Medakson - cephalosporin III generation; broad-spectrum antibiotic.
Release form and composition
Medaxone dosage form is a powder for preparing a solution for parenteral use: slightly hygroscopic, white or white with a yellowish tinge (in bottles, in a cardboard box of 1 or 100 bottles).
The active ingredient of the drug is ceftriaxone (in the form of sodium salt). In 1 bottle it contains 0.5 or 1 g.
Indications for use
Medaxone is used to treat the following inflammatory diseases, pathogens that are sensitive to ceftriaxone:
- Infections of ENT organs;
- Respiratory tract infections (including pneumonia);
- Infections of the skin and soft tissues;
- Infections of bones and joints;
- Infections of the kidneys and urinary tract;
- Infections of the abdominal cavity (inflammatory diseases of the gastrointestinal tract and biliary tract, peritonitis);
- Genital infections (including gonorrhea);
- Infections with reduced immunity.
In addition, Medaxone can be used to prevent infections in the postoperative period.
- I trimester of pregnancy;
- Hypersensitivity to the drug or penicillins.
- Renal / hepatic impairment;
- Enteritis and colitis caused by antibiotics;
- Nonspecific ulcerative colitis;
- Hyperbilirubinemia in newborns;
- Premature newborns;
- II and III trimesters of pregnancy;
Dosing and Administration
Medakson is intended for intravenous (IV) and intramuscular (IM) administration.
Terms of preparation and administration of solutions:
- For intramuscular administration: 1 g of ceftriaxone is diluted in 3.5 ml of 1% lidocaine solution and injected deep into the gluteal muscle. In one muscle, you can enter no more than 1 g of the drug;
- For i / v injection: 1 g of ceftriaxone is diluted in 10 ml of sterile distilled water and injected slowly in / in (within 2-4 minutes);
- For i / v infusion: 2 g of ceftriaxone is diluted in approximately 40 ml of calcium-free solution (for example, 5% or 10% dextrose solution, 0.9% sodium chloride solution, 5% fructose solution) and administered for at least 30 minutes .
Average daily doses:
- Adults and children over 12 years old - 1-2 g once a day. In severe disease and infections caused by moderately sensitive pathogens, the daily dose is increased to 4 g;
- Newborns up to 2 weeks - 0.02-0.05 g / kg 1 time per day;
- Breast children and children up to 12 years old with body weight up to 50 kg - 0.02-0.075 g / kg;
- Children weighing more than 50 kg - a dose similar to adults, the drug is administered as an intravenous infusion for at least 30 minutes.
The duration of treatment is determined by the doctor depending on the type and course of the disease.
With bacterial meningitis in children (including newborns), the initial dose is 0.1 g / kg 1 time per day, the maximum - 4 g per day. After isolating the pathogen, its sensitivity is determined and the dose is reduced accordingly.
Duration of treatment depending on the type of pathogen:
- Neisseria meningitidis - 4 days;
- Haemophilus influenzae - 6 days;
- Streptococcus pneumoniae - 7 days;
- Enterobacteriacease - 10-14 days.
For gonorrhea, including those caused by the penicillinase-forming strains, Medaxone is administered intramuscularly in a dose of 0.25 g once.
For the prevention of infections in the postoperative period, a single injection of the drug in a dose of 1-2 g for 30-90 minutes before surgery is recommended.
The daily dose for patients with severe renal insufficiency (creatinine clearance less than 10 ml / minute) should not exceed 2 g.
- Digestive system: taste disorder, glossitis, stomatitis, flatulence, diarrhea or constipation, abdominal pain, pseudomembranous enterocolitis, nausea, vomiting, dysbacteriosis, abnormal liver function (increased activity of hepatic transaminases; rarely, cholestatic jaundice, increased alkaline phosphatase or bilirubirubina, elevated alkaline phosphatase,
- Urinary system: anuria, oliguria, impaired renal function (increased blood urea, cylindruria, hypercreatininemia, azotemia, glycosuria, hematuria);
- Hematopoietic system: lymphopenia, granulocytopenia, thrombocytosis, hypocoagulation, neutropenia, hemolytic anemia, leukopenia, thrombocytopenia, prolongation of the prothrombin time, decrease in the concentration of plasma coagulation factors (II, VII, IX, X);
- Allergic reactions: rash, itching, fever, urticaria; rarely - eosinophilia, bronchospasm, polymorphic exudative erythema, serum sickness, angioedema, anaphylactic shock;
- Local reactions: soreness and formation of infiltrate at the site of the / m injection, soreness along the veins, phlebitis;
- Other: candidiasis, nasal bleeding, dizziness, headache, superinfection.
With long-term treatment, all patients should monitor the peripheral blood picture, the functional state of the liver and kidneys.
Patients diagnosed with severe pathologies of the kidneys and liver, as well as patients on hemodialysis, in addition, regular monitoring of the concentration of ceftriaxone in serum is necessary.
Despite a thorough history, the risk of anaphylactic shock cannot be excluded. In this case, immediate therapy is required - first, intravenous administration of epinephrine, then glucocorticoid.
In rare cases with ultrasound examination of the gallbladder, there are blackouts, which disappear after drug withdrawal. Treatment with Medakson in this case continues, but if this phenomenon is accompanied by pain in the right hypochondrium, additional symptomatic therapy is recommended.
The entire period of treatment is contraindicated in the use of alcoholic beverages, because When combined with ceftriaxone and ethanol, disulfiram-like effects may occur, showing spasms in the stomach, redness of the face, nausea, vomiting, headache, shortness of breath, tachycardia and a decrease in blood pressure.
Weakened and elderly patients may need a vitamin K prescription during treatment.
Ceftriaxone is incompatible with ethanol and solutions containing other antibiotics.
There is a synergism between ceftriaxone and aminoglycosides regarding the effect on many gram-negative bacteria, therefore, in case of severe and life-threatening infections (for example, caused by Pseudomonas aeruginosa), their joint appointment is justified. However, in this case they should be applied separately.
With the simultaneous use of nonsteroidal anti-inflammatory drugs or other inhibitors of platelet aggregation increases the likelihood of bleeding; loop diuretics or other nephrotoxic drugs - the risk of nephrotoxicity.
Medaxone should not be mixed in the same syringe or infusion bottle with other antibiotics, since they are chemically incompatible.
Terms and conditions of storage
Store at a temperature not exceeding 25 ° C in a dry, dark place and out of reach of children.
Shelf life - 2 years.