Glevo
Glevo: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Use in the elderly
- 14. Drug interactions
- 15. Analogs
- 16. Terms and conditions of storage
- 17. Terms of dispensing from pharmacies
- 18. Reviews
- 19. Price in pharmacies
Latin name: Glevo
ATX code: J01MA12
Active ingredient: levofloxacin (levofloxacin)
Manufacturer: Glenmark Pharmaceuticals Ltd. (VMG Pharmaceuticals, Private Ltd.) (India)
Description and photo update: 2019-21-08
Prices in pharmacies: from 38 rubles.
Buy
Glevo is a drug with antimicrobial bactericidal action.
Release form and composition
- solution for infusion: transparent, yellow with a greenish tinge (100 ml in polyethylene bottles, 1 bottle in a cardboard box);
- film-coated tablets: 250 mg each - round, biconvex, brick-red, with a break line on one side, smooth on the other side; 500 mg each - biconvex, oblong-shaped, light orange with a pink tinge, with a break line on one side, slight surface roughness is possible (5 pcs. in blisters, in a cardboard box 2 or 5 blisters).
The composition of the solution in 1 bottle (100 ml):
- active substance: levofloxacin (in the form of hemihydrate) - 500 mg;
- additional components: water for injection, sodium hydroxide, anhydrous dextrose (glucose), hydrochloric acid.
Composition of 1 coated tablet:
- active substance: levofloxacin (in the form of hemihydrate) - 250 or 500 mg;
- additional components: MCC (microcrystalline cellulose), MCC Avicel pH101, crospovidone, K-30 povidone, magnesium stearate, starch;
- film shell: macrogol (polyethylene glycol 6000), hypromellose, dibutyl phthalate, titanium dioxide, talc, iron dye red oxide; 500 mg tablets additionally contain iron oxide yellow dye.
Pharmacological properties
Pharmacodynamics
The active ingredient in Glevo is levofloxacin, a levorotatory isomer of ofloxacin, an agent from the group of fluoroquinolones, which has a broad spectrum of antimicrobial action.
The mechanism of action of levofloxacin is due to its ability to block DNA gyrase (topoisomerase II) and topoisomerase IV, disrupt supercoiling and stitching of DNA breaks (deoxyribonucleic acid), inhibit bacterial DNA synthesis, and induce deep morphological changes in the cytoplasm, cell wall and bacterial membranes.
Glevo is active against most strains of microorganisms in vitro and in vivo.
In vitro sensitive to levofloxacin [minimum inhibitory concentration (MIC) ≤ 2 mg / ml]:
- aerobic gram-positive microorganisms: Staphylococcus aureus (methicillin-susceptible strains), Staphylococcus spp. (leukotoxin-containing and coagulase-negative methicillin-sensitive and moderately sensitive strains), Staphylococcus spp. (coagulase-negative methicillin-susceptible and moderately susceptible strains), Staphylococcus epidermidis (methicillin-susceptible strains), Listeria monocytogenes, Enterococcus spp. (including Enterococcus faecalis), Corynebacterium diphtheriae, Streptococcus spp. viridans groups (penicillin-sensitive and resistant strains), Streptococcus pyogenes, Streptococcus spp. groups C and G, Streptococcus pneumoniae (penicillin-sensitive, moderately sensitive and resistant strains), Streptococcus agalactiae;
- aerobic gram-negative microorganisms: Proteus mirabilis, Proteus vulgaris, Providencia spp. (including P. rettgeri and stuartii), Escherichia coli, Enterobacter aerogenes, Enterobacter spp. (including E. cloacae), Acinetobacter spp., Enterobacter agglomerans, Acinetobacter baumannii, Eikenella corrodens, Citrobacter freundii, Actinobacillus actinomycetemcomitans, Gardnerella vaginalis, Pasteurella spp. (including P. canis, P. dagmatis and P. multocida), Morganella morganii, Moraxella catarrhalis (strains producing and non-producing β-lactamase), Klebsiella spp. (including K. oxytoca and K. pneumoniae), Neisseria meningitidis, Neisseria gonorrhoeae (strains producing and non-producing penicillinase), Helicobacter pylori, Haemophilus influenzae (ampicillin-sensitive and resistant strains), Haemluenophilus parafilusSerratia spp. (including S. marcescens), Salmonella spp., Pseudomonas spp. (including P. aeruginosa);
- anaerobic microorganisms: Propionibacterium spp., Fusobacterium spp., Clostridium perfringens, Bifidobacterium spp., Bacteroides fragilis, Veillonella spp., Peptostreptococcus spp.;
- other microorganisms: Chlamydia trachomatis, Bartonella spp., Chlamydia psittaci, Legionella spp., Chlamydia pneumoniae, Legionella pneumophila, Rickettsia spp., Mycoplasma hominis, Mycoplasma pneumoniae, Mycobacterium spp. (including M. leprae and tuberculosis), Ureaplasma urealyticum.
Moderately sensitive to levofloxacin (MIC ≥ 4 mg / l):
- aerobic gram-positive microorganisms: Staphylococcus haemolyticus (methicillin-resistant strains), Staphylococcus epidermidis (methicillin-resistant strains), Corynebacterium xerosis, Corynebacterium urealyticum, Enterococcus faecium;
- aerobic gram-negative microorganisms: Campylobacter coli, Campylobacter jejuni, Burkholderia cepacia;
- anaerobic microorganisms: Bacteroides ovatus, Bacteroides vulgatus, Bacteroides thetaiotaomicron, Porphyromonas spp., Prevotella spp.
Resistance to levofloxacin (MIC ≥ 8 mg / l) is shown by:
- aerobic gram-negative microorganisms: Alcaligenes xylosoxidans;
- aerobic gram-positive microorganisms: Staphylococcus spp. (coagulase-negative methicillin-resistant strains), Staphylococcus aureus (methicillin-resistant strains), Corynebacterium jeikeium;
- other microorganisms: Mycobacterium avium.
Pharmacokinetics
After oral administration, levofloxacin is rapidly and almost completely absorbed. Bioavailability is 99%. The maximum concentration when taking Glevo at a dose of 250 and 500 mg, respectively, is 2.8 and 5.2 mcg / ml, achieved within 1-2 hours.
After a single intravenous injection of 150, 300 or 500 mg of levofloxacin, the average urinary concentrations after 8-12 hours are 44, 91 or 200 g / l, respectively.
The substance binds to plasma proteins by 30-40%. When using Glevo daily at 500 mg, the accumulation of levofloxacin is insignificant, when applied at 500 mg 2 times a day, a slight accumulation of the substance is possible. Equilibrium concentrations are reached within 3 days of treatment.
Levofloxacin penetrates well into organs and tissues: sputum, bronchial mucosa, lungs, bone tissue, genitals, prostate gland, organs of the urinary system, alveolar macrophages, polymorphonuclear leukocytes. Poorly penetrates the cerebrospinal fluid.
A small part of levofloxacin is metabolized in the liver (by oxidation and deacetylation) to form desmethyl levofloxacin and levofloxacin-N-oxide - they make up less than 5% of the substance excreted by the kidneys. The renal clearance of the drug is up to 70% of the total clearance.
The half-life (T 1/2) is 6-8 hours. The drug is excreted from the body mainly by the kidneys by glomerular filtration and tubular secretion. Less than 5% is excreted as metabolites. 70% is excreted unchanged by the kidneys within 24 hours, and 87% within 48 hours. In the intestine, 4% of the dose taken orally is found within 72 hours.
Indications for use
According to the instructions, Glevo is prescribed for the treatment of infectious and inflammatory diseases caused by microorganisms sensitive to the active substance of the drug, the following systems and organs:
- ENT organs (including acute sinusitis);
- Urinary system and kidneys (complicated and uncomplicated infections, including prostatitis, acute pyelonephritis);
- Lower respiratory tract (including community-acquired pneumonia, exacerbation of chronic bronchitis);
- Soft tissues and skin (abscess, suppurative atheroma, furunculosis);
- Genital organs;
- Abdominal cavity (along with other drugs that have an effect on the anaerobic microflora).
Contraindications
- Epilepsy;
- Tendon affection during previous treatment with quinolones;
- Pregnancy and lactation (breastfeeding);
- Age (up to 18 years old);
- Hypersensitivity to the components of the drug, as well as to other fluoroquinolones.
Glevo tablets should be administered with caution in case of glucose-6-phosphate dehydrogenase deficiency.
In the form of a solution for infusion, Glevo should also be used with caution in the following cases: a history of brain damage (severe trauma, stroke), pseudoparalytic myasthenia gravis (myasthenia gravis), the presence of risk factors for prolonging the QT interval, the need for the simultaneous use of drugs that reduce the threshold of convulsive readiness of the brain (due to the risk of seizures).
Instructions for use Glevo: method and dosage
In the form of a solution, Glevo is injected intravenously. The duration of the infusion of 100 ml of infusion solution (500 mg of levofloxacin) should be at least 60 minutes. If the patient's condition allows, after a few days of treatment he is transferred to Glevo in the form of coated tablets. Changing the dosage regimen is not required.
The tablets are taken orally 1-2 times a day, swallowed whole and washed down with a sufficient amount of liquid (100-250 ml). The drug can be taken between meals or before meals.
Doses are determined by the severity and nature of the infection, as well as the sensitivity to the action of Glevo of the alleged pathogen.
Patients with normal or moderately reduced renal function (creatinine clearance greater than 50 ml per minute) are recommended the following dosage regimen Glevo:
- Sinusitis: 500 mg once a day for 10-14 days;
- Exacerbation of chronic bronchitis: once a day, 250 or 500 mg for 7-10 days;
- Community-acquired pneumonia: 1-2 times a day, 500 mg for 7-14 days;
- Uncomplicated urinary tract infections: 250 mg once a day for 3 days;
- Prostatitis: 500 mg once a day for 28 days;
- Complicated urinary tract infections, including pyelonephritis: 250 mg once a day for 7-10 days;
- Infections of soft tissues and skin: 1-2 times a day, 250 or 500 mg for 7-14 days;
- Abdominal infections: once a day, 500 mg for 7-14 days (simultaneously with antibacterial drugs acting on the anaerobic flora).
Patients with impaired renal function require correction of the dosage regimen Glevo.
As with the use of other antibiotic agents, it is recommended to continue Glevo therapy for at least 2-3 days after reliable eradication of the pathogen or after normalization of body temperature.
No additional doses are required after continuous ambulatory peritoneal dialysis (CAPD) or hemodialysis.
For elderly patients, the dosage regimen is not changed, except in cases of low creatinine clearance.
With functional disorders of the liver, a special selection of doses is not required, since the active substance is metabolized in the liver to an insignificant extent.
If Glevo's reception was missed, you need to take the pill as soon as possible. In the future, you should continue taking the drug according to the scheme.
Side effects
During therapy, it is possible to develop disorders from some systems and organs:
- Cardiovascular system: prolongation of the QT interval, vascular collapse, lowering of blood pressure, tachycardia; extremely rare - atrial fibrillation;
- Urinary system: acute renal failure, interstitial nephritis, hypercreatininemia;
- Digestive system: decreased appetite, nausea, hepatitis, diarrhea (including with blood), indigestion, vomiting, pseudomembranous enterocolitis, abdominal pain, hyperbilirubinemia, increased activity of hepatic transaminases, dysbiosis;
- Musculoskeletal system: tendonitis, muscle weakness, arthralgia, tendon rupture, myalgia, rhabdomyolysis;
- Endocrine system: hypoglycemia (increased sweating, increased appetite, nervousness, trembling);
- Central and peripheral nervous system: dizziness, headache, confusion, weakness, insomnia, drowsiness, anxiety, tremor, fear, paresthesia, movement disorders, hallucinations, depression, epileptic seizures (in predisposed patients);
- Hematopoietic system: thrombocytopenia, neutropenia, hemolytic anemia, eosinophilia, leukopenia, pancytopenia, agranulocytosis, hemorrhages;
- Sense organs: impaired hearing, vision, smell, tactile and gustatory sensitivity;
- Allergic reactions: hyperemia and itching of the skin, edema of mucous membranes and skin, anaphylactic shock, malignant exudative erythema (Stevens-Johnson syndrome), urticaria, bronchospasm, allergic pneumonitis, dyspnea, toxic epidermal necrolysis (Lyell's syndrome), vasculitis;
- Others: the development of superinfection, asthenia, photosensitivity, persistent fever, exacerbation of porphyria.
With intravenous administration of Glevo, the following local reactions may also occur: redness and pain at the injection site, phlebitis.
Overdose
Symptoms: phenomena from the central nervous system, such as disturbance or confusion of consciousness, dizziness, convulsions of the type of epileptic seizures; also possible gastrointestinal disorders (eg, nausea), erosive lesions of the mucous membranes of the gastrointestinal tract, prolongation of the QT interval.
The specific antidote for levofloxacin is not known. Dialysis is ineffective. Treatment of an overdose of Glevo is symptomatic.
special instructions
Patients during therapy need to carry out adequate hydration of the body.
With the development of signs of pseudomembranous colitis and tendinitis, it is necessary to immediately cancel Glevo and prescribe appropriate therapy.
To avoid damage to the skin (photosensitization) during treatment, artificial and solar UV exposure should be avoided.
Patients with a history of brain lesions (severe trauma, stroke) may develop seizures. The risk of developing hemolysis increases with deficiency of glucose-6-phosphate dehydrogenase.
Influence on the ability to drive vehicles and complex mechanisms
During therapy, caution should be exercised when driving vehicles, as well as when performing potentially hazardous work that requires a high concentration of attention and rapid psychomotor reactions.
Application during pregnancy and lactation
Antibiotic Glevo is contraindicated for use during pregnancy and lactation.
Pediatric use
Glevo is not used in pediatric practice (for the treatment of children and adolescents under the age of 18).
With impaired renal function
For patients with impaired renal function, the doctor prescribes one of the following dosage regimens for Glevo, taking into account creatinine clearance (CC, ml / min):
- CC 20-50: if the first dose should be 250 mg, then 125 mg once a day; if the first dose is required 500 mg, then - 250 mg 1 time per day or 250 mg 2 times a day (with an interval of 12 hours);
- CC 10-19: if the first dose should be 250 mg, then - 125 mg 1 time in 2 days; if the first dose is 500 mg, then 125 mg 1 time per day or 125 mg 2 times a day (with an interval of 12 hours);
- CC <10 (including hemodialysis and continuous outpatient peritoneal dialysis): if the first dose should be 250 mg, then 125 mg once every 2 days; if the first dose is required 500 mg, then 125 mg once a day.
The introduction of additional doses of Glevo after a hemodialysis / peritoneal dialysis session is not required.
For violations of liver function
In the liver, levofloxacin is metabolized only to a small extent; therefore, patients with impaired hepatic function do not need to adjust the dose of Glevo.
Use in the elderly
The antibiotic Glevo should be used with caution in this category of patients, since the elderly may have concomitant renal dysfunction, which requires correction of the dosage regimen of the drug.
Drug interactions
With the simultaneous use of Glevo with some drugs, undesirable effects may occur:
- Non-steroidal anti-inflammatory drugs, theophylline: convulsive readiness increases;
- Cimetidine and drugs that block tubular secretion: the excretion of levofloxacin slows down;
- Glucocorticosteroids: increased risk of tendon rupture;
- Hypoglycemic drugs: the development of hyper- and hypoglycemia is possible (strict control of blood glucose levels is required).
Action Glevo lowers sucralfate, drugs that inhibit intestinal motility, antacid drugs containing aluminum / magnesium and iron salts (a break between doses of at least 2 hours should be observed).
Analogs
Glevo analogs are: Zolev, Levofloxacin, Levofloxacin-Teva, Levostar, Leflobact, Levobax, Lebel, Levokils, Levobact, Levoximed, Levoksa, Levomak, Levolet, Levotor, Levostad, Levoflox, Signicef, Tavanik, Toxlef, Tigeron, Elex Floxium.
Terms and conditions of storage
Store in a dark, dry place out of reach of children at temperatures up to 25 ° C.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Glevo
Reviews about Glevo on the network are rather contradictory. A positive assessment of the drug is given by patients who have undergone a successful course of treatment with a minimum of side effects. In negative statements, adverse reactions are usually described, including quite pronounced effects that required interruption of therapy: dizziness, severe headaches, weakness, nausea, increased blood pressure, palpitations, tremors, tendon damage, bronchospasm.
Doctors note that Glevo is a strong antibiotic, so it should only be used as directed by a doctor. In order to avoid disturbance of the intestinal microflora during treatment, it is recommended to take probiotics.
Price for Glevo in pharmacies
Average prices for Glevo in the form of 500 mg coated tablets are: 46 rubles. per pack of 5 pcs., 86 rubles. per pack of 10 pcs., 187 rubles. per pack of 25 The cost of 250 mg coated tablets and infusion solution is currently unknown.
Glevo: prices in online pharmacies
|
Drug name Price Pharmacy |
|
Glevo 500 mg film-coated tablets 5 pcs. RUB 38 Buy |
|
Glevo 500 mg film-coated tablets 10 pcs. RUB 69 Buy |
|
Glevo 500 mg film-coated tablets 25 pcs. 179 r Buy |
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
