Furadonin Avexima tablets 100 mg N20 Irbitsky Chemical Pharmaceutical Plant OJSC - Russia in pharmacies in the city of Ekaterinburg

Release form and composition

The dosage form of Furadonin Avexim is tablets: flat-cylindrical, yellow or yellow with a greenish tint (in a cardboard pack there are 1–5 blister/cellless packages of 10 tablets; 1 blister pack or 1 jar of 20 tablets).

Composition of 1 tablet:

• active substance: furadonin (nitrofurantoin) – 50 or 100 mg;
• auxiliary components (50/100 mg): aerosil – 2/4 mg; potato starch – 46.15/92.3 mg; stearic acid – 1/2 mg; polysorbate 80 – 0.85/1.7 mg.

Pharmacological properties

Pharmacodynamics

Furadonin Avexima is one of the antimicrobial agents from the nitrofuran group; used primarily to treat urinary tract infections. Nitrofurantoin disrupts protein synthesis in bacteria and cell membrane permeability.

In small doses the substance has a bacteriostatic effect, in large doses it has a bactericidal effect.

Effective against gram-positive/gram-negative bacteria, including Proteus spp., Escherichia coli, Streptococcus spp., Staphylococcus spp., Shigella flexneri, Shigella dysenteriae, Shigella sonnei, Shigella boydii.

Acinetobacter spp., Pseudomonas cepacia, Pseudomonas aeruginosa, Providencia spp. are resistant to nitrofurantoin.

The drug is not used in the treatment of urinary tract infections caused by mycoplasmas, chlamydia, and gonococci.

Pharmacokinetics

Nitrofurantoin is well absorbed from the gastrointestinal tract. Bioavailability is 50%; food intake increases bioavailability. The rate of absorption depends on the size of the crystals - the microcrystalline form is characterized by rapid solubility and absorption rate, a short time to reach Cmax (maximum concentration of the substance) in the urine.

The connection with blood plasma proteins is 60%. Penetrates the blood-brain barrier, the placenta, and is excreted in breast milk. Effective therapeutic concentrations are achieved in the urinary tract rather than in tissues and blood.

Metabolism occurs in muscle tissue and liver.

T1/2 (half-life) is in the range of 20–25 minutes. Completely excreted by the kidneys (unchanged - from 30 to 50%).

With impaired renal function, T1/2 and plasma concentrations of nitrofurantoin in the blood increase. When creatinine clearance is less than 60 ml/min, the therapeutic concentration of the substance in the urine is not achieved, accumulation of nitrofurantoin and an increased likelihood of toxicity are possible.

Nitrofurantoin exhibits greater activity in acidic urine. When urine pH is above 8, Furadonin Avexima loses its bactericidal activity.

Indications for use

According to the instructions, Furadonin Avexima is prescribed for bacterial urinary tract infections caused by microorganisms sensitive to the action of nitrofurantoin:

• severe complicated recurrent infections;
• acute uncomplicated infections;
• urinary tract infections, including for uncomplicated chronic diseases and urological operations/examinations - cystoscopy, catheterization of the urinary tract, etc. (for preventive purposes).

Features of the drug

Furadonin Avexima gradually penetrates the liver and muscle cells. The half-life is at least 25 minutes. The drug is able to penetrate to the unborn child through the placenta. The drug is excreted from the body by the kidneys.

What does Furadonin Avexima help with? There are the following indications for using the medicine:

• the patient has a bacterial infection of the urinary system. Such diseases include cystitis, pyelonephritis, inflammation of the urethra;
• Furadonin Avexim tablets are also used for preventive purposes. They are used in various urological operations.

The medication is also used during various medical procedures. An inexpensive remedy for cystitis is produced in various dosage forms:

• suspension;
• pills;
• powder intended for the preparation of a medicinal solution.

Tablets for oral administration are coated, dissolving in the intestinal area. One package may contain a different number of tablets. Their number varies from 10 to 50.

Contraindications

Absolute:

• chronic renal failure;
• heart failure stage II–III;
• deficiency of glucose-6-phosphate dehydrogenase;
• chronic hepatitis;
• cirrhosis of the liver;
• acute porphyria;
• oliguria, anuria;
• polyneuropathy/neuritis;
• pulmonary fibrosis;
• pregnancy and lactation;
• age up to 3 or 12 years (for tablets 50 or 100 mg, respectively);
• individual intolerance to the components of the drug.

Relative (Furadonin Avexima is prescribed under medical supervision):

• diabetes;
• electrolyte imbalance;
• anemia;
• liver function failure;
• deficiency of B vitamins;
• tendency to the appearance of peripheral neuropathies (itching of legs, hands, numbness);
• lung diseases.

How to take it correctly

The antimicrobial drug is well absorbed by the liver. After entering the body, the active substance begins to act within 3–4 hours. The tablets must be washed down with a significant amount of water. The medicine should be taken after meals, thus significantly increasing the effectiveness of the active component of the drug.

The drug is used for children in the form of a suspension.

The tablets have an unpleasant bitter taste, so it is not recommended to take them in crushed form. For ease of treatment, Furadonin Avexima is available in the form of a suspension with a measuring cup and spoon, which is convenient to give to a child. For maximum results of antimicrobial therapy, Furadonin should be taken at the same time.

The antibacterial effect depends on the dosage, which is calculated based on the form of bladder inflammation and the age of the patient. When prescribing medication, they are also guided by the patient’s weight. The approximate amount of a single dose should be approximately 6–8 mg of the active component per 1 kg of body weight.

For acute and chronic cystitis, Furadonin Avexima is taken in different ways, the duration of use and dosage of the medicine is determined by the attending physician. The therapeutic effect of nitrofurantoin begins to appear 2-3 days after the start of administration. The tablets are taken at the same time; if missed, you can take the next dose at the scheduled time.

When the symptoms of cystitis are alleviated, treatment is not interrupted; the course of taking the drug must be completed completely. For children, an antimicrobial agent can be prescribed from the age of one month.

Treatment with Furadonin in most cases occurs without complications, the substance is quite well tolerated by patients. The most common complaints are headaches, dizziness, and nausea. To avoid dyspeptic reactions, it is not recommended to take the medicine on an empty stomach; it may irritate the mucous membrane.

The antibacterial effect of the antibiotic is reduced in alkaline urine. Medications that increase urine pH are used for urolithiasis. These include: Blemaren, Uronefron, Rovatinex, Uralit-U.

Uronephron

The use of an antimicrobial drug has its own characteristics:

• When taking the medicine by patients with a deficiency of B vitamins, suffering from diabetes mellitus, anemia, peripheral neuropathy may develop.
• The medicine is not used for the treatment of prostatitis, with purulent inflammation of the perinephric tissue.
• Nitrofuran should not be taken together with medications that affect renal function.

In case of overdose, vomiting may occur. To detoxify the body, dialysis is performed and large amounts of fluids are consumed.

In the absence of antibacterial action, as directed by a doctor, nitrofurantoin is replaced with another medication. The drug is metabolized in the liver, so during treatment it is prohibited to drink alcoholic beverages.

Instructions for use of Furadonin Avexim: method and dosage

Furadonin Avexima is taken orally with plenty of water.

Recommended application:

• adults: 100–150 mg 3–4 times a day; maximum single dose – 300 mg, daily dose – 600 mg;
• children: 5–8 mg/kg per day in 4 divided doses. Children 3–12 years old are prescribed Furadonin Avexima 50 mg tablets.

The duration of treatment for acute urinary tract infections is from 7 to 10 days.

It is necessary to take into account that the symptoms of the disease may disappear before the infection is cured, and if therapy with Furadonin Avexima is stopped, the disease may worsen again.

If nausea occurs, reduce the dose or stop taking the drug.

Preventive, anti-relapse therapy with Furadonin Avexim is carried out from 3 to 12 months (depending on the nature of the disease). In such cases, the daily dose is 1–2 mg/kg.

Usage diagram

The following question is logical: how to take Furadonin Avexima? The instructions included with the medicine say that it should be taken with a sufficient amount of water. The product should be drunk after meals. The tablets have a bitter taste, so they do not need to be chewed.

The recommended daily dosage for children is 0.3 g, for adult patients - 0.6 g. The drug must be taken three times a day. The optimal single dose is one or two tablets of Furadonin Avexim.

In case of acute urological diseases, you should take the drug for at least a week. If during this period the patient’s well-being does not improve, further treatment with this medication should be discontinued.

The drug Furadonin Avexima is also used for chronic cystitis in children. The drug is prescribed at the rate of 5 mg per 1 kg of child weight. The recommended dosage of the drug should be divided into several doses. When using tablets for preventive purposes, you should be guided by the following proportion: 1 mg per 1 kg of child weight per day.

Furadonin Avexima is excellent for cystitis. Therefore, it is used to treat both acute and chronic forms of pathology.

Side effects

Possible adverse reactions (> 10% - very common; > 1% and < 10% - often; > 0.1% and < 1% - uncommon; > 0.01% and < 0.1% - rare; < 0. 01% – very rarely; with uncertain frequency – in cases where it is impossible to determine the frequency of occurrence of violations):

• immune system: very rarely - lupus-like syndrome (in the form of rash, eosinophilia, fever, arthralgia, while an increase in two or more parameters is observed in the blood serum - antinuclear antibodies, antibodies to the glomerular basement membrane or smooth muscle and Coombs' reaction); in some cases - anaphylaxis, angioedema, autoimmune reactions that are associated with chronic changes in the liver/lungs;
• respiratory system: very rarely - acute/chronic reactions of pulmonary hypersensitivity (in the form of fever, eosinophilia, cough, chest pain, shortness of breath), pleurisy, broncho-obstructive syndrome, interstitial changes in the lungs; pulmonary infiltration or compactions and pleural effusion may appear within several hours or days after starting to take Furadonin Avexim; after discontinuation of therapy, they usually resolve; with prolonged therapy, acute/subacute pulmonary symptoms may unnoticed, including pulmonary fibrosis; fibrosis may be irreversible, especially if the drug is not discontinued after the onset of symptoms;
• nervous system: often – headache; rarely - increased intracranial pressure; with an unknown frequency - drowsiness, dizziness, nystagmus, asthenia, peripheral polyneuropathy (including optic neuritis, the first symptoms manifest themselves as a burning sensation/numbness in the legs, muscle weakness);
• digestive system: often – vomiting, nausea, lack of appetite; rarely - pancreatitis, inflammation of the salivary glands, diarrhea, abdominal pain;
• infectious/parasitic diseases: with an unknown frequency - superinfection of the genitourinary tract (most often caused by Pseudomonas aeruginosa or Candida spp.), pseudomembranous colitis;
• genitals/breast: very rarely – transient disorder of spermatogenesis;
• blood/lymphatic system: rarely - thrombocytopenia, leukopenia, megaloblastic anemia, agranulocytosis or granulocytopenia, hemolytic anemia due to glucose-6-phosphate dehydrogenase deficiency;
• skin/subcutaneous tissues: often – allergic reactions (in the form of skin rashes, urticaria, itching); very rarely - erythema multiforme, exfoliative dermatitis;
• liver/biliary tract: rarely – cholestatic jaundice, hepatitis (violations are dose-independent and disappear after discontinuation of the drug);
• others: rarely – hair loss (reversible), joint pain.

special instructions

When taking Furadonin Avexim with food and liquid in large quantities, the frequency of adverse reactions from the digestive system decreases.

If the first signs of peripheral neuropathy (development of paresthesia) appear, Furadonin Avexim is discontinued, since this complication can be life-threatening. Also, discontinuation of the drug is required if hepatitis develops, blood disorders occur, or the first reactions of increased sensitivity of the lungs appear.

Furadonin Avexima should not be used to treat prostatitis, purulent paranephritis and diseases of the renal cortex. Also, the drug is not prescribed for the treatment of pyelonephritis, which is accompanied by perirenal inflammation or inflammation of parenchymal tissue.

Nitrofurantoin may turn your urine brown or dark yellow.

With prolonged therapy, it is necessary to monitor pulmonary function (especially in elderly patients in whom pulmonary function may deteriorate) and liver function.

The therapeutic concentration of nitrofurantoin in urine is not achieved when creatinine clearance is less than 60 ml/min. This increases the risk of toxicity and accumulation of the active substance.

If signs of hemolysis appear in patients with suspected glucose-6-phosphate dehydrogenase deficiency, treatment with Furadonin Avexim is discontinued.

You should not drink alcoholic beverages during treatment.

Combined use with drugs that cause renal dysfunction is not recommended.

During therapy, false positive reactions may be observed when determining glucose in urine.

Taking Furadonin Avexim can lead to the emergence of resistant microorganisms.

Impact on the ability to drive vehicles and complex mechanisms

During the period of treatment with Furadonin Avexim, patients should be careful when driving vehicles, which is associated with the likelihood of developing adverse reactions from the nervous system.

Symptoms of inflammation

Inflammation of the bladder is characterized by frequent urination. The patient experiences a burning sensation in the pubic area and pain in the lumbar region. Bloody impurities are often present in the urine.

If a patient has acute inflammation of the bladder, the body temperature often rises. Pain sensations spread to the pelvic organs.

Inflammation of the bladder usually occurs due to the following reasons:

1. Hypothermia.
2. Wearing tight underwear that restricts movement.
3. Decreased immunity.
4. Emotional fatigue.
5. Sedentary lifestyle.

In the presence of acute cystitis, urgent measures are usually taken: the patient is prescribed antibiotics and antimicrobial agents. In addition, for inflammation of the bladder, folk remedies (decoctions based on chamomile or calendula) and physiotherapeutic procedures are used. Severe pain that occurs with cystitis is relieved with painkillers.

Drug interactions

Possible interactions:

• sulfinpyrazone, probenecid (drugs that promote the excretion of uric acid and block tubular secretion): the concentration of nitrofurantoin in the urine decreases, and in the blood increases (leads to a decrease in the antibacterial effect and an increase in toxicity);
• adsorbents and antacids: absorption of nitrofurantoin is reduced;
• drugs that increase urine pH: the antibacterial effect of nitrofurantoin in an alkaline environment is reduced, the combination is not recommended;
• drugs of the quinolone group (fluoroquinolones, nalidixic acid): their antibacterial effect decreases; Furadonin Avexima is incompatible with fluoroquinolones.