Klion
Klion: 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: Klion
ATX code: J01XD01
Active ingredient: Metronidazole (Metronidazole)
Manufacturer: Gedeon Richter, Plc. (Hungary), Gedeon Richter-RUS (Russia)
Description and photo update: 2018-23-10
Prices in pharmacies: from 67 rubles.
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Klion is a drug with antibacterial, antiprotozoal, antimicrobial action.
Release form and composition
Dosage forms of release of Klion:
- tablets: flat-cylindrical, white or white with a shade from yellowish-greenish to light yellow with greenish, on one side of the risk, on both sides of the chamfer (10 pcs. in blisters, in a cardboard box 2 packs);
- solution for infusion: colorless or slightly greenish or greenish-yellow, transparent, has no mechanical impurities (100 ml in glass bottles, in a cardboard box 1 bottle).
Composition of 1 tablet:
- active substance: metronidazole - 250 mg;
- additional components: talc - 8 mg; corn starch - 150 mg; magnesium stearate - 2.5 mg; microcrystalline cellulose - 39.5 mg; colloidal silicon dioxide - 20 mg; glycerol - 7.5 mg; povidone - 22.5 mg.
Composition of 1 ml solution:
- active substance: metronidazole - 5 mg;
- additional components: sodium chloride - 8 mg; sodium dihydrogen phosphate dihydrate - 0.45 mg; sodium hydrogen phosphate dodecahydrate - 0.6 mg; water for injection - up to 1 ml.
Pharmacological properties
Pharmacodynamics
Klion is one of the antiprotozoal and antimicrobial drugs derived from 5-nitroimidazole. The mechanism of its action lies in the biochemical reduction of the 5-nitro group of metronidazole by intracellular transport proteins of protozoa and anaerobic microorganisms. After reduction, the 5-nitro group interacts with the DNA of the cell of microorganisms, as a result of which the synthesis of nucleic acids is inhibited and the death of microorganisms occurs.
Klion is active against Giardia intestinalis, Entamoeba histolytica, Trichomonas vaginalis, Gardnerella vaginalis, as well as the obligate anaerobes Bacteroides spp. (including Bacteroides distasonis, Bacteroides fragilis, Bacteroides thetaiotaomicron, Bacteroides ovatus, Bacteroides vulgatus), Veillonella spp., Fusobacterium spp., Prevotella and some gram-positive microorganisms (Peptostreptococcus spp., Epptost. spp., spp. spp. The combination with amoxicillin is active against Helicobacter pylori.
Aerobic microorganisms and facultative anaerobes are insensitive to the action of the drug, however, metronidazole in the presence of mixed flora (anaerobes and aerobes) acts synergistically with antibacterial drugs that are effective against conventional aerobes.
Thanks to the use of Klion, the sensitivity of tumors to radiation increases, and reparative processes are stimulated. The drug can cause disulfiram-like reactions.
Pharmacokinetics
When taken orally, it has a high absorption. Bioavailability is not less than 80%. C max (maximum concentration of a substance) in blood plasma is in the range of 6-40 μg / ml (depending on the dose). T max (time to reach maximum concentration) varies from 1 to 3 hours.
Metronidazole penetrates the blood-brain and placental barriers, has a high penetrating ability and reaches bactericidal concentrations in most body fluids and tissues, including abscess cavities, lungs, kidneys, bile, vaginal secretions, liver, skin, brain, saliva, breast milk, spinal cord, amniotic and seminal fluid.
The volume of distribution in newborns is about 0.54-0.81 l / kg, in adults - 0.55 l / kg. Plasma protein binding - from 10 to 20%.
Approximately 30-60% of the dose is metabolized by hydroxylation, glucuronidation and oxidation. 2-oxymetronidazole is the main metabolite. It also has antimicrobial and antiprotozoal effects.
In the absence of liver dysfunction T 1/2 (half-life) varies within 6-12 hours (on average - 8 hours). Renal clearance - 10.2 ml / min. From 60 to 80% of the substance is excreted by the kidneys (unchanged - about 20%), from 6 to 15% - through the intestines.
In patients with severe renal impairment, after repeated administration of the drug, accumulation of metronidazole in the blood serum may occur. In this regard, it is recommended to reduce the frequency of Klion's use in this group of patients.
T 1/2 in different groups of patients may vary:
- patients with alcoholic liver damage: 10–29 hours (average - 18 hours);
- newborns (depending on due date): 28–30 weeks - approximately 75 hours; 32–35 weeks - 35 hours; 36-40 weeks - 25 hours.
During hemodialysis, metronidazole and its main metabolites are rapidly removed from the blood (T 1/2 is reduced to 2.6 hours). During peritoneal dialysis, the substance is excreted in a small amount.
Indications for use
- infections caused by Bacteroides spp. (including Bacteroides ovatus, Bacteroides fragilis, Bacteroides distasonis, Bacteroides thetaiotaomicron, Bacteroides vulgatus): infections of joints and bones, infections of the central nervous system (including brain abscess, meningitis), lung abscess, pneumonia, bacterial endyemaarditis,
- protozoal infections: extraintestinal amebiasis, including amoebic liver abscess, amoebic dysentery (intestinal amebiasis), trichomoniasis (including trichomonas vaginitis, trichomonas urethritis), giardiasis, balantidiasis, cutaneous leishmaniasis;
- infections caused by Peptococcus spp., Clostridium spp., Peptostreptococcus spp.: infections of the pelvic organs (abscess of the ovaries and fallopian tubes, endometritis, infections of the vaginal vault after surgery), infections of the abdominal cavity (liver abscess, peritonitis), soft tissue infections and skin;
- gastritis or duodenal ulcer, which are associated with Helicobacter pylori;
- pseudomembranous colitis (associated with antibiotic therapy);
- complications in the postoperative period (with a prophylactic purpose, especially after appendectomy, interventions in the peri-rectal region, colon, as well as after gynecological operations);
- radiation therapy for patients with tumors (as a radiosensitizing agent in cases where tumor resistance is due to hypoxia in tumor cells) (tablets).
Contraindications
Absolute:
- organic lesions of the central nervous system, including epilepsy;
- hepatic impairment (with the appointment of Klion in high doses);
- leukopenia, including a burdened history;
- I trimester of pregnancy and the period of breastfeeding;
- age up to 3 years (tablets);
- individual intolerance to the components of the drug and other nitroimidazoles.
Relative (diseases / conditions in the presence of which the appointment of Klion requires caution):
- hepatic / renal failure;
- II – III trimesters of pregnancy.
Instructions for the use of Klion: method and dosage
Pills
Klion tablets are taken orally with milk, preferably during / after meals. Do not chew the tablets.
The scheme for using Klion is determined by the indications:
- giardiasis: adults - 2 times a day, 500 mg for 5-7 days; children - the daily dose is 250 mg (3-5 years), 375 mg (5-8 years), or 500 mg (from 8 years), the frequency of administration is 2 times a day; also Klion can be administered in a daily dose of 15 mg / kg in 3 divided doses; course duration - 5 days;
- trichomoniasis: adults - 2 times a day, 250 mg for 10 days or 400 mg for 5 to 8 days; women are additionally prescribed metronidazole in the form of vaginal tablets / suppositories; repeat the course of treatment if necessary; it is also possible to increase the daily dose to 750-1000 mg; the interval between courses is 3-4 weeks (repeated control laboratory tests are required); an alternative regimen of use is a single dose of Klion 2000 mg by the patient and his sexual partner; children - the daily dose is 250 mg (2–5 years), 250–375 mg (5–10 years) or 500 mg (from 10 years), the frequency of administration is 2 times a day, the duration of the course is 10 days;
- balantidiasis: 750 mg 3 times a day for 5–6 days;
- liver abscess: adults - the maximum daily dose is 2500 mg in 1-3 doses for a course of 3 to 5 days, the drug is used simultaneously with antibacterial drugs (tetracyclines) and as part of complex treatment; children - 1/4 (from 3 years old), 1/3 (3–7 years old) or 1/2 (7–10 years old) of the adult dose;
- chronic amebiasis: 3 times a day, 500 mg for 5-10 days;
- asymptomatic amebiasis (when a cyst is diagnosed): 2-3 times a day, 500 mg for a course of 5-7 days;
- acute amoebic dysentery: 2250 mg per day in 3 divided doses, therapy is carried out until symptoms disappear;
- ulcerative stomatitis: adults - 2 times a day, 500 mg for a course of 3-5 days; children Klion in this case is not assigned;
- eradication of Helicobacter pylori: 3 times a day, 500 mg for a course of 7 days (simultaneously with other drugs, in particular, in combination with amoxicillin in a daily dose of 2250 mg);
- pseudomembranous colitis: 3-4 times a day, 500 mg;
- chronic alcoholism: 500 mg per day for up to 6 months;
- anaerobic infections: the maximum daily dose is 1500–2000 mg;
- prevention of infectious complications: 750-1500 mg per day in 3 divided doses 3-4 days before the operation, or once 1000 mg in the first 24 hours after the operation; 1-2 days after surgery (when oral administration is already allowed) - 750 mg per day for a course of 7 days.
In the presence of severe renal dysfunction (creatinine clearance <10 ml / min), the daily dose of Klion is reduced by 2 times.
Infusion solution
According to the instructions, Klion is injected intravenously at a rate of 5 ml / min.
After improving the patient's condition, they are transferred to the drug intake.
The recommended dosage regimen of Klion for infections caused by anaerobic microorganisms:
- adults (weighing approximately 70 kg) and children from 12 years old: initial dose - 15 mg / kg (3 ml / kg), maintenance dose - 7.5 mg / kg (1.5 ml / kg); Klion is injected for 3 days every 6 hours, then the frequency of use is reduced to 2 times a day (every 12 hours); the maximum daily dose is 4000 mg; the average duration of use is from 7 to 10 days; in the treatment of more severe infections, the course can be increased to 14–21 days;
- children under 12 years of age: the initial dose is 7.5 mg / kg (1.5 ml / kg) for 3 days every 8 hours, then the frequency of use is reduced to 2 times a day (every 12 hours).
In order to prevent postoperative complications, Klion is prescribed according to the following scheme:
- adults (weighing about 70 kg) and children from 12 years old: intravenous drip of 15 mg / kg (3 ml / kg) for 30-60 minutes; the introduction of the solution is stopped before the start of the operation for 1 hour. If necessary, 6–8 or even 12–16 hours after the operation, Klion can be administered at a dose of 7.5 mg / kg (1.5 ml / kg);
- children under 12 years of age: the drug is prescribed according to the above scheme in a single dose of 7.5 mg / kg (1.5 ml / kg).
In elderly patients, it may be necessary to monitor the serum concentration of metronidazole in the blood.
In the presence of severe renal dysfunction (creatinine clearance <10 ml / min), the daily dose of Klion is reduced by 2 times.
With hemodialysis, the half-life of metronidazole decreases sharply, and therefore sometimes it may be necessary to prescribe additional doses of Klion.
For patients with severe liver diseases, the dose and the duration of the intervals between injections of the drug should be established by the doctor, depending on the degree of liver damage.
Side effects
- digestive system: pancreatitis, dry mouth, nausea, loss of appetite, cramping pains in the lower abdomen, constipation, diarrhea, vomiting, tongue lining, metallic / bitter taste in the mouth, glossitis;
- urinary system: cystitis, dysuria, polyuria, candidiasis, urinary incontinence, urine staining red-brown (has no clinical significance);
- hepatobiliary system: cholestasis, increased activity of liver enzymes, jaundice;
- central and peripheral nervous system: peripheral neuropathy; rarely and only during a long course - impaired coordination of movements, headaches, drowsiness, weakness, increased excitability, hallucinations, insomnia, convulsions, dizziness, confusion, depression;
- hematopoietic system: reversible neutropenia (leukopenia);
- local reactions (at the injection site of the infusion solution): thrombophlebitis;
- allergic reactions: exudative erythema multiforme, skin rash, pruritus, urticaria, anaphylactic reaction, angioedema;
- others: an increase in body temperature, a decrease in the amplitude of the T wave on the ECG.
Overdose
The main symptoms are nausea, vomiting, ataxia.
Therapy: symptomatic. Metronidazole and its metabolites are well eliminated by hemodialysis. There is no specific antidote.
special instructions
During therapy, drinking alcohol is contraindicated, which is associated with the likelihood of developing a disulfiram-like reaction, manifested in the form of headache, spastic abdominal pain, vomiting, nausea, sudden flushes of blood to the face.
Pills
With leukopenia, the possibility of continuing therapy is determined by the risk of an infectious process.
During a long course, you need to control the blood picture.
The development of disorders such as ataxia, dizziness and any other deterioration in neurological status is the reason for the cancellation of Klion.
Metronidazole can immobilize treponemas, resulting in a false Nelson test.
For the duration of the treatment of Trichomonas vaginitis in women and Trichomonas urethritis in men, one should refrain from sexual activity. Simultaneous treatment of sexual partners is required. You should not interrupt the use of Klion for the period of menstruation. After the therapy of trichomoniasis, control tests should be carried out for three successive cycles before and after menstruation.
Klion stains the urine dark.
After treatment of giardiasis, provided that symptoms persist, 3 fecal analyzes are performed after 3-4 weeks with intervals of several days (in some successfully treated patients, lactose intolerance associated with invasion may persist for several weeks or months, resembling the symptoms of giardiasis).
Infusion solution
Intravenous administration of Klion is indicated in cases of impossibility of oral administration of the drug.
In the treatment of mixed infections, it can be used in combination with parenteral antibiotics. Preparations should not be mixed with each other.
In the case of a course lasting more than 10 days, careful monitoring of the patient's condition is required, as well as regular monitoring of laboratory blood parameters. Before prescribing a longer course, the doctor must correlate the expected benefit with the existing risk of complications.
During the use of Klion, candidiasis may worsen.
Influence on the ability to drive vehicles and complex mechanisms
In cases of the development of adverse reactions from the central nervous system, patients should refrain from driving vehicles.
Application during pregnancy and lactation
- I trimester of pregnancy and the period of breastfeeding - Klion is contraindicated;
- II – III trimesters - the drug can be administered with caution.
Pediatric use
Klion tablets are not prescribed for children under 3 years old. The drug in combination with amoxicillin is not recommended for use in patients under 18 years of age.
With impaired renal function
With renal failure, therapy is carried out with caution.
For violations of liver function
The appointment of high doses of Klion in patients with hepatic insufficiency is contraindicated. In other cases, the drug can be used with caution.
Use in the elderly
In elderly patients, it may be necessary to monitor the serum concentration of metronidazole in the blood.
Drug interactions
Possible interactions:
- oral anticoagulants: enhancing their action; an increase in prothrombin time is possible, in connection with which a correction of their dose may be required;
- cimetidine: an increase in the plasma concentration of metronidazole and the risk of adverse reactions;
- phenobarbital, phenytoin and other inducers of liver microsomal oxidation enzymes: acceleration of the elimination of metronidazole, which leads to a decrease in its plasma concentration in the blood;
- fluorouracil: a decrease in its clearance and an increase in toxicity;
- disulfiram: additive action, may cause confusion; the combination is contraindicated;
- alcohol: development of reactions similar to reactions to the administration of disulfiram; the combination is contraindicated;
- lithium preparations: an increase in the concentration of lithium in the blood; it is necessary to reduce their dose or temporarily cancel;
- cyclosporine: an increase in its plasma concentration (monitoring of this indicator is required);
- other solutions containing sodium salt (infusion of Klion): sodium retention in the body.
In laboratory studies during the period of therapy, difficulties in determining the activity of hepatic transaminases, the content of triglycerides and lactate dehydrogenase are possible.
Analogs
Klion's analogs are: Metroseptol, Nirmet, Metronidazole, Trichocept, Metrolacer, Metron, Efloran, Metrogyl, Batsimex, Trichobrol, Rozex, Trichopol, Metrovagin, Cyptrogil, Metronidal, Flagil and others.
Terms and conditions of storage
Store in a place protected from light at a temperature of 15-30 ° C. Keep out of the reach of children.
Shelf life:
- tablets - 5 years;
- infusion solution - 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Klion
According to reviews, Klion is an inexpensive and effective drug. Tablets are usually taken in the treatment of thrush, infusion solution - for prophylactic purposes in the postoperative period. Of the shortcomings, they usually indicate the development of adverse reactions and the need for a long course. In some cases, its low efficiency is noted.
Price for Klion in pharmacies
The approximate price for Klion is:
- tablets (20 pcs. in a package) - 61–76 rubles;
- infusion solution (1 bottle 100 ml) - 102 rubles.
Klion: prices in online pharmacies
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Drug name Price Pharmacy |
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Klion 250 mg tablets 20 pcs. RUB 67 Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, 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!
