Avelox analogues in tablets are imported. Directory of medicines

Avelox ® is a fourth-generation fluoroquinolone antibacterial therapeutic drug. Produced by the German pharmacological company Bayer AG ® . It is characterized by high antibacterial activity against a large list of pathogenic microorganisms.

The mechanism of action is due to a slowdown in the work of bacterial topoisomerase enzymes, which is accompanied by errors in the process of protein replication and transcription of prokaryotic nucleic acids, and also leads to cell death.

Avelox ® antibiotic or not?

Yes, this drug is an antibiotic, so only the attending physician can prescribe it after diagnosis and an accurate diagnosis. Improvement in the patient's condition occurs after 2-3 days, however, this time is not enough to completely destroy the pathogen, so it is important to drink the full course.

Pharmacological group of the drug

4th generation fluoroquinolones.

The active substance Avelox ® - is included in the list of the most important and necessary for life medications since 2012. The minimum inhibitory levels of the active component, which are created in the cells and tissues of living beings, are sufficient for the complete destruction of infectious agents.

Action spectrum

The antibacterial effect of the drug covers many groups of pathogenic and opportunistic bacteria. In particular, it is able to inhibit the vital activity of the following prokaryotic microorganisms:

• Gram + gardnerella vaginalis - facultative anaerobes, are part of the normal microflora of the vagina of women. With a decrease in general immunity, they cause a disease - while suppressing the vital activity of symbiotic microbes;
• Gram + streptococcus pneumoniae, also known as Frenkel's diplococcus, are facultative anaerobes that begin to multiply actively when the level of CO 2 in the air rises to 7%. Cause infectious processes in the brain and spinal cord, hearing aid and lungs.
• Gram + streptococci that inhabit the human skin, vagina and pharynx, under certain conditions, become the causative agents of scarlet fever. The strains of S. viridans, S. anginosus, S. constellatus and S. intermedius are characterized by low virulence, but when the body's defenses are weakened, they can cause infectious processes;
• Gram+ bacteria of the Streptococcaceae family are opportunistic representatives of the normal microflora of the human body. Able to induce the development of pathological and purulent processes in almost all human organs. The exception is strains of Staphylococcus aureus with multidrug resistance;
• Gram-hemophilic bacillus Pfeiffer is an immobile coccobacillus that provokes the development of acute infectious pathologies of the respiratory and central organs. nervous system, as well as purulent manifestations of almost all human organs;
• Grammoraxella catharsis - colonizes the upper respiratory tract of children (from 30 to 100%), less often - adults (from 1 to 10%). It is sown at purulent otitis media, sinusitis and other diseases of the respiratory system;
• Gram-bacteria Borde-Gangu are small immobile coccobacilli with high virulence. Under natural conditions, isolated only from pathological material of people. It provokes an atypical lesion of the epithelial tissue of the bronchi - whooping cough;
• Gram-legionella pneumophila - movable rods, belong to the second group of pathogenicity. They are the causative agents of legionellosis;
• Gram-acinetobacters are cosmopolitans, distributed everywhere. Able to induce the development of various infectious pathologies;
• Anaerobic bacteria of the families Fusobacteriaceae, Porphyromonaceae, Prevotellaceae and Propionibacteriaceae;
• Atypical strains of chlamydia, mycoplasmas, legionella and coxiella.

Composition of Avelox ®

Prescription for Avelox ® in Latin

Rep.: Tab. Aveloxi 0.4

S. Take one tablet once a day

Release form Avelox ®

Avelok ® s is produced in two main variants:

• Tablet version - elongated pink tablets, on one side of the tablet the logo "BAYER ®" is engraved, on the other - M400 (dose active substance). In cardboard packages there are 1 or 2 contour cells with 5-7 tablets. in each, as well as instructions with recommendations for use under the brand name Avelox Premium ® ;
• Solution for infusion - a colorless or yellow solution is poured into transparent glass bottles. The bottles are placed in a cardboard box with instructions.

Indications for use

The prescription is written by the attending physician after the isolation of the causative agent of the disease, identification and determination of susceptibility to various classes of bactericidal substances. List of infectious and inflammatory diseases for which treatment is prescribed:

• acute form;
• severe otitis;
• exacerbation of the chronic form;
• infections of the lungs and lung tissue caused by strains of bacteria resistant to many classes of bactericidal substances;
• infectious diseases and soft tissues;
• infections with complications of the skin and subcutaneous tissue, including diabetic foot syndrome with the addition of infection;
• complicated infections of the abdominal region, including those of a polybacterial nature;
• inflammation of the organs and tissues of the small pelvis, gynecological infections.

An extended list of bactericidal activity allows it to be used in many infectious and purulent conditions. Experts note that Avelox ® for prostatitis is preferable for long-term drug therapy and shows maximum efficiency. In addition, Avelox ® is highly effective in ureaplasma.

Determined that active ingredient has a detrimental effect on some strains of virulent microbes that exhibit a high degree resistance to penicillins, carbopenems, monobactams, macrolides, tetracyclines and their synthetic analogues. It is important to take into account the current current official recommendations on the rules for the use of antibiotic substances.

Dosage of the drug

The permitted dose of the active ingredient is 400 mg per day, both for intravenous administration and for oral administration. The drug Avelox ® in tablets and in the form of solutions can be taken regardless of food. Tablets must be swallowed whole, without breaking the shell, with small volumes of water.

Depending on the severity of the disease, the necessary dosage regimen is selected:

The maximum course of treatment is 21 days.

Does not require correction of the dosage regimen:

• To old people;
• representatives of various races and ethnic groups.

According to indications, dose adjustment can be carried out:

• patients with liver pathology and renal failure;
• people with an installed “artificial kidney” device and a course of therapy with a dialysis solution in the interabdominal region;

During infusion treatment, the drug is used in the form of dilute or undiluted solutions for infusion, by intravenous administration of the drug for an hour using an adapter. It is recommended to dilute the solution with the following liquids:

• one percent or one molar solution of Na chloride;
• five or ten percent solution of glucose;
• multicomponent p-rum Ringer.

The finished solution should be transparent. The diluted solution can be stored for a day in compliance with the temperature regime - not higher than 25C. It is forbidden to freeze ready solution or leave in the refrigerator. It is recommended to breed and store in the original packaging. If multiple solutions are needed, intravenous administration carried out separately for each of the substances.

Side effects of Avelox ®

In the course of preclinical and clinical trials, a rather extensive list of negative effects on the human body has been established. It is necessary to carefully study possible adverse reactions and, at the first symptoms of their manifestation, stop taking the drug and consult a doctor. Negative symptoms and their frequency of manifestation are presented in the table.

It was found that with stepwise therapy, the frequency of manifestation negative symptoms was much higher than in the monotherapy group.

Negative reactions are observed not only on the part of the patient, but also on the part of prokaryotic cells. Against the background of global growth rates of resistance of microorganisms to all known antibiotic molecules, the issue of limiting and stopping this process is one of the most urgent in modern medicine. Everywhere, bacteria develop new mechanisms for survival and block the main targets that antibiotics act on.

It is noted that the mechanisms of resistance to penicillins, carbapenems, monobactams, cephalosporins, tetracyclines and macrolides are not effective against fluoroquinolones. Also, cross-resistance between the indicated groups of bactericidal substances was not revealed. To date, plasmids carrying the moxifloxacin resistance gene have not been identified. The prevalence of resistant microbes varies from 10-7 to 10-10.

In evolutionary terms, the development of resistance to the described substance requires the simultaneous restructuring of almost all metabolic processes in the cell, through multiple mutations. Even with consistent repeated exposure to bacteria with different dosages of an antibacterial substance, a mass appearance of resistant strains in the population was not recorded. Nevertheless, even with low risks of developing resistance, large-scale and uncontrolled treatment with medicinal antibacterial agents should not be allowed.

Antibiotic compatibility with alcohol

It is recommended to exclude alcohol during the course of drug therapy, as it weakens the effectiveness of drug therapy. Compatibility and admissible terms of acceptance of alcohol and Aveloks ® are specified in the table.

It is important to strictly observe the permissible terms for taking alcoholic beverages and medications. Violation of this recommendation entails a serious danger to the life and health of the patient.

Terms of purchase and storage

The drug can be bought at a pharmacy with a doctor's prescription. The tablet form and solution for infusion must be stored in compliance with the temperature regime - below 25C. Do not freeze and keep within reach of children.

Avelox ® - analogues are cheaper

The average price of a medicine varies from 680 to 870 rubles. The main analogues are presented in the table.

Avelox ® - reviews of doctors

Experts from various fields of medicine note the significant therapeutic efficacy of this drug. It was noted that Avelox ® in case of prostatitis is characterized by reliable effectiveness, in comparison with other groups of antibacterial components. An important feature is the antibacterial effect on bacterial strains that are resistant to other antimicrobial agents.

However, reviews do not always positively describe the impressions of treatment. Authors negative feedback were patients who experienced side effects from use. The list of adverse symptoms is long, but, despite all the warnings, some patients neglect the recommendations of specialists.

The result of this attitude is the development of severe complications while taking the drug. The instructions note that the drug is unacceptable for the treatment of patients with impaired liver function. This fact has been confirmed not only by many years of clinical trials, but also by numerous reviews on the effect of Avelox ® premium on liver function.

Graduated specialist, in 2014 she graduated with honors from Orenburg State University with a degree in microbiology. Postgraduate graduate of FGBOU VO Orenburg State Agrarian University.

In 2015 at the Institute of Cellular and Intracellular Symbiosis of the Ural Branch of the Russian Academy of Sciences, she underwent advanced training in the additional professional program "Bacteriology".

Laureate of the All-Russian competition for the best scientific work in the nomination "Biological Sciences" in 2017.

Avelox- an antibiotic of the fluoroquinol group, active against a number of gram-positive and gram-negative bacteria, as well as chlamydia, mycoplasma, legionella, anaerobic and atypical pathogens, Escherichia and Pseudomonas aeruginosa and other infections.

Active substance medicinal product Avelox - moxifloxacin disrupts DNA biosynthesis in microbial cells. When taken orally, the drug is well absorbed into the blood from the gastrointestinal tract and is evenly distributed throughout the tissues and fluids in the human body.

Belonging to the group of antibiotics, Avelox is used in the treatment of many diseases of infectious etiology, such as:

• Chronical bronchitis;
• pneumonia;
• skin infections and soft tissue inflammation;
• intra-abdominal abscess;
• urogenital infections.

Attention! Avelox is a powerful antibiotic, so only a specialist can recommend it for use by determining the dosage and methods of taking the drug, taking into account general condition patient, localization and severity of the infectious disease.

Avelox and its analogues should be used exactly according to the instructions, without chewing the tablets and drinking a small amount of water. And even with the observance of the dosage and the rules of admission during the treatment with Avelox, pronounced side effects can be observed:

• dysfunction of the heart (arrhythmia, tachycardia, etc.);
• nausea and vomiting;
• dizziness and headaches;
• fainting;
• sleep disorders;
• increase and decrease in pressure;
• digestive system disorder, etc.

There are a number of contraindications to the use of the drug. These include:

• period of pregnancy and lactation;
• childhood and adolescence;
• hypersensitivity to the components of the drug.

Also, caution is advised to take the medicine for patients with pathologies of the central nervous system and with functional disorders of the liver or kidneys.

How to replace Avelox?

A significant number of contraindications and the presence of many side effects raises a logical question: what can replace Avelox?

To date pharmaceutical industry produces quite a few analogues of Avelox. So, along with Avelox, Moxifloxacin belongs to the 4th generation fluoroquinolones. The group of quinolones introduced into medical practice at the end of the 20th century and having a detrimental effect on a wide range of infectious agents includes:

• Vigamox;
• Moxin;
• Moximac;
• Levofloxacin and a number of other drugs.

Based on the fact that all the indicated drugs act approximately the same, they have similar contraindications and side effects. It should also be noted that both Avelox and all analogues medicinal product are not cheap and have approximately the same cost. In this regard, at in the presence of serious contraindications and worrisome complications, you should consult a doctor with a request to replace Avelox or one of its analogues with an antibiotic belonging to another pharmaceutical group.

Experts recommend if available chronic diseases of the digestive system, do not use an antibiotic in tablets, but purchase an infusion solution for intravenous injections in order to prevent an exacerbation of the underlying disease. Ciprofloxacin, available as eye drops, is used to treat severe eye infections. With mycoplasma, with the permission of the attending physician, Avelox can be replaced with Doxycycline monohydrate.

In this article, you can read the instructions for using the drug Avelox. Reviews of site visitors - consumers of this medicine, as well as opinions of doctors of specialists on the use of Avelox in their practice are presented. A big request to actively add your reviews about the drug: did the medicine help or not help get rid of the disease, what complications were observed and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Avelox in the presence of existing structural analogues. Use for the treatment of chlamydia, mycoplasmosis, chronic bronchitis and prostatitis in adults, children, as well as during pregnancy and lactation. The composition and interaction of the drug with alcohol.

Avelox- an antibacterial drug of the fluoroquinolone group. It has a bactericidal effect. The mechanism of action is due to the inhibition of bacterial topoisomerases 2 and 4, which leads to a disruption in the synthesis of microbial cell DNA and, as a result, to the death of the microbial cell. The minimum bactericidal concentrations of the drug are generally comparable to its MIC.

The drug is active against a wide range of gram-negative and gram-positive microorganisms, anaerobes, acid-fast bacteria and atypical forms such as Mycoplasma spp. (mycoplasma), Chlamydia spp. (chlamydia), Legionella spp. (legionella), as well as bacteria resistant to beta-lactam and macrolide antibiotics.

Gram-positive and gram-negative aerobic bacteria, anaerobic bacteria, atypical bacteria are sensitive to Avelox: Chlamydia pneumoniae, Mycoplasma pneumoniae, Legionella pneumophila, Coxiella burnettii, Chlamydia trachomatis, Mycoplasma hominis, Mycoplasma genitalium.

Moxifloxacin ( active substance Avelox) is less active against Staphylococcus aureus (methicillin/ofloxacin resistant strains), Staphylococcus epidermidis (methicillin/ofloxacin resistant strains), Pseudomonas aeruginosa, Pseudomonas fluorescens, Burkholderia cepacia, Stenotrophomonas maltophilia, Neisseria gonorrhoea.

The mechanisms leading to the development of resistance to penicillins, cephalosporins, aminoglycosides, macrolides and tetracyclines do not impair the antibacterial activity of moxifloxacin. Cross stability between these groups antibacterial drugs and moxifloxacin is not noted. No cases of plasmid resistance have been observed so far either. The overall frequency of development of resistance is very low (10-7-10-10). Resistance to moxifloxacin develops slowly through multiple mutations. Repeated exposure of microorganisms to moxifloxacin at concentrations below the MIC is accompanied by only a slight increase in the MIC.

Cases of cross-resistance to quinolones have been reported. However, some Gram-positive and anaerobic organisms resistant to other quinolones are sensitive to moxifloxacin.

Compound

Moxifloxacin hydrochloride + excipients.

Pharmacokinetics

After oral administration, Avelox is absorbed quickly and almost completely. When taking moxifloxacin with food, the duration of absorption does not change. The drug can be used regardless of the meal. Absolute bioavailability is about 91%. Binding to blood proteins (mainly albumin) is about 45%. Moxifloxacin is rapidly distributed in organs and tissues. High concentrations of the drug, exceeding those in plasma, are created in the lung tissue (including in alveolar macrophages), in the bronchial mucosa, in the nasal sinuses, in soft tissues, skin and subcutaneous structures, and foci of inflammation. In the interstitial fluid and in saliva, the drug is determined in a free, non-protein-bound form, at a concentration higher than in plasma. In addition, high concentrations of the drug are determined in the organs of the abdominal cavity and peritoneal fluid, as well as in the tissues of the female genital organs.

Biotransformed to inactive sulfo compounds and glucuronides. After passing through the 2nd phase of biotransformation, moxifloxacin is excreted from the body by the kidneys and through the intestines both unchanged and in the form of inactive sulfo compounds and glucuronides. It is excreted in the urine, as well as in the feces, both unchanged and in the form of inactive metabolites.

There were no differences in the pharmacokinetic parameters of moxifloxacin depending on age, gender and race.

Pharmacokinetic studies of moxifloxacin in children have not been conducted.

Indications

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

• acute sinusitis;
• community-acquired pneumonia (including those caused by strains of microorganisms with multiple antibiotic resistance);
• exacerbation of chronic bronchitis;
• uncomplicated infections of the skin and soft tissues;
• complicated infections of the skin and subcutaneous structures (including an infected diabetic foot);
• complicated intra-abdominal infections, including polymicrobial infections, incl. intraperitoneal abscesses;
• uncomplicated inflammatory diseases of the pelvic organs (including salpingitis and endometritis).

Release form

Film-coated tablets 400 mg.

Solution for infusion (injections in ampoules for injection).

Instructions for use and dosing regimen

The drug is prescribed orally and intravenously, 400 mg 1 time per day.

The duration of treatment with Avelox when administered orally and intravenously is determined by the severity of the infection and the clinical effect and is: with exacerbation of chronic bronchitis - 5 days; at community-acquired pneumonia the total duration of stepwise therapy (in / in the introduction followed by oral administration) - 7-14 days, first in / in, then inside, or 10 days inside; with acute sinusitis and uncomplicated infections of the skin and soft tissues - 7 days; with complicated infections of the skin and subcutaneous tissues - the total duration of gradual therapy (in / in the introduction followed by oral administration) is 7-21 days; with complicated intra-abdominal infections - the total duration of gradual therapy (in / in the introduction of the drug, followed by oral administration) is 5-14 days; with uncomplicated inflammatory diseases of the pelvic organs -14 days.

The duration of treatment with Avelox intravenously can reach 14 days, orally - 21 days.

Elderly patients, patients with mild hepatic impairment (Child-Pugh class A or B), patients with impaired renal function (including those with CC<30 мл/мин/1.73 м2), а также пациентам, находящимся на непрерывном гемодиализе и длительном амбулаторном перитонеальном диализе, изменений режима дозирования не требуется.

Tablets should be taken without chewing, with a small amount of water, regardless of the meal.

The solution for infusion should be administered intravenously slowly over 60 minutes. The drug can be administered both diluted and undiluted. Avelox solution is compatible with the following solutions: water for injection, sodium chloride solution 0.9%, sodium chloride solution 1M, dextrose solution 5%, dextrose solution 10%, dextrose solution 40%, xylitol solution 20%, Ringer's solution, Ringer's lactate solution, aminofusin solution 10%, ionosteril solution. Only clear solution should be used.

Side effect

• prolongation of the QT interval (often in patients with concomitant hypokalemia, sometimes in other patients);
• tachycardia and vasodilation (flushing of the face);
• arterial hypotension;
• arterial hypertension;
• fainting;
• ventricular tachyarrhythmias;
• nonspecific arrhythmias (including extrasystole);
• polymorphic ventricular tachycardia (ventricular arrhythmia of the "pirouette" type) or cardiac arrest, mainly in individuals with conditions predisposing to arrhythmias, such as clinically significant bradycardia, acute myocardial ischemia;
• shortness of breath, including an asthmatic condition;
• nausea, vomiting;
• stomach ache;
• diarrhea;
• anorexia;
• constipation;
• dyspepsia;
• flatulence;
• gastroenteritis (other than erosive gastroenteritis);
• stomatitis;
• pseudomembranous colitis (in very rare cases, associated with life-threatening complications);
• jaundice;
• hepatitis (mainly cholestatic);
• dizziness;
• headache;
• confusion;
• disorientation;
• drowsiness;
• tremor;
• sleep disorders;
• sense of anxiety;
• increased psychomotor activity;
• impaired coordination (including gait disturbance due to dizziness, in very rare cases leading to injuries due to falls, especially in elderly patients);
• convulsive seizures with various clinical manifestations (including grand mal seizures);
• attention disorders;
• speech disorders;
• amnesia;
• depression (in very rare cases, behavior with a tendency to self-harm is possible);
• hallucinations;
• psychotic reactions (potentially manifested in behavior with a tendency to self-harm);
• taste disorders;
• visual disturbances (blurring, decreased visual acuity, diplopia, especially in combination with dizziness and confusion);
• noise in ears;
• impaired sense of smell, including anosmia;
• loss of taste sensitivity;
• anemia, leukopenia (including neutropenia), thrombocytopenia, thrombocytosis, prolongation of prothrombin time and decrease in INR;
• arthralgia;
• myalgia;
• tendinitis;
• increased muscle tone and cramps;
• tendon ruptures;
• candida superinfection;
• vaginitis;
• dehydration (caused by diarrhea or decreased fluid intake);
• impaired renal function;
• renal failure as a result of dehydration, which can lead to kidney damage (especially in elderly patients with concomitant impaired renal function);
• bullous skin reactions, such as Stevens-Johnson syndrome or toxic epidermal necrolysis (potentially life-threatening);
• hives;
• rash;
• eosinophilia;
• anaphylactic / anaphylactoid reactions;
• angioedema, including laryngeal edema (potentially life-threatening);
• anaphylactic shock (including life-threatening);
• general malaise (including symptoms of feeling unwell, non-specific pain and sweating);
• swelling.

Contraindications

• pregnancy;
• lactation (breastfeeding);
• children and adolescents up to 18 years of age;
• hypersensitivity to moxifloxacin and other components of the drug.

Use during pregnancy and lactation

The safety of Avelox during pregnancy has not been established, so its use is contraindicated.

A small amount of moxifloxacin is excreted in breast milk. Data on the use of moxifloxacin in women during lactation are not available. Therefore, the use of Avelox during breastfeeding is also contraindicated.

In experimental studies, when studying the effect of moxifloxacin on reproductive function in rats, rabbits and monkeys, it was proved that moxifloxacin crosses the placental barrier. Studies conducted in rats (with the introduction of moxifloxacin orally and / in) and monkeys (with the introduction of moxifloxacin orally) did not reveal the teratogenic effect of moxifloxacin and its effect on fertility. With intravenous administration of moxifloxacin to rabbits at a dose of 20 mg/kg, skeletal malformations were observed. An increase in the number of miscarriages in monkeys and rabbits was found with the use of moxifloxacin at a therapeutic dose. In rats, a decrease in fetal weight, an increase in miscarriages, a slight increase in the duration of pregnancy, and an increase in spontaneous activity of the offspring of both sexes were observed when using moxifloxacin, the dose of which was 63 times higher than the recommended one.

Use in elderly patients

Elderly patients do not need to change the dosing regimen.

Use in children

The drug is contraindicated in children and adolescents under 18 years of age.

special instructions

It should be borne in mind that when prescribing Avelox, the risk of convulsive seizures increases, therefore, the drug is prescribed with caution to patients with CNS diseases accompanied by convulsions or predisposing to their development or a decrease in the threshold of convulsive readiness, as well as if such diseases and conditions are suspected.

When using Avelox, some patients may experience a prolongation of the QT interval. In this regard, the drug should be avoided in patients with prolongation of the QT interval, hypokalemia, as well as against the background of treatment with class 1 A antiarrhythmic drugs (quinidine, procainamide) or class 3 (amiodarone, sotalol) antiarrhythmic drugs, since the experience of using moxifloxacin in these patients is limited. Avelox should be administered with caution along with drugs that prolong the QT interval (cisapride, erythromycin, antipsychotics, tricyclic antidepressants), as well as in patients with conditions predisposing to arrhythmias, such as bradycardia, acute myocardial ischemia. The degree of prolongation of the QT interval may increase with increasing concentration of the drug, so do not exceed the recommended dose. Prolongation of the QT interval is associated with an increased risk of ventricular arrhythmias, including polymorphic ventricular tachycardia. In patients with pneumonia, there was no correlation between plasma concentrations of moxifloxacin and prolongation of the QT interval. None of the 9000 patients treated with moxifloxacin experienced QT-related cardiovascular complications and deaths. However, in patients with predisposing conditions to arrhythmias, the use of moxifloxacin may increase the risk of developing ventricular arrhythmias.

Against the background of therapy with fluoroquinolones, incl. moxifloxacin, especially in the elderly and patients receiving glucocorticosteroids (GCS), tendinitis and tendon rupture may develop. If pain or signs of inflammation of the tendon appear, stop taking Avelox and unload the affected limb.

The use of broad-spectrum antibacterial drugs is associated with the risk of developing pseudomembranous colitis. This should be borne in mind if severe diarrhea occurs during treatment with Avelox. In this case, the drug should be discontinued and appropriate therapy should be prescribed immediately.

Do not use Avelox together with ethanol (alcohol).

There is a risk of developing hypersensitivity reactions and anaphylactic reactions during the initial use of the drug. Very rarely, an anaphylactic reaction can progress to anaphylactic shock. In such cases, you should immediately stop the administration of the drug and take appropriate resuscitation measures (including anti-shock).

When using quinolones, photosensitivity reactions are noted. However, when conducting preclinical, clinical studies, as well as when using Avelox in clinical practice, no photosensitivity reactions were noted. However, patients during the period of taking the drug should avoid direct sunlight and UV radiation.

Patients of different ethnic groups do not require dose adjustment.

Influence on the ability to drive vehicles and control mechanisms

Despite the fact that moxifloxacin rarely causes adverse reactions from the central nervous system, the question of the possibility of driving a car or moving machinery is decided individually after assessing the patient's response to taking the drug.

drug interaction

No dose adjustment is required when Avelox is co-administered with atenolol, ranitidine, calcium-containing supplements, theophylline, oral contraceptives, glibenclamide, itraconazole, digoxin, morphine, probenecid (no clinically significant interaction with moxifloxacin has been confirmed).

The combined use of Avelox and antacids, minerals and vitamin-mineral complexes inside can disrupt the absorption of moxifloxacin due to the formation of chelate complexes with the polyvalent cations contained in these preparations, and therefore, reduce the concentration of moxifloxacin in the blood plasma. In this regard, antacids, antiretroviral and other drugs containing calcium, magnesium, aluminum, iron, sucralfate should be taken at least 4 hours before or 2 hours after ingestion of Avelox.

With the combined use of Avelox with warfarin, prothrombin time and other parameters of blood coagulation do not change.

In patients receiving anticoagulants in combination with antibiotics, incl. with moxifloxacin, there have been cases of increased anticoagulant activity of anticoagulants. Risk factors are the presence of an infectious disease (and concomitant inflammatory process), the age and general condition of the patient. Despite the fact that the interaction between moxifloxacin and warfarin is not detected, in patients receiving concomitant treatment with these drugs, it is necessary to monitor the INR and, if necessary, adjust the dose of oral anticoagulants.

Moxifloxacin and digoxin do not significantly affect each other's pharmacokinetic parameters.

With the simultaneous use of activated charcoal and oral moxifloxacin at a dose of 400 mg, the systemic bioavailability of the drug is reduced by more than 80% as a result of slowing down its absorption. In case of an overdose, the use of activated charcoal at an early stage of absorption prevents a further increase in systemic exposure.

The absorption of moxifloxacin does not change with the simultaneous ingestion of food (including dairy products). Moxifloxacin can be taken with or without food.

Analogues of the drug Avelox

Structural analogues for the active substance:

• Vigamox;
• Moximac;
• Moxin;
• Moxifloxacin;
• Moxifur;
• Plevilox.

Analogues by pharmacological group (antibiotics quinolones and fluoroquinolones):

• Abaktal;
• Alcipro;
• Vigamox;
• Gatispan;
• Glevo;
• Zanocin;
• Zoflox;
• Quipro;
• Levolet R;
• Levofloxacin;
• Lomefloxacin;
• Microflox;
• Nevigramon;
• Negroes;
• Nolicin;
• Norbactin;
• Norfloxacin;
• Ofloks;
• Ofloxacin;
• Oflocid;
• Oflocid forte;
• Palin;
• Pefloxacin;
• Recipro;
• Sifloks;
• Tavanic;
• Uniflox;
• Factive;
• Floracid;
• Hyleflox;
• Ciprobay;
• Tsiprolet;
• Ciprofloxacin;
• Cifran;
• Elefloks;
• Unikpef;
• Youtibid.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases that the corresponding drug helps with and see the available analogues for the therapeutic effect.

International name

Group affiliation

Dosage form

pharmachologic effect

An antimicrobial agent from the group of fluoroquinolones, acts bactericidal. Shows activity against a wide range of gram-positive and gram-negative microorganisms, anaerobic, acid-resistant and atypical bacteria: Mycoplasma spp., Chlamydia spp., Legionella spp. Effective against bacterial strains resistant to beta-lactam antibiotics and macrolides.

Active against most strains of microorganisms: gram-positive - Staphylococcus aureus (including strains insensitive to methicillin), Streptococcus pneumoniae (including strains resistant to penicillin and macrolides), Streptococcus pyogenes (group A); gram-negative - Haemophilus influenzae (including both beta-lactamase producing and non-beta-lactamase producing strains), Haemophilus parainfluenzae, Klebsiella pneumoniae, Moraxella catarrhalis (including both beta-lactamase producing and non-beta-lactamase producing strains), Escherichia coli, Enterobacter cloacae; atypical - Chlamydia pneumoniae, Mycoplasma pneumoniae.

According to in vitro studies, although the microorganisms listed below are sensitive to moxifloxacin, nevertheless, its safety and effectiveness in the treatment of infections have not been established. Gram-positive microorganisms: Streptococcus milleri, Streptococcus mitis, Streptococcus agalactiae, Streptococcus dysgalactiae, Staphylococcus cohnii, Staphylococcus epidermidis (including strains sensitive to methicillin), Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus saprophyticus, Staphylococcus simacterulans. Gram-negative microorganisms: Bordetella pertussis, Klebsiella oxytoca, Enterobacter aerogenes, Enterobacter agglomerans, Enterobacter intermedius, Enterobacter sakazakii, Proteus mirabilis, Proteus vulgaris, Morganella morganii, Providencia rettgeri, Providencia stuartii.

Анаэробные микроорганизмы: Bacteroides distasonis, Bacteroides eggerthii, Bacteroides fragilis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacteroides uniformis, Fusobacterium spp., Porphyromonas spp., Porphyromonas anaerobius, Porphyromonas asaccharolyticus, Porphyromonas magnus, Prevotella spp., Propionibacterium spp., Clostridium perfringens, Clostridium ramosum. Atypical microorganisms: Legionella pneumophila, Coxiella burnetii.

It blocks with topoisomerases II and IV enzymes that control the topological properties of DNA and are involved in DNA replication, repair and transcription. The action of moxifloxacin depends on its concentration in the blood and tissues. The minimum bactericidal concentrations almost do not differ from the IPC.

There is no cross-resistance with penicillins, cephalosporins, aminoglycosides, macrolides and tetracyclines. The overall incidence of resistance is low. In vitro studies have shown that resistance to moxifloxacin develops slowly as a result of a series of successive mutations. Between drugs from the group of fluoroquinolones, cross-resistance is observed. However, some Gram-positive and anaerobic organisms resistant to other fluoroquinolones are sensitive to moxifloxacin.

Does not have a photosensitizing effect.

Indications

Contraindications

Side effects

Often - 1-10%, rarely - 0.1-1%, extremely rarely - 0.01-0.1%.

From the digestive system: often - abdominal pain, dyspepsia (including flatulence, nausea, vomiting, constipation, diarrhea), increased activity of "liver" transaminases; rarely - dry mouth, candidiasis of the oral mucosa, anorexia, stomatitis, glossitis, increased gamma-glutamine transferase; extremely rarely - gastritis, discoloration of the tongue, dysphagia, transient jaundice.

From the nervous system: often - dizziness, headache; rarely - asthenia, insomnia or drowsiness, nervousness, anxiety, tremor, paresthesia; extremely rarely - hallucinations, depersonalization, increased muscle tone, impaired coordination of movements, agitation, amnesia, aphasia, emotional lability, sleep disturbance, speech disorders, impaired cognitive processes, hypesthesia, convulsions, confusion, depression.

From the senses: often - a change in taste; extremely rarely - visual impairment, amblyopia, loss of taste sensitivity, parosmia.

From the side of the CCC: rarely - tachycardia, increased blood pressure, palpitations, chest pain, prolongation of the Q-T interval; extremely rare - decrease in blood pressure, vasodilation,

From the respiratory system: rarely - shortness of breath; extremely rare - bronchial asthma.

From the musculoskeletal system: rarely - arthralgia, myalgia; extremely rarely - back pain, pain in the legs, arthritis, tendinopathy.

From the genitourinary system: rarely - vaginal candidiasis, vaginitis; extremely rarely - pain in the lower abdomen, swelling of the face, peripheral edema, impaired renal function.

Allergic reactions: rarely - rash, itching; extremely rarely - urticaria, anaphylactic shock.

Local reactions: often - swelling, inflammation, pain at the injection site; rarely - phlebitis.

Laboratory indicators: rarely - leukopenia, increased prothrombin time, eosinophilia, thrombocytosis, increased amylase activity; extremely rarely - a decrease in thromboplastin concentration, a decrease in prothrombin time, thrombocytopenia, anemia, hyperglycemia, hyperlipidemia, hyperuricemia, increased LDH activity. The connection with taking the drug has not been proven: an increase or decrease in hematocrit, leukocytosis, erythrocytosis or erythropenia, a decrease in the concentration of glucose, Hb, urea, an increase in alkaline phosphatase activity.

Other: rarely - candidiasis, general discomfort, sweating.

Application and dosage

Inside or in the form of an intravenous infusion (slowly, over 60 minutes) - 400 mg 1 time per day. The tablet is swallowed whole, without chewing, regardless of the meal. The course of treatment for exacerbation of chronic bronchitis - 5 days, community-acquired pneumonia - 10 days, acute sinusitis, infections of the skin and soft tissues - 7 days.

No change in dosing regimen is required in elderly patients, with hepatic (groups A, B on the Child-Puge scale) and / or renal (including with CC less than 30 ml / min / 1.73 sq.m) insufficiency.

special instructions

During therapy with fluoroquinolones, inflammation and tendon rupture may develop, especially in elderly patients and in patients receiving corticosteroids in parallel. At the first sign of pain or inflammation of the tendons, patients should stop treatment and immobilize the affected limb.

There is a direct relationship between an increase in the concentration of moxifloxacin and an increase in the Q-T interval (risk of developing ventricular arrhythmias, including torsades de pointes). As a result, the recommended dose (400 mg) and infusion rate (at least 60 minutes) should not be exceeded.

If severe diarrhea develops during treatment, the drug should be discontinued.

Interaction

Antacids, minerals, multivitamins impair absorption (due to the formation of chelate complexes with polyvalent cations) and reduce the plasma concentration of moxifloxacin (simultaneous administration is possible at intervals of 4 hours before or 2 hours after taking moxifloxacin).

Simultaneous use with other quinolones increases the risk of prolongation of the QT interval.

Ranitidine reduces the absorption of moxifloxacin.

Does not interact with probenecid, warfarin, oral contraceptives, theophylline, glibenclamide, morphine, itraconazole.

Slightly affects the pharmacokinetic parameters of digoxin.

Corticosteroids increase the risk of tendovaginitis or tendon rupture.

The solution for infusion is compatible with the following drug solutions: 0.9% and 1 molar NaCl solution, water for injection, dextrose solution (5, 10 and 40%), xylitol 20% solution, Ringer's solution, Ringer's lactate, 10% Aminofusine solution, solution Ionosteril.

Incompatible with 10 and 20% NaCl solutions, 4.2 and 8.4% Na bicarbonate solutions.

Reviews about the drug Avelox: 0

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Avelox is an antibacterial drug of the fluoroquinolone group. The active substance is moxifloxacin.

Antibacterial drug of the fluoroquinolone series with a wide spectrum of action. The bactericidal effect of the drug is due to the inhibition of bacterial topoisomerases II and IV, which leads to disruption of DNA biosynthesis of the microbial cell and its death.

The activity of moxifloxacin depends on its concentration in blood plasma: the minimum bactericidal concentrations correspond to the minimum bacteriostatic. The resistance mechanisms of microorganisms that inactivate penicillins, cephalosporins, aminoglycosides, macrolides and tetracyclines do not affect the antibacterial efficacy of moxifloxacin.

Cross-resistance between the drug Avelox and the listed antibiotics is not noted. There were also no cases of plasmid resistance.

Available in the form of coated tablets and solution for infusion. The active substance is moxifloxacin: in 1 tablet Avelox and 250 ml of solution - 400 mg.

Tablet excipients: lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, magnesium stearate, hypromellose, yellow iron oxide, macrogol 4000, titanium dioxide.

Auxiliary components of the solution: hydrochloric acid 1M, sodium chloride, sodium hydroxide solution 2M, water for injection.

Avelox in vitro is active against a wide range of gram-positive and gram-negative bacteria, anaerobes, atypical and acid-resistant microorganisms (for example, Legionella spp., Chlamydia spp., Mycoplasma spp.), as well as microorganisms resistant to macrolide and β-lactam antibiotics.

Less active against Staphylococcus aureus (methicillin/ofloxacin resistant strains)*, Staphylococcus epidermidis (methicillin/ofloxacin resistant strains)*, Pseudomonas aeruginosa, Pseudomonas fluorescens, Burkholderia cepacia, Stenotrophomonas maltophilia, Neisseria gonorrhoea.

Indications for use

What helps Avelox? According to the instructions, the drug is prescribed in the following cases:

• acute sinusitis;
• community-acquired pneumonia (including those caused by strains of microorganisms with multiple antibiotic resistance*);
• exacerbation of chronic bronchitis;
• uncomplicated infections of the skin and soft tissues;
• complicated infections of the skin and subcutaneous structures (including an infected diabetic foot);
• complicated intra-abdominal infections, including polymicrobial infections, incl. intraperitoneal abscesses;
• uncomplicated inflammatory diseases of the pelvic organs (including salpingitis and endometritis).

* - Streptococcus pneumoniae with multiple antibiotic resistance includes penicillin-resistant strains and strains resistant to two or more antibiotics from such groups as penicillins (at a minimum inhibitory concentration ≥2 mg / ml), second-generation cephalosporins (cefuroxime), macrolides , tetracyclines and trimethoprim/sulfamethoxazole.

Instructions for use Avelox 400 mg, dosage

Intravenously

Avelox is administered intravenously in a dose of 400 mg once a day.

It is rational to use a stepwise scheme of pharmacotherapy, which implies that after 3-4 days of intravenous infusions, they switch to a tablet intake of an antibacterial agent.

For patients of the older age group, dose adjustment is not performed.

Avelox tablets 400 mg

Tablets can be taken at any time of the day, regardless of food intake, swallowing whole. Reception at the same time is recommended.

The standard dosage, according to the instructions for use, is 1 tablet of Avelox 400 mg once a day. The course of treatment for exacerbation of chronic bronchitis - 5 days, community-acquired pneumonia - 10 days, acute sinusitis, infections of the skin and soft tissues - 7 days.

No change in dosing regimen is required in elderly patients, with hepatic (groups A, B on the Child-Puge scale) and / or renal (including with CC less than 30 ml / min / 1.73 sq.m) insufficiency.

Side effects

The instruction warns of the possibility of developing the following side effects when prescribing Avelox 400:

• From the digestive system: often - abdominal pain, dyspepsia (including flatulence, nausea, vomiting, constipation, diarrhea), increased activity of "liver" transaminases; rarely - dry mouth, candidiasis of the oral mucosa, anorexia, stomatitis, glossitis, increased gamma-glutamine transferase; extremely rarely - gastritis, discoloration of the tongue, dysphagia, transient jaundice.
• From the nervous system: often - dizziness, headache; rarely - asthenia, insomnia or drowsiness, nervousness, anxiety, tremor, paresthesia; extremely rarely - hallucinations, depersonalization, increased muscle tone, impaired coordination of movements, agitation, amnesia, aphasia, emotional lability, sleep disturbance, speech disorders, impaired cognitive processes, hypesthesia, convulsions, confusion, depression.
• From the senses: often - a change in taste; extremely rarely - visual impairment, amblyopia, loss of taste sensitivity, parosmia.
• From the side of the CCC: rarely - tachycardia, increased blood pressure, palpitations, chest pain, prolongation of the Q-T interval; extremely rare - decrease in blood pressure, vasodilation,
• From the respiratory system: rarely - shortness of breath; extremely rare - bronchial asthma.
• From the musculoskeletal system: rarely - arthralgia, myalgia; extremely rarely - back pain, pain in the legs, arthritis, tendinopathy.
• From the genitourinary system: rarely - vaginal candidiasis, vaginitis; extremely rarely - pain in the lower abdomen, swelling of the face, peripheral edema, impaired renal function.
• Allergic reactions: rarely - rash, itching; extremely rarely - urticaria, anaphylactic shock.
• Local reactions: often - swelling, inflammation, pain at the injection site; rarely - phlebitis.
• Laboratory indicators: rarely - leukopenia, increased prothrombin time, eosinophilia, thrombocytosis, increased amylase activity; extremely rarely - a decrease in thromboplastin concentration, a decrease in prothrombin time, thrombocytopenia, anemia, hyperglycemia, hyperlipidemia, hyperuricemia, increased LDH activity. The connection with taking the drug has not been proven: an increase or decrease in hematocrit, leukocytosis, erythrocytosis or erythropenia, a decrease in the concentration of glucose, Hb, urea, an increase in alkaline phosphatase activity.
• Other: rarely - candidiasis, general discomfort, sweating.

Contraindications

Avelox is contraindicated in the following cases:

• Breast-feeding.
• Pregnancy at any time.
• Intolerance to the active substance or other components of the drug.
• Age less than 18 years.

If pain occurs in the joints or tendons while taking Avelox, the drug is canceled to prevent tendon rupture.

In patients with epilepsy, the administration of the drug may provoke convulsions.

With the development of severe diarrhea on the background of admission, the drug is canceled.

Overdose

With a single use of the drug at a dose of up to 1200 mg or when it enters the body in doses not exceeding 600 mg, no side effects have been recorded for 10 days.

In case of overdose, it is necessary to carefully study the clinical picture of the patient's condition and prescribe symptomatic supportive therapy in combination with ECG monitoring.

Taking activated charcoal immediately after oral administration of moxifloxacin often avoids excessive systemic drug exposure in the event of an overdose.

Analogues of Avelox 400 mg, price in pharmacies

If necessary, you can replace Avelox with an analogue of the active substance - these are drugs:

1. Vigamox;
2. Moximac;
3. Moxin;
4. Moxifloxacin hydrochloride;
5. Plevilox.

Analogues by ATX code:

• Aquamox,
• maxiflox,
• moxifloxacin,
• Moflaxia.

When choosing analogues, it is important to understand that the instructions for use of Avelox 400mg, price and reviews, do not apply to drugs of similar action. It is important to consult a doctor and not to make an independent replacement of the drug.

Price in pharmacies in Moscow and Russia: Avelox tablets 400 mg 5 pcs. - from 644 rkbl, the price of a solution for infusions 1.6 mg / ml 250 ml 4 pcs. - from 9515 rubles, according to 572 pharmacies.

Tablets should be stored out of the reach of children, in a dry place at a temperature not exceeding 25°C. Shelf life - 5 years.

Conditions for dispensing from pharmacies - by prescription.