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Buy Fosfomycin Esparma powder for oral solution 3g No. 1 in pharmacies
Dosage form:
powder for solution for oral administration
Compound:
1 package 8 g contains:
Active substance:
fosfomycin trometamol - 5.631 g (equivalent to 3.0 g fosfomycin);
Excipients:
sucrose - 2.244 g; orange flavoring - 0.065 g; tangerine flavoring - 0.050 g; sodium saccharin - 0.010 g.
Description:
homogeneous powder of white or almost white color, with a fruity odor, without agglomerates and foreign particles.
Pharmacotherapeutic group:
antibiotic
Pharmacological properties
Pharmacodynamics:
Broad-spectrum antibiotic. Has a bactericidal effect. It is a structural analogue of phosphoenol pyruvate and penetrates into the microbial cell, j The drug irreversibly inhibits the enzyme N-acetyl-glucosamino-3-o-enolpyruvyl transferase, irreversibly blocks the condensation of uridine diphosphate-N-acetyl-glucosamine with phosphoenolpyruvate, inhibits the synthesis UDP-N-acetyl-muramic acid, thus inhibiting the initial stage of peptidoglycan formation in the bacterial cell wall.
Cross-resistance of the drug with other antibacterial agents is unknown. In vitro, when combined with amoxicillin, cephalexin, pipemidic acid, a pronounced synergism of antimicrobial action is noted.
In vitro, gram-positive (Staphylococcus saprophytticus, Enterococcus faecalis) and gram-negative (Escherichia coli, Klebsiella pneumoniea, Citrobacter spp., Enterobacter spp., Proteus mirabilis) microorganisms are sensitive to fosfomycin. In vitro, fosfomycin trometamol reduces the adhesion of a number of bacteria to the epithelium of the urinary tract.
Pharmacokinetics
Suction:
Fosfomycin is moderately absorbed from the gastrointestinal tract when taken orally. In the body it dissociates into fosfomycin and trometamol.
The bioavailability of a single dose of 3 g when taken orally ranges from 32% to 54%. The maximum concentration in plasma (C max) is observed 2-3 hours (t max) after oral administration and is about 30 mg/l. The half-life from blood plasma varies from 3 to 4 hours.
Distribution:
Fosfomycin does not bind to plasma proteins, is not metabolized, and predominantly accumulates in the urine. Already 2-4 hours after oral administration of a single dose of 3 g, a high therapeutic concentration of 2-4 g/l is achieved in the urine, decreasing to 1-2 g/l after 6-12 hours. Average concentrations after 12-24 hours and after 36-48 hours were 0.762 g/l and 0.147 g/l, respectively.
The minimum inhibitory concentration (0.128 g/l), bactericidal for most common pathogens of urinary tract infections, remains in the urine for at least 48 hours, which determines treatment with a single dose.
Removal:
The main part is excreted unchanged by the kidneys. A small part is excreted through the intestines.
In cases of moderate decline in renal function, the half-life of fosfomycin by the kidneys is slightly prolonged depending on the degree of functional impairment.
Indications for use
Bacterial infections of the urinary tract of various localizations caused by microorganisms sensitive to fosfomycin:
- acute uncomplicated urinary tract infections; - asymptomatic bacteriuria; prevention of infections; — urinary tract after surgery and transurethral diagnostic studies.
Contraindications
- hypersensitivity to fosfomycin or other components of the drug; - severe renal failure (creatinine clearance <20 ml/min); - children under 12 years of age, since there is insufficient data on its use; - sucrase/isomaltase deficiency; - fructose intolerance; - glucose-galactose malabsorption.
Use during pregnancy and breastfeeding
During pregnancy, it is used only if the expected benefit to the mother outweighs the potential risk to the fetus.
When prescribing the drug during lactation, breastfeeding should be stopped for the duration of treatment.
Directions for use and doses
Inside.
Fosfomycin Esparma is used once, on an empty stomach, 2-3 hours before or after a meal, preferably before bedtime, after emptying the bladder: adults and children over 12 years old in a daily dose of 3 g. The contents of one package are dissolved in approximately 150-200 ml of water and taken immediately after preparation.
The course of treatment is 1 day.
To prevent urinary tract infections during surgery and diagnostic procedures, the indicated dose is taken 2 times - 3 hours before the intervention and 24 hours after it.
Fosfomycin Esparma should not be taken by patients weighing less than 50 kg and children under 12 years of age, as the dose cannot be divided or reduced.
Side effect
According to the frequency of development, side effects are in the following groups: Very common: (> 1/10) Frequent: (> 1/100 - < 1/10) Not common: (> 1/1,000 - < 1/100) Rare: (> 1/10,000 - < 1/1,000) Very rare: (< 1/10,000) Unknown: (the incidence of adverse events is not determined based on existing data). From the nervous system: Common: headache, dizziness, asthenia Not common: sensation of numbness of the skin, “crawling”, paresthesia Not known: optic neuritis From the cardiovascular system: Rare: tachycardia Not known: decreased blood pressure From the respiratory system , organs of the chest and mediastinum: Not known: bronchial asthma From the immune system: Not known: skin itching, anaphylactic shock, hypersensitivity reactions (angioedema, skin rash, urticaria) From the gastrointestinal tract: Not common: diarrhea, nausea, dyspepsia Rare: vomiting Unknown: pseudomembranous colitis, abdominal pain From the liver and biliary tract: Not common: increased activity of “liver” transaminases From the genital organs and mammary gland: Not common: vulvovaginitis From the blood and lymphatic system: Not common: thrombocytosis, leukopenia If any of the side effects indicated in the instructions get worse or you notice any other side effects not listed in the instructions, tell your doctor.
Overdose
Symptoms of overdose: vestibular syndrome, hearing impairment, “metallic” taste and general taste disturbances, diarrhea. A specific antidote has not been identified. If necessary, symptomatic treatment is carried out.
Interaction with other drugs
Concomitant use with metoclopramide, antacids or drugs containing calcium salts may lead to a decrease in the concentration of fosfomycin in the blood serum and urine. For this reason, it is recommended to take medications at intervals of 2-3 hours.
Concomitant use with other drugs that increase gastrointestinal motility can also lead to a decrease in the concentration of fosfomycin in the blood serum and urine.
special instructions
The occurrence of acute and persistent diarrhea during or after antibiotic treatment may be a symptom of antibiotic-induced colitis. The most serious form is pseudomembranous colitis.
In the case of pseudomembranous colitis, appropriate measures must be taken immediately. In this case, the use of drugs that slow down peristalsis is contraindicated.
The drug contains sucrose. Patients with rare hereditary diseases, fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase deficiency should not take this drug.
One packet of Fosfomycin Esparma contains approximately 2.3 g of sucrose, which is equivalent to approximately 0.19 bread units (XU).
Simultaneous food intake slows down the absorption of granules, so it is recommended to take the drug on an empty stomach, 2-3 hours before or after a meal.
Impact on the ability to drive vehicles and machines Patients should be warned about the possibility of developing dizziness and if dizziness occurs, they should refrain from performing these types of activities.
Release form:
Powder for solution for oral administration 3 g.
8 g of powder in bags made of three-layer material (paper-aluminum-polyethylene).
1 package with instructions for use in a cardboard box.
Storage conditions:
At a temperature not higher than 25 °C.
Keep out of the reach of children.
Best before date:
2 years.
Do not use after the expiration date stated on the packaging.
Conditions for dispensing from pharmacies:
On prescription.
Fosfomycin
- Pharmacodynamics The active substance of the drug is fosfomycin in the form of fosfomycin trometamol salt. Fosfomycin has a bactericidal effect by inhibiting the formation of bacterial cell walls. Violation of the process of cell wall creation occurs due to inhibition of the early stage of peptidoglycan synthesis. Fosfomycin is a phosphonic acid derivative and has a similar structure to p-enolpyruvate. Fosfomycin inactivates the enzyme enolpyruvil transferase. Due to the inactivation of this enzyme, the condensation of uridine diphosphate-N-acetylglucosamine with p-enolpyruvate is irreversibly blocked. And this is one of the first stages of bacterial cell wall synthesis. Fosfomycin is able to prevent the adhesion of bacteria to the mucous membrane of the bladder. Adhesion may be a predisposing factor to recurrent urinary tract infections. Fosfomycin is active against a wide range of bacteria, including the most common pathogens of urinary tract diseases. The group of sensitive microorganisms includes most gram-positive (Staphylococcus aureus, Staphylococcus saprophyticus, Enterococcus faecalis) and gram-negative (Escherichia coli, Klebsiella spp., Citrobacter spp., Enterobacter spp., Proteus mirabilis) bacteria, including bacteria that produce the enzyme penicillinase. The activity of fosfomycin against the most common pathogens of urinary tract infections remains unchanged. Only a small number of bacteria are capable of developing resistance to the active substance of the drug. For example, the resistance rate of Escherichia coli, which is a very common cause of uncomplicated urinary tract infections, is low. Most multidrug-resistant Escherichia coli strains and strains of other members of the family Enterobacteriaceae that produce extended-spectrum beta-lactamases are sensitive to fosfomycin. Most strains of MRSA (methicillin-resistant Staphylococcus aureus) are also susceptible to fosfomycin. There have been no cases of cross-resistance with other drugs with antibacterial activity. Cross-resistance should not be expected, since the chemical structure of fosfomycin is fundamentally different from the chemical structure of all other antibiotics and fosfomycin demonstrates a unique mechanism of action. Pharmacokinetics Absorption When administered orally, fosfomycin trometamol is rapidly absorbed from the gastrointestinal tract; the amount of absorbed substance is approximately 50% of the dose taken. With a single oral dose of 50 mg/kg body weight, the concentration of the active substance in the blood plasma reaches its maximum value after 2-2.5 hours and is equal to 20-30 mcg/ml. Distribution Less than 5% of the administered dose of fosfomycin forms compounds with plasma proteins. Fosfomycin crosses the placental barrier and passes into breast milk. The active substance accumulates mainly in the urine. Metabolism Fosfomycin is not metabolized. Elimination The half-life from plasma is approximately 4 hours. 2-4 hours after a single oral dose of 3 g of fosfomycin, the concentration of the active substance in the urine reaches a significant value, in the range of 1800-3000 mcg/ml. Therapeutically effective concentrations (range 200-300 mcg/ml) are maintained in the urine for up to 48 hours. Therefore, as a rule, the course of treatment is limited to a single dose of the drug in a dose of 3 g (in terms of fosfomycin). Unchanged fosfomycin is excreted 90% by the kidneys and 10% through the intestines. 40-50% of the dose is excreted unchanged in the urine within 48 hours. In patients with renal failure, the rate of elimination of fosfomycin slows down in accordance with the degree of renal impairment, and the plasma half-life increases (T ½ reaches 50 hours with a creatinine clearance of 10 ml/min). If there is a moderate decrease in renal function (creatinine clearance less than 80 ml/min), including a physiological decrease in the elderly, the half-life of fosfomycin increases slightly, but the concentration of the active substance in the urine remains at a therapeutic level.
Fosfomycin (por.d.prig.solution d.pr.inward 3 g No. 1)
A country
Germany
The country of production may vary depending on the batch of goods. Please check with the operator for detailed information when confirming your order.
Compound:
1 package of 8 g contains: Active substance: fosfomycin trometamol - 5.631 g (equivalent to 3.0 g fosfomycin); Excipients: sucrose - 2.244 g; orange flavoring - 0.065 g; tangerine flavoring - 0.050 g; sodium saccharin - 0.010 g. Description: homogeneous powder of white or almost white color, with a fruity odor, without agglomerates and foreign particles. Release form: Powder for the preparation of a solution for oral administration, 3 g. 8 g of powder in bags made of three-layer material (paper-aluminum-polyethylene). 1 package with instructions for use in a cardboard box.
Pharmacological properties
Pharmacodynamics: Broad-spectrum antibiotic. Has a bactericidal effect. It is a structural analogue of phosphoenol pyruvate and penetrates the microbial cell. The drug irreversibly inhibits the enzyme N-acetyl-glucosamino-3-o-enolpyruvyl transferase, irreversibly blocks the condensation of uridine diphosphate-N-acetyl-glucosamine with phosphoenolpyruvate, suppresses the synthesis of UDP-N-acetylmuramic acid, thus inhibiting the initial stage of peptidoglycan formation bacterial cell wall. Cross-resistance of the drug with other antibacterial agents is unknown. In vitro, when combined with amoxicillin, cephalexin, pipemidic acid, a pronounced synergism of antimicrobial action is noted. In vitro, gram-positive (Staphylococcus saprophytticus, Enterococcus faecalis) and gram-negative (Escherichia coli, Klebsiella pneumoniea, Citrobacter spp., Enterobacter spp., Proteus mirabilis) microorganisms are sensitive to fosfomycin. In vitro, fosfomycin trometamol reduces the adhesion of a number of bacteria to the epithelium of the urinary tract. Pharmacokinetics Absorption: Fosfomycin is moderately absorbed from the gastrointestinal tract when administered orally. In the body it dissociates into fosfomycin and trometamol. The bioavailability of a single dose of 3 g when taken orally ranges from 32% to 54%. The maximum concentration in plasma (Cmax) is observed 2-3 hours (tmax) after oral administration and is about 30 mg/l. The half-life from blood plasma varies from 3 to 4 hours. Distribution: Fosfomycin does not bind to plasma proteins, is not metabolized, and predominantly accumulates in the urine. Already 2-4 hours after oral administration of a single dose of 3 g, a high therapeutic concentration of 2-4 g/l is achieved in the urine, decreasing to 1-2 g/l after 6-12 hours. The average concentrations after 12-24 hours and after 36-48 hours were 0.762 g/L and 0.147 g/L, respectively. The minimum inhibitory concentration (0.128 g/l), bactericidal for most common pathogens of urinary tract infections, remains in the urine for at least 48 hours, which determines treatment with a single dose. Excretion: The main part is excreted unchanged by the kidneys. A small part is excreted through the intestines. In cases of moderate decline in renal function, the half-life of fosfomycin by the kidneys is slightly prolonged depending on the degree of functional impairment.
Indications for use
Bacterial urinary tract infections of various localizations caused by microorganisms sensitive to fosfomycin: acute uncomplicated urinary tract infections; asymptomatic bacteriuria; prevention of urinary tract infections after surgery and transurethral diagnostic studies.
Contraindications
- hypersensitivity to fosfomycin or other components of the drug; - severe renal failure (creatinine clearance - children under 12 years of age, since there is insufficient data on its use; - sucrase/isomaltase deficiency; - fructose intolerance; - glucose-galactose malabsorption.
Use during pregnancy and breastfeeding
During pregnancy, it is used only if the expected benefit to the mother outweighs the potential risk to the fetus. When prescribing the drug during lactation, breastfeeding should be stopped for the duration of treatment.
Directions for use and doses
Inside. Fosfomycin Esparma is used once, on an empty stomach, 2-3 hours before or after a meal, preferably before bedtime, after emptying the bladder: adults and children over 12 years old in a daily dose of 3 g. The contents of one package are dissolved in approximately 150-200 ml of water and taken immediately after preparation. The course of treatment is 1 day. For the prevention of urinary tract infections during surgery and diagnostic procedures, the indicated dose is taken 2 times - 3 hours before the intervention and 24 hours after it. Fosfomycin Esparma should not be taken by patients weighing less than 50 kg and children under 12 years of age, as the dose cannot be divided or reduced.
Side effect
According to the frequency of development, side effects are in the following groups: Very common: (≥ 1/10) Frequent: (≥ 1/100 - Not common: (≥ 1/1,000 - Rare: (≥ 1/10,000 - Very rare: (Unknown: (the incidence of side effects is not determined based on existing data.) From the nervous system: Common: headache, dizziness, asthenia Not common: numbness of the skin, crawling, paresthesia Not known: optic neuritis From the cardiovascular system : Rare: tachycardia Not known: decreased blood pressure From the respiratory system, chest and mediastinal organs: Not known: bronchial asthma From the immune system: Not known: skin itching, anaphylactic shock, hypersensitivity reactions (angioedema, skin rash, urticaria) With Parts of the gastrointestinal tract: Not common: diarrhea, nausea, dyspepsia Rare: vomiting Not known: pseudomembranous colitis, abdominal pain From the liver and biliary tract: Not frequent: increased activity of “liver” transaminases From the genital organs and mammary gland: Not common: vulvovaginitis From the blood and lymphatic system: Not common: thrombocytosis, leukopenia If any of the side effects indicated in the instructions get worse or you notice any other side effects not listed in the instructions, tell your doctor.
Overdose
Symptoms of overdose: vestibular syndrome, hearing impairment, “metallic” taste and general taste disturbances, diarrhea. A specific antidote has not been identified. If necessary, symptomatic treatment is carried out.
Interaction with other drugs
Concomitant use with metoclopramide, antacids or drugs containing calcium salts may lead to a decrease in the concentration of fosfomycin in the blood serum and urine. For this reason, it is recommended to take medications at intervals of 2-3 hours. Concomitant use with other drugs that increase gastrointestinal motility can also lead to a decrease in the concentration of fosfomycin in the blood serum and urine.
special instructions
The occurrence of acute and persistent diarrhea during or after antibiotic treatment may be a symptom of antibiotic-induced colitis. The most serious form is pseudomembranous colitis. In the case of pseudomembranous colitis, appropriate measures must be taken immediately. In this case, the use of drugs that slow down peristalsis is contraindicated. The drug contains sucrose. Patients with rare hereditary diseases, fructose intolerance, glucose-lactose malabsorption or sucrase-isomaltase deficiency should not take this drug. One packet of Fosfomycin Esparma contains approximately 2.3 g of sucrose, which is equivalent to approximately 0.19 bread units (XU). Simultaneous food intake slows down the absorption of granules, so it is recommended to take the drug on an empty stomach, 2-3 hours before or after a meal.
Impact on the ability to drive vehicles and machinery
Patients should be warned about the possibility of developing dizziness and if dizziness occurs, they should refrain from performing these activities.
Dispensing conditions in pharmacies
On prescription