominal pain, flatulence, nausea, diarrhea, vomiting.
• From the musculoskeletal system - pain in muscles and joints, muscle weakness.
• From the cardiovascular system - hypotension, tachycardia.
• Allergic reactions - reddening of the skin, itching, urticaria.

Overdose

In case of an overdose, the patient is given multiple gastric lavages and symptomatic treatment is prescribed.

Analogues

Analogues: Avelox, Maksakvin, Liprokhin, Tsiprrosan, Tariferid, Norfacin, Renor, Oflocid, Medotsiprin, Tsipropan, Lomefloxacin, Tsiprovin, Norilet, Sifloks, Ciprolon, Microfloks, Perth, Tsiproquin, Quintor, Oflomak, Tsiprobid, Negafloks and others.

Drugs with a similar mechanism of action (coincidence of the ATC code of the 4th level): Nolicin.

pharmachologic effect

Tsiprinol disrupts DNA synthesis, which helps to stop the growth and division of microorganisms. The use of an antibiotic is effective in the treatment of infectious diseases with intracellular localization of pathogens, since it is able to quickly penetrate into the cells.

• Shows high activity against gram-negative bacteria (Salmonella, Klebsiella, Shigella, Escherichia coli and others), gram-positive bacteria (staphylococci and streptococci) and intracellular microorganisms (mycobacterium tuberculosis, chlamydia, etc.). It has the highest efficiency among all fluoroquinolones in the treatment of infectious diseases provoked by the activity of Pseudomonas aeruginosa.
• The drug is inactive against anaerobic bacteria and mycoplasmas. In addition, it is not effective for viral and fungal infections.
• When taken orally, the antibiotic is well absorbed. The maximum content of its active substance in the blood is observed 1.5 hours after ingestion.

special instructions

• With the development of severe and prolonged diarrhea, it is necessary to exclude the diagnosis of pseudomembranous colitis, which requires discontinuation of the drug and the appointment of appropriate treatment.
• During the period of treatment to prevent crystalluria, an increase in the recommended daily dose is unacceptable. Patients should be given plenty of fluids to keep urine acidic and maintain normal diuresis.
• When the first symptoms of tendovaginitis appear, treatment with the drug should be stopped. Isolated cases of tendon inflammation and rupture have been described during treatment with fluoroquinolones.
• Due to possible photosensitivity, contact with direct sunlight should be avoided.
• When using drugs, one should refrain from engaging in potentially hazardous activities that require increased concentration of attention and speed of psychomotor reactions.

During pregnancy and breastfeeding

Contraindicated.

In childhood

Contraindicated under 18 years of age.

In old age

Assigned with caution.

For impaired renal function

For patients with functional impairment of the kidneys, a single dose (for oral administration) is half the average daily dose.

For people on peritoneal dialysis or hemodialysis, the drug is prescribed after dialysis at a dose of 250-500 mg 1 time per 24 hours.

For impaired liver function

Assigned with caution.

drug interaction

• The use together with theophylline increases the concentration of the latter in the blood plasma.
• The simultaneous use of Tsiprinol and non-steroidal anti-inflammatory drugs (except aspirin) increases the risk of seizures.
• The combination with other antibiotics leads to synergism.

Terms of dispensing from pharmacies

Released by prescription.

Terms and conditions of storage

Store in a place protected from light and moisture, out of the reach of children, at a temperature not exceeding 25 °C. Shelf life - 5 years.

4.14 out of 5 (7 Votes)

The antimicrobial drug Tsiprinol 500 is used to counteract an infectious lesion of the body that causes inflammation. The toxic effect on pathogens leads to the destruction of topoisomerase, the main enzyme of the vital activity of microorganisms. The shell of the bacterium is torn and general reproduction is suspended.

Other names and classification

International non-proprietary name

Ciprofloxacin

Trade names

The names Tsiprinol SR, Tsiprolon, Tsipreks, Ciprofloxacin are used.

Registration number

LSR-007078/08 dated 12/14/2015

Composition and dosage forms

The active ingredient in the manufacture is ciprofloxacin in the form of hydrochloride monohydrate. Its concentration is 500 mg. The tablet contains additional components:

• microcrystalline cellulose;
• croscarmellose sodium powder;
• sodium starch type A;
• talc;
• titanium dioxide;
• silica;
• propylene glycol;
• hydromellose.

Available in oval-shaped tablets with a white shell, a notch is made on one side. There are 5 or 7 pieces in the plate, 1 (7 pieces) or 2 (5 pieces each) blisters are packed in a cardboard box.

Pharmacological group

Antibacterial agents intended for systemic use. According to the anatomical-therapeutic-chemical classifier (ATC), the code J01MA02 was assigned.

pharmachologic effect

The action is manifested in relation to a wide range of pathogens. The antibiotic suppresses the complex complexes of molecules necessary for the development and life of microorganisms. Efficacy is determined by the ratio between the amount required to inhibit the pathogen and the volume contained in the blood serum.

The substance is absorbed within a short time, getting into the upper part of the small intestine. The maximum content is detected in the blood serum after 1-2 hours. The amount of the substance increases with an increase in the intake rate. Bioavailability is at the level of 75-80%.

Ciprofloxacin slightly binds to blood proteins - 25-30%. The substance penetrates into the space between the vessels and forms concentrations in the tissues that exceed the volume in the blood. Ciprofloxacin is found in tissues:

• epithelial layer of the lungs;
• alveolar protective cells;
• damaged cells;
• urinary tract;
• endometrium of the genital organs;
• samples when taking for analysis.

The half-life is 5-7 hours with good kidney function. The substance leaves the body 80% unchanged through the intestines and urinary system.

What helps Tsiprinol 500?

The drug is prescribed after obtaining data on the resistance of the identified pathogen to ciprofloxacin. Tsiprinol treats diseases caused by pathogenic microorganisms:

Method of application and dosage of Tsiprinol 500

The dosage is selected taking into account the site of infection in the body, the sensitivity of infectious agents and the severity of the disease, the doctor prescribes tablets. The work of the kidneys is taken into account, and in children - body weight. The duration of therapy depends on the reaction of the body, the characteristics of the course of the disease and the type of pathogen.

Getting rid of some types of pathogens, such as staphylococcal infections, requires the use of high doses of ciprofloxacin with the co-administration of other antibiotics, the use of injections. Combination therapy is required in the treatment of inflammation of the genital, urinary organs, stomach and intestines, as well as in a condition aggravated by concomitant diseases.

The drug is used 2 times a day, the dose for admission is 500 mg. The dosage varies upwards or downwards depending on the severity. On average, the course lasts 5-10 days.

The tablet should not be chewed, it is swallowed whole, on an empty stomach the substance is absorbed faster. It is not recommended to consume dairy products or fruit juices with mineral supplements at the same time.

special instructions

Ciprinol is not prescribed as monotherapy to get rid of a severe infectious lesion caused by representatives of anaerobic or gram-positive groups of bacteria. Treatment of streptococci with ciprofloxacin is ineffective. Therapy of inflammation of the urinary tract is carried out taking into account resistance and local contamination by microorganisms.

In uncomplicated forms of cystitis in the period before menopause in women, a long period of treatment is effective compared to single doses. This is taken into account with the growth of resistance. The drug is prescribed if other drugs are excluded, the choice is based on the results of the study in the laboratory.

Infections of the joints and bone tissue are treated after the exclusion of tendon rupture with the help of research, Tsiprinol is used in combination with other antibiotics. The use of the drug is justified in the case of severe specific infectious lesions according to the results of the analyzes after assessing the risk-benefit ratio.

The use of ciprofloxacin is not practiced in patients with tendon diseases or if disorders caused by quinolones have occurred in the past. A medicine is prescribed in exceptional cases, if it is not possible to use other medicines. Therapy threatens with the development of tendonitis, inflammation of the tendon and its rupture, sometimes from 2 sides. Complications occur within 2 days after administration.

Several cases of photosensitivity have been reported, so when treated with an antibiotic, patients avoid sunlight or ultraviolet radiation in cosmetic clinics. The use of the drug affects the threshold for seizures, so discomfort is common. In order to avoid further disorders of the central nervous system, stop using the medication. Changes in the functioning of the nervous system are observed even after the first doses taken. Rarely, psychosis or depression can trigger a suicide attempt. The drug is immediately canceled.

For patients with cardiac disorders, the use of fluoroquinolones requires caution and regular monitoring of system performance. There is a possibility of QT interval prolongation in patients:

• with a hereditary predisposition to pathology;
• in case of simultaneous use of antiarrhythmic drugs of category AI and AIII, macrolides, antidepressants, neuroleptics;
• in case of imbalance of electrolytes in the body (lack of potassium and magnesium);
• with diagnosed insufficiency of the heart, after a heart attack, with bradycardia, the development of arrhythmia;
• in elderly patients.

In patients with diabetes, there is a risk of hypoglycemia, more often in the elderly, so sugar control is required. It is not recommended to take the drug after treatment of severe diarrhea or in case of diarrhea during therapy. Cancel ciprofloxacin and prescribe appropriate medications that do not reduce intestinal motility.

Drink plenty of water to reduce the risk of developing crystalluria, reduce the intake of alkaline foods. Rarely, anaphylactic reactions develop to a state of shock. As a result of the use of Tsiprinol, hepatic necrosis and insufficiency of the organ may develop. In case of vomiting, cholestatic jaundice, an increase in the number of transferases, the level of alkaline phosphatase, the drug is immediately canceled.

During pregnancy and lactation

As a result of examinations of pregnant women using Tsiprinol, there were no deviations in childbearing, developmental disorders of the fetus and placenta. Theoretically, the risk of abnormal cartilage development in newborns is dangerous for the embryo. The use of the drug during pregnancy is excluded.

Due to the penetration of ciprofloxacin into human milk, there is a risk of a negative effect on the child's body, in particular, damage to the joints and cartilage. Treatment with Tsiprinol is not recommended when breastfeeding a child.

In childhood

Treatment is carried out only according to official current recommendations. The drug in childhood is prescribed by a doctor, self-medication is unacceptable. Recommendations for therapy:

• cystic fibrosis is treated at the rate of 20 mg per kilogram of the child's weight, the duration of the course is from 10 to 14 days;
• pyelonephritis, complex infections of the urinary system and pathological seeding of internal organs are to be treated in an amount of 10 to 20 mg / kg 2 times a day with a maximum rate of 750 mg per day, the duration of the course is from 10 to 21 days.

Therapy of severe infections begins after an objective assessment of the situation.

In old age

For the elderly, the choice of dosage and duration of the course is determined in accordance with the severity of the infection. If a person does not have deviations in creatinine clearance, severe diseases of internal organs and other contraindications, then standard therapy is prescribed.

For impaired renal function

Due to the fact that ciprofloxacin is excreted from the body mainly through the kidneys and ureters, when choosing a treatment, attention is paid to the state of the urinary system. To avoid the accumulation of a substance in the body, adjust the dose of the drug.

Side effects of Tsiprinol 500

Most often, there are complaints about the development of diarrhea, the appearance of nausea, turning into vomiting. Side effects look like this:

• invasions, fungal infections, antibiotic colitis develop;
• the blood and lymph system react with thrombocytopenia, eosinophilia, leukopenia, agranulocytosis, inhibition of the bone marrow;
• the immune system produces allergic or anaphylactic reactions, angioedema, symptoms of serum sickness;
• nerve disorders manifest themselves in the form of agitation, confusion, anxiety, bad dreams, hallucinations;
• decreased appetite, pain in the intestines and stomach;
• color perception is disturbed, vision deteriorates;
• increased levels of transaminases, bilirubin.

Contraindications