Nolitsin: indications and instructions for use, price of the drug

pharmachologic effect

Many people wonder: Is Nolitsin an antibiotic or not? The active substance has an antimicrobial effect against staphylococci, Klebsiella, Enterobacteriaceae, Neisseria, Escherichia coli, Chlamydia, Legionella, Salmonella, Shigella and other pathogens of infectious diseases. The mechanism of action of the drug is based on the interaction of norfloxacin with DNA gyrase (an enzyme of a microorganism), which leads to destabilization of the DNA chain and subsequent death of the microorganism. From this we can conclude that Nolitsin is an antibiotic, as it has a detrimental effect on bacteria.

The antimicrobial effect can last up to 12 hours. The antibiotic Nolitsin can be prescribed for diseases caused by mycobacteria and enterococci. Wikipedia contains a complete list of microorganisms that are sensitive to the action of the antibiotic.

Pharmacodynamics and pharmacokinetics

The active substance is absorbed quite quickly from the digestive system , peak concentrations in the blood are recorded within 1-2 hours after taking the medication. The biological availability of the drug reaches 30-40%. About 15% of the active substance binds to plasma proteins.

unchanged through the renal system In patients with severe pathology of the renal system, pharmacokinetic parameters are changed.

Nolitsin

Nolitsin (INN - norfloxacin) is a “branded” antimicrobial drug from the fluoroquinolone group from the Slovenian pharmaceutical company, used mainly for the treatment of urogenital infections. Speaking about the latter, it should be noted with regret that in recent years, due to the widespread development of bacterial resistance to many antibiotics, the treatment of these diseases has become quite difficult. Thus, sulfonamides, ampicillin and biseptol can no longer be considered as drugs of choice for the treatment of genitourinary tract infections. But nolicin, along with macrolides and third-generation cephalosporins, still remains at the forefront of antimicrobial therapy of the urinary tract, and nolicin is the first choice drug on this list. By the way, it can also be prescribed for so-called empirical treatment, when the causative agent of the infection is not precisely known. And the microorganism that most often causes infections of the urogenital tract - Escherichia coli (the notorious E. coli) - is extremely sensitive to nolitsin and is destroyed without any sentiment in 97% of cases.

The bactericidal effect of nolitsin is due to its ability to affect the enzyme DNA gyrase, which plays a critical role in maintaining the stability of bacterial DNA.

Thus, the processes of protein and DNA synthesis in bacteria are disrupted, and they ultimately die. Nolitsin has a wide radius of antimicrobial damage: Staphylococcus aureus (including methicillin-resistant strains of Staphylococcus spp.), Staphylococcus epidermidis, Neisseria meningitidis, Neisseria gonorrhoeae, (yes, that same one), Citrobacter spp. are sensitive to this drug. , Escherichia coli, Enterobacter spp., Klebsiella spp., Proteus spp. Hafnia alvei, Chlamydia spp., Salmonella spp., Yersinia enterocolitica, Shigella spp., Campylobacter jejuni, Vibrio parahaemolyticus, Plesiomonas spp., Aeromonas spp., Haemophilus influenzae, Legionella spp., Vibrio cholerae. With varying success, nolitsin acts on Mycoplasma pneumoniae, Mycoplasma hominis, Mycobacterium fortuitum, Mycobacterium tuberculosis, Enterococcus faecalis, three varieties of Streptococcus spp. (pneumoniae, viridans and pyogenes), Acinetobacter spp., Pseudomonas aeruginosa, Serratia marcescens.

Nolicin is available exclusively in tablets. They should be taken 1 hour before a meal, or 2 hours after it, making it easier for the tablets to reach the site of the main battles with sufficient liquid. The standard single dose is 400 mg 2 times a day

Indications for use of Nolicin

Nolicin tablets, what are they for? The drug is prescribed for the treatment of infectious and inflammatory diseases of the genitourinary system:

chronic prostatitis of bacterial origin;
endometritis;
cervicitis;
cystitis;
pyelonephritis;
urethritis;
uncomplicated form of gonorrhea.

What else can Nolitsin be prescribed for: bacterial gastroenteritis, shigellosis , salmonellosis . Additional indications for the use of tablets: prevention of traveler's diarrhea and prevention of septic complications in patients with neutropenia .

Instructions for use NOLICIN®

Taking fluoroquinolones, incl. and norfloxacin may be associated with an increased risk of tendonitis or tendon rupture. This risk increases in patients over 60 years of age, in those taking corticosteroid medications, and in patients who have had a kidney, heart, or lung transplant.

Isolated cases of serious hypersensitivity reactions (anaphylactic reactions) have been reported, incl. after taking a single dose of norfloxacin. If allergic reactions occur, the drug should be discontinued.

Nolitsin® should be prescribed with caution to patients with central nervous system disorders (especially epilepsy and other conditions accompanied by seizures).

During treatment with the drug, patients should avoid exposure to direct sunlight. If photosensitivity occurs, treatment should be discontinued.

Quinolones, including norfloxacin, may worsen myasthenia gravis symptoms. Caution should be exercised when prescribing the drug to this category of patients.

In rare cases, when taking quinolones, incl. and norfloxacin, in patients with latent or overt impairment of glucose-6-phosphate dehydrogenase activity, hemolytic reactions are possible.

In very rare cases, quinolones may be associated with ECG QT prolongation and arrhythmia (including extremely rare cases of torsade de pointes). As with other drugs that prolong the QT interval, caution should be exercised when prescribing norfloxacin to patients with hypolipidemia, severe bradycardia, and patients receiving treatment with class IA or III antiarrhythmic drugs.

Rare cases of peripheral neuropathy have been reported while taking quinolones. If symptoms of neuropathy (pain, burning, tingling, numbness, weakness) appear, the drug should be discontinued in order to prevent the development of irreversible conditions.

Patients should be adequately hydrated. In case of renal failure, a dosage change is required.

If you take antibacterial drugs, you may develop pseudomembranous colitis caused by Clostridium difficile (CDAD). This fact should be taken into account when diagnosing and prescribing treatment for patients with diarrhea while taking these drugs. In the case of a suspected or confirmed diagnosis of CDAD, the prescribed antibacterial therapy for the underlying disease should be discontinued and antibiotics active against Clostridium difficile should be prescribed in combination with adequate rehydration therapy and correction of electrolyte imbalances. In some cases, a consultation with a surgeon may be required.

It should be kept in mind that norfloxacin is not indicated for the treatment of syphilis. Antimicrobial drugs used in high doses for a short period of time to treat gonorrhea may mask or delay the onset of symptoms of developing syphilis. In all patients with gonorrhea, a serological test for syphilis is required at the time of diagnosis, and a repeat test is recommended 3 months after the prescription of norfloxacin.

Dye E110, which is part of the drug, can cause allergic reactions.

Impact on the ability to drive vehicles and operate machinery

Nolitsin has a slight or moderate effect on the ability to drive a car or use other machinery. Quinolones, although in rare cases, can cause seizures and should not be prescribed to patients with a history of seizures.

In very rare cases, norfloxacin causes dizziness and headache. These adverse events may affect the patient's caution, especially in cases of simultaneous use of Nolitsin and alcohol. Doctors and pharmacists should warn patients about these adverse reactions.

Contraindications

The summary of the drug contains the following absolute contraindications:

intolerance to fluoroquinolones;
carrying a pregnancy;
congenital deficiency of the enzyme glucose-6-phosphate dehydrogenase.

The drug is not used in pediatrics.

Relative contraindications:

allergic responses to acetylsalicylic acid;
epileptic syndrome;
disorders of cerebral blood supply;
atherosclerotic changes in cerebral vessels;

Nolicin®

Crystalluria

Renal dysfunction

In patients with severe renal impairment, the risk/benefit ratio when using norfloxacin tablets should be carefully assessed on a case-by-case basis. Kidney function declines with age, particularly in older patients. In case of severe renal impairment, the concentration of norfloxacin in the urine may decrease, since norfloxacin is excreted primarily by the kidneys.

During therapy, the prothrombin index may increase (during surgery, the state of the blood coagulation system should be monitored).

Photosensitivity reaction

When taking norfloxacin, a photosensitivity reaction may occur, so patients should avoid contact with direct sunlight and artificial ultraviolet (UV) radiation. If symptoms of photosensitivity occur (for example, skin changes reminiscent of sunburn), norfloxacin therapy should be discontinued and medical attention should be sought.

Tendinitis and tendon rupture

Norfloxacin, like other fluoroquinolones, can cause tendinitis and tendon rupture, especially in the presence of the following risk factors: age over 60 years, use of glucocorticosteroids, kidney, heart or lung transplantation, increased physical activity, chronic renal failure, history of tendon damage. These phenomena may occur several months after stopping the drug. At the first sign of tendonitis or tendon rupture, you should stop taking norfloxacin and consult a doctor. During therapy with norfloxacin, it is recommended to avoid excessive physical activity. Norfloxacin is contraindicated in patients with tendonitis and/or tendon rupture associated with the use of fluoroquinolones (including a history).

Aneurysm and aortic dissection

Epidemiological studies have reported an increased risk of aortic aneurysm and aortic dissection following the use of fluoroquinolones, especially in elderly patients.

Therefore, in patients with a history of aortic aneurysm, aortic aneurysm and/or aortic dissection, or other risk factors or conditions predisposing to the development of an aortic aneurysm or aortic dissection (eg, Marfan syndrome, vascular type Ehlers-Danlos syndrome, Takayasu's arteritis, giant cell arteritis, Behçet's disease, hypertension, atherosclerosis), fluoroquinolones should be used only after a careful benefit-risk assessment and consideration of alternative treatment options.

If sudden pain in the abdomen, chest, or back occurs, patients should seek medical attention immediately at the emergency room.
QT
prolongation Caution should be used when using fluoroquinolones, including norfloxacin, in patients with established risk factors for QT prolongation, such as:

- congenital long QT interval syndrome or acquired QT interval prolongation;

- simultaneous use of drugs that prolong the QT interval (for example, cisapride, class IA and III antiarrhythmic drugs, tricyclic and tetracyclic antidepressants, macrolides, antipsychotics, antifungals, imidazole derivatives, some antihistamines, including astemizole, terfenadine, ebastine);

- electrolyte imbalance (for example, with hypokalemia, hypomagnesemia);

- with heart disease (for example, heart failure, myocardial infarction, bradycardia).

Elderly patients and women have increased sensitivity to the effects of drugs that cause prolongation of the corrected QT interval (QTc). Therefore, caution should be exercised when using fluoroquinolones, including norfloxacin, in these groups of patients (see sections "Side effects", "Overdose" and "Interaction with other drugs").

If visual impairment or any other change in the organ of vision occurs, you should immediately contact an ophthalmologist.

Convulsive syndrome

Norfloxacin, like other fluoroquinolones, can provoke seizures and lower the seizure threshold. For patients with epilepsy and other diseases of the central nervous system (for example, a predisposition to convulsive reactions, cerebral atherosclerosis, cerebrovascular accidents, organic diseases of the central nervous system), norfloxacin should be used only in cases where the expected clinical effect outweighs the possible risk of developing side effects of the drug. Norfloxacin should be used with caution in patients concomitantly receiving drugs that lower the seizure threshold of the brain (theophylline, fenbufen [and other similar NSAIDs]). If seizures occur, use of norfloxacin should be discontinued. Fluoroquinolones can also stimulate the central nervous system, causing tremors, toxic psychoses, anxiety, confusion and hallucinations, and increased intracranial pressure.

In patients with established or suspected mental disorders, hallucinations and/or confusion, the use of norfloxacin may lead to their exacerbation and intensification.

Psychotic reactions

Psychotic adverse reactions, including suicidal thoughts/attempts, may occur in patients taking fluoroquinolones, including norfloxacin, sometimes after a single dose. In case of development of any side effects from the central nervous system, including mental disorders, treatment with norfloxacin should be stopped immediately and appropriate therapy should be prescribed. In these cases, it is recommended to switch to therapy with an antibiotic other than a fluoroquinolone, if possible.

Nolicin® should be prescribed with caution to patients with psychosis or patients with a history of mental illness (see section "With caution").

Norfloxacin is ineffective against syphilis.

Pseudomembranous colitis

The use of norfloxacin can lead to the development of pseudomembranous colitis caused by Clostridium
difficile .
In this case, it is necessary to discontinue the drug and prescribe appropriate treatment (oral vancomycin or metronidazole). The use of drugs that inhibit intestinal motility is contraindicated.

Neuropathy

In patients taking fluoroquinolones, including norfloxacin, cases of sensory and sensorimotor axonal polyneuropathy affecting small and/or large axons and leading to paresthesia, hypoesthesia, dysesthesia and weakness have been reported. Symptoms may appear soon after starting use and may be irreversible. If the patient develops symptoms of neuropathy, including pain, burning, tingling, numbness and/or weakness or other sensory disturbances, including tactile, pain, temperature, vibration and positional sense, norfloxacin should be discontinued.

Liver dysfunction

Cases of cholestatic hepatitis have been reported with the use of norfloxacin. The patient should be informed that if symptoms of liver dysfunction occur (anorexia, jaundice, dark urine, itching, abdominal pain), consult a doctor before continuing treatment with norfloxacin.

Myasthenia gravis

In patients receiving norfloxacin, the development of myasthenia gravis or its exacerbation was noted. Because this can lead to potentially life-threatening respiratory failure, patients with myasthenia gravis should be advised to seek immediate medical attention if symptoms worsen.

Hypersensitivity and allergic reactions

In some cases, after the first use of the drug, hypersensitivity reactions and allergic reactions may develop, which should be reported to your doctor immediately. Very rarely, even after the first use of the drug, anaphylactic reactions can progress to life-threatening anaphylactic shock. In this case, treatment with norfloxacin should be discontinued and the necessary therapeutic measures (including anti-shock) should be taken.

In rare cases, hemolytic reactions have been reported in patients with latent or actual glucose-6-phosphate dehydrogenase deficiency taking quinolone antibacterial agents, including norfloxacin.

Hypoglycemia and hyperglycemia (dysglycemia)

As with the use of other quinolones, cases of hyperglycemia and hypoglycemia have been observed with the use of norfloxacin. During therapy with norfloxacin, dysglycemia may occur more frequently in elderly patients and patients with diabetes mellitus receiving concomitant therapy with oral hypoglycemic drugs or insulin. When using norfloxacin in such patients, the risk of developing hypoglycemia, including hypoglycemic coma, increases. It is necessary to inform patients about the symptoms of hypoglycemia (confusion, dizziness, ravenous appetite, headache, nervousness, palpitations or increased heart rate, pale skin, perspiration, trembling, weakness). If the patient develops hypoglycemia, treatment with norfloxacin should be stopped immediately and appropriate therapy should be initiated. In these cases, it is recommended to switch to therapy with an antibiotic other than a fluoroquinolone, if possible. When treating with norfloxacin in elderly patients and patients with diabetes mellitus, careful monitoring of blood glucose concentrations is recommended.

Special information on excipients

If you have an allergic reaction to acetylsalicylic acid, azo dye (E110) (sunset yellow dye (E110)) may cause a hypersensitivity reaction.

Side effects of Nolicin

From the genitourinary system:

hypercreatininemia;
glomerulonephritis;
polyuria;
urethral bleeding;
crystalluria;
dysuria;
albuminuria.

From the digestive tract:

pseudomembranous enterocolitis;
epigastric pain;
appetite disorders;
diarrhea syndrome;
vomit;
nausea;
bitterness in the mouth;
increase in ALT, AST.

The development of hallucinations, headaches, arrhythmia, tachycardia , vasculitis, itching, fainting, insomnia, swelling, urticaria, exudative erythema with a malignant course is possible. Candidiasis, decreased hematocrit, changes in blood counts, arthralgia , chemosis, and fear of light are rarely recorded.

Instructions for use of Nolicin (Method and dosage)

How to use Nolitsin correctly? Instructions for use instruct you to take the medication orally.

For infectious lesions of the genitourinary system: 400 mg twice a day, course 7-10 days.

Treatment of uncomplicated cystitis is carried out within 3-7 days.

Chronically recurrent infectious diseases of the urinary tract are treated within 12 weeks.

How to take Nolicin for acute gastroenteritis of bacterial origin : 400 mg twice a day for 5 days. For cervicitis, proctitis , urethritis and pharyngitis, 400 mg of norfloxacin is prescribed once.

Nolicin film-coated tablets 400 mg 10 pcs. in Kursk

In case of prolonged treatment, urine analysis should be monitored for crystalluria. Crystalluria is not expected to occur if the 400 mg twice daily dosage regimen is followed, so as a precaution the recommended daily dose should not be exceeded and sufficient fluid intake should be taken to ensure adequate fluid replacement and adequate diuresis (monitored diuresis). In patients with severe renal impairment, the risk/benefit ratio when using norfloxacin tablets should be carefully assessed on a case-by-case basis. Kidney function declines with age, particularly in older patients. In severe renal impairment, the concentration of norfloxacin in the urine may decrease, since norfloxacin is excreted primarily by the kidneys.

During therapy, the prothrombin index may increase (during surgery, the state of the blood coagulation system should be monitored).

Aneurysm and aortic dissection

Epidemiological studies have reported an increased risk of aortic aneurysm and aortic dissection following the use of fluoroquinolones, especially in elderly patients.

If sudden pain in the abdomen, chest, or back occurs, patients should seek medical attention immediately at the emergency room.

Caution should be exercised when using fluoroquinolones, including norfloxacin, in patients with established risk factors for QT prolongation, such as:

congenital long QT interval syndrome or acquired QT interval prolongation;
simultaneous use of drugs that prolong the QT interval (for example, cisapride, class IA and III antiarrhythmic drugs, tricyclic and tetracyclic antidepressants, macrolides, antipsychotics, antifungals, imidazole derivatives, some antihistamines, including astemizole, terfenadine, ebastine);
electrolyte imbalance (eg, hypokalemia, hypomagnesemia);
with heart disease (for example, heart failure, myocardial infarction, bradycardia).

Elderly patients and women have increased sensitivity to the effects of drugs that cause prolongation of the corrected QT interval (QTc). Therefore, caution should be exercised when using fluoroquinolones, including norfloxacin, in these groups of patients (see sections "Interaction with other drugs", "Side effects" and "Overdose").

If visual impairment or any other change in the organ of vision occurs, you should immediately contact an ophthalmologist.

Fluoroquinolones can also stimulate the central nervous system, causing tremors, toxic psychoses, anxiety, confusion and hallucinations, and increased intracranial pressure.

In patients with established or suspected mental disorders, hallucinations and/or confusion, the use of norfloxacin may lead to their exacerbation and intensification.

Psychotic reactions

Nolicin® should be prescribed with caution to patients with psychosis or patients with a history of mental illness (see section "With caution").

Norfloxacin is ineffective against syphilis.

The use of norfloxacin can lead to the development of pseudomembranous colitis caused by Clostridium difficile.

In this case, it is necessary to discontinue the drug and prescribe appropriate treatment (oral vancomycin or metronidazole). The use of drugs that inhibit intestinal motility is contraindicated.

In rare cases, hemolytic reactions have been reported in patients with latent or actual glucose-6-phosphate dehydrogenase deficiency taking quinolone antibacterial agents, including norfloxacin.

Hypoglycemia and hyperglycemia (dysglycemia)

Special information on excipients

If you have an allergic reaction to acetylsalicylic acid, azo dye (E110) (sunset yellow dye (E110)) may cause a hypersensitivity reaction.

Impact on driving vehicles and machinery

Care must be taken when driving a car and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions. The potential for side effects such as dizziness, drowsiness and visual disturbances should be taken into account. If the described adverse events occur, you should refrain from these types of activities.

Interaction

The medication reduces the effectiveness of nitrofurans , increases the concentration of cyclosporine (mutual action) and indirect anticoagulants . Norfloxacin reduces the total clearance of theophylline by 1/4.

When treated simultaneously with medications that lower the epileptic threshold, epileptiform seizures . Antacids reduce the absorption of Nolicin. When taking antihypertensive drugs, a sharp drop in blood pressure is recorded. The use of medications for general anesthesia requires mandatory monitoring of heart rate, blood pressure, and heart function (ECG).

special instructions

Before prescribing an antibiotic, it is necessary to determine the sensitivity of the flora to norfloxacin. Why is this being done? Infectious agents may be sensitive to this drug, and the expected therapeutic effect will not be achieved in the required time frame.

For pyelonephritis, Nolitsin is recommended to be prescribed in combination with herbal medications (for example, Canephron ). When treating with norfloxacin, reviews for pyelonephritis are mostly positive. Monural is also used to treat diseases of the genitourinary system. Only the attending physician can decide what is best to prescribe.

Nolicin film-coated tablets 400 mg 20 pcs. in Moscow

During therapy, the prothrombin index may increase (during surgery, the state of the blood coagulation system should be monitored).

Aneurysm and aortic dissection

Epidemiological studies have reported an increased risk of aortic aneurysm and aortic dissection following the use of fluoroquinolones, especially in elderly patients.

If sudden pain in the abdomen, chest, or back occurs, patients should seek medical attention immediately at the emergency room.

Caution should be exercised when using fluoroquinolones, including norfloxacin, in patients with established risk factors for QT prolongation, such as:

congenital long QT interval syndrome or acquired QT interval prolongation;
simultaneous use of drugs that prolong the QT interval (for example, cisapride, class IA and III antiarrhythmic drugs, tricyclic and tetracyclic antidepressants, macrolides, antipsychotics, antifungals, imidazole derivatives, some antihistamines, including astemizole, terfenadine, ebastine);
electrolyte imbalance (eg, hypokalemia, hypomagnesemia);
with heart disease (for example, heart failure, myocardial infarction, bradycardia).

Elderly patients and women have increased sensitivity to the effects of drugs that cause prolongation of the corrected QT interval (QTc). Therefore, caution should be exercised when using fluoroquinolones, including norfloxacin, in these groups of patients (see sections "Interaction with other drugs", "Side effects" and "Overdose").

If visual impairment or any other change in the organ of vision occurs, you should immediately contact an ophthalmologist.

Fluoroquinolones can also stimulate the central nervous system, causing tremors, toxic psychoses, anxiety, confusion and hallucinations, and increased intracranial pressure.

In patients with established or suspected mental disorders, hallucinations and/or confusion, the use of norfloxacin may lead to their exacerbation and intensification.

Psychotic reactions

Nolicin® should be prescribed with caution to patients with psychosis or patients with a history of mental illness (see section "With caution").

Norfloxacin is ineffective against syphilis.

The use of norfloxacin can lead to the development of pseudomembranous colitis caused by Clostridium difficile.

In this case, it is necessary to discontinue the drug and prescribe appropriate treatment (oral vancomycin or metronidazole). The use of drugs that inhibit intestinal motility is contraindicated.

In rare cases, hemolytic reactions have been reported in patients with latent or actual glucose-6-phosphate dehydrogenase deficiency taking quinolone antibacterial agents, including norfloxacin.

Hypoglycemia and hyperglycemia (dysglycemia)

Special information on excipients

If you have an allergic reaction to acetylsalicylic acid, azo dye (E110) (sunset yellow dye (E110)) may cause a hypersensitivity reaction.

Impact on driving vehicles and machinery

Analogues of Nolitsin in Russia

Level 4 ATX code matches:
Siflox

Hyleflox

Leflobakt

Lefoccin

Gatifloxacin

Ofloxacin

Faktiv

Tigeron

Lebel

Zanotsin

Lomefloxacin

Eleflox

Lomflox

Pefloxacin

Tsiprobay

Sparflo

Tariwid

Zoflox

Abaktal

Moxifloxacin

Loxon-400, Sophasin, Norfatsin, Norilet, Norbactin , Renor.

Nolitsin price, where to buy

The price of tablets depends on the packaging. You can buy Nolitsin in Russia at a price of 10 pieces - 200 rubles, 20 pieces - 430 rubles. You can find out how much the medicine costs in your region by calling the pharmacy chain.

Online pharmacies in RussiaRussia
Online pharmacies in KazakhstanKazakhstan

ZdravCity

Nolicin tablets p.p.o.
400 mg 10 pcs. Krka-Rus LLC 191 rub. order
Nolicin tablets p.p.o. 400 mg 20 pcs. Krka-Rus LLC
RUR 366 order

Pharmacy Dialogue

Nolicin tablets 400 mg No. 10KPKA
RUB 221 order
Nolicin tablets 400 mg No. 20KPKA
RUB 423 order