The drug is given in / m and / in (slowly stream or drip). The drug is injected deep in the / m into the large gluteus muscle or the anterior surface of the thigh. With IV slow injection, the maximum single dose of the drug is 2 g; duration of administration - at least 3-5 minutes. The duration of IV infusion is 15-60 minutes.
The dose for adults is 2-4 g / day, divided into 2 injections, every 12 hours. In severe infections, the dose may be increased to 8 g / day, divided into 2 injections, every 12 hours. Treatment with the drug can begin before the study results are obtained sensitivity of microorganisms.
In uncomplicated gonococcal urethritis, a single I / m dose of 500 mg is recommended.
Prevention of postoperative complications
Apply 1 g or 2 g of IV in 30-90 minutes before the operation. When
The need for the drug can be repeated every 12 hours (in most cases
within no more than 24 hours). At operations with an increased risk of infection
(for example, operations in the colorectal area), in open-heart surgery or joint replacement, preventive use of the drug may continue for 72 hours after the operation is completed.
Impaired liver function
Dose adjustments may be required in cases of severe obstructed bile duct obstruction, severe liver disease, or concomitant liver and kidney dysfunction. In this case, the daily dose should not exceed 2 g.
Impaired renal function
Because the cefoperazone in general, is excreted with bile, then correction of the dose for renal dysfunction when used in recommended doses (2-4 g / day) is not required. Patients who have a glomerular filtration rate of less than 18 ml / min or a serum creatinine concentration greater than 3.5 mg / dl should not exceed a daily dose of 4 g.
When hemodialysis T1 / 2 cefoperazona from blood serum is slightly reduced, so the drug should be administered after the end of the dialysis session.
Impaired liver and kidney function
It is recommended to monitor the concentration of cefoperazone in the blood serum and, if necessary, adjust the dose. There is no need to monitor serum concentrations provided that the daily dose does not exceed 2 g.
Children
The dose for children is 50-200 mg / kg / day, divided into equal parts, administered every 8-12 hours.
The maximum dose should not exceed 12 g / day.
With IV slow injection, the maximum single dose is 50 mg / kg
body weight; duration of administration - at least 3-5 minutes.
Newborns (aged less than 8 days)
50-200 mg / kg body weight / day in equal parts every 12 hours.
In the treatment of infections caused by Streptococcus pyogenes, the duration of therapy should be at least 10 days.
Rules for the preparation of solutions
Intramuscular injection
To prepare solutions, sterile or bacteriostatic water for injections is used. If it is necessary to prepare a solution with a concentration of 250 mg / ml or more, the dilution recommended lidocaine solution, which is prepared by dilution of 2% lidocaine solution in sterile water for injection (approximate concentration of lidocaine hydrochloride in the resulting solution - 0.5%).
The drug is diluted in 2 stages: 1) first add the necessary amount of sterile or bacteriostatic water for injection and shake until the powder is completely dissolved, 2) then add the necessary amount of 2% lidocaine solution and mix.
| The ultimate concentration cefoperazone | 1st stage The volume of sterile water for injection | 2 nd stage Volume of 2% lidocaine solution | Input Volume ** |
| 250 mg / ml | 2.6 ml | 0.9 ml | 4.0 |
| 333 mg / ml | 1.8 ml | 0.6 ml | 3.0 |
* Bacteriostatic water for injection containing gasoline alcohol can not be used to dilute the drug intended for administration in newborns.
** Excess volume allows to completely fill the syringe of the specified volume. Intravenous administration
General recommendations
The contents of the vial are first dissolved in one of the following compatible solutions for intravenous administration (at a minimum of 2.8 ml per g of cefoperazone): 5% dextrose injection, 10% dextrose injection, 5% dextrose in 0.9% sodium solution chloride for injection, 0.9% solution of sodium chloride for injection, 5% dextrose solution in 0.2% solution of sodium chloride for injection, sterile water for injections.
To facilitate dissolution, it is recommended to use 5 ml of solvent per 1 g of cefoperazone. Then, the resulting amount of solution is further diluted in one of the following solvents: 5% dextrose injection, 10% dextrose injection, 5% dextrose solution in Ringer's lactate solution, Ringer's lactate solution, 0.9% sodium chloride solution for injection, 5 % dextrose solution in 0.9% solution of sodium chloride for injection, 5% dextrose solution in 0.2% sodium chloride solution for injection.
Intravenous drip introduction
The contents of one vial are dissolved in 20-100 ml of a compatible sterile solution for intravenous injection of the above. Infusion is carried out for 15 minutes to 1 hour. When using sterile water for injection, the total volume should not exceed 20 ml.
Prolonged intravenous infusion
The contents of one vial (1 g) are dissolved in 5 ml of sterile water for injection; the resulting solution is added to the corresponding solution for iv administration.
Intravenous Jet Slow Injection
The maximum dose of cefoperazone should not exceed 2 g per administration in adults and 50 mg / kg of body weight in children.The drug is dissolved in a suitable solvent (final concentration of 100 mg / ml) and injected for at least 3-5 minutes.
Stability of solutions
The following solvents and exemplary concentrations of cefoperazone ensure the stability of the solution under the following conditions and for the specified periods of time. After expiration of the indicated periods of storage, unused residues of solutions should be destroyed.
| At a temperature of 15 ° - 25 ° C - within 24 hours | Approximate concentrations |
| 5% Dextrose Solution for Injection in Ringer's Lactate Solution for Injection | 2-50 mg / ml |
| 10% solution of dextrose injection | 2-50 mg / ml |
| At a temperature of 15 ° - 25 ° C - for 24 hours or in a refrigerator (2 8 ° C) - for 5 days |
|
| Bacteriostatic water for injections | 300 mg / ml |
| 5% dextrose injection solution | 2-50 mg / ml |
| 5% dextrose solution in 0.9% solution of sodium chloride for injection | 2-50 mg / ml |
| 5% dextrose solution in 0.2% solution of sodium chloride for injection | 2-50 mg / ml |
| Ringsra solution lactate for injection | 2 mg / ml |
| 0.5% lidocaine for injection | 300 mg / ml |
| 0.9% solution of sodium chloride for injection | 2-300 mg / ml |
| Normosol M in a 5% solution of dextrose for injection | 2-50 mg / ml |
| Normosol R | 2-50 mg / ml |
| Sterile water for injections | 300 mg / ml |
| In the freezer (-20 ° С ± 2 ° С) - within 3 weeks |
|
| 5% dextrose injection solution | 50 mg / ml |
| 5% dextrose solution in 0.9% solution of sodium chloride for injection | 2 mg / ml |
| 5% dextrose solution in 0.2% solution of sodium chloride for injection | 2 mg / ml |
| In the freezer (-20 ° С ± 2 ° С) - within 5 weeks |
|
| 0.9% solution of sodium chloride for injection | 300 mg / ml |
| Sterile water for injections | 300 mg / ml
|
Restored solutions snore in glass or plastic syringes, glass or flexible plastic containers, intended for parenteral solutions. In the freezing chamber, the reconstituted solutions are stored at a temperature of minus 20 ° C ± 2 ° Сin polypropylene syringes or flexible containers of low density polyethylene, intended for parenteral solutions.
Before use, frozen drug solutions are thawed at room temperature. Unused thawed solution must be destroyed. Do not refreeze the solution.