Biseptol: composition, when prescribed

Compound

The drug contains a combined active substance Co-Trimoxazole , which in turn consists of the substances sulfamethoxazole (200 mg for suspension and 100 mg (400 mg) for tablets) and trimethoprim (40 mg for suspension and 20 mg (80 mg) for tablets ).

Additional funds

For suspension: purified water, macrogol, sodium carmellose, propylene glycol, propyl parahydroxybenzoate, aluminum magnesium silicate, sodium saccharin, citric acid monohydrate, maltitol, sodium hydrogen phosphate dodecahydrate, methyl parahydroxybenzoate.

For tablets: propylene glycol, potato starch, methyl parahydroxybenzoate, talc, propyl parahydroxybenzoate, magnesium stearate, polyvinyl alcohol.

Pharmacodynamics and pharmacokinetics

Combined antimicrobial drug. The main active ingredient is Co-Trimoxazole (trimethoprim + sulfamethoxazole). What is it used for? Biseptol has a double blocking effect on bacterial metabolism. Trimethoprim has an inhibitory effect on the enzyme involved in the metabolism of folic acid and converts dihydrofolate to tetrahydroflorate. Sulfamethoxazole has a bacteriostatic effect. In combination, the components of the drug Biseptol block the biosynthesis of purines and nucleic acids, without which the reproduction and growth of bacteria is impossible.

The active substances are actively absorbed from the gastrointestinal tract. They are excreted mainly through the kidneys.

Biseptol® 480 (Biseptol® 480)

Hypersensitivity and allergic reactions: at the first appearance of skin rash or any other severe adverse reaction, the drug should be discontinued. Patients with a tendency to allergic reactions and bronchial asthma should be prescribed co-trimoxazole with caution.

Infiltrates in the lungs (like eosinophilic and allergic alveolitis) can manifest themselves with symptoms such as cough or shortness of breath. If these symptoms appear or suddenly increase, it is necessary to re-examine the patient and consider stopping treatment with co-trimoxazole.

Renal disorders: Sulfonamides, including co-trimoxazole, may increase diuresis, especially in patients with edema due to heart failure. Careful monitoring of renal function and serum potassium concentrations is necessary in patients receiving high doses of co-trimoxazole (including in the treatment of pneumonia caused by P. jirovecii), as well as in the following groups of patients: patients with a history of impaired potassium metabolism receiving standard doses drug; patients with renal failure; patients receiving drugs that contribute to the development of hyperkalemia.

Serious Adverse Reactions: Fatalities, although rare, have been reported associated with adverse reactions such as blood abnormalities, Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell's syndrome), drug reaction with eosinophilia and systemic manifestations (DRESS syndrome), and fulminant liver necrosis.

Special groups of patients: in elderly and senile patients, as well as in patients with concomitant diseases, for example, impaired renal and/or liver function, or while taking other drugs, there is an increased risk of severe adverse reactions; in these cases, the risk is related to the dose and duration of therapy. Patients should be informed of the signs and symptoms of these serious side effects and closely monitored for skin reactions.

The risk of severe skin reactions is greatest in the first few weeks of treatment. If signs or symptoms of severe skin reactions occur (eg, progressive rash, often with blisters or associated mucosal lesions), cotrimoxazole therapy should be discontinued. The course of these reactions is largely determined by early diagnosis and immediate cessation of all suspected medications, which improves the prognosis. Following the occurrence of severe skin reactions associated with the use of co-trimoxazole, the patient should never re-use co-trimoxazole.

The duration of treatment with co-trimoxazole should be as short as possible, especially in elderly and senile patients.

If renal function is impaired, the dose should be adjusted. Patients with severe renal impairment (creatinine clearance 15-30 ml/min) receiving co-trimoxazole should be carefully monitored for the development of symptoms of toxicity (nausea, vomiting, hyperkalemia).

In elderly and senile patients, as well as in patients with pre-existing folic acid deficiency or renal failure, hematological changes characteristic of folic acid deficiency may occur. They disappear after administration of folic acid.

Due to the possibility of hemolysis, co-trimoxazole should not be prescribed to patients with glucose-6-phosphate dehydrogenase deficiency.

As with any sulfonamides, caution must be exercised in patients with thyroid dysfunction.

Patients whose metabolism is characterized by “slow acetylation” are more likely to develop idiosyncrasy to sulfonamides.

Long-term therapy: with long-term administration of co-trimoxazole, it is necessary to regularly determine the number of blood cells.

If there is a significant decrease in the number of any blood cells, co-trimoxazole should be discontinued.

Patients receiving long-term treatment with co-trimoxazole (especially with renal failure) should regularly undergo a general urine test and monitor kidney function. During treatment, it is necessary to ensure sufficient fluid intake and adequate diuresis to prevent crystalluria.

Pseudomembranous colitis caused by Clostridium difficile can appear both during long-term use and 2-3 weeks after stopping treatment; manifested by diarrhea, leukocytosis, fever, abdominal pain (sometimes accompanied by the release of blood and mucus in the stool). If these phenomena occur, in mild cases, it is sufficient to discontinue treatment and use ion exchange resins (colestyramine, colestipol); in severe cases, replacement of the loss of fluid, electrolytes and protein, and the appointment of oral vancomycin or metronidazole are indicated. Do not use medications that inhibit intestinal motility.

The drug Biseptol 480 should not be used in the treatment of pharyngitis caused by beta-hemolytic streptococci from group A. The eradication of these bacteria in the nasopharynx with this drug is less effective than with the use of penicillin.

The administration of co-trimoxazole should be avoided in patients with established porphyria or in patients at risk of developing porphyria. Both trimethoprim and sulfonamides (although not specific to sulfamethoxazole) are associated with clinical exacerbations of porphyria.

Due to the propylene glycol content (2000 mg/5 ml), the drug may cause symptoms similar to those that occur after drinking alcohol.

One ampoule of the drug contains 12.4% vol. ethanol (alcohol), i.e. up to 500 mg/5 ml, which is equivalent to 11.88 ml beer or 4.95 ml wine. It is harmful for patients with alcohol disease. The alcohol content should be taken into account when using the drug in pregnant or breastfeeding women, children and patients at high risk, such as those with liver disease or epilepsy.

Biseptol 480 contains sodium disulfite (5 mg/5 ml), which in rare cases can cause severe hypersensitivity reactions and bronchospasm.

The drug Biseptol 480 contains sodium (39 mg/5 ml). This should be taken into account in patients on a controlled sodium diet.

Biseptol 480 contains two antibacterial components. The drug Biseptol 480 should be used only in cases where, in the opinion of the doctor, the expected benefit from its use exceeds any possible risk; the possibility of using single-component effective antibacterial drugs should be considered.

Indications for use of Biseptol

What are these tablets and suspension for?

In general, the drug is prescribed for infectious lesions of the urinary tract: pyelitis, urethritis , prostatitis , pyelonephritis , gonorrhea , epididymitis, lymphogranuloma venereum, chancroid , inguinal granuloma. Let's look at what Biseptol helps with in different parts of the body.

Indications for the use of Biseptol for gastrointestinal infections: paratyphoid , cholera , typhoid fever , cholangitis, dysentery , gastroenteritis (E. coli), cholangitis, salmonella carriage.

Respiratory tract infections: lobar pneumonia, bronchiectasis, bronchitis (acute and chronic), Pneumocystis pneumonia, bronchopneumonia .

Infections of the ENT organs: tonsillitis , sinusitis , otitis media , scarlet fever , laryngitis .

Infections of soft tissues, skin: furunculosis, acne , wound infections, pyoderma . In complex therapy it is used to treat toxoplasmosis, malaria, South American blastomycosis, and acute brucellosis.

BISEPTOL - an antibiotic or not?

Representative office of Polpharma SA

Antibiotics are drugs based on substances produced by microorganisms or obtained by semi-synthetic methods. There are also synthetic drugs - these are artificially created substances with a similar effect; they are combined under the general term “antibacterial drugs”.

In popular scientific literature, the term “antibiotic” is often used to refer to all antimicrobial agents.

Some people categorically do not use antibiotics; in others, the body responds to their use with allergic reactions. What should such patients do if they need to cope with an infection? There is one remedy that has been tested by time and the practice of pediatricians. This is BISEPTOL suspension.

The active component of BISEPTOL suspension is co-trimoxazole. This is a product that destroys pathogenic microflora. Co-trimaxozole consists of two components, which, on the one hand, disrupt important life processes occurring in the cells of harmful microbes, and on the other, activate the production of substances that suppress the proliferation of microbes.

BISEPTOL is an antibacterial drug, but not an antibiotic.

BISEPTOL suspension can help destroy pathogens such as staphylococci, streptococci, salmonella, Haemophilus influenzae, Shigella, Legionella, Proteus, Brucella, Neisseria, mycobacteria and many others.

A special form of BISEPTOL for children is produced in Poland, part of the pharmaceutical industry. This suspension has a strawberry flavor, does not contain sugar and can be used in children from the age of three months.

In what cases can children be prescribed BISEPTOL suspension?

BISEPTOL suspension is used for such infectious and inflammatory diseases as inflammation of the bronchi and lungs, inflammation of the middle ear, tonsils, paranasal sinuses, larynx, kidney disease, urinary tract and intestines. BISEPTOL will also help with infections localized in the digestive tract, as well as with infectious skin lesions, furunculosis and purulent wounds. BISEPTOL is effective even in case of infection that has settled deep in the bone tissue.

Who is not recommended to take BISEPTOL suspension?

If your child has an individual intolerance to a number of sulfonamides or very severe kidney and liver diseases, blood diseases or streptococcal tonsillitis, then BISEPTOL suspension should not be taken.

How to take BISEPTOL suspension?

BISEPTOL suspension is taken after meals in the morning and evening.

The dosage depends on the disease and the age of the patient.

One measuring cap holds 10 ml. with divisions into 2.5 ml 5 ml, 7.5 ml and 10 ml, which is very convenient for parents.

BISEPTOL suspension is prescribed to children starting from three months.

Warning!

It is not advisable to treat babies with BISEPTOL for less than three days. When all the manifestations of the disease completely disappear, you need to take BISEPTOL for two more days, that is, only 5-7 days, but the duration of therapy should always be determined only by the attending physician.

Special instructions

If your child takes BISEPTOL suspension, then it is advisable to adjust his diet. Try to give him more fluids and not give him a lot of green leafy vegetables, cabbage of all kinds, peas and beans, as well as tomatoes, carrots, desserts and baked goods. This is due to the fact that BISEPTOL improves the functioning of the kidneys and intestines.

During treatment with BISEPTOL, support the baby’s body with vitamins approved by the attending physician. For example, ascorbic acid in CEVICAP .

“CEVIKAP” is the only form of ascorbic acid in drops specially designed for children, has a pleasant taste and is accepted with pleasure by children.

Just a few drops a day, depending on age, will significantly strengthen your child’s immunity. "CEVIKAP" - with love and care for the baby.

For more information contact:

Representative office of Polpharma SA

Side effects

Nervous system: dizziness, headaches, rarely depression, aseptic meningitis , tremor, apathy , peripheral neuritis.

Respiratory system: pulmonary infiltrates, bronchospasm.

Digestive system: dyspeptic disorders, cholestasis, diarrhea, vomiting, loss of appetite, glossitis, epigastric pain, gastritis, increased levels of liver transaminases, stomatitis, pseudomembranous enterocolitis, hepatonecrosis, hepatitis.

Hematopoietic organs: megaloblastic anemia, agranulocytosis, neutropenia, leukopenia, thrombocytopenia.

Side effects from the urinary system: crystalluria, interstitial nephritis, polyuria, toxic nephropathy with anuria , oliguria, increased urea levels, hematuria, impaired renal function.

Musculoskeletal system: myalgia, arthralgia. thrombophlebitis , hypoglycemia, allergies .

Instructions for use of Biseptol (Method and dosage)

The dose of the drug in each case is prescribed by the doctor.

Biseptol tablets, instructions for use

Adults: 960 mg once, or 480 mg in 2 doses. Severe infections: 480 mg three times. Course 1-2 weeks.

For acute brucellosis, the course of treatment is 3-4 weeks, for paratyphoid and typhoid fever - up to 3 months.

Chronic infections: twice 480 mg tablets.

Instructions for use for children

For children, Biseptol is prescribed twice a day, dose from 120 to 480 mg.

At the age of 3-5 years: 2 times 120 mg per 24 hours.

Biseptol suspension, instructions for use

The syrup is used in the same way as the tablets.

Overdose

Intestinal colic, dyspeptic disorders, headaches, dizziness, drowsiness, vomiting, confusion, fever, depression, hematuria , fainting, visual impairment, leukopenia, fever, crystalluria . With prolonged overdose, jaundice, megaloblastic anemia, thrombocytopenia, and leukopenia are noted. It is necessary to administer trimethoprim, calcium folinate intramuscularly at a dose of 5-15 mg/day. If necessary, hemodialysis is prescribed. There is no specific antidote.

Side effects and overdose

Taking the drug may be accompanied by the development of many unwanted reactions. Most often, dizziness, loss of appetite, dyspeptic syndrome (nausea, vomiting, stool disorders), pain in muscles and joints occur.

More rare side effects are depression, apathy, insomnia, bronchospasm, gastritis, hepatitis, agranulocytosis, anemia, nephropathy, decreased plasma glucose levels.

It is also possible to develop various allergic reactions.

An overdose can be accompanied by all of the listed symptoms. The clinic is also supplemented by an increase in body temperature, abdominal pain, the appearance of a jaundiced coloration of the skin, and disturbances in vision and consciousness.

First aid: intramuscular injection of 5-15 mg of calcium folinate and trimetropim.

Interaction

Biseptol enhances the effect of hypoglycemic drugs, indirect anticoagulants, methotrexate. The drug reduces the effectiveness and reliability of oral contraception. The risk of developing megaloblastic anemia increases when taken concomitantly with pyrimethamine (more than 25 mg per week). Thiazides may cause thrombocytopenia. The effectiveness of Biseptol is reduced by procainamide , procaine , and benzocaine . The drug leads to the development of cross-allergy when taken simultaneously with oral hypoglycemic drugs. Lack of folic acid increases with the prescription of barbiturates, phenytoin, PAS . Crystalluria develops when taking hexamethylenetetramine , ascorbic acid.

Drug interactions

Biseptol interacts with a large number of drugs. It improves efficiency:

• hypoglycemic agents;
• methotrexate;
• indirect anticoagulants.

Reduces the effectiveness of oral contraceptives.

The simultaneous use of hypoglycemic drugs and Biseptol can provoke the development of cross-allergy. And treatment with benzocaine, procaine and procainamide blocks the effect of the drug.

The interaction with alcohol has not been fully studied at the moment, so it is recommended to abstain from drinking alcohol during therapy.

special instructions

Regular monitoring of the concentration of sulfamethoxazole in the blood is necessary. If the value is more than 150 mcg/ml, then treatment is stopped until the value reaches 120 mcg/ml or lower. If the course of treatment lasts a month or more, then regular monitoring of the blood condition is required. When folic acid , hematological changes are reversible. In patients with AIDS, side effects are more common and more pronounced. Biseptol is not recommended to be prescribed for pharyngitis and tonsillitis caused by beta-hemolytic streptococcus gr. A.

Biseptol - an antibiotic or not? According to the annotation, the drug is not an antibiotic.

The recipe in Latin may look something like this: Rp: “Biseptoli-420” Dtd No. 20 in tab.

There is no description of the drug on Wikipedia.

Biseptol®

Pharmacokinetic interaction

Trimethoprim is an inhibitor of organic cation transporter 2 (OCT2), as well as a weak inhibitor of the CYP2C8 isoenzyme. Sulfamethoxazole is a weak inhibitor of the CYP2C9 isoenzyme.

Systemic exposure to drugs transported by OCT2 (eg, dofetilide, amantadine, memantine, and lamivudine) may be increased when trimethoprim-sulfamethoxazole is coadministered.

Trimethoprim-sulfamethoxazole and dofetilide should not be used simultaneously. Trimethoprim inhibits the renal excretion of dofetilide, increases the area under the concentration-time curve AUC by 103% and the maximum concentration of dofetilide by 93%. Increasing concentrations of dofetilide may cause serious ventricular arrhythmias with QT prolongation, including torsades de pointes.

Patients receiving amantadine or memantine have an increased risk of developing nervous system adverse events (such as delirium and myoclonus).

Systemic exposure to drugs predominantly metabolized by CYP2C8 (e.g., paclitaxel, amiodarone, dapsone, repaglinide, rosiglitazone and pioglitazone) may be increased when trimethoprim-sulfamethoxazole is coadministered.

Paclitaxel and amiodarone have a low therapeutic index; their simultaneous use with trimethoprim-sulfamethoxazole is not recommended.

Dapsone and trimethoprim-sulfamethoxazole may cause the development of methemoglobinemia, as there is a potential for their pharmacokinetic and pharmacodynamic interactions. Patients receiving dapsone and trimethoprim-sulfamethoxazole should be closely monitored for the development of methemoglobinemia. If necessary, alternative therapy should be prescribed. Patients receiving repaglinide or pioglitazone should be regularly monitored for the development of hypoglycemia.

Systemic exposure to drugs predominantly metabolized by the CYP2C9 isoenzyme (for example, coumarins (warfarin, acenocoumarol), phenytoin and sulfonylurea derivatives (glibenclamide, gliclazide and glipizide)) may be increased when combined with trimethoprim-sulfamethoxazole.

Blood clotting should be monitored in patients receiving coumarins. Biseptol may inhibit the hepatic metabolism of phenytoin. After administration of standard doses of trimethoprim and sulfamethoxazole, an increase in the half-life of phenytoin by 39% and a decrease in its clearance by 27% were observed. Patients receiving phenytoin should be monitored for phenytoin toxicity. Patients receiving sulfonylurea derivatives (glibenclamide, gliclazide and glipizide) should be monitored for the development of hypoglycemia.

The drug Biseptol can reduce the effectiveness of oral contraceptives. During therapy with Biseptol, women are recommended to use additional methods of contraception.

The simultaneous use of trimethoprim-sulfamethoxazole and indomethacin may cause an increase in the concentration of sulfamethoxazole in the blood plasma.

Biseptol may increase serum digoxin concentrations, especially in elderly patients, so monitoring of serum digoxin concentrations is necessary.

Pharmacodynamic interactions and interactions with unknown mechanism

The incidence and severity of myelotoxic and nephrotoxic adverse events may be increased with concomitant use of trimethoprim-sulfamethoxazole and other drugs that have a myelosuppressive effect or can cause renal impairment (nucleoside analogues, tacrolimus, azathioprine or mercaptopurine). Patients receiving such drugs concomitantly with trimethoprim-sulfamethoxazole should be monitored for the development of hematologic and/or renal toxicity.

Concomitant use with clozapine should be avoided, since the latter is known to cause agranulocytosis.

In elderly and senile patients, with the simultaneous use of certain diuretics (mainly thiazide), an increase in the number of cases of thrombocytopenia was observed.

In patients receiving diuretics, platelet levels in the blood should be regularly monitored.

Patients receiving trimethoprim-sulfamethoxazole and cyclosporine after renal transplantation may experience a reversible deterioration in renal function.

Sulfonamides, including sulfamethoxazole, may compete for protein binding and renal transport of methotrexate, thereby increasing free methotrexate concentrations and systemic effect.

Cases of pancytopenia have been described in patients taking trimethoprim and methotrexate. Trimethoprim has low affinity for human dehydrofolate reductase, but may increase the toxicity of methotrexate, especially in the presence of risk factors such as old age, hypoalbuminemia, renal impairment, bone marrow suppression, and in patients receiving high doses of methotrexate. To prevent myelosuppression, such patients should be prescribed folic acid or calcium folinate.

It can be assumed that when trimethoprim-sulfamethoxazole is co-administered to patients receiving pyrimethamine for malaria prophylaxis in doses greater than 25 mg per week, they may develop interregional anemia. Caution must be exercised during the simultaneous use of trimethoprim-sulfamethoxazole and drugs that increase the concentration of potassium in the blood serum (such as ACE inhibitors, angiotensin receptor blockers, potassium-sparing diuretics and prednisolone), due to the potassium-sparing effect of trimethoprim-sulfamethoxazole.

In addition to other drugs that may cause hyperkalemia, the combined use of trimethoprim-sulfamethoxazole (co-trimoxazole) and spironolactone may result in clinically significant hyperkalemia.

Laboratory research

Trimethoprim-sulfamethoxazole and, in particular, trimethoprim, which is part of it, may affect the results of determining the concentration of methotrexate in serum, carried out by the competitive protein binding method using bacterial dihydrofolate reductase as a ligand. However, when methotrexate is determined by the radioimmune method, there is no influence.

Trimethoprim and sulfamethoxazole can also affect the results of the Jaffe test (determination of creatinine by reaction with picric acid in an alkaline medium), and in the normal range the results are overestimated by approximately 10%.

Biseptol for children

It is noted that the drug can be used from 3 months of life; naturally, the doses will vary. However, this should be done with caution and only as directed by a doctor. In some countries of the world, Biseptol for children is allowed to be used only from 12 years of age.

Usually they can prescribe a suspension from 3 months, tablets from 2 years.

Instructions for Biseptol for children

At the age of 3 to 6 months, 2.5 ml of syrup is prescribed 2 times a day. The interval between doses should be at least 12 hours. From six months to 3 years, take up to 5 ml of Biseptol suspension for children twice a day.

From 3 to 6 years, the dosage is made equal to 5-10 ml twice, 6-12 years - 10 ml 2 times a day. From 12 years of age, take 20 ml every 12 hours.

How to take pills for children?

At the age of 2-5 years: 2 times 120 mg per 24 hours. From 6 to 12 years, use 480 mg every 12 hours.

The course of treatment is 5-7 days. When using drugs for children, you should drink plenty of water.

Biseptol

Use during pregnancy and breastfeeding

During pregnancy, the drug should be prescribed only if the expected benefit from its use outweighs the possible risk to the fetus, since both trimethoprim and sulfamethoxazole cross the placental barrier and thus can affect folic acid metabolism.
In late pregnancy, the use of the drug should be avoided due to the possible risk of developing kernicterus in newborns.

Due to the fact that trimethoprim and sulfamethoxazole pass into breast milk, the use of co-trimaxazole during lactation is contraindicated.

Pregnant women receiving the drug are recommended to take 5 mg of folic acid per day.

Use for liver dysfunction

Contraindicated:

• liver failure.

Use for renal impairment

Contraindicated:

• renal failure (creatinine clearance less than 15 ml/min).

Use in children

Contraindicated:

• children up to 2 months or up to 6 weeks at birth from a mother with HIV infection.

Children: from 2 months (or 6 weeks at birth from mothers with HIV infection) to 5 months - 120 mg, from 6 months to 5 years - 240 mg, from 6 to 12 years - 480 mg every 12 hours, which approximately corresponds to a dose of 36 mg/kg per day.

special instructions

Co-trimoxazole should be prescribed only in cases where the advantage of such combination therapy over other antibacterial monotherapy drugs outweighs the possible risk.

Because the sensitivity of bacteria to antibacterial drugs in vitro varies across different geographic areas and over time, local patterns of bacterial susceptibility should be taken into account when selecting a drug.

With long courses of treatment, regular blood tests are necessary, since there is a possibility of hematological changes (most often asymptomatic). These changes can be reversible with the administration of folic acid (3-6 mg/day), which does not significantly impair the antimicrobial activity of the drug.

Particular caution should be exercised when treating elderly patients or patients with suspected underlying folate deficiency.

The administration of folic acid is also advisable for long-term treatment in high doses.

If there is a significant decrease in the number of any blood cells, the drug should be discontinued.

During treatment, it is also inadvisable to consume foods containing large quantities of PABA - green parts of plants (cauliflower, spinach, legumes), carrots, tomatoes.

For long-term courses (especially in cases of renal failure), it is necessary to regularly conduct a general urine test and monitor kidney function.

To prevent crystalluria, it is recommended to maintain a sufficient volume of urine excreted.

The likelihood of toxic and allergic complications of sulfonamides increases significantly with a decrease in the filtration function of the kidneys. At the first appearance of skin rash or any other severe adverse reaction, the drug should be discontinued.

If cough or shortness of breath suddenly appears or worsens, the patient should be re-examined and discontinuation of drug treatment should be considered.

Excessive sunlight and ultraviolet radiation should be avoided.

The risk of side effects is significantly higher in patients with AIDS.

It is not recommended for use in diseases caused by group A beta-hemolytic streptococcus due to widespread strain resistance.

Cases of pancytopenia have been described in patients taking co-trimoxazole.

Trimethoprim has low affinity for human dehydrofolate reductase, but may increase the toxicity of methotrexate, especially in the presence of other risk factors such as old age, hypoalbuminemia, renal impairment, bone marrow suppression. Such adverse reactions are more likely if methotrexate is prescribed in large doses. To prevent myelosuppression, it is recommended to prescribe folic acid or calcium folinate to such patients.

Trimethoprim disrupts phenylalanine metabolism, but this does not affect patients with phenylketonuria provided they follow an appropriate diet.

Patients whose metabolism is characterized by “slow acetylation” are more

The duration of treatment should be as short as possible, especially in elderly and senile patients.

Co-trimoxazole and, in particular, trimethoprim, which is part of it, can affect the results of determining the concentration of methotrexate in serum, carried out by the competitive protein binding method using bacterial dihydrofolate reductase as a ligand. However, when methotrexate is determined by the radioimmune method, interference does not occur.

Trimethoprim and sulfamethoxazole can affect the results of the Jaffe test (determination of creatinine by reaction with picric acid in an alkaline medium), and in the normal range the results are overestimated by approximately 10%.

Impact on the ability to drive vehicles and operate machinery

Considering the possibility of developing significant side effects, during the treatment period it is necessary to be careful when driving vehicles and engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Biseptol's analogs

Level 4 ATC code matches:
Biseptol 480

Co-trimoxazole

Bactrim

Analogues are the following drugs: Bactiseptol , Bactrim , Biseptazol , Biseptrim , Groseptol , Co-Trimoxazole , Oriprim , Raseptol , Solyuseptol , Sumetrolim , Triseptol .

Reviews of Biseptol

The product is very effective, especially for respiratory diseases. Has an excellent antibacterial effect. Among the disadvantages, it should be noted that there are sometimes side effects. Should not be used without the direction of the attending physician.

Biseptol for children, reviews

It is considered a very effective means of combating microbes. There are generally no negative reviews when treating children with Biseptol syrup.

Reviews of Biseptol for cystitis

The drug is effective against cystitis, but do not forget about the side effects.

For sore throat

Prescribed when it is impossible to take antibiotics. According to research, microorganisms that cause sore throat have begun to lose sensitivity to this drug.

BISEPTOL (tablets)

– can be crushed.
Each tablet is marked with a “Bs” sign and has a notch. This means that it can be divided: Many people are interested in this question: Is Biseptol an antibiotic or not? No, this drug belongs to the sulfonamides, but these drugs have a common goal - to fight microbes. And not only with pathogenic ones, therefore, during or after treatment, these drugs also need to restore the intestinal microflora.

The main composition can be seen on the packaging:

Pay attention to excipients, in particular preservatives. Yes, yes, you were not mistaken, these are the same parabens that so scare ardent supporters of natural cosmetics. Many people are afraid of creams with parabens like fire, not even suspecting that they are ingesting them with some medications and even food products.

Why are they added there? Yes, because these are the cheapest and most studied preservatives to date. They provide a fairly long shelf life to the products they are added to and are well tolerated by the body.

Some time ago, rumors appeared about their involvement in the occurrence of cancer and other unpleasant diseases. But these are just hypotheses that do not yet have any scientific confirmation and require careful additional research.

In the wake of these rumors, manufacturers, fearing to scare off consumers, add other, less studied preservatives to cosmetics, etc., which may be even more dangerous than these. After all, without preservatives, nothing can be stored for more than a few days. But natural options cannot provide such a long shelf life.

Therefore, I am loyal to parabens. But, naturally, I don’t abuse them. After all, as Paracelsus said: “Everything is poison, and everything is medicine. Both are determined only by the dose.”

And here are the storage conditions:

The full composition, as well as indications, contraindications and recommendations for use can be read in the attached instructions:

HOW IS CHILDREN'S BISEPTOL 120 DIFFERENT FROM ADULT 480?

First of all, the dosage, so the packaging is much more compact:

Their composition is identical in terms of the presence of certain substances:

The instructions are the same (see above). Therefore, Biseptol 480 can also be given to children by adjusting the dose (remember the notch that allows you to divide the tablet).

And, of course, the size of the tablet:

Here the diameter is about 8 mm. Here's a comparison photo:

IMPRESSIONS OF USE

So, I have about 20 years of experience using this product. I think this is a fair amount of time to draw appropriate conclusions.

I took it myself and gave it to my son (in the past, pediatricians often prescribed Biseptol to children). Basically, the intake was associated with the occurrence of complications after suffering from acute respiratory viral infections in the form of otitis, sinusitis, tracheitis and bronchitis. I can’t say anything bad about it - the drug has always worked conscientiously. Despite the impressive list of side effects, no negative reactions were observed in me, my husband, or my son during all this time.

I don’t even remember how much these drugs cost. Now the price of such Biseptol 480 in online pharmacies is about 100 rubles.

CONCLUSION

I haven't used Biseptol for several years now. The medications in the photo were purchased just in case for a trip to the village (the pharmacy is far away - you never know if you need it urgently). The adult version recently came in handy for my husband - he still loves it. I never gave it to my daughter at all.

The fact is that now many new antibacterial agents have appeared with a less impressive range of possible side effects and a wider spectrum of action. Often they have virtually no serious contraindications. And the microbes have not yet had time to adapt to them. Of course, I'm inclined to choose them.

But if the need arises and there is no new generation drug at hand, I will use Biseptol without hesitation.

Biseptol price

The price of Biseptol in 120 mg tablets is 35 rubles for 20 pieces. You can buy 480 mg tablets for 100 rubles per pack of 28 pieces.

The price of Biseptol syrup is approximately 130 rubles.

• Online pharmacies in RussiaRussia
• Online pharmacies in UkraineUkraine
• Online pharmacies in KazakhstanKazakhstan

ZdravCity

• Biseptol tab.
  480 mg n28 JSC "Adamed Pharma" 98 rub. order
• Biseptol tab. 120 mg n20 JSC "Adamed Pharma"

  34 RUR order

Pharmacy Dialogue

• Biseptol 480 tablets 480 mg No. 28Polfa

  100 rub. order

• Biseptol 120 tablets 120 mg No. 20Polfa

  34 RUR order

• Biseptol suspension (vial 240mg/5ml 80ml)Medana

  138 RUR order

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Pharmacy24

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PaniPharmacy

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