Cifran ST film-coated tablets 10 pcs. in Moscow
Both ciprofloxacin and tinidazole are well absorbed from the gastrointestinal tract. Cmax of each component is reached within 1–2 hours. Full tank ciprofloxacin and tinidazole are well absorbed from the gastrointestinal tract. The Cmax of each component is achieved within 1–2 hours. The complete bioavailability of tinidazole is 100%, and plasma protein binding is 12%. T1/2 - about 12–14 hours. The drug quickly penetrates the body tissues, reaching high concentrations there.
Tinidazole creates concentrations in the cerebrospinal fluid equal to its plasma concentrations and is reabsorbed in the renal tubules. Tinidazole is excreted into bile in concentrations slightly below 50% of its plasma concentration. About 25% of the dose taken is excreted unchanged in the urine. Metabolites account for 12% of the administered dose and are also excreted in the urine. Along with this, there is a slight excretion of tinidazole in feces.
Ciprofloxacin is well absorbed after oral administration. The bioavailability of ciprofloxacin is about 70%. When used together with food, the absorption of ciprofloxacin is slowed down. 20–40% of the drug is bound to plasma proteins. Ciprofloxacin penetrates well into fluids and tissues of the body: lungs, skin, fat, muscle and cartilage tissue, as well as 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 taken is excreted unchanged in the urine, 15% in the form of active metabolites such as oxyciprofloxacin. The rest of the dose is excreted in bile, partially reabsorbed. About 15–30% of ciprofloxacin is excreted in the feces. T1/2 - about 3.5–4.5 hours. T1/2 can be prolonged with severe renal failure and in elderly patients. Ciprofloxacin slows down. 20–40% of the drug is bound to plasma proteins. Ciprofloxacin penetrates well into fluids and tissues of the body: lungs, skin, fat, muscle and cartilage tissue, as well as 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 taken is excreted unchanged in the urine, 15% in the form of active metabolites such as oxyciprofloxacin. The rest of the dose is excreted in bile, partially reabsorbed. About 15–30% of ciprofloxacin is excreted in the feces. T1/2 - about 3.5–4.5 hours. T1/2 can be prolonged with severe renal failure and in elderly patients.
CIFRAN ST (tablets)
they are.
Photo1. An hour after the bite (I washed it with running water, poured it with Miramistin, and treated it with brilliant green). In the photo you can see that one hole is very large, a fang got into it, and in Maine Coons it is hefty. Photo2. Second day. I naively hoped that I would be “carried away”, because the cat was tested at the veterinary clinic for all kinds of cat infections and it turned out to be not contagious. And she refused to believe that cats’ teeth were “dirty” and full of other bacteria and infections (after all, my cat was sick and had not eaten for three days). I shouldn't have hoped. The wounds, however, festered, the hand turned red and swollen. Frightened that they would completely cut off my arm, I ran to the emergency room, where they prescribed me the antibiotic “Tsifran-ST” for a course of 5 days (1 tablet 2 times a day). The antibiotic, in my opinion, is inexpensive; for children, I buy antibiotics that are many times more expensive. There are 10 tablets in the box of this rather large size (~ 2 cm), but I had no problems swallowing them. I tried to photograph the indications for use, they seem to be readable. The instructions are so long and printed in such small print that it can take a couple of hours to read. Very often this antibiotic is prescribed in dentistry, but in my case it coped with the task. This is what the hand began to look like 4 days after taking the drug. A noticeable effect was achieved already on the second day of administration. AND NOW ABOUT THE SIDE EFFECTS!!! The instructions indicate that side effects are observed rarely or in isolated cases. What’s wrong with me that I felt more than half of them? I couldn’t wait until the 5-day course ended. I don’t want to scare anyone, but I’ll list the side effects that I experienced already on the second day of taking it: - from the gastrointestinal tract: nausea, vomiting, taste disturbances (no matter what I ate, the food tasted the same and disgustingly bitter, it felt like that for all five days I ate tangerine peels; and between meals my mouth was constantly bitter), coated tongue; - from the central nervous system: dizziness, insomnia, tremor of the facial muscles and fingers, tic, confusion, nightmares; it was something, especially when you work with numbers and a large flow of information, periodically “stuck” for several minutes, could not concentrate and perform the simplest addition and subtraction of numbers, stuttered and could not answer the questions of others, falling into a stupor; - from the musculoskeletal system: joint pain; - from the senses: blurred vision, decreased visual acuity; - other: general weakness. And I listed what I could feel and evaluate. And there is also a side effect on the internal organs (such as liver necrosis, intestinal perforation, etc.), but for this you need to undergo an ultrasound and tests. I don’t want to do something, it becomes scary. I don’t know how long the side effects will last; I just finished taking the drug yesterday.
CONCLUSION: I recommend this drug if the situation is really bad and in the opinion of the doctor you cannot do without it. Keep in mind the extensive list of side effects and it is better not to drive while taking this drug.
Instructions for use of CIFRAN
Severe infectious diseases and mixed infectious processes caused by gram-positive and anaerobic pathogenic flora
Monotherapy with ciprofloxacin is not suitable for the treatment of severe infections and diseases that may be caused by anaerobic pathogenic flora. In these cases, ciprofloxacin should be prescribed simultaneously with other antibacterial drugs.
Streptococcal infection (including Streptococcus pneumoniae)
Ciprofloxacin is not recommended for the treatment of streptococcal infections due to lack of effectiveness.
Genital tract infections
Epididymo-orchitis and pelvic diseases can be caused by fluoroquinolone-resistant Neisseria gonorrhoeae. Ciprofloxacin should be co-administered with other antibacterial drugs, unless ciprofloxacin-resistant Neisseria gonorrhoeae can be excluded. If clinical improvement is not observed within 3 days, then treatment should be reconsidered.
Intra-abdominal infectious diseases
There is limited data on the effectiveness of ciprofloxacin for the treatment of postoperative intraperitoneal infections.
Traveler's diarrhea
When choosing ciprofloxacin, it is necessary to take into account information about drug resistance of the relevant pathogenic microorganism in the country being visited.
Infectious diseases of bones and joints
Ciprofloxacin should be prescribed in combination with other antimicrobial drugs and only after a microbiological study.
anthrax
Use in humans is based on in vitro sensitivity studies and animal studies. Information on the use of the drug in humans is limited. The treating doctor should refer to national and/or international documents related to the treatment of the specified disease.
Children and teenagers
Treatment can only be prescribed by a specialist experienced in the treatment of cystic fibrosis and/or severe infectious diseases in children and adolescents. Safety data obtained from randomized, double-blind studies of ciprofloxacin in children have identified cases of possible drug-related arthropathy (identified by clinical signs and symptoms). The incidence of the disease over a one-year period was 9.0% and 5.7%. Treatment should be started only after assessing the benefit/risk ratio, as joint-related adverse reactions may occur.
Bronchopulmonary infectious diseases
Clinical studies included children and adolescents aged 5-17 years. There are limited data regarding the treatment of children aged 1 to 5 years.
Complicated urinary tract infections and pyelonephritis
Treatment with ciprofloxacin should be considered in cases where treatment with other drugs is not possible, and only after microbiological analysis.
Clinical studies included children and adolescents aged 1 to 17 years.
Other specific severe infectious diseases
Ciprofloxacin is used in the treatment of other serious infectious diseases according to official guidelines or after a careful assessment of the benefit/risk ratio in cases where other treatment is not possible, or after an unfavorable outcome of conventional treatment, and only after microbiological analysis.
Hypersensitivity
After taking a single dose of the drug, hypersensitivity reactions may occur, including anaphylactic and anaphylactoid reactions. If these reactions occur, it is necessary to stop taking the drug and prescribe appropriate conservative treatment.
Musculoskeletal system
At the first signs of tendinitis (painful swelling in the joint area, inflammation), the use of ciprofloxacin should be stopped and physical activity should be avoided, because There is a risk of tendon rupture, and consult a doctor.
In elderly patients with tendon diseases, or those previously treated with corticosteroids, cases of tendon rupture (mainly Achilles tendon) may occur.
Ciprofloxacin should be used with caution in patients with a history of tendon diseases associated with quinolones. Fluoroquinvlones, including ciprofloxacin, reduce neuromuscular transmission and may worsen muscle weakness in individuals with myasthenia gravis.
Photosensitivity
Ciprofloxacin has been shown to cause photosensitivity reactions. Patients taking ciprofloxacin should avoid direct exposure to sunlight and UV radiation.
CNS
It is known that quinolones can initiate a seizure and lower the seizure threshold, due to the stimulating effect of ciprofloxacin on the central nervous system. Cifran should be used with caution in patients with diseases of the central nervous system that provoke seizures, and if these phenomena occur, stop taking the drug.
Cases of polyneuropathy (based on neurological symptoms such as pain, burning, agitation) have been reported in patients receiving ciprofloxacin. If symptoms of this disease occur, including pain, burning, tinnitus, numbness and/or weakness, the drug should be discontinued to prevent the development of an irreversible condition.
The cardiovascular system
Caution should be exercised when using fluoroquinolones, including coprofloxacin, in patients with known risk factors for QT prolongation such as:
- congenital long QT syndrome;
- simultaneous use of drugs that are known to prolong the QT interval (for example, class IA and III antiarrhythmics, tricyclic antidepressants, macrolides, antipsychotics);
- electrolyte imbalance (eg, hypokalemia, hypomagnesemia);
- elderly age;
- heart disease (eg, heart failure, myocardial infarction, bradycardia).
Gastrointestinal tract
The presence of severe and persistent diarrhea during or after treatment with the drug (including several weeks after treatment) may indicate pseudomembranous colitis (life-threatening, possibly fatal), requiring immediate treatment. In such cases, ciprofloxacin should be immediately discontinued and appropriate treatment initiated. The use of antiperistaltic drugs in this situation is contraindicated.
Renal and urinary system
During treatment with ciprofloxacin, to avoid the development of crystalluria, it is necessary to ensure that the patient receives a sufficient amount of fluid.
Hepatobiliary system
Cases of liver necrosis and life-threatening liver failure associated with the use of ciprofloxacin have been reported. If any signs or symptoms of liver disease (such as anorexia, jaundice, dark urine, itching or a tense abdomen) appear, treatment with the drug should be stopped.
Glucose-6-phosphate dehydrogenase deficiency
In patients with glucose-6-phosphate dehydrogenase deficiency, the use of ciprofloxacin may cause hemolytic reactions. It is necessary to avoid prescribing the drug to such patients, except in cases where the potential benefit outweighs the possible risk. In this case, the potential for hemolysis should be monitored.
Resistance
During long-term therapy and in cases of treatment of nosocomial infections and/or infections caused by Staphylococcus and Pseudomonas, there may be a potential risk of isolation of ciprofloxacin-resistant bacteria.
Cytochrome P450
Ciprofloxacin inhibits CYP1A2, thereby causing an increase in serum concentrations of drugs metabolized by this enzyme (for example, theophylline, clozapine, ropinirole, tizanidine). Patients taking these drugs concomitantly with ciprofloxacin should be under medical supervision to identify clinical signs of overdose.
Effect on laboratory parameters
When assessing the results of bacteriological tests, the in vitro activity of ciprofloxacin against Mycobacterium tuberculosis should be taken into account.
The drug reduces the speed of psychomotor reactions, which must be taken into account when driving vehicles and working with mechanisms that require concentration.
