Tsifran or Tsifran st which is better - myLor. Tsifran: analogs by active substance and action, indications, pricing policy

Tsifran ST (tinidazole + ciprofloxacin) is a combined antibacterial drug. Used for the treatment of combined aerobic and anaerobic invasions, as well as bacterial invasions of the gastrointestinal tract ( chronic inflammation sinus sinuses, abscess pneumonia, pyothorax, infections that develop when the anatomical barriers of the gastrointestinal tract are violated, gynecological infections, infections after surgical interventions, purulent-necrotic process in bone tissue, dermatological infections, oral infections, amoebic and/or bacterial diarrhea and dysentery). Anaerobes - clostridia, bacteroides, peptococci and peptostreptococci - are sensitive to tinidazole. In most cases, in the presence of an anaerobic infection, aerobes are also present in the lesion, therefore, to increase efficiency, an antibacterial drug effective against aerobes is added. In Cifran ST, this is ciprofloxacin, sensitivity to which is shown by such aerobes as Escherichia coli, Klebsiella, Salmonella, Yersinia, Shigella, Haemophilus influenzae, Neisseria, mycoplasma, Vibrio cholerae, staphylococcus, streptococcus, chlamydia, mycoplasma, legionella, mycobacterium tuberculosis. Tinidazole and ciprofloxacin are rapidly absorbed into digestive tract. Maximum concentrations of both substances are observed 1-2 hours after administration. The half-life of tinidazole is 12-14 hours. The drug has good penetrating ability.

It is excreted mainly in urine and in small quantities in feces. The presence of food contents in the gastrointestinal tract slows down the absorption of ciprofloxacin. Half-life is 3.5-4.5 hours. Cifran ST is not used in persons with individual intolerance to tinidazole and/or ciprofloxacin, as well as any other fluoroquinolone or imidazole antibiotics, organic lesions nervous system. In pediatrics, Tsifran ST is not used. It is not recommended to use the drug in pregnant women and nursing mothers. Optimal time taking the drug - after meals. The structure of the tablet does not imply its breaking, chewing or any other violation of integrity. The tablet should be taken with a sufficient amount of water so that it can easily reach the site of absorption. The frequency of taking the drug is twice a day. The number of tablets per dose is determined by the dose medicine: 2 tablets (for a dose of 250/300 mg) and 1 tablet (for a dose of 500/600 mg). During the course of medication, it is recommended to avoid long stay exposure to the sun to avoid phototoxicity reactions (if they develop, it is necessary to immediately interrupt pharmacotherapy). It is strictly not recommended to combine Tsifran ST with alcohol consumption, because ethanol in combination with tinidazole can provoke gastrointestinal spasms and dyspeptic reactions in the form of nausea and vomiting. During the course of medication, it is recommended to periodically do blood tests.

Pharmacology

Combined drug. Tinidazole is an antiprotozoal and antimicrobial agent, an imidazole derivative, effective against anaerobic microorganisms such as Clostridium difficile, Clostridium perfringens, Bacteroides fragilis, Peptococcus and Peptostreptococcus anaerobius.

Ciprofloxacin - antibiotic wide range action, active against most aerobic gram-positive and gram-negative microorganisms, such as Escherichia coli, Klebsiella spp., Salmonella typhi and other strains of Salmonella, Proteus mirabilis, Proteus vulgaris, Yersinia enterocoilitica, Pseudomonas aeruginosa, Shigella flexneri, Shigella sonnei, Haemophilus ducreyi, Haemophilus influenzae, Neisseria gonorrhoeae, Moraxella catarrhalis, Vibrio cholerae, Bacteroides fragilis, Staphylococcus aureus(including methicillin-resistant strains), Staphylococcus epidermidis, Streptococcus pyogenes, Streptococcus pneumoniae, Mycoplasma, Legionella and Mycobacterium tuberculosis.

Pharmacokinetics

Bioavailability of tinidazole is 100%, protein binding is 12%. T 1/2 - 12-14 hours. Tinidazole penetrates into cerebrospinal fluid in a concentration equal to that in plasma, and is reabsorbed in the renal tubules. Tinidazole is excreted into bile in concentrations slightly below 50% of its plasma concentration. About 25% is excreted unchanged in the urine, 12% in the form of metabolites. Minor amounts are excreted in the feces.

The bioavailability of ciprofloxacin is about 70%. Simultaneous use food slows down absorption. Connection with proteins - 20-40%. Ciprofloxacin penetrates well into body fluids and tissues: lungs, skin, fat, muscle and cartilage tissue, and bone tissue and organs of the urinary system, including prostate gland. Ciprofloxacin is partially metabolized in the liver. T1/2 - about 3.5-4.5 hours, can be prolonged with severe renal failure and in elderly patients. About 50% is excreted unchanged in the urine, 15% is excreted in the form of active metabolites (including oxoprofloxacin). The rest is excreted in bile, partially reabsorbed. About 15-30% of ciprofloxacin is excreted in the feces.

Release form

10 pieces. - contour cell packaging (1) - cardboard packs
10 pieces. - contour cell packaging (10) - cardboard packs.

Dosage

Inside, after meals, with plenty of water. Do not break, chew, or crush the tablet.

Overdose

Interaction

Tinidazole.

Enhances the effect indirect anticoagulants(to reduce the risk of bleeding, the dose is reduced by 50%) and the effect of ethanol (disulfiram-like reactions).

Compatible with sulfonamides and antibiotics (aminoglycosides, erythromycin, rifampicin, cephalosporins).

Phenobarbital speeds up metabolism.

Ciprofloxacin.

Due to a decrease in the activity of microsomal oxidation processes in hepatocytes, it increases the concentration and lengthens T1/2 of theophylline (and other xanthines, including caffeine), oral hypoglycemic drugs, indirect anticoagulants, and helps reduce the prothrombin index.

When combined with other antimicrobial drugs (beta-lactam antibiotics, aminoglycosides, clindamycin, metronidazole), synergism is usually observed.

Enhances the nephrotoxic effect of cyclosprorine, there is an increase in serum creatinine, in such patients it is necessary to monitor this indicator 2 times a week.

Oral administration together with iron-containing drugs, sucralfate and antacid drugs containing magnesium, calcium, aluminum salts leads to a decrease in the absorption of ciprofloxacin, so it should be prescribed 1-2 hours before or 4 hours after taking the above drugs.

NSAIDs (except acetylsalicylic acid) increase the risk of developing seizures.

Didanosine reduces the absorption of ciprofloxacin due to the formation of complexes with the magnesium and aluminum ions contained in didanosine.

Metoclopramide accelerates absorption, which leads to a decrease in the time to reach Cmax.

Joint reception with uricosuric drugs leads to a slower elimination (up to 50%) and an increase in the plasma concentration of ciprofloxacin.

Side effects

From the outside digestive system: loss of appetite, dry oral mucosa, “metallic” taste in the mouth, nausea, vomiting, diarrhea, abdominal pain, flatulence, cholestatic jaundice (especially in patients with past diseases liver), hepatitis, hepatonecrosis.

From the central nervous system and peripheral nervous system: headache, dizziness, increased fatigue, impaired coordination of movements (including locomotor ataxia), dysarthria, peripheral neuropathy, rarely - convulsions, weakness, tremor, insomnia, increased intracranial pressure, confusion, depression, hallucinations, as well as other manifestations of psychotic reactions, migraine, thrombosis of cerebral arteries.

From the senses: disturbances of taste and smell, visual impairment (diplopia, changes in color vision), tinnitus, hearing loss.

From the outside of cardio-vascular system: tachycardia, arrhythmia, decreased blood pressure, fainting.

From the hematopoietic organs: leukopenia, granulocytopenia, anemia (including hemolytic), thrombocytopenia, leukocytosis, thrombocytosis.

From the urinary system: hematuria, crystalluria (with an alkaline reaction of urine and decreased diuresis), glomerulonephritis, dysuria, polyuria, urinary retention, decreased nitrogen excretory function of the kidneys, interstitial nephritis.

Allergic reactions: itchy skin, urticaria, skin rash, drug fever, petechiae, swelling of the face or larynx, shortness of breath, eosinophilia, photosensitivity, vasculitis, erythema nodosum, multiform exudative erythema(including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome).

From the outside laboratory parameters: hypoprothrombinemia, increased activity of liver transminases and alkaline phosphatase, hypercreatininemia, hyperbilirubinemia, hyperglycemia.

Other: arthralgia, arthritis, tenosynovitis, tendon ruptures, asthenia, myalgia, superinfections (candidiasis, pseudomembranous colitis), flushing of the face, increased sweating.

Indications

Mixed infections caused by sensitive anaerobic and aerobic microorganisms:

• chronic sinusitis;
• lung abscess;
• empyema;
• intra-abdominal infections;
• inflammatory gynecological diseases;
• postoperative infections with the possible presence of aerobic and anaerobic bacteria;
• chronic osteomyelitis;
• skin and soft tissue infections;
• skin ulcers in diabetic foot;
• bedsores;
• infections oral cavity(including periodontitis and periostitis).

  Diarrhea or dysentery of amoebic or mixed (amebic and bacterial) etiology.

Contraindications

• hypersensitivity (including to fluoroquinolone or imidazole derivatives);
• blood diseases (history);
• inhibition of bone marrow hematopoiesis;
• acute porphyria;
• organic diseases of the central nervous system;
• age under 18 years;
• pregnancy;
• lactation period.

With caution: severe cerebral atherosclerosis, impaired cerebral circulation, mental illness, epilepsy, history of seizures, severe renal and/or liver failure, elderly age.

Features of application

Use during pregnancy and breastfeeding

The use of the drug during pregnancy is not recommended. Tinidazole may be carcinogenic and mutagenic. Ciprofloxacin penetrates the placental barrier.

Tinidazole and ciprofloxacin are excreted into breast milk. Therefore, if it is necessary to use the drug during lactation, breastfeeding should be stopped.

Use for liver dysfunction

Use for renal impairment

Use in children

Contraindicated in children and adolescents under 18 years of age.

Use in elderly patients

special instructions

When using tinidazole (imidazole derivative), it is possible (rarely) to develop generalized urticaria, swelling of the face and larynx, decreased blood pressure, bronchospasm and dyspnea. Therefore, patients with hypersensitivity to other imidazole derivatives may develop cross-sensitivity to tinidazole; the development of a cross-allergic reaction to ciprofloxacin is also possible in patients with hypersensitivity to other fluoroquinolone derivatives. The possibility of cross-allergic reactions should be taken into account.

To avoid the development of crystalluria, the recommended daily dose should not be exceeded; it is also necessary sufficient consumption fluids and maintaining acidic urine. Causes dark coloration of urine, which has no clinical significance.

Patients with epilepsy, a history of seizures, vascular diseases and organic brain damage, due to the threat of adverse reactions from the central nervous system, the drug should be prescribed only for health reasons.

If it occurs during or after treatment for severe and prolonged diarrhea the diagnosis of pseudomembranous colitis should be excluded, which requires immediate discontinuation of the drug and the appointment of appropriate treatment.

If pain appears in the tendons or when the first signs of tenosynovitis appear, treatment should be stopped.

During treatment, peripheral blood patterns should be monitored.

During treatment, you should refrain from potentially active activities dangerous species activities that require increased concentration and speed of psychomotor reactions.

In this article you can read the instructions for use of the drug Tsifran. Feedback from site visitors - consumers - is presented of this medicine, as well as the opinions of specialist doctors on the use of Tsifran in their practice. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogues of Tsifran in the presence of existing structural analogues. Use for the treatment of sore throat and conjunctivitis in adults, children, as well as during pregnancy and breastfeeding.

Tsifrana- a broad-spectrum antimicrobial agent of the fluoroquinolone group. Has a bactericidal effect. Suppresses DNA gyrase and inhibits bacterial DNA synthesis.

Highly active against most gram-negative bacteria: Pseudomonas aeruginosa, Haemophilus influenzae, Escherichia coli, Shigella spp., Salmonella spp., Neisseria meningitidis, Neisseria gonorrhoeae.

Active against Staphylococcus spp. (including strains that produce and do not produce penicillinase, methicillin-resistant strains), some strains of Enterococcus spp., Campylobacter spp., Legionella spp., Mycoplasma spp., Chlamydia spp., Mycobacterium spp.

Ciprofloxacin (the active ingredient of the drug Cifran) is active against bacteria that produce beta-lactamases.

Resistant to ciprofloxacin Ureaplasma urealyticum, Clostridium difficile, Nocardia asteroides. Action regarding Treponema pallidum not studied enough.

Tinidazole is an antiprotozoal and antimicrobial agent, an imidazole derivative, effective against anaerobic microorganisms such as Clostridium difficile, Clostridium perfringens, Bacteroides fragilis, Peptococcus and Peptostreptococcus anaerobius.

Pharmacokinetics

Rapidly absorbed from the gastrointestinal tract. Food intake has little effect on the absorption of Cifran. Plasma protein binding is 20-40%. Distributed in tissues and body fluids. Penetrates into the cerebrospinal fluid: concentrations of ciprofloxacin with non-inflamed meninges reach 10%, with inflamed meninges - up to 37%. High concentrations are achieved in bile. Excreted in urine and bile.

Indications

• infectious and inflammatory diseases caused by microorganisms sensitive to ciprofloxacin, incl. diseases respiratory tract, abdominal cavity and pelvic organs, bones, joints, skin; septicemia; severe infections of the ENT organs. Treatment of postoperative infections. Prevention and treatment of infections in patients with reduced immunity;
• for local use: acute and subacute conjunctivitis, blepharoconjunctivitis, blepharitis, bacterial corneal ulcers, keratitis, keratoconjunctivitis, chronic dacryocystitis, meibomitis. Infectious lesions eyes after injury or contact foreign bodies. Preoperative prophylaxis in ophthalmic surgery.

Release forms

Film-coated tablets 250 mg and 500 mg (OD - prolonged action and ST - contains tinidazole).

Eye drops.

Solution for infusion (injections in injection ampoules).

Instructions for use and dosage regimen

Individual. Orally - 250-750 mg 2 times a day. The duration of treatment is from 7-10 days to 4 weeks.

For intravenous administration single dose- 200-400 mg, frequency of administration - 2 times a day; Duration of treatment is 1-2 weeks, or more if necessary. It can be administered intravenously as a bolus, but more preferably by drip (dropper) over 30 minutes.

When applied topically, instill 1-2 drops into the lower conjunctival sac affected eye every 1-4 hours. After the condition improves, the intervals between instillations can be increased.

The maximum daily dose for adults when taken orally is 1.5 g.

Side effect

• nausea, vomiting;
• diarrhea;
• stomach ache;
• pseudomembranous colitis;
• headache;
• dizziness;
• feeling tired;
• sleep disorders;
• nightmares;
• hallucinations;
• fainting;
• visual disturbances;
• glomerulonephritis;
• dysuria;
• polyuria;
• albuminuria;
• hematuria;
• eosinophilia, leukopenia, neutropenia, changes in platelet count;
• tachycardia;
• violations heart rate;
• arterial hypotension;
• skin itching;
• hives;
• Quincke's edema;
• Stevens-Johnson syndrome;
• candidiasis;
• vasculitis;
• phlebitis (with intravenous administration);
• mild soreness and hyperemia of the conjunctiva ( eye drops).

Contraindications

• pregnancy;
• lactation (breastfeeding);
• children's and adolescence up to 15 years;
• increased sensitivity to ciprofloxacin and other quinolone drugs.

Use during pregnancy and breastfeeding

Cifran penetrates the placental barrier and is excreted from breast milk. Use during pregnancy or breastfeeding is not recommended.

special instructions

In patients with impaired renal function, dosage regimen adjustment is required. Use with caution in elderly patients, with cerebral atherosclerosis, cerebrovascular accidents, epilepsy, convulsive syndrome unknown etiology.

During treatment, patients should receive sufficient fluids.

In case of persistent diarrhea, Cifran should be discontinued.

With simultaneous intravenous administration of ciprofloxacin and barbiturates, monitoring of heart rate, blood pressure, and ECG is necessary. During treatment, it is necessary to control the concentration of urea, creatinine, and liver transaminases in the blood.

During treatment, a decrease in reactivity is possible (especially when used simultaneously with alcohol).

It is not allowed to administer Cifran subconjunctivally or directly into the anterior chamber of the eye.

Drug interactions

With simultaneous use of ciprofloxacin with didanosine, the absorption of ciprofloxacin is reduced due to the formation of ciprofloxacin complexes with aluminum and magnesium buffers contained in didanosine.

When used simultaneously with warfarin, the risk of bleeding increases.

With the simultaneous use of Cifran and theophylline, it is possible to increase the concentration of theophylline in the blood plasma, increase T1/2 of theophylline, which leads to an increased risk of developing toxic effect associated with theophylline.

Simultaneous use of antacids, as well as drugs containing aluminum, zinc, iron or magnesium ions, can cause a decrease in the absorption of ciprofloxacin, so the interval between the administration of these drugs should be at least 4 hours.

Analogues of the drug Tsifran

Structural analogues of the active substance:

• Alcipro;
• Afenoxin;
• Basijen;
• Betaciprol;
• Vero-Ciprofloxacin;
• Zindolin 250;
• Ificipro;
• Quintor;
• Quipro;
• Liproquin;
• Microflox;
• Oftocipro;
• Procipro;
• Recipro;
• Syphlox;
• Tseprova;
• Ciloxane;
• Cypraz;
• Cyprinol;
• Ciprobay;
• Ciprobid;
• Cyprobrine;
• Ciprodox;
• Ciprolacare;
• Tsiprolet;
• Ciprolone;
• Tsipromed;
• Cypropane;
• Tsiprosan;
• Cyprosyn;
• Ciprosol;
• Ciprofloxabol;
• Ciprofloxacin;
• Citeral;
• Cifloxinal;
• Tsifran OD;
• Tsifran ST;
• Ecotsifol.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.

Cifran (ciprofloxacin) is an antibacterial drug of the fluoroquinolone series. Exhibits a bactericidal effect. Compliance (adherence to treatment) is one of the most current problems modern medicine. Proper compliance is ensured by a number of factors, including: taking the drug together before, with or after meals, dosing frequency 1 time per day, good tolerability and oral route of administration. Considering that the effectiveness of antibacterial drugs largely depends on the regularity and timeliness of their administration, the creation of drugs that can be taken once a day is of particular importance. Lack of compliance can lead to such undesirable consequences, such as recurrence of the disease or its more severe course, the development of complications, increased cost of treatment, the need to admit the patient to a hospital, the emergence of drug-resistant pharmacological effects bacterial strains. Tsifran from the Indian pharmaceutical company "Ranbaxy" - innovative antibiotic long-acting, which is sufficient to take once a day. The purpose of its creation was maximum compliance. This task was complicated by the fact that ciprofloxacin is absorbed only in a limited area of ​​the duodenum, not exceeding 20–30 cm in length. It was necessary to develop a technology that would prevent the drug from being removed from the gastrointestinal tract until the tablet is completely dissolved. It took 7 years to develop Cifran. The drug uses Float Erode Diffusion Technology, which allows the tablet to remain in the stomach for a long time. The basis of the dosage form is represented by a matrix that provides layer-by-layer release of ciprofloxacin into the lumen of the stomach.

The excipients introduced into the drug, interacting with the acidic contents of the stomach, push the tablet onto its surface, thereby preventing its premature evacuation. Cifran has a wide therapeutic range, covering microorganisms such as coli, Klebsiella, Salmonella, Proteus, Shigella, Yersinia, Enterobacter, Morganella, Vibrio cholerae, Serratia, Pseudomonas, Neisseria, Moraxella, Gardnerella, Helicobacter, Staphylococcus, Streptococcus, Listeria, etc. The drug exhibits high efficiency in the treatment of infections in both acute and chronic phases, incl. in cases of persistence of slowly growing microorganisms with slow metabolism in infectious foci. Cifran acts on pathogens resistant to other antibiotics: aminoglycosides, cephalosporins, etc. It is not characterized by the phenomenon of cross-resistance and hypersensitivity to other antibacterial drugs. Cifran has good pharmacokinetic characteristics, incl. high bioavailability, optimal distribution in organs and tissues, long half-life. Tsifran is particularly effective in the treatment of infections of the urogenital tract. Because active ingredient 40–50% of the drug is excreted by the kidneys in its original form, high concentrations are created in the urine, which provides a pronounced bactericidal effect and clinical effectiveness. In patients with renal failure the dosage regimen needs to be adjusted downward. During the medication course, patients need to consume sufficient amounts of water. Alcohol is contraindicated during treatment.

Pharmacology

Antimicrobial agent broad spectrum of action of the group of fluoroquinolones. Has a bactericidal effect. Suppresses DNA gyrase and inhibits bacterial DNA synthesis.

Highly active against most gram-negative bacteria: Pseudomonas aeruginosa, Haemophilus influenzae, Escherichia coli, Shigella spp., Salmonella spp., Neisseria meningitidis, Neisseria gonorrhoeae.

Active against Staphylococcus spp. (including strains that produce and do not produce penicillinase, methicillin-resistant strains), some strains of Enterococcus spp., Campylobacter spp., Legionella spp., Mycoplasma spp., Chlamydia spp., Mycobacterium spp.

Ciprofloxacin is active against bacteria that produce β-lactamases.

Ureaplasma urealyticum, Clostridium difficile, and Nocardia asteroides are resistant to ciprofloxacin. The effect against Treponema pallidum has not been sufficiently studied.

Pharmacokinetics

Release form

10 pieces. - contour cellular packaging (1) - cardboard packs.
10 pieces. - contour cell packaging (10) - cardboard packs.
10 pieces. - contour cell packaging (100) - cardboard packs.
10 pieces. - aluminum contour cellular packaging (1) - cardboard packs.
10 pieces. - aluminum contour cellular packaging (10) - cardboard packs.

Dosage

Individual. Orally - 250-750 mg 2 times a day. The duration of treatment is from 7-10 days to 4 weeks.

For intravenous administration, a single dose is 200-400 mg, the frequency of administration is 2 times a day; Duration of treatment is 1-2 weeks, or more if necessary. It can be administered intravenously as a stream, but drip administration over 30 minutes is more preferable.

When applied topically, instill 1-2 drops into the lower conjunctival sac of the affected eye every 1-4 hours. After the condition improves, the intervals between instillations can be increased.

The maximum daily dose for adults when taken orally is 1.5 g.

Interaction

With simultaneous use of ciprofloxacin with didanosine, the absorption of ciprofloxacin is reduced due to the formation of ciprofloxacin complexes with aluminum and magnesium buffers contained in didanosine.

When used simultaneously with warfarin, the risk of bleeding increases.

With the simultaneous use of ciprofloxacin and theophylline, it is possible to increase the concentration of theophylline in the blood plasma, increase T1/2 of theophylline, which leads to an increased risk of developing toxic effects associated with theophylline.

Simultaneous use of antacids, as well as drugs containing aluminum, zinc, iron or magnesium ions, can cause a decrease in the absorption of ciprofloxacin, so the interval between the administration of these drugs should be at least 4 hours.

Side effects

From the digestive system: nausea, vomiting, diarrhea, abdominal pain, increased activity of liver transaminases, alkaline phosphatase, LDH, bilirubin, pseudomembranous colitis.

From the central nervous system: headache, dizziness, feeling of fatigue, sleep disorders, nightmares, hallucinations, fainting, visual disturbances.

From the urinary system: crystalluria, glomerulonephritis, dysuria, polyuria, albuminuria, hematuria, transient increase in serum creatinine.

From the hematopoietic system: eosinophilia, leukopenia, neutropenia, change in platelet count.

From the cardiovascular system: tachycardia, heart rhythm disturbances, arterial hypotension.

Allergic reactions: skin itching, urticaria, Quincke's edema, Stevens-Johnson syndrome, arthralgia.

Adverse reactions associated with chemotherapy: candidiasis.

Local reactions: pain, phlebitis (with intravenous administration). When using eye drops in some cases, mild soreness and hyperemia of the conjunctiva are possible.

Other: vasculitis.

Indications

Infectious and inflammatory diseases caused by microorganisms sensitive to ciprofloxacin, incl. diseases of the respiratory tract, abdominal cavity and pelvic organs, bones, joints, skin; septicemia; severe infections of the ENT organs. Treatment of postoperative infections. Prevention and treatment of infections in patients with reduced immunity.

For local use: acute and subacute conjunctivitis, blepharoconjunctivitis, blepharitis, bacterial corneal ulcers, keratitis, keratoconjunctivitis, chronic dacryocystitis, meibomitis. Infectious eye lesions after injury or foreign bodies. Preoperative prophylaxis in ophthalmic surgery.

Use for renal impairment

Use in children

Contraindicated in children and adolescents under 15 years of age.

Use in elderly patients

special instructions

In patients with impaired renal function, dosage regimen adjustment is required. Use with caution in elderly patients, with atherosclerosis of cerebral vessels, cerebrovascular accidents, epilepsy, and convulsive syndrome of unknown etiology.

During treatment, patients should receive sufficient fluids.

In case of persistent diarrhea, ciprofloxacin should be discontinued.

With simultaneous intravenous administration of ciprofloxacin and barbiturates, monitoring of heart rate, blood pressure, and ECG is necessary. During treatment, it is necessary to control the concentration of urea, creatinine, and liver transaminases in the blood.

During treatment, a decrease in reactivity is possible (especially when used simultaneously with alcohol).

Ciprofloxacin should not be administered subconjunctivally or directly into the anterior chamber of the eye.

Cifran is an antibacterial drug belonging to the group of quinolones (fluoroquinolones).

Pharmacological action of Tsifran

According to the instructions, Tsifran is antimicrobial drug broad action. Main active substance The drug Cifran is ciprofloxacin. The basis of the action of this drug is the inhibition of bacterial enzymes and disruption of their DNA synthesis. Cifran also has a bactericidal effect on the cell membrane of harmful microorganisms. Cifran exhibits its effect on bacteria that are both in the reproduction stage and in the dormant stage.

Cifran is active against gram-negative and gram-positive bacteria, and the drug also exhibits its effect against intracellular bacteria. However, anaerobic bacteria are resistant to Cifran.

The use of Tsifran does not violate natural microflora vagina and intestines.

Forms of release of Tsifran

The pharmaceutical industry produces three dosage forms of Cifran. These are tablets that weigh 250 and 500 mg. The tablets are coated with a special coating. Sold in cardboard packs of 10 or 100 pieces.

In pharmacies you can purchase a solution for infusion that contains ciprofloxacin in the amount of 2 mg per 1 ml of the drug. The bottle contains 100 ml of solution, it is packed in a box.

Another one dosage form Tsifrana are eye drops containing 3 mg of ciprofloxacin in 1 ml. Drops are sold in a dark bottle, packed in a cardboard box.

Indications for use of Tsifran

According to the instructions, Cifran is used to treat infectious and inflammatory diseases. It can be used for infections genitourinary system, including cystitis, prostatitis; for respiratory tract infections, including bronchopneumonia, pneumonia, bronchitis in acute form, pleurisy, lung abscess. Indications for Tsifran recommend this medicinal product for use for gonorrhea, pharyngitis, urethritis, infections of the ENT organs, otitis media and sinusitis. The drug is effectively used for infections of soft tissues and skin, for the treatment infected wounds, for infectious eye diseases. Treatment with Cifran is also indicated for infections of the joints and bones, various infections in immunocompromised patients. According to the instructions, Cifran is used to prevent postoperative complications.

Contraindications

Treatment with Cifran is contraindicated if the patient has hypersensitivity to quinols, including ciprofloxacin. The drug should not be taken during pregnancy or breastfeeding. Tsifran is also contraindicated for patients under 12 years of age. Patients who have chronic diseases, as well as cerebrovascular accidents, epilepsy and epileptic syndrome, Cifran should be taken under the close supervision of a physician. Treatment with Cifran is also indicated for elderly patients with caution and under medical supervision.

Analogues of Tsifran

Analogues of Cifran, which are identical in action and composition, include the drugs Basijen, Quipro, Alcipro, Quintor and others. If the patient decides to use Cifran analogues, then it is necessary to consult a doctor.

Directions for use and dosage

The dosage during treatment with Tsifran is determined by the doctor individually. Many aspects are taken into account here: the severity of the disease, the weight and age of the patient, the type of pathogen, kidney function, and the presence of other diseases. Children over 12 years of age take Cifran in the amount of 5-10 mg per kilogram of body weight per day. This dose must be divided into two doses. It is recommended to take the tablets before meals.

Intravenous infusions are administered twice a day in an amount of 200 mg, if there are diseases urinary system and infections of the lower extremities. The drug must be administered slowly. For bacteremia, the dose is 400 mg, given twice a day every 12 hours. If the patient has kidney problems, then the dose of Tsifran is reduced by half. Sometimes, after using Cifran in the form of infusions, the patient is recommended to take another course of drug tablets.

Treatment with Tsifran should be carried out for at least 5-7 days. The doctor determines a more precise course of treatment.

Indications for Tsifran recommend the drug for treatment infectious diseases eyes, in this case eye drops are used. Drops should be used every four hours. It is necessary to instill one or two drops into the lower conjunctival sac of the affected eye. At severe course diseases, drops of Cifran should be instilled every hour, two drops until improvement occurs.

Side effects of Tsifran

The use of the drug Cifran may cause side effects of different nature. Patients sometimes experience abdominal pain, flatulence, vomiting, nausea, heart rhythm disturbances, and tachycardia. Also during treatment there are headaches, tremors of the limbs, depression, general weakness, increased sweating, disturbances of taste, smell, vision. The drug can also cause allergic reactions in the form of urticaria, rash, pinpoint hemorrhages on the skin, and allergic fever. With strong side effects You should consult a doctor for advice.

Conditions and periods of storage of Tsifran

Tsifran must be stored in a dry place, out of reach of children. Storage temperature should not exceed 25 degrees Celsius.

The drug can be used for two years from the date of release.

Tsifran can be purchased in pharmacies with a doctor's prescription.

Drug name: CIFRAN(CIFRAN)
International name: ciprofloxacin (ciprofloxacin)
KFG: Antibacterial drug fluoroquinolone group
Owner reg. certificates: RANBAXY LABORATORIES Ltd. (India)

DOSAGE FORM, COMPOSITION AND PACKAGING:

10 pieces. - contour cellular packaging (1) - cardboard packs.

PHARMACHOLOGIC EFFECT

Broad-spectrum antimicrobial agent of the fluoroquinolone group. Has a bactericidal effect. Suppresses DNA gyrase and inhibits bacterial DNA synthesis.

Highly active against most gram-negative bacteria: Pseudomonas aeruginosa, Haemophilus influenzae, Escherichia coli, Shigella spp., Salmonella spp., Neisseria meningitidis, Neisseria gonorrhoeae.

Active against Staphylococcus spp. (including strains that produce and do not produce penicillinase, methicillin-resistant strains), some strains of Enterococcus spp., Campylobacter spp., Legionella spp., Mycoplasma spp., Chlamydia spp., Mycobacterium spp.

Ciprofloxacin is active against bacteria that produce beta-lactamases.

Ureaplasma urealyticum, Clostridium difficile, and Nocardia asteroides are resistant to ciprofloxacin. The effect against Treponema pallidum has not been sufficiently studied.

PHARMACOKINETICS

Rapidly absorbed from the gastrointestinal tract. Bioavailability after oral administration is 70%. Food intake has little effect on the absorption of ciprofloxacin. Plasma protein binding is 20-40%. Distributed in tissues and body fluids. Penetrates into the cerebrospinal fluid: concentrations of ciprofloxacin with non-inflamed meninges reach 10%, with inflamed meninges - up to 37%. High concentrations are achieved in bile. Excreted in urine and bile.

INDICATIONS

Infectious and inflammatory diseases caused by microorganisms sensitive to ciprofloxacin, incl. diseases of the respiratory tract, abdominal cavity and pelvic organs, bones, joints, skin; septicemia; severe infections of the ENT organs. Treatment of postoperative infections. Prevention and treatment of infections in patients with reduced immunity.

For local use: acute and subacute conjunctivitis, blepharoconjunctivitis, blepharitis, bacterial corneal ulcers, keratitis, keratoconjunctivitis, chronic dacryocystitis, meibomitis. Infectious eye lesions after injury or foreign bodies. Preoperative prophylaxis in ophthalmic surgery.

DOSING REGIME

Individual. Orally - 250-750 mg 2 times a day. The duration of treatment is from 7-10 days to 4 weeks.

For intravenous administration, a single dose is 200-400 mg, the frequency of administration is 2 times a day; Duration of treatment is 1-2 weeks, or more if necessary. It can be administered intravenously as a stream, but drip administration over 30 minutes is more preferable.

When applied topically, instill 1-2 drops into the lower conjunctival sac of the affected eye every 1-4 hours. After the condition improves, the intervals between instillations can be increased.

Maximum daily dose for adults when taken orally it is 1.5 g.

SIDE EFFECT

From the digestive system: nausea, vomiting, diarrhea, abdominal pain, increased activity of liver transaminases, alkaline phosphatase, LDH, bilirubin, pseudomembranous colitis.

From the side of the central nervous system: headache, dizziness, feeling tired, sleep disorders, nightmares, hallucinations, fainting, visual disturbances.

From the urinary system: crystalluria, glomerulonephritis, dysuria, polyuria, albuminuria, hematuria, transient increase in serum creatinine.

From the hematopoietic system: eosinophilia, leukopenia, neutropenia, changes in platelet count.

From the cardiovascular system: tachycardia, heart rhythm disturbances, arterial hypotension.

Allergic reactions: skin itching, urticaria, Quincke's edema, Stevens-Johnson syndrome, arthralgia.

Adverse reactions associated with chemotherapy: candidiasis.

Local reactions: pain, phlebitis (with intravenous administration). When using eye drops, in some cases, mild soreness and hyperemia of the conjunctiva are possible.

Others: vasculitis

CONTRAINDICATIONS

Pregnancy, lactation (breastfeeding), childhood and adolescence up to 15 years, hypersensitivity to ciprofloxacin and other quinolone drugs.

PREGNANCY AND LACTATION

Contraindicated during pregnancy and lactation.

Ciprofloxacin penetrates the placental barrier and is excreted in breast milk.

In experimental studies It has been found to cause arthropathy.

SPECIAL INSTRUCTIONS

In patients with impaired renal function, dosage regimen adjustment is required. Use with caution in elderly patients, with atherosclerosis of cerebral vessels, cerebrovascular accidents, epilepsy, and convulsive syndrome of unknown etiology.

During treatment, patients should receive sufficient fluids.

In case of persistent diarrhea, ciprofloxacin should be discontinued.

With simultaneous intravenous administration of ciprofloxacin and barbiturates, monitoring of heart rate, blood pressure, and ECG is necessary. During treatment, it is necessary to control the concentration of urea, creatinine, and liver transaminases in the blood.

During treatment, a decrease in reactivity is possible (especially when used simultaneously with alcohol).

Ciprofloxacin should not be administered subconjunctivally or directly into the anterior chamber of the eye.

DRUG INTERACTIONS

With simultaneous use of ciprofloxacin with didanosine, the absorption of ciprofloxacin is reduced due to the formation of ciprofloxacin complexes with aluminum and magnesium buffers contained in didanosine.

When used simultaneously with warfarin, the risk of bleeding increases.

With the simultaneous use of ciprofloxacin and theophylline, it is possible to increase the concentration of theophylline in the blood plasma, increase T1/2 of theophylline, which leads to an increased risk of developing toxic effects associated with theophylline.

Simultaneous use of antacids, as well as drugs containing aluminum, zinc, iron or magnesium ions, can cause a decrease in the absorption of ciprofloxacin, so the interval between the administration of these drugs should be at least 4 hours.

Source of information: Vidal Directory