Loraxon is an antibiotic drug of the cephalosporin series.
Release form and composition
Loraxon is produced in the form of a powder for preparing a solution for intravenous and intramuscular administration: crystalline, from white with a yellowish tinge to white (in transparent glass bottles of 10 ml; 1 bottle or 1 bottle of 1 ampoule with a solvent or 12 bottles of carton box).
The composition of 1 bottle of the drug contains the active substance: ceftriaxone - 0.5 or 1 g (in the form of sodium salt).
Solvent: water for injection - 5 or 10 ml.
Indications for use
Loraxon is prescribed for the treatment of the following infectious and inflammatory diseases caused by microorganisms sensitive to the action of the active substance (Ceftriaxone):
- Infections of joints, bones, skin, urinary tract, kidney, ENT organs, abdominal cavity (including peritonitis, inflammatory diseases of the biliary tract and the gastrointestinal tract), respiratory tract (including pneumonia), genital organs (including gonorrhea);
- Infections in patients with reduced immunity.
Also, the drug is used in the postoperative period for the prevention of infections.
- First trimester of pregnancy;
- Hypersensitivity to cephalosporins and penicillins.
Loraxon should be used with caution in preterm babies, nursing and pregnant women in 2-3 trimesters, as well as in hyperbilirubinemia in newborns, liver and kidney failure, nonspecific ulcerative colitis, colitis or enteritis associated with the use of antibacterial drugs.
Dosing and Administration
Loraxon is used intramuscularly and intravenously.
For children from 12 years and adults, the average daily dose is usually 1-2 g. A single dose is used 1 time per day (after 24 hours). When treating infections caused by pathogens with moderate sensitivity, or in severe cases, the daily dose can be increased to 4 g.
Newborns up to 2 weeks are recommended to use 20-50 mg / kg of Loraxon 1 time per day. The daily dose for infants and children up to 12 years is 20-75 mg / kg. Children with a body weight of 50 kg of the drug is prescribed in adult doses.
When applying doses greater than 50 mg / kg body weight, Loraxon should be administered as an intravenous infusion. Duration of infusion - at least 30 minutes.
The duration of treatment is determined by indications.
In children (including newborns) in the treatment of bacterial meningitis, the initial dose is 100 mg / kg of body weight, the frequency of use is 1 time per day. The maximum dose is 4 g per day. After identifying the pathogen and determining its sensitivity, the dose should be reduced accordingly. The best results are usually achieved with the following terms of treatment:
- Neisseria meningitidis - 4 days;
- Streptococcus pneumonia - 7 days;
- Haemophilus influenzae - 6 days;
- Sensitive Enterobacteriacease - 10-14 days.
The recommended dose for treating gonorrhea caused by strains that do not form or form penicillinase is 250 mg once. The drug should be administered intramuscularly.
For prophylactic purposes, prior to performing infected or suspected infected surgical interventions, depending on the danger of infection, a single dose of Loraxon is recommended for 30–90 minutes before surgery at a dose of 1-2 g.
In patients with impaired renal function with creatinine clearance of more than 10 ml per minute, subject to normal liver function, there is no need to reduce the dose of the drug. In severe renal failure (creatinine clearance less than 10 ml per minute) the daily dose should not exceed 2 g.
With functional disorders of the liver (provided that kidney function is preserved), the dose of Loraxon is not reduced. With simultaneous severe pathology of the kidneys and liver, the concentration of ceftriaxone in the serum should be regularly monitored. Patients on hemodialysis will not need to change the dose of Loraxon after this procedure.
For intramuscular administration, 1 g of the drug must be diluted in 3.5 ml of 1% lidocaine solution. Loraxon is injected deep into the buttock muscle, it is not recommended to inject more than 1 g of the drug into one buttock. Lidocaine solution can not be administered intravenously.
For intravenous injection, 1 g of the powder is diluted in 10 ml of sterile distilled water. Loraxon is administered slowly over 2-4 minutes.
For intravenous infusion, 2 g of the drug is diluted in approximately 40 ml of calcium-free solution, for example: in 0.9% sodium chloride solution, 5% fructose solution, in 10% or 5% dextrose solution. The duration of intravenous infusion should be at least 30 minutes.
During therapy may develop the following disorders:
- Digestive system: taste disturbance, vomiting, nausea, stomatitis, flatulence, constipation or diarrhea, abdominal pain, glossitis, pseudomembranous enterocolitis, dysbacteriosis, impaired liver function (increased activity of hepatic transaminases; rarely - bilirubin or alkaline phosphatase) cholestatic jaundice;
- Urinary system: impaired renal function (hypercreatininemia, azotemia, cylindruria, anuria, increased blood urea, glycosuria, oliguria, hematuria);
- Hematopoietic system: granulocytopenia, leukopenia, lymphopenia, lengthening of the prothrombin time, neutropenia, hypocoagulation, thrombocytosis, hemolytic anemia, thrombocytopenia, a decrease in the concentration of plasma coagulation factors (II, VII, IX, X);
- Allergic reactions: rash, urticaria, fever or chills, itching; rarely, eosinophilia, angioedema, anaphylactic shock, bronchospasm, serum sickness, polymorphic exudative erythema (including Stevens-Johnson syndrome);
- Local reactions: pain along the vein, phlebitis, infiltration and soreness at the site of intramuscular injection;
- Other: superinfection, candidiasis, dizziness, headache, nosebleeds.
With simultaneous severe hepatic and renal failure, regular monitoring of Loraxon plasma concentrations is recommended. Patients on hemodialysis should monitor plasma plasma concentration of ceftriaxone, since in these cases the rate of excretion may decrease.
With prolonged therapy should regularly monitor indicators of the functional state of the kidneys and liver, the picture of peripheral blood.
In rare cases, ultrasound (ultrasound) of the gallbladder was accompanied by blackouts, which disappeared after Loraxon was canceled (even in cases where this phenomenon is accompanied by pain in the right hypochondrium, continued use of the drug and symptomatic treatment are recommended).
Alcohol consumption (ethanol) during therapy is contraindicated, since it can cause disulfiram-like effects (lower blood pressure, vomiting, facial flushing, stomach cramps, nausea, headache, tachycardia, shortness of breath).
Despite the detailed history, which should be collected when using all cephalosporin antibiotics, it is impossible to exclude the possibility of the development of anaphylactic shock. With the appearance of its signs, immediate therapy is required (first, intravenous administration of epinephrine, then glucocorticosteroids).
During treatment, weakened and elderly patients may require the use of vitamin K.
Since Loraxon is able to displace bilirubin associated with serum albumin, the use of the drug in newborns with hyperbilirubinemia and especially in premature newborns requires even greater caution.
Synergism has been observed between Loraxone and aminoglycosides with respect to exposure to many gram-negative bacteria. In severe and life-threatening infections, their joint appointment is reasonable.
Loraxon with ethanol is incompatible.
Nonsteroidal anti-inflammatory drugs and other inhibitors of platelet aggregation increase the likelihood of bleeding.
With the simultaneous appointment of Loraxone with loop diuretics and other nephrotoxic drugs increases the risk of nephrotoxicity.
Due to the physical incompatibility of ceftriaxone and aminoglycosides, they should be administered separately at recommended doses.
It is not possible to mix Loraxon with another antibiotic in one syringe or infusion bottle.
Terms and conditions of storage
Store in a dark, out of reach of children at a temperature up to 25 ° C.
Shelf life - 2 years.
The prepared solutions of Lorakson are chemically and physically stable for 6 hours when stored at room temperature.