Lendacin
Lendacin: 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: Lendacin
ATX code: J01DD04
Active ingredient: ceftriaxone (ceftriaxone)
Manufacturer: LEK dd (Slovenia), SANDOZ, GmbH (Austria)
Description and photo updated: 22.11.2018
Lendacin is a broad-spectrum antibacterial drug.
Release form and composition
Lendacin dosage forms:
- powder for the preparation of a solution for intravenous (intravenous) and intramuscular (intramuscular) injections: white or white with a light yellow tint (in a colorless glass bottle 250 or 1000 mg, in a cardboard box 1, 5, 10 or 50 bottles);
- powder for preparation of solution for infusion: white or white with a light yellow tinge (in a colorless glass bottle 250, 1000 or 2000 mg, in a cardboard box 1, 5, 10 or 50 bottles).
The powder of both dosage forms has an identical composition, 1 mg of which contains the active substance ceftriaxone (in the form of ceftriaxone sodium salt) - 1 mg.
Pharmacological properties
Pharmacodynamics
Ceftriaxone is a third generation cephalosporin antibiotic with a broad spectrum of action for parenteral administration. The bactericidal effect is due to inhibition of the synthesis of the cell walls of microorganisms (violation of the cross-linking of peptidoglycans). The active substance has bactericidal activity against many gram-positive and gram-negative microorganisms, shows resistance to the action of beta-lactamases.
Ceftriaxone is active against the following gram-positive aerobic bacteria: Staphylococcus epidermidis, Staphylococcus aureus (including strains producing penicillinase), Streptococcus viridans, Streptococcus pyogenes, Streptococcus pneumoniae.
Gram-negative aerobic microorganisms susceptible to the action of ceftriaxone: Enterobacter cloacae, Enterobacter aerogenes, Acinetobacter calcoaceticus, Escherichia coli, Haemophilus parainfluenzae, Haemophilus influenzae (including penicillinase-forming strains, including Kapppiella spp., Including catppllinase strains), Moralraxella spp. (including Klebsiella pneumoniae), Neisseria meningitidis, Neisseria gonorrhoeae (including penicillinase-forming strains), Morganella morganii, Serratia spp. (including Serratia marcescens), Proteus vulgaris, Proteus mirabilis, some Pseudomonas aeruginosa strains.
Anaerobic microorganisms sensitive to ceftriaxone: Peptostreptococcus spp., Clostridium spp. (except Clostridium difficile), Bacteroides fragilis.
Ceftriaxone is active in vitro against most strains of the following bacteria: Providencia rettgeri, Providencia spp., Citrobacter freundii, Citrobacter koseri (diversus), Shigella spp., Salmonella spp. (including Salmonella typhi), Bacteroides melaninogenicus, Bacteroides bivius, Streptococcus agalactiae. However, the clinical significance of the antibiotic action against them has not been studied.
Resistant to ceftriaxone are Bacteroides fragilis, Campylobacter jejuni, Pseudomonas aeruginosa, Acinetobacter spp., Enterococcus faecalis, Listeria monocytogenes, Clostridium difficile and methicillin-resistant staphylococci.
Show resistance to cephalosporin antibiotics of mycobacteria, mycoplasma and chlamydia.
Some strains resistant to other cephalosporins may be susceptible to ceftriaxone.
Lendacin can be administered once a day due to its prolonged (about 8 hours) excretion from the body.
Pharmacokinetics
- absorption: after i / m administration, ceftriaxone is well absorbed at the injection site, reaching a high concentration in the blood serum. The bioavailability of the active substance is 100%;
- distribution: ceftriaxone is characterized by good penetration into tissues and body fluids and a high volume of distribution. In children (including newborns), the substance penetrates into the cerebrospinal fluid, reaching a concentration that is about 17% of the plasma concentration. After a single dose of 50 mg / kg of ceftriaxone in adults, after 2-24 hours, its content in the cerebrospinal fluid exceeds the minimum inhibitory concentration (MIC) for most of the most common pathogens of meningitis;
- excretion: 50-60% of the active substance is excreted in the urine, 40-50% through the intestines. The average T 1/2 (half-life) is 8 hours.
Concentrations of ceftriaxone in tissues and blood plasma, exceeding the MIC for most sensitive microorganisms, persist for 24 hours due to prolonged T 1/2 of the drug.
In children in the first 8 days of life and in patients over 75 years old, T 1/2 is 16 hours.
In newborns, approximately 70% of ceftriaxone is excreted by the kidneys.
Indications for use
According to the instructions, Lendacin is indicated for the treatment of infectious and inflammatory diseases caused by microorganisms sensitive to ceftriaxone:
- bacterial infections of the upper and lower respiratory tract;
- endocarditis;
- ENT infections;
- bacterial meningitis;
- infections of the abdominal organs (including inflammatory diseases of the gastrointestinal tract, biliary tract, peritonitis);
- septicemia;
- infectious diseases of the genitourinary system (including gonorrhea and chancre);
- infections of the skin, soft tissues;
- tick-borne borreliosis (Lyme disease);
- infected wounds and burns;
- shigellosis, invasive salmonellosis, typhoid fever;
- neutropenic fever against the background of malignant neoplasms;
- infections of the joints, bones.
Contraindications
Contraindications to the use of Lendacin are the lactation period, as well as increased individual sensitivity to cephalosporin antibiotics.
The drug should not be administered to newborns with hyperbilirubinemia.
Prescribing Lendacin to patients with hypersensitivity to penicillins, concomitant impairment of kidney and liver function, a history of gallbladder and gastrointestinal tract diseases requires caution because of the risk of cross-allergy reactions. An antibiotic should also be used with caution during pregnancy.
Instructions for the use of Lendacin: method and dosage
The previously dissolved Lendacin powder is administered intravenously, intramuscularly and as a slow intravenous infusion lasting at least 30 minutes.
To prepare a solution intended for intravenous administration, dilute 1000 mg of powder in 10 ml (250 mg - in 5 ml) of sterile water for injection. The solution should be injected slowly over 2–4 minutes.
For i / m administration of the drug, 1000 mg of powder is diluted in 3.5 ml (250 mg - in 2 ml) of 1% lidocaine solution. The injection is carried out deep into the gluteus muscle. It is recommended that no more than 1000 mg of ceftriaxone be injected into each buttock. Injections into the right and left buttocks should be alternated to avoid local reactions. A solution with lidocaine cannot be administered intravenously.
The solution for intravenous infusion is prepared as follows: 2000 mg of ceftriaxone is diluted in 40 ml of an infusion solution that does not contain calcium. As solvents, you can use: 0.9 or 0.45% sodium chloride solution, 5% levulose solution, dextrose solution (2.5; 5 or 10%), 6% dextrin solution in dextrose. The duration of the infusion should be at least 30 minutes.
Recommended dosage regimens for Lendacin:
- adults and children over 12 years old: 1000–2000 mg once a day. Perhaps the introduction of 2 times a day (with an interval of 12 hours). The maximum daily dose is 4000 mg (2000 mg is administered as an intravenous infusion over 30 minutes with an interval of 12 hours);
- children under 12 years of age: daily dose - from 50 to 75 mg / kg of body weight, but not more than 2000 mg / day. Lendacin is administered, as a rule, once a day, but if necessary, it can be administered 2 times a day with an interval of 12 hours;
- neonates: 20 to 50 mg / kg of body weight as an intravenous slow infusion.
Infants and children under 12 years of age with bacterial meningitis are prescribed ceftriaxone at a dose of 100 mg / kg of body weight, but not more than 4000 mg per day. The duration of the course is from 7 to 14 days.
In the case of uncomplicated gonorrhea in women and men, a single intramuscular injection at a dose of 250 mg is recommended.
In case of moderate renal impairment, there is no need to reduce the dose of Lendacin, provided the liver is functioning normally.
In patients with severe renal failure (with creatinine clearance of 10 ml / min or less), the dosage regimen requires correction.
It is not necessary to reduce the dose of Lendacin in case of impaired liver function, provided that the kidneys function normally.
In the case of severe concomitant renal-hepatic failure, it is recommended to reduce the dose of Lendacin by half and systematically monitor the concentration of ceftriaxone in the blood plasma.
There is no need to adjust the dose of Lendacin in elderly patients.
Side effects
Possible side reactions from systems and organs:
- digestive system: nausea, vomiting, flatulence, diarrhea, stomatitis, hyperbilirubinemia, increased enzymatic activity of hepatic transaminases; rarely - pseudomembranous colitis;
- hematopoietic system: leukopenia, thrombocytopenia, thrombocytosis, eosinophilia, decreased prothrombin time, hemolytic anemia;
- urinary system: oliguria, increased serum creatinine concentration;
- central nervous system: dizziness, headache;
- allergic reactions: pruritus, allergic dermatitis, urticaria, angioedema; rarely - fever, exudative erythema multiforme, anaphylactic shock (arterial hypotension, bronchospasm);
- local reactions: soreness at the injection site, phlebitis.
Overdose
In case of an overdose of Lendacin, symptoms such as diarrhea, nausea, vomiting, confusion, and convulsions may occur.
There is no specific antidote for ceftriaxone. In case of overdose, symptomatic therapy is recommended. The hemodialysis procedure is ineffective.
special instructions
With the use of cephalosporins (including ceftriaxone), cases of anaphylactic reactions, with fatal outcomes, have been reported, even in the absence of allergic reactions in the patient's history. With the development of hypersensitivity reactions, Lendacin should be discontinued and appropriate therapy should be carried out.
Patients with vitamin K deficiency, in case of a violation of its synthesis or errors in nutrition, may require the appointment of this vitamin at a dose of 10 mg per week if there is an increase in prothrombin time before or during drug therapy.
The use of Lendacin, as well as treatment with other antibacterial drugs, increases the risk of superinfection caused by antibiotic-resistant microorganisms. Pseudomembranous colitis is unlikely to develop.
During the period of ceftriaxone therapy, there may be darkening in the places of its cumulation in the gallbladder during ultrasound examination, which should not be mistaken for stones. Such deposits of ceftriaxone are often noted, but they are usually asymptomatic and go away on their own.
The use of Lendacin can lead to false-positive results of the Coombs test, false-positive tests for galactosemia, in determining the glucose content in urine (glycosuria should be carried out exclusively by an enzymatic method).
During treatment with ceftriaxone, as with other antibiotics, it is recommended not to consume alcohol.
Influence on the ability to drive vehicles and complex mechanisms
In rare cases, Lendacin will cause dizziness. Therefore, during the period of drug therapy, care should be taken when driving vehicles and performing other potentially hazardous activities that require increased concentration of attention and a quick psychomotor reaction.
Application during pregnancy and lactation
Prescribing Lendacin to pregnant women is possible only if the intended therapeutic benefit to the mother is higher than the potential risks to the fetus.
Since ceftriaxone in low concentrations can penetrate into breast milk, if it is necessary to prescribe Lendacin during lactation, it is recommended to stop breastfeeding during the period of its use.
Pediatric use
Lendacin can be prescribed to children from the moment of birth, strictly observing the indications and using the minimum effective dose.
With impaired renal function
Lendacin should be used with caution in patients with concomitant renal-hepatic insufficiency.
In severe renal impairment (creatinine clearance not higher than 10 ml / min), it is necessary to reduce the dose of ceftriaxone.
For violations of liver function
In the case of severe combined impairment of renal and liver function, it is recommended to reduce the dose of Lendacin by half and systematically monitor the plasma content of ceftriaxone.
Use in the elderly
It is not required to adjust the dose of Lendacin in elderly patients.
Drug interactions
The use of ceftriaxone concurrently with certain drugs can lead to the development of the following effects:
- cyclosporine: increased plasma levels and toxicity;
- non-steroidal anti-inflammatory drugs and other inhibitors of platelet aggregation: increased risk of bleeding;
- diclofenac: increased excretion of ceftriaxone in bile and decreased total urinary clearance;
- acetazolamide: increasing the concentration of ceftriaxone in the stomach contents;
- bacteriostatic antibiotics: reducing the bactericidal effect of ceftriaxone;
- probenecid: no interactions noted;
- oral contraceptives: decrease in their effectiveness. It is recommended to use additional non-hormonal contraceptives during Lendacin therapy and within 1 month after its end.
Ceftriaxone should not be mixed with calcium-containing solutions.
Lendacin solution is not recommended to be simultaneously administered or mixed with other antimicrobial drugs.
Analogs
Lendacin analogs are Axone, Betasporin, Biotraxon, Lifaxon, Medaxon, Oframax, Rocefin, Triaxon, Cefatrin, Ceftriaxone, Ceftriaxone-Vial and others.
Terms and conditions of storage
Store in a dark place at a temperature not exceeding 25 ° C.
Keep out of the reach of children.
Shelf life is 3 years.
Shelf life of the prepared solution: 6 hours - when stored at a temperature of up to 25 ° C; 24 hours - when stored in a refrigerator from 2 to 8 ° C.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Lendacin
Reviews of Lendacin indicate that the drug is highly effective in the treatment of various infectious and inflammatory diseases, provided that the infection is caused by bacteria sensitive to this antibiotic. In most cases, therapy is successful and goes without complications.
At the same time, users often complain of pain in the / m injections, even with lidocaine, and infiltrates in the gluteal muscles.
Price for Lendacin in pharmacies
The price of Lendacin for a pack of 10 bottles of 1000 mg is approximately 2300 rubles.
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!
