"Biseptol 480" in tablets: instructions for use, what helps, reviews
The medicine "Biseptol 480" is a combined antimicrobial sulfa drug
One of the pharmacological forms of the drug is a concentrate for the manufacture of solutions for infusions, which is a clear, colorless or yellowish liquid with a specific smell of ethanol, poured into 5 ml glass ampoules. Ampoules are packed in cardboard packs of two contour cells, or without them - 10 ampoules per box.
The composition of the concentrate in one ampoule: the active elements sulfamethoxazole and trimethoprim, as well as additional substances - sodium hydroxide, sodium metabisulfite, ethyl alcohol, propylene glycol, benzyl alcohol, water for injection.
Tablets "Biseptol 480" have a white color with a yellowish tinge, round flat shape, risk and engraving "Bs".They include trimethoprim and sulfamethoxazole (as active ingredients), as well as auxiliary ingredients: potato starch, polyvinyl alcohol, magnesium stearate, talc, methyl parahydroxybenzoate, propylene glycol, propyl parahydroxybenzoate. They are packaged in red blisters of 14 pieces (2 blisters in a carton) or 20 pieces (1 blister in a pack).
Reviews of tablets "Biseptol 480" are mostly positive. The drug is popular with consumers.
The medicine "Biseptol 480" is an antibacterial combined agent containing sulfamethoxazole, a highly effective antimicrobial chemical substance of medium duration, which suppresses folic acid production by antagonism with para-aminobenzoic acid. In addition, the preparation also contains a second active substance, trimethoprim, which is a bacteriostatic antibiotic that suppresses bacterial reductase of dihydrofolic acid.
Such a combination contributes to the synergism of antibacterial effects, in connection with which the therapeutic effect of such a complex is significantly increased in comparison with the effect of other drugs.
According to the instructions, "Biseptol 480 mg" is an antibiotic of a broad spectrum of activity, and manifests it in relation to the following types of pathological microorganisms:
- Neisseria gonorrhoeae (including enterotoxogenic strains);
- Streptococcus (Streptococcus pneumoniae);
- Neisseria meningitides;
- Escherichia coli;
- Haemophilus influenza;
- Proteus spp .;
- Salmonella spp. (including Salmonella paratyphi and Salmonella typhi);
- Proteus mirabilis;
- Bacillus anthracis;
- Vibrio cholera;
- Listeria spp .;
- Bordetella pertussis;
- Nocardia asteroids;
- Enterococcus faecalis;
- Pasteurella spp .;
- Mycobacterium spp. (including Mycobacterium leprae);
- Legionella pneumonia;
- some varieties of Pseudomonas (except P.aeruginosa);
- Morganella spp .;
- Serratia marcescens;
- Yersinia spp .;
- Actinomyces israelii;
- Chlamydia spp. (including Chlamydia psittaci and Chlamydia trachomatis);
- Plasmodium spp .;
- Pneumocystis carinii;
- Histoplasma capsulatum;
- Leishmania spp.
The drug suppresses the vital activity of Escherichia coli, reduces the level of synthesis of nicotinic acid, thiamine, riboflavin, and other B vitamins in the intestine. The duration of therapeutic effect is seven hours.
This is confirmed by the instructions to "Biseptol 480".
The medicine penetrates rapidly into all tissues and systems of the body, as well as into its biological fluids. It is able to penetrate the histohematic and blood-brain barriers and stand out with breast milk. The concentration of active elements in the lungs and urine significantly exceeds the plasma. In vaginal discharge, bronchial secretions, saliva, bones, tissues, fluids of the prostate gland and the middle ear,breast milk, bile, moisture of the eye, cerebrospinal and interstitial fluids trimethoprim and sulfamethoxazole accumulate the least.
According to the instructions for use for the Biseptol 480 tablets and the solution, both active components are distributed differently: trimethoprim — outside and inside the cell structures, and sulfamethoxazole — exclusively in extracellular spaces. 43% of trimethoprim and 68% of sulfamethoxazole are associated with plasma proteins. Both major elements undergo active metabolism in the liver tissues. Sulfamethoxazole resembles metabolism to the greatest extent, forming acetylated derivatives - degradation products that do not possess antimicrobial functionality.
In accordance with the instructions for "Biseptolum 480", this drug is excreted by the kidneys by the method of glomerular filtration, as well as by tubular secretion. Up to 85% of the total concentration of active substances is excreted in about 72 hours by metabolites. Approximately 18% sulfamethoxazole and 51% trimethoprim are excreted. The concentration of active elements in the urine is higher than in the blood.
Through the intestinal medication is excreted in insignificant amounts. For sulfamethoxazole, the half-life is approximately 9–11 hours, for trimethoprim, 11–13 hours. In childhood, this figure is much less and directly depends on the patient's age: in the first year of life, it is 7–9 hours, from 1 to 10 years - 5–7 hours. The half-life in patients with elderly kidney disorders increases.
When is it appropriate to use "Biseptol 480"?
Indications for appointment
From what this medicine helps, it is possible to learn from the summary on its application. The list of basic conditions in which this medical device can be used includes:
- infections of the digestive organs: typhoid fever, paratyphoid fever, dysentery, salmonella carrier, cholangitis, cholecystitis, caused by enterotoxic species of E. coli, gastroenteritis, cholera;
- infections of organs of the urinary and reproductive systems of acute and chronic course: pyelitis, urethritis, venereal lymphogranuloma, pyelonephritis, cystitis, prostatitis, gonorrhea, epididymitis, soft chancre, inguinal granuloma;
- infectious lesion of the upper respiratory tract: otitis media, angina, inflammation of the vocal cords, scarlet fever, sinusitis;
- infections of the respiratory organs: acute and chronic bronchitis, lung abscess, lobar pneumonia, pneumocystis pneumonia, bronchopneumonia, empyema, bronchiectasis;
- skin infections and damage to soft tissues: acne, pyoderma, furunculosis, infections of the wound surfaces and abscesses, infection after surgery;
- other infectious pathologies: sepsis, acute brucellosis, toxoplasmosis, whooping cough (as part of a combination therapy), osteomyelitis, osteoarthritis infections, malaria, South American blastomycosis.
Contraindications to use
For the use of "Biseptol" 480 mg there are absolute and relative limitations. The list of absolute contraindications includes the following states:
- liver failure;
- renal failure with creatinine clearance of less than 14 ml / min;
- megaloblastic anemia resulting from folic acid deficiency;
- aplastic anemia;
- anemia associated with a lack of vitamin B 12;
- deficiency of glucose-6-phosphate dehydrogenase;
- hyperbilirubinemia in childhood;
- intramuscular injections of the drug in children older than 6 years;
- newborn and infancy up to 2 months;
- pregnancy, lactation;
- high sensitivity to sulfa drugs, trimethoprim and other elements of the means "Biseptol 480".
The relative contraindications for prescribing this medication (use with caution) are:
- vitamin B9 deficiency;
- bronchial asthma,
- lack of liver and kidney function;
- thyroid pathology.
Dosing regimen and instructions
The solution, which is prepared from the concentrate of the drug, should be administered by intravenous drip. Do not use the drug in the form of a quick injection. The following infusion solutions are allowed for the dilution of the concentrate:
- dextrose solution;
- sodium chloride solution (as well as both in combination);
- ringer's solution.
- children under 12 years of age: the dose is determined at the rate of 35 mg per kilogram of weight and divided into two administrations in equal volumes;
- children over 12 years old and adult patients: 960 mg 2 times a day; if necessary, increase the dosage to 1440 mg.
The preparation of the concentrate of this medicinal product is recommended in the following proportions: 1 ampoule of the drug - 125 ml of solution for infusion; 2 ampoules of medication - 250 ml of solution; 3 ampoules - 500 ml of solution.
With infusion solutions that are not listed above, or other medicines "Biseptol 480" can not be mixed. Patients with kidney failure with CK from 14 to 35 ml / min reduce the dosage of the drug by half the therapeutic dose.
When using "Biseptol 480" according to indications in compliance with dosing regimens, the drug is well tolerated by patients in most cases, however, the development of such side effects may occur:
- CNS: cephalgia, dizziness, peripheral neuritis apathy, tremor, depression, aseptic meningitis;
- digestion: anorexia, vomiting, diarrhea, nausea, abdominal pain, gastritis, stomatitis, glossitis, increased liver enzymes, hepatitis, hepatic necrosis, pseudomembranous enterocolitis, cholestasis;
- respiratory organs: bronchospasms, pulmonary tissue infiltration;
- hematopoiesis: leukopenia, thrombocytopenia, neutropenia, agranulocytosis, hypoprothrombinemia, megaloblastic anemia;
- urination: impaired renal functionality, interstitial nephritis, hematuria, polyuria, hypocreatininemia, crystalluria, increased concentrations of urea, toxic nephropathy with a decrease in diuresis before anuria and oliguria;
- bone and muscular system: arthralgia, myalgia;
- hypersensitivity: skin rash, pruritus, exfoliative dermatitis, polymorphic erythema, allergic myocarditis, photosensitization, hyperthermia, angioedema, red sclera;
- reactions at the injection sites: thrombophlebitis, soreness;
- Other effects: hypoglycemia.
This is confirmed by the instructions and reviews for the Biseptol 480 tablets, as well as to the solution.
Symptoms of overdose
Symptoms of an overdose with this medicine can be: intestinal colic, vomiting, nausea, cephalalgia, dizziness, fainting, depression, confusion, drowsiness, hematuria, vision changes, fever, crystalluria. As a result of prolonged overdose, the formation of leukopenia, thrombocytopenia, anemia, jaundice is possible.
For the treatment of such pathological conditions, it is necessary to wash the stomach and provide medication that provokes acidification of urine to increase the excretion of trimethoprim.In addition, you should ensure the reception of an increased volume of fluid. To eliminate the effects on the bone marrow of trimethoprim, calcium folinate should be injected intramuscularly at a dosage of 5-15 mg / day.
In order to stimulate erythropoiesis, when trimethoprim suppresses the functions of blood formation in the bone marrow, folic acid should be injected intramuscularly. If necessary, hemodialysis is recommended.
So it is said in the instructions for use for tablets "Biseptol 480" for adults, as well as the solution.
When using a medical device in patients with immunodeficiency syndrome, using co-trimoxazole for the treatment of Pneumonia, more often there are negative effects such as skin rashes, hyperthermia, leukopenia.
The concentration of sulfamethoxazole in the blood is recommended to determine every three days before the next infusion. If this figure is less than 150 µg / ml, the drug should be discontinued until it reaches a level of 120 µg / ml. Long-term medication treatment is required under the control of the liver, kidney and the properties of peripheral blood.
In order to prevent crystalluria in patients it is necessary to maintain a sufficient amount of urine excreted. As a result of the deterioration of kidney function, the probability of toxic and allergic complications with the use of sulfonamides increases significantly.
During therapy, it is inappropriate to eat such foods that contain para-aminobenzoic acid in large quantities (legumes, tomatoes, spinach, carrots, cauliflower). Due to the potential for increased photosensitivity when using the Biseptol 480 tablets, it is recommended to avoid artificial and solar ultraviolet irradiation.
With simultaneous therapy with this drug with phenytoin, oral hypoglycemic drugs, warfarin derivatives, their effect is enhanced, there is a prolongation of prothrombin time and duration of bleeding. Simultaneously with diuretics and thiazide diuretics, the likelihood of thrombocytopenia in the elderly increases. During therapy with cyclosporine, its plasma concentration decreases.
The interaction of Biseptol 480 with drugs containing bicarbonate and co-trimoxazole is prohibited. With indirect coagulants - their anticoagulant activity is enhanced, with hypoglycemic agents and methotrexate - their effectiveness increases, with rifampicin - it reduces the half-life of the trimethoprim element, with warfarin - liver metabolism is weakened and its effect is enhanced. Pyrimethamine increases the risk of megaloblastic anemia. When taken with diuretics thrombocytopenia develops. When used concurrently with procaine, procainamide, benzocaine and other drugs, during the hydrolysis of which PABA is formed: the effect of co-trimoxazole is reduced. With barbiturates, phenytoin, para-aminosalicylic acid, manifestations of folic acid deficiency increase.
Instructions for use to "Biseptol" 480 mg should be strictly followed.
Cost of medication
The average cost of this drug in the form of solutions for infusions is 420 rubles. The medicine in the form of tablets costs about 30 rubles.
Similar in content of active elements and therapeutic effectsdrugs are:
- Bi Septin;
- "Metosulfol" and others.
It is a broad-spectrum antibiotic. Effective against many known strains of bacteria. You can take the medication only after consulting a doctor, since side effects are not excluded.
Instructions for use describes in detail the method of use and dosage, which are set in accordance with the patient's age. These guidelines should be followed to minimize adverse effects caused by excessive concentrations of drugs in the body.
It is indicated for urinary tract infections: urethritis, cystitis, pyelitis, pyelonephritis, prostatitis, epididymitis, gonorrhea (male and female), soft chancre, venereal lymphogranuloma, inguinal granuloma; respiratory tract infections: bronchitis (acute and chronic), bronchiectasis, croupous pneumonia, bronchopneumonia, pneumocystis pneumonia; infections of ENT organs: otitis media, sinusitis, laryngitis, sore throat, scarlet fever; gastrointestinal infections: typhoid, paratyphoid fever,salmonellosis, cholera, dysentery, cholecystitis, cholangitis, gastroenteritis caused by enterotoxic Escherichia coli strains; infections of the skin and soft tissues: acne, furunculosis, pyoderma, wound infections; osteomyelitis (acute and chronic) and others, osteoarticular infections; brucellosis (acute); South American blastomycosis; malaria (Plasmodium falciparum); toxoplasmosis (as part of complex therapy).
Antimicrobial agent of a broad spectrum. The drug is indicated for venereal lymphogranuloma, epididymitis, cystitis, pyelitis, pyelonephritis, gonorrhea, inguinal granuloma, soft chancre, urethritis, prostate; gastrointestinal tract pathologies: cholera, typhoid fever, dysentery, gastroenteritis, cholecystitis, cholangitis, paratyphoid fever, salmonellosis and salmonella carrier; respiratory diseases: pneumocystis pneumonia, acute and chronic bronchitis, lobar pneumonia, bronchiectasis, bronchopneumonia; ENT-organs: with angina, laryngitis, scarlet fever, otitis media, sinusitis; soft tissues and skin: furunculosis, acne, pyoderma, and wound infections. In addition, Bactrim is effective in brucellosis, osteoarticular infections, malaria, toxoplasmosis, and South American blastomycosis.
Reviews Biseptol 480
Practically every person today is aware of this drug, which is due to its very long-standing existence in the domestic pharmacological market. Patients note that taking this medication is always accompanied by many unpleasant symptoms of side effects. In most cases, they develop pronounced dyspepsia phenomena, which require the use of other medications for symptomatic treatment, as well as headaches, impaired urine outflow, and pain in the liver, which may be due to a disruption of its work and obstructed outflow of bile. In short, patients are afraid of taking this drug due to the fact that with its high efficiency may be even greater harm to health.
Experts say that such a drug in no case can not be used independently, because it has a lot of serious contraindications and restrictions to use.
We reviewed the instructions for use and reviews of "Biseptolum 480" tablets and solution.