Cefanorm
Cefanorm: 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: Cefanorm
ATX code: J01DE02
Active ingredient: cefpirome
Manufacturer: Simpex Pharma Pvt. Ltd. (India)
Description and photo update: 2020-01-04
Cefanorm is an antibiotic that belongs to the cephalosporin group.
Release form and composition
The drug is produced in the form of a powder for the preparation of a solution for intravenous (i / v) and intramuscular (i / m) administration: from white to white with a cream or yellow tint (500 mg of cefpirome in a colorless glass bottle, 10 or 20 ml volume, or 1000 mg - in a bottle of 20 or 30 ml; in a cardboard box 1, 5 or 10 bottles and instructions for the use of Cefanorm).
Composition for 1 bottle of powder at a dose of 500 mg: a sterile mixture containing cefpirome sulfate - 595 mg (equivalent to cefpirome in an amount of 500 mg) and sodium carbonate - 104 mg.
Composition for 1 bottle of powder at a dose of 1000 mg: a sterile mixture containing cefpirome sulfate - 1190 mg (equivalent to cefpirome in an amount of 1000 mg) and sodium carbonate - 208 mg.
Pharmacological properties
Pharmacodynamics
Cefpirome is a IV generation cephalosporin antibiotic. Demonstrates bactericidal effect by inhibiting the synthesis of the cell wall of the microbe. Has a wide spectrum of action against gram-negative (including Pseudomonas aeruginosa) and gram-positive bacteria, including strains resistant to the effects of aminoglycosides and / or cephalosporins of the third generation. The active substance is highly resistant to the influence of most β-lactamases; penicillin-binding proteins are molecular targets inside the bacterial cell.
Cefanorm is active in relation to the following microorganisms: Citrobacter freundii, Citrobacter diversus, Clostridium perfringens, Acinetobacter spp., Enterococcus faecium, Enterobacter spp., Escherichia coli, Enterococcus faecalis, Haemophilus influenzae, Hafhiaella alvehaltsella, Kelly, Kelly oxytoca, Peptostreptococcus spp., Neisseria spp., Providencia spp., Proteus mirabilis, Proteus vulgaris, Pseudomonas aeruginosa, Shigella spp., Staphylococcus spp., Serratia spp., Salmonella spp., Streptococcus spp.
Pharmacokinetics
I use Cefpirome parenterally. The active substance penetrates well into such organs and body fluids as kidneys, prostate gland, female genital organs, cerebrospinal fluid, wound exudate, bronchial mucosa, sputum, bronchial secretions, gallbladder tissue, peritoneal fluid. It passes through the placenta and is excreted in a small amount in breast milk. After administration for 12 hours, it is detected in therapeutic concentrations in blood plasma and in a large number of tissues and fluids.
With intravenous and intramuscular administration, the kinetics of the concentration of the active substance in the blood is linear and depends on the dose received. After repeated intravenous or intramuscular injection with an interval of 12 hours for 3-5 days, the accumulation of the drug and changes in its main pharmacokinetic parameters are not recorded.
The connection of cefpirome with plasma proteins is insignificant - 10%. The dose of the drug has no effect on the total clearance and half-life (T ½). The volume of distribution (Vр) is 12–21 l, T ½ in persons with normal renal activity - 1.8–2.2 hours. The agent does not undergo metabolic transformation in the body, 80–90% of the administered dose is excreted by the kidneys through glomerular filtration, the rest - with bile.
Indications for use
Cefanorm is recommended for the treatment of the following infectious and inflammatory diseases caused by microorganisms sensitive to cefpirome:
- respiratory tract infections (including pneumonia, pleural empyema, lung abscess);
- complicated infections of the urinary system (urethritis, cystitis, pyelonephritis, pyelitis);
- sepsis / bacteremia;
- wound infections, skin and soft tissue infections;
- infections with neutropenia.
Contraindications
Absolute:
- age up to 12 years;
- pregnancy;
- hypersensitivity to the drug or other β-lactam antibiotics.
Relative (use Cefanorm under medical supervision):
- severe renal failure;
- diseases of the gastrointestinal tract, including indications in the history of antibiotic-associated colitis, regional enteritis, ulcerative colitis.
Cefanorm, instructions for use: method and dosage
The solution prepared from Tsefanorm powder is injected intramuscularly or intravenously in a stream or drip for 30 minutes.
Cefanorm at a dose of 500 or 1000 mg (contents of 1 bottle), depending on the route of administration, is recommended to be dissolved in one of the following drugs:
- i / m introduction: water for injection - in a dose of 5 ml;
- IV jet injection: sodium chloride solution (NaCl) 0.9%, fructose solution 5%, dextrose solution 5%, Ringer's solution - at a dose of 10 ml;
- intravenous drip injection: NaCl solution 0.9%, dextrose solutions 5%, fructose solution 5%, Ringer's solution - in a dose of 100 ml.
Recommended daily doses of Cefanorm:
- infections of soft tissues or skin, infections of the urinary system: 2000 mg each, in severe cases - up to 4000 mg;
- respiratory infections: 2000-4000 mg;
- infections in patients with neutropenia, sepsis: 4000 mg.
The daily dose should be divided into 2 administrations with an interval of 12 hours.
The course of therapy with Cefanorm is established individually by the doctor, taking into account the sensitivity of the microflora, as well as the characteristics and severity of the course of the infectious disease. Typically, the duration of treatment varies from 5 to 10 days.
Side effects
- hematopoietic organs: leukopenia, neutropenia, hemolytic anemia, thrombocytopenia, granulocytopenia;
- urinary system: oliguria, functional disorders of the kidneys, interstitial nephritis;
- cardiovascular system: after a quick bolus injection into the central vein - potentially life-threatening arrhythmias;
- digestive system: flatulence, nausea, vomiting, dysbiosis, abdominal pain, liver dysfunction, diarrhea / constipation; rarely - candidal glossitis and / or stomatitis, pseudomembranous enterocolitis;
- nervous system: dizziness, headache, encephalopathy;
- allergic reactions: chills / fever, pruritus, rash, urticaria; rarely - eosinophilia, bronchospasm, toxic epidermal necrolysis (Lyell's syndrome), angioedema, malignant exudative erythema (Stevens-Johnson syndrome); extremely rare - anaphylactic shock;
- laboratory parameters: increased blood urea, increased activity of alkaline phosphatase (ALP) and hepatic transaminases, azotemia, hyperbilirubinemia, hypercreatininemia, hypocoagulation, positive Coombs' reaction;
- local reactions: soreness along the vein, phlebitis, pain and infiltration at the IM injection site;
- others: superinfection (eg, candidal vaginitis).
Overdose
Symptoms of an overdose of Cefanorm include: increased neuromuscular irritability, tremor; convulsions, encephalopathy - when using large doses, especially in patients with renal insufficiency.
In this condition, symptomatic therapy, hemodialysis is prescribed.
special instructions
In view of the possible development of an anaphylactic reaction, the first administration of Cefanorm should be carried out in the presence of a doctor. In the event of anaphylactic reactions, urgent therapy is necessary - the introduction of epinephrine, dopamine, correction of electrolyte balance, the use of antihistamines and glucocorticosteroids, oxygen therapy.
During the period of therapy with cefpirome, it is necessary to take into account the risk of developing pseudomembranous colitis, in the event of which the administration of Cefanorm should be stopped immediately and appropriate treatment should be carried out (including oral administration of vancomycin or metronidazole).
Against the background of long-term therapy, regular monitoring of peripheral blood is necessary (every 10 days - control of the number of leukocytes) and indicators characterizing the functions of the liver and kidneys.
In the case of treatment of mixed aerobic-anaerobic infection, prior to the determination of pathogenic bacteria-pathogens, it is advisable to use concomitant drugs that are active against anaerobes.
Application during pregnancy and lactation
According to data from preclinical studies in animals, no negative effect of the drug on the developing fetus has been established. However, the use of Cefanorm in pregnant women is contraindicated.
If necessary, drug therapy during lactation is required to stop breastfeeding.
Pediatric use
In children, no significant changes in the kinetics of cefpirome were recorded. Cefanorm is not prescribed for children under 12 years old.
With impaired renal function
Patients with severe renal insufficiency should use Cefanorm with extreme caution, adjusting cefpirome doses taking into account the creatinine clearance (CC) values. In such patients, the first (initial) dose may be 1–2 g, then the drug is prescribed at a dose of 0.5–1 g 1 time / day - with CC 5–20 ml / min and 2 times / day - with CC 20– 50 ml / min. Patients on hemodialysis are injected with Cefanorm in a daily dose of 0.5-1 g, after each hemodialysis session, cefpirome is additionally used in a dose of 0.25-0.5 g.
For violations of liver function
In patients with severe hepatic impairment and concomitant severe renal dysfunction, it is necessary to regularly determine the plasma level of Cefanorm in the blood and make dose changes depending on the CC.
Use in the elderly
In elderly patients, there may be changes in the pharmacokinetics of cefpirome, depending on the degree of renal dysfunction. Individuals with CC below 50 ml / min need a dose adjustment of Cefanorm.
Drug interactions
- diuretics, non-steroidal anti-inflammatory drugs (NSAIDs), polymyxin B, aminoglycosides; drugs that block tubular secretion: the elimination of cephalosporins slows down and their serum concentration in the blood increases, and T ½ is lengthened, the threat of bleeding and nephrotoxic reactions is aggravated;
- bactericidal antibiotics: there is a synergistic phenomenon;
- other antibiotics, heparin, sodium bicarbonate solution, most other antimicrobial drugs: the pharmaceutical incompatibility of cefpirome with these drugs has been established;
- indirect anticoagulants: the effect of these funds is enhanced;
- tetracyclines, macrolides, chloramphenicol and other bacteriostatic antibiotics: antagonism is noted.
Analogs
Analogues of Cefanorm are: Cefaktiv, Isodep, Cefpirome sulfate and sodium carbonate.
Terms and conditions of storage
Keep out of the reach of children. Store at a temperature not exceeding 25 ° C, in a place protected from light and moisture.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Cefanorm
Currently, there are no reviews about Cefanorm, with the help of which it would be possible to assess the effectiveness and disadvantages of this tool, on specialized sites.
Price for Cefanorm in pharmacies
The reliable price for Cefanorm is unknown, due to the fact that at the moment the drug is not sold in pharmacies.
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!
