Tsifran ST - Instructions For Use, Price, Reviews, Analogs Of Tablets

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Tsifran ST

Tsifran ST: instructions for use and reviews

1. 1. Release form and composition
2. 2. Pharmacological properties
3. 3. Indications for use
4. 4. Contraindications
5. 5. Method of application and dosage
6. 6. Side effects
7. 7. Overdose
8. 8. Special instructions
9. 9. Application during pregnancy and lactation
10. 10. Use in childhood
11. 11. In case of impaired renal function
12. 12. For violations of liver function
13. 13. Use in the elderly
14. 14. Drug interactions
15. 15. Analogs
16. 16. Terms and conditions of storage
17. 17. Terms of dispensing from pharmacies
18. 18. Reviews
19. 19. Price in pharmacies

Latin name: Cifran CT

ATX code: J01RA11

Active ingredient: tinidazole (tinidazole) + ciprofloxacin (ciprofloxacin)

Manufacturer: Ranbaxy (India)

Description and photo updated: 22.11.2018

Prices in pharmacies: from 294 rubles.

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Tsifran ST is a combined preparation with a broad spectrum bactericidal, antibacterial action.

Release form and composition

Dosage form of Tsifran ST - coated tablets: tablets 250 mg + 300 mg - yellow, oval; forte tablets 500 mg + 600 mg - yellow, oval, on one side with a dividing line (in a cardboard box 1, 2 or 10 blisters of 10 pcs.).

Active ingredients in 1 tablet:

• ciprofloxacin - 250 or 500 mg (as hydrochloride monohydrate);
• tinidazole BP - 300 or 600 mg.

Auxiliary components:

• core: sodium lauryl sulfate, sodium starch glycolate, microcrystalline cellulose, anhydrous colloidal silicon, magnesium stearate;
• components of the outer layer of the granules: sodium starch glycolate, purified talc, sodium lauryl sulfate, microcrystalline cellulose, anhydrous colloidal silicon, magnesium stearate;
• shell: yellow Opadry, purified water.

Pharmacological properties

Pharmacodynamics

Cifran ST is one of the combined drugs, the active substances of which - tinidazole and ciprofloxacin - are used in the treatment of infections caused by aerobic and anaerobic microorganisms.

The main properties of the active ingredients:

• tinidazole: has antiprotozoal and antimicrobial effects. The mechanism of its action is based on inhibition of synthesis and disruption of the structure of DNA-sensitive microorganisms. Tinidazole is effective against protozoa (Entamoeba histolytica, Trichomonas vaginalis, Lamblia spp.) And anaerobic microorganisms (Eubacterium spp., Bacteroides fragilis, Clostridium difficile, Peptococcus, Fusobacterium Clostridium spp., Peptococcus, Fusobacterium Clorellium spp., Bacteroides
• ciprofloxacin: is a broad-spectrum antibiotic from the fluoroquinolone group. Inhibits the enzyme DNA gyrase of bacteria, thereby disrupting DNA replication and the synthesis of bacterial cellular proteins. Shows activity against most aerobic Gram-positive / Gram-negative microorganisms, including Klebsiella spp., E. coli, S. typhi and other strains of Salmonella, Pseudomonas aeruginosa, Proteus mirabilis, Yersinia enterocolitica, Proteus vulgaris, Shigella duophilus, Haemella soni Vibrio cholerae, Neisseria gonorrhoeae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus (including methicillin-resistant strains), Legionella pneumophila, Chlamydia trachomatis, Streptococcus pyogenes pneumonia, Staphylococcus pneumoniae, Staphylococcus pneumoniae, epidermia pneumoniaMycoplasma hominis, Mycobacterium tuberculosis.

Pharmacokinetics

The active ingredients are well absorbed in the gastrointestinal tract. The maximum concentrations (C _max) of each of the components are reached within 1–2 hours.

Tinidazole

Bioavailability is 100%, binding to blood plasma proteins is about 12%. The half-life is in the range of 12 to 14 hours.

It quickly penetrates the tissues of the body and reaches high concentrations there. Penetrates into the cerebrospinal fluid at a concentration equal to its plasma concentration, is reabsorbed in the renal tubules.

It is excreted into bile at concentrations slightly below 50% of its serum concentration in the blood. Approximately 25% of the dose taken is excreted by the kidneys unchanged. Tinidazole metabolites make up 12% of the administered dose, they are also excreted by the kidneys. In addition, a small amount of tinidazole is excreted through the gastrointestinal tract.

Ciprofloxacin

After oral administration, it is well absorbed. Bioavailability is approximately 70%. With simultaneous use with food, the absorption of the substance slows down. Plasma proteins bind from 20 to 40% of ciprofloxacin.

It penetrates well into fluids and tissues of the body - skin, lungs, adipose, cartilaginous, bone and muscle tissues, as well as into the organs of the genitourinary system, including the prostate gland. High concentrations of ciprofloxacin are found in saliva, bronchi, nasal mucus, lymph, peritoneal fluid, semen and bile.

Ciprofloxacin is metabolized in part by the liver. Approximately 50% of the dose is excreted by the kidneys unchanged, 15% - in the form of active metabolites, in particular, oxocyprofloxacin. The rest of the dose received is excreted in the bile, partially reabsorbed. From 15 to 30% of ciprofloxacin is excreted through the gastrointestinal tract. The half-life is approximately 3.5-4.5 hours.

In elderly patients and with severe renal failure, the half-life may be lengthened.

Indications for use

According to the instructions, Cifran ST is prescribed for the treatment of the following mixed bacterial infections caused by sensitive gram-positive / gram-negative microorganisms, in association with anaerobic and aerobic microorganisms and / or protozoa:

• ENT infections: sinusitis, otitis media, tonsillitis, pharyngitis, mastoiditis, frontal sinusitis, sinusitis;
• skin / soft tissue infections: infected ulcers, ulcerative skin lesions in diabetic foot syndrome, wounds, bedsores, abscesses, burns, phlegmon;
• oral infections: periostitis, periodontitis, acute ulcerative gingivitis;
• infections of the pelvic organs and genitals, including in combination with trichomoniasis: salpingitis, tubular abscess, pelvioperitonitis, oophoritis, endometritis, prostatitis;
• infections of bones and joints: osteomyelitis, septic arthritis;
• infections of the gastrointestinal tract: shigellosis, typhoid fever, amebiasis;
• urinary tract and kidney infections: cystitis, pyelonephritis;
• complicated intra-abdominal infections;
• lower respiratory tract diseases: acute and chronic (during exacerbation) bronchitis, bronchiectasis, pneumonia;
• period after surgery (prevention of infections).

Contraindications

Absolute:

• blood diseases, inhibition of bone marrow hematopoiesis;
• organic lesions of the nervous system;
• acute porphyria;
• lactose intolerance, lactase deficiency, glucose-galactose malabsorption;
• combined therapy with tizanidine (associated with the likelihood of a pronounced decrease in blood pressure and the development of severe drowsiness);
• age up to 18 years;
• pregnancy and the period of breastfeeding;
• individual intolerance to the components of the drug, as well as other fluoroquinolones and imidazoles.

Relative (Tsifran ST is prescribed under medical supervision):

• disorders of cerebral circulation;
• tendon lesions during previous therapy with fluoroquinolones;
• pronounced atherosclerosis of the vessels of the brain;
• heart disease (myocardial infarction, heart failure, bradycardia);
• congenital lengthening of the QT interval;
• electrolyte imbalance, including hypokalemia, hypomagnesemia;
• mental illness;
• severe renal / hepatic impairment;
• epilepsy, epileptic syndrome;
• combination therapy with drugs that prolong the QT interval, including class IA and III antiarrhythmics;
• combination therapy with inhibitors of CYP4501A2 isoenzymes, including theophylline, methylxanthine, caffeine, duloxetine, clozapine;
• elderly age.

Instructions for use Tsifran CT: method and dosage

Cifran ST is taken orally with plenty of water, preferably after meals. Do not chew, crush, or otherwise break the tablet.

Recommended adult dose of Cifran CT:

• 250 mg + 300 mg: 2 tablets 2 times a day;
• 500 mg + 600 mg: 2 times a day, 1 tablet.

Side effects

• nervous system: vertigo, headache, dizziness, impaired coordination of movements (including locomotor ataxia), dysesthesia, hypesthesia, hyperesthesia, paresthesia, disorientation, gait disturbance, dysarthria, increased fatigue, convulsions, tremor, weakness, peripheral neuropathy, insomnia, confusion, nightmares, increased intracranial pressure, thrombosis of the cerebral arteries, fainting, migraine, agitation, anxiety, depression, hallucinations, and other manifestations of psychotic reactions (sometimes progressing to states in which the patient can harm himself), polyneuropathy, peripheral paralgesia;
• digestive system: decreased appetite, xerostomia, metallic taste in the mouth, abdominal pain, nausea, diarrhea, vomiting, pancreatitis, hepatonecrosis, hepatitis, flatulence, cholestatic jaundice (especially in patients with previous liver disease);
• cardiovascular system: decreased blood pressure, heart rhythm disturbances, tachycardia, prolongation of the QT interval on the electrocardiogram, ventricular arrhythmias (including pirouette type);
• hematopoietic system: granulocytopenia, leukocytosis, serum sickness, hemolytic anemia, neutropenia, agranulocytosis, vasodilation, pancytopenia, inhibition of bone marrow hematopoiesis, thrombocytosis, thrombocytopenia, leukopenia, anemia;
• sense organs: impairment of smell / taste, tinnitus, hearing loss / loss, visual impairment (in the form of diplopia, changes in color perception, increased photosensitivity);
• respiratory system: breathing disorders (including bronchospasm);
• urinary system: urinary retention, polyuria, renal failure, interstitial nephritis, hematuria, decreased nitrogen excretion function of the kidneys, crystalluria (with decreased urine output and alkaline urine), glomerulonephritis, dysuria;
• musculoskeletal system: exacerbation of myasthenia gravis symptoms, increased muscle tone, tendon ruptures, arthralgia, tendovaginitis, arthritis, myalgia, muscle weakness;
• laboratory parameters: hypercreatininemia, hyperglycemia, hyperbilirubinemia, hypoprothrombinemia, increased activity of amylase, alkaline phosphatase, hepatic transaminases;
• allergic reactions: urticaria, pruritus, blistering accompanied by bleeding, and small nodules that later form scabs, punctate hemorrhages on the skin (petechiae), drug fever, laryngeal / facial edema, shortness of breath, vasculitis, eosinophilia, erythema nodosum, toxic epidermal necrolysis (Lyell's syndrome), exudative erythema multiforme (including Stevens-Johnson syndrome), anaphylactic shock, anaphylactic reactions;
• others: increased sweating, flushing of the skin of the face, asthenia, superinfection (including pseudomembranous colitis, candidiasis).

Overdose

There is no specific antidote, therefore, in case of an overdose, symptomatic therapy is indicated, including the following measures: gastric lavage or induction of vomiting, measures for adequate hydration of the body (infusion therapy), supportive treatment.

With the help of hemo- or peritoneal dialysis, tinidazole can be completely excreted from the body, ciprofloxacin - in a small amount (about 10%).

special instructions

During the course of treatment, excessive exposure to sunlight is recommended to be avoided, as there is a possibility of developing phototoxic reactions. In the event of their appearance, the CT numbers are immediately canceled.

To reduce the likelihood of crystalluria, the recommended daily dose should not be exceeded. Also, the patient needs to ensure sufficient fluid intake and maintain an acidic urine reaction. Taking the drug causes dark staining of urine.

In rare cases, during the period of therapy, the development of disorders such as generalized urticaria, decreased blood pressure, edema of the face / larynx, dyspnea and bronchospasm is noted. If you are allergic to any imidazole derivative, cross-sensitivity to tinidazole is possible; the appearance of a cross-allergic reaction to ciprofloxacin can also be observed in patients with allergies to other fluoroquinolone derivatives. Therefore, in cases where the patient has developed any allergic reactions to similar drugs, the likelihood of cross-allergic reactions to Cifran ST should be taken into account.

During therapy, it is necessary to monitor the picture of peripheral blood.

The combined use of Tsifran CT with alcohol is contraindicated, since when tinidazole and alcohol are combined, painful abdominal cramps, vomiting and nausea may develop.

Against the background of epilepsy, aggravated history of seizures, vascular diseases and organic brain lesions, Tsifran ST can only be used for health reasons, which is associated with the threat of adverse reactions from the central nervous system.

The efficacy / safety of Tsifran CT for the treatment and prevention of anaerobic infections in children under 12 years of age has not been established.

If severe and prolonged diarrhea develops during / after therapy, pseudomembranous colitis should be excluded, which requires immediate discontinuation of the drug and the appointment of appropriate treatment.

In cases of pain in the tendons or manifestations of the first signs of tendovaginitis, Tsifran ST is canceled.

Influence on the ability to drive vehicles and complex mechanisms

During the period of therapy with Tsifran ST, one should refrain from driving and working with complex mechanisms.

Application during pregnancy and lactation

Cifran CT is not prescribed during pregnancy / lactation.

Ciprofloxacin crosses the blood-placental barrier. Tinidazole may have mutagenic and carcinogenic effects. Both active components are excreted in breast milk.

Pediatric use

Cifran CT therapy is contraindicated in patients under 18 years of age.

With impaired renal function

Severe renal failure: Cifran CT should be used under medical supervision.

For violations of liver function

Severe hepatic impairment: Cifran CT should be used under medical supervision.

Use in the elderly

Advanced age: Cifran CT should be used under medical supervision.

Drug interactions

Tinidazole

• indirect anticoagulants: their effect is enhanced, in order to reduce the likelihood of bleeding, the dose is reduced by 50%;
• ethanol: its effect is enhanced, the development of disulfiram-like reactions is likely;
• ethionamide: the combination is not recommended;
• phenobarbital: the metabolism of tinidazole is accelerated.

Tinidazole can be used in conjunction with sulfonamides and antibiotics (erythromycin, aminoglycosides, rifampicin, cephalosporins).

Ciprofloxacin

• theophylline (and other xanthines, for example, caffeine), oral hypoglycemic drugs, indirect anticoagulants: their concentration increases, the half-life is lengthened; ciprofloxacin helps to reduce the prothrombin index;
• other antimicrobial drugs (beta-lactam antibiotics, clindamycin, aminoglycosides, metronidazole): synergism of action;
• cyclosporine: its nephrotoxic effect increases, while serum creatinine increases, as a result of which this indicator needs to be monitored twice a week;
• iron-containing drugs, sucralfate, antacids containing calcium, magnesium, aluminum ions: absorption of ciprofloxacin is reduced, therefore Cifran CT should be used 1-2 hours before or 4 hours after taking these drugs;
• non-steroidal anti-inflammatory drugs (except for acetylsalicylic acid): the risk of seizures increases;
• didanosine: absorption of ciprofloxacin is reduced;
• metoclopramide: the absorption of ciprofloxacin is accelerated, this leads to a decrease in the time to reach it C _max;
• uricosuric drugs: the elimination of ciprofloxacin is significantly slowed down, its plasma concentration increases;
• tizanidine: its C _max increases significantly, which causes the development of side effects, including drowsiness and a marked decrease in blood pressure;
• drugs that prolong the QT interval (class IA and III antiarrhythmics): the QT interval on the electrocardiogram is lengthened;
• omeprazole: its C _max decreases slightly, and AUC (area under the concentration-time curve) also decreases;
• probenecid: the concentration of ciprofloxacin in the blood plasma increases;
• methotrexate: its renal metabolism slows down, which may be accompanied by an increase in the plasma concentration of methotrexate in the blood (the likelihood of its adverse reactions increases);
• duloxetine and potent inhibitors of the isoenzyme CYP4501A2 (in particular, fluvoxamine): its AUC and C _max increase;
• ropinirole: its C _max and AUC increase significantly, control of the development of adverse reactions is required;
• clozapine (therapy for 7 days, dose of ciprofloxacin - 250 mg): serum concentrations of clozapine and N-desmethylclozapine increase; during its joint use and for a short time after its termination, correction of the clozapine dosage regimen is required;
• sildenafil: its C _max and AUC increase significantly, combined use is possible after assessing the benefit / risk ratio;
• lidocaine (when administered intravenously): its clearance is significantly reduced.

Analogs

The analogue of Tsifran ST is Tsiprolet A.

Terms and conditions of storage

Store in a place protected from moisture at temperatures up to 25 ° C. Keep out of the reach of children.

Shelf life is 2 years.

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews about Tsifran ST

According to reviews, Cifran ST is an affordable and effective drug with a wide spectrum of action. Among the shortcomings, they point to a bitter taste, large tablet size, high cost and side effects, which in some cases are strong.

Price for Tsifran ST in pharmacies

The approximate price for Tsifran ST (10 tablets of 250 mg + 300 mg or 500 mg + 600 mg) is 310–370 rubles or 298–442 rubles.

Tsifran ST: prices in online pharmacies

Drug name Price Pharmacy

Cifran ST 500 mg + 600 mg film-coated tablets 10 pcs. 294 r Buy

Cifran ST tablets p.o. 500 / 600mg 10 pcs. 308 RUB 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!