Ciprofloxacin al 500mg - Allgemeines

Impaired liver function No adjustment of dose is required since levofloxacin is not metabolised to any relevant extent by the liver and is mainly excreted by the kidneys. Elderly population No adjustment of dose is required in the elderly, other than that imposed by consideration of renal function see section 4. Paediatric population Levofloxacin mg Film-coated Tablets is contraindicated in children and growing adolescents see section 4, ciprofloxacin al 500mg.

Method of administration Levofloxacin mg Film-coated Tablets tablets should be swallowed without crushing and with sufficient amount of liquid. They may be divided at the score line to adapt the dose. The tablets may be taken during meals or between meals. Levofloxacin mg Film-coated Tablets tablets should be taken at least two hours before or after iron salts, ciprofloxacin al 500mg, zinc salts, magnesium- or aluminium-containing antacids, or didanosine only didanosine formulations with aluminium or magnesium containing buffering agents ,and sucralfate administration, since reduction of absorption can occur see section 4.

Therefore levofloxacin is not recommended for the treatment of known or suspected MRSA infections unless laboratory results have confirmed susceptibility of the organism to levofloxacin and commonly recommended antibacterial agents for the treatment of MRSA-infections are considered inappropriate. 500mg may be used in the treatment of Acute Bacterial Sinusitis and Acute Exacerbation of Chronic Bronchitis when these infections have been adequately diagnosed.

Resistance to fluoroquinolones of E, ciprofloxacin al 500mg. Prescribers are advised to take into account the local prevalence of resistance in E. Use in humans is based on in vitro Bacillus anthracis susceptibility data and on animal experimental data together with limited human 500mg.

Tendinitis and tendon rupture Tendinitis may rarely occur. It most frequently involves the Achilles tendon and may lead to tendon rupture.

Tendinitis and tendon rupture, sometimes bilateral, may occur within 48 hours of starting treatment with levofloxacin ciprofloxacin have been reported up to several months after discontinuation of treatment.

The risk of tendinitis and tendon rupture is ciprofloxacin in patients aged over 60 years, in patients receiving daily doses of mg and in patients using corticosteroids. The daily dose should be adjusted in elderly patients based on creatinine clearance see section 4.

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Close monitoring of these patients is therefore necessary if they are prescribed levofloxacin. All patients should consult their physician if they experience symptoms of tendinitis. If tendinitis is suspected, treatment with levofloxacin must be halted immediately, and appropriate treatment e, ciprofloxacin al 500mg.

CDAD may range in severity from mild to life threatening, the most severe form of which is pseudomembranous colitis see section 4. It is therefore important to consider this diagnosis in patients who develop serious diarrhoea during or after treatment with levofloxacin. If CDAD is suspected or confirmed, levofloxacin should be stopped immediately and appropriate treatment initiated without delay. Anti-peristaltic medicinal products are contraindicated in this clinical situation.

Patients predisposed to seizures Quinolones may lower the seizure threshold and may trigger seizures. Levofloxacin is contraindicated in patients with a history of epilepsy see ciprofloxacin 4. In case of convulsive seizures see section 4. Patients with G phosphate dehydrogenase deficiency Patients with latent or actual defects in glucosephosphate dehydrogenase activity may be prone to haemolytic reactions when treated with quinolone antibacterial agents.

Therefore, if levofloxacin has to be used in these patients, potential occurrence of haemolysis should be monitored. Patients with renal impairment Since levofloxacin is excreted mainly by the kidneys, the dose of levofloxacin ciprofloxacin be adjusted in patients with renal impairment see section 4.

Hypersensitivity reactions Levofloxacin can cause serious, potentially fatal hypersensitivity reactions e. Patients should discontinue treatment immediately and contact their physician or an emergency physician, who will initiate appropriate emergency measures. Severe 500mg reactions Cases of severe bullous skin reactions such as Stevens-Johnson syndrome or toxic epidermal necrolysis have been reported with levofloxacin see section 4.

Dysglycaemia As with all quinolones, disturbances in blood glucose, including both hypoglycaemia and hyperglycaemia have been reported, usually 500mg diabetic patients receiving concomitant treatment with an oral vardenafil rezeptfrei apotheke agent e.

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Cases of hypoglycaemic coma have been reported. In diabetic patients, careful monitoring of blood glucose is recommended see section 4. Prevention of photosensitisation Photosensitisation has been reported with levofloxacin see section 4. It is recommended that patients should not expose themselves unnecessarily to strong sunlight or to artificial Ciprofloxacin rays e.

Psychotic reactions Psychotic reactions have been reported in patients receiving quinolones, including levofloxacin. In very rare cases these have progressed to suicidal thoughts and self-endangering behaviour- sometimes after only a single dose of levofloxacin see section 4.

In the event that the patient develops these reactions, levofloxacin should be discontinued and appropriate measures instituted. Caution is recommended if levofloxacin is to be used in psychotic patients or in patients with history of psychiatric disease.

QT ciprofloxacin prolongation Caution should be taken when using fluoroquinolones, including levofloxacin in patients with known risk factors for prolongation of the QT interval such as, for example: Therefore, caution should be ciprofloxacin when using fluoroquinolones, including levofloxacin, in these 500mg. Peripheral neuropathy Peripheral sensory neuropathy and peripheral sensory motor neuropathy have been reported in patients receiving fluoroquinolones, including levofloxacin, which can be rapid in its onset see section 4.

Levofloxacin should be discontinued if the patient experiences symptoms of neuropathy in order to prevent the development of an irreversible condition. Hepatobiliary disorders Cases of hepatic necrosis up to fatal hepatic failure have been reported with levofloxacin, primarily in patients with severe underlying diseases, e. Patients should be advised to stop treatment and contact their doctor if signs and symptoms of hepatic disease develop such as anorexia, jaundice, dark urine, ciprofloxacin al 500mg, 500mg or tender abdomen.

Exacerbation of myasthenia gravis Fluoroquinolones, including levofloxacin, have neuromuscular blocking activity and may exacerbate muscle weakness in patients with myasthenia gravis.

Postmarketing serious adverse reactions, including deaths and the requirement for respiratory support, have been associated with fluoroquinolone use in patients with 500mg gravis. Levofloxacin is 500mg recommended in patients with a known history of myasthenia gravis. Vision disorders If vision becomes impaired or any effects on the eyes are experienced, an eye specialist should be consulted immediately see sections 4, ciprofloxacin al 500mg.

Superinfection The use of levofloxacin, especially if prolonged, may result in overgrowth of non-susceptible organisms, ciprofloxacin al 500mg. If superinfection occurs during therapy, appropriate measures should be taken, ciprofloxacin al 500mg. Interference with laboratory tests In patients treated with levofloxacin, determination of opiates in urine may give false-positive results. It may be necessary to confirm positive opiate screens by more specific method. Levofloxacin may 500mg the growth of Mycobacterium tuberculosis and, ciprofloxacin al 500mg, therefore, may give false-negative results in the bacteriological diagnosis of tuberculosis.

Levofloxacin mg Film-coated Tablets contains lactose monohydrate. Ciprofloxacin with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine. Concurrent administration of fluoroquinolones with multi-vitamins containing zinc appears to reduce their oral absorption. It is recommended that preparations containing divalent or trivalent cautions such as iron salts, zinc-salts or magnesium- or aluminium-containing antacids, or didanosine only didanosine formulations with aluminium or magnesium containing buffering agents should not be taken 2 hours before or after Levofloxacin mg Film-coated Tablets administration see ciprofloxacin 4.

Calcium salts have a minimal effect on the oral absorption of levofloxacin. Sucralfate The bioavailability of Levofloxacin mg Film-coated Tablets is significantly reduced when administered together with sucralfate. If the patient is to receive both sucralfate and levofloxacin, it is best to administer sucralfate 2 nicotinell mint 2mg hinta after the Levofloxacin mg Film-coated Tablets administration see section 4.

Theophylline, ciprofloxacin or similar non-steroidal anti-inflammatory drugs No pharmacokinetic interactions of levofloxacin were found with theophylline in a clinical study. However a pronounced 500mg of the cerebral seizure threshold may occur when quinolones are given concurrently with theophylline, non-steroidal anti-inflammatory drugs, or other agents which lower the seizure threshold.

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Ciprofloxacin and cimetidine Probenecid and cimetidine had a statistically significant effect on the elimination of levofloxacin.

This is because both drugs are capable of blocking the renal tubular secretion of levofloxacin. However, at the tested 500mg in the study, the statistically significant kinetic differences are unlikely to be of clinical relevance. Caution should be exercised when levofloxacin is coadministered with drugs that affect the tubular renal secretion such as probenecid and cimetidine, especially in renally impaired patients.

Other relevant information Clinical pharmacology studies have shown ciprofloxacin the pharmacokinetics of levofloxacin were not affected to any clinically relevant extent when levofloxacin was administered together with the following drugs: Coagulation tests, therefore, should be monitored in patients treated with vitamin K antagonists see section 4, ciprofloxacin al 500mg. 500mg known to prolong QT interval Levofloxacin, like other fluoroquinolones, should be used with caution in patients receiving drugs known to prolong the QT interval e.

QT interval prolongation Other relevant information In a pharmacokinetic interaction study, levofloxacin did not affect the pharmacokinetics of theophylline which is a probe substrate for CYP1A2indicating that levofloxacin is not a CYP1A2 inhibitor.

Other forms of interactions Food There is no clinically relevant interaction with food, ciprofloxacin al 500mg. Levofloxacin mg Film-coated Tablets may ciprofloxacin be administered regardless of food intake.

Animal studies do not indicate direct or indirect harmful effects with respect to reproductive toxicity see section 5. However in the absence of human data and due 500mg that experimental data suggest a risk of damage by fluoroquinolones to the weight-bearing cartilage of the growing organism, levofloxacin must not be used in pregnant women see sections 4, ciprofloxacin al 500mg.

Ciprofloxacin 500mg Film-Coated Tablets

ciprofloxacin Lactation Levofloxacin mg Film-coated Tablets is contraindicated in breast-feeding women. There is insufficient information on the excretion of levofloxacin in human milk; however other fluoroquinolones are excreted in breast milk.

In the absence of human data and due to that experimental data suggest a risk of damage by fluoroquinolones 500mg the weight-bearing cartilage of the growing organism, ciprofloxacin al 500mg, levofloxacin must not be in breast-feeding women see section 4. Fertility Levofloxacin caused no impairment of fertility or reproductive performance in rats. Frequencies are defined using the following convention: