Buy Suprax granules for suspension 30g 100mg/5ml 60ml in pharmacies


Description of the drug

Suprax is a modern cephalosporin antibiotic. Used in the treatment of complex infections caused by gram-negative or gram-positive bacteria, as well as aerobic or anaerobic microorganisms. Shown to be effective against streptococcus and staphylococcus.

Produced in the form of capsules and suspensions. Both dosage forms of Suprax have the antibiotic cefixime as the main active ingredient.

Capsules contain 400 mg of the medicinal component. Excipients include silicon dioxide, azorubine, magnesium stearate, and cellulose. Sold 6 pieces in a cardboard box containing instructions.

Patients aged 6 months to 12 years need to purchase the medicine in powder form to make a suspension themselves. 5 ml of the finished medicine contains 100 mg of cefixime. The cardboard box contains one 60 ml bottle of white or slightly cream-colored powder, instructions for preparing the liquid form and a dosing syringe. The suspension additionally includes: sodium benzoate, xanthan gum, sucrose and flavoring.

Buy Suprax granules for suspension 30g 100mg/5ml 60ml in pharmacies

International nonproprietary name:

cefixime

Chemical name:

-(6R, 7R)-7-[(Z)-2-(2-amino-4-thiazolyl)-2-(carboxy-methoxyimino)acetamido]-8-oxo-3-vinyl-5-thia-1- azabicyclo[4,2,0]-oct-2-ene-2-carboxylic acid trihydrate.

Dosage form:

granules for the preparation of suspension for oral administration.

Composition per 1 bottle for the preparation of oral suspension 100 mg/5 ml:

Active ingredient: cefixime trihydrate (micronized) 1.402 g (equivalent to 1.2 g cefixime + 4% refill).

Inactive ingredients: sodium benzoate 0.03 g, sucrose 30.225 g, xanthan gum 0.155 g, strawberry flavor 0.048 g.

Description

Almost white to cream-colored small granules. Once mixed, it forms an off-white to cream-colored slurry with a sweet strawberry aroma.

Pharmacotherapeutic group:

Antibiotic cephalosporin.

Pharmacological properties

Cefixime is a semi-synthetic cephalosporin antibiotic of the third generation with a broad spectrum of action. Cefixime acts bactericidal, inhibiting the synthesis of the cell membrane, and is resistant to the action of beta-lactamases produced by most gram-positive and gram-negative bacteria.

Cefixime is active against the following microorganisms:

gram-positive: Streptococcus spp. (Streptococcus pneumoniae, Streptococcus pyogenes); gram-negative: Neisseria gonorrhoeae, Moraxella (Branhamella) catarrhalis, Escherichia coli, Klebsiella spp., Serratia spp., Proteus spp., Morganella morganii, Providencia spp. and Haemophilus influenzae.

Note: Pseudomonas species, Enterococcus (Streptococcus) serogroup D, Listeria monocytogenes, Staphylococcus spp., including methicillin-resistant strains, Enterobacter spp., Bacteroides fragilis, Clostridium spp. resistant to cefixime.

Pharmacokinetics

Absorption:

According to the results of studies involving healthy volunteers, after oral administration of cefixime, maximum serum concentrations are usually achieved after 3-4 hours. Following single doses of 50, 100, and 200 mg, mean maximum serum concentrations were 1.02, 1.46, and 2.63 mg/L, respectively, in 12 healthy Caucasians, and 0.69, 1.13, and 1.95 mg/l, respectively, in 12 healthy Japanese subjects.

Children's population:

After single doses of 1.5, 3.0, and 6.0 mg/kg cefixime were administered to Japanese pediatric patients, peak serum concentrations after 3 to 4 hours were 1.14, 2.01, and 3.97 mg/L, respectively.

Distribution:

In human plasma, cefixime is approximately 70% protein bound, with the level of binding independent of concentration in the range of 0.5-30 mg/l. Cefixime is distributed, reaching concentrations in organs/tissues and biological fluids, such as saliva, tonsils, mucous membrane of the maxillary sinuses, middle ear discharge, bile, lung tissue and gall bladder.

Metabolism and excretion:

Biologically active metabolites of cefixime were not detected in the plasma or urine of healthy volunteers after oral administration of the drug. Approximately 20% of a 200 mg dose of cefixime in healthy volunteers is excreted unchanged by the kidneys. The half-life is 2-4 hours.

Kidney failure:

The pharmacokinetics of a single 400 mg oral dose were studied in studies involving patients with varying degrees of renal impairment. Based on the results of studies, half-life, total clearance (CL/F), renal clearance and area under the pharmacokinetic curve (AUC) in patients with severe renal impairment (creatinine clearance < 20 ml/min), patients on hemodialysis or on continuous ambulatory peritoneal dialysis (CAPD) differed from the corresponding indicators of healthy volunteers.

Pharmacokinetic characteristics (mean values) of cefixime in healthy volunteers and patients with varying degrees of severity of renal dysfunction

Study groupCLCr (ml/min/1.73 m2)Cmax (mg/l)Tmax (h)T1/2β (h)AUC (mg×h/l)CL/F (ml/kg/h)Renal clearance (ml/kg/h)
Healthy Volunteers1114,94,93,24014122
Severity of renal dysfunction
Very light715,84,04,75712722
Light517,64,57,0907010
Moderate287,53,57,2100803,7
Heavy9,89,66,011,5 #188 #41 #2,1 #
Hemodialysis1,36,24,88,294730,4 #
CAPD3,010,25,014,9 #220 #42 #0,5 #

The discrepancy is statistically significant compared to the values ​​of healthy volunteers.

Abbreviations: CLCr - creatinine clearance, Cmax - maximum concentration, Tmax - time to reach maximum concentration, T1/2β - half-life, CL/F - total clearance, CAPD - continuous ambulatory peritoneal dialysis, AUC - area under the pharmacokinetic curve # p < 0 .05 compared to healthy volunteers

Indications for use

Infectious and inflammatory diseases caused by microorganisms sensitive to the drug:

- upper respiratory tract infections, for example, pharyngitis, tonsillitis; otitis media, sinusitis; - lower respiratory tract infections, for example, acute bronchitis, exacerbation of chronic bronchitis; - urinary tract infections, for example, cystitis, cystourethritis, uncomplicated pyelonephritis, urethritis, acute uncomplicated gonorrhea.

Contraindications

- Hypersensitivity to cefixime, cephalosporins or any component of the drug. - History of severe immediate hypersensitivity reactions (for example, anaphylactic reaction) to other beta-lactam antibiotics and penicillins (see section Special instructions). — Hereditary fructose intolerance, glucose-galactose malabsorption, or sucrase-isomaltase deficiency. — Children's age up to 6 months.

With caution: old age, chronic renal failure, pseudomembranous colitis (history).

Carefully:

History of mild immediate hypersensitivity reactions to penicillins and other beta-lactam antibiotics.

Use during pregnancy and breastfeeding

The use of the drug during pregnancy is possible when the expected benefit to the mother outweighs the potential risk to the fetus.

If it is necessary to prescribe the drug during lactation, breastfeeding should be stopped.

Directions for use and doses

Children aged 6 months to 12 years are prescribed as a suspension at a dose of 8 mg/kg/day once or in 2 doses of 4 mg/kg every 12 hours. You must always strictly adhere to the dosage prescribed by your doctor. If you have any doubts about the correct use, you should consult your doctor.

If the package is equipped with a dosage syringe, you must be guided by the following dose selection table:

Dose selection of oral suspension, 100 mg/5 ml, using a dosage syringe

Body weight, kgDaily dose, mgDose of suspension, ml (taken once a day)Dose of suspension, ml (taken 2 times a day)
6482,41,2
7562,81,4
8643,21,6
9723,61,8
108042
11884,42,2
12964,82,4
131045,22,6
4.8 ml + 0.4 ml
141125,62,8
1 full syringe + 0.6 ml
1512063
1 full syringe + 1 ml
161286,43,2
1 full syringe + 1.4 ml
171366,83,4
1 full syringe + 1.8 ml
181447,23,6
1 full syringe + 2.2 ml
191527,63,8
1 full syringe + 2.6 ml
2016084
1 full syringe + 3 ml
211688,44,2
1 full syringe + 3.4 ml
221768,84,4
1 full syringe + 3.8 ml
231849,24,6
1 full syringe + 4.2 ml
241929,64,8
1 full syringe + 4.6 ml
25200105
2 full syringes
2620810,45,2
2 full syringes + 0.4 ml4.8 + 0.4 ml
2721610,85,4
2 full syringes + 0.8 ml1 full syringe + 0.4 ml
2822411,25,6
2 full syringes + 1.2 ml1 full syringe + 0.6 ml
2923211,65,8
2 full syringes + 1.6 ml1 full syringe + 0.8 ml
30240126
2 full syringes + 2 ml1 full syringe + 1 ml
3124812,46,2
2 full syringes + 2.4 ml1 full syringe + 1.2 ml
3225612,86,4
2 full syringes + 2.8 ml1 full syringe + 1.4 ml
3326413,26,6
2 full syringes + 3.2 ml1 full syringe + 1.6 ml
3427213,66,8
2 full syringes + 3.6 ml1 full syringe + 1.8 ml
35280147
2 full syringes + 4 ml1 full syringe + 2 ml
3628814,47,2
2 full syringes + 4.4 ml1 full syringe + 2.2 ml
3729614,87,4
2 full syringes + 4.8 ml1 full syringe + 2.4 ml
3830415,27,6
2 full syringes + 4.8 + 0.4 ml1 full syringe + 2.6 ml
3931215,67,8
3 full syringes + 0.6 ml1 full syringe + 2.8 ml
40320168
3 full syringes + 1 ml1 full syringe + 3 ml
4132816,48,2
3 full syringes + 1.4 ml1 full syringe + 3.2 ml
4233616,88,4
3 full syringes + 1.8 ml1 full syringe + 3.4 ml
4334417,28,6
3 full syringes + 2.2 ml1 full syringe + 3.6 ml
4435217,68,8
3 full syringes + 2.6 ml1 full syringe + 3.8 ml
45360189
3 full syringes + 3 ml1 full syringe + 4 ml
4636818,49,2
3 full syringes + 3.4 ml1 full syringe + 4.2 ml
4737618,89,4
3 full syringes + 3.8 ml1 full syringe + 4.4 ml
4838419,29,6
3 full syringes + 4.2 ml1 full syringe + 4.6 ml
4939219,69,8
3 full syringes + 4.6 ml1 full syringe + 4.8 ml
504002010
4 full syringes2 full syringes

If the package is equipped with a dosage spoon, you must be guided by the following dose selection table:

Selection of the dose of oral suspension 100 mg/5 ml using a dosage spoon

Body weight, kgDose of suspension, ml (taken once a day)Dose of suspension, ml (taken 2 times a day)
Up to 6 kg2.5 ml1.25 ml
6 – 12.5 kg5 ml2.5 ml
12.5 – 25 kg10 ml5 ml
25 – 37.5 kg15 ml7.5 ml
more than 37.5 kg20 ml10 ml

For adults and children over 12 years of age weighing more than 50 kg - 400 mg 1 time per day or 200 mg 2 times per day.

The average duration of treatment is 7-10 days

For diseases caused by Streptococcus pyrogenes, the course of treatment is at least 10 days.

In case of impaired renal function, the dose is set depending on the creatinine clearance (CC): with creatinine clearance 21-60 ml/min or in patients on hemodialysis, the daily dose should be reduced by 25%. With a CC of 20 ml/min in patients on peritoneal dialysis, the daily dose should be halved.

Be careful! The dosing syringe or dosing spoon is used exclusively for the oral administration of Suprax suspension and should not be used for dosing other medicinal products. Do not use other devices for dosing and administering the drug Suprax (syringe, spoon, pipette from another drug), in addition to the special syringe or spoon supplied in the kit.

Method for preparing the suspension:

turn the bottle over and shake the contents of the bottle. Add 40 ml (total volume) of cooled boiled water in 2 stages or bring the volume of the suspension to the mark (arrow mark on the bottle label, if this mark is present). Shake the suspension until a homogeneous suspension is formed, let it stand for 5 minutes to ensure complete dissolution of the powder. If there is an arrow mark on the bottle, make sure (after the foam has settled) that the volume reaches the mark. If this does not happen, bring the volume to the mark again.

Before use, the prepared suspension must be shaken well.

Use the suspension within 14 days from the date of preparation, subject to storage conditions (from 15 to 25C). Do not freeze!

Side effect

Blood and lymphatic system disorders:

eosinophilia, granulocytopenia, hemolytic anemia, thrombocytopenia, pancytopenia, leukopenia, neutropenia, agranulocytosis, aplastic anemia, bleeding.

Gastrointestinal tract disorders: abdominal pain, diarrhea, dyspepsia, nausea, vomiting, dry mouth, anorexia, constipation, flatulence, dysbacteriosis, stomatitis, glossitis.

Disorders of the liver and biliary tract: jaundice, impaired liver function, cholestasis, hepatitis.

Infectious and parasitic diseases: pseudomembranous colitis, candidiasis.

Immune system disorders: anaphylactic reaction, serum sickness, anaphylactic shock.

Changes in laboratory parameters: increased aspartate aminotransferase level, increased alanine aminotransferase level, increased blood alkaline phosphatase level, increased blood bilirubin level, increased blood urea level, increased blood creatinine level, increased prothrombin time.

Nervous system disorders: dizziness, headache, tinnitus, convulsions, hypersensitivity.

Skin and subcutaneous tissue disorders: drug rash with eosinophilia and systemic symptoms (DRESS syndrome), itching, rash, exudative erythema multiforme (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome), urticaria, angioedema, erythema multiforme.

From the urinary system: interstitial nephritis, impaired renal function, acute renal failure.

From the reproductive system: vaginitis, itching of the genitals.

Other: fever, facial swelling, shortness of breath, development of hypovitaminosis B.

Overdose

Symptoms: increased adverse reactions, especially from the gastrointestinal tract, with the exception of allergic reactions.

Treatment: gastric lavage, symptomatic and supportive therapy.

There is no specific antidote. Cefixime is not excreted in large quantities from the body by hemo- or peritoneal dialysis.

Interaction with other drugs

Blockers of tubular secretion, allopurinol, diuretics delay the excretion of cefixime by the kidneys, which can lead to an increase in the concentration of the drug in the blood plasma.

When used simultaneously with carbamazepine, its concentration in the blood plasma increases.

Cefixime reduces the prothrombin index and enhances the effect of indirect anticoagulants. Cefixime should be administered with caution to patients taking coumarin anticoagulants such as warfarin. Since cefixime may enhance the effects of anticoagulants, the combined use of these drugs may lead to an increase in prothrombin time with the possible development of bleeding.

Antacids containing magnesium or aluminum hydroxide slow down the absorption of the drug, so cefixime should be taken 1-2 hours before or 4 hours after taking the above medications.

Taking cefixime may cause a false positive result in a urine glucose test using Benedict's solution, Fehling's solution, or the Clinitest test. In this case, it is recommended to use tests based on enzymatic glucose oxidase reactions (for example, Tes-Tape strips).

It is possible to obtain a false-positive direct Coombs test result in patients taking cefixime.

When cefixime is used concomitantly with potentially nephrotoxic drugs (for example, aminoglycosides, polymyxin B, colistin and viomycin) and diuretics (ethacrynic acid, furosemide), the risk of renal dysfunction increases.

The effectiveness of oral contraceptives may be reduced when taken together with cefixime.

special instructions

Patients with a history of allergic reactions to penicillins and other β-lactam antibiotics may have increased sensitivity to cephalosporin antibiotics. If toxic epidermal necrolysis (Lyell's syndrome), Stevens-Johnson syndrome, drug rash with eosinophilia and systemic symptoms (DRESS syndrome) occurs, cefixime should be discontinued and the necessary therapy should be carried out.

Cases of drug-induced hemolytic anemia, including serious and fatal cases, have been reported for cephalosporins (as a class). Cases of reoccurrence of hemolytic anemia after resumption of cephalosporin therapy have been reported in patients with a history of cephalosporin (including cefixime)-induced hemolytic anemia.

Like other cephalosporins, cefixime can cause acute renal failure, including tubulointerstitial nephritis. In case of acute renal failure, stop taking cefixime and institute appropriate treatment/take necessary measures.

Monitoring of renal function is necessary when cefixime is co-administered with the following drugs: aminoglycosides, polymyxin B, colistin, high-dose loop diuretics.

When using cefixime, the risk of developing a decrease in prothrombin activity increases.

When using cefixime, the risk of developing antibiotic resistance increases.

Long-term use of the drug may disrupt the normal intestinal microflora, which can lead to the growth of Clostridium difficile, causing severe diarrhea and pseudomembranous colitis. In this case, the use of drugs that inhibit intestinal motility is contraindicated.

When prescribing the drug, it is necessary to take into account that one bottle of suspension contains 30.225 g of sucrose, which is about 3 XE.

Use in children:

The safety of taking the drug cefixime in premature infants and newborns has not been established.

Influence on the ability to drive vehicles and machinery.

Patients taking cefixime should be careful when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions, taking into account the side effect profile.

Release form

Granules for the preparation of suspension for oral administration, 100 mg/5 ml.

From 30.3 to 35.0 g (equivalent to 1.2 g of cefixime + 4% refill) granules for the preparation of an oral suspension of 100 mg/5 ml in dark glass bottles with a screw-on plastic cap.

Storage conditions

At temperatures from 15 oC to 25 oC. Keep out of the reach of children!

Best before date

3 years. Do not use after the expiration date indicated on the package.

Vacation conditions

On prescription.

When is Suprax prescribed?

This antibiotic is prescribed for:

  • Infectious lesions of the ENT organs (sinusitis, inflammatory processes in the pharynx, tonsillitis, frontal sinusitis, otitis media);
  • mild infections of the urinary system (inflammation of the bladder or kidneys);
  • infections localized in the lower respiratory tract (bronchi, lungs);
  • bacterial damage to the skin and soft tissues;
  • osteomyelitis;
  • Lyme disease;
  • endometritis and gonorrhea.

Indications

Suprax is intended for the treatment of infectious and inflammatory processes caused by bacteria that are sensitive to cefixime. Therefore, before starting treatment, it is necessary to undergo tests to determine the causative agent of the infection. Thus, Suprax is used for the following diseases:

  • infections of the nasopharynx and upper respiratory tract (sinusitis, acute pharyngitis, agranulocytic tonsillitis, chronic pharyngitis, sinusitis, tonsillitis);
  • infections of the lower respiratory tract (acute and chronic bronchitis of bacterial origin, pneumonia);
  • otitis media;
  • uncomplicated urinary tract infections (cystitis, urethritis, pyelonephritis);
  • uncomplicated gonorrhea (cervical, urethral);
  • shigellosis.

How to take Suprax

The medicine is taken orally, regardless of meals, with a sufficient amount of water. Adult patients and children over 12 years of age who weigh more than 50 kg are prescribed capsules. Dosage – 400 mg once a day, it is important to take it at the same time. The duration of treatment is from 7 to 10 days, depending on the severity of the condition and the causative agent of the disease.

If the patient is diagnosed with kidney problems, the dose is reduced by ¼.

For uncomplicated gonorrhea, one 400 mg capsule is recommended.

Suprax suspension for children from 6 months to 12 years is prescribed based on the calculation:

  • 8 mg of cefixime per 1 kg of child’s weight, given once a day;
  • 4 mg of cefixime per 1 kg, but taken twice a day with an interval of 12 hours.

Thus, children are prescribed the following daily volumes of suspension depending on age:

  • 6 months-1 year: 2.5-4 ml;
  • 2-4 years: 5 ml;
  • 5-11 years: 6-10 ml.

Additional information about the drug

So, cephalosporins are antibiotics that are characterized by a wide spectrum of action; they are highly bactericidal and immune to beta-lactamases (bacterial enzymes that destroy the antibiotic, causing its action to become ineffective). In general, in some ways, cephalosporins are more effective than penicillins. And Suprax is based on third generation cephalosporins. And this is the first such antibiotic that can be taken orally. Suprax is based on cefixime. Cefixime affects the cell wall of the pathogen, inhibiting its formation.

Suprax inhibits the vital activity of streptococci, Haemophilus influenzae, Escherichia coli, Proteus, Salmonella, Citrobacter and gonococci. However, Suprax is powerless against Pseudomonas aeruginosa, most staphylococci, enterobacters and listeria. As for taking the drug, food does not affect its bioavailability in any way. Yes, it prolongs the period of reaching the maximum content in the blood and that’s all. Another good thing about Suprax is that you need to take it once a day. This is due to the half-life of the drug from the body. It takes a long time to come out. About 50% of the drug is excreted in the urine. And this is great because it is effective in treating urinary tract infections. However, it is better not to take it with diuretics, as the withdrawal of the drug is slowed down. In general, Suprax penetrates well to the site of infection. The main foci of infection with which Suprax interacts are the middle ear cavity, paranasal sinuses, tonsils, lungs, and bile ducts. If we rely on patient reviews about taking Suprax, they note a slight suppression of intestinal microflora. You can find Suprax in two dosage forms that are aimed at different age groups: 400 mg capsules for adult patients and granules for the preparation of a strawberry-flavored suspension 100 mg / 5 ml - 60 ml for children.

How to prepare a suspension

To prepare the liquid form of the medicine, you must follow the instructions for the Suprax suspension:

  1. Shake the bottle to agitate the contents.
  2. In two stages, add 40 ml of boiled water at room temperature to the powder.
  3. Shake the contents thoroughly after each addition of water.
  4. Allow the suspension to stand for at least 5 minutes until the granules are completely dissolved.

The contents of the bottle must be shaken before each use.

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.

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

Side effects

During therapeutic treatment, Suprax may cause the following side effects:

  • Allergic reactions: skin itching, skin flushing, eosinophilia, fever, urticaria, erythema multiforme, anaphylactic shock, toxic epidermal necrolysis, reactions resembling serum sickness.
  • From the digestive system: dry mouth, anorexia, diarrhea, nausea, vomiting, abdominal pain, flatulence, transient increase in the activity of liver transaminases and alkaline phosphatase, hyperbilirubinemia, jaundice, gastrointestinal candidiasis, dysbacteriosis; rarely – stomatitis, glossitis, pseudomembranous enterocolitis.

One of the side effects of the drug is abdominal pain.

  • From the hematopoietic system: agranulocytosis, neutropenia, thrombocytopenia, leukopenia, pancytopenia, bleeding, hemolytic and aplastic anemia.
  • From the reproductive system: genital itching, vaginitis.
  • From the urinary system: interstitial nephritis.
  • From the nervous system: tinnitus, headache, dizziness, convulsions.
  • Other: shortness of breath, candidomycosis;

Typically, these adverse reactions do not appear clearly enough and are mild. Therefore, in most cases, treatment cessation is not required.

special instructions

For patients suffering from diabetes, it is important to take into account the presence of sucrose in the suspension (20 ml contains 15 g). During antibiotic treatment, you must refrain from drinking alcoholic beverages.

If the patient has an allergic reaction to penicillin, then Suprax 400 mg should be taken with caution according to the instructions.

With an overdose of an antibiotic, there is an increase in side effects. In this case, gastric lavage, taking antiallergic drugs, and in severe cases mechanical ventilation and dialysis are indicated.

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