Suprax - an antibiotic for infectious diseases

Pharmacodynamics and pharmacokinetics

The antibiotic Suprax Solutab is semi-synthetic. Easily and quickly absorbed into the gastrointestinal tract. Antibiotics of this series inhibit the activity of cell membranes of harmful bacteria by inhibiting the synthesis of peptidoglycan. Active against gram-positive and gram-negative bacteria.

This group of antibiotics, when released into the blood plasma, binds to proteins (albumin). It is practically not metabolized in the organs and is excreted in the urine almost unchanged.

The price of the antibiotic is high, but this is fully justified by its effectiveness.

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.

Indications for use

According to the instructions, the drug is intended to treat inflammation caused by various infections, i.e. bacteria sensitive to the action of cefixime :

• respiratory tract infections: sinusitis , acute pharyngitis , agranulocytic tonsillitis , acute bronchitis , chronic pharyngitis , tonsillitis and bronchitis ;
• otitis media;
• urinary tract infections;
• shigellosis;
• uncomplicated gonorrhea (cervix, urethra).

Side effects

According to the annotation:

• allergies: skin itching , urticaria - rarely, drug fever - very rarely;
• headache, tinnitus, dizziness;
• thrombocytopenia , bleeding, agranulocytosis - very rare;
• abdominal pain, indigestion, constipation , nausea, vomiting - often;
• impaired renal function, nephritis - rare.

Before use, you should consult your doctor.

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

Instructions for use of Suprax (Method and dosage)

How to take - before or after meals? Eating doesn't matter.

How to take the medicine? For adults and children weighing more than 50 kg, the daily dose is 400 mg of the drug in 1-2 doses. If the weight is from 25 to 50 kg - 200 mg per day at a time. The tablet is swallowed with plenty of water or a suspension is prepared (see instructions for use of the suspension). You can prepare sweet syrup for children.

The duration of treatment is prescribed by the doctor and depends on the severity of the type of infection, on average one or two weeks.

• for gonorrhea – 1 day;
• for mild forms of genitourinary infection – from 3 to 7 days;
• for angina - a course of 7-14 days is prescribed (for angina in children, the daily dose is reduced);

How to prepare Suprax suspension and how to dilute it correctly

Dissolve one tablet in a small amount of water and shake well. The suspension should be diluted in a glass or enamel container. Let the mixture stand for 5 minutes until the granules are completely dissolved. Shake before use.

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.

Interaction

• blockers of tubular secretion (various diuretics, Allopurinol ) have the ability to delay the excretion of cefixime by the kidneys;
• when using the drug together with Carbamazepine , the level of concentration of the latter in the blood plasma may increase;
• significantly reduces the prothrombin index, enhances the effect of indirect anticoagulants;
• It is not recommended to take the drug simultaneously with antacids containing magnesium or aluminum hydroxide, because Absorption through the gastrointestinal tract will slow down.

Analogues of Suprax Solutab

Level 4 ATC code matches:
Cephosin

Lendatsin

Medakson

Loprax

Ceftriaxone

Cefixime

Lorakson

Sulperazon

Cefoperazone

Rocephin

Tsedex

Fortum

Ceftazidime

Cefotaxime

Cefix

Ceforal Solutab

Pantsef

Claforan

Cefodox

For an analogue of Suprax, the instructions for use must indicate that this is a third-generation cephalosporin drug and have cefixime as the main active ingredient. Often the price of analogues is slightly lower.

Common analogues of the antibiotic Suprax are:

• Suprax
• Cefixime
• Ixim Lupine
• Cemidexor
• Cefix
• Pantsef

The best analogue option for children is Ceforal Solutab.

Which is better: Pancef or Suprax?

The active ingredient in both antibiotics is the same. There is an opinion that allergies to Pancef are less common and its side effects are not so pronounced.

Suprax for children

The dosage for children (weighing from 25 to 50 kg) is 200 mg per day, at a time. For pneumonia and bronchitis in children, the course of treatment is 7-14 days. The antibiotic can be simply swallowed with enough water or a suspension can be prepared. How to dilute Suprax Solutab is described above.

Reviews of Suprax for children

Reviews of the suspension for children are mostly positive, the drug is well tolerated, and adverse reactions from the gastrointestinal tract rarely occur.

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.

Reviews

Generally, doctors' reviews of the antibiotic are good. A high-quality and effective drug, well absorbed by patients.

Positive reviews of Suprax Solutab for cystitis . Recovery occurs quickly, side effects are rare.

If used frequently for the treatment of ENT diseases, the drug should not be used. However, the medicine has good reviews for sinusitis . It is convenient that you can prepare a suspension for children (or use 400 mg capsules).

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.

Price, where to buy

How much does the medicine cost? The price of tablets depends on the dosage form of the drug. On average, the cost of 7 dispersible tablets of 400 mg is about 800 rubles.

The price of Suprax for children (it is better to buy a ready-made suspension) is about 600 rubles per 30 ml.

The price of Suprax Solutab in Ukraine is about 250 hryvnia for 400 mg tablets, 7 pieces.

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

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