Furamag for cystitis

Non-specific (and not only) inflammations of the urinary tract have long been effectively treated with drugs belonging to the nitrofuran group. They are active against most bacteria infecting the lower parts of the urinary tract. Resistance to 5-nitrofuran derivatives in pathogenic microorganisms develops slowly and usually does not have time to reach clinically significant value even during a long course of treatment. And nitrofurans can be prescribed in short courses countless times. A relatively new and frequently prescribed drug Furamag for cystitis also represents this drug group. It has some advantages over its predecessors, which concern 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, bacterial, fungal, protozoal origin, caused by microorganisms sensitive to the active ingredient of the drug - furazidine. 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, 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 preventive purposes after unprotected sex.

Release form

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

Pharmacodynamics

The powdered contents of the capsule are a compound of soluble furazidin potassium salt and magnesium hydroxycarbonate in equal proportions. 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 occur. Due to this, several positive effects are achieved at once. The bioavailability of furazidin increases compared to its other forms (by 2.5-3 times), which allows you to quickly achieve 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, typical of nitrofurans, is minimized. The results of comparative studies of clinical efficacy have shown that Furamag is superior to not only nitrofuran class drugs, but also antibiotics used in urology (ciprofloxacin, amoxicillin/clavulanate, cefazolin, nalidixic acid, etc.). The causative agents of common non-specific cystitis in women were especially sensitive to the action of Furamag: Escherichia coli, Enterococcus faecalis, Staphylococcus saprophyticus, other staphylococci, Morgan's proteus and myribilis.

Like other nitrofurans, furazidin binds oxygen molecules, and pathogenic microorganisms experience hypoxia. During the treatment, the key stage of bacterial cellular respiration, the Krebs cycle, suffers. In addition, under the influence of the drug, microbes stop synthesizing nucleic acids, which leads to the destruction of their cell membranes, cessation of vital activity and death. As a result of taking the first doses of the drug, the concentration of toxic products of microbes' vital activity 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 urine is much higher (5-6 times) after taking a furamag capsule than in the case of taking a furagin tablet, i.e. the bacteriostatic/bactericidal effects are more powerful in the first drug. The dosage of the active substance in both drugs 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 poorly soluble furagin.

Passive diffuse absorption increases as the drug moves through the small intestine and is most intense in the distal section. In the large intestine, absorption almost does not occur.

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 bile, a lower one in blood plasma, saliva and cerebrospinal fluid. The highest content of the active substance is found in urine, where it reaches a maximum three to four hours after taking the drug. In blood plasma, the highest content can remain for 3-8 hours. Absorption of furamag increases if taken after meals.

Up to 85% is excreted by the kidneys, the rest is metabolized in the liver. In case of kidney excretory function disorders, the metabolic process is more intensive.

Dosing and administration

Furamag for cystitis in 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. The frequency of administration is three times a day after meals. To avoid overdose, the daily dose should not exceed 300 mg and you cannot take a double dose to compensate for a missed dose.

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

Children weighing over 30 kg (approximately over ten years of age) are given 50 mg three times a day.

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

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

For prophylactic 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, you should wash it down with plenty of water.

Furamag capsules have very good reviews for cystitis. They are recommended for adult patients as a means of first and emergency aid. However, it should be taken into account that instant relief does not mean that the disease has passed. It is necessary to complete the prescribed course. Furamag is especially relevant for cystitis in women. Anatomical features of the external female genitalia make the weaker sex predisposed to frequent non-specific 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 nitrofuran drugs can affect the quality and quantity of sperm produced, reduce sperm motility and lead to pathomorphological changes in them. Therefore, although there is no direct contraindication to the use of Furamag in men, it should not be treated without extreme necessity.

• Application for children

Based on clinical experience, in pediatric practice, the drug can be used to treat infants who are already one full month old. Low toxicity and the virtual absence of common side effects of nitrofurans make Furamag the drug of choice for treating children.

The official instructions specify the age of admission as 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 data that it is safe for expectant mothers and during lactation. It is compared with 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 up to 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 is allowed to be used in exceptional cases to treat cystitis in nursing mothers.

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

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

Contraindications

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

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

Porphyria, G6PD deficiency, polyneuropathy of any etiology.

Temporary contraindications include hemodialysis at any age, urosepsis, lung diseases, iron deficiency and B-deficiency anemia, and renal parenchyma infections.

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 nitrofuran drugs, occurring in approximately 50% of cases, occur ten times less frequently (5%) with Furamag; however, this possibility cannot be ruled out.

Hematopoiesis disorders, drowsiness, headache, mild hypertension, subfebrile temperature, dizziness, local peripheral and generalized neuritis and neuralgia, visual and hearing impairment, hoarseness, reversible baldness, 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. The number of eosinophils in the blood increases. Chronic reactions occur with more subtle symptoms and develop gradually after prolonged use of the drug, sometimes at the end of the course of treatment. If their symptoms are ignored, they can lead to pneumonia or pulmonary fibrosis.

Undesirable effects from the hepatobiliary system may develop.

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

Overdose

Symptoms of overdose are characterized by a clinical picture of neurointoxication - lack of coordination of movements, trembling of the limbs.

Overdose assistance includes immediate discontinuation of the drug, drinking plenty of fluids. In acute intoxication, antiallergic drugs and B vitamins can be taken to stabilize the nervous system.

Interactions with other drugs

Medicines that oxidize urine (vitamin C, calcium chloride, etc.) increase the concentration of furazidin in urine, increasing the effectiveness of treatment and at the same time the risk of increased side effects. Medicines that alkalize urine neutralize the therapeutic effect of the drug, since they accelerate its elimination with urine.

Increased side effects from hematopoiesis (inhibition) are observed with a combination of furamag with drugs from the sulfonamide group and the antibiotics chloramphenicol and ristomycin.

Laboratory studies have shown that this drug should not be combined with other urological antibiotics of the fluoroquinolone class, since they mutually counteract each other.

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

Patients with renal dysfunction should not be prescribed furamag in combination with aminoglycoside antibiotics.

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

During treatment with nitrofurans, it is prohibited to consume alcoholic beverages and medicinal tinctures.

During treatment with Furamag, you should not test your urine for glucose using 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 higher than 25℃ in places protected from direct sunlight and inaccessible to children and animals. It is also worth paying attention to the expiration date indicated on the package. After this period, the drug cannot be used.

Analogues

There are many drugs. What is better for cystitis? The answer depends on what caused the inflammation. Patients with cystitis undergo urine culture for bacterial flora, however, the result is not immediately known, so treatment is prescribed with a drug with a broad spectrum of action, and then, after receiving the analysis, the prescription 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 capsule contents or the active substance - furazidin, preference should be given to the 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 Nolitsin. The first is an antimicrobial drug, the second is an antibiotic from the fluoroquinolone group. In comparative studies, as mentioned above, Furamag was more effective than fluoroquinolones in treating non-specific cystitis. In addition, antibiotics of this group have many side effects. For example, they are prohibited for people with a tendency to epileptiform seizures.

The same applies to the choice - Furamag or Monural. The second drug is used once, maximum twice. This is great, but each drug has a spectrum of action, and each patient has individual tolerance. Therefore, the question of choice is, first of all, a question of tolerance and effectiveness of treatment. It is best to decide this together with the attending physician.

Reviews of Furamag are very good. It just seems that it is often used incorrectly, once or twice, the symptoms are removed - and that's it. Such self-medication is fraught with chronicity of the process. It is good to provide yourself with first aid and alleviate the condition, but it is even better to take, albeit later, a test for the pathogen, cure cystitis completely and forget about it.