Tsifran OD
Tsifran OD: 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: Cifran OD
ATX code: J01MA02
Active ingredient: ciprofloxacin (ciprofloxacin)
Manufacturer: San Pharmaceutical Industries Ltd. (India)
Description and photo updated: 22.11.2018
Prices in pharmacies: from 170 rubles.
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Tsifran OD is a broad-spectrum antibacterial drug, fluoroquinolone.
Release form and composition
Tsifran OD is produced in the form of tablets of prolonged action, film-coated: from almost white to white, oval, on the film shell there is an inscription in black food ink "Cifran OD 500 mg" or "Cifran OD 1000 mg" (5 pcs. In blisters, in a cardboard box 1 or 2 blisters).
1 tablet contains:
- active substance: ciprofloxacin - 500 mg or 1000 mg;
- auxiliary components: sodium bicarbonate, sodium alginate (Kelton LVCR), crospovidone (Kollidon CLM), hydroxypropyl methylcellulose, magnesium stearate, aerosil 200, talc;
- shell composition: Opadry 31В58910 white (lactose monohydrate, hypromellose, macrogol 400, titanium dioxide), talc, hydroxypropyl methylcellulose, purified water.
Pharmacological properties
Pharmacodynamics
Tsifran OD is an antimicrobial drug. Its mechanism of action is due to the bactericidal activity of ciprofloxacin (fluoroquinolone), which disrupts the action of topoisomerase II, a bacterial enzyme necessary for the normal replication of bacterial DNA (deoxyribonucleic acid). The absence of topoisomerase in the biochemical process causes a disruption in the synthesis of normal proteins in bacteria.
Ciprofloxacin is active against most strains of the following bacteria:
- aerobic gram-positive: Listeria monocytogenes, Bacillus anthracis, Enterococcus faecalis (relative sensitivity of most strains), Streptococcus pyogenes, Staphylococcus epidermidis, Staphylococcus aureus (susceptible to methicillin and Staphyllinum-producing methicillin, partly methicillin pneumonia, Staphyllinum-resistant strains)
- aerobic gram-negative: Citrobacter diversus, Campylobacter jejuni, Citrobacter freundii, Escherichia coli, Enterobacter cloacae, Moraxella catarrhalis, Haemophilus parainfluenzae, Haemophilus influenzae, Klebsiella aerialis pneumoniae, Proteinacea pneumoniae, Proteinsella morganii, Proteinse glens, Proteinse gum, Shigella boydii, Shigella flexneri, Shigella dysenteriae, Shigella sonnei, Salmonella typhi.
In vitro, ciprofloxacin at a minimum inhibitory concentration (MIC) of 0.001 mg / ml is active against more than 90% of strains of the following microorganisms (the clinical efficacy of this activity has not been specified):
- aerobic gram-positive: Staphylococcus haemophilus, Staphylococcus hominis;
- aerobic gram-negative: Edwardsiella tarda, Aeromonas hydrophila, Acinetobacter lwoffii, Brucella melitensis, Salmonella enteritidis, Legionella pneumophila, Vibrio parahaemolyticus, Vibrio cholerae, Vibrio vulnificus, Yersinia enterocolitica o, Klebsiella;
- others: relatively sensitive - Chlamydia trachomatis, Mycobacterium tuberculosis.
Resistance to ciprofloxacin is shown by: Burkholderia cepacia (most strains), Stenotrophomonas maltophilia (some strains), Bacteroides fragilis, Clostridium difficile and many other anaerobic bacteria.
Pharmacokinetics
After oral administration, absorption of ciprofloxacin from the gastrointestinal tract occurs rapidly. Uniform long-term release of ciprofloxacin ensures the maintenance of its required concentration in the blood plasma when taking Tsifran OD once a day.
The maximum concentration (C max) of the active substance in the blood plasma is reached in 6 hours and can be approximately 0.0013 mg / ml after a single dose of the tablet Cifran OD 500 mg and 0.0024 mg / ml - Cifran OD 1000 mg. The total concentration (AUC) of ciprofloxacin in the blood plasma is approximately 0.0083 and 0.0189 mg / ml / h.
Plasma proteins bind 20-40%.
Ciprofloxacin easily penetrates into body fluids and tissues. It is found in saliva, secretions of the nasal and bronchial mucosa, lymph, peritoneal fluid, semen, and prostate secretions. Distributed in the lungs, skin, muscles, adipose, cartilaginous and bone tissues, the prostate gland.
In the liver, ciprofloxacin is partially metabolized.
T 1/2 (half-life) - 3.5-4.5 hours.
Through the kidneys, about 50% of the orally taken dose is excreted unchanged, in the form of active metabolites - about 15%. Approximately 35% of the dose received undergoes enterohepatic circulation.
With severe renal failure and in the elderly, T 1/2 may be lengthened, therefore the dosage regimen must be adjusted taking into account the patient's creatinine clearance (CC).
With a stable course of liver cirrhosis, the pharmacokinetics of ciprofloxacin does not change significantly. Care should be taken in acute hepatic failure due to the lack of data on the kinetics of the active substance.
Indications for use
According to the instructions, Tsifran OD is indicated for the treatment of infectious and inflammatory diseases caused by sensitive microorganisms:
- pneumonia, exacerbation of chronic bronchitis, infectious complications of cystic fibrosis and other inflammatory diseases of the lower respiratory system of infectious etiology;
- acute sinusitis;
- cystitis, pyelonephritis (including complicated forms);
- gonorrhea;
- chronic bacterial prostatitis;
- cholecystitis, cholangitis, empyema of the gallbladder, peritonitis, intra-abdominal abscesses and other intra-abdominal infections - in combination with metronidazole;
- dermatological infections;
- acute and chronic form of osteomyelitis and other infectious diseases of the joints and bones;
- anthrax;
- diarrhea of infectious origin (including "traveler's diarrhea");
- typhoid fever.
Contraindications
- chronic renal failure (with CC less than 29 ml / min, including patients on hemodialysis);
- pseudomembranous colitis;
- concomitant therapy with tizanidine;
- age up to 18 years;
- period of pregnancy;
- breast-feeding;
- hypersensitivity to drugs of the fluoroquinolone group;
- individual intolerance to the components of the drug.
Care should be taken to prescribe the use of Tsifran OD in severe hepatic failure, renal failure with CC 35-50 ml / min, cerebrovascular accident, severe atherosclerosis of the cerebral vessels, mental illness, epilepsy, tendon damage on the background of previous treatment with fluoroquinolones, in old age.
Instructions for use of Tsifran OD: method and dosage
Cifran OD tablets are taken orally, after a meal, swallowing whole (without breaking the membrane) and drinking plenty of water.
The patient takes the prescribed dose 1 time per day.
Recommended dosage of Tsifran OD:
- infectious and inflammatory pathologies of the lower parts of the respiratory system: mild and moderate - 1 g for 7-14 days; severe and complicated forms - 1.5 g for 7-14 days;
- acute sinusitis: mild to moderate severity - 1 g for 10 days;
- urinary tract infections: acute uncomplicated form - 0.5 g for 3 days, mild and moderate severity - 0.5 g for 7-14 days; severe and complicated forms - 1 g for 7-14 days;
- gonorrhea: acute uncomplicated form - 0.5 g for 1 day, complicated - 0.5 g for 3-5 days;
- chronic bacterial prostatitis: mild and moderate severity - 1 g each, duration of treatment - 28 days;
- intra-abdominal infections (in combination with metronidazole): complicated forms - 1 g each for 7-14 days;
- infectious diseases of the skin: mild and moderate severity - 1 g for 7-14 days; severe and complicated forms of infection - 1.5 g each, course of treatment - 7-14 days;
- Infectious diseases of joints and bones: mild and moderate severity - 1 g for 28-42 days, severe and complicated forms - 1.5 g for 28-42 days or more;
- diarrhea of infectious etiology: mild, moderate or severe - 1 g for 5-7 days;
- typhoid fever: mild, moderate - 1 g for 10 days;
- anthrax (prevention and treatment): 1 g each, course duration - 60 days.
Taking these doses should be continued for at least 2 days after the symptoms of the disease have completely disappeared.
In renal failure, the dosage regimen of Tsifran OD is adjusted taking into account the patient's CC value in the following accordance:
- CC above 50 ml / min: usual dose;
- CC 30-50 ml / min: 0.5-1 g per day;
- CC 5-29 ml / min, patients on hemodialysis or peritoneal dialysis: use is not recommended.
For men, CC can be determined by multiplying the patient's weight (kg) by the difference obtained after subtracting his age in years from 140. The result is divided by the product - the number obtained by multiplying 72 by the plasma creatinine concentration (mg / dl).
For women, CC corresponds to the indicator calculated according to the scheme for men, and additionally multiplied by a coefficient of 0.85.
In elderly patients, the appointment of fluoroquinolones should be made taking into account the possible age-related decline in renal function.
Side effects
- from the nervous system: photophobia, insomnia, irritability, headache, dizziness, increased fatigue, paresthesia, nightmares, anxiety, tremor, confusion, peripheral paralgesia (violation of pain sensitivity), depression, increased intracranial pressure, hallucinations, fainting, manifestations psychotic reactions (including self-harm), cerebral artery thrombosis, migraine;
- on the part of the senses: impairment of smell and taste, diplopia, hearing loss, tinnitus;
- from the digestive system: flatulence, abdominal pain, nausea, vomiting, anorexia, diarrhea, hepatitis, cholestatic jaundice (more often against the background of past liver diseases), hepatonecrosis;
- on the part of the cardiovascular system: lowering blood pressure (BP), tachycardia, flushing of the face, heart rhythm disturbances;
- from the hematopoietic system: leukopenia, granulocytopenia, eosinophilia, anemia, thrombocytopenia, hemolytic anemia, leukocytosis, thrombocytosis;
- from the urinary system: urinary retention, hematuria, dysuria, polyuria, crystalluria (more often against the background of an alkaline urine reaction, low urine output), acute interstitial nephritis, albuminuria, glomerulonephritis, urethral bleeding, acute renal failure, decreased nitrogen excretion function of the kidneys;
- on the part of the immune system: pruritus, drug fever, urticaria, petechiae, blistering (including those accompanied by bleeding), the appearance of small nodules that form scabs, shortness of breath, swelling of the face and / or larynx, erythema nodosum, vasculitis, erythema multiforme, toxic epidermal necrolysis (Lyell's syndrome), malignant exudative erythema (Stevens-Johnson syndrome);
- on the part of the musculoskeletal system: arthritis, tendovaginitis, arthralgia, myalgia, tendon ruptures;
- laboratory parameters: hypercreatininemia, hypoprothrombinemia, hyperglycemia, increased activity of hepatic transaminases, hyperbilirubinemia, increased activity of lactate dehydrogenase and alkaline phosphatase;
- others: general weakness, excessive sweating, pseudomembranous colitis, candidiasis, photosensitivity.
Overdose
Symptoms: Reversible kidney toxicity.
Treatment: no specific antidote. In this regard, it is necessary to urgently induce artificial vomiting or gastric lavage. Further - the appointment of symptomatic therapy, including the administration of infusions and other measures for adequate hydration of the body; supportive therapy. The use of hemo- and peritoneal dialysis is ineffective, up to 10% of the taken dose of ciprofloxacin can be removed.
special instructions
Due to the risk of developing photosensitivity reactions during the use of fluoroquinolones, excessive exposure to ultraviolet radiation, including direct sunlight, should be avoided during treatment. In the event of a photosensitivity reaction, taking the tablets must be discontinued.
When diagnosing the cause of severe and prolonged diarrhea that occurred during or immediately after treatment with Cifran OD, the possible development of pseudomembranous colitis should be considered. If pseudomembranous colitis is confirmed, immediate discontinuation of the drug and the appointment of appropriate therapy are required.
To prevent the development of crystalluria during the period of taking the tablets, it is necessary to drink a sufficient amount of liquid, maintain the acidic reaction of urine and prevent the daily dose of the drug from exceeding.
Since in case of organic brain lesions, vascular diseases, epilepsy or seizures in the anamnesis, the use of ciprofloxacin causes a threat to the development of undesirable phenomena from the nervous system, patients with these pathologies can be prescribed Cifran OD only for health reasons.
Patients should be informed about the need for immediate discontinuation of the drug when pain in the tendons and the first signs of tendovaginitis appear.
Influence on the ability to drive vehicles and complex mechanisms
During the entire period of treatment, one should not engage in potentially hazardous activities, including driving transport, since Tsifran OD can cause a decrease in the speed of psychomotor reactions and attention.
Application during pregnancy and lactation
It is not recommended to use Tsifran OD during the gestation period.
Since ciprofloxacin is excreted in breast milk, if it is necessary to prescribe the drug during lactation, breastfeeding should be discontinued.
Pediatric use
The appointment of Tsifran OD for the treatment of patients under the age of 18 is contraindicated, since the process of skeletal formation has not yet been completed.
With impaired renal function
The appointment of Tsifran OD is contraindicated in patients with chronic renal failure with CC less than 29 ml / min, including those on hemodialysis and peritoneal dialysis.
It should be used with caution in renal failure with CC 35-50 ml / min.
For violations of liver function
With caution, it is necessary to prescribe Tsifran OD in case of severe hepatic failure.
Use in the elderly
Care should be taken to prescribe fluoroquinolones to elderly patients, taking into account the likelihood of age-related decrease in their renal function, and the correction of the dosage regimen corresponding to the degree of impairment.
Drug interactions
With the simultaneous use of Tsifran OD:
- metronidazole, beta-lactams, clindamycin, aminoglycosides and other antimicrobial agents: cause synergy. For the successful treatment of infections caused by Pseudomonas speciales, a combination with ceftazidime and azlocillin is shown, streptococcal infections - with beta-lactam antibiotics (mezlocillin, azlocillin), staphylococcal infections - with vancomycin isoxazolpenicillins, and anaerobic infections - with anaerobic infections
- theophylline: increases its concentration in blood plasma;
- tizanidine: increases the risk of a pronounced decrease in blood pressure, the appearance of drowsiness;
- immunosuppressive and antineoplastic agents: reduce the absorption of Tsifran OD when taken orally;
- didanosine: helps to reduce the absorption of ciprofloxacin;
- antacids containing aluminum or magnesium hydroxide: help to reduce the absorption of ciprofloxacin, therefore this combination is contraindicated;
- drugs that block tubular secretion, including probenecid: reduce the renal excretion of ciprofloxacin;
- analgesics: cause an increase in the side effects of ciprofloxacin from the central nervous system;
- phenytoin: may decrease or increase your plasma level;
- sucralfate: reduces the absorption of Tsifran OD;
- antagonists of H 2 - histamine receptors: they do not have a clinically significant effect on the bioavailability of ciprofloxacin;
- oral anticoagulants, including warfarin and its derivatives: enhance their effect, therefore, when combined with the drug, regular studies of the blood coagulation system are required;
- glyburide: may cause severe hypoglycemia;
- oral hypoglycemic agents, caffeine and other xanthines: increase their concentration level and lengthen T 1/2;
- metoclopramide: accelerates its absorption;
- uricosuric agents: slow down the excretion of ciprofloxacin by almost 50%, causing an increase in its plasma concentration;
- cyclosporine: enhances its nephrotoxic effect. Since there is an increase in serum creatinine, its level must be monitored 2 times a week.
Analogs
Analogs of Cifran OD are: Cifran, Ciprofloxacin, Vero-Ciprofloxacin, Ificipro, Quintor, Basigen, Betacyprol, Nircip, Procypro, Ciprinol, Ciprobai, Ciprolaker, Cipromed, Ciprofloxabol, Cifloxinal, Ciprobid, Ciprobid.
Terms and conditions of storage
Keep out of the reach of children.
Store at temperatures up to 25 ° C, protected from moisture.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Tsifran OD
Reviews about Tsifran OD are positive, they indicate the high clinical efficacy of the drug in the treatment of a wide range of bacterial infections.
Patients report a fairly good tolerance of Tsifran OD, the absence of pronounced side effects, a rapid onset of relief with severe pain syndrome.
Price for Tsifran OD in pharmacies
The price for Tsifran OD 1000 mg per pack containing 10 tablets can be 267–325 rubles. 10 tablets of Cifran OD 500 mg cost 170–206 rubles.
Tsifran OD: prices in online pharmacies
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Drug name Price Pharmacy |
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Tsifran OD 500 mg film-coated tablets of prolonged action 10 pcs. 170 RUB Buy |
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Tsifran OD 1000 mg film-coated tablets of prolonged action 10 pcs. 188 r Buy |
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Tsifran OD tablets p.o. prolonged action 500mg 10 pcs. 204 RUB Buy |
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Tsifran OD tablets p.o. prolonged action 1000mg 10 pcs. 309 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!
