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What is it?
It is antibacterial agent group II fluoroquinolones. It is synthetic pyridine carboxylic analog of nalidixic acid. It is characterized as a fluorine atom in position 6 (enhances the effect on gram-negative microorganisms) and a piperazine group in position 7 (provides activity against pseudomonads). Norfloxacin is a metabolite of pefloxacin, from which it is distinguished by the absence of a methyl group in the piperazine nucleus.
Pharmacological action – bactericidal, broad-spectrum antibacterial. It inhibits bacterial DNA synthesis (an enzyme necessary for replication, transcription and repair of bacterial DNA). It violates the synthesis of DNA and proteins, which leads to the death of bacteria.
Indications
Infections caused by pathogens that are sensitive to norfloxacin:
- orally – acute and chronic urinary tract infections (including pyelonephritis, cystitis, urethritis), infections of the genital organs (including prostatitis, cervicitis, endometritis), uncomplicated gonorrhea, gastrointestinal tract (including salmonellosis, shigellosis);
- prevention of infections in patients with granulocytopenia;
- local – external otitis, acute and exacerbation of chronic otitis media;
- eye infections, including conjunctivitis, keratitis, keratoconjunctivitis, corneal ulcer, blepharitis, blepharoconjunctivitis.
Dosage and mode of application
Before starting to use Noroxin, it is recommended to determine how sensitive the microflora to it is, which caused the disease. The initial dosage of the drug is 0.4 g twice a day. The maximum daily dose of this antibiotic is 1.5 g. The duration of treatment is on average from 7 to 14 days. While treating severe infections, the course of treatment can be extended.
When using this remedy in the treatment of patients on hemodialysis, dosage adjustment is required.
When combining norfloxacin with antacid agents, a decrease in the intensity of its absorption is observed. In this regard, norfloxacin is prescribed 1 or 2 hours before or 4 hours after taking antacids.
Overdose
Symptoms (3 g in 45 minutes) are: dizziness, nausea, vomiting, drowsiness, cold sweat (without changes in the basic hemodynamic parameters), convulsive syndrome.
Treatment: gastric lavage, adequate hydration therapy with forced diuresis, the appointment of symptomatic agents. The specific antidote is absent.
Contraindications
- Hypersensitivity (including history);
- Tendonitis or tendon rupture associated with taking norfloxacin or another drug from the quinolone group;
- Glucose-6-phosphate dehydrogenase deficiency;
- Children and adolescents under 18 years old.
Restrictions on the use
- Atherosclerosis of cerebral vessels;
- Impaired cerebral circulation;
- Epilepsy and convulsive syndrome;
- Myasthenia gravis;
- Renal/hepatic failure.
Side effects
- Gastrointestinal organs: loss of appetite, nausea, vomiting, bitter taste in the mouth, abdominal pain, diarrhea, increased activity of hepatic transaminases, alkaline phosphatase, LDH, pseudomembranous colitis (with a long-lasting course).
- Urinary system: crystalluria, glomerulonephritis, dysuria, polyuria, albuminuria, hypercreatininemia, urethral bleeding.
- Nervous system and sensory organs: headache, dizziness, insomnia, hallucinations, fainting.
- Cardiovascular system and blood (hematopoiesis, hemostasis): tachycardia, cardiac arrhythmia, a decrease in blood pressure, vasculitis, leukopenia, eosinophilia, a decrease in hematocrit.
- Musculoskeletal system: tendinitis, tendon rupture, arthralgia.
- Allergic reactions: pruritus, urticaria, edema, Stevens-Johnson syndrome.
- Other: candidiasis.
- When putting in the eye: blurred vision, burning and eye pain, conjunctival hyperemia, chemosis, photophobia, allergic reactions.
Pregnancy and breastfeeding
During pregnancy, it is possible if the expected effect of therapy in the mother outweighs the potential risk to the fetus (adequate and strictly controlled studies of the safety of using norfloxacin in pregnant women have not been carried out, including for local use in the form of drops).
The category of action on the fetus by the FDA is C. It is not known whether norfloxacin penetrates into the milk of lactating women.
Interactions
The simultaneous application of antacids containing aluminum hydroxide or magnesium hydroxide, drugs containing iron, zinc and sucralfate reduces the absorption of norfloxacin (the time interval between their appointment must be at least 2-4 hours). This antibiotic decreases theophylline clearance by 25% (with simultaneous use, reduce the dose of theophylline), increases the serum concentration of indirect anticoagulants, cyclosporine (mutually).
Simultaneous administration with medications that have the potential to lower blood pressure may cause its sharp decrease; in such cases, as well as the simultaneous introduction of barbiturates and other drugs for general anesthesia, the heart rate, blood pressure and ECG should be monitored. Simultaneous use with drugs that reduce convulsive threshold can lead to the development of epileptiform seizures. This drug reduces the effect of nitrofurans.
Safety precautions
Hypersensitivity/Anaphylaxis. Cases of the development of serious hypersensitivity reactions (anaphylactoid and anaphylactic) have been reported while taking the first dose of quinolones. In some cases, these reactions were accompanied by cardiac collapse, loss of consciousness, fainting, swelling of the pharynx or face, dyspnea, urticaria, itching. In the case of allergic reactions to norfloxacin, it is necessary to withdraw the drug. With the development of severe acute hypersensitivity reactions, immediate administration of epinephrine and appropriate examinations (oxygen, intravenous fluids, antihistamine drugs, corticosteroids, etc.) are required.
How to Buy Noroxin?
Antibiotics online are sold on the Internet, nowadays. We offer to buy Noroxin online at a reasonable rate without sending us a prescription. But we recommend our customers to consult a doctor as only he can establish the correct diagnosis, specify the therapy course and dosage.
Online pharmacy is your way to save money and efforts. It becomes possible to buy medications online at much more reasonable prices. All the medications are produced according to quality certificates. The mandatory condition is to visit your healthcare giver. This consultation will help you avoid severe ramifications caused by an incorrect regimen of Noroxin application.