Cyprinol
Tsiprinol: 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: Ciprinol
ATX code: J01MA02
Active ingredient: ciprofloxacin (ciprofloxacin)
Manufacturer: KRKA, dd (Slovenia)
Description and photo update: 2019-26-08
Prices in pharmacies: from 64 rubles.
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Tsiprinol is a systemic antibacterial drug belonging to the group of fluoroquinolones.
Release form and composition
Dosage forms of Tsiprinol:
- solution for infusion: transparent, yellowish-green (in bottles of 50, 100 and 200 ml, 1 bottle in a cardboard box);
- concentrate for the preparation of a solution for infusion: a transparent, colorless or slightly greenish-yellow solution without mechanical impurities (10 ml in ampoules, 5 ampoules in a blister strip, 1 package in a cardboard box);
- film-coated tablets: 250 mg - round, with beveled edges, convex on both sides, white, with a notch on one side (10 pcs. in a blister, 1 blister in a cardboard box); 500 mg - oval, white, with a notch on one side (10 pcs. In a blister, 1 blister in a cardboard box); 750 mg - oval, almost white or white, with a notch on one side (10 pcs. In a blister, in a cardboard box 1 or 2 blisters).
The active substance of Ciprinol is ciprofloxacin (in the form of lactate), its content is:
- 1 ml of solution - 2 mg;
- 1 ml of concentrate - 10 mg;
- 1 tablet - 250, 500 or 750 mg.
Excipients:
- solution: hydrochloric acid, solution for injection, sodium chloride, sodium lactate;
- concentrate: hydrochloric acid, water for injection, lactic acid, disodium edetate;
- tablets: anhydrous colloidal silicon dioxide, magnesium stearate, croscarmellose sodium, microcrystalline cellulose, sodium carboxymethyl starch, povidone; shell composition - propylene glycol, hypromellose, titanium dioxide (E171), talc.
Pharmacological properties
Pharmacodynamics
Tsiprinol is one of the broad-spectrum antimicrobial agents from the group of fluoroquinolones. Ciprofloxacin is an active substance of the drug, it has a bactericidal effect.
Inhibits the enzyme DNA gyrase of bacteria, thereby disrupting DNA replication (deoxyribonucleic acid) and the biosynthesis of bacterial cellular proteins. Ciprofloxacin has an effect on both multiplying microorganisms and microorganisms that are in the resting phase.
Tsiprinol is active:
- gram-negative bacteria: Moraxella catarrhalis, Pseudomonas aeruginosa, Plesiomonas shigelloides, Neisseria spp., Campylobacter jejuni, Pasteurella multocida, Proteus vulgaris, Citrobacter spp., Escherichia coli, Shigella spp., spp., Sallemonella spp.., Haemophilus spp., Morganella morganii, Yersinia spp., Vibrio spp., Proteus mirabilis, Serratia marcescens, Hafnia alvei, Edwardsiella tarda, Providencia spp.;
- gram-positive bacteria: Staphylococcus spp. (including Staphylococcus hominis, Staphylococcus aureus, Staphylococcus haemolyticus, Staphylococcus saprophyticus), Streptococcus spp. (including Streptococcus agalactiae, Streptococcus pyogenes);
- intracellular microorganisms: Mycobacterium avium-intracellulare, Mycobacterium kansasii, Mycobacterium tuberculosis, Brucella spp., Legionella pneumophila, Chlamydia trachomatis, Listeria monocytogenes.
Most staphylococci that are resistant to methicillin are also resistant to ciprofloxacin.
Moderately sensitive to the action of the drug Enterococcus faecalis, Streptococcus pneumoniae.
Resistant to Tsiprinol: Pseudomonas cepacia, Pseudomonas maltophilia, Ureaplasma urealyticum, Nocardia asteroids, Clostridium difficile, Bacteroides fragilis, Corynebacterium spp.
In relation to Treponema pallidum, the effectiveness of Tsiprinol has not been studied enough.
During therapy with Tsiprinol, the development of parallel resistance to other antibiotics that do not belong to the group of gyrase inhibitors does not occur. This makes it highly effective against bacteria that are resistant to tetracyclines, aminoglycosides, cephalosporins, and penicillins.
Pharmacokinetics
Ciprofloxacin is rapidly absorbed from the gastrointestinal tract after taking the drug. Food intake slows down the absorption of the substance, but does not affect the value of C max (maximum concentration of the substance) and bioavailability. Bioavailability is in the range of 50–85%. C max in blood serum after ingestion (before meals) of Tsiprinol at a dose of 250, 500, 750 and 1000 mg is achieved in 1-1.5 hours and is 1.2; 2.4; 4.3 and 5.4 μg / ml, respectively.
After intravenous (intravenous) infusion of 200 mg or 400 mg of Tsiprinol, TC max (time to reach maximum concentration) is 1 hour, C max - 2.1 μg / ml or 4.6 μg / ml, respectively.
The substance is well distributed in tissues and body fluids. High concentrations of ciprofloxacin are recorded in the endometrium, prostate tissue, lungs, bile, kidneys, gallbladder, liver, seminal fluid, tonsils, uterus, ovaries and fallopian tubes. The concentration of ciprofloxacin in these tissues exceeds the serum concentration. The substance also penetrates well into bones, eye fluids, saliva, bronchial secretions, skin, pleura, muscles, lymph and peritoneum. A small amount of ciprofloxacin penetrates into the cerebrospinal fluid, with non-inflamed meninges, the concentration is 6-10% of that in the blood serum, with inflamed meninges, it is in the range from 14 to 37%. In neutrophils, the concentration of ciprofloxacin exceeds the serum concentration by 2-7 times.
V d (volume of distribution) when taking Tsiprinol inside is 2–3.5 l / kg, with intravenous administration - 1.74–5 l / kg.
When taken orally, ciprofloxacin binds to plasma proteins at a level of 30%, with intravenous administration - 19-40%.
Penetrates the placental barrier.
Biotransformation occurs in the liver (15-30%), resulting in the formation of low-active metabolites (formylcyprofloxacin, sulfocyprofloxacin, diethylcyprofloxacin, oxocyprofloxacin). Excretion is carried out mainly with urine and feces (50–70% and 15–30%, respectively). T 1/2 (half-life) is 3-5 hours. When administered intravenously through the kidneys, 10% is excreted in the form of metabolites.
In patients with chronic renal failure, T 1/2 increases up to 12 hours.
Small amounts of ciprofloxacin are excreted in breast milk.
Indications for use
According to the instructions, Tsiprinol is intended for the treatment of infectious and inflammatory diseases caused by microorganisms sensitive to ciprofloxacin:
- ear, throat, and nose infections;
- respiratory tract infections;
- infections of the musculoskeletal system;
- infections of the digestive system (including teeth, mouth, jaws);
- infections of the gallbladder and biliary tract;
- kidney and urinary tract infections;
- infections of mucous membranes, soft tissues, skin;
- genital infections (adnexitis, gonorrhea, postpartum infections, prostatitis).
Also, Tsiprinol is used in the following cases:
- peritonitis;
- sepsis;
- infections in patients with reduced immunity due to immunosuppressive therapy (prevention and treatment).
Contraindications
Absolute contraindications to Tsiprinol:
- age up to 18 years;
- During pregnancy and breastfeeding;
- hypersensitivity to any component of Tsiprinol or other drugs from the fluoroquinolone group.
Additionally for intravenous administration:
- deficiency of glucose-6-phosphate dehydrogenase;
- pseudomembranous colitis.
Relative contraindications to Tsiprinol:
- cerebral atherosclerosis;
- disorders of cerebral circulation;
- convulsive syndrome;
- epilepsy;
- mental illness;
- severe hepatic / renal failure;
- elderly age.
Instructions for the use of Tsiprinol: method and dosage
The doctor determines the therapeutic doses, the method of administration and the duration of treatment individually, depending on the type of infection, its localization and severity of the course, as well as the general condition of the patient, his body weight and kidney function.
Film-coated tablets
Tsiprinol should be taken orally on an empty stomach with a sufficient amount of liquid.
Recommended doses:
- diseases of the urinary tract and kidneys: uncomplicated - 250 mg 2 times a day, complicated - Tsiprinol 500 mg or 750 mg 2 times a day;
- diarrhea: 250 mg 2 times a day;
- severe colitis, enteritis, osteomyelitis, prostatitis, gynecological infections: 500-750 mg 2 times a day;
- diseases of the lower respiratory tract: 250 mg 2 times a day, in severe cases - 500-750 mg 2 times a day;
- gonorrhea: 250-500 mg once;
- prevention of surgical infections: 500-750 mg every other day.
The duration of the course of therapy depends on the severity of the course of the disease.
In chronic renal failure, the dose of Tsiprinol depends on creatinine clearance (CC):
- CC> 50 ml / minute - usual dosing regimen;
- CC 30-50 ml / minute - 250-500 mg every 12 hours;
- CC 5-29 ml / minute: 250-500 mg every 18 hours.
For patients on hemodialysis or peritoneal dialysis, the drug is prescribed after dialysis every 24 hours at 250–500 mg.
In case of impaired renal function, a single dose of Tsiprinol in the form of tablets is halved.
Solution for infusion and concentrate for preparation of solution for infusion
A solution of Tsiprinol (including those prepared from a concentrate) is administered intravenously, preferably by drip over 30 or 60 minutes (the time is indicated for the drug at a dose of 200 and 400 mg, respectively). Jet injection is also possible.
The average therapeutic dose is 200 mg 2 times a day. In severe infectious process, a single dose is increased to 400 mg. The duration of treatment is usually 1-2 weeks, if necessary, the course is extended.
In acute gonorrhea, Tsiprinol is administered at a dose of 100 mg once.
For the prevention of postoperative infections, Tsiprinol is prescribed at a dose of 200-400 mg 30-60 minutes before surgery.
Side effects
- on the part of the cardiovascular system: arterial hypotension, cardiac arrhythmias, tachycardia, hot flashes (with intravenous administration);
- from the central and peripheral nervous system: cerebral artery thrombosis, migraine, fainting, confusion, anxiety, increased fatigue, insomnia, tremors, headache, increased intracranial pressure, nightmares, dizziness, depression, peripheral paralgesia, hallucinations and other manifestations psychotic reactions, rarely progressing to conditions in which the patient can harm himself;
- from the urinary system: increased levels of urea, creatinine, dysuria, glomerulonephritis, polyuria, interstitial nephritis, decreased nitrogen excretion function of the kidneys, hematuria, albuminuria, crystalluria, urinary retention;
- from the hematopoietic system: anemia, hemolytic anemia, thrombocytosis, granulocytopenia (with intravenous administration), neutropenia, leukopenia, eosinophilia, thrombocytopenia;
- from the musculoskeletal system: rarely - myalgia (with intravenous administration), arthralgia, tendovaginitis, arthritis, tendon rupture;
- from the digestive system: pseudomembranous colitis, vomiting, loss of appetite, flatulence, diarrhea, nausea, hepatonecrosis, hepatitis, cholestatic jaundice (especially in patients with previous liver diseases), increased bilirubin, alkaline phosphatase, hepatic transaminase activity, lactate dehydrogenase;
- on the part of the senses: hearing loss, tinnitus, visual disturbances (changes in color perception, diplopia), disturbances in taste and smell;
- allergic reactions: exudative erythema multiforme, erythema nodosum, vasculitis, Lyell's syndrome (when administered intravenously), urticaria, pruritus, Quincke's edema, arthralgia, Stevens-Johnson syndrome;
- local reactions: with intravenous administration - pain, burning, phlebitis;
- others: increased sweating, photosensitivity, general weakness, hyperglycemia (with intravenous administration).
Overdose
The main symptoms are: nausea, diarrhea, vomiting, dizziness, headache, kidney and liver disorders, hematuria and crystalluria; in more severe cases, hallucinations, tremors, confusion, convulsions.
Therapy: gastric lavage, monitoring of the patient's condition, if necessary, symptomatic treatment is prescribed. It is required to ensure a sufficient intake of fluid in the body.
With the help of peritoneal dialysis or hemodialysis, only a small amount of ciprofloxacin (up to 10%) can be excreted. The specific antidote is unknown.
special instructions
The recommended daily dose should not be exceeded in order to avoid the development of crystalluria, and it is also necessary to ensure a sufficient intake of fluid in the body to maintain an acidic urine reaction and normal urine output.
In case of pain in the tendons or the first signs of tendovaginitis, Tsiprinol should be discontinued, since there is a risk of inflammation and even rupture of the tendons.
In the event of severe and prolonged diarrhea, it is necessary to conduct an examination to exclude pseudomembranous colitis, which requires the immediate cancellation of Tsiprinol and appropriate treatment.
Due to the risk of developing photosensitivity during treatment, exposure to direct sunlight should be avoided.
Influence on the ability to drive vehicles and complex mechanisms
During therapy with Tsiprinol, it is recommended to refrain from driving and performing tasks that require speed of reactions and increased attention.
Application during pregnancy and lactation
Tsiprinol is not prescribed during pregnancy / lactation.
Pediatric use
The appointment of Tsiprinol to patients under 18 years of age is contraindicated.
The exception is the treatment of complications caused by Pseudomonas aeruginosa in children with cystic fibrosis of the lungs aged 5 to 17 years, and the treatment and prevention of anthrax (subject to suspected or proven infection with Bacillus anthracis).
With impaired renal function
With severe renal failure, Tsiprinol should be used under medical supervision.
For violations of liver function
With severe hepatic impairment, Tsiprinol should be used under medical supervision.
Use in the elderly
Ciprinol therapy in elderly patients should be carried out with caution.
Drug interactions
- didanosine: absorption of ciprofloxacin decreases;
- oral hypoglycemic agents, indirect anticoagulants: prothrombin index decreases;
- non-steroidal anti-inflammatory drugs, including acetylsalicylic acid: the risk of seizures increases;
- cyclosporine: its nephrotoxic effect is enhanced;
- metoclopramide: the absorption of ciprofloxacin is accelerated, as a result of which the time to reach its maximum concentration in blood plasma is reduced;
- uricosuric drugs: excretion slows down (up to 50%) and the plasma concentration of ciprofloxacin increases;
- antacids and preparations containing ions of zinc, aluminum, magnesium and iron: absorption of ciprofloxacin decreases (the interval between doses should be at least 4 hours);
- theophylline and other xanthines: their concentration increases and the half-life increases;
- other antimicrobial drugs (aminoglycosides, metronidazole, clindamycin, beta-lactam antibiotics): synergistic action is noted.
Tsiprinol can be used in combination with other drugs:
- for infections caused by Pseudomonas spp. - with ceftazidime and azlocillin;
- with streptococcal infections - with beta-lactam antibiotics, including azlocillin and mezlocillin;
- with anaerobic infections - with metronidazole and clindamycin;
- with staphylococcal infections - with isoxazolpenicillins and vancomycin.
Analogs
Analogs of Tsiprinol are: Tsiprolet, Tsiprobay, Tsifran, Ciprofloxacin, Tsiplox, Tseprova, Tatsip, Tsiprobid, Quintor.
Terms and conditions of storage
Keep out of the reach of children, protected from light and moisture, at temperatures up to 25 ° C.
The shelf life is 5 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Tsiprinol
Reviews of Tsiprinol are mostly positive. Its high efficiency is noted in the treatment of a wide range of diseases. The main disadvantage is the development of adverse reactions.
The price of Tsiprinol in pharmacies
The approximate price for Tsiprinol 500 mg is 97–126 rubles. for 10 tablets, 250 mg –57–80 rubles. for 10 tablets.
Tsiprinol: prices in online pharmacies
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Drug name Price Pharmacy |
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Tsiprinol 250 mg film-coated tablets 10 pcs. RUB 64 Buy |
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Tsiprinol 500 mg film-coated tablets 10 pcs. RUB 101 Buy |
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Tsiprinol tablets p.p. 500mg 10 pcs. 129 RUB 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!
