TAVANIK film-coated tablets 500 mg No. 10

Compound

The drug is produced in the form of tablets and solution for infusion .
One Tavanic 500 mg tablet contains 0.5 g of levofloxacin and excipients ( crospovidone, MCC, sodium stearyl fumarate, hypromellose, macrogol 8000, E171, talc, E172 red and yellow ).

Tablets of 0.25 g of levofloxacin contain the same excipients.

Per 100 ml solution of levofloxacin 0.5 g + sodium hydroxide, water, sodium chloride, concentrated hydrochloric acid .

Pharmacodynamics and pharmacokinetics

The antibiotic Levofloxacin affects the processes of DNA supercoiling in cells of harmful bacteria. The synthesis of protein , DNA and RNA is inhibited, which leads to the inevitable death of pathogenic microorganisms .

It should be noted that levofloxacin is much stronger than ofloxacin . The product exhibits bactericidal activity against aerobic, anaerobic, gram-positive and negative microorganisms. In particular, cocci, streptococci, various intracellular pathogens, Haemophilus influenzae , enterobacteria and Pseudomonas aeruginosa .

The antibiotic is practically useless against strains of Staphylococcus aureus , Salmonella , Shigella , Enterococcus, Gonococcus, Pseudomonas , and some strains of Pneumococcus .

In the patient's body it quickly (within 2 hours) penetrates almost all organs affected by bacteria. It is usually excreted by the kidneys within 6-8 hours. In people with kidney disease, pharmacokinetic parameters may change.

Tavanic, 5 pcs., 500 mg, film-coated tablets

Hospital-acquired infections caused by Pseudomonas aeruginosa

, may require combination treatment.

The prevalence of acquired resistance in cultured strains of microorganisms may vary by geographic region and over time. In this regard, information on drug resistance in a specific country is required. For the treatment of severe infections or if treatment is ineffective, a microbiological diagnosis must be established with the isolation of the pathogen and determination of its sensitivity to levofloxacin.

Methicillin-resistant streptococcus aureus.

There is a high likelihood that methicillin-resistant Staphylococcus aureus will be resistant to fluoroquinolones, including levofloxacin. Therefore, levofloxacin is not recommended for the treatment of known or suspected infections caused by methicillin-resistant Staphylococcus aureus unless laboratory tests have confirmed the sensitivity of this organism to levofloxacin.

Patients predisposed to developing seizures.

Like other quinolones, levofloxacin should be used with great caution in patients with a predisposition to seizures. Such patients include patients with previous CNS lesions, such as stroke, severe TBI; patients concomitantly receiving drugs that lower the seizure threshold of the brain, such as fenbufen and other similar NSAIDs, or other drugs that lower the seizure threshold, such as theophylline (see “Interactions”).

Pseudomembranous colitis.

Diarrhea that develops during or after treatment with levofloxacin, especially severe, persistent and/or bloody, may be symptoms of pseudomembranous colitis caused by
Clostridium difficile.
If pseudomembranous colitis is suspected, treatment with levofloxacin should be stopped immediately and specific antibiotic therapy (vancomycin, teicoplanin or oral metronidazole) should be started immediately. Drugs that inhibit intestinal motility are contraindicated.

Tendinitis.

Rarely observed, tendonitis with quinolones, including levofloxacin, can lead to rupture of tendons, including the Achilles tendon. This side effect can develop within 48 hours after starting treatment and can be bilateral. Elderly patients are more prone to developing tendinitis. The risk of tendon rupture may increase when taking corticosteroids simultaneously. If tendonitis is suspected, treatment with Tavanic® should be stopped immediately and appropriate treatment of the affected tendon should be initiated, for example by providing sufficient immobilization (see “Contraindications” and “Side Effects”).

Hypersensitivity reactions.

Levofloxacin may cause serious, potentially fatal, hypersensitivity reactions (angioedema, anaphylactic shock), even with initial doses (see Side Effects). Patients should immediately stop taking the drug and consult a doctor. If they develop, patients should immediately stop taking the drug and immediately consult a doctor.

Severe bullous reactions.

Cases of severe bullous skin reactions such as Stevens-Johnson syndrome or toxic epidermal necrolysis have been observed while taking levofloxacin (see "Side effects"). In case of development of any reactions from the skin or mucous membranes, the patient should immediately consult a doctor and not continue treatment until his consultation.

From the liver and bile ducts.

Cases of hepatic necrosis, including the development of fatal liver failure, have been reported with the use of levofloxacin, mainly in patients with severe underlying diseases, such as sepsis (see "Side effects"). Patients should be warned to stop treatment and seek immediate medical attention if signs and symptoms of liver damage occur, such as anorexia, jaundice, dark urine, itching and abdominal pain.

Patients with renal failure.

Since levofloxacin is excreted mainly through the kidneys, patients with impaired renal function require mandatory monitoring of renal function, as well as adjustment of the dosage regimen (see “Dosage and Administration”). When treating elderly patients, it should be borne in mind that patients in this group often have impaired renal function (see “Dosage and Administration”).

Preventing the development of photosensitivity reactions.

Although photosensitivity occurs very rarely with the use of levofloxacin, to prevent its development, patients are not recommended to be unnecessarily exposed to strong solar or artificial UV irradiation (for example, visiting a solarium).

Superinfection.

As with the use of other antibiotics, the use of levofloxacin, especially for a long time, can lead to increased proliferation of microorganisms that are insensitive to it (bacteria and fungi), which can cause changes in the microflora that is normally present in humans. As a result, superinfection may develop. Therefore, during treatment, it is imperative to re-evaluate the patient’s condition, and if superinfection develops during treatment, appropriate measures should be taken.

Prolongation of the QT interval.

Very rare cases of QT prolongation have been reported in patients taking fluoroquinolones, including levofloxacin.

When using fluoroquinolones, including levofloxacin, caution should be exercised in patients with known risk factors for prolongation of the QT interval: in patients with uncorrected electrolyte disturbances (with hypokalemia, hypomagnesemia); c congenital long QT syndrome; with heart disease (heart failure, myocardial infarction, bradycardia); while taking drugs that can prolong the QT interval, such as class IA and III antiarrhythmic drugs, tricyclic antidepressants, macrolides, antipsychotics.

Elderly and female patients may be more sensitive to drugs that prolong the QT interval. Therefore, fluoroquinolones, including levofloxacin, should be used with caution in them (see Caution).

, “Method of administration and dosage”, “Side effects” and “Overdose” “Interaction”).

Patients with glucose-6-phosphate dehydrogenase deficiency.

Patients with latent or manifest glucose-6-phosphate dehydrogenase deficiency are predisposed to hemolytic reactions when treated with quinolones, which should be taken into account when treated with levofloxacin.

Hypo- and hyperlycemia (dysglycemia).

As with the use of other quinolones, cases of hyperglycemia and hypoglycemia have been observed with the use of levofloxacin, usually in patients with diabetes mellitus receiving concomitant treatment with oral hypoglycemic drugs (for example, glibenclamide) or insulin preparations. Cases of hypoglycemic coma have been reported. In patients with diabetes mellitus, monitoring of blood glucose concentrations is required (see “Side Effects”).

Peripheral neuropathy.

Sensory and sensorimotor peripheral neuropathy, which may have a rapid onset, has been reported in patients taking fluoroquinolones, including levofloxacin. If the patient develops symptoms of neuropathy, levofloxacin should be discontinued. This minimizes the possible risk of developing irreversible changes.

Exacerbation of pseudoparalytic myasthenia gravis (myasthenia gravis).

Fluoroquinolones, including levofloxacin, have neuromuscular blocking activity and may increase muscle weakness in patients with myasthenia gravis. Post-marketing adverse reactions, including pulmonary failure requiring mechanical ventilation and death, have been associated with the use of fluoroquinolones in patients with myasthenia gravis. The use of levofloxacin in a patient with an established diagnosis of pseudoparalytic myasthenia gravis is not recommended (see section "Side effects").

Application for airborne anthrax infection.

The use of levofloxacin in humans for this indication is based on susceptibility data from
Bacillus anthracis
obtained from
in vitro
and experimental animal studies, as well as limited data from the use of levofloxacin in humans. Treating physicians should refer to national and/or international documents that reflect the collectively developed point of view on the treatment of anthrax.

Psychotic reactions.

With the use of quinolones, including levofloxacin, the development of psychotic reactions has been reported, which in very rare cases progressed to the development of suicidal ideation and behavior disorders with self-harm (sometimes after taking a single dose of levofloxacin (see "Side effects"). When such reactions develop Treatment with levofloxacin should be discontinued and appropriate therapy should be prescribed.The drug should be used with caution in patients with psychosis or patients with a history of mental illness.

Visual impairment.

If any visual impairment develops, immediate consultation with an ophthalmologist is necessary (see “Side effects”).

Effect on laboratory tests.

In patients taking levofloxacin, the determination of opiates in urine may lead to false-positive results, which should be confirmed by more specific methods.

Levofloxacin may inhibit the growth of Mycobacterium tuberculosis

and subsequently lead to false negative results of the bacteriological diagnosis of tuberculosis.

Impact on the ability to drive vehicles or engage in other potentially hazardous activities.

Side effects of Tavanic®, such as dizziness or vertigo, drowsiness and visual disturbances (see section “Side effects”), may reduce psychomotor reactions and the ability to concentrate. This may pose a certain risk in situations where these abilities are of particular importance (for example, when driving a car, when servicing machines and mechanisms, when performing work in an unstable position).

Indications for use

The antibiotic Tavanik in tablet form is prescribed for:

• bronchitis (exacerbation of the chronic form);
• various urinary tract infections with or without complications;
• pneumonia;
• sinusitis;
• prostatitis caused by bacteria, chronic;
• bacteremia ( septicymia );
• of tuberculosis that are difficult to treat ;
• various infections of the skin, soft tissues and abdominal cavity.

The solution is used to treat:

• intra-abdominal infection;
• pneumonia;
• various genitourinary infections;
• tuberculosis;
• septicemia (bacteremia).

Evidence-based criteria for diagnosis

Evidence is provided by X-ray examination [5], in which the detected pathology may be characteristic of certain pathogens. Infiltrative changes can be lobar and multilobar, which is typical for bacterial pneumonia (including pneumococcal, legionella, caused by anaerobes, fungi) and mycobacteriosis, including pulmonary tuberculosis. Diffuse bilateral infiltration is typical for pathogens such as influenza virus, pneumococcus, staphylococcus, legionella. Focal and multifocal infiltration can be homogeneous (pneumococcus, legionella) or inhomogeneous (staphylococcus, viruses, mycoplasma). The combination of infiltrative and interstitial changes is typical for pneumonia of a viral, mycoplasma and pneumocystis nature. Interstitial changes can be miliary (mycobacterium tuberculosis, salmonella, fungi) or reticular (viruses, pneumocystis, mycoplasma, chlamydia). The combination of infiltrative or interstitial changes against the background of lymphadenopathy is quite typical for pulmonary tuberculosis and pneumonia caused by fungi, mycoplasma, chlamydia, measles and varicella viruses. Finally, with pneumonia, radiographic changes may be absent. This happens at the very beginning of the disease, with dehydration, severe neutropenia, as well as with pneumocystis etiology of the disease.

X-ray of the lungs reveals complications such as abscess formation, exudative pleurisy. Computed tomography of the lungs is justified only for differential diagnosis, if a regular X-ray is not very informative, as well as for a more accurate assessment of possible complications. Computed tomography makes it possible to detect early infiltrative and interstitial changes in cases where standard radiography is not yet demonstrative. Cavities, lymphadenopathy, pleural effusion and multifocal changes are clearly identified.

When studying the leukocyte formula, leukocytosis of more than 10 × 1000/μl, a shift of the leukocyte formula to the left (more than 10% of band neutrophils), and toxic granularity of neutrophils are typical. With the so-called In atypical pneumonias (mycoplasma and chlamydial), the leukocyte formula is often unchanged; moderate leukocytosis without neutrophilia is usually observed.

To identify the causative agent, bacteriological examination of sputum is traditionally carried out. Quantitative assessment of microflora is considered necessary, since concentrations of more than 1 million microbial bodies in 1 ml of sputum are diagnostically significant. The most convincing data are from sputum cultures obtained before the start of treatment, as long as the results of bacteriological examination are not distorted by previous ABT.

Determining the sensitivity of microflora isolated from sputum (blood, pleural fluid) to antibiotics can be a good help for the clinician, especially in cases where the initial therapy was ineffective. For the etiological deciphering of chlamydial, mycoplasma, and legionella pneumonia, serotyping is usually used. Specific antibodies to these pathogens are determined using the indirect immunofluorescence reaction (IRIF) or more modern methods - the ELISA test (IgM and IgG antibodies to mycoplasma and chlamydia) and determination of antigen in urine (legionella).

It should be noted that the current classification of pneumonia has led doctors to simplified diagnoses such as “community-acquired pneumonia”, “domestic pneumonia”, etc. It should be borne in mind that such diagnoses do not correspond to the International Classification of Diseases, 10th revision, according to which statistical records are kept. The requirement of Roszdravnadzor for statistical encryption of pneumonia based on etiological principles is legitimate.

Side effects

Sometimes there are:

• pain in the stomach and abdomen, diarrhea , dyspepsia ;
• sinus tachycardia , decreased blood pressure ;
• leukopenia , neutropenia , thrombocytopenia , eosinophilia ;
• vision problems;
• vertigo , tinnitus;
• headache , drowsiness and dizziness ;
• skin rashes, itching;
• arthralgia and tendonitis ;
• hypoglycemia and anorexia ;
• exacerbation or occurrence of fungus ;
• difficulty breathing;
• increased levels of bilirubin and liver enzymes ;
• confusion, sleep disturbance, anxiety;
• phlebitis may occur at the injection site .

Clinical diagnosis of pneumonia

Usually the onset of the disease is acute, less often gradual, sometimes the development of pneumonia is preceded by an episode of acute respiratory viral infection or tracheobronchitis. Clinical diagnosis of pneumonia is usually [5] based on such signs as fever to febrile and subfebrile levels, cough (usually with sputum production). Some patients experience chills, chest pain, and shortness of breath. With lobar pneumonia, signs of consolidation of the lung tissue are revealed - shortening of the percussion sound, bronchial breathing, increased vocal tremors. The phenomenon of crepitus is characteristic, although local fine-bubble rales are most often detected on auscultation.

Severe pneumonia is characterized by the following clinical signs [3–5]: • bilateral, multilobar localization or abscess formation; • rapid progression of the process (increase in the infiltration zone by 50% or more within 48 hours of observation); • severe respiratory failure; • severe vascular insufficiency requiring the use of pressor amines; • leukopenia less than 4 or hyperleukocytosis more than 20 × 1000/μl with the number of immature neutrophils more than 10%; • oliguria or manifestations of acute renal failure.

In severe cases of pneumonia, life-threatening manifestations such as infectious-toxic shock, distress syndrome, disseminated intravascular coagulation syndrome, and multiple organ failure are often diagnosed. Severe pneumonia is diagnosed in the presence of 2–3 or more of the listed signs.

Elderly and senile individuals may not have the classic manifestations of pneumonia, but may experience fever, hypothermia, confusion, shortness of breath (or a combination of these symptoms).

When examining the patient, you should carefully record dangerous symptoms: shortness of breath, hypotension, oliguria, severe bradycardia/tachycardia, confusion. Of the possible complications, pleurisy is the most common, and abscess formation is less common. However, we should not forget about more rare and severe complications: meningitis, brain abscess, arthritis, pericarditis, endocarditis, peritonitis, pleural empyema.

Pneumonia of mycoplasma nature is characterized by signs of pharyngo-laryngo-tracheobronchitis at the onset of the disease, myalgia, profuse sweating (even with low subfebrility), an obsessive dry “whooping cough” cough of an unusually low timbre (manifestations of tracheobronchial dyskinesia). The same features (except for myalgia and profuse sweating) are common with chlamydial pneumonia.

Instructions for use Tavanik (Method and dosage)

The dosage of the antibiotic and the duration of treatment should be prescribed by the attending physician, it all depends on the disease and its severity.

According to the instructions for Tavanik, the tablets are taken orally. They can be crushed and broken.

For sinusitis, bronchitis , genitourinary infections and prostatitis, the daily dose is 0.25-0.5 g per day at a time. The course ranges from three to 14 days. For prostatitis - 28.

Infections of soft tissue, skin and hypodermis are treated within one to two weeks. 0.25-0.5 g once or twice a day.

For septicemia and infections of the abdominal area, take 500 mg of medication 10-14 times a day for one to two days.

For kidney disease, the daily dosage should be reduced.

Infusion of the solution is carried out slowly, over at least an hour. No more than two weeks. If necessary, switch to tablet form.

Interaction

Particular care should be taken when combined with antacids containing magnesium and aluminum, sucralfate , and iron supplements .

Avoid combinations of levofloxacin and phenibufen , macrolides , theophylline , indirect anticoagulants, cimetidine , probenecid , GSK , cyclosporine , tricyclic antidepressants .

Overdose

Symptoms: Based on data obtained from toxicological studies conducted in animals, the most important expected symptoms of an acute overdose of Tavanic® are central nervous system symptoms (impaired consciousness, including confusion, dizziness and convulsions).

During post-marketing use of the drug in overdose, CNS effects have been observed, including confusion, convulsions, hallucinations and tremor.

Nausea and erosions of the gastrointestinal mucosa may develop.

In clinical and pharmacological studies conducted with doses of levofloxacin exceeding therapeutic levels, prolongation of the QT interval was shown.

Treatment: in case of overdose, careful monitoring of the patient is required, including ECG monitoring. Treatment is symptomatic. In case of acute overdose of Tavanic® tablets, gastric lavage and administration of antacids are indicated to protect the gastric mucosa. Levofloxacin is not eliminated by dialysis (hemodialysis, peritoneal dialysis and continuous ambulatory peritoneal dialysis). There is no specific antidote.

Tavanika's analogs

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

The closest analogues of Tavanik: Zolev, Leflokad, Levobakt, Glevo, Levobax, Levocin, Levoxa, Lebel, Levomak, Levotor, Levoximed, Levostad, Levoflox, Levocel, Levofloxacin, Levoflocin, Leflok, Loxof, Tigeron, Lexid, Floxium .

The price of analogues may differ significantly from the original.

Reviews about Tavanika

Reviews from doctors : The antibiotic Tavanik is an excellent remedy, it has a wide spectrum of action. And, as a rule, if you follow the general recommendations when taking antibiotics, it is well tolerated. While taking the medicine, you should consume more fermented milk products, drugs to protect the gastrointestinal tract, eat well, drink plenty of fluids and follow a rest regime.

Reviews for Tavanic 500 mg on forums are different. Someone writes about how serious and poorly tolerated the drug is and that they were afraid to take it because of the number of side effects. However, those who have taken it note its high effectiveness in combating a large list of diseases caused by various bacteria. If the regimen and dosage are followed, the medicine is well tolerated. Sometimes headache and slight dizziness were noted.

Deciding on the choice of antibacterial drug

Establishing a diagnosis of pneumonia is an absolute indication for prescribing ABT. In this case, it is necessary to take into account the following factors: • reliability of the diagnosis of pneumonia (clinical and radiological data, assessment of the leukocyte formula); • presumptive etiological agent (features of clinical, radiological and laboratory data, analysis of the epidemiological situation); • allergy history; • adequacy of the choice of antibacterial drug and treatment regimen; • determination of criteria for the effectiveness of antibacterial therapy.

In young people without bad habits, pneumonia is usually caused by mycoplasma, chlamydia, and pneumococci. In persons over 60 years of age, the more common etiological agents are pneumococci and Haemophilus influenzae, and often associations of gram-positive and gram-negative microorganisms. With previous chronic bronchitis, the causative agent of pneumonia can be Haemophilus influenzae and Moraxella. The same pathogens are also characteristic of the smoking habit, which

certainly leads to the development of chronic bronchitis. Intracellular agents - legionella, mycoplasma, chlamydia - cause the so-called. atypical pneumonia, second only to pneumococcal infection in frequency. Mycoplasma and chlamydial pneumonia are characterized by the development of intrafamilial foci of bronchopulmonary infection. Chlamydial pneumonia can also develop through contact with birds. Aspiration pneumonia sometimes complicates diseases such as strokes, alcoholism, and is usually caused by gram-negative flora and/or anaerobes. During influenza epidemics, the incidence of staphylococcal pneumonia increases. Pneumonia in persons with neutropenia or against the background of various immunodeficiencies can be caused by various gram-positive and gram-negative microorganisms (including opportunistic flora), fungi, pneumocystis, and mycobacteria. Alcoholism has a high incidence of Klebsiel pneumonia.

Hospital-acquired pneumonia is often caused by resistant strains of staphylococci, gram-negative (often multiresistant) bacilli, and anaerobes.

Tavanika price (where to buy)

The price of Tavanik 500 mg is approximately 964 rubles for 10 tablets.

You can buy a bottle of infusion solution in Moscow for up to 1,600 rubles for 500 mg. You can buy tablets for 1000 rubles (10 tablets of 500 mg each).

• Online pharmacies in RussiaRussia
• Online pharmacies in KazakhstanKazakhstan

ZdravCity

• Tavanic tablets p.p.o.
  250 mg 10 pcs. Sanofi-Winthrop Industrie RUR 454 order

Pharmacy Dialogue

• Tavanik (tablet p/o 500 mg No. 5)Sanofi-Winthrop Industrie

  RUB 462 order

• Tavanik tablets p/o 250 mg No. 10Sanofi-Winthrop Industrie

  300 rub. order

• Tavanik (tablet p/o 500 mg No. 10)Sanofi-Winthrop Industrie

  870 rub. order

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