Ofloxacin - dosage, indications, side effects of the antibiotic. Ofloxacin in urological practice Ofloxacin official instructions for use

The antibiotic Ofloxacin is a broad-spectrum antimicrobial drug prescribed for the treatment of bacterial infections of various organs and functional systems. It has a bactericidal and bacteriostatic effect, stopping the reproduction of pathogens sensitive to this drug.

Pharmacological properties of the drug

The main active ingredient in the drug is ofloxacin (ofloxacin), which effectively affects microorganisms that are multi-resistant to other antibiotics that inhibit DNA synthesis (anzamycin, nitrofuran, trimetroprim, sulfanilamide).

The antimicrobial agent Ofloxacin belongs to the group II generation, which stop the activity of the bacterial enzyme DNA-gyrase, which leads to disruption of DNA synthesis and cell division.

The antibacterial properties of the drug extend to gram-positive and gram-negative microorganisms, as well as, to a certain extent, to pathogenic microbes, which are most often transmitted sexually. The resistance of microflora (resistance to the drug) develops rather slowly. The post-antibiotic effect is noticeably manifested - the antibacterial activity of the drug after its cancellation.

It is active against some gram-positive microorganisms: staphylococci, streptococci, especially beta-hemolytic streptococci.

It exhibits bactericidal properties against many gram-negative bacteria: salmonella, citrobacteria, enterobacteria and others, including microorganisms resistant to penicillin antibiotics.

Anaerobic bacteria that can develop in anoxic conditions (except Bacteroides ureolyticus) are not sensitive to Ofloxacin.

Answering the question whether Ofloxacin is an antibiotic or not, the following definition can be given: “antibiotics are substances of natural or synthetic origin that are capable of suppressing certain microorganisms.” Therefore, Ofloxacin is a synthetic antibiotic active against the above bacteria.

Dosage and methods of using the drug

According to the instructions for use, the antibiotic Ofloxacin is presented in various dosage forms:

• Ofloxacin tablets - 1 tablet contains 200 mg of the active ingredient and auxiliary components to give the necessary qualities in the manufacturing process of the drug; each blister contains 6 or 10 tablets;
• eye ointment 0.3% - is in aluminum tubes in the amount of 3 or 5 grams, which, together with the instructions, are placed in a cardboard box;
• solution for infusion 0.2% - 100 ml solution in a glass bottle, 1 bottle in a cardboard box.

The dose of the drug depends on the type and duration of the infection, the general well-being of the patient and is selected at the consultation with a specialist doctor.

1. Ofloxacin tablets are taken orally before or during meals as a whole, without crushing or chewing, with clean water. Therapeutic dosage ranges from 1 tablet (200 mg) to 4 tablets (800 mg) per day. Sometimes it is allowed to prescribe 2 tablets of Ofloxacin (400 mg) as a single dose per day (to be taken in the morning).

The average course of therapy lasts 7-10 days, it is required to continue treatment for at least three days after the symptoms of the disease have disappeared. The total duration of the use of Ofloxacin should not exceed 8 weeks of treatment.

Permissible dosage of tablets per day, indicated in the instructions for use, in the treatment of infection:

• respiratory and hearing organs - two tablets (400 mg);
• digestive organs - two tablets (400 mg);
• urinary tract and genital organs - two tablets (400 mg), with uncomplicated infection of the lower urinary tract - one tablet (100 mg);
• skin and soft tissues - two tablets (400 mg);
• bones and joints - two tablets (400 mg);
• in the treatment of gonorrhea - two tablets (400 mg) at the same time.

In some cases (with a severe degree of the disease, with insufficient absorption of the drug), it is allowed to increase the dosage to 3-4 tablets (up to 800 mg). Then the antibiotic is taken twice a day, in the morning and evening. Dosage for patients with impaired liver and kidney function may be adjusted downward.

The use of Ofloxacin simultaneously with antacids (to reduce acidity in the stomach) causes a decrease in the antimicrobial effect, since insoluble compounds are formed in this case. Therefore, Ofloxacin, like any similar antibiotic, must be taken 2 hours before these drugs.

1. Ofloxacin ointment is used for such diseases:

• bacterial infections of the eyes, cornea and eyelids (blepharitis, conjunctivitis, etc.);
• purulent inflammation of the eyelash root (barley);
• dacryocystitis, inflammation of the lacrimal duct;
• chlamydial eye infections.

In the course of treatment, the ointment is used 2-3 times a day, and in the presence of a chlamydial infection - 5 times a day, the treatment course lasts no more than 2 weeks. Ointment, which should be treated with extreme caution, is applied directly to the eyeball, pulling the lower eyelid. Squeeze out from the tube about a drop of ointment 0.10-0.15 g, close the eyelids and distribute the ointment with soft movements.

1. For infusion therapy, intravenous administration of a single dose of the drug in a volume of 200-400 ml is recommended with a frequency of 1-2 times a day. The treatment solution is introduced gradually over a period of 30-60 minutes.

It is proposed to mix Ofloxacin with an isotonic solution of glucose, fructose or sodium chloride. For the procedure it is necessary to use only freshly prepared solution.

Parenteral fluid therapy involves the use of a solution with ofloxacin in the treatment of the respiratory tract, gastrointestinal and urinary systems, infectious lesions of bones and joints, in the treatment of diseases of the skin and soft tissues.

Special remarks

Patients taking this drug should avoid exposure to sunlight or artificial UV radiation.

To the attention of drivers: ofloxacin belongs to the list of drugs that change the reaction rate, therefore, the ability to drive a car and participate in the general flow of traffic is impaired. It is recommended to limit driving or other complex mechanisms while using the drug.

The use of Ofloxacin is excluded during childbearing and breastfeeding, if it is impossible to prescribe other treatment, it is necessary to curtail the lactation process.

Use of this medicinal product in patients under 18 years of age is permitted only if there is a vital indication or when it is not possible to offer an alternative treatment option. The dose is calculated according to the weight of the child: the average daily amount of the drug is 8-15 mg / kg.

Indications for the use of Ofloxacin

The antibiotic Ofloxacin is prescribed for the treatment of acute, persistent and repeated bacterial infections:

• respiratory tract (inflammation of the bronchi, pneumonia);
• respiratory organs, smell, hearing (inflammation of the pharynx, larynx, paranasal sinuses, otitis media);
• skin surface and soft tissues (destructive ulcers, furunculosis);
• osteoarticular system (osteomyelitis, rheumatoid arthritis, purulent complications after fractures);
• digestive organs and abdominal cavity (peritonitis, enterocolitis);
• nervous system (with primary and secondary meningitis);
• pelvic organs and genitourinary system (pyelonephritis, vaginitis, colpitis, cystitis, urethritis, prostatitis);
• in case of STD (gonorrhea, chlamydia).

It is used to prevent diseases in immunocompromised patients against the background of neutropenia (decrease in the number of neutrophils), when the likelihood of contracting bacterial and fungal infections increases.

Side effects and contraindications

During therapy, as indicated in the instructions for use of the drug, Ofloxacin can cause side effects:

• in the gastrointestinal tract - pain in the stomach and intestines, lack of appetite, urge to nausea and vomiting, indigestion; persistent diarrhea in the first 2 weeks of treatment indicates pseudomembranous colitis, then you should immediately stop taking this remedy and carry out the necessary treatment, while you do not need to use medications that suppress the contraction of the intestinal walls;
• on the function of the liver and bile ducts - very rarely there is inflammation of the liver and an increased level of liver enzymes and bilirubin in the blood serum (cholestatic jaundice);
• on the kidneys and urinary tract - very rarely there is an acute inflammation of the kidneys (interstitial nephritis) up to a violation of excretory function; problems with urination (delay or increased frequency);
• in the cardiovascular system - tachycardia (rapid heartbeat), vasculitis (inflammation of the vascular walls), decreased tone of blood vessels;
• in the central nervous system - pain and heaviness in the head, sudden convulsions, a feeling of numb limbs, impaired coordination; rarely - diplopia (double vision), increased intracranial pressure, impaired sense of smell and color perception, loss of balance; anxiety, depression, which may occur immediately after the first dose of the drug, then it is necessary to suspend treatment and notify the attending physician;
• in the immune system very rarely - hypersensitive reactions (anaphylactic, anaphylactoid, angioedema) with signs of suffocation;
• in the hematopoietic system - very rarely there is a decrease in the number of blood cells, in a short time after discontinuation of the drug, normal indicators are restored;
• in the musculoskeletal system - muscle and joint pain, reactive inflammation of the ligaments (tendivitis), joint bags (synovitis); very rarely - pathological tendon ruptures;
• allergic reactions on the skin in the form of itching and rashes, rarely - petechial hemorrhages, erythema multiforme exudative, hypersensitivity of the skin to UV rays.

Sometimes patients complain of tachycardia (rapid heartbeat), muscle and joint pain, general weakness. The use of the drug in women can provoke vaginal candidiasis, and therefore constant monitoring by a gynecologist is recommended.

In diabetic patients, it may enhance the hypoglycemic effects of insulin and oral glucose-lowering agents. In the case of prescribing the drug to patients with pathologies of the liver or kidneys, the concentration of ofloxacin in the blood plasma should be carefully monitored. With severe liver or kidney failure, the likelihood of toxic poisoning increases significantly. In such cases, the dose should be adjusted or the drug should be discontinued.

Ofloxacin should not be used in patients with hypersensitivity to ofloxacin and all fluoroquinolone derivatives. This drug should not be used for epilepsy, mental illness, cerebrovascular accident, after receiving a traumatic brain injury. It is not prescribed for inflammation of the lymph nodes and tonsils, for pneumococcal pneumonia; for this, a drug from another group of antibiotics is selected.

For the entire period of use of the antibiotic drug, it is necessary to exclude the use of alcoholic beverages and narcotic substances.

Interaction with various drugs

The combination of the drug with antihypertensive drugs can cause a sharp decrease in blood pressure, in which case it is necessary to check the functions of the cardiovascular system and adjust the dosage.

The combination of Ofloxacin and glucocorticoids (hormones produced by the adrenal cortex) significantly increases the risk of tendon damage, especially in older people.

In combination with drugs that have alkaline properties (sodium bicarbonate, carbonic anhydrase inhibitors), Ofloxacin can provoke the development of crystalluria (accumulation of salts in the body).

Drugs such as methotrexate, cimetidine and others, which inhibit the excretion of the drug, contribute to an increased concentration of ofloxacin in the blood plasma.

When taken simultaneously with theophylline, warfarin, methylxanthine, cyclosporine, the drug prolongs the period of elimination of these drugs, so their dosage should be adjusted.

The appointment of NSAIDs, synthetic AMPs with high activity against anaerobic bacteria and pathogens of protozoal infections in combination with ofloxacin leads to convulsive contractions and increases the possibility of a toxic effect.

Overdose

Symptoms of an overdose of Ofloxacin: pain in various parts of the body, dizziness, urge to nausea and vomiting, disorientation, lethargy, drowsiness, confusion. In case of an overdose, gastric lavage is done, and then symptomatic treatment is prescribed.

To restore the body, detoxification is carried out to remove toxic substances, enhanced hydration to replenish fluid reserves in the body and desensitizing therapy. A specific antidote is not indicated, the procedure of hemodialysis or peritoneal dialysis in this case is recognized as not effective.

Conclusion

The antibiotic Ofloxacin is an effective drug that is used for the etiotropic therapy of infectious diseases.

Instructions for use Ofloxacin describes in detail the properties and features of the use of an antibacterial agent with a wide spectrum of antimicrobial action. Ofloxacin is used in various fields of medicine - therapy, urology, ophthalmology, venereology.

Antibiotic Ofloxacin - description of the drug

Ofloxacin is an antibacterial drug from the group of fluorinated quinolones, which is based on the active ingredient of the same name (ofloxacin). Its bactericidal action is based on blocking the enzyme DNA gyrase, which is responsible for the synthesis and division of microbial cells. As a result, DNA chains are destabilized, the process of destruction of the cytoplasm and cell walls is triggered, which leads to the death of pathogenic microorganisms.

Good to know

The advantage of the drug lies in its unique chemical formula. Due to the fact that a fluorine atom has been added to the quinoline molecule, the antibacterial effect of Ofloxacin has increased several times. The updated formula makes it possible to deal with those strains of pathogens that develop resistance to other antibiotics.

Ofloxacin is active against a wide range of gram-positive and gram-negative bacterial microflora, including effectively destroying mycoplasmas, chlamydia, ureaplasma, gardnerella, mycobacterium tuberculosis and beta-lactamase microorganisms. At the same time, some strains of anaerobic and aerobic bacteria (Peptococcus spp., Clostridium difficile, Bacteroides spp, Nocardia asteroides, etc.), as well as Treponema pallidum, show resistance to the drug.

After oral administration, the active substance is rapidly and almost completely absorbed (by 95%), but food intake may slightly slow down absorption, while only slightly affecting the bioavailability of the drug. Ofloxacin quickly penetrates into all organs, tissues, bone structures and biological fluids (saliva, sputum, cerebrospinal fluid) and passes through all barriers. The maximum concentration of the drug is noted within 1 hour after taking the pill. It is excreted from the body mainly by the kidneys, a small part is excreted in the bile. The half-life is 6-7 hours.

Release forms

Ofloxacin is available in several forms:

• Ofloxacin tablets - biconvex, white, film-coated, with different concentrations of the active substance - 100, 200 and 400 mg. Of the auxiliary components, they contain cellulose, starch, talc, calcium stearate, povidone. A contour cell with 10 tablets is inserted into the package with the drug.

• Ofloxacin eye ointment (0.3%) - white with a yellowish tint. 1 g of ointment contains 3 mg of ofloxacin + excipients that form the basis of the drug. The ointment is available in aluminum tubes of 3 and 5 g.
• Ofloxacin solution (0.2%) is a colorless transparent solution for intravenous injection. Produced in glass bottles of 100 ml.

There are no other forms of medication, for example, Ofloxacin drops or capsules. Drops, which are based on the active ingredient ofloxacin, are called Floksal, Dancil or Uniflox.

Why are tablets or drops of Ofloxacin prescribed?

Ofloxacin is prescribed for the treatment of infectious and inflammatory diseases of the following organs and systems:

1. respiratory tract (bronchitis, pneumonia);
2. ENT organs (otitis, pharyngitis, tracheitis, laryngitis);
3. infections of soft tissues, skin (carbuncles, boils);
4. infectious and inflammatory processes in bone tissues and joints;
5. diseases of the abdominal cavity and biliary system (cholecystitis, cholangitis);
6. meningitis;
7. urinary tract and kidney infections (cystitis, urethritis, pyelonephritis);
8. infectious diseases of the reproductive system and pelvic organs (prostatitis, endometritis, cervicitis, colpitis, orchitis, salpingitis).

Intravenous administration of Ofloxacin solution is indicated for the treatment of genital infections (gonorrhea, ureaplasmosis, chlamydia). Ophthalmic ointment is prescribed as part of a complex treatment of corneal ulcers, keratitis, blepharitis, conjunctivitis, chlamydial lesions or to prevent bacterial infections after surgical interventions on the organs of vision. As a prophylactic agent that prevents infection, the drug is used in patients with immunodeficiency conditions.

Instructions for use

Ofloxacin tablets

The dosage of the drug and the optimal treatment regimen is selected by the doctor, taking into account many parameters - the area of ​​localization and severity of the infectious process, the general condition of the patient, the sensitivity of pathogens to ofloxacin, possible contraindications associated with the functionality of the liver and kidneys.

Ofloxacin tablets should be taken whole with a meal, drinking plenty of fluids. The standard daily dosage is from 200 to 800 mg, divided into two doses. The duration of the course of treatment is usually 7-10 days.

Ofloxacin for prostatitis is prescribed in a single dose of 200 mg, 1 tablet in the morning and evening. The course of treatment is long - up to 6 weeks. With gastroenteritis, the daily dose of the drug is 400 mg, divided into 2 doses. Treatment takes 5 days. In order to prevent gastropathology, take 1 tablet (200 mg) once a day.

For treatment, Ofloxacin 200 mg is prescribed. Take 1 tablet in the morning and evening for 7 days. The duration of treatment for infections of the pelvic organs is 2 weeks, for diseases of the respiratory system and infection of the skin - 10 days. For gonorrhea, Ofloxacin 400 mg is taken once, preferably in the morning.

The drug is canceled no earlier than three days after the improvement of the condition and the disappearance of the symptoms of the disease. Ofloxacin for children is prescribed only for life-threatening infections and the inability to use less toxic drugs. The dosage is selected by the doctor, taking into account body weight, at the rate of 7.5 mg / kg.

Ofloxacin solution

Injections are done intravenously, by drip. The dose of the drug is selected by the doctor individually, taking into account the patient's condition and possible contraindications. The initial dose is 200 mg administered over 30-60 minutes. After the patient's condition improves, Ofloxacin tablets are prescribed in the same daily dose.

For urinary tract infections, the drug is administered at a dose of 100 mg, injections are made twice a day. In the treatment of ENT organs, soft tissues, joints, abdominal organs, two infusions of 200 mg are prescribed per day. If necessary, this dose is doubled. In case of kidney diseases, 100 ml of solution is administered using a dropper, 1-2 times a day.

Ointment Ofloxacin

Apply topically, laying a strip of the drug (1 cm long) in the lower eyelid up to three times a day. The standard course of therapy is 2 weeks. With chlamydial infections, the frequency of application of the ointment is increased to 5-6 times a day, the duration of treatment is up to 5 weeks.

Contraindications

The drug Ofloxacin is prohibited for use in the following conditions:

• individual intolerance to fluoroquinolones;
• age up to 18 years (for tablets);
• age up to 1 year (for ointment);
• pregnancy, lactation;
• lack of glucose-6-phosphate dehydrogenase in the body;
• epilepsy or a decrease in the threshold of convulsive activity due to traumatic brain injury, stroke, CNS damage;

Ofloxacin should not be used for tendon ruptures, conditions such as lactose intolerance or peripheral neuropathy.

With extreme caution, the drug is prescribed for organic brain lesions, severe kidney and liver diseases, myasthenia gravis, heart failure, diabetes mellitus, hepatic porphyria, bradycardia, and elderly patients.

Adverse reactions

The use of Ofloxacin can lead to the development of serious adverse reactions from various organs and systems. Most often, negative manifestations occur from the digestive tract and are expressed by nausea, lack of appetite. Sometimes there are bouts of vomiting, diarrhea, flatulence, or abdominal pain.

Adverse reactions that are much less common:

• migraine, dizziness;
• increased irritability, anxiety, unreasonable fears;
• sleep disorders, depression;
• changes in blood counts (thrombocytopenia, leukopenia);
• cholestatic jaundice, anemia;
• paresthesia and tremor of the limbs, convulsions;
• hearing loss, changes in taste sensations;
• conjunctivitis, impaired color perception, double vision;
• tendon rupture, symptoms of arthralgia, myalgia, tendonitis;
• palpitations, arrhythmia;
• shortness of breath, dry cough, bronchospasm;
• urinary retention, impaired renal function;
• imbalance of microflora in the intestine;
• allergic reactions (skin itch, rash, urticaria).

In severe cases, in persons with a tendency to allergic reactions, dangerous conditions may occur - allergic pneumonitis and nephritis, Quincke's edema. Patients with diabetes may develop hypoglycemia. When using a solution for infusion, local reactions are observed - redness, pain and swelling in the injection area. When treated with ointment, sensations such as burning, dryness of the conjunctiva, photophobia and lacrimation may occur. Most often, these symptoms are short-lived and quickly disappear after discontinuation of the drug.

Good to know

The list of side effects is long, but with strict adherence to the recommendations of the attending physician and the right dosage, the likelihood of their occurrence is significantly reduced.

Analogues

Ofloxacin has quite a few structural analogues containing the same active ingredient. These are drugs such as:

• glaufos,
• Dancil,
• Zanotsin,
• Ofloks,
• Ofloxabal,
• Ofloksin,
• Oflocid,
• Taricin,
• Uniflox,

Which drug from this list is best suited for the patient, the attending physician should decide. It is not necessary to arbitrarily replace Ofloxacin tablets with other analogues in order to avoid the development of undesirable complications and dangerous side reactions.

The cost of the drug

The price of Ofloxacin depends on the manufacturer, the form of release and the trade markup of pharmacists. Ofloxacin Teva is the most expensive, the price for a pack of tablets (200 mg) ranges from 160 to 180 rubles.

Other forms of the drug are much more affordable. So, Ofloxacin 200mg (10pcs) costs from 26 rubles, Ofloxacin 400mg (10pcs) - from 50 rubles. The cost of Ofloxacin solution is from 28 rubles per bottle (100 ml), eye ointment - from 40 rubles.

The antibacterial drug is ofloxacin. Instructions for use indicate that tablets 100 mg, 200 mg and 400 mg, injections in ampoules for injection, eye ointment 0.3% belong to the group of fluoroquinolones. Reviews of therapists confirm that this medication helps with bronchitis and pneumonia.

Release form and composition

The drug is produced in the following dosage forms:

1. Film-coated tablets: biconvex, round, shell and layer on a cross-section of almost white Ofloxacin tablets are packaged in a blister of 10 pieces. The cardboard pack contains one blister with tablets and instructions for the use of the drug.
2. Solution for infusion: transparent greenish-yellow liquid (100 ml in colorless or dark glass bottles, 1 bottle in a cardboard box).
3. Eye ointment 0.3%: a homogeneous substance of yellow, white with a yellow tinge or white (5 g each in aluminum tubes, 1 tube in a cardboard box).

The main active ingredient of the drug is ofloxacin, its content in one tablet is 200 and 400 mg.

Composition of 1 ml of solution: Active ingredient - ofloxacin - 0.002 g, auxiliary components: sodium chloride, distilled water.

Composition of 1 g of ointment: Active ingredient - ofloxacin - 0.003 g, excipients: methyl parahydroxybenzoate, propyl parahydroxybenzoate, petrolatum.

pharmachologic effect

The drug belongs to antimicrobial drugs with a wide spectrum of action. The mechanism of the antibacterial action of Ofloxacin is based on its ability to destabilize the DNA chains of bacterial microorganisms, thereby ensuring their destruction.

When using the drug, a moderate bactericidal effect is also manifested. Ofloxacin is active against rapidly growing atypical mycobacteria and beta-lactamase microorganisms.

Anaerobic bacteria Peptococcus spp., Bacteroides spp., Fusobacterium spp., Peptostreptococcus spp., Eubacterium spp., Clostridium difficile and bacteria species Nocardia asteroides are resistant to the drug. The drug is not active against Treponema pallidum.

Indications for use

What helps Ofloxacin? Ointment, tablets and injections are prescribed if the patient has:

• corneal ulcers, blepharitis, conjunctivitis, keratitis, barley, chlamydial eye lesions, prevention of infection after injuries and operations (for ointment);
• bronchitis, pneumonia;
• gonorrhea, chlamydia;
• diseases of ENT organs (pharyngitis, sinusitis, otitis media, laryngitis);
• infections of the skin, soft tissues, bones;
• endometritis, salpingitis, parametritis, oophoritis, cervicitis, colpitis, prostatitis, epididymitis, orchitis;
• diseases of the kidneys and urinary tract (pyelonephritis, urethritis, cystitis).

Instructions for use

Taken inside. The dose is selected individually depending on the location, severity of the infection, the sensitivity of microorganisms, as well as the general condition of the patient and the function of the liver and kidneys. Adults - 200-800 mg per day, course of treatment - 7-10 days, frequency of use - 2 times a day. Doses up to 400 mg per day can be given as a single dose, preferably in the morning.

With gonorrhea - 400 mg once. In patients with impaired renal function (with creatinine clearance 50-20 ml / min) 100-200 mg per day. With creatinine clearance less than 20 ml / min - 100 mg every 24 hours; with hemodialysis and peritoneal dialysis - 100 mg every 24 hours. The maximum daily dose for liver failure is 400 mg per day.

Tablets are taken whole with water, before or during meals. The duration of treatment is determined by the sensitivity of the pathogen and the clinical picture; treatment should be continued for at least 3 more days after the disappearance of the symptoms of the disease and the complete normalization of body temperature.

In the treatment of uncomplicated and complicated infections of the lower urinary tract, the course of treatment is 7 and 10 days, respectively, with prostatitis - up to 6 weeks, with infections of the pelvic organs - 10-14 days, with infections of the respiratory organs and skin - 10 days.

Solution for infusion

The drug is administered intravenously drip. Begin therapy with Ofloxacin with a drip intravenous injection of 0.2 g for 30-60 minutes. In case of improvement in the patient's condition, they are transferred to taking the drug orally (tablets) while maintaining the dosage. Recommended doses of Ofloxacin depending on the disease and the location of the infection:

• Urinary tract - 0.1 g 1-2 times a day.
• Kidneys and genital organs - 0.1-0.2 g each, divided into 2 injections per day.
• Respiratory tract, ENT organs, skin and soft tissues, bones and joints, abdominal cavity, as well as septic infections - 0.2 g each, divided into 2 injections per day; it is allowed to increase the daily dose, if necessary, up to 0.4 g, while maintaining the frequency of administration.
• Prevention of infection in patients with a pronounced decrease in immunity - 0.4-0.6 g per day.

Ointment

locally. For the lower eyelid of the affected eye 2-3 times a day lay 1 cm strips of ointment (0.12 mg ofloxacin). With chlamydial infections, the ointment is applied 5-6 times a day.

To administer the ointment, gently pull the lower eyelid down and, gently pressing on the tube, insert a 1 cm long strip of ointment into the conjunctival sac. Then close the eyelid and move the eyeball to evenly distribute the ointment. The duration of the course of treatment is no more than 2 weeks (for chlamydial infections, the course is extended to 4-5 weeks).

Contraindications

Taking Ofloxacin tablets is contraindicated in several pathological and physiological conditions of the body, which include:

• Epilepsy (periodic development of pronounced tonic-clonic convulsions against the background of impaired consciousness), including those suffered in the past.
• Pregnancy at any stage of development and lactation (breastfeeding).
• Children's age up to 18 years, which is associated with the incomplete formation of the bones of the skeleton.
• Predisposition to the development of seizures (decrease in the seizure threshold) against the background of a traumatic brain injury, inflammatory pathology of the structures of the central nervous system, as well as a cerebral stroke.
• Hypersensitivity to the active substance and auxiliary components of the drug.

With caution, Ofloxacin tablets are used for atherosclerosis (deposition of cholesterol in the wall of arteries) of cerebral vessels, circulatory disorders in the brain (including those suffered in the past), organic lesions of the structures of the central nervous system, chronic decrease in the functional activity of the liver. Before you start taking the drug, you need to make sure that there are no contraindications.

Side effects

The use of the drug Ofloxacin can cause the following side effects:

• intense or "nightmare" dreams, phobias, anxiety, a state of excitement, psychotic reactions, hallucinations, depression, confusion, increased intracranial pressure;
• tachycardia, collapse, vasculitis, anemia, hemolytic and aplastic anemia, leukopenia, agranulocytosis, pancytopenia, thrombocytopenia, with intravenous administration - lowering blood pressure;
• impaired renal function, acute interstitial nephritis, increased urea levels, hypercreatinemia;
• pinpoint hemorrhages, hemorrhagic bullous dermatitis, papular rash (manifestations of vasculitis);
• diplopia, violation of color perception, taste, hearing, smell, balance;
• allergic pneumonitis and nephritis, skin rash, itching, erythema multiforme, urticaria, fever, bronchospasm, Quincke's edema, Stevens-Johnson and Lyell's syndrome, eosinophilia, photosensitivity, in rare cases - anaphylactic shock;
• myalgia, arthralgia, tendinitis, tendosynovitis, tendon rupture;
• dizziness, headache, tremor, numbness and paresthesia of the extremities, uncertainty of movements, convulsions.

When using the drug in the form of an ointment, side effects such as itching and dryness of the conjunctiva, burning and eye discomfort, lacrimation, redness of the eyes, and photophobia may occur. When using Ofloxacin according to indications in strict accordance with the instructions and doctor's prescription, the likelihood of side effects is significantly reduced.

Children, during pregnancy and lactation

The drug is contraindicated for use during pregnancy and lactation.

Use in children

The drug is contraindicated in children and adolescents under 18 years of age, because. skeletal growth has not been completed. In children, the drug is used only for life-threatening infections, taking into account the expected clinical efficacy and the potential risk of side effects when less toxic drugs cannot be used. The average daily dose in this case is 7.5 mg/kg of body weight, the maximum is 15 mg/kg.

special instructions

Ofloxacin is not indicated for the treatment of acute tonsillitis and is not the drug of choice in the treatment of pneumonia caused by pneumococci. The drug affects the speed of psychomotor reactions. When using Ofloxacin, it is recommended to refrain from driving vehicles and engaging in potentially hazardous activities, as well as from drinking alcohol.

Against the background of taking the drug, it is not recommended to use hygienic tampons due to the increased risk of thrush. Seizures may become more frequent in patients predisposed to porphyria. May worsen the course of myasthenia gravis. The drug can cause false-negative results in the bacteriological diagnosis of tuberculosis.

drug interaction

• There is an increase in the effectiveness of indirect anticoagulants when taken with this drug. Control of the coagulation system is necessary.
• The risk of neurotoxic effects and convulsive activity increases with the simultaneous administration of NSAIDs, nitroimidazole derivatives and methylxanthines.
• A sharp decrease in blood pressure is possible with the use of barbiturates and antihypertensive drugs.
• When used with glucocorticosteroids, there is a risk of tendon rupture.
• Probenecid, Cimetidine and Methotrexate reduce the tubular secretion of the active substance, which leads to an increase in its concentration in the blood plasma.
• When used with Cyclosporine, an increase in its concentration in the blood and half-life is observed.
• The simultaneous use of hypoglycemic agents may lead to hypo- or hyperglycemic conditions.
• When used with Theophylline, its clearance decreases and the half-life increases.
• It is possible to prolong the QT interval with the use of neuroleptics, antiarrhythmic drugs, tricyclic antidepressants, macrolides, imidazole derivatives, astemizole, terfenadine, ebastine.
• The use of inhibitors of carbonic anhydrase, sodium bicarbonate and citrates, which alkalize the urine, increases the risk of crystalluria and nephrotoxicity.
• With the appointment of sucralfate, antacids and drugs containing aluminum, zinc, magnesium or iron, the absorption of ofloxacin is reduced.

Analogues of the drug Ofloxacin

According to the structure, analogues are determined:

1. Vero Ofloxacin.
2. Dancil.
3. Oflocid forte.
4. Zanocin.
5. Glaufos.
6. Ofloksin 200.
7. Ofloxabol.
8. Uniflox.
9. Oflo.
10. Oflomac.
11. Tarivid.
12. Ofloks.
13. Tariferid.
14. Oflocid.
15. Ofloksin.
16. Ofloxacin DS (Protech, Stada, Promed, Teva).
17. Taricin.
18. Zoflox.

Holiday conditions and price

The average cost of Ofloxacin (tablets 400 mg No. 10) in Moscow is 55 rubles. Released by prescription.

List B. Store in a dry, dark place and out of the reach of children at a temperature not exceeding 25 C. Shelf life - 2 years.

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Description

Film-coated tablets, pink, with a biconvex surface. Two layers are visible in cross section, the inner layer is white with a yellowish tinge to yellow.

Compound

1 tablet contains: active substance- ofloxacin - 200 mg; Excipients: lactose monohydrate, povidone, calcium stearate, starch 1500 (corn starch partially pregelatinized), croscarmellose sodium, crospovidone, Opadry (including polyvinyl alcohol, partially hydrolyzed, macrogol 3350, talc, lecithin (soy), titanium dioxide E 171, aluminum varnish based on carmoisine E 122, aluminum varnish based on indigo carmine E 132).

Pharmacotherapeutic group

Antibacterial agents for systemic use. Fluoroquinolones.
ATX code– J01MA01.

Pharmacological properties

Pharmacodynamics
Broad-spectrum antimicrobial drug
from the group of fluoroquinolones. The mechanism of action is due to the suppression of bacterial DNA replication by blocking DNA topoisomerase IV and DNA topoisomerase II (gyrase).
It has a bactericidal effect.
The drug is active against microorganisms producing beta-lactamase and fast-growing atypical mycobacteria.
The following are sensitive to the drug: Staphylococcus aureus(including meticillin resistant staphylococci), Staphylococcus epidermidis, Neisseria species, Escherichia coli, Citrobacter, Klebsiella, Enterobacter, Hafnia, Proteus(indole-negative and indole-positive strains), Haemophilus influenzae, Chlamydiae, Legionella, Gardnerella.
Different sensitivity to the drug have: Streptococci, Serratia marcescens, Pseudomonas aeruginosa and Mycoplasmas.
Anaerobic bacteria (eg. Fusobacterium species, Bacteroides species, Eubacterium species, Peptococci, Peptostreptococci).
Ofloxacin is not active against Treponema pallidum.
Pharmacokinetics
After taking the drug inside, absorption is fast and complete (95%). Bioavailability - more than 96%.
The maximum plasma concentration is reached 1-3 hours after taking a dose of the drug; half-life - 5-7 hours.
Distribution
Plasma protein binding - 25%. After a single dose of the drug at a dose of 200 mg and 400 mg, Cmax is 2.5 μg / ml and
5 µg/ml, respectively. Eating may slow down absorption, but does not significantly affect bioavailability.
Apparent Vd - 100 l. Ofloxacin is distributed in leukocytes, alveolar macrophages, skin, soft tissues, bones, abdominal and pelvic organs, respiratory system, urine, saliva, bile, and prostate secretions. It penetrates well through the blood-brain and placental barrier, is excreted in breast milk. Penetrates into the cerebrospinal fluid with inflamed and non-inflamed meninges (14 - 60%). Does not accumulate.
Metabolism
Metabolized in the liver (about 5%) with the formation of N-oxide ofloxacin and dimethylofloxacin.
breeding
T1 / 2 - 4.5-7 hours (regardless of dose). Excreted by the kidneys unchanged - 75 - 90%, with bile - about 4%. Extrarenal clearance - less than 20%.
After a single application at a dose of 200 mg, it is detected in the urine within 20-24 hours.
Pharmacokinetics in special clinical situations
With renal or hepatic insufficiency, excretion may slow down.

Indications for use

Ofloxacin is a synthetic fluoroquinolone antibacterial agent with bactericidal activity against a wide range of gram-negative and gram-positive microorganisms. It is indicated for the treatment of infections caused by susceptible microorganisms:
- infections of the upper and lower urinary tract;
- infections of the lower respiratory tract;
- uncomplicated urethral and cervical gonorrhea;
- non-gonococcal urethritis and cervicitis;
- infectious lesions of the skin and soft tissues;
- as part of the complex treatment of inflammatory diseases of the pelvic organs;
-prostatitis.
Ofloxacin tablets can be used in the sequential transition from parenteral to oral administration of the drug (step therapy).

Contraindications

Deficiency of glucose-6-phosphate dehydrogenase;
- epilepsy (including history);
- reduction of the convulsive threshold (including after a traumatic brain injury, stroke or inflammatory processes in the central nervous system);
- damage to the tendons in the previous treatment with fluoroquinolones;
- age up to 18 years (because the growth of the skeleton is not completed);
- pregnancy;
- lactation (breastfeeding);
- Hypersensitivity to the components of the drug.

Dosage and administration

The dose of ofloxacin is determined by the type and severity of the infection. The average daily dose for adults ranges from 200 mg to 800 mg. Ofloxacin at a dose of up to 400 mg is recommended to be taken in one dose, preferably in the morning. Large doses are recommended to be taken at approximately equal intervals. It is recommended to swallow a tablet of ofloxacin whole with a sufficient amount of water, on an empty stomach or with meals. Avoid concomitant use with antacids.
Lower urinary tract infections: 200 - 400 mg per day.
Upper urinary tract infections: 200 - 400 mg per day; up to 400 mg twice daily as needed.
Lower respiratory tract infections: 400 mg per day; up to 400 mg twice daily as needed.
Uncomplicated urethral and cervical gonorrhea: 400 mg once.
Non-gonococcal urethritis and cervicitis: 400 mg daily in one or more divided doses.
Skin and soft tissue infections: 400 mg twice daily.
Acute pelvic inflammatory disease (including severe infections): 200 to 400 mg twice daily for 10 to 14 days.
Prostatitis: 300 mg twice daily for up to 6 weeks.
In case of impaired renal function, the dose should be reduced. If creatinine clearance is 20-50 ml/min (serum creatinine 1.5-5.0 mg/dl), the dose should be halved (100-200 mg per day). If creatinine clearance is less than 20 ml/min (serum creatinine greater than 5 mg/dl), 100 mg should be administered every 24 hours. In patients undergoing hemodialysis or peritoneal dialysis, the recommended dose is 100 mg every 24 hours.
Impaired liver function (for example, cirrhosis with ascites): the maximum daily dose is 400 mg, since the excretion of ofloxacin from the body may be slowed down.
No special dose adjustment is required in the elderly, except in cases of impaired liver and kidney function, as well as prolongation of the QT interval.
The duration of treatment depends on the severity of the infection and the response to treatment. The usual duration of treatment is 5-10 days, except for uncomplicated gonorrhea, where a single dose is recommended.
The total duration of treatment should not exceed 2 months.

Side effect

Interactions with other drugs

Drugs that prolong the QT interval
Ofloxacin, like other fluoroquinolones, should be used with caution in patients receiving drugs that prolong the QT interval: class IA and III antiarrhythmics, tricyclic antidepressants, macrolides, antipsychotics.
Antacids, sucralfate, metal cations
Antacids containing magnesium, aluminum sucralfate, zinc or iron reduce the absorption of ofloxacin. Therefore, ofloxacin should be taken 2 hours before the use of antacids.
Anticoagulants
Prolongation of bleeding time has been noted during the simultaneous use of ofloxacin and anticoagulants.
Theophylline, some non-steroidal anti-inflammatory drugs and other drugs that lower the seizure threshold
It is possible to sum up the effect of reducing the threshold of convulsive activity while taking it with fluoroquinolones. Ofloxacin may prolong the half-life of theophylline, increase theophylline serum concentrations, and increase the risk of theophylline toxic effects. Serum concentrations of theophylline should be monitored while taking.
Hypoglycemic agents (insulin, glibenclamide, glyburide, etc.)
Ofloxacin may cause hypoglycemia or hyperglycemia in patients receiving hypoglycemic agents. It is recommended to control the level of glucose with simultaneous use. Ofloxacin may cause some increase in serum concentrations of glibenclamide when co-administered; the condition of patients taking this combination should be monitored.
Drugs undergoing tubular secretion
When high doses of quinolones are used concomitantly with the use of drugs that undergo renal tubular secretion, their excretion may be impaired and serum levels may increase (for example, probenecid, cimetidine, furosemide and methotrexate).
Interaction with laboratory tests
The determination of opiates or porphyrins in the urine may give false positive results in the treatment of ofloxacin.
Vitamin K antagonists
With the simultaneous use of ofloxacin with vitamin K antagonists, monitoring of coagulation tests is necessary due to a possible increase in the action of coumarin derivatives.

Precautionary measures

With caution, the drug should be prescribed for atherosclerosis of cerebral vessels, cerebrovascular accidents (in history), chronic renal failure, prolongation of the QT interval, organic lesions of the central nervous system.
Ofloxacin is not the drug of first choice for pneumonia caused by pneumococcus or Mycoplasma, an infection caused by β-hemolytic streptococcus.
Hypersensitivity and allergic reactions have been reported for fluoroquinolones after the first use. Anaphylactic and anaphylactoid reactions may progress to life-threatening shock, even after the first application. In these cases, ofloxacin should be discontinued and anti-shock measures initiated.
Clostridium - associated diseases
Diarrhea, especially severe, persistent and/or bloody during or after treatment with ofloxacin, may be a symptom of pseudomembranous colitis. If pseudomembranous colitis is suspected, ofloxacin should be discontinued immediately. Appropriate therapy should be started immediately.
Products that inhibit peristalsis are contraindicated in this clinical situation.
Patients predisposed to epileptic seizures
In the event of seizures, treatment with ofloxacin should be discontinued.
Cardiac disorders
In very rare cases, QT interval prolongation has been reported in patients taking fluoroquinolones. Caution should be exercised when using fluoroquinolones, including ofloxacin, in patients with known risk factors for QT prolongation, such as, for example:
congenital long QT syndrome;
simultaneous use with drugs known to prolong the QT interval (for example, antiarrhythmics, class IA and III, tricyclic antidepressants, macrolides, antipsychotics);
electrolyte imbalance (eg, hypokalemia, hypomagnesemia);
elderly patients;
heart disease (eg, heart failure, myocardial infarction, bradycardia).
photosensitization
Patients receiving ofloxacin should avoid strong sunlight and UV rays (sun lamps, solarium) during the entire duration of treatment and 48 hours after its completion.
Patients with a history of psychotic disorders
Psychotic reactions have been reported in patients treated with fluoroquinolones. In some cases, patients have expressed suicidal thoughts or exhibited auto-aggressive behavior, including suicide attempts, sometimes after a single dose. If the patient develops such reactions, ofloxacin should be discontinued and appropriate measures taken. Ofloxacin should be used with caution in patients with a history of psychotic disorder or in patients with psychiatric illness.
Patients with impaired liver function
Ofloxacin should be used with caution in patients with hepatic impairment. Cases of fulminant hepatitis leading to liver failure (including death) have been reported. Patients should be advised to stop treatment and contact their physician if symptoms of liver damage develop such as anorexia, jaundice, dark urine, pruritus, or abdominal wall defence.
Patients receiving vitamin K antagonists
Due to the possible increased risk of bleeding in patients treated with fluoroquinolones, including ofloxacin in combination with vitamin K antagonists, coagulation tests should be monitored.
myasthenia gravis
Ofloxacin should be used with caution in patients with a history of myasthenia gravis.
Peripheral neuropathy
Sensory or sensorimotor peripheral neuropathy has been reported in patients treated with fluoroquinolones, including ofloxacin. If the patient experiences symptoms of neuropathy, ofloxacin should be discontinued to avoid the development of irreversible conditions.
hypoglycemia
In diabetic patients treated with oral hypoglycemic agents (eg, glibenclamide) or insulin, the use of fluoroquinolones may cause hypoglycemia. Patients with diabetes require careful monitoring of blood glucose levels.
Patients with glucose-6-phosphate dehydrogenase deficiency
Patients with latent or diagnosed glucose-6-phosphate dehydrogenase deficiency may be predisposed to a hemolytic reaction while taking quinolones, including ofloxacin.
Patients with rare hereditary disorders
Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicinal product.
Risk of developing secondary infections
Prescribing antibiotics, especially over a long period of time, can lead to the formation of antibiotic-resistant strains. The patient's condition must be assessed at regular intervals and, if a secondary infection develops, appropriate measures should be taken.
Tendonopathy and tendon rupture
The use of fluoroquinolones is associated with an increased risk of tendonitis and tendon rupture. Factors that increase the risk of tendinopathy are age over 60 years, concomitant use of corticosteroids, and conditions after transplantation (kidney, heart, lung). Other risk factors include high physical activity, kidney failure, and the presence of concomitant diseases such as rheumatoid arthritis. Fluoroquinolones should be discontinued if patients experience pain or signs of tendon inflammation. It is necessary to advise patients about the need to immediately stop taking fluoroquinolones, to ensure rest in the affected area and to immediately contact the attending physician if initial symptoms such as pain, swelling, inflammation occur.
visual impairment
In case of visual disturbances or any discomfort in the eyes, you should immediately consult a specialist doctor.

Gross formula

C 18 H 20 FN 3 O 4

Pharmacological group of the substance Ofloxacin

Nosological classification (ICD-10)

CAS code

83380-47-6

Characteristics of the substance Ofloxacin

Antibacterial agent of the fluoroquinolone group II generation. Slightly yellowish crystalline powder, odorless, bitter taste. Slightly soluble in water and alcohol. Molecular weight 361.4.

Pharmacology

pharmachologic effect- antibacterial, bactericidal.

It inhibits DNA gyrase (topoisomerase II and IV), disrupts the process of supercoiling and cross-linking of DNA breaks, inhibits cell division, causes structural changes in the cytoplasm and death of microorganisms.

Has a wide spectrum of activity. Affects mainly gram-negative and some gram-positive microorganisms. Effective against microorganisms resistant to most antibiotics and sulfa drugs. Cross-resistance of bacteria to ofloxacin and other fluoroquinolones is possible. The spectrum of action includes: E. coli, Salmonella spp., Enterobacter spp., Serratia spp., Citrobacter spp., Yersinia spp., Haemophilus influenzae, Haemophilus ducreyi, Proteus mirabilis, Proteus vulgaris, Pseudomonas spp., including Pseudomonas aeruginosa, Acinetobacter spp., Aeromonas hydrophilia, Bordetella parapertussis, Bordetella pertussis, Klebsiella spp., including Klebsiella pneumoniaе, Moraxella (Branhamella) catarrhalis, Morganella morganii, Providencia spp., Neisseria gonorrhoeae, Neisseria meningitidis, Shigella sonnei, Helicobacter pylori, Mycoplasma spp., Ureaplasma urealyticum, Vibrio spp., Gardnerella vaginalis, Chlamydia spp., Legionella p neumophila, Staphylococcus spp., Streptococcus spp., Enterococcus faecalis, Listeria monocytogenes, Propionibacterium acnes, Clostridium perfringens, Mycobacterium tuberculosis(including multi-resistant strains).

When taken orally, it is completely absorbed from the gastrointestinal tract (about 95%), absolute bioavailability is 96%. After taking ofloxacin in the dosage form of conventional tablets, Cmax in plasma is reached after 1-2 hours, after taking prolonged-release tablets - within 6-8 hours. Plasma protein binding - 32%. The apparent volume of distribution is 100 liters. T 1/2 when taking conventional tablets - 4.5-7 hours. Penetrates into cells (leukocytes, alveolar macrophages) of most organs and tissues, creates high concentrations in urine, bile, saliva, sputum, prostate secretion, kidneys, liver, gallbladder, skin, lungs, passes through the BBB and the placental barrier. In the liver (about 5%) it turns into the N-oxide of ofloxacin and demethylofloxacin. It is excreted mainly by the kidneys unchanged (80-90%); a small part is excreted in bile, feces, breast milk (extrarenal clearance is less than 20%). After a single oral administration of 200 mg in the urine, it is detected within 20-24 hours. In diseases of the liver and / or kidneys, excretion may slow down. Reappointment does not lead to cumulation.

The use of the substance Ofloxacin

Infectious and inflammatory diseases caused by sensitive microorganisms, incl. infections of the respiratory tract (pneumonia, exacerbation of bronchitis), ENT organs (sinusitis, pharyngitis, otitis media, laryngitis, tracheitis), skin and soft tissues, bones and joints, abdominal cavity, pelvic organs, kidneys and urinary tract (pyelonephritis, cystitis , urethritis), genital organs (including gonorrhea, prostatitis), chlamydial infections, septicemia, tuberculosis (as part of complex therapy), prevention of infections in patients with immunodeficiency.

In ophthalmology: bacterial corneal ulcers, conjunctivitis, blepharitis, meibomitis, dacryocystitis, keratitis, chlamydial eye infections, prevention of infectious complications in the postoperative period after surgical interventions for the removal of a foreign body and eye injury.

ENT practice: acute and chronic bacterial external and otitis media, otitis media with perforation of the tympanic membrane or tympanopuncture; prevention of infectious complications during surgical interventions.

Contraindications

Hypersensitivity (including to other fluoroquinolones, quinolones), epilepsy (including history), dysfunction of the central nervous system with a decrease in the threshold of convulsive readiness (including after TBI, stroke, inflammatory processes in the central nervous system), tendon involvement with prior fluoroquinolone treatment, age under 18 years (until skeletal growth is completed). For local forms: chronic non-bacterial conjunctivitis or otitis.

Use during pregnancy and lactation

Use during pregnancy is possible (including in the form of dosage forms for topical use) if the expected effect of therapy outweighs the potential risk to the fetus (adequate and well-controlled studies of the safety of use in pregnant women have not been conducted).

teratogenic effects. Ofloxacin did not have a teratogenic effect when administered to pregnant animals during the period of organogenesis: rats at doses above 810 mg / kg / day, which is 11 times higher than the MRDC when taken orally and 9000 times when used in the form of eye drops; rabbits at doses over 160 mg / kg / day, which exceeds the MRDC by 4 and 1800 times, respectively. Oral doses equivalent to 50 and 10 MRDA were fetotoxic, with a decrease in fetal body weight and an increase in fetal mortality in rats and rabbits.

With a single dose of 200 mg of ofloxacin in breastfeeding women, its concentrations in breast milk are similar to those in plasma. Since ofloxacin has the potential to cause serious adverse reactions in breastfed infants, lactating women should stop either breastfeeding or taking ofloxacin (given the importance of the drug to the mother).

Side effects of Ofloxacin

From the digestive tract: dyspepsia, nausea, vomiting, diarrhea, anorexia, abdominal pain, dry mouth, transient increase in plasma bilirubin and liver enzymes, hepatitis, jaundice, dysbacteriosis, pseudomembranous colitis.

From the nervous system and sensory organs: dizziness, headache, insomnia, anxiety, decreased reaction rate, agitation, increased intracranial pressure, tremor, convulsions, nightmares, hallucinations, psychosis, paresthesia, phobias, impaired coordination of movements, taste, smell, vision, diplopia, color perception disorders, loss of consciousness.

From the side of the cardiovascular system and blood (hematopoiesis, hemostasis): cardiovascular collapse, hemolytic and aplastic anemia, thrombocytopenia, including thrombocytopenic purpura, leukopenia, neutropenia, agranulocytosis, pancytopenia.

From the genitourinary system: acute interstitial nephritis, violation of the excretory function of the kidneys with an increase in the level of urea and creatinine, vaginitis.

Allergic reactions: skin rash, itching, angioedema, incl. laryngeal, pharyngeal, face, vocal cords, bronchospasm, urticaria, erythema multiforme exudative, Stevens-Johnson syndrome, toxic epidermal necrolysis, anaphylactic shock.

Others: hypoglycemia (in patients with diabetes mellitus), vasculitis, tendonitis, myalgia, arthralgia, superinfection, photosensitivity.

When used in ophthalmology: burning sensation and discomfort in the eyes, redness, itching and dryness of the conjunctiva, photophobia, lacrimation; rarely - dizziness, nausea.

After instillation into the ear canal: itching in the ear canal, a bitter taste in the mouth; rarely - systemic reactions (eczema, dizziness, noise and pain in the ears, dryness of the oral mucosa).

Interaction

Antacids containing Al 3+ , Ca 2+ , Mg 2+ , iron salts, saline laxatives, sucralfate, zinc reduce absorption and reduce activity (the interval between doses should be at least 2 hours). With the concomitant use of NSAIDs and quinolones (including ofloxacin), the risk of CNS stimulation and the development of seizures may increase. With the simultaneous administration of ofloxacin with theophylline, T 1/2 may be prolonged and C ss of theophylline may increase, as a result of which the risk of theophylline toxicity increases. Furosemide and methotrexate inhibit elimination and may increase toxicity. Increases the concentration of glibenclamide. Do not mix in solution with heparin (risk of precipitation).

Overdose

Symptoms: drowsiness, nausea, vomiting, dizziness, disorientation, lethargy, confusion.

Treatment: gastric lavage, maintenance of vital functions.

Routes of administration

Inside, in / in, locally (subconjunctival, into the external auditory canal).

Substance Precautions Ofloxacin

After the disappearance of clinical signs, treatment is continued for 2-3 days. Be wary appoint patients with atherosclerosis of cerebral vessels. Constant monitoring is necessary when combined with insulin, caffeine, theophylline, cyclosporine, NSAIDs, oral anticoagulants (including warfarin) and drugs metabolized with the participation of cytochrome P450.

In children, it is used only when life is threatened (due to the risk of side effects). With rapid on / in the introduction, a decrease in blood pressure is possible.

Do not inject subconjunctivally or inject into the anterior chamber of the eye. When using ophthalmic forms, it is not recommended to wear eye lenses. Perhaps the combined use of eye drops and eye ointment, while the ointment is used last.

During the treatment period, you should not be exposed to sunlight or UV radiation. It is recommended to refrain from activities that require the speed of psychomotor reactions (driving vehicles, working with potentially dangerous mechanisms) and drinking alcohol.

Interactions with other active substances

Trade names

Name	The value of the Wyshkovsky Index ®
	0.1437