Zinnat granules for the preparation of suspension for oral administration 125 mg/5 ml bottle 50 ml in Moscow

Zinnat granules for the preparation of suspension for oral administration 125 mg/5 ml bottle 50 ml in Moscow

Pharmacological action: Cefuroxime axetil is a precursor to cefuroxime, which is a second generation cephalosporin antibiotic. Cefuroxime is active against a wide range of pathogens, including strains that produce β-lactamases.

Cefuroxime is resistant to bacterial β-lactamases and is therefore effective against ampicillin-resistant or amoxicillin-resistant strains.

The bactericidal effect of cefuroxime is associated with the suppression of bacterial cell wall synthesis as a result of binding to the main target proteins.

Cefuroxime is generally active in vitro against the following microorganisms.

Gram-negative aerobes: Haemophilus influenzae (including ampicillin-resistant strains), Haemophilus parainfluenzae, Moraxella (Branhamella) catarrhalis, Neisseria gonorrhoeae (including strains that produce and do not produce penicillinase); Escherichia coli, Klebsiella spp., Proteus mirabilis, Providencia spp.

Gram-positive aerobes: Staphylococcus aureus (including penicillinase-producing strains, but excluding methicillin-resistant strains), Staphylococcus epidermidis (including penicillinase-producing strains, but excluding methicillin-resistant strains), Streptococcus pyogenes (and other beta-hemolytic streptococci), Streptococcus pneumoniae, group B streptococci (Streptococcus agalactiae).

Anaerobes: gram-positive and gram-negative cocci (including species of the genera Peptococcus spp. and Peptostreptococcus spp.), gram-positive rods (including species of the genus Clostridium spp., except Clostridium difficile, Propionibacterium spp.), gram-negative rods (including Bacteroides spp. and species of the genus Fusobacterium spp. .), gram-negative spirochetes (including Borrelia spp.).

The following microorganisms are insensitive to cefuroxime.

Clostridium difficile, Pseudomonas spp., Campylobacter spp., Acinetobacter calcoaceticus, Listeria monocytogenes, methicillin-resistant strains of Staphylococcus aureus and Staphylococcus epidermidis, Legionella spp.

Some strains of the following genera are insensitive to cefuroxime.

Enterococcus (Streptococcus) faecalis, Morganella morganii, Proteus vulgaris, Enterobacter spp., Citrobacter spp., Serratia spp., Bacteroides fragilis.

Pharmacokinetics:

Suction:

After oral administration of cefuroxime, axetil is slowly absorbed from the gastrointestinal tract and rapidly hydrolyzed in the mucous membrane of the small intestine and blood to release cefuroxime. Cefuroxime penetrates the blood-brain barrier, the placenta and is excreted in breast milk. Cefuroxime axetil is optimally absorbed when taken immediately after meals.

Additionally for film-coated tablets. Cmax of cefuroxime (2.9 mg/l for a dose of 125 mg and 4.4 mg/l for a dose of 250 mg) are observed after approximately 2.4 hours when taking the drug after meals.

Additionally for granules for the preparation of suspension for oral administration. Cmax of cefuroxime (2-3 mg/l for a dose of 125 mg and 4-6 mg/l for a dose of 250 mg) are observed after approximately 2-3 hours when taking the drug after meals.

Distribution:

The binding to plasma proteins is approximately 33–50%.

Metabolism:

Cefuroxime is not metabolized.

Removal:

T1/2 is 1–1.5 hours. Cefuroxime is excreted by glomerular filtration and tubular secretion. With simultaneous administration of probenecid, the AUC increases by 50%. Serum concentrations of cefuroxime decrease with dialysis.

Zinnat®

The standard course of therapy is about 7 days (from 5 to 10 days). For optimal absorption, Zinnat® suspension should be taken with food.

Adults

Special patient groups

Children

There are no data from clinical studies regarding the use of Zinnat® in children under 3 months of age. If a fixed dose is preferred, 125 mg twice daily is recommended for most infections. Children aged two years and older with otitis media or more severe infections are prescribed 250 mg twice a day; the maximum daily dose is 500 mg. When treating children, it may be necessary to calculate the dose depending on body weight and age. For most infections, the dose for children aged 3 months to 12 years is 10 mg/kg twice a day, but not more than 250 mg per day. For otitis media and more severe infections, the recommended dose is 15 mg/kg twice a day, but not more than 500 mg per day.

The following tables show doses depending on the age and body weight of the child for dosing Zinnat® suspension 125 mg/5 ml with a 5 ml measuring spoon included in the package.

Dose of 10 mg/kg
body weight
prescribed for most infections

Dose of 15 mg/kg
body weight prescribed for otitis media and more severe infections

Cefuroxime is also available in the form of a sodium salt (Zinacef®) for parenteral administration. This allows switching from parenteral cefuroxime to oral administration if clinically indicated.

Patients with impaired renal function

Cefuroxime is excreted primarily by the kidneys.

It is recommended to reduce the dose of cefuroxime in patients with severe renal impairment to compensate for delayed elimination (see table below).

Method of preparing the suspension

- Shake the bottle of granules several times.

— Pour 20 ml of water into a measuring glass up to the mark (this amount of water is sufficient to prepare a 50 ml suspension).

— Pour the measured amount of water into the bottle and close the bottle with a lid.

— Turn the bottle over and shake it vigorously (about 1.5 minutes) to mix the drug well.

Turn the bottle over to its original position and shake vigorously. Before each use of the drug, shake the bottle of suspension vigorously.

When taking the drug, you can add cold fruit juice or milk to each portion of the suspension, and this portion of the suspension should be used immediately. Do not dilute the entire volume of suspension with juice or milk at once.

Zinnat bottle 125mg/5ml 50ml suspension

A country

United Kingdom
Country of origin may vary by batch. Please check with the operator for detailed information when confirming your order.

Active substance

Cefuroxime

Compound

The active ingredient is cefuroxime.

pharmachologic effect

Antibacterial (bactericidal). Inhibits transpeptidase, disrupts the biosynthesis of mucopeptide in the cell wall of microorganisms. It is practically not absorbed when taken orally. After intramuscular administration at a dose of 750 mg, the maximum concentration is achieved within 15-60 minutes. The half-life for intravenous and intramuscular administration is about 80 minutes (in newborns it can be 3-5 times higher). Excreted by the kidneys. Passes through the placenta and penetrates into breast milk. The maximum concentration in the blood is created after using tablets after 2.5-3 hours, suspensions after 2.5-3.5 hours, the half-life is 1.2-1.3 hours and 1 ,4-1.9 hours respectively. If renal function is impaired, the half-life increases. It has a wide spectrum of action, is stable in the presence of most beta-lactamases, and acts on strains resistant to ampicillin and amoxicillin. Active against aerobic gram-positive (Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Streptococcus pyogenes and other streptococci) and gram-negative (Enterobacter spp., Escherichia coli, Haemophilus influenzae, including strains that produce penicillinase, Haemophilus parainfluenzae, Klebsiella spp., for example Klebsiella pneumoniae, Moraxella catarrhalis, including ampicillin- and cephalosporin-resistant strains, Morganella morganii, Neisseria meningitidis, Neisseria gonorrhoeae, including penicillinase-producing strains, Proteus mirabilis, Proteus rettgeri, some strains of Citrobacter spp., Salmonella spp., Providencia spp., Shigella spp.) microorganisms, anaerobes (Clostridium spp., Peptococcus and Peptostreptococcus spp., Bacteroides, Fusobacterium spp.).

Indications for use

Infections of the upper and lower respiratory tract (acute and chronic bronchitis, infected bronchiectasis, pneumonia, lung abscess, pleural empyema), ear, throat and nose (otitis media, pharyngitis, tonsillitis, sinusitis), skin and soft tissues (erysipelas, cellulitis, pyoderma, impetigo, furunculosis), genitourinary tract (urethritis, acute and chronic pyelonephritis, cystitis, asymptomatic bacteriuria), joints, pelvic and abdominal organs, biliary tract and gastrointestinal tract, wound, gonorrhea (acute gonococcal urethritis and cervicitis), sepsis, bacterial septicemia , osteomyelitis, peritonitis, meningitis; prevention of infectious complications during operations.

Interaction

Diuretics and nephrotoxic antibiotics increase the risk of kidney damage, and NSAIDs increase the risk of bleeding. Drugs that reduce stomach acidity may reduce the bioavailability of tablets. Probenecid reduces tubular secretion, reduces renal clearance, increases maximum concentration, half-life and toxicity.

Side effect

Diarrhea, nausea, vomiting, constipation, flatulence, abdominal cramps and pain, dyspepsia, oral ulcers, anorexia, thirst, oral candidiasis, glossitis, pseudomembranous colitis, transient increases in transaminases, alkaline phosphatase, LDH or bilirubin, liver dysfunction , cholestasis, impaired renal function, increased creatinine and/or urea nitrogen in the blood serum, decreased Cl creatinine, dysuria, itching in the perineum, vaginitis, chest pain, shortening of breathing, decreased hemoglobin and hematocrit, transient eosinophilia, neutropenia, leukopenia, aplastic and hemolytic anemia, thrombocytopenia, agranulocytosis, hypoprothrombinemia, prolongation of prothrombin time, headache, drowsiness, dysbiosis, superinfection, candidiasis, hearing impairment, convulsions (with renal failure), allergic reactions: rash, itching, urticaria; rarely - drug fever or chills, serum sickness, bronchospasm, positive Coombs test, erythema multiforme, interstitial nephritis, Stevens-Johnson syndrome and anaphylactic shock; local reactions: pain or infiltration at the injection site, thrombophlebitis after intravenous administration.

Contraindications

Hypersensitivity (including to other cephalosporins, penicillins, carbapenems), bleeding and gastrointestinal diseases in the anamnesis, incl. nonspecific ulcerative colitis; pregnancy, lactation.

Overdose

Symptoms: central nervous system stimulation, convulsions. Treatment: hemodialysis and peritoneal dialysis.

special instructions

With long-term use, it is recommended to monitor kidney function and prevent dysbacteriosis. In patients with impaired renal function, the dose is reduced. Before intramuscular administration, an aspiration test is performed. After the disappearance of clinical signs of the disease, it should be prescribed for another 2-3 days. A false positive reaction to sugar in the urine may occur. Cefuroxime suspension is active for 10 days.

Dispensing conditions in pharmacies

On prescription