The pharmacokinetics of gemifloxacin is linear in the range 40-640 mg doses. The drug accumulates almost no (less than 30% at a dose of 640 mg during 7 days). In exchange receiving gemifloxacin 320 mg once a day equilibrium concentration is reached on the third day.
Gemifloxacin is rapidly absorbed from the gastrointestinal tract. The time to reach maximum plasma concentration )amounts to 0.5-2 hours after administration of one tablet. After testosterone enanthate 250 repeated administration of 320 mg of its maximum concentration in the plasma and area under the curve “concentration-time».The absolute bioavailability of gemifloxacin is approximately 71%.
Food intake is almost does not change the pharmacokinetics of gemifloxacin, and the drug can be taken without regard to food.
If readmission, 55-73% of the drug binds to plasma proteins, the proportion of bound fraction is independent of age.
Gemifloxacin concentration in bronchoalveolar lavage fluid is higher than that in plasma. Gemifloxacin penetrates well into lung tissue.
The small amount of gemifloxacin is metabolized in the liver. After 4 hours after receiving an unmodified gemifloxacin prevalent among drug metabolites (65%) in the blood plasma.
Gemifloxacin not metaboliziziruetsya cytochrome and does not inhibit the metabolic activity of the cytochrome P450 enzyme system.
In healthy persons 61 ± 9,5% dose gemifloxacin output through the intestines, and 36 ± 9,3% kidneys as unchanged drug and metabolic products.
The half-life of plasma and urine approximately 8 hours and 15 hours, respectively.
in hemodialysis displayed 20-30% of the dose gemifloxacin plasma.
pharmacokinetics in children has not been studied .
Age did not affect the pharmacokinetics of gemifloxacin.
in liver failure, a slight increase in the maximum concentration of gemifloxacin plasma that does not require dose adjustments.
in renal failure has been a slight increase in elimination gemifloxacin plasma time without changing the maximum concentration.
dose adjustment in patients with a creatinine clearance of patients > 40 ml / min is required. In patients with creatinine testosterone enanthate 250min is recommended to change the dose of the drug (see. “Dosage and administration”).
Indications for use
Infectious diseases caused by susceptible to gemifloxacin microorganisms:
community-acquired pneumonia, including caused by multidrug-resistant strains.
exacerbation of chronic bronchitis,
- Hypersensitivity to gemifloxacin and other fluoroquinolones.
- Pregnancy and lactation.
- Children under 18 years old.
- Defeats tendons transferred earlier due to the use of fluoroquinolones.
- epilepsy and predisposition to convulsive reactions
- Extension , including innate.
- deficiency of glucose-6-phosphate dehydrogenase (risk of hemolytic anemia)
- patients receiving steroids, especially the elderly, due to increased risk of tendons;
- concomitant use with drugs that prolong : antiarrhythmic drugs class IA (quinidine, procainamide) and Class III (amiodarone, sotalol);
- patients with severe renal impairment;
- Patients with impaired water and electrolyte testosterone enanthate 250 balance (hypokalaemia, gipomagnemiya).
Inside. Apply regardless of the meal, without chewing, with a small amount of water.
The recommended daily dose – 320 mg 1 time per day. Community-acquired pneumonia – 320 mg once a day – seven days. If necessary, the treatment may be extended to 14 days.
Exacerbation of chronic bronchitis – 320 mg once daily – 5 days.
Acute sinusitis – 320 mg once daily – 5 days.
No dose adjustment is required for patients with mild to moderate severity of renal failure (creatinine clearance of> 40 ml / min). In-severe renal insufficiency (creatinine clearance less than 40 ml / min) and in patients on hemodialysis or continuous ambulatory peritoneal dialysis, the recommended dose -. 160 mg 1 time per day
in patients with hepatic failure dose adjustment is required.
In elderly patients dose adjustment is required.
Precautions for use
During treatment, gemifloxacin is necessary to ensure a sufficient amount of fluid to comply with normal urine output.
Before the drug (such as the use of other fluoroquinolones), you may experience photosensitivity reactions, it is recommended to avoid exposure to direct sunlight. Treatment should be discontinued if symptoms of photosensitivity observed (for example, a change in the skin resemble sunburn).
At the first sign of tendonitis (pain and swelling in the tendons) use of the drug should be discontinued, eliminate physical exertion and consult a doctor. The risk of tendon injury may be increased in patients receiving corticosteroids, especially the elderly, with the appearance of pain in the tendon during exercise, tendon inflammation, or rupture of receiving gemifloxacin testosterone enanthate 250 stop (tendon rupture can occur both during treatment with any fluoroquinolone, and after it).
Pseudomembranous colitis should be suspected in patients with diarrhea developed after initiation of treatment gemifloxacin. The most common cause of colitis is Clostridium difficile. In most cases, discontinuation of gemifloxacin enough for the disappearance of the symptoms of colitis.