Tablets: infectious and inflammatory diseases caused by microorganisms sensitive to the drug: typhoid fever, paratyphoid, yersiniosis, brucellosis, shigellosis, salmonellosis, tularemia, rickettsiosis, chlamydia, purulent peritonitis, bacterial meningitis, biliary tract infections. Drops: conjunctivitis, keratitis, blepharitis caused by microorganisms sensitive to the drug.
Levomycetin tablets Composition
active substance: chloramphenicol;
1 tablet contains chloramphenicol (chloramphenicol) in terms of 100% substance 250 mg or 500 mg
excipients: potato starch, calcium stearate.
Levomycetin tablets Dosage form
Basic physical and chemical properties: round tablets with a flat surface, white,
color, white or white with a yellowish tinge, with a line and a chamfer.
Levomycetin tablets Pharmacological group
Antibacterial agents for systemic use. Amphenicol. ATX code J01B A01.
Levomycetin tablets Pharmacological properties
Levomycetin is a broad-spectrum bacteriostatic antibiotic. The action is associated with a disruption in the process of protein synthesis in a microbial cell at the stage of transfer of t-RNA amino acids to ribosomes. Effective against many gram-positive and gram-negative bacteria: Escherichia coli, Shigella flexneri spp., Shigella boydii spp., Shigella sonnei spp., Salmonella spp., (Including Salmonella typhi), acts on Streptococcus spp. (including Streptococcus pneumoniae), Neisseria gonorrhoeae, Neisseria meningitidis, a number of Proteus spp. , for some strains of Pseudomonas aeruginosa; active against Ricketsia spp., Treponema spp., Chlamydia spp. (including Chlamydia trachomatis), causative agents of purulent infections, typhoid fever, dysentery, meningococcal infection, brucella, rickettsia, chlamydia, spirochetes. Does not affect Mycobacterium tuberculosis, pathogenic protozoa and fungi. It is active against strains of bacteria resistant to penicillin, tetracyclines, sulfonamides. Resistance of microorganisms develops slowly. The drug is inactive against acid-fast bacteria, Pseudomonas aeruginosa, clostridia and protozoa.
The mechanism of action is due to the inhibition of protein synthesis in the cells of microorganisms. In therapeutic concentrations, it exhibits a bacteriostatic effect. Resistance of microorganisms to the drug develops slowly and, as a rule, there is no cross-resistance to other chemotherapeutic agents. Due to its high toxicity, Levomycetin is used to treat severe infections in which less toxic antibacterial agents are ineffective or contraindicated.
It is well and quickly absorbed after ingestion: the maximum concentration in the blood is reached after 2-3 hours, the therapeutic concentration in the blood is maintained for 4-5 hours after application. Penetrates into organs, tissues and body fluids, passes through the blood-brain barrier, well into the cerebrospinal fluid (up to 50% of the content in the blood). The drug crosses the placenta and appears in breast milk. Therapeutic concentrations of the drug when applied inside are detected in the vitreous body, cornea, iris, aqueous humor of the eye (the drug does not penetrate into the lens). It is excreted mainly in the urine (mainly in the form of inactive metabolites), partly in the bile and feces. In the intestine, under the influence of intestinal bacteria, it is hydrolyzed to form inactive metabolites.
Infectious and inflammatory diseases caused by microorganisms sensitive to the drug: typhoid fever, paratyphoid fever, yersiniosis, brucellosis, shigellosis, salmonellosis, tularemia, rickettsioses, chlamydia, purulent peritonitis, bacterial meningitis, biliary tract infections.
The drug is indicated in cases of ineffectiveness of other antimicrobial agents, given the possibility of severe side effects.
Hypersensitivity to chloramphenicol, other amphenicoliv and / or other components of the drug; oppression of hematopoiesis, blood diseases, skin diseases (psoriasis, eczema, fungal lesions); severe liver and / or kidney dysfunction; deficiency of the enzyme glucose-6-phosphate dehydrogenase; porphyria.
Levomycetin should not be prescribed for acute respiratory diseases, sore throat, as well as for the prevention of bacterial infection.
Interaction with other medicinal products and other types of interactions
Long-term use of Levomycetin, which is an inhibitor of liver enzymes in the preoperative period or during surgery, can reduce clearance and increase the duration of action of alfetanyl.
Chloramphenicol inhibits the enzyme system of cytochrome P450, therefore, when used simultaneously with antiepileptic drugs (phenobarbital, phenytoin), indirect anticoagulants (dicoumarin warfarin), a weakening of the metabolism of these drugs, slowing down of withdrawal, an increase in their concentration in blood plasma and an increase in their toxicity are noted.
With the simultaneous use of Levomycetin with tolbutamide (butamide) and chlorpropamide, their hypoglycemic effect may increase (due to inhibition of metabolism in the liver and an increase in their concentration), which requires dose adjustment.
Phenobarbital, rifampicin, rifabutin reduce the concentration of chloramphenicol in the blood plasma by accelerating its metabolism in the liver.
When used simultaneously with steam