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Nolicin®

Crystalluria

In case of prolonged treatment, urine analysis should be monitored for crystalluria. Crystalluria is not expected to occur if the 400 mg twice daily dosage regimen is followed, so as a precaution the recommended daily dose should not be exceeded and sufficient fluid intake should be taken to ensure adequate fluid replacement and adequate diuresis (monitored diuresis).

Renal dysfunction

In patients with severe renal impairment, the risk/benefit ratio when using norfloxacin tablets should be carefully assessed on a case-by-case basis. Kidney function declines with age, particularly in older patients. In case of severe renal impairment, the concentration of norfloxacin in the urine may decrease, since norfloxacin is excreted primarily by the kidneys.

During therapy, the prothrombin index may increase (during surgery, the state of the blood coagulation system should be monitored).

Photosensitivity reaction

When taking norfloxacin, a photosensitivity reaction may occur, so patients should avoid contact with direct sunlight and artificial ultraviolet (UV) radiation. If symptoms of photosensitivity occur (for example, skin changes reminiscent of sunburn), norfloxacin therapy should be discontinued and medical attention should be sought.

Tendinitis and tendon rupture

Norfloxacin, like other fluoroquinolones, can cause tendinitis and tendon rupture, especially in the presence of the following risk factors: age over 60 years, use of glucocorticosteroids, kidney, heart or lung transplantation, increased physical activity, chronic renal failure, history of tendon damage. These phenomena may occur several months after stopping the drug. At the first sign of tendonitis or tendon rupture, you should stop taking norfloxacin and consult a doctor. During therapy with norfloxacin, it is recommended to avoid excessive physical activity. Norfloxacin is contraindicated in patients with tendonitis and/or tendon rupture associated with the use of fluoroquinolones (including a history).

Aneurysm and aortic dissection

Epidemiological studies have reported an increased risk of aortic aneurysm and aortic dissection following the use of fluoroquinolones, especially in elderly patients.

Therefore, in patients with a history of aortic aneurysm, aortic aneurysm and/or aortic dissection, or other risk factors or conditions predisposing to the development of an aortic aneurysm or aortic dissection (eg, Marfan syndrome, vascular type Ehlers-Danlos syndrome, Takayasu's arteritis, giant cell arteritis, Behçet's disease, hypertension, atherosclerosis), fluoroquinolones should be used only after a careful benefit-risk assessment and consideration of alternative treatment options.

If sudden pain in the abdomen, chest, or back occurs, patients should seek medical attention immediately at the emergency room.
QT
prolongation Caution should be used when using fluoroquinolones, including norfloxacin, in patients with established risk factors for QT prolongation, such as:

- congenital long QT interval syndrome or acquired QT interval prolongation;

- simultaneous use of drugs that prolong the QT interval (for example, cisapride, class IA and III antiarrhythmic drugs, tricyclic and tetracyclic antidepressants, macrolides, antipsychotics, antifungals, imidazole derivatives, some antihistamines, including astemizole, terfenadine, ebastine);

- electrolyte imbalance (for example, with hypokalemia, hypomagnesemia);

- with heart disease (for example, heart failure, myocardial infarction, bradycardia).

Elderly patients and women have increased sensitivity to the effects of drugs that cause prolongation of the corrected QT interval (QTc). Therefore, caution should be exercised when using fluoroquinolones, including norfloxacin, in these groups of patients (see sections "Side effects", "Overdose" and "Interaction with other drugs").

If visual impairment or any other change in the organ of vision occurs, you should immediately contact an ophthalmologist.

Convulsive syndrome

Norfloxacin, like other fluoroquinolones, can provoke seizures and lower the seizure threshold. For patients with epilepsy and other diseases of the central nervous system (for example, a predisposition to convulsive reactions, cerebral atherosclerosis, cerebrovascular accidents, organic diseases of the central nervous system), norfloxacin should be used only in cases where the expected clinical effect outweighs the possible risk of developing side effects of the drug. Norfloxacin should be used with caution in patients concomitantly receiving drugs that lower the seizure threshold of the brain (theophylline, fenbufen [and other similar NSAIDs]). If seizures occur, use of norfloxacin should be discontinued. Fluoroquinolones can also stimulate the central nervous system, causing tremors, toxic psychoses, anxiety, confusion and hallucinations, and increased intracranial pressure.

In patients with established or suspected mental disorders, hallucinations and/or confusion, the use of norfloxacin may lead to their exacerbation and intensification.

Psychotic reactions

Psychotic adverse reactions, including suicidal thoughts/attempts, may occur in patients taking fluoroquinolones, including norfloxacin, sometimes after a single dose. In case of development of any side effects from the central nervous system, including mental disorders, treatment with norfloxacin should be stopped immediately and appropriate therapy should be prescribed. In these cases, it is recommended to switch to therapy with an antibiotic other than a fluoroquinolone, if possible.

Nolicin® should be prescribed with caution to patients with psychosis or patients with a history of mental illness (see section "With caution").

Norfloxacin is ineffective against syphilis.

Pseudomembranous colitis

The use of norfloxacin can lead to the development of pseudomembranous colitis caused by Clostridium
difficile .
In this case, it is necessary to discontinue the drug and prescribe appropriate treatment (oral vancomycin or metronidazole). The use of drugs that inhibit intestinal motility is contraindicated.

Neuropathy

In patients taking fluoroquinolones, including norfloxacin, cases of sensory and sensorimotor axonal polyneuropathy affecting small and/or large axons and leading to paresthesia, hypoesthesia, dysesthesia and weakness have been reported. Symptoms may appear soon after starting use and may be irreversible. If the patient develops symptoms of neuropathy, including pain, burning, tingling, numbness and/or weakness or other sensory disturbances, including tactile, pain, temperature, vibration and positional sense, norfloxacin should be discontinued.

Liver dysfunction

Cases of cholestatic hepatitis have been reported with the use of norfloxacin. The patient should be informed that if symptoms of liver dysfunction occur (anorexia, jaundice, dark urine, itching, abdominal pain), consult a doctor before continuing treatment with norfloxacin.

Myasthenia gravis

In patients receiving norfloxacin, the development of myasthenia gravis or its exacerbation was noted. Because this can lead to potentially life-threatening respiratory failure, patients with myasthenia gravis should be advised to seek immediate medical attention if symptoms worsen.

Hypersensitivity and allergic reactions

In some cases, after the first use of the drug, hypersensitivity reactions and allergic reactions may develop, which should be reported to your doctor immediately. Very rarely, even after the first use of the drug, anaphylactic reactions can progress to life-threatening anaphylactic shock. In this case, treatment with norfloxacin should be discontinued and the necessary therapeutic measures (including anti-shock) should be taken.

In rare cases, hemolytic reactions have been reported in patients with latent or actual glucose-6-phosphate dehydrogenase deficiency taking quinolone antibacterial agents, including norfloxacin.

Hypoglycemia and hyperglycemia (dysglycemia)

As with the use of other quinolones, cases of hyperglycemia and hypoglycemia have been observed with the use of norfloxacin. During therapy with norfloxacin, dysglycemia may occur more frequently in elderly patients and patients with diabetes mellitus receiving concomitant therapy with oral hypoglycemic drugs or insulin. When using norfloxacin in such patients, the risk of developing hypoglycemia, including hypoglycemic coma, increases. It is necessary to inform patients about the symptoms of hypoglycemia (confusion, dizziness, ravenous appetite, headache, nervousness, palpitations or increased heart rate, pale skin, perspiration, trembling, weakness). If the patient develops hypoglycemia, treatment with norfloxacin should be stopped immediately and appropriate therapy should be initiated. In these cases, it is recommended to switch to therapy with an antibiotic other than a fluoroquinolone, if possible. When treating with norfloxacin in elderly patients and patients with diabetes mellitus, careful monitoring of blood glucose concentrations is recommended.

Special information on excipients

If you have an allergic reaction to acetylsalicylic acid, azo dye (E110) (sunset yellow dye (E110)) may cause a hypersensitivity reaction.

Pharmacodynamics and pharmacokinetics

The active substance is absorbed quite quickly from the digestive system , peak concentrations in the blood are recorded within 1-2 hours after taking the medication. The biological availability of the drug reaches 30-40%. About 15% of the active substance binds to plasma proteins.

unchanged through the renal system In patients with severe pathology of the renal system, pharmacokinetic parameters are changed.

Interaction

The medication reduces the effectiveness of nitrofurans , increases the concentration of cyclosporine (mutual action) and indirect anticoagulants . Norfloxacin reduces the total clearance of theophylline by 1/4.

When treated simultaneously with medications that lower the epileptic threshold, epileptiform seizures . Antacids reduce the absorption of Nolicin. When taking antihypertensive drugs, a sharp drop in blood pressure is recorded. The use of medications for general anesthesia requires mandatory monitoring of heart rate, blood pressure, and heart function (ECG).

special instructions

Before prescribing an antibiotic, it is necessary to determine the sensitivity of the flora to norfloxacin. Why is this being done? Infectious agents may be sensitive to this drug, and the expected therapeutic effect will not be achieved in the required time frame.

For pyelonephritis, Nolitsin is recommended to be prescribed in combination with herbal medications (for example, Canephron ). When treating with norfloxacin, reviews for pyelonephritis are mostly positive. Monural is also used to treat diseases of the genitourinary system. Only the attending physician can decide what is best to prescribe.

Tablets "Nolitsin": composition and description

The drug is available in the form of tablets, the active ingredient is norfloxacin - 400 mg per 1 piece. Auxiliary components are silicon dioxide, water, cellulose talc and other substances.

"Nolitsin" is an antibiotic. It has an antibacterial effect - the drug destroys chlamydia, salmonella, staphylococcus, shigella and many other bacteria. It interacts with the enzymes of microorganisms and destroys DNA, which leads to the death of the pest. The therapeutic effect lasts for 12 hours.

The active substance is absorbed by the organs of the digestive system, after 2 hours its concentration in the blood reaches its maximum values. It is excreted by the kidneys in a chemically unchanged form.

The medicine can be stored at room temperature no more than 25 degrees, in the absence of direct sunlight. Access by children should be excluded. The shelf life is 5 years from the date of production.

Contraindications

The summary of the drug contains the following absolute contraindications:

intolerance to fluoroquinolones;
carrying a pregnancy;
congenital deficiency of the enzyme glucose-6-phosphate dehydrogenase.

The drug is not used in pediatrics.

Relative contraindications:

allergic responses to acetylsalicylic acid;
epileptic syndrome;
disorders of cerebral blood supply;
atherosclerotic changes in cerebral vessels;

Side effects of Nolicin

From the genitourinary system:

hypercreatininemia;
glomerulonephritis;
polyuria;
urethral bleeding;
crystalluria;
dysuria;
albuminuria.

From the digestive tract:

pseudomembranous enterocolitis;
epigastric pain;
appetite disorders;
diarrhea syndrome;
vomit;
nausea;
bitterness in the mouth;
increase in ALT, AST.

The development of hallucinations, headaches, arrhythmia, tachycardia , vasculitis, itching, fainting, insomnia, swelling, urticaria, exudative erythema with a malignant course is possible. Candidiasis, decreased hematocrit, changes in blood counts, arthralgia , chemosis, and fear of light are rarely recorded.

Analogues of Nolitsin in Russia

Level 4 ATX code matches:
Siflox

Hyleflox

Leflobakt

Lefoccin

Gatifloxacin

Ofloxacin

Faktiv

Tigeron

Lebel

Zanotsin

Lomefloxacin

Eleflox

Lomflox

Pefloxacin

Tsiprobay

Sparflo

Tariwid

Zoflox

Abaktal

Moxifloxacin

Loxon-400, Sophasin, Norfatsin, Norilet, Norbactin , Renor.

Indications for use of Nolicin

Nolicin tablets, what are they for? The drug is prescribed for the treatment of infectious and inflammatory diseases of the genitourinary system:

chronic prostatitis of bacterial origin;
endometritis;
cervicitis;
cystitis;
pyelonephritis;
urethritis;
uncomplicated form of gonorrhea.

What else can Nolitsin be prescribed for: bacterial gastroenteritis, shigellosis , salmonellosis . Additional indications for the use of tablets: prevention of traveler's diarrhea and prevention of septic complications in patients with neutropenia .

pharmachologic effect

Many people wonder: Is Nolitsin an antibiotic or not? The active substance has an antimicrobial effect against staphylococci, Klebsiella, Enterobacteriaceae, Neisseria, Escherichia coli, Chlamydia, Legionella, Salmonella, Shigella and other pathogens of infectious diseases. The mechanism of action of the drug is based on the interaction of norfloxacin with DNA gyrase (an enzyme of a microorganism), which leads to destabilization of the DNA chain and subsequent death of the microorganism. From this we can conclude that Nolitsin is an antibiotic, as it has a detrimental effect on bacteria.

The antimicrobial effect can last up to 12 hours. The antibiotic Nolitsin can be prescribed for diseases caused by mycobacteria and enterococci. Wikipedia contains a complete list of microorganisms that are sensitive to the action of the antibiotic.

Instructions for use "Nolitsin"

The drug is taken 1 tablet 2 times a day with water. The total duration of the course is from 7 to 10 days. In the case of cystitis without complications, 3-7 days are enough.

For the treatment of chronic urinary tract infections with relapses, the course lasts 12 weeks. The dosage and duration of therapy is determined by the doctor.

When treating acute bacterial gastroenteritis, the drug is taken in the same dosage for 5 days. For the treatment of pharyngitis, urethritis, proctitis, cervicitis, a different regimen has been established - 1 tablet per day.

In case of an overdose, phenomena such as drowsiness, “cold” sweat, dizziness, nausea, and vomiting occur. In this case, gastric lavage is indicated. There is no symptomatic treatment, since an appropriate antidote has not been created.

Important!

Concomitant use with alcohol is prohibited. During pregnancy, your doctor may authorize the use of the drug only if absolutely necessary.