Ceftazidime Sandoz - instructions for use, dose, side effects, contraindications

Synthetic cephalosporin antibiotic III generation for parenteral use. The mechanism of bactericidal action of cephalosporins is associated with damage to the cell membrane of bacteria in the propagation stage, which is caused by specific inhibition of enzymes that participate in the synthesis of peptidoglycans, resulting in lysis and death of the bacterium. Ceftazidime has a broad spectrum of action, is resistant to the action of most beta-lactamases, acts on many strains resistant to ampicillin and other cephalosporins.

Active in a relationship Gram-negative microorganisms:

Citrobacter spp., including Citrobacter divers us, Citrobacter freundii, Enterobacter spp., including Enterobacter aerogenes, Enterobacter cloacae, Escherichia coli, Haemophilus influenzae (including strains resistant to ampicillin), Klebsiella spp., including Klebsiella pneumoniae, Neisseria meningitides, Neisseria gonorrhoeae, Pasteurella multocida, Proteus mirabilis, Proteus vulgaris, Pseudomonas spp., in t.ch. Pseudomonas aeruginosa.

Inactive in a relationship:

Campylobacter spp., Chlamydia spp., Clostridium difficile, Enterococcus spp., Eusobacterium spp., Legionella spp., Listeria monocytogenes, Mycobacterium spp., Mycoplasma spp., Staphylococcus spp., Streptococcus milleri, resistant to methicillin, Streptococcus spp. groups Viridans, Enterococcus faecalis.

Active in vitro (clinical value this activity unknown): Acinetobacter spp., Clostridium perfringens, Haemophilus parainfluenzae, Morganella morganii, Peptococcus spp., Peptostreptococcus spp., Providencia spp. (including Providencia rettgeri), Salmonella spp., Shigella spp., Staphylococcus epidermidis, Yersinia enterocolitica.

Pharmacokinetics:

Maximum concentrations of ceftazidime in blood plasma (Cmax) have the following meanings:

	Intramuscular	Intravenous bolus
Dose	introduction	injection
	(after 1 hour)	(after 5 minutes)
500 mg	18 mg / l	46 mg / l
1 g	37 mg / l	87 mg / l
2 grams		170 mg / l

The therapeutically effective concentrations of ceftazidime persist in the plasma for 8-12 hours after intravenous or intramuscular administration. Cumulation of ceftazidime (in patients with normal renal function) after repeated intravenous administration in doses of 1 g or 2 g every 8 hours for 10 days was not noted.

Communication with plasma proteins is less than 10%. Concentrations of ceftazidime exceeding the minimal inhibitory for the most common pathogens are achieved in bone tissue, heart, bile, sputum, intraocular, synovial, pleural and peritoneal fluids.

The antibiotic easily penetrates the placenta and is excreted in breast milk in low concentrations.

In the absence of an inflammatory process ceftazidime poorly penetrates the blood-brain barrier. With inflammation of the meninges, ceftazidime concentrations in the cerebrospinal fluid reach a therapeutic level (4-20 mg / L and higher). Ceftazidime not is metabolized.

Displayed in unmodified form by kidneys (by glomerular filtration) 80-90% within 24 hours, as a result of which high concentrations of the drug are created in the urine. Less than 1% is excreted with bile. The half-life (T_1/2) is approximately 2 hours after intravenous or intramuscular administration.

In patients with impaired renal function it is necessary to reduce the dose of ceftazidime.

Disorders of liver function of mild to moderate severity does not affect the pharmacokinetics of ceftazidime, since less than 1% is excreted with bile.

Have elderly patients due to a possible decrease in kidney function and a decrease in renal clearance of ceftazidime, it is recommended to reduce the dose of the drug. When ceftazidime was administered as a bolus injection at a dose of 2 g once or twice a day for 7 days in patients 80 years and older, T1 / 2 ceftazidime ranged from 3.5 to 4 hours.

Have newborns when applying a dose of 25-30 mg / kg T1 / 2 ceftazidime varies from 4.5 to 7.5 hours.

In children older than 2 months T1/2 ceftazidime is similar to adults.

Indications:

Infectious and inflammatory diseases caused by strains of microorganisms sensitive to ceftazidime:

- infections of the lower respiratory tract (including nosocomial pneumonia);

- infections of the lower respiratory tract in patients with cystic fibrosis;

- infection of ENT organs (including chronic purulent otitis media, malignant external otitis);

- complicated urinary tract infections;

- complicated skin and soft tissue infections;

- complicated intra-abdominal infections;

- infection of bones and joints;

- bacterial meningitis;

- perioperative prevention of urinary tract infections during transurethral resection of the prostate;

- infection in patients with immunodeficiency (including patients with neutropenia);

- peritonitis in patients on dialysis;

- bacteremia associated with the above indications.

The spread of strains with acquired resistance may vary depending on the geographic region and over time.In this regard, when testing the sensitivity of a strain, it is desirable to have local information on resistance, especially when treating severe infections.

Contraindications:

Hypersensitivity to ceftazidime, other cephalosporins or to any of the components of the drug.

Severe hypersensitivity reactions in the anamnesis (for example, anaphylactic reactions) to any other beta-lactam antibiotic (penicillins, monobactams and carbapenems).

Carefully:The drug should be used with caution in patients with renal insufficiency, diseases of the gastrointestinal tract (including ulcerative colitis and pseudomembranous colitis in the anamnesis), in newborns, while using with aminoglycosides, loop diuretics, vancomycin, in patients with mild reactions of hypersensitivity to penicillin and other beta-lactam antibacterial drugs, in anamnesis, during pregnancy, during breast-feeding.

Pregnancy and lactation:Use during pregnancy is only possible if the intended benefit to the mother exceeds the potential risk to the fetus.

It is excreted in breast milk in low concentrations. The child may have diarrhea, hypersensitivity reactions and fungal infection of the mucous membranes. If the infant has adverse effects, breastfeeding should be discontinued. During the period of breastfeeding, they are used only if the intended benefit to the mother exceeds the potential risk for the child.

Dosing and Administration:

Ceftazidime is administered intramuscularly (in the upper outer quadrant of the gluteus maximus or in the region of the lateral surface of the thigh) or intravenously (injection, infusion).

Adults and children with a body weight of 40 kg or more (intramuscularly, intravenously (drip or drip)):

Infections of the lower respiratory tract in patients with cystic fibrosis: 100-150 mg / kg / day every 8 hours. The maximum daily dose is 9 g. Nosocomial pneumonia, bacterial meningitis, bacteremia, infection in patients with immunodeficiency (including patients with neutropenia): 2 g every 8 hours.

Infections of bones and joints, complicated rumen and soft tissue infections, complicated intra-abdominal infections, peritonitis in patients on dialysis: 1-2 g every 8 hours. Complicated urinary tract infections: 1-2 g every 8 or 12 hours. Perioperative prophylaxis for transurethral resection of the prostate: 1 g of ceftazidime during anesthesia, the second dose when the catheter is removed.

Infections LOP-organ (including chronic purulent otitis media and

malignant external otitis media): 1-2 g every 8 h.

Adults and children with a body weight of 40 kg and more (extended infusion regimen):

Nosocomial pneumonia, lower respiratory tract infection

patients with cystic fibrosis, bacterial meningitis, bacteremia, infections of bones and joints, complicated skin and soft tissue infections, complicated intra-abdominal infections, peritonitis in dialysis patients, infections in patients with immunodeficiency (including neutropenic patients): a loading dose of 2 g, then 4-6 g every 24 hours as an infusion.

Children older than 2 months with a body weight of less than 40 kg (intramuscularly, intravenously (struino or drip)):

Complicated urinary tract infections, chronic suppurative otitis media and malignant otitis externa, infections of bones and joints, complicated skin and soft tissue infections, complicated intra-abdominal infections, peritonitis in dialysis patients: 100-150 mg / kg / day in 3 injections, the maximum daily dose is 6 g. Infections in patients with immunodeficiency (including patients with neutropenia), lower respiratory infections in patients with cystic fibrosis, bacterial meningitis, bacteremia: 150 mg / kg / day in 3 injections, the maximum daily dose is 6 g.

Children older than 2 months with a body weight of less than 40 kg (prolonged infusion regimen):

Infections in patients with immunodeficiency (including patients with neutropenia), nosocomial pneumonia, lower respiratory tract infections in patients with cystic fibrosis, bacterial meningitis, bacteremia, infections of bones and joints, complicated skin and soft tissue infections, complicated intra-abdominal infections, peritonitis in patients on dialysis: the loading dose is 60-100 mg / kg, then 100-200 mg / kg / day, the maximum daily dose is 6 g.

Newborns and children 2 months and younger (intramuscularly, intravenously (either jet or drip)): 25-60 mg / kg / day in 2 injections.

The safety and efficacy of ceftazidime, administered by prolonged infusion to infants and newborns <2 months, have not been established.

Elderly patients (over 80 years)

The maximum daily dose, as a rule, should not exceed 3 g.

Correction of dose in renal failure

The initial loading dose of ceftazidime is 1 g, the subsequent maintenance doses should be adjusted depending on the creatinine clearance (CK).

Adults and children with a body weight of 40 kg and more (intramuscularly, intravenously (struino or drip))

Recommended doses of ceftazidime in adults and children with a body weight of 40 kg or more with kidney failure when administered intramuscularly, intravenously (struino or drip)

Creatinine clearance, ml / min	Approximate values of serum creatinine concentration, μmol / L (mg / dL)	Recommended single dose of ceftazidime (g)	The interval between drug administration (h)
50-31	150-200 (1,7-2,3)	1	12
30-16	200-350 (2,3-4,0)	1	24
15-6	350-500 (4,0-5,6)	0,5	24
<5	>500 (>5,6)	0,5	48

In patients with severe infection, the dose is recommended to be increased by 50% or to increase the frequency of admission.

In children, QC should be adjusted for body surface area or lean body mass.

Children older than 2 months with a body weight of less than 40 kg (intramuscularly, intravenously (struino or drip))

Recommended doses of ceftazidime in children older than 2 months with a body weight of less than 40 kg with renal insufficiency when administered intramuscularly, intravenously (by jet or drip)

Clearance	Approximate	Recommended	The interval between
creatinine ,**	meanings	single dose	introductions
ml / min	*concentration of creatine in the blood serum, μmol / l (mg / dl)**	ceftazidime (mg / kg body weight)		preparation (h)
50-31	150-200 (1,7-2,3)	25		12
30-16	200-350 (2,3-4,0)	25		24
15-6	350-500 (4,0-5,6)	12,5		24
<5	1 500 2 5,6	12,5		48

* The indices of serum concentration of creathnin are approximate

values and may not necessarily accurately indicate a similar degree of dose reduction

for all patients with renal insufficiency.

** Estimated for body surface area or measured.

Adults and children with a body weight of 40 kg and more (prolonged infusion regimen)

Recommended doses of ceftazidime in adults and children with a body weight of 40 kg or more with renal failure in the regime of prolonged infusion

Cleanserin clearance, ml / min	Approximate values of serum creatinine concentration, μmol / l (mg / dL)	Recommended dose ceftazidime and the interval between administrations
50-31	150-200 (1,7-2,3)	The loading dose is 2 g, then 1 -3 g every 24 h
30-16	200-350 (2,3-4,0)	The loading dose is 2 g, then 1 g every 24 h
< 15	> 350 (> 4,0)	Not defined

Children older than 2 months with a body weight of less than 40 kg (prolonged infusion regimen)

Data on the efficacy and safety of ceftazidime in patients with renal insufficiency in this age group are not available, and therefore careful monitoring of efficacy and safety when prescribing ceftazidime to these patients is recommended.In children, QC should be adjusted for body surface area or lean body mass.

Hemodialysis

In patients on hemodialysis, the half-life of ceftazidime is 3 to 5 hours. After each hemodialysis session, the administration of the maintenance dose of ceftazidime, indicated in the table below, should be repeated.

Peritoneal dialysis

Ceftazidime may be given during peritoneal dialysis or continuous ambulatory peritoneal dialysis. In addition to intravenous administration, ceftazidime can be added to the dialysate (usually 125-250 mg per 2 liters of dialysate solution). In patients with renal insufficiency on continuous arteriovenous dialysis or hemofiltration using high-flux membranes located in intensive care units, the recommended daily dose of ceftazidime is 1 g in one or more injections. When carrying out haemofiltration using low-flux membranes it is necessary to use the doses recommended for patients with renal insufficiency.

Patients on continuous hemodialysis using a venovenous shunt should be given doses of ceftazidime indicated in the tables below.

Recommended maintenance doses of ceftazidime in patients,

located on a permanent vein-venous hemofiltration

Clearance	The maintenance dose (mg), depending on
creatinine	ultrafiltration rate (ml / min)
ml / min	5	16,7	33,3	50
0	250	250	500	500
5	250	250	500	500
10	250	500	500	750
15	250	500	500	750
20	500	500	500	750

* The maintenance dose is given every 12 hours

Recommended maintenance doses of ceftazidime in patients on permanent veno-venous hemodialysis

Creatinine clearance ml / min	The maintenance dose (mg) and the dependence on the flow rate dialysate
	1 l / h			2 l / h
	Rate of ultrafiltration (l / h)
	0,5	1,0	2,0	0,5	1,0	2,0
0	500	500	500	500	500	750
5	500	500	750	500	500	750
10	500	500	750	500	750	1000
15	500	750	750	750	750	1000
20	750	750	1000	750	750	1000

* The maintenance dose is given every 12 hours Patients with hepatic impairment

According to the available data, there is no need for correction of the dosing regimen in patients with mild or moderate severity of liver function disorder. There are no results of studies involving patients with impaired hepatic function. It is recommended to carefully monitor the safety and effectiveness of the therapy.

Preparation of solutions

Only clear solutions should be used. After adding the solvent, shake the bottle until a clear solution is obtained.

The solution should be used immediately after preparation.

For intramuscular injection ceftazidime are dissolved in water for injection or 0.5% or 1% lidocaine solution, as shown in the table below.

For intravenous injection ceftazidime are dissolved in water for injection, as shown in the table below, administered slowly (duration of administration up to 5 minutes).

For use in extended infusion ceftazidime dissolved in water for injection, 0.9% solution of sodium chloride (saline), 5% glucose solution, 0.9% sodium chloride solution + 5% glucose solution (1: 1 by volume), Ringer-Lactate solution.

Mode of administration / Dose	The amount of gel sol (ml)	Approximate volume (ml)	Approximate concentration ceftazidime (mg / ml)
Intramuscularly
500 mg	1,5	2,10	238
1 g	3,0	3,80	263
Intravenously
500 mg	5	5,50	91
1 g	10	11,00	91
2 grams	10	11,50	174
Infusion
1 g	40*	41	25
2 grams	40*	42	50

* Dissolution of the drug should be carried out in 2 stages

Preparation of solution for intramuscular and intravenous administration

1. Insert the needle of the syringe into the vial through the rubber stopper and add the recommended amount of solvent through it.

2. Remove the syringe needle and shake the vial to get a clear solution.

3. Flip the bottle. With a piston fully inserted into the syringe, pierce the rubber stopper of the vial with a needle and push it into the vial so that it is completely in solution.Collect the entire solution in a syringe. Small bubbles of carbon dioxide may be present in the resulting solution, which does not affect the effectiveness of the preparation. If there are bubbles in the syringe, they must be removed before the drug is injected.

Preparation of the solution for use in the extended infusion mode:

1. Insert the needle of the syringe into the vial through the rubber stopper and add 10 ml of solvent through the nurse.

2. Remove the syringe needle and shake the vial to get a clear solution.

3. Insert the vent to relieve the pressure before adding more solvent to the vial.

4. Without removing the needle to exit the gas, add the remaining amount of the solvent to the vial through the syringe needle. Remove both needles (gas outlet needle and syringe needle) from the vial plug, shake the vial and install it for infusion.

To ensure sterility, it is important not to inject the gas outlet needle into the bottle until the powder dissolves.

Depending on the concentration and solvent, solutions of ceftazidime can be from light yellow to amber.

From the point of view of microbiological purity, the prepared solutions should be used immediately.At room temperature, the stability of solutions for extended infusion, prepared using solvents such as water for injections, 0.9% sodium chloride solution, 5% glucose solution, 0.9% sodium chloride solution + 5% glucose solution (1: 1 by volume), Ringer-Lactate solution, stored for 30 min. At a temperature of 2-8 ° C, the prepared solutions remain chemically and physically stable for 24 hours. The solutions in this case can be used if their preparation takes place in controlled and validated aseptic conditions.

Side effects:

According to the World Health Organization (WHO), adverse reactions are classified according to their frequency of development as follows: very often (> 1/10), often (>1/100, <1/10), infrequently (>1/1000, <1/100), rarely (>1/10000, <1/1000) and very rarely (<1/10000); frequency is unknown - according to available data, it was not possible to establish the frequency of occurrence.

Infections

infrequently: Candidiasis (including vaginitis and candidiasis of the oral mucosa).

Immune system disorders

frequency is unknown: anaphylactic reactions (including bronchospasm and / or lowering of blood pressure).

Disturbances from the nervous system

infrequently: headache, dizziness;

frequency is unknown: paresthesia, neurological complications (tremor, convulsions, myoclonia, encephalopathy and coma in patients with renal insufficiency, in which the dose of ceftazidime has not been adequately reduced).

Disorders from the gastrointestinal tract

often: diarrhea;

infrequently: nausea, vomiting, abdominal pain, diarrhea and colitis associated with antibiotics (including pseudomembranous colitis);

rarely: unpleasant taste in the mouth.

Disturbances from the liver and bile ducts

often: transient increase in the activity of "liver" transaminases and

alkaline phosphatase;

frequency is unknown: jaundice.

Disorders from the genitourinary system

infrequently: transient increase in the concentration of urea, urea nitrogen and / or serum creatinine;

rarely: interstitial nephritis, acute renal failure.

Violations of the blood and lymphatic system

often: eosinophilia, thrombocytosis;

infrequently: leukopenia, neutropenia, thrombocytopenia;

frequency is unknown: lymphocytosis, agranulocytosis, hemolytic anemia.

Disturbances from the skin and subcutaneous tissues

often: maculopapular or urticaria rash;

infrequently: itching;

frequency is unknown: erythema multiforme, toxic epidermal necrolysis, Stevens-Johnson syndrome, angioedema.

Local Reactions

With intramuscular injection

often: soreness, inflammation at the injection site.

With intravenous administration

often: phlebitis, thrombophlebitis.

Other:

infrequently: fever;

rarely: a false positive test of Coombs, a false positive urine reaction to glucose, an increase in prothrombin time.

Overdose:

It often occurs in patients with renal insufficiency.

Symptoms: dizziness, paresthesia, headache, changes in the results of laboratory tests (increase in the concentration of urea and creatinine in the blood plasma, hyperbilirubinemia, thrombocytosis, thrombocytopenia, eosinophilia, leukopenia, prolongation of prothrombin time), in patients with renal insufficiency - convulsions, encephalopathy, "fluttering "tremor, coma, neuromuscular excitability. An overdose of ceftazidime can cause pain, inflammation, phlebitis at the site of infusion.

Treatment: Since there is no specific antidote, treatment is symptomatic and supportive, measures aimed at controlling seizures are also needed.

In patients with impaired renal function, and also in case of severe overdose, when conservative therapy is unsuccessful, the concentration of ceftazidime in the blood plasma can be reduced by hemodialysis and peritoneal dialysis.

Interaction:

Joint application of "loop "diuretics and cephalosporins may increase the risk of nephrotoxicity.

When combined with aminoglycosides, clindamycin, vancomycin the risk of developing nephrotoxicity and ototoxicity increases.

The drug is not pharmaceutically compatible with chloramphenicol. In conditions in vitro bacteriostatic antibiotics (incl. chloramphenicol) reduce the effectiveness of ceftazidime. The clinical significance of this phenomenon is unknown.

When used simultaneously with combined oral hormonal contraceptives It must be borne in mind that ceftazidime can reduce the effectiveness of such drugs, affecting the intestinal microflora and contributing to a decrease in the level of absorption of estrogen.

Do not use a solution sodium bicarbonate as a solvent and mixed with solutions, pH which are more than 7.5. Pharmaceutically incompatible with aminoglycosides (significant mutual inactivation: with simultaneous application, these drugs should be injected into different parts of the body, it should not be mixed in one system due to the possibility of precipitation) and vancomycin (forms a precipitate depending on the concentration, if necessary, administer two drugs through a single tube, between their use of the system for intravenous administration should be washed with 0.9% sodium chloride solution).

Special instructions:As with the use of other beta-lactam antibacterial drugs, cases of severe hypersensitivity reactions and, in some cases, fatal hypersensitivity reactions, have been documented. With the development of hypersensitivity reactions, ceftazidime should be discontinued immediately and all necessary emergency measures taken. Before the start of treatment, it is necessary to establish whether the patient had a history of hypersensitivity reactions to ceftazidime, other cephalosporins, or any other types of beta-lactam antibacterials (penicillins, carbapenems).Care should be taken when using the drug Ceftazidime Sandoz® for the treatment of patients who had a history of mild hypersensitivity to other beta-lactam antibacterial drugs. Patients who have a history of allergic reactions to penicillins, carbapenems, may have increased sensitivity to ceftazidime.

Ceftazidime has a limited spectrum of antibacterial activity. It is not suitable for use in monotherapy in the treatment of certain types of infections, except when the pathogenic microorganism has already been determined and it is known that it is sensitive to ceftazidime treatment, or there is a very high probability that ceftazidime is suitable for the treatment of infections caused by these pathogenic microorganisms. This, in particular, concerns the treatment of patients with bacteremia, as well as in the treatment of bacterial meningitis, infections of the skin and soft tissues and infections of bones and joints. Besides, ceftazidime is sensitive to hydrolysis by several extended-spectrum beta-lactamases (ESBL). Thus, if you select

ceftazidime for treatment, it is necessary to take into account information on the prevalence of microorganisms producing ESBL.

As with other cephalosporins, prolonged therapy with the drug Ceftazidime Sandoz® can be accompanied by an excessive growth of microorganisms insensitive to the given preparation, such as Enterococci, Candida and Serratia. With prolonged use of the drug

Ceftazidime Sandoz® may develop superinfection.

During prolonged therapy with ceftazidime, it is recommended that a general blood test and a study of renal and hepatic function be performed on a regular basis.

Diarrhea (especially in cases of severe, persistent and / or blooded impurities) during or after treatment with the drug Ceftazidime Sandoz® can be a symptom of a disease caused by Clostridium difficile, the most severe form of which is pseudomembranous colitis. If there is a suspicion of pseudomembranous colitis, discontinue drug therapy immediately Ceftazidime Sandoz® and conduct symptomatic treatment (eg, vancomycin orally). In this condition, drugs that inhibit peristalsis are contraindicated.

During treatment is not recommended to use ethanol because of the risk of developing disulfiram-like reactions.

Patients with acute and chronic renal failure need dose adjustment for ceftazidime due to the risk of developing clinically relevant disorders, such as seizures (see section "Method of administration and dose"). Application Ceftazidime Sandoz® does not affect the results of enzymatic analysis of glucosuria, but the results of enzymatic analysis of copper reduction may be distorted (Cliuitest, Benedict's test, Felling). Ceftazidime does not affect the results of gestation on the determination of creatinine content based on alkaline picrate. False positive Coombs test is observed in approximately 5% of cases of drug use Ceftazidime Sandoz®.

It is necessary to take into account the sodium content in the preparation (26 mg sodium in the dosage form 500 mg ceftazidime, 52 mg sodium in the dosage form 1.0 g ceftazidime and 104 mg sodium in the dosage form 2.0 g ceftazidime) when prescribing ceftazidime to patients who need to limit consumption sodium.

When undertaking a prolonged course of ceftazidime, regular blood testing is recommended to assess liver and kidney function.

Special precautions for the destruction of unused medicinal product.

There is no need for special precautions when destroying an unused preparation Ceftazidime Sandoz®.

Effect on the ability to drive transp. cf. and fur:Data on the adverse effects of the drug Ceftazidime Sandoz® on the ability to drive a car or work with mechanisms there. However, because of the likelihood of side effects, such as dizziness and convulsions, caution should be exercised when engaging in potentially dangerous activities requiring increased concentration and speed of psychomotor reactions.

Form release / dosage:

Powder for the preparation of solution for intravenous and intramuscular injection 0.5 g, 1 g and 2 g.

Packaging:

0.5 g of active substance in a bottle of colorless glass with a capacity of 15 ml with a rubber stopper, closed with an aluminum crimp cover with a plastic disc for opening the vial.

1 g of active substance in a bottle of colorless glass with a capacity of 20 ml with a rubber stopper, closed by an aluminum crimp cap with a plastic disc for opening the vial.

2 g of active substance in a bottle of colorless glass with a capacity of 50 ml with a rubber stopper, closed with an aluminum crimp cover with a plastic disc for opening the vial.

Individual packing (cardboard tutu).

One bottle together with instructions for use in a cardboard tutu.

Packing for hospitals.

For 10, 25 or 50 bottles together with instructions for use in a cardboard box.

Storage conditions:In the dark place at a temperature of no higher than 25 ° C. Keep out of the reach of children.

Shelf life:

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

Terms of leave from pharmacies:On prescription

Registration number:LP-000361

Date of registration:22.02.2011

Expiration Date:22.02.2016

Date of cancellation:2016-02-29

The owner of the registration certificate:Sandoz GmbHSandoz GmbH Austria

Manufacturer: & nbsp

SANDOZ, GmbH Austria

Representation: & nbspSANDOZ SANDOZ Switzerland

Information update date: & nbsp29.02.2016

Illustrated instructions

Instructions

Ceftazidime Sandoz® (Ceftazidime Sandoz®)