Sulfadimethoxin - instructions for use, dose, side effects, contraindications

Structural analogue of PABA, necessary for microorganisms for the synthesis of dihydrofolic acid. Competitive blockade of dihydropteroate synthetase of bacteria: disruption of the synthesis of dihydropteroic acid (precursor of tetrahydrofolic acid - cofactor of purine synthesis). Only those microorganisms that are forced to synthesize folic acid themselves are sensitive.

Pharmacokinetics:

Absorption is fast. Distribution is good, weakly penetrates the BBB, but increases with meningitis. The connection with plasma proteins is 90-99%. Biotransformation in the liver (glucuronidation, acetylation). Elimination of kidneys in the form of metabolites (20-44% within 24 hours, after 48 hours - up to 56%, after 96 hours - up to 83.3%).

Indications:

Infectious-inflammatory diseases caused by microorganisms sensitive to sulfadimethoxin, incl. angina, sinusitis, otitis media, bronchitis, dysentery, inflammatory diseases of the bile and urinary tract, erysipelas, wound infections, trachoma.

ICD-10

I.A00-A09.A03.9 Shigellosis, unspecified

I.A30-A49.A46 Erys

I.A70-A74.A71 Trachoma

VIII.H65-H75.H66 Purulent and unspecified otitis media

X.J00-J06.J01 Acute Sinusitis

X.J00-J06.J02 Acute pharyngitis

X.J00-J06.J03 Acute tonsillitis

X.J20-J22.J20 Acute bronchitis

XI.K80-K87.K81.0 Acute cholecystitis

XI.K80-K87.K81.1 Chronic cholecystitis

XI.K80-K87.K83.0 Cholangitis

XIV.N10-N16.N10 Acute tubulointerstitial nephritis

XIV.N10-N16.N11 Chronic tubulointerstitial nephritis

XIV.N30-N39.N30 Cystitis

XIV.N30-N39.N34 Urethritis and urethral syndrome

XIV.N40-N51.N41 Inflammatory diseases of the prostate

XIX.T79.T79.3 Post-traumatic wound infection, not elsewhere classified

Contraindications:

Hypersensitivity, oppression of bone marrow hematopoiesis, renal / hepatic insufficiency, CHF, congenital deficiency G-6-PD, porphyria, azotemia, pregnancy.

Carefully:

Allergy to other medicines containing a sulfonamide moiety; CRF, hepatic insufficiency, bronchial asthma, systemic lupus erythematosus, G-6-FD deficiency, age up to 2 months, HIV infection, AIDS (systemic use).

Pregnancy and lactation:

Adequate and well-controlled studies in humans and animals have not been conducted. Do not apply! There is no information on the penetration into breast milk. Do not apply!

The category of FDA recommendations is not defined.

Dosing and Administration:

Adults on the 1st day of treatment - 1 g, in subsequent days - 500 mg / day. In severe disease, the dose may be increased. Children on the first day of treatment - 25 mg / kg, in the following days - 12.5 mg / kg / day.

Take 1 time / day after meals. Duration of treatment 7-10 days.

Side effects:

From the side of the central nervous system: a headache is possible.

On the part of the digestive system: dyspeptic symptoms, nausea, vomiting, cholestatic hepatitis.

Allergic reactions: skin rashes, drug fever.

From the hemopoietic system: rarely - leukopenia, agranulocytosis.

Overdose:

Oppression of bone marrow hematopoiesis: leukopenia, agranulocytosis, infection.

Treatment is symptomatic.

Interaction:

Cimetidine - increases the risk of developing leukopenia.

Special instructions:

During treatment, an abundant alkaline drink is recommended, monitoring the blood and urine.

It is applied externally as a part of combined preparations.

Parts of the body treated with the drug are recommended to protect from direct sunlight.

Instructions

Sulfadimethoxin (Sulfadimethoxinum)

Infectious-inflammatory diseases caused by microorganisms sensitive to sulfadimethoxin, incl. angina, sinusitis, otitis media, bronchitis, dysentery, inflammatory diseases of the bile and urinary tract, erysipelas, wound infections, trachoma.