Furamag for cystitis

Nonspecific (and not only) inflammation of the urinary tract has been treated quite effectively for a long time with drugs belonging to the group of nitrofurans. They are active against most bacteria that infect the lower urinary tract. Resistance to 5-nitrofuran derivatives in pathogenic microorganisms develops slowly and usually does not have time to reach a clinically significant value even after a long course of treatment. And short courses of nitrofurans can be prescribed countless times. The relatively new and often recently prescribed drug furamag for cystitis also represents this drug group. It has some advantages over its predecessors, which relate to a fundamentally new structure of the drug, contributing to its higher bioavailability and expanding the degree of activity, which makes Furamag more effective in the treatment of acute and chronic inflammatory diseases of the bladder.

Indications Furamaga for cystitis

Acute cystitis, of bacterial, fungal, protozoal origin, caused by microorganisms sensitive to the active ingredient of the drug - furazidin. Relief of the condition occurs within 20 minutes after taking the drug, however, this does not mean that the treatment is over, it is necessary to drink the entire course of the drug prescribed by the doctor.

Furamag also helps with chronic cystitis, the duration of the course in this case is a little longer, with frequent relapses, the daily intake of the drug once before bedtime for several months helps to cope.

Furamag is often prescribed for the prevention of cystitis in patients who are to undergo invasive diagnostics of the genitourinary organs, surgery, catheterization, and also for prophylactic purposes after unprotected sex.

Release form

The drug is available as a powder, enclosed in gelatin capsules with a dosage of 25 or 50 mg.

Pharmacodynamics

The powdered contents of the capsule is a compound in equal proportions of soluble furazidin potassium salt and magnesium hydroxycarbonate. The two-component composition prevents the conversion of furazidin into poorly soluble furagin. In addition, the capsule does not dissolve in the stomach, but reaches the small intestine, where dissolution and absorption occurs. Thanks to this, several positive effects are achieved at once. The bioavailability of furazidin increases compared to its other forms (2.5-3 times), which allows you to quickly reach the required concentration in the urine, which ensures the suppression of the activity of pathogenic microorganisms and their death. In addition, the effect of the drug is prolonged, the therapeutically effective dose is halved, and the risk of side effects from the gastrointestinal tract, characteristic of nitrofurans, is minimized. The results of comparative studies of clinical efficacy have shown that Furamag is superior not only to drugs of the nitrofuran class, but also to antibiotics used in urology (ciprofloxacin, amoxicillin / clavulanate, cefazolin, nalidixic acid, and others). Particularly sensitive to the action of Furamag were the causative agents of common nonspecific cystitis in women: E. Coli, fecal enterococcus, saprophytic staphylococcus, other staphylococci, Morgan's proteus and miribilis.

Like other nitrofurans, furazidin binds oxygen molecules, and pathogenic microorganisms experience hypoxia. In the process of treatment, the key stage of cellular respiration of bacteria, the Krebs cycle, suffers. In addition, microbes under the action of the drug stop the synthesis of nucleic acids, which leads to the destruction of their cell membranes, cessation of life and death. As a result of taking the first doses of the drug, the concentration of toxic waste products of microbes decreases almost immediately, and the patient's condition improves significantly. Unlike antibiotics, nitrofurans do not have an immunosuppressive effect, but, on the contrary, stimulate leukopoiesis and, as a result, phagocytosis, which also contributes to the destruction of microorganisms.

Pharmacokinetics

A study comparing the pharmacokinetics of furazidin derivatives - furamag and furagin showed that the concentration of the active substance in the urine is much higher (5-6 times) after using the furamag capsule than in the case of taking the furagin tablet, that is, the bacteriostatic / bactericidal effects are more powerful in the first drug. The dosage of the active substance in both preparations was the same. This is due to the fact that the capsule dissolves in the small intestine, its contents do not come into contact with the acid in the stomach and do not turn into the sparingly soluble furagin.

Passive diffuse absorption increases as the drug moves through the small intestine and occurs most intensively in the distal section. Absorption almost does not occur in the large intestine.

A high clinically significant concentration of furazidin is found in the lymph, which prevents the spread of infection by the lymphogenous route, a good one in the bile, and a lower one in the blood plasma, saliva and cerebrospinal fluid. The highest content of the active substance is in the urine, where it reaches a maximum after three to four hours from the moment of taking the drug. In the blood plasma, the highest content can be stored for 3-8 hours. The absorption of furamag is increased if taken after a meal.

Excreted by the kidneys up to 85%, the rest is metabolized in the liver. With violations of the excretory function of the kidneys, the metabolic process occurs more intensively.

Dosing and administration

Furamag with cystitis for adults is prescribed by a doctor, depending on the form and stage of the disease. The standard single dose recommended for adult patients is from 50 to 100 mg of the drug. Multiplicity of reception - three times a day after meals. To avoid overdose, the daily dose should not exceed 300 mg and do not take a double dose to compensate for missed doses.

For children whose weight does not exceed 30 kg, that is, from three to ten years of age, the daily dose is calculated according to the proportion of 5 mg per kilogram of weight. The result is divided into three steps.

Children weighing more than 30 kg (approximately older than ten years) are given 50 mg three times a day.

The standard duration of treatment is five to ten days. After taking a ten-day or two-week break, you can, if necessary, and after agreeing with your doctor, repeat taking the drug.

After treatment of chronic recurrent cystitis, in order to prevent exacerbations, a long course (3-6 months) of a third to a quarter of the daily dose once a day at bedtime is prescribed.

For preventive purposes, to prevent the development of cystitis due to surgical and other invasive interventions, a single dose for adult patients is 50 mg, for children - 25 mg three times a day.

When taking the drug should be well washed down with water.

Furamag capsules have very good reviews for cystitis. They are recommended for adult patients as a means of first aid and emergency. However, it should be noted that instant relief does not mean that the disease has passed. You must complete the course. Furamag is especially relevant for cystitis in women. The anatomical features of the external female genital organs make the weaker sex predisposed to frequent nonspecific cystitis. In this case, the drug of choice is Furamag.

In men, cystitis is usually caused by specific infections and requires different treatment. In addition, clinical studies have shown that drugs of the nitrofuran group can affect the quality and quantity of sperm produced, reduce sperm motility and lead to pathomorphological changes in them. Therefore, although there are no direct contraindications to the use of furamag in men, they should not be treated unless absolutely necessary.

• Application for children

Based on clinical experience, in pediatric practice, the use of the drug for the treatment of infants who are already one full month old is allowed. Low toxicity and the practical absence of common side effects of nitrofurans make Furamag the drug of choice for the treatment of children.

The official instructions stipulate the age of admission - from three years.

Use Furamaga for cystitis during pregnancy

Furazidin derivatives, including furamag, are not certified for risks during pregnancy, since no authoritative studies have been conducted for this contingent. There is no evidence that it is safe for expectant mothers and during lactation. It is compared to certified nitrofurantoin (furadonin), which belongs to the same class, has similar properties and is used in the same cases. It is believed that the drug is safe until the 38th week of pregnancy, and in later weeks it is not recommended due to the possible development of hemolytic jaundice in the newborn. Also, by analogy with nitrofurantoin, furamag, in exceptional cases, is allowed to be used to treat cystitis in nursing mothers.

Considering that such recommendations are not based on serious research data, one should be very careful when treating these categories of the population with furamag.

The official instructions do not recommend taking the drug to pregnant and lactating women.

Contraindications

Permanent: a history of allergic reactions to drugs of the nitrofuran class, directly to furazidin and auxiliary components of the drug.

Severe form of liver and kidney dysfunction (creatinine clearance ˂30 ml/s).

Porphyria, G6PD deficiency, polyneuropathy of any etiology.

A temporary contraindication is hemodialysis at any age, urosepsis, lung disease, iron deficiency and B-deficiency anemia, infections of the kidney parenchyma.

Side effects Furamaga for cystitis

Allergic reactions of all kinds from the banal small itchy urticaria to Quincke's edema.

Gastrointestinal disorders, the most typical consequences of treatment with drugs of the nitrofuran group, which occur in about 50% of cases, occur ten times less often from furamag (5%), however, this possibility is not excluded.

Hemopoiesis disorders, drowsiness, headache, slight hypertension, low-grade fever, dizziness, local peripheral and generalized neuritis and neuralgia, visual impairment, hearing impairment, hoarseness, reversible alopecia, myalgia and arthralgia may occur.

Respiratory effects are most often manifested by hypersensitivity of the lungs. The reaction can be acute when the drug is first taken. Its symptoms are fever, cough, chest pain, shortness of breath along with skin allergic manifestations - rash, itching, swelling, redness. This increases the number of eosinophils in the blood. Chronic reactions proceed with smoother symptoms and develop gradually after prolonged use of the drug, sometimes at the end of the course of treatment. If ignored, their symptoms can lead to pneumonia or pulmonary fibrosis.

Undesirable effects from the hepatobiliary system may develop.

All side effects are reversible and disappear after discontinuation of the drug. With the development of neuropathies and for their prevention, it is recommended to take vitamins of group B in parallel.

Overdose

The symptomatology of exceeding the dose is characterized by the clinical picture of neurointoxication - uncoordinated movements, trembling of the limbs.

Help with overdose includes immediate withdrawal of the drug, drinking plenty of fluids. In acute intoxication, you can take antiallergic drugs and B vitamins to stabilize the nervous system.

Interactions with other drugs

Drugs that oxidize urine (vitamin C, calcium chloride and others) increase the concentration of furazidin in the urine, increasing the effectiveness of treatment and at the same time the risk of increasing side effects. Medications that alkalinize urine neutralize the therapeutic effect of the drug, as they accelerate its elimination in the urine.

An increase in side effects on the part of hematopoiesis (oppression) is observed when furamag is combined with drugs from the sulfonamide group and antibiotics chloramphenicol and ristomycin.

In laboratory studies, it was found that it is not worth combining this drug with other urological antibiotics of the fluoroquinolone class, since they mutually counteract each other.

Simultaneous use with sulfinpyrazone and probenecid reduces the rate of elimination of furazidin and increases the risk of toxic effects, and with antacids, which include magnesium, reduces the absorption of the active substance furamaga from the small intestine.

Patients with renal dysfunction should not be given Furamag in combination with antibiotics of the aminoglycoside class.

Furamag is well combined with penicillins and cephalosporins (mutual enhancement of action), it can also be combined with erythromycin and tetracycline.

In the process of treatment with nitrofurans, it is forbidden to drink alcohol-containing drinks and medicinal tinctures.

During the period of treatment with furamag, it is not necessary to conduct a urine test for glucose by the copper reduction method - the result may be false positive.

The storage conditions of the drug specified by the manufacturer should be observed: store at room temperature no more than 25℃ in places protected from direct sunlight and inaccessible to children and animals. You should also pay attention to the expiration date indicated on the package. After this period, the drug can not be used.

Analogues

There are many drugs. What is best for cystitis? The answer depends on what caused the inflammation. Patients with cystitis do urine culture for bacterial flora, however, the result is not immediately known, therefore, treatment with a drug with a wide spectrum of action is prescribed, and then, after receiving the analysis, the appointment can be adjusted.

So, furamag or furadonin. Both drugs have the same spectrum of action and are used in the same cases. Furamag has some features that make it more effective (described above). Therefore, if there are no other reasons, for example, intolerance to the auxiliary components of the contents of the capsule or the active substance - furazidin, preference should be given to a more effective drug.

The same applies to the choice - furagin or furamag, especially since the active substance of the drugs is the same. But the soluble form gives furagin great advantages, in particular, it is taken in a smaller dose with the same effect.

Furamag or nolicin. The first is an antimicrobial drug, the second is an antibiotic from the group of fluoroquinolones. In comparative studies, as mentioned above, furamag with nonspecific cystitis showed higher efficacy than fluoroquinolones. In addition, antibiotics of this group have many side effects. For example, they are forbidden to people with a tendency to epileptiform seizures.

The same applies to the choice - furamag or monural. The second drug is used once, maximum two. This is great, but each of the drugs has a spectrum of action, and each patient has an individual tolerance. Therefore, the question of choice is primarily a question of tolerability and effectiveness of treatment. It is best dealt with in consultation with your doctor.

Furamag reviews are very good. It just seems that it is often used not quite correctly, once or twice, the symptoms have been removed - and that's it. Such self-treatment is fraught with a chronic process. To provide yourself with an ambulance and alleviate the condition is good, but even better is to pass, albeit later, an analysis for the pathogen, cure cystitis completely and forget about it.