Treatment: therapy for overdose of the drug Tsifran® CT should be symptomatic and include the following measures:
- induction of vomiting or gastric lavage,
- carrying out measures for adequate hydration of the body (infusion therapy),
- maintenance therapy.
There is no specific antidote.
hypersensitivity to any derivatives of fluoroquinolone or imidazole,
hematological diseases,
organic neurological lesions,
suppression of bone marrow hematopoiesis,
porphyria,
children's age (up to 18 years).
With caution: severe atherosclerosis of the cerebral vessels, impaired cerebral circulation, mental illness, epilepsy, epileptic syndrome, severe renal and / or liver failure.
When using the drug in the elderly, there were no significant problems. However, in elderly patients, there may be an age-dependent decrease in kidney function, so caution should be exercised when using the drug in such patients.
Tinidazole
Increases the effect of indirect anticoagulants (to reduce the risk of bleeding, the dose is reduced by 50%) and the effect of ethanol (disulfiram-like reactions).
It is compatible with sulfonamides and antibiotics (aminoglycosides, erythromycin, rifampicin, cephalosporins).
It is not recommended to prescribe with ethionamide.
Phenobarbital accelerates the metabolism.
Ciprofloxacin
Due to a decrease in the activity of microsomal oxidation processes in hepatocytes, it increases the concentration and lengthens the T1/2 theophylline (and other xanthines, such as caffeine), oral hypoglycemic drugs, indirect anticoagulants, helps to reduce the prothrombin index.
When combined with other antimicrobial drugs (beta-lactam antibiotics, aminoglycosides, clindamycin, metronidazole), synergy is usually observed.
Increases the nephrotoxic effect of cyclosporine, there is an increase in serum creatinine, in such patients, it is necessary to monitor this indicator 2 times a week.
When taken simultaneously, it increases the effect of indirect anticoagulants.
Oral administration together with iron-containing drugs, sucralfate and antacid drugs containing Mg2 , Ca2 , A13 it leads to a decrease in the absorption of ciprofloxacin, so it should be prescribed 1-2 hours before or 4 hours after taking the above drugs.
NSAIDs (excluding acetylsalicylic acid) increase the risk of seizures.
Didanosine reduces the absorption of ciprofloxacin due to the formation of complexes with Mg contained in didanosine2 , A13 .
Metoclopramide accelerates absorption, which reduces the time to reach its maximum concentration.
Co-administration of uricosuric drugs leads to a slowdown in the elimination (up to 50%) and an increase in the plasma concentration of ciprofloxacin.
Tablets 250 mg/300 mg: oval shape, yellow color, covered with a film shell.
Forte tablets 500 mg/600 mg: oval shape, yellow color, with a dividing line on one side, covered with a film shell
From the digestive system: decreased appetite, dryness of the oral mucosa, "metallic" taste in the mouth, nausea, vomiting, diarrhea, abdominal pain, flatulence, cholestatic jaundice (especially in patients with previous liver diseases), hepatitis, hepatonecrosis.
From the central nervous system: headache, dizziness, increased fatigue, impaired coordination of movements (including locomotor ataxia), dysarthria, peripheral neuropathy, rarely convulsions, weakness, tremor, insomnia, increased sweating, increased intracranial pressure, confusion, depression, hallucinations, as well as other manifestations of psychotic reactions, migraine, fainting, cerebral artery thrombosis.
On the part of the senses: taste and smell disorders, visual impairment (diplopia, color perception changes), tinnitus, hearing loss.
From the cardiovascular system: tachycardia, heart rhythm disorders, decreased blood pressure.
From the hematopoietic system: leukopenia, granulocytopenia, anemia, thrombocytopenia, leukocytosis, thrombocytosis, hemolytic anemia.
On the part of laboratory parameters: hypoprothrombinemia, increased activity of hepatic transaminases and alkaline phosphatase, hypercreatinemia, hyperbilirubinemia, hyperglycemia.
From the urinary system: hematuria, crystalluria (with alkaline urine and low diuresis), glomerulonephritis, dysuria, polyuria, urinary retention, decreased nitrogen-releasing kidney function, interstitial nephritis.
Allergic reactions: skin itching, urticaria, blistering, accompanied by bleeding, and the appearance of small nodules forming scabs, drug fever, spot hemorrhages on the skin (petechiae), swelling of the face or larynx, shortness of breath, eosinophilia, increased photosensitivity, vasculitis, erythema nodosum, erythema multiforme (including Stevens-Johnson syndrome), toxic epidermal necrolysis (syndrome Lyell).
Other: arthralgia, arthritis, tendovaginitis, tendon tears, asthenia, myalgia, superinfections (candidiasis, pseudomembranous colitis), flushes of blood to the face.
According to the recipe.
It is recommended to avoid excessive exposure to sunlight during the course of therapy with Tsifran® ST, since some patients treated with fluoroquinolones had phototoxicity reactions. If phototoxicity reactions occur, the drug should be discontinued immediately.
When using tinidazole, it is possible (but rare) to develop generalized urticaria, edema of the face and larynx, decreased blood pressure, bronchospasm and dyspnea. If the patient is allergic to any imidazole derivative, then cross-sensitivity to tinidazole may develop, and the development of a cross-allergic reaction to ciprofloxacin is also possible in patients with allergies to other derivatives of fluoroquinolones. Therefore, if the patient has any allergic reactions to similar drugs, the possibility of cross-allergic reactions to Cyfran should be considered® ST.
With the combined use of tinidazole with alcohol, painful abdominal cramps, nausea and vomiting may occur. Therefore, the joint use of Digitals® ST and alcohol are contraindicated.
To avoid the development of crystalluria unacceptable excess of the recommended daily dose, should also adequate fluid intake and maintaining acidic urine. Causes dark staining of the urine.
During treatment, you should refrain from engaging in potentially dangerous activities that require increased attention and speed of mental and motor reactions.
Patients with epilepsy, seizures in the anamnesis, vascular diseases and organic brain damage, due to the threat of adverse reactions from the central nervous system, the drug should be prescribed only for vital indications.
If severe and prolonged diarrhea occurs during or after treatment, the diagnosis of pseudomembranous colitis should be excluded, which requires immediate discontinuation of the drug and the appointment of appropriate treatment.
If you experience pain in the tendons or the first signs of tendovaginitis, treatment should be discontinued.
In the course of treatment, the picture of peripheral blood should be monitored.
The safety and efficacy of the drug for the treatment and prevention of anaerobic infections in children under 12 years of age has not been established.
Treatment of mixed infections caused by sensitive anaerobic and aerobic microorganisms:
chronic sinusitis,
lung abscess,
empyema,
intra-abdominal infections,
inflammatory gynecological diseases,
postoperative infections (with the possible presence of aerobic and anaerobic bacteria),
chronic osteomyelitis,
skin and soft tissue infections,
ulcers on the diabetic foot,
bedsores,
infection of the oral cavity (including periodontitis and periodontitis).
Treatment of diarrhea or dysentery of amoebic or mixed (amoebic and bacterial) etiology.
A combined drug intended for the treatment of mixed infections caused by anaerobic and aerobic microorganisms, as well as gastrointestinal infections, such as diarrhea or dysentery, amoebic or mixed (amoebic and bacterial) nature.
Tinidazole it is effective against anaerobic microorganisms, such as Clostridium difficile, Clostridium perfringens, Bacteroides fragilis, Peptococcus and Peptostreptococcus anaerobius. Anaerobic microorganisms cause mainly diseases of the abdominal cavity, small pelvis, lungs or organs of the oral cavity. In anaerobic infections, a mixture of anaerobic and aerobic bacteria is most often present. Therefore, in case of mixed anaerobic infection, an antibiotic active against aerobic bacteria is added to the therapy.
Ciprofloxacin - broad-spectrum antibiotic, active against most aerobic gram-positive and gram-negative microorganisms, such as E.coli, Klebsiella spp., S.typhi and other strains Salmonella, P.mirabilis, P.vulgaris, Yersinia enterocoilitica, Ps.aeruginosa, Shigella flexneri, Shigella sonnei, H.ducreyi, H.influenzae, N.gonorrhoeae, M.catarrhalis, V.cholerae, B.fragilis, St.aureus (including methicillin-resistant strains), St.epidermidis, S.pyogenes, S.pneumoniae, Chlamidia, Mycoplasma, Legionella and Mycobacterium tuberculosis.
Both ciprofloxacin and tinidazole are well absorbed in the gastrointestinal tract. Cmax each component is achieved within 1-2 hours. The total bioavailability of tinidazole is 100%, and the binding of plasma proteins is 12%. T1/2 - about 12-14 hours. The drug quickly penetrates into the tissues of the body, reaching high concentrations there.
Tinidazole creates concentrations in the cerebrospinal fluid equal to its plasma concentrations, and undergoes reabsorption in the renal tubules. Tinidazole is excreted in the bile at concentrations slightly below 50% of its plasma concentration. About 25% of the dose is excreted unchanged in the urine. The metabolites make up 12% of the administered dose and are also excreted in the urine. Along with this, there is a slight excretion of tinidazole in the feces.
Ciprofloxacin it is well absorbed after oral administration. The bioavailability of ciprofloxacin is about 70%. When combined with food, the absorption of ciprofloxacin slows down. 20-40% of the drug is bound by plasma proteins. Ciprofloxacin penetrates well into liquid media and body tissues: lungs, skin, fat, muscle and cartilage tissues, as well as into bone tissue and organs of the urinary system, prostate. The drug is found in high concentrations in saliva, nasal mucus and bronchial secretions, semen, lymph, peritoneal fluid, bile and prostate secretions. Ciprofloxacin is partially metabolized by the liver. About 50% of the dose is excreted unchanged in the urine,15% - in the form of active metabolites, such as oxyciprofloxacin. The rest of the dose is excreted in the bile, partially reabsorbed. About 15-30% of ciprofloxacin is excreted in the feces. T1/2 - about 3.5-4.5 h. T1/2 it can be prolonged in severe renal insufficiency and in elderly patients.
In a dry place, at a temperature not exceeding 25 °C.
Keep out of reach of children.
Shelf life of the drug Tsifran® ST2 года.Do not use after the expiration date indicated on the package.
| Coated tablets (250 mg 300 mg) | 1 table. |
| Ciprofloxacin hydrochloride USP, equivalent to ciprofloxacin, | 250 mg |
| tinidazole BP | 300 mg |
in a blister pack of 10 pcs. , in a box of 1 or 10 blisters.
| Coated tablets (500 mg 600 mg) | 1 table. |
| Ciprofloxacin hydrochloride USP, equivalent to ciprofloxacin, | 500 mg |
| tinidazole BP | 600 mg |
in a blister pack of 10 pcs. , in a box of 1 or 10 blisters.
Use during pregnancy is not recommended. Tinidazole can have carcinogenic and mutagenic effects. Ciprofloxacin penetrates gepatoprotektory barrier.
In the period of breastfeeding, use is contraindicated. Tinidazole and ciprofloxacin are excreted in breast milk. Therefore, during lactation, if it is necessary to use the drug, you should stop breastfeeding.
Inside, after eating, drink plenty of water.
It should not be broken, chewed or in any other way to destroy the pill.
Recommended dose for adults
Tsifran® ST 250/300 mg — 2 tables. 2 times a day.
Tsifran® ST 500/600 mg — 1 table. 2 times a day.
J01 Systemic antibacterial drugs
