How to dilute Suprax (suspension): rules and recommendations

Before diluting Suprax (suspension), you must carefully read the instructions for use of the drug. This medication should be taken as prescribed by a doctor. Moreover, its sale is free. You can buy the medicine at any pharmacy. The antibiotic "Suprax" is intended for the treatment of bacterial diseases of the ENT organs, respiratory system, and genitourinary system. The active ingredient of the drug is cefixime, a component that is effective against many pathogenic microorganisms.

What to breed with?

The drug "Suprax" is available in several forms. Tablets are more popular, but they should not be given to small children. To take it in liquid form, you can use granules (from which syrup is prepared) and dispersible tablets (dissolved in a small amount of liquid before taking). How to breed Suprax? The suspension must be prepared using clean water. Each bottle of the drug contains granules, from which you will receive 60 ml of medication. For every 5 ml there are 100 mg of active substance.

The manufacturer recommends using only clean water to prepare the antibiotic. You can take the one that is sold in bottles. It is important that it does not contain gases, preservatives or sweeteners. If you are not sure of the sterility of the liquid you will use, be sure to boil it for 10-15 minutes. After this, the water must be cooled to room temperature. The instructions prohibit the preparation of Suprax from hot liquid. How to dilute the suspension is described in detail in the annotation that comes with each bottle of antibacterial medicine.

Suprax®

Absorption:

According to the results of studies involving healthy volunteers, after oral administration of cefixime, maximum serum concentrations are usually achieved after 3-4 hours. Following single doses of 50, 100, and 200 mg, mean maximum serum concentrations were 1.02, 1.46, and 2.63 mg/L, respectively, in 12 healthy Caucasians, and 0.69, 1.13, and 1.95 mg/l, respectively, in 12 healthy Japanese subjects.

Children's population:

After single doses of 1.5, 3.0, and 6.0 mg/kg cefixime were administered to Japanese pediatric patients, peak serum concentrations after 3 to 4 hours were 1.14, 2.01, and 3.97 mg/L, respectively.

Distribution:

In human plasma, cefixime is approximately 70% protein bound, with the level of binding independent of concentration in the range of 0.5-30 mg/l. Cefixime is distributed, reaching concentrations in organs/tissues and biological fluids, such as saliva, tonsils, mucous membrane of the maxillary sinuses, middle ear discharge, bile, lung tissue and gall bladder.

Metabolism and excretion:

Biologically active metabolites of cefixime were not detected in the plasma or urine of healthy volunteers after oral administration of the drug. Approximately 20% of a 200 mg dose of cefixime in healthy volunteers is excreted unchanged by the kidneys. The half-life is 2-4 hours.

Kidney failure:

The pharmacokinetics of a single 400 mg oral dose were studied in studies involving patients with varying degrees of renal impairment. Based on the results of studies, half-life, total clearance (CL/F), renal clearance and area under the pharmacokinetic curve (AUC) in patients with severe renal impairment (creatinine clearance < 20 ml/min), patients on hemodialysis or on continuous ambulatory peritoneal dialysis (CAPD) differed from the corresponding indicators of healthy volunteers.

Pharmacokinetic characteristics (mean values) of cefixime in healthy volunteers and patients with varying degrees of severity of renal dysfunction

The discrepancy is statistically significant compared to the values ​​of healthy volunteers.

Abbreviations: CLCr - creatinine clearance, Cmax - maximum concentration, Tmax - time to reach maximum concentration, T1/2β - half-life, CL/F - total clearance, CAPD - continuous ambulatory peritoneal dialysis, AUC - area under the pharmacokinetic curve # p < 0 .05 compared to healthy volunteers

Detailed algorithm

How to dilute Suprax (suspension)? To ensure that the medication is prepared correctly, you must perform the following steps:

1. Open the cardboard packaging and remove the bottle of granules.
2. Turn the bottle over and shake it for a few seconds.
3. Prepare 40 ml of water.
4. With clean hands, open the bottle and pour in half the liquid.
5. Close the bottle tightly and shake the substance thoroughly.
6. Open the bottle again and add the remaining water.
7. Shake the resulting mass until a homogeneous consistency is obtained.

After preparing the medicine, you need to let it sit for a while. This is necessary so that the granules dissolve completely. The waiting time usually does not exceed 10 minutes. After this, you can take the medication as prescribed by your doctor.

Suprax gran d/susp i.n. approx 100 mg/5 ml 30.3 g x1

Suprax gran d/susp i.n. approx 100 mg/5 ml 30.3 g x1, ATX code: J01DD08 (Cefixime) Active substance: cefixime (cefixime) Rec.INN registered by WHO

Dosage form

SUPRAX®

granules for preparation. susp. for oral administration 100 mg/5 ml: vial. 30.3-35.0 g per set with dosage spoonreg. No.: P N013023/02 dated 06/09/09 - Indefinitely

Release form, composition and packaging

The granules for the preparation of an oral suspension are almost white to cream in color, fine, after mixing, an almost white to cream suspension with a sweet strawberry aroma is formed.

1 fl. 5 ml of ready-made suspension.

cefixime trihydrate (micronized) 1.402 g 100 mg

 (equivalent to 1.2 g cefixime + 4% refill)

Excipients: sodium benzoate - 0.03 g, sucrose - 30.225 g, xanthan gum - 0.155 g, strawberry flavor - 0.048 g.

Clinical-pharmacological group: III generation cephalosporin Pharmaco-therapeutic group: Antibiotic, cephalosporin The scientific information provided is general and cannot be used to make a decision about the possibility of using a specific drug.

pharmachologic effect

Semisynthetic cephalosporin antibiotic of the third generation for oral administration with a broad spectrum of action. Acts bactericidal. The mechanism of action is due to inhibition of the synthesis of the pathogen's cell membrane. Cefixime is resistant to the action of β-lactamases produced by most gram-positive and gram-negative bacteria.

In vitro, cefixime is active against gram-positive bacteria: Streptococcus agalactiae, gram-negative bacteria: Haemophilus parainfluenzae, Proteus vulgaris, Klebsiella pneumoniae, Klebsiella oxytoca, Pasteurella multocida, Providencia spp., Salmonella spp., Shigella spp., Citrobacter amalonaticus, Citrobacter diversus, Serratia marcescen s .

In vitro and in clinical practice, cefixime is active against gram-positive bacteria: Streptococcus pneumoniae, Streptococcus pyogenes, gram-negative bacteria: Haemophilus influenzae, Moraxella (Branhamella) catarrhalis, Escherichia coli, Proteus mirabilis, Neisseria gonorrhoeae.

Pseudomonas spp., Enterococcus (Streptococcus) serogroup D, Listeria monocytogenes, most Staphylococcus spp. are resistant to cefixime. (including methicillin-resistant strains), Enterobacter spp., Bacteroides fragilis, Clostridium spp.

Pharmacokinetics

When taken orally, the bioavailability of cefixime is 40-50%, regardless of food intake, however, the Cmax of cefixime in serum is achieved faster by 0.8 hours when taking the drug with food. Binding to plasma proteins, mainly albumin, is 65%. About 50% of the dose is excreted unchanged in the urine within 24 hours, about 10% of the dose is excreted in bile. T1/2 depends on the dose and is 3-4 hours. In patients with impaired renal function with CC from 20 to 40 ml/min, T1/2 increases to 6.4 hours, with CC 5-10 ml/min - up to 11.5 hours.

Indications

Infectious and inflammatory diseases caused by sensitive microorganisms: pharyngitis, tonsillitis, sinusitis, acute and chronic bronchitis, otitis media, uncomplicated urinary tract infections, uncomplicated gonorrhea.

ICD-10 codes

Dosage regimen

For adults and children over 12 years of age weighing more than 50 kg, the daily dose is 400 mg (1 time/day or 200 mg 2 times/day). The duration of treatment is 7-10 days. For uncomplicated gonorrhea - 400 mg once.

Children under 12 years of age - 8 mg/kg body weight 1 time/day or 4 mg/kg every 12 hours.

For infections caused by Streptococcus pyogenes, the course of treatment should be at least 10 days.

In case of impaired renal function (with CC from 21 to 60 ml/min) or in patients on hemodialysis, the daily dose should be reduced by 25%.

With CC≤20 ml/min or in patients on peritoneal dialysis, the daily dose should be reduced by 2 times.

Side effect

From the digestive system: dry mouth, anorexia, diarrhea, nausea, vomiting, abdominal pain, flatulence, transient increase in the activity of liver transaminases and alkaline phosphatase, hyperbilirubinemia, jaundice, gastrointestinal candidiasis, dysbacteriosis, rarely - stomatitis, glossitis, pseudomembranous enterocolitis.

From the hematopoietic system: leukopenia, thrombocytopenia, neutropenia, hemolytic anemia.

From the side of the central nervous system: dizziness, headache.

From the urinary system: interstitial nephritis.

Allergic reactions: skin itching, urticaria, skin hyperemia, eosinophilia, fever.

Contraindications for use

Hypersensitivity to cephalosporins and penicillins.

Use during pregnancy and breastfeeding

Use during pregnancy is possible only when the expected benefit to the mother outweighs the potential risk to the fetus.

If necessary, use during lactation should stop breastfeeding.

Use for renal impairment

In case of impaired renal function (with CC from 21 to 60 ml/min) or in patients on hemodialysis, the daily dose should be reduced by 25%. With CC≤20 ml/min, the daily dose should be reduced by 2 times.

Use in children Use with caution in children under 6 months of age.

Use in elderly patients Use with caution in elderly patients.

special instructions

Use with caution in elderly patients, patients with chronic renal failure or pseudomembranous colitis (history), and in children under 6 months of age.

With long-term use, normal intestinal microflora may be disrupted, which can lead to the growth of Clostridium difficile and cause the development of severe diarrhea and pseudomembranous colitis.

In patients with a history of allergic reactions to penicillins, manifestations of hypersensitivity to cephalosporin antibiotics are possible.

During treatment, a positive direct Coombs test and a false positive urine test for glucose are possible.

Overdose

Blockers of tubular secretion (allopurinol, diuretics) delay the excretion of cefixime by the kidneys, which can lead to increased toxicity.

Cefixime reduces the prothrombin index and enhances the effect of indirect anticoagulants.

Antacids containing magnesium or aluminum hydroxide slow down the absorption of cefixime.

Taking the drug

Many parents ask themselves the question in advance: “How to dilute the Suprax suspension for children?” After all, not every baby will be happy to take medicine. It’s worth immediately making a reservation that the antibiotic “Suprax” (suspension) has a pleasant sweet taste. The medicine has no bitterness. Therefore, children calmly take the syrup, especially since it is only necessary once a day.

It would be a good idea for moms and dads to know how to dilute Suprax (suspension) for children. The drug, says the manufacturer, can be added to drinks or food. If your baby drinks juice, formula, or is breastfed, you can use this base. Simply dilute the liquid medication with the appropriate product. You can dilute the drug with porridge or puree soup. It is important that the food is not hot.

Let's summarize

You already know the basic rules about how to dilute Suprax (suspension). If you prepare the medication incorrectly, you may simply not get a positive effect. Such treatment will be in vain, and the patient will need stronger drugs. The granules from which the syrup is prepared must be diluted strictly according to the instructions. If you are not sure of some action, then it is better not to perform it. Consult your doctor with any questions you may have.

Suprax dispersible tablets are diluted in clean drinking water. The solution must be prepared immediately before use. It is unacceptable to store the tablet in liquid form. But the syrup, prepared taking into account all the rules, can be kept in the refrigerator for two weeks. Suprax dispersible tablets can be dissolved or taken as is. This will not change the effectiveness of treatment. If you do not feel better after 2-3 days, be sure to notify your doctor.