Tarivid
Tarivid: 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. Drug interactions
- 10. Analogs
- 11. Terms and conditions of storage
- 12. Terms of dispensing from pharmacies
- 13. Reviews
- 14. Price in pharmacies
Latin name: Tarivid
ATX code: J01MA01
Active ingredient: Ofloxacin (Ofloxacin)
Producer: Aventis Pharma Deutschland GmbH / Hoechst (Germany), Turk Hoechst (Turkey), Hoechst Marion Roussel / Aventis Pharma (India)
Description and photo update: 2019-12-08
Tarivid is a drug with antibacterial, bactericidal action.
Release form and composition
Dosage forms of Tarivid release:
- film-coated tablets: biconvex, oblong, white with a yellowish tinge, have a dividing groove, engraved on both sides of the tablet - M and XI, on the left and right sides of the groove (respectively) (10 pcs. in blisters, 1 package in a carton box);
- solution for infusion: greenish-yellow, transparent (100 ml in colorless glass bottles, 1 bottle in a cardboard box).
Composition of 1 tablet:
- active substance: ofloxacin - 200 mg;
- auxiliary components: polyethylene glycol (macrogol) 8000, starch, hypromellose (hydroxypropyl methylcellulose), lactose, titanium dioxide (E171), hydroxypropyl cellulose (hyprolose), carboxymethyl cellulose (carmellose), talc, magnesium stearate.
Composition of 100 ml infusion solution:
- active substance: ofloxacin - 200 mg (ofloxacin hydrochloride - 220 mg);
- auxiliary components: hydrochloric acid 1N (to adjust the pH level), sodium chloride, water for injection.
Pharmacological properties
Pharmacodynamics
Tarivid is a broad-spectrum antimicrobial agent belonging to the group of fluoroquinolones. It has a bactericidal effect associated with the blockade of the enzyme DNA gyrase in bacterial cells.
Ofloxacin, the active component of Tarivid, is characterized by high activity against most gram-negative and some gram-positive organisms: Staphylococcus coagulase negative, Staphylococcus aureus methi-S, Aeromonas hydrophila, Chlamydia trachomatis, Branhamella catarrhalis, Neisseria sludge. Clostridium perfringens, Escherichia coli, Vibrio spp., Salmonella spp., Mycoplasma spp., Enterobacter spp., Helicobacter pylori, Serratia spp., Klebsiella spp., Including Klebsiella pneumoniae, Citrobacter spp., Yraxinella morganii. (indole + and indole -), Proteus spp. including Proteus mirabilis, Providencia spp., Shigella spp., Haemophilus ducreyi, Haemophilus influenzae and parainfluenzae, Legionella, Plesiomonas.
Streptococcus spp. Have moderate sensitivity to ofloxacin. (especially β-hemolytic type), Acinetobacter spp., Pseudomonas spp., Ureaplasma urealyticum, Streptococcus pneumoniae, Bacteroides fragilis, Enterococcus faecalis, Mycobacterium tuberculosis, Anaerobic Gram positive cocci, Chlamciydia psitta.
The drug does not act on the following microorganisms: Treponema pallidum, Acinetobacter baumannii, Nocardia spp., Clostridium difficile, Staphylococci methi-R, Listeria monocytogenes, Enterococcus.
Pharmacokinetics
After oral administration ofloxacin at a high rate and is almost completely absorbed from the gastrointestinal tract. Its bioavailability reaches 100%. The maximum concentration of this substance in the blood plasma after a single dose of 200 mg is 2.5-3 μg / ml and is reached after about 1 hour. Ofloxacin binds to plasma proteins by 25% and is metabolized by approximately 5%. The half-life is 6-7 hours. The volume of distribution is approximately 120 liters. Up to 90% of ofloxacin is excreted unchanged through the kidneys, approximately 4% is excreted in the bile.
Indications for use
According to the instructions, Tarivid is prescribed for the treatment of infectious and inflammatory diseases that are caused by microorganisms that are sensitive to the action of the active substance of the drug (ofloxacin), including infections of the following organs / systems:
- respiratory tract (except pneumococcal infection);
- ear, throat, nose (except for acute tonsillitis);
- abdominal cavity and biliary tract;
- kidneys, urinary tract, prostate gland, urethra (including infections of gonococcal etiology);
- organs of the small pelvis;
- bones and joints;
- leather and soft tissues.
Also Tarivid is used in patients with impaired immune status, including patients with neutropenia, for prophylactic purposes.
Contraindications
Absolute:
- tendon lesions against the background of previous treatment with quinolones;
- epilepsy;
- lesions of the central nervous system with a low seizure threshold - after a stroke, traumatic brain injury, inflammatory processes in the central nervous system (for tablets);
- age up to 18 years;
- pregnancy and the period of breastfeeding;
- hypersensitivity to the components of the drug, as well as other quinolones.
Relative (caution is required in the presence of the following diseases / conditions):
- organic lesions of the central nervous system, proceeding with prolongation of the QT interval (for tablets);
- atherosclerosis of cerebral vessels (for tablets);
- chronic renal failure (for tablets);
- burdened history of circulatory disorders (for tablets);
- lesions of the central nervous system with a low seizure threshold - after a stroke, traumatic brain injury, inflammatory processes in the central nervous system (for infusion solution).
Instructions for the use of Tarivid: method and dosage
The dosage regimen and duration of the course are determined by the general condition, severity and type of infection, as well as the functional state of the kidneys.
Pills
Tarivid is taken orally, whole, with water. Reception is possible before and during meals. Combined use with antacids should be avoided.
The average adult daily dose can vary within 200-600 mg, the duration of the course is 7-10 days.
The recommended frequency of administration (depending on the daily dose):
- up to 400 mg: in 1 dose (preferably in the morning);
- from 400 mg: in 2 doses, observing equal intervals between them.
Special applications:
- uncomplicated infections of the lower urinary tract: 200 mg per day for a course of 3-5 days;
- severe infections or therapy for overweight patients: an increase in the daily dose to 800 mg is possible;
- gonorrhea: 400 mg once.
Correction of the dosage regimen for patients with functional impairment of the kidneys (depending on creatinine clearance: single dose / break between taking them):
- 50–20 ml / min: 100–200 mg / 24 hours;
- up to 20 ml / min or hemodialysis: 100 mg / 24 hours;
- up to 20 ml / min or peritoneal dialysis: 200 mg / 48 hours.
The maximum permissible daily dose for liver failure is 400 mg.
After using the infusion solution of Tarivid, if the patient's condition improves, therapy can be continued with oral administration of the drug.
Infusion solution
Tarivid solution is administered intravenously (slowly drip).
Infusion time: for every 200 mg - at least 30 minutes. This is especially important to take into account when combined with drugs with antihypertensive action and drugs for anesthesia from the group of barbiturates.
Standard dosage regimen: 2 times a day (with an interval of 12 hours), 200 mg. Daily doses up to 400 mg per day can be used once a day (preferably in the morning), above - divided into 2 administrations, observing equal intervals between them.
When treating severe infections or overweight in a patient, it is possible to increase the daily dose to 600 mg.
In the presence of functional disorders of the kidneys, the drug is prescribed in the same way as for the tablet form.
If it is impossible to determine the creatinine clearance in men, its value is calculated using one of two Cockcroft formulas according to the serum creatinine level (in ml / min):
- weight (kg) × (140 - age) / 72 × creatinine (mg%);
- weight (kg) × (140 - age) / 0.814 × creatinine (mmol / l).
To find out the creatinine clearance in women, the indicator in men is multiplied by 0.85.
The maximum permissible daily dose for liver failure is 400 mg.
Monitoring the serum concentration of ofloxacin is recommended for severe renal failure and in patients on hemodialysis.
After improvement of the patient's condition, therapy can be continued by taking Tarivid orally.
The duration of the course is determined by the severity of the condition. After normalization of body temperature or if there is evidence of eradication of the bacterial agent, the use of the drug should be continued for at least 2-3 days.
Side effects
Possible side effects identified on the basis of clinical data and wide post-marketing experience with Tarivid (very often - 10%; often - 1-10%; infrequently - 0.1-1%; rarely - 0.01-0.1%; very rarely - up to 0.01%, taking into account individual cases):
- central nervous system: infrequently - headache, agitation, dizziness, insomnia / sleep disturbances; rarely - confusion, psychotic reactions (for example, hallucinations), anxiety, nightmares, depression, drowsiness, impaired peripheral sensitivity (including paresthesia, impairment of smell, taste, vision); very rarely - hearing impairment (including epileptic seizures, tinnitus or hearing loss), extrapyramidal disorders or other disorders of muscle coordination, tremor, hypesthesia, convulsions; in some cases, psychotic reactions occurring with behavior dangerous for the patient (including increased intracranial pressure, suicidal tendencies);
- cardiovascular system: rarely - tachycardia, hypotension; with intravenous administration - tachycardia and a decrease in blood pressure (in rare cases it is pronounced; with a noticeable decrease in blood pressure, the administration is stopped);
- allergic reactions: infrequently - dry cough, itching, burning in the eyes, rash, rhinitis; rarely - angioedema, pustular rash, urticaria, bronchospasm / dyspnea, sweating, hyperemia; very rarely - persistent drug rash, anaphylactic / anaphylactoid shock, toxic epidermal necrolysis, erythema multiforme, photosensitization, vascular purpura, vasculitis, which in exceptional cases can lead to skin necrosis; in some cases - severe suffocation, Stevens-Johnson syndrome;
- musculoskeletal system: rarely - tendonitis; very rarely - myalgia, arthralgia, rupture of the Achilles tendon (usually within 2 days from the start of treatment; may be bilateral); in some cases - acute skeletal muscle necrosis / myopathy, muscle weakness (especially important in the presence of severe pseudoparalytic myasthenia gravis);
- digestive system: infrequently - vomiting, abdominal pain, nausea, diarrhea, loss of appetite; rarely - flatulence, anorexia, enterocolitis; very rarely - pseudomembranous colitis;
- peripheral blood: very rarely - leukopenia, anemia, thrombocytopenia, hemolytic anemia, eosinophilia, agranulocytosis; in some cases - inhibition of bone marrow hematopoiesis, pancytopenia;
- kidneys: rarely - an increase in the concentration of urea and serum creatinine; very rarely - acute renal failure; in some cases - interstitial nephritis;
- liver: rarely - an increase in bilirubin and / or liver enzymes (aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, gamma glutamyl transferase / alkaline phosphatase); very rarely - cholestatic jaundice; in some cases - hepatitis (can occur in severe forms);
- others: often - redness / pain at the injection site of the infusion solution and phlebitis; infrequently - the development of a secondary infection caused by microorganisms and fungi showing resistance to the action of the drug; in some cases - acute attacks of porphyria in patients with porphyria, allergic pulmonitis, hypoglycemia (in diabetes mellitus during therapy with hypoglycemic drugs).
Overdose
An overdose can be suspected by such symptoms from the central nervous system as drowsiness, lethargy, blurred consciousness, disorientation in space, dizziness. Reactions from the gastrointestinal tract are possible, most often manifested by nausea and vomiting.
When taking too high doses of the drug, it is recommended to rinse the stomach (in the case of tablets) and conduct symptomatic therapy. The specific antidote for ofloxacin is unknown.
special instructions
Due to the high risk of developing photosensitization, it is recommended to avoid exposure to ultraviolet rays / bright sunlight.
During therapy, especially during a long course, it is possible to develop a secondary infection associated with the growth of microorganisms showing resistance to the drug. It is necessary to re-evaluate the patient's condition. If a secondary infection develops during a therapeutic course, appropriate measures should be taken.
When prescribing Tarivid, it is necessary to take into account the following risk factors for prolongation of the QT interval:
- diseases of the cardiovascular system, including heart failure, myocardial infarction, bradycardia;
- congenital lengthening of the QT interval;
- uncorrectable electrolyte imbalances (eg, hypomagnesemia, hypokalemia);
- combined use with drugs that prolong the QT interval, including macrolides, tricyclic antidepressants, class IA and III antiarrhythmic drugs;
- elderly age.
The appearance of signs of tendinitis, especially in elderly patients, is the reason for the cancellation of therapy (immobilization of the Achilles tendon and consultation with an orthopedist are required).
If during the period of drug use or after the end of the course diarrhea develops (especially persistent or severe and / or mixed with blood), this may be a sign of the development of pseudomembranous colitis. If there is a suspicion of this disorder, Tarivid is immediately canceled and specific antibiotic therapy is prescribed (for example, oral vancomycin, oral teicoplanin, or metronidazole), the use of drugs that suppress intestinal motility is prohibited.
During therapy, the likelihood of the following conditions / disorders should be considered:
- increased frequency of attacks of porphyria;
- worsening of myasthenia gravis;
- the appearance of false-positive results in the determination of porphyrins and opiates in the urine, as well as during the bacteriological diagnosis of tuberculosis.
Tarivid is not the drug of choice in the treatment of pneumococcal pneumonia. For the treatment of acute tonsillitis, the drug is not prescribed.
During the period of application of Tarivid it is not recommended:
- the use of hygienic tampons by women (associated with an increased likelihood of thrush);
- the use of ethanol.
Since some adverse reactions, including visual disturbances, drowsiness and dizziness, can affect the ability to concentrate and reaction, the risk increases in situations where the presence of these abilities is especially important (for example, while driving vehicles or other mechanisms).
Drug interactions
With the simultaneous use of certain drugs / substances, the following effects may develop:
- aluminum phosphate, iron, zinc, antacids containing aluminum hydroxide (including sucralfate) and magnesium: a decrease in the absorption of ofloxacin (the interval between single doses should be at least 2 hours);
- other drugs excreted by renal tubular secretion, including cimetidine, probenicid, methotrexate, furosemide: an increase in the serum concentration of ofloxacin;
- glibenclamide: a slight increase in its serum concentration;
- nonsteroidal anti-inflammatory drugs, derivatives of methylxanthines and nitroimidazole: an increase in the likelihood of neurotoxic effects;
- theophylline, fenbufen or other non-steroidal anti-inflammatory drugs, as well as other drugs that can lower the seizure threshold: a noticeable decrease in the seizure threshold;
- vitamin K antagonists: development of interaction (control of the blood coagulation system is required);
- drugs that prolong the QT interval (macrolides, tricyclic antidepressants, class IA and III antiarrhythmics): an increase in the likelihood of prolongation of the QT interval;
- glucocorticosteroids: an increase in the likelihood of tendon rupture, especially in elderly patients;
- drugs that alkalize urine, including citrates, carbonic anhydrase inhibitors, sodium bicarbonate: an increase in the likelihood of nephrotoxic effects and crystalluria.
Analogs
Tarivid analogs are: Oflox, Ashof, Zoflox, Glaufos, Geoflox.
Terms and conditions of storage
Store in a dark place at temperatures up to 25 ° C (infusion solution) or 30 ° C (tablets). Keep out of the reach of children. Do not allow the infusion solution to freeze.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Tarivid
Reviews about Tarivid differ significantly, since the drug is produced by several manufacturing companies. Patients confirm the effectiveness of this antibacterial drug when undergoing a standard course of therapy for 7 days, however, they note a high frequency of side effects such as headache. It is also desirable that the Tarivid treatment regimen be selected by an experienced doctor to avoid overdose.
Price for Tarivid in pharmacies
The price for Tarivid in pharmacies is about 350-390 rubles for 10 tablets. The cost of the solution for infusion is on average 180 rubles per 100 ml bottle.
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!
