Zinnat 250mg tablets 10
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Active substance: cefuroxime axetil * 300.72 mg, which corresponds to the content of cefuroxime 250 mg.
Excipients: microcrystalline cellulose** - 95.03 mg, croscarmellose sodium - 40 mg, sodium lauryl sulfate - 4.5 mg, vegetable hydrogenated oil - 8.5 mg, silicon dioxide colloidal - 1.25 mg.
Composition of the film shell: hypromellose - 7.4 mg, propylene glycol - 0.44 mg, methyl parahydroxybenzoate - 0.07 mg, propyl parahydroxybenzoate - 0.06 mg, white spray dye - 2.03 mg (hypromellose - 3%, titanium dioxide - 36%, sodium benzoate - 0.1%).
Cefuroxime axetil is a precursor to cefuroxime - an antibiotic of the cephalosporin group of the II generation with a bactericidal effect. Cefuroxime is active against a wide spectrum pathogens, including strains that produce lactamase β. Cefuroxime is resistant to the action of bacterial β-lactamases, so it is effective against ampicillin-resistant or amoxicillin-resistant strains.
The bactericidal effect of cefuroxime is associated with the suppression of the synthesis of the cell wall of bacteria as a result of binding to the main target proteins.
The prevalence of acquired bacterial resistance to cefuroxim varies by region and over time in certain species of microorganisms resistance can be very high. It is preferable to have local sensitivity data, especially in the treatment of severe infections.
Indications for use
Treatment of infectious and inflammatory diseases caused by microorganisms sensitive to the drug:
- infections of the upper respiratory tract, ENT organs (otitis media, sinusitis, tonsillitis, pharyngitis);
- lower respiratory tract infections (including pneumonia, acute bacterial bronchitis and exacerbation of chronic bronchitis);
- urinary tract infections (including pyelonephritis, cystitis, urethritis);
- infections of the skin and soft tissues (including furunculosis, pyoderma, impetigo);
- gonorrhea: acute uncomplicated gonorrheal urethritis and cervicitis;
- treatment of borreliosis (Lyme disease) at an early stage and prevention of late stages of this disease in adults and children over 12 years of age.
Cefuroxime is also available in the form of sodium salt (the drug Zinacef ®) for parenteral administration. This allows for step therapy using the transition from parenteral to oral cefuroxime, if there are clinical indications for this.
If necessary, step therapy is indicated in the treatment of pneumonia and in exacerbation of chronic bronchitis.
The sensitivity of bacteria to cefuroxim varies by region and over time. Where possible, local sensitivity data should be taken into account.
- children's age up to 3 years (for children from 3 months to 3 years of age Zinnat ® , granules for the preparation of suspension for oral administration);
- hypersensitivity to beta-lactam antibiotics (in particular to cephalosporin antibiotics, penicillins and carbapenems in the anamnesis).
Caution should be exercised when used in patients with impaired renal function; diseases of the gastrointestinal tract (including in the anamnesis, as well as with ulcerative colitis); in pregnant women and during breastfeeding.
Use in pregnancy and lactation
Drug Zinnat ® should be used if the potential benefit to the mother outweighs the potential risk to the fetus and baby.
There is no experimental evidence of embryopathic or teratogenic effects of cefuroxime axetil, but just as with other drugs, caution should be exercised when prescribing it in early pregnancy.
Caution should be exercised when prescribing the drug to nursing mothers, since the drug is excreted in breast milk.
Use in renal dysfunction
Caution should be exercised when prescribing to patients with impaired renal function.
Use in children
Contraindicated in children under 3 years of age.
Before use, it is necessary to carefully collect an allergic history.
In the process of treatment, it is necessary to monitor kidney function, especially in patients receiving the drug in a high dose.
During the reception period preparation Zinnat ® a false-positive reaction of urine to glucose is possible.
As with the use of other antibiotics, long-term use of the drug Zinnat ® can lead to excessive growth of fungi of the genus Candida. Long-term use may cause the growth of other resistant microorganisms (Enterococcus and Clostridium difficile), which may require discontinuation of treatment.
Cases of pseudomembranous colitis when taking antibiotics are described, the severity of which can vary from mild to life-threatening. Therefore, it is necessary to carry out differential diagnosis of pseudomembranous colitis in patients with diarrhea that occurs during or after a course of antibiotic treatment. If the diarrhea is prolonged or pronounced or the patient experiences abdominal cramps, treatment with Zinnat ® should be stopped immediately, the patient should be examined.
Jaris's reaction- Herxheimer was observed in borreliosis (Lyme disease) while taking the drug Zinnat ® and is due to the bactericidal activity of the drug against the causative agent of the disease spirochete Borrelia burgdorferi. Patients should be informed that these symptoms are a typical consequence of the use of antibiotics for this disease.
With step therapy, the time of transition to oral therapy is determined by the severity of the infection, the clinical condition of the patients and the sensitivity of the pathogen. If the clinical effect is not achieved within 72 hours from the start of treatment, parenteral therapy should be continued.
Before starting step therapy, you should carefully read the instructions for the use of the sodium salt of cefuroxime for parenteral administration (the drug Zinacef ® ).
Influence on the ability to drive vehicles and control mechanisms
Since Cefuroxime Axetil can cause dizziness, it is necessary to warn patients about precautions when driving a vehicle or working with moving mechanisms.
Drugs that reduce the acidity of gastric juice can reduce the bioavailability of cefuroxime axetil when comparing it with that observed after taking the drug on an empty stomach, and also neutralize the effect of increased absorption of the drug after a meal.
Like other antibiotics, Zinnat ® can affect the intestinal microflora, which leads to a decrease in estrogen reabsorption and, as a result, to a decrease in the effectiveness of oral hormonal combined contraceptives.
When conducting a ferrocyanide test, a false negative result may be observed, therefore, glucose oxidase or hexokinase methods are recommended to determine the level of glucose in the blood and / or plasma.
Drug Zinnat ® does not affect the quantitative determination of creatinine by the alkaline-picrate method.
Simultaneous reception with "loop" diuretics slows down tubular secretion, reduces renal clearance, increases plasma concentration and increases T 1/2 cefuroxime.
Simultaneous administration of cefuroxime and probenecid leads to an increase in the AUC of cefuroxime by 50%.
With simultaneous administration with aminoglycosides and diuretics, the risk of nephrotoxic effects increases.
Dosage and Administration
A single dose for adults and children over 12 years of age is usually 250 mg 2 times a day.
In severe infections of the lower respiratory tract - 500 mg 2 times a day.
For urinary tract infections, 125 mg is prescribed 2 times a day, with pyelonephritis - 250 mg 2 times a day.
In the treatment of uncomplicated gonorrhea, 1 g is prescribed once.
In Lyme disease – 500 mg 2 times a day for 20 days.
Symptoms: An overdose of cephalosporins can cause an increase in brain excitability with the development of seizures.
Treatment: conduct symptomatic therapy. Serum concentrations of cefuroxime can be reduced with hemodialysis and peritoneal dialysis.
Undesirable reactions when using cefuroxime axetil are usually mild, short-lived and reversible.
Undesirable reactions presented below are listed in accordance with the defeat of organs and organ systems and the frequency of occurrence. The frequency of occurrence is determined as follows: very often (≥1/10), often (≥1/100 and <1/10), infrequently (≥1/1000 and <1/100), rarely (≥1/10,000 and <1/1000), very rare (<1/10,000, including individual cases).
Frequency categories were formed on the basis of clinical studies of the drug and post-registration surveillance.
Infectious and parasitic diseases: often - excessive growth of fungi of the genus Candida.
From the hematopoietic system: often - eosinophilia; infrequently - a positive Coombs test, thrombocytopenia, leukopenia (sometimes severe); very rarely - hemolytic anemia. Cephalosporins are absorbed on the surface of the cell membrane of erythrocytes, binding to antibodies to cephalosporins, which leads to a positive result of the Coombs reaction (which can affect cross-compatibility) and in very rare cases - to hemolytic anemia.
From the immune system: hypersensitivity reactions, incl. infrequently - skin rash; rarely - urticaria, itching; very rarely - drug fever, serum sickness and anaphylaxis.
From the nervous system: often - headache, dizziness.
From the digestive system: often - gastrointestinal disorders, including diarrhea, nausea, pain in abdomen, transient increase in the activity of liver enzymes ALT, ACT, LDH; infrequently - vomiting; rarely - pseudomembranous colitis; very rarely - jaundice (mainly cholestatic), hepatitis.
From the skin and subcutaneous fat: very rarely - erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis.
The drug should be stored out of the reach of children at a temperature not exceeding 30 ° C.
Shelf life - 3 years. Do not use after the expiry date stated on the carton.
- Dosage form
- 250 mg
- Number of tablets
- INN Russian
- Russian title