Antibiotic "Remedia": instructions for use, reviews, analogues

Modern treatment of infectious processes is not conceivable without the use of antibacterial drugs. The constantly growing resistance of microorganisms determines the search for new drugs or the use of combinations of old, well-proven antibiotics. Not in favor of rational use of antibacterial drugs is the uncontrolled administration of broad-spectrum antibiotics, instead of the initial assessment of the flora sensitivity to the drugs of this group. Medicinal remedy, having significant pharmacokinetic and pharmacodynamic advantages in a number of fluoroquinolones, is increasingly used to treat infectious diseases of various etiologies.

Clinical and pharmacological characteristics

The Remedia remedy, or Levofloxacin (an international nonproprietary name), is an antibacterial preparation from a number of fluoroquinolones, intended for enteral and parenteral routes of administration.

By its nature, Remedia (the instruction for use gives exactly this information) is monofluoroquinolone, an isomer of ofloxacin, and, in comparison with other drugs, has significant pharmacokinetic advantages:

• Bioavailability for oral administration is 100%, with the degree of kinship with plasma proteins reaching 40%;
• The maximum content of the drug in the blood serum is observed 1-2 hours after ingestion and is comparable with that after intravenous administration;
• "Remedia" is characterized by an increased volume of distribution in the body, due to intensive penetration into tissues;
• Has a long half-life from the body, which causes only a single dose of the drug per day.

Given that the significant therapeutic effect of fluoroquinolones causes a rapid rate of increase in the therapeutic concentration of the drug in the blood, the above pharmacokinetic parameters create favorable conditions for the complete elimination of microorganisms.

By its type of action on the growth and reproduction of bacteria, "Remedia" has a bactericidal effect, affecting not only the active forms of pathogenic bacteria, but also vegetative and inactive.

Metabolism of a small amount of the drug occurs in the hepatocytes by oxidation or deacetylation. About 5% of the drug is excreted by the kidneys in the form of metabolites, and the rest is secreted by glomerular filtration and tubular secretion. It should be noted that after oral administration a significant part of the drug (about 70%) is excreted from the body within 24 hours with urine, and about 80% of the dose is eliminated after 48 hours. The proportion of withdrawn drug through the gastrointestinal tract is low and is only about 4%.

When using the drug at a dose of more than 1000 mg per day (twice taking tablets of 500 mg), there is little chance of developing a cumulative effect.

Mechanism of action

The mechanism of action of the drug is based on the inhibition of a specific enzyme called DNA-gyrase, which participates in the replication of genetic material, sewing positive turns of the DNA helix into negative ones. As a result of the inhibition of this enzyme, DNA replication, cell division, and cell death occur.

Remedia: instructions for use and indications

To date, the main indications for prescribing the drug are the infectious processes of bacterial etiology caused by antibiotic-sensitive strains of microorganisms in persons over 18 years of age.

Remedia remedy has proven itself in the treatment of respiratory bacterial infections of the upper and lower respiratory tract, such as acute bronchitis, sinusitis, inflammatory diseases of lung tissue. This is due, above all, to the excellent penetration of the drug into the epithelium of the bronchi and lungs, where even after the first administration of the drug an effective concentration is created.

Also, the drug is successfully used for the treatment of urinary tract infections (pyelonephritis, cystitis, urethritis, etc.), infections of bile ducts, prostatitis, skin infections, intra-abdominal infections and septic conditions.

In order to treat infectious diseases of the respiratory tract, Remedia is prescribed (depending on the severity of the course of the disease) 1-2 times a day for 500 mg in the tablet or injection form of the drug.

For treatment of urinary tract infections, a dose of 250 mg of the drug is sufficient once a day, and in severe cases, the daily dose can be 500 mg (Remedia 500). Instruction for use says that twice taking a dose of 250 mg can be replaced by a single dose of 500 mg, depending on the severity of the disease.

For the treatment of infectious diseases of the skin and mucous membranes, Remedia is administered at a dosage of 250 mg twice a day.

Contraindications

Absolute contraindication to taking the drug is hypersensitivity and the presence of allergic reactions in the anamnesis for the drugs of the group of fluoroquinolones.

There is no single-valued data regarding the intake of the drug during pregnancy, as controlled studies to study teratogenic or embryotoxic effects have not been conducted.

Therefore, the appointment of Remedia to pregnant women should be avoided, except when the potential risk of prescribing is lower than the benefits of Remedia.

In the case of using the drug in patients suffering from porphyria, there may be an exacerbation of the disease.

With extreme caution, the infusion solution should be used in patients with previous lesions of the central nervous system (strokes, heart attacks, traumatic brain damage), due to the high likelihood of convulsions.

For patients working with complex mechanisms in the workplace or driving vehicles, there is no specific indication, but the possibility of side effects from the central nervous system in the form of drowsiness, confusion, etc. should be taken into account. Therefore, it is worth refraining from this kind of work.

Side effects

One of the most significant side effects that develop against the background of fluoroquinolones is the development of cartilaginous tissue due to damage to the chondrocytes of the epiphyses and the tissue itself. In view of this, the drug is contraindicated for persons under 18 years of age and pregnant. It should be noted that in patients older than 18 years on the background of long-term use of the drug, there was no occurrence of arthralgia or impaired function of the joints. Other side effects include the following.

On the part of the gastrointestinal tract - nausea, vomiting, decreased appetite, the appearance of uncomfortable sensations in the epigastric region, possibly the occurrence of gastrointestinal bleeding and the development of gastroenteritis; Increase in the level of aminotransferases in blood plasma.

From the central nervous system - the development of symptoms of encephalopathy, headache, dizziness, loss of consciousness, sleep disorders and frequent changes in mood, the appearance of paresthesias, hallucinations and delusions.

From the immune system - the development of allergic reactions in the form of skin rashes, itching, and with the condition of increased insolation photodermatitis can develop.

From the urinary system - the development of crystalluria.

On the part of the respiratory system, the appearance of bronchospasm is likely, and on the part of the circulatory system, a sharp decrease in arterial pressure, the development of hypoglycemia, reactions from the cellular link of hemostasis (in the form of thrombocytopenia, etc.).

Interaction with other drugs

Preparations of the group of fluoroquinolones are not prescribed together with antacids, as it significantly reduces the absorption and bioavailability of antibiotics. It is not recommended simultaneous application of "Remedia" with iron preparations, as well as with drugs that affect the functional activity of the central nervous system. In addition, there are data on the effects of probenecid and cimetidine on excretion of the drug from the body (these substances can reduce antibiotic elimination).

There is no single indication of drug interactions with levofloxacin. In view of the low metabolism of the drug in the hepatic tissue and the lack of interaction with the enzymes of the cytochrome P450 group, Remedia does not change the activity of the latter, however, like the rest of the fluoroquinolones, this drug should not be combined with theophylline preparations and indirect anticoagulants, In view of a possible increase in the concentration of the latter in the blood.

Use of the drug during breastfeeding

To date, there is no information on the ability of the drug to penetrate into the mother's breast milk. If there is a need for antibiotic therapy during breastfeeding, the latter should be temporarily discontinued for a while (duration depends on the severity of the infection process and the estimated duration of antibiotic therapy). If necessary, with the purpose of preserving lactation, periodic pumping is performed or the lactation is stopped completely with the help of medical devices.

In extreme cases, breastfeeding and antibiotic therapy are possible in assessing the risks to the child and mother.

Form release and dosage

"Remedia" is available in two forms: for enteral and parenteral administration. For oral administration, there is a tablet form containing 250 or 500 mg of the preparation (respectively under the trade names "Remedia 250" and "Remedia 500"). For parenteral administration , a solution for infusion is available.

Remedia tablets are taken 1-2 times a day before meals or during a break between its administration, without chewing, squeezed with enough water. In case of necessity to divide the dose of the drug in half, the tablet can be broken on the label into two parts.

For parenteral administration, an injection solution is available with an active ingredient concentration of 500 mg / 100 ml solution (Remedia 500). In the case of intravenous injection, the drug is administered no faster than for 1 hour.

After the infusion of the drug is recommended to further transition to the tablet form. The estimated duration directly depends on the severity of the infectious process and the sensitivity of the pathogenic microflora to the antibiotic. Therapy (regardless of the form of administration) is recommended to continue for 3-4 days after the normalization of body temperature. Self-treatment and early termination of the drug is not recommended, due to the high risk of adverse reactions and the likely development of resistance of the microflora to the drug.

special instructions

Before the beginning of therapy with the use of Remedia, the instruction for use commits a sample to the sensitivity of the strain of microorganisms to this preparation. However, in the form of a broad spectrum of action, treatment can be initiated without a sample, followed by the determination of the most effective drug.

When prescribing Remedia medicine, special attention should be given to analyzes aimed at assessing renal blood flow, since the bulk of the drug is excreted through the kidneys. In case of violations of the function of the latter, the dosage of the drug must be adjusted in accordance with the clearance of endogenous creatinine.

Infusion forms of the drug are categorically forbidden to mix with solutions for injections that have an alkaline reaction (sodium bicarbonate), as well as with heparin. For the purpose of dilution, the infusion set "Remedia" is compatible with isotonic sodium chloride solution , isotonic glucose solution and Ringer's solution.

During the reception of Remedy, alcohol intake should be avoided, as it helps to increase the toxic effect of levofloxacin on the central nervous system and a more pronounced manifestation of side effects.

If it is decided to apply Remedia on its own, the instructions for use, analogues, should be studied carefully, since it is the completeness of the information and reliance on sufficient knowledge about the preparation to avoid gross mistakes.

Storage and dispensing from pharmacies

The drug does not require special storage conditions. Its safety is ensured at an ambient temperature of no more than 25 degrees Celsius. From pharmacies "Remedia" (antibiotic) is released on prescription.

When buying a drug, you must pay attention to the integrity and safety of the package, the date of manufacture and the expiration date. The instruction for use must be present in the box with the remedy remedy. Tablets should be in high-quality packaging. You can check the tactile sensations from it (no matter how strange it may seem). This is due to the fact that falsifications and counterfeits appear more and more often in the pharmaceutical market, which at best are not capable of providing the proper antibacterial effect when taken orally, and at worst - causing severe side effects. Therefore, when purchasing a drug, do not be lazy to ask the pharmacist about the availability of a quality certificate confirming the origin of the remedy medicine (tablets). Instructions for use (according to the prescription of the purchased product) should contain information about the origin of the product.

Overdose

In the case of an overdose, there is no specific antidote. The symptomatology when the dose is exceeded is due mainly to the influence of the latter on the functional activity of the central nervous system. In this case, confusion, drowsiness, dizziness, as well as symptoms of excitation of the nervous system in the form of psychoses, epileptic seizures, etc., are observed.

Treatment is aimed at prompt removal of the drug from the body. Given the high bioavailability and distribution of the drug throughout the body, hemodialysis methods of detoxification are ineffective. It is necessary to stop the receipt of the drug in the body and carry out symptomatic treatment.

Due to the considerable elimination of "Remedia" by filtration in the renal glomeruli, an effective method of detoxification is the use of water-salt infusion solutions and diuretic drugs of the loop type of action.

Reviews about the drug

In general, there are positive reviews of the drug because of its high effectiveness for the treatment of infectious diseases of various etiologies. As the instructions for use refer to Remedia, reviews of the drug are left not only by patients, but also by attending physicians who note its high efficacy, up to the treatment of hospital and nosocomial infections.

Negative reviews and dissatisfaction with the drug are left mostly by patients. This is due to the development of their side effects or improper application of Remedia. The instruction, however, gives quite comprehensive information for this preparation. Negative reviews are caused by the use of the medicinal product in cases when it is ineffective due to a mismatch in the spectrum of antibacterial action of the microbial infection. It should be noted that critical opinions are often left by patients engaged in self-medication and taking on self-prescription or on the recommendation of friends or acquaintances of Remedia (the instruction is often ignored, which is highly discouraged). Negative feedback from medical specialists is practically not observed. This is due to the correct and rational use of the medicinal product (information about Remedia 500, the instruction contains enough information for the proper administration of the medicinal product).

Analogues of the remedy remedy

For Remedia, the analogues instruction describes as follows: since this drug is a fluoroquinolone antibiotic levofloxacin, it is quite possible to consider fully all analogous drugs of similar composition. Among those, we should mention first of all "Levofloxacin", "Zolev", "Lebed", "Levoximed" and many others. For "Remedia" (tablets), the instruction on the use of analogues suggests in the form of such drugs as "Leflok", "Floksium" and others.

Conclusion

The active component of Remedia is the antibiotic levofloxacin. It is an excellent antibacterial preparation with a broad spectrum of action with bactericidal effect. Due to the low incidence of adverse reactions and the lack of resistance to the antibiotic of various bacterial strains, it is successfully used in the clinical practice of Remedia. Instruction for use provides quite comprehensive information on the activity of the drug.