Biseptol for cystitis in women and men: how to take?

In case of cystitis, the main treatments should be those that stop the inflammatory process and have a detrimental effect on the bacteria that cause the disease. The complex drug Biseptol, consisting of two important components: sulfamethoxazole and trimethoprim, fully meets these requirements. Biseptol acts gently and effectively in case of cystitis, inhibiting the development of microbes and accelerating recovery. Trimethoprim-sulfamethoxazole has long been considered the standard of therapy for acute and recurrent urinary tract infections due to its activity against the most common uropathogens and its low cost and tolerability. The synergistic combination of trimethoprim and sulfamethoxazole works at two separate stages of bacterial folate metabolism, which leads to inhibition of DNA synthesis. [ 1 ]

Is it possible to use Biseptol for cystitis?

Cystitis is a common and extremely unpleasant disease that affects mainly women due to anatomical features. But men are not immune from developing cystitis either. What does a person experience during the disease? Pain when urinating, painful and frequent urges, discomfort in the lower abdomen and groin. The inflammatory process has an extremely negative effect on the quality of life and ability to work. To eliminate the problem, Biseptol often becomes the drug of choice.

This medication is quite powerful, although inexpensive. It has a large number of side effects, so only a doctor can prescribe and calculate its dosage.

If the bacteria that caused the disease are sensitive to sulfamethoxazole and trimethoprim, then Biseptol will really help with cystitis. The drug will destroy the bacteria, stop the inflammatory process and cleanse the urinary system. Self-medication can do a "disservice": incorrect doses of the drug can only put the microbes to sleep, which will soon wake up again in the form of a relapse of cystitis. Therefore, trust your doctor and take the entire necessary course of treatment to get rid of the problem for a long time.

Indications Biseptol for cystitis

Biseptol is prescribed not only for cystitis. The drug is indicated for the treatment of infectious diseases if the microbes are sensitive to Biseptol:

• for acute and chronic bronchitis, bronchiectasis, pneumonia, pharyngitis, tonsillitis, sinusitis, otitis media;
• for acute and chronic cystitis, pyelonephritis, urethritis or prostatitis;
• for typhoid fever and paratyphoid fever, for intestinal disorders;
• for acute and chronic osteomyelitis, brucellosis, actinomycosis, toxoplasmosis, nocardiosis.

Biseptol is usually taken only for medicinal purposes. The medication is not used for prevention.

Cystitis is an inflammatory process that is accompanied by irritation and damage to the internal tissues of the bladder. It is no secret that the disease is found mainly among female patients. Thus, every three women out of ten have suffered from bladder inflammation at least once.

Biseptol for cystitis in women is prescribed according to indications, and its use is not uncommon.

Men are much less likely to suffer from cystitis than women. Only one man in ten has ever suffered from or suffers from this disease. Most often, we are talking about patients aged 45 years and older.

Such significant differences in the incidence rate between the sexes can be explained by significant anatomical and physiological features of the structure of the genitourinary system. The male urethra is longer and more tortuous than the female one, and the opening for urination is located relatively far from the anus, which eliminates the possibility of pathogens from the anus entering the urinary system. Female anatomy provides more opportunities for infection to enter the urethra - for example, with banal failure to observe personal hygiene rules.

Biseptol for cystitis in men is prescribed only for the bacterial form of the disease. Fungal cystitis is treated with other appropriate drugs.

Release form

The main dosage form of Biseptil is considered to be tablets: tablets are round, white or slightly yellowish in color, with clear edges and a line for dosing.

Biseptol tablets are available in 100 mg and 400 mg strengths.

A blister strip contains 14 or 20 tablets. Each blister is packed in a cardboard box. A full container contains 1000 packed tablets.

Pharmacodynamics

Biseptol is a complex bactericidal agent, the effect of which is based on the properties of sulfamethoxazole, a sulfanilamide component of medium-term action. Sulfamethoxazole suppresses the production of folic acid by competitive antagonism with para-aminobenzoic acid. Another active ingredient is trimethoprim, a substance that inhibits microbial reductase of dihydrofolic acid, responsible for the production of bioactive tetrahydrofolic acid. Pharmacologists call the combination of these components co-trimoxazole.

The components of Biseptol act on one chain of biochemical processes, causing synergism of antimicrobial resistance.

Biseptol is active against Escherichia coli, Proteus, Morganella, Klebsiella, Enterobacter, Haemophilus influenzae, Streptococcus, Shigella, Neucheria, and Pneumocystis.

Pharmacokinetics

The active ingredients of Biseptol are well absorbed and pass into the blood through the walls of the digestive system. The maximum content of the combination of active substances is detected 1-4 hours after taking the tablet orally. The binding of trimethoprim to plasma albumins reaches 70%, and sulfamethoxazole - approximately 44-62%.

The distribution of active substances is not uniform. Trimethoprim is found in all body fluids, while sulfamethoxazole is found only in the intercellular space.

High concentrations are found in bronchial secretions, prostate gland and bile. Both compounds are present in therapeutic quantities in sputum, vaginal secretions and middle ear fluid.

In terms of distribution volume, sulfamethoxazole has a distribution volume of 0.36 liters/kg, while trimethoprim has a distribution volume of 2 liters/kg.

Metabolism occurs in the liver by oxidation, hydroxylation, acetylation and conjugation with glucuronic acid.

The drug is excreted by the kidneys, through filtration.

The concentration of active compounds in urine significantly exceeds that in the blood, which allows Biseptol to be successfully used for cystitis.

The drug enters the milk of a lactating woman and crosses the placental barrier.

Dosing and administration

For adult patients, the initial dose of Biseptol for cystitis is 2 tablets of 400 mg each twice a day after meals, with water. It is permissible to increase the dosage to 3 tablets twice a day. As a rule, treatment lasts 10-14 days, depending on the severity of the disease.

The Infectious Diseases Society of America Guidelines also concluded that 3-day regimens of trimethoprim, trimethoprim-sulfamethoxazole, and fluoroquinolones were more effective than single-dose regimens, and that 1- or 3-day regimens were better tolerated than longer regimens (7-10 days). Patients who may require 7 days of therapy include pregnant women, patients with diabetes mellitus, and those with symptoms lasting more than 1 week.[ 4 ] For uncomplicated cystitis, treatment with trimethoprim-sulfamethoxazole, trimethoprim, or fluoroquinolones for 3 days should result in eradication rates greater than 90% with a low incidence of adverse effects.

Ten-day therapy with Biseptol in acute uncomplicated cystitis caused by E. coli is more effective than single-dose therapy (four tablets). Both regimens were well tolerated. However, serious adverse reactions were fewer in patients receiving a single dose (8.5%) than in patients receiving 10-day treatment (15%). [ 5 ]

Biseptol for cystitis in a child aged 6-12 years is prescribed in the amount of one tablet of 400 mg twice a day. For children under six years of age, there is a special children's form of the drug - in the form of a suspension. The dosage of the suspension is calculated individually, depending on the age and body weight of the child.

It is advisable to take Biseptol for cystitis in the morning and evening, at equal intervals (for example, at nine o'clock in the morning and at nine o'clock in the evening), with a large glass of water. The tablets are taken continuously for at least five days: optimally - until the painful symptoms disappear, plus another 2-3 days.

If any allergies or other side effects occur, you should consult your doctor.

Application for children

In childhood, Biseptol is used in the form of a suspension, because the baby will not be able to swallow a large enough, and also tasteless tablet. It is necessary to be careful when prescribing this drug to a child: if there is a tendency to allergies, with diathesis, Biseptol is better replaced with other, safer drugs. If a rash or itching of the skin appears during treatment, the drug is discontinued.

The suspension is usually prescribed to children in the following quantities:

• for infants 3-6 months – 2.5 ml twice a day;
• for children from seven months to three years old – 3-5 ml twice a day;
• for children 4-6 years old – 5-8 ml twice a day;
• for children over seven years old – 10 ml in the morning and evening.

If treatment is prescribed, it is necessary to ensure that the baby receives a sufficient amount of fluid during the day (prevention of crystalluria and urolithiasis). It is also important to regularly assess the peripheral blood picture.

Use Biseptol for cystitis during pregnancy

Since the immunity of pregnant women is often slightly weakened, the risk of developing infectious diseases increases. Therefore, cystitis during pregnancy, unfortunately, is a frequent "guest". And often expectant mothers choose well-known and time-tested medications for treatment - for example, Biseptol. However, clinical trials have proven that the active ingredients of this drug easily overcome the placental barrier, ending up in the blood and tissues of the baby, so they can cause significant damage to its health and development.

Doctors warn: Biseptol should not be chosen for cystitis if the patient is pregnant. As a result of such a choice, the child's development may be disrupted, the likelihood of premature termination of pregnancy or premature birth will increase. [ 2 ]

The disease can be cured by taking other, safer medications. They will be prescribed by a doctor during an individual consultation.

The lactation period is another contraindication to the treatment of cystitis with Biseptol. The drug gets into the mother's milk, and then into the baby's body, which is unacceptable.

Contraindications

Biseptol may not be prescribed for cystitis in all cases. As with other medications, there are certain contraindications for the use of Biseptol:

• hypersensitivity of the body to the components of the drug, as well as to sulfonamide drugs, antidiabetic agents based on sulfonylurea;
• acute inflammation of liver tissue, serious liver pathologies, porphyria;
• blood diseases, impaired hematopoiesis, megaloblastic anemia, conditions threatening the development of hemolysis;
• severe kidney disease;
• combination with a course of chemotherapy;
• combination with dofetilide.

Biseptol is not prescribed for cystitis in pregnant and lactating patients.

Side effects Biseptol for cystitis

The most common side effects, occurring in 3-5% of patients, are skin rash, nausea, and vomiting. More serious side effects, such as anemia and Stevens-Johnson syndrome, are rare, but patients should always be monitored for their occurrence. Trimethoprim-sulfamethoxazole should be used with caution in patients with glucose-6-phosphate dehydrogenase deficiency or renal and hepatic impairment. Trimethoprim-sulfamethoxazole may enhance the serum glucose-lowering effects of sulfonylureas (such as glipizide). Because the use of trimethoprim-sulfamethoxazole may increase the risk of bleeding in patients taking warfarin sodium, co-administration of these agents should be carefully monitored.[ 3 ]

Most often, treatment of cystitis with Biseptol is accompanied by adverse reactions from the digestive system (nausea, loss of appetite), or skin allergic reactions (rash, redness, itching).

Much less frequently, more severe symptoms such as Stevens-Johnson syndrome, toxic epidermal necrolysis, and acute liver necrosis are observed.

With long-term treatment, activation of fungal infection (in particular, candidiasis) is possible.

In general, undesirable signs may be:

• anemia, eosinophilia, leukopenia, thrombocytopenia, agranulocytosis;
• fever, photophobia, allergic vasculitis or myocarditis, general dermatological reactions, dermatitis;
• hypersensitivity of the conjunctiva and sclera;
• diarrhea, abdominal pain, enterocolitis, pancreatitis, stomatitis, increased bilirubin levels;
• increased levels of aminotransferases, inflammation of liver tissue;
• increased urine output, crystalluria, renal dysfunction;
• hypoglycemia, weight loss;
• development of depressive states, psychoses in elderly patients;
• joint pain, cramps, neuropathy, myopathy;
• cough, weakness, sleep disturbances.

The duration of taking the drug and its dosage directly affect the development of side effects. To avoid negative effects, it is necessary to strictly adhere to the cystitis treatment regimen prescribed by the doctor.

Overdose

Excessive intake of Biseptol for cystitis may cause the following symptoms:

• loss of appetite;
• pain and cramping in the abdomen;
• nausea with vomiting;
• diarrhea, loose stools;
• dizziness, headaches;
• drowsiness, loss of consciousness.

Crystalluria, hematuria, suppression of bone marrow function, and development of hepatitis may occur.

In case of acute overdose, it is necessary to clean and wash the stomach. If the kidney function is intact, the patient should be given a large volume of liquid. Additionally, blood parameters and electrolyte status are monitored. Hemodialysis and peritoneal dialysis are ineffective or not effective at all.

Interactions with other drugs

Biseptol should not be combined for cystitis with non-steroidal anti-inflammatory drugs, antidiabetic agents based on sulfonylurea, as well as with diphenin, indirect anticoagulants, barbiturates.

When taken simultaneously with vitamin C, the likelihood of developing salt diathesis increases.

Biseptol can increase the toxic properties of methotrexate and enhance the effect of hypoglycemic agents.

When taking Biseptol and anticoagulants (for example, Warfarin) in combination, prothrombin time may increase. Therefore, it is very important to regularly determine the quality and duration of blood clotting during treatment.

It is not advisable to use Biseptol together with Indomethacin, Amantadine, thiazides, digitalis preparations, tricyclic antidepressants, Phenytoin, Pyremethamine.

Concomitant use with oral contraceptives reduces their effectiveness, which may lead to unplanned pregnancy.

A combination such as Biseptol and Dofetilide is prohibited: it results in the development of serious ventricular arrhythmia.

Trichopolum and Biseptol are often prescribed together for cystitis: it is believed that Biseptol enhances and complements the effect of Metronidazole.

Storage conditions

What is the best way to store Biseptol tablets? It is best to allocate a separate cabinet or closed shelf for the medications, away from heating devices and direct sunlight. The storage room should not be damp (the bathroom is not suitable), nor too hot, since the optimal temperature for preserving tablets is from +18 to +25°C.

Access to the storage area for medications should be restricted for children, mentally unstable people, and elderly people with poor eyesight and memory, who may mistakenly take the wrong medication.

There is no need to put the drug in the refrigerator. In extreme cases (for example, if the room is very hot), the package of Biseptol can be placed on the refrigerator door, on the farthest shelf from the freezer. The medicine cannot be frozen, otherwise it will lose its medicinal properties.

Shelf life

The shelf life of Biseptol is usually indicated on the packaging and on the blister plate. The shelf life is defined as five years.

Analogues of Biseptol for cystitis

Sometimes the question arises of what to replace Biseptol with for cystitis - for example, during pregnancy, or in the presence of other contraindications, or simply in the absence of such a drug in the pharmacy. There is nothing wrong with such a replacement, but you should definitely discuss this issue with your doctor.

Consulting a doctor about changing medication is an adequate and even necessary measure. Self-treatment does not always lead to a positive effect, and during pregnancy it even threatens unfavorable and difficult to predict results.

Often, Biseptol for cystitis is replaced by similar medications:

• Bactrim;
• Biseptrim;
• Bi-sept;
• Oriprim;
• Raseptol;
• Sumetrolim;
• Triseptol;
• Soluseptol;
• Co-trimoxazole;
• Groseptol;
• Biseptazole.

The indicated medications are complete analogues of Biseptol and can be used to treat urological infections.

It is possible to use medications with a completely different composition. For example, the doctor may recommend taking antibiotics (Ampicillin, Amoxicillin, Azithromycin, Erythromycin, Norbactin, Nitroxoline, Fitolizin, Nolitsin, Furangin ), uroseptics, diuretics, etc.

Ofloxacin for 3 to 7 days is as safe and effective as Biseptol for the treatment of uncomplicated cystitis in women. [ 6 ]

A 5-day course of nitrofurantoin is clinically and microbiologically equivalent to a 3-day course of trimethoprim-sulfamethoxazole and should be considered as an effective alternative to a fluoroquinolone for the treatment of acute cystitis in women.[ 7 ]

Ciprofloxacin had similar efficacy when used as Biseptol for 3 days for the treatment of acute, symptomatic, uncomplicated lower urinary tract infection in women.[ 8 ]

Reviews of Biseptol for cystitis

The well-known and time-tested Biseptol tablets have many fans, both from patients and doctors. In the eighties of the last century, this medication was prescribed for almost any inflammatory pathology - in therapy, pediatrics, urology. Today, pharmacies have been replenished with new powerful and effective drugs, but Biseptol is clearly not going to give up its positions - its active use continues today.

Of course, any disease adds problems and worries to a person. But you need to understand that you should never self-medicate, even if the drug is obviously effective and proven. It is better if Biseptol for cystitis is prescribed by a medical specialist - after all, there is a high probability of developing side effects, and there are quite a few contraindications to taking the drug. The attending physician should answer any questions that arise during treatment: this is the only way to achieve complete elimination of the disease.