Zinnat, 10 pcs., 250 mg, film-coated tablets

Zinnat, 10 pcs., 250 mg, film-coated tablets

For all dosage forms

Inside

, after meals (tablets)/during meals (suspension). The standard course of therapy is about 7 days (from 5 to 10 days).

Adults:

Additionally for film-coated tablets

Step therapy

Cefuroxime is also available as a sodium salt (Zinacef®) for parenteral administration, which allows the same antibiotic to be prescribed sequentially when switching from parenteral to oral therapy is necessary.

The drug Zinnat® is effective after parenteral use of the drug Zinacef® for the treatment of pneumonia and exacerbation of chronic bronchitis.

The duration of parenteral and oral courses of treatment is determined by the severity of the infection and the clinical picture.

Pneumonia.

The drug Zinacef® at a dose of 1.5 g 2–3 times a day (IV or IM) for 48–72 hours, and then the drug Zinnat® orally at a dose of 500 mg 2 times a day for 7–10 days.

Exacerbation of chronic bronchitis.

Zinacef® at a dose of 750 mg 2–3 times a day (IV or IM) for 48–72 hours, then a course of treatment with Zinnat® orally at a dose of 500 mg 2 times a day for 5–10 days .

Children from 3 years old:

Additionally for granules for the preparation of oral suspension

Special patient groups

Children.

There are no clinical trial data regarding the use of Zinnat® in children under 3 months of age.

If a fixed dose is preferred, then for most infections it is recommended to take 125 mg 2 times a day. Children 2 years of age and older with otitis media or more severe infections are prescribed 250 mg 2 times a day; the maximum daily dose is 500 mg.

When treating infants and children, it may be necessary to calculate the dose depending on body weight and age. For most infections, the dose for infants and children aged 3 months to 12 years is 10 mg/kg 2 times a day, but not more than 250 mg/day. For otitis media and more severe infections, the recommended dose is 15 mg/kg 2 times a day, but not more than 500 mg/day.

The tables below show doses depending on the age and weight of the child for dosing Zinnat® suspension 125 mg/5 ml in 5 ml measuring spoons included in the package.

10 mg/kg dose prescribed for most infections

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

pharmachologic effect

The substance cefuroxime axetil is a precursor of cefuroxime, belonging to the second generation of cephalosporin antibiotics . Shows activity against a wide range of pathogens, including strains that produce β-lactamases.

Cefuroxime is noted to be resistant to bacterial β-lactamases, so the substance is effective against ampicillin-resistant or amoxicillin-resistant strains. It has a bactericidal effect, which is associated with the process of suppressing the synthesis of bacterial cell walls due to binding to the main target proteins.

In vitro activity of cefuroxime was noted against a number of gram-negative aerobes, gram-negative aerobes, anaerobes (gram-positive and gram-negative cocci, gram-positive and gram-negative rods, gram-negative spirochetes).

The following microorganisms are insensitive to cefuroxime: Pseudomonas spp., Clostridium difficile, Acinetobacter calcoaceticus, Campylobacter spp., strains of Staphylococcus aureus and Staphylococcus epidermidis that are resistant to methicillin, Legionella spp., Listeria monocytogenes. Also insensitive to the active substance of the drug Zinnat are certain strains of the following genera: Morganella morganii, Enterococcus (Streptococcus) faecalis, Serratia spp., Citrobacter spp., Proteus vulgaris, Bacteroides fragilis, Enterobacter spp.

Contraindications

All dosage forms of the drug Zinnat are contraindicated in case of hypersensitivity to β-lactam antibiotics (if there is a history of sensitivity to cephalosporin antibiotics , carbapenems , penicillins ).

Zinnat tablets should not be taken by children under 3 years of age.

A suspension prepared from granules is not prescribed to people who have hypersensitivity to aspartame or phenylketonuria . This form of antibiotic should also not be used to treat children under 3 months of age.

Zinnat is prescribed with caution for diseases of the digestive system (including a history of it), ulcerative colitis , impaired renal function, as well as during pregnancy and breastfeeding.

Reviews about Zinnat

Those parents who gave the antibiotic Zinnat to their children wrote mostly positive reviews. They note that the drug significantly improved the condition of infectious diseases after just a few days of use. However, side effects are rare. As a rule, these are allergic reactions and headaches. However, most patients, both adults and those users who gave the drug to children, note that there is a need to take probiotics after a course of treatment with this medicine. The ease of use of the product in the form of a suspension is also mentioned.

Side effects

As a rule, negative reactions when treated with a drug containing the active substance cefuroxime axetil are not significant, they are reversible and short-lived. The following side effects may occur:

• superinfection with fungi of the genus Candida;
• lymphatic and hematopoietic systems: eosinophilia , thrombocytopenia , false-positive Coombs test, leukopenia , in very rare cases - hemolytic anemia ;
• immune system: manifestations of hypersensitivity reactions in the form of skin rash, urticaria , itching , in very rare cases - serum sickness, drug fever , anaphylaxis ;
• nervous system: headaches, dizziness;
• digestive system: dysfunction of the gastrointestinal tract, which is manifested by diarrhea , nausea , abdominal pain, sometimes vomiting, in rare cases - pseudomembranous colitis ;
• biliary tract and liver: transient increase in the activity of liver enzymes, in rare cases - hepatitis , jaundice (mainly cholestatic);
• skin, subcutaneous fat: in very rare cases - erythema multiforme , Stevens-Johnson syndrome .

special instructions

Caution should be exercised when prescribing an antibiotic to people who have a history of an allergic reaction to beta-lactam antibiotics.

It is important to monitor renal function during treatment. This should be done charmingly to those patients who are receiving high doses of medication.

During treatment, patients may experience a false-positive urine reaction to glucose.

With prolonged use of the antibiotic Zinnat, active growth of fungi of the genus Candida is possible. Also, with prolonged treatment, the growth of some other resistant microorganisms may occur. In this case, it is advisable to discontinue therapy.

pseudomembranous colitis may develop during treatment with broad-spectrum antibiotics , it is important to make a differential diagnosis of pseudomembranous colitis in people who have severe diarrhea during antibiotic treatment or after completing a course of therapy.

borreliosis with Zinnat, a Jarisch-Herxheimer reaction may occur , which is associated with the bactericidal activity of the drug against the spirochete Borrelia burgdorferi. Patients should be informed about the possibility of developing such symptoms.

If no clinical effect was noted within 3 days after the start of treatment, you should continue taking the drug.

Do not crush or break Zinnat tablets. Therefore, this form of medication is not prescribed to young children, as well as to those patients who have difficulty swallowing.

People with diabetes should note that 5 ml of the finished Zinnat suspension contains 0.25 XE.

Since axetil may cause dizziness , patients should be warned about the need to drive carefully and engage in potentially hazardous activities.

Interaction

The bioavailability of cefuroxime may be reduced when taking medications that reduce gastric acidity. Such drugs neutralize the effect of increasing the absorption of the drug when taken after meals.

Zinnat can affect the state of the intestinal microflora, and this leads to a decrease in estrogen . As a result, the effect of hormonal oral combined contraceptives .

Since a false negative result is possible due to the ferrocyanide test, it is advisable to use hexokinase or glucose oxidase methods to determine the level of glucose in the blood and plasma.

Taking Zinnat does not affect the quantitative determination of creatinine by the alkaline picrate method.

When used simultaneously with loop diuretics , tubular secretion and renal clearance decrease, the concentration of cefuroxime in plasma increases, as well as its half-life.

When taken simultaneously with diuretics and aminoglycosides , the likelihood of developing nephrotoxic effects increases.

Zinnat's analogs

Level 4 ATC code matches:
Cefutil

Zinatsef

Analogs of this medicine are the following drugs: Axosef , Antibioxime , Zinacef , Zinoximor , Xorim , Cefurabol , Cefurosin , Cefuroxime sodium , Cefuroxime axetil , etc. Only the attending physician can select Zinnat analogues for children after establishing the correct diagnosis.

Indications for use

Zinnat tablets and suspension are indicated for use against a wide range of gram-positive and gram-negative bacteria. It is used to treat infectious and inflammatory diseases caused by bacteria that are sensitive to cefuroxime:

• infectious diseases of the ENT organs and upper respiratory tract (sinusitis, otitis media , pharyngitis , etc.);
• infectious diseases of the lower respiratory tract ( bronchitis , pneumonia , exacerbation of chronic bronchitis);
• infectious diseases of soft tissues and skin ( furunculosis , pyoderma , etc.);
• infectious diseases of the urinary tract ( pyelonephritis , cystitis , urethritis , etc.);
• Lyme disease in its early stages, prevention of the development of later stages of this disease in patients over 12 years of age;
• gonorrhea;
• meningitis;
• peritonitis;
• sepsis.

Pharmacokinetics and pharmacodynamics

After the medicine has been taken orally, the substance cefuroxime axetil is slowly absorbed from the digestive tract. The substance is rapidly hydrolyzed to release cefuroxime in the small intestinal mucosa and in the blood. Penetrates through the placenta, the blood-brain barrier, and enters breast milk. Optimal absorption of the drug occurs if it is taken immediately after a meal.

The highest concentration of the active substance after taking the tablets is observed after approximately 2.4 hours, provided that the medicine was taken after a meal.

The highest concentration after taking the suspension is observed approximately 2-3 hours later, provided the medication is taken after meals.

The connection with plasma proteins is approximately 33–50%.

Cefuroxime is not metabolized in the body.

The half-life is 1–1.5 hours. It is excreted by tubular secretion and glomerular filtration. During dialysis, serum concentrations of the substance decrease.