L-Flox

L-Flox is an antimicrobial drug that has a broad spectrum of action. The action of the drug is aimed at the destruction of the cellular structure of bacteria, enzymes - isomerases (affecting the structure of DNA) and DNA gyrase.

It is prohibited to use L-Flox in childhood and adolescence, since the drug can damage cartilaginous joints. When treating elderly people, it is necessary to take into account that kidney function may be impaired. When treating with this drug, after the body temperature becomes normal, the drug is taken for another 2-3 days. During treatment with L-Flox, it is necessary to avoid sunlight (damage to the skin due to photosensitivity is possible). It is also worth paying attention to the patient's medical history, since brain injuries (stroke, neurotrauma) can lead to convulsive syndrome.

When taking the drug, it is forbidden to drink alcohol in any form, in addition, the drug greatly affects the reaction rate, therefore, when treating with L-Flox, it is forbidden to drive vehicles and other mechanisms that require increased attention and speed.

L-Flox should be taken only as prescribed by a doctor and under his strict supervision.

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Indications L-Flox

L-Flox is prescribed for infections caused by microorganisms that are sensitive to the active substance included in the drug. Such diseases include acute sinusitis, otitis, sinusitis (all diseases of the ENT organs), pneumonia, bronchitis (diseases of the upper and lower respiratory tract), prostatitis, pyelonephritis in the acute stage (diseases of the genitourinary system), lesions of soft tissues and skin. The active substance of the drug is levofloxacin, an antibiotic that has a detrimental effect on bacteria and stops their further development. It is necessary to remember that excessive or prolonged use of L-Flox may lead to a decrease in effectiveness.

Release form

L-Flox for intravenous administration is available in special 100 ml ampoules, one ampoule contains 500 mg of the main active ingredient.

The oral form is available as tablets coated with a yellowish shell. One tablet contains a standard dose of 250 or 500 mg of the active substance.

Pharmacodynamics

The main active ingredient of L-Flox is levofloxacin, an antimicrobial synthetic drug belonging to the fluoroquinolone group. The main action of the antimicrobial agent is aimed at the DNA gyrase complex and isomerase enzymes. As a rule, there is no cross-resistance between the active ingredient of L-Flox and other groups of antimicrobial agents.

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Pharmacokinetics

L-Flox has a good ability to penetrate into the intercellular and intracellular fluids, due to which a high concentration of the drug is observed after administration. The drug is well absorbed from the gastrointestinal tract, the maximum content of the active substance in the blood is observed 2 - 3 hours after administration.

It is excreted mainly by the kidneys, 87% of the drug is excreted in the urine, due to which a large amount of the drug accumulates in the genitourinary system. The drug is partially excreted by the gallbladder. From 3 to 15% of the drug is excreted with feces.

Impaired liver function does not require additional adjustment of the drug dosage, and this also applies to reduced creatinine clearance.

There is no significant difference between intravenous administration of the drug and oral administration. Intravenous administration leads to accumulation of the drug in the bronchial mucosa, bronchial secretion of the lung tissue, and urine. The active substance enters the cerebrospinal fluid in very small doses.

In patients with renal insufficiency, the excretion of the drug is reduced and the half-life is increased.

The use of L-Flox in young and old age does not have any special differences, except for cases related to the elimination of creatinine.

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Dosing and administration

L-Flox is usually prescribed at 500 mg per day. The drug should be taken before meals, the course of treatment is usually two weeks (without breaks).

Intravenous administration of the drug is carried out no later than 3 hours after opening the bottle, to prevent bacterial contamination). The dose of the drug is prescribed individually, depending on the patient's condition, severity of the disease, type of microorganisms. The solution is administered by drip method, very slowly. It is necessary to administer a 100 ml bottle (containing 500 mg of the active substance) for at least an hour. When administered intravenously, it is extremely important to monitor the patient's reaction to the drug; after a few days, you can switch to oral administration of the drug in the same dosage.

In case of severe infection, the dosage of the drug may be increased (only for intravenous administration). For patients with impaired renal function, the dosage of the drug should be reduced. In old age (if there are no renal disorders), in case of liver failure, adjustment of the dosage of L-Flox is not required.

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Use L-Flox during pregnancy

L-Flox is strictly prohibited during pregnancy and for women who are breastfeeding. There have been few studies in this area, there is a possibility that the drug can damage the cartilage joint in a new growing organism.

If a woman discovers that she is pregnant while taking L-Flox, she should immediately inform her doctor.

Contraindications

L-Flox is contraindicated in case of individual intolerance to levofloxacin or other drugs of the quinolone group. Also, the drug is not prescribed if epileptic seizures have occurred previously. L-Flox is not prescribed to patients who have previously experienced side effects after taking quinolones.

L-Flox is not prescribed for children and adolescents.

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Side effects L-Flox

Taking L-Flox may cause nausea, burning in the upper abdomen, skin rashes, headache, decreased vision, tremors, convulsions, candidiasis. The drug affects the nervous system, which may lead to impaired coordination of movements.

In very rare cases, the drug provokes anorexia, hypoglycemia (especially in patients who suffer from diabetes).

Anaphylactic shock may occur from the immune system, the frequency of such reactions is unknown.

Mental disorders are possible - insomnia, nervousness. In very rare cases, depression, confusion, anxiety, hallucinations, self-destructive behavior (suicidal thoughts) are observed.

L-Phlox can affect the nervous system, causing a person to feel dizzy, have a headache, and feel sleepy. In very rare cases, a disorder or loss of taste, impaired sense of smell (also complete lack of sense of smell), and hearing loss (ringing in the ears) develop.

Cardiac disorders are possible: tachycardia. The drug can also provoke bronchospasms, in very rare cases allergic pneumonitis develops.

Possible digestive system disorders: nausea, diarrhea, abdominal pain, bloating, constipation.

After the first dose or over time, a mucocutaneous reaction to the drug may develop. Musculoskeletal disorders (tendon damage, myalgia, etc.) are possible. In rare cases, the drug provokes tendon rupture, such a reaction develops within 48 hours from the moment of taking the first dose. Muscle weakness is possible.

L-Flox may increase serum creatinine levels, and in very rare cases, renal failure may develop.

Other adverse reactions to L-Flox may include hypersensitivity vasculitis, various coordination disorders, and attacks of porphyria in patients who have this disease (one of the genetic liver pathologies).

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Overdose

The most significant symptoms of an overdose of L-Flox are loss of consciousness, convulsions, and dizziness. Clinical studies show that an overdose of the drug leads to an increase in the QT interval on the ECG (heart rhythm disturbance, gastric tachycardia). In case of an overdose, the patient's condition should be closely monitored, in particular, cardiac activity should be monitored. Symptomatic treatment is carried out in case of overdose. Currently, there are no special antidotes for removing levofloxacin from the body; peritoneal dialysis or detoxification will not have a sufficiently effective result.

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Interactions with other drugs

When the drug L-Flox interacts with non-steroidal anti-inflammatory drugs (theophylline, fenbufen), a decrease in seizures is observed, while the concentration of levofloxacin increases by 13%.

Cimetidine and probenecid affect the excretion of the active substance of L-Flox. The excretory function of the kidneys with cimetidine decreases by 24%, with probenecid by 34%. This is due to the fact that these two drugs block the tubular secretion of levofloxacin. It is necessary to use levofloxacin and drugs that affect the transport of substances from the blood to the urine (tubular lumen), such as probenecid or cimetidine, at the same time with extreme caution, especially in patients with renal insufficiency.

Calcium carbonate, digoxin, glibenclamide, and ranitidine do not have clinically significant effects on concomitant administration with levofloxacin.

L-Flox affects the elimination of cyclosporine from the body, the half-life is 33% longer.

Taking the drug simultaneously with vitamin K antagonists (warfarin, etc.) may provoke bleeding or increase coagulation tests. Therefore, patients who take vitamin K antagonists in parallel with L-Flox need to monitor coagulation indicators.

L-Flox should be used with caution in patients taking drugs that increase the QT interval (class IA, III drugs, macrolides, tricyclic antidepressants).

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Storage conditions

L-Flox should be stored in a place well protected from sunlight and moisture, at room temperature (up to 250C). The drug should be stored out of the reach of small children. The drug should not be frozen.

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Shelf life

L-Phlox can be stored for two years, provided that all storage conditions are met.