Description of the drug
Suprax is a modern cephalosporin antibiotic. Used in the treatment of complex infections caused by gram-negative or gram-positive bacteria, as well as aerobic or anaerobic microorganisms. Shown to be effective against streptococcus and staphylococcus.
Produced in the form of capsules and suspensions. Both dosage forms of Suprax have the antibiotic cefixime as the main active ingredient.
Capsules contain 400 mg of the medicinal component. Excipients include silicon dioxide, azorubine, magnesium stearate, and cellulose. Sold 6 pieces in a cardboard box containing instructions.
Patients aged 6 months to 12 years need to purchase the medicine in powder form to make a suspension themselves. 5 ml of the finished medicine contains 100 mg of cefixime. The cardboard box contains one 60 ml bottle of white or slightly cream-colored powder, instructions for preparing the liquid form and a dosing syringe. The suspension additionally includes: sodium benzoate, xanthan gum, sucrose and flavoring.
Composition and release form
Capsules - 1 capsule:
- cefixime - 200/400 mg;
- excipients: colloidal silicon dioxide; magnesium stearate; carboxymethylcellulose; azorubine;
- capsule shell composition: titanium dioxide; dyes - D&C yellow 10, FD&C yellow 6, indigo carmine, FD&C blue; gelatin.
In a blister pack 6 pcs.; in a cardboard pack 1 package.
Granules for the preparation of suspension for oral administration - 5 ml:
- cefixime - 100 mg;
- excipients: sodium benzoate; sucrose; yellow resin; strawberry flavoring.
In dark glass bottles of 60 ml; in a cardboard pack 1 bottle complete with a dosing spoon.
When is Suprax prescribed?
This antibiotic is prescribed for:
- Infectious lesions of the ENT organs (sinusitis, inflammatory processes in the pharynx, tonsillitis, frontal sinusitis, otitis media);
- mild infections of the urinary system (inflammation of the bladder or kidneys);
- infections localized in the lower respiratory tract (bronchi, lungs);
- bacterial damage to the skin and soft tissues;
- osteomyelitis;
- Lyme disease;
- endometritis and gonorrhea.
How to take Suprax
The medicine is taken orally, regardless of meals, with a sufficient amount of water. Adult patients and children over 12 years of age who weigh more than 50 kg are prescribed capsules. Dosage – 400 mg once a day, it is important to take it at the same time. The duration of treatment is from 7 to 10 days, depending on the severity of the condition and the causative agent of the disease.
If the patient is diagnosed with kidney problems, the dose is reduced by ¼.
For uncomplicated gonorrhea, one 400 mg capsule is recommended.
Suprax suspension for children from 6 months to 12 years is prescribed based on the calculation:
- 8 mg of cefixime per 1 kg of child’s weight, given once a day;
- 4 mg of cefixime per 1 kg, but taken twice a day with an interval of 12 hours.
Thus, children are prescribed the following daily volumes of suspension depending on age:
- 6 months-1 year: 2.5-4 ml;
- 2-4 years: 5 ml;
- 5-11 years: 6-10 ml.
Characteristic
Semisynthetic cephalosporin antibiotic of the third generation for oral administration.
Pharmacokinetics
When taken orally, the bioavailability of cefixime is 40–50%, regardless of food intake, however, the Cmax of cefixime in serum is achieved 0.8 hours faster when taking the drug with food.
When taking the drug in capsule form at a dose of 200 mg, Cmax in serum is achieved after 4 hours and is 2 mcg/ml, when taken at a dose of 400 mg - 3.5 mcg/ml. When taking the drug in the form of a suspension at a dose of 200 mg, Cmax in serum is achieved after 4 hours and is 2.8 mcg/ml, when taken at a dose of 400 mg - 4.4 mcg/ml. Binding to plasma proteins, mainly albumin, is 65%.
About 50% of the dose is excreted unchanged in the urine within 24 hours, about 10% of the dose is excreted in bile. T1/2 depends on the dose and is 3–4 hours.
In patients with impaired renal function, with a creatinine Cl of 20-40 ml/min, T1/2 increases to 6.4 hours, with a creatinine Cl of 5-10 ml/min - up to 11.5 hours.
Pharmacodynamics
Inhibits the synthesis of the pathogen's cell membrane. Cefixime is resistant to beta-lactamases produced by most gram-positive and gram-negative bacteria.
In vitro, cefixime is active against gram-positive bacteria: Streptococcus agalactiae; gram-negative bacteria: Haemophilus parainfluenzae, Proteus vulgaris, Klebsiella pneumoniae, Klebsiella oxytoca, Pasteurella multocida, Providencia spp., Salmonella spp., Shigella spp., Citrobacter amalonaticus, Citrobacter diversus, Serratia marcescens.
In vitro and in clinical practice, cefixime is active against gram-positive bacteria: Streptococcus pneumoniae, Streptococcus pyogenes; gram-negative bacteria: Haemophilus influenzae, Moraxella (Branhamella) catarrhalis, E.coli, Proteus mirabilis, Neisseria gonorrhoeae.
Pseudomonas spp., Enterococcus (Streptococcus) serogroup D, Listeria monocytogenes, most Staphylococcus spp. are resistant to the drug. (including methicillin-resistant strains), Enterobacter spp., Bacteroides fragilis, Clostridium spp.
How to prepare a suspension
To prepare the liquid form of the medicine, you must follow the instructions for the Suprax suspension:
- Shake the bottle to agitate the contents.
- In two stages, add 40 ml of boiled water at room temperature to the powder.
- Shake the contents thoroughly after each addition of water.
- Allow the suspension to stand for at least 5 minutes until the granules are completely dissolved.
The contents of the bottle must be shaken before each use.
Is Suprax allowed for pregnant women and children?
During the period of bearing a child, the antibiotic Suprax is prescribed only by a doctor if the benefits of use exceed all possible risks for the development of the fetus. If treatment with the drug is necessary during lactation, breastfeeding should be suspended.
Suprax suspension is actively used in the treatment of children over 6 months of age. Indicated for serious infections, as well as when milder antibiotics are ineffective. Capsules are contraindicated for children under 12 years of age.
Suprax Solutab
Suprax solutab (cefixime) is a semisynthetic cephalosporin antibiotic for oral use. It has a bactericidal (causes the death of microorganisms) effect, suppressing the formation of the plasma membrane of the infectious agent. Resistant to beta-lactamases produced by most bacteria. Acts on Streptococcus agalactia, Haemophilus influenzae, Proteus, Klebsiella oxytoca, Klebsiella pneumoniae, Pasteurella, Providencia, Salmonella, Shigella, Citrobacter, Serratia, pyogenic and pneumoniae streptococcus, Moraxella, Escherichia coli, Neisseria. Does not affect pseudomonads, enterococci serogroup D, listeria, most staphylococci, enterobacter, clostridia, bacteroides. Eating does not affect the bioavailability of the drug (which is 40-50%), but if taken with food, the peak concentration of the active substance in the blood is achieved 50 minutes faster. The half-life of the drug is 3-4 hours (in persons suffering from renal failure, it will be longer). Suprax Solutab is used for infections caused by bacteria sensitive to the drug: inflammation of the mucous membrane and lymphoid tissue of the pharynx, tonsils, sinuses, bronchi, middle ear, uncomplicated infections of the urogenital tract.
Solutab is a soluble dosage form that compares favorably with both suspensions and traditional “effervescent” tablets containing sodium citrate as an auxiliary component. Thus, in suspensions, due to the need to achieve the optimal “active ingredient-stabilizer” ratio, it is difficult to achieve a high content of the active substance. And in “effervescent” tablets, the pharmacokinetic characteristics (absorption, time to reach peak concentration, rate of development of the pharmacological effect and its duration) differ from those of conventional tablets, not for the better.
Preparations in the form of Solutab, incl. Suprax are devoid of such disadvantages and, in addition to this, have a number of undeniable advantages. First of all, this is a favorable pharmacokinetic profile that does not change depending on the method of administration, be it swallowing, chewing, or taking after pre-dissolving the tablet in water. Other advantages of the Solutab form include a large absorption zone and stability of this process, which ensures high bioavailability and the absence of sharp peaks and declines in the concentration of the active component in the blood, as well as the absence of negative effects on the intestinal microflora, which ensures good tolerability of the drug. In addition to the above, the Solutab dosage form is easy to administer and is available for use in patients with difficulty swallowing. Suprax Solutab is used in pediatrics, incl. in newborns (in children under 6 months - with extreme caution). With prolonged use of the drug, it is possible to suppress the growth of normal microflora and develop dysbacteriosis and pseudomembranous colitis. Persons hypersensitive to penicillins may experience similar reactions to cephalosporins. Drugs that block secretion in the renal tubules (allopurinol, diuretics) slow down the elimination of cefixime by the kidneys, which increases the risk of toxicity. Drugs that reduce stomach acidity slow down the absorption of cefixime from the digestive tract.
Contraindications and side effects
Suprax is contraindicated in case of individual intolerance to the components and hypersensitivity to penicillin, as well as in infants under 6 months.
With special attention, this antibiotic is used to treat elderly patients, as well as people with renal failure and colitis.
The drug has an impressive list of possible negative manifestations:
- allergic reaction (in the form of urticaria, itching, Quincke's edema, anaphylactic shock);
- disruptions in the gastrointestinal tract (loose stools, constipation, enterocolitis, attacks of nausea and vomiting);
- the appearance of pain in the head, dizziness, ringing in the ears;
- changes in the functioning of the hematopoietic system (decrease in platelets, leukocytes, hemoglobin, bleeding);
- disorders of the kidneys;
- vaginitis
Suprax Solutab, 7 pcs., 400 mg, dispersible tablets
Due to the possibility of cross-allergic reactions with penicillins, it is recommended to carefully evaluate the patient's medical history. If an allergic reaction occurs, use of the drug should be stopped immediately.
If toxic epidermal necrolysis (Lyell's syndrome), Stevens-Johnson syndrome, drug rash syndrome with eosinophilia and systemic manifestations occur, cefixime should be discontinued and the necessary therapy should be carried out.
If anaphylactic shock develops, the drug must be stopped and epinephrine (adrenaline), systemic glucocorticosteroids and antihistamines administered.
Long-term use of the drug may disrupt the normal intestinal microflora, which can lead to excessive proliferation of Clostridium difficile
and the development of pseudomembranous colitis. If mild forms of antibiotic-associated diarrhea occur, it is usually sufficient to stop taking the drug. For more severe forms, corrective treatment is recommended (for example, vancomycin 250 mg orally 4 times a day). Antidiarrheal drugs that inhibit gastrointestinal motility are contraindicated in the development of pseudomembranous colitis.
Like other cephalosporins, cefixime can cause acute renal failure accompanied by tubulointerstitial nephritis. In case of acute renal failure, you should stop taking cefixime, take the necessary measures and/or prescribe appropriate treatment.
If Suprax® Solutab® is used simultaneously with aminoglycosides, polymyxin B, sodium colistimethate, and loop diuretics (furosemide, ethacrynic acid) in high doses, it is necessary to monitor renal function. After long-term treatment with Suprax® Solutab®, the state of hematopoietic function should be checked.
Dispersible tablets should only be dissolved in water. During treatment, a false-positive direct Coombs test and a false-positive urine test for glucose are possible when using some test systems for rapid diagnosis.
Impact on the ability to drive vehicles and operate machinery
No studies have been conducted on the effects of Suprax® Solutab® on the ability to drive vehicles and operate machinery. Due to possible adverse effects (eg dizziness), caution should be exercised.
special instructions
For patients suffering from diabetes, it is important to take into account the presence of sucrose in the suspension (20 ml contains 15 g). During antibiotic treatment, you must refrain from drinking alcoholic beverages.
If the patient has an allergic reaction to penicillin, then Suprax 400 mg should be taken with caution according to the instructions.
With an overdose of an antibiotic, there is an increase in side effects. In this case, gastric lavage, taking antiallergic drugs, and in severe cases mechanical ventilation and dialysis are indicated.
Description of the dosage form
200 mg capsules with a yellow cap and a white body, containing a mixture of powder and small granules of a yellowish-white color.
400 mg capsules with a purple cap and a white body, containing a mixture of powder and small granules of a yellowish-white color. The code H808 is marked on the capsule.
Granules for the preparation of suspension for oral administration: small granules from white to cream color. After dilution, the suspension is almost white to cream in color with a sweet strawberry aroma.
