Combiflox, 500 mg+200 mg, film-coated tablets, 10 pcs.

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Combiflox is a combined antiprotozoal and antimicrobial drug. Active ingredients: Ornidazole and Ofloxacin.

You need to know that the half-life depends on the components of the drug: Ofloxacin - 4.5-7 hours, Ornidazole - 12-14 hours. Combiflox is prescribed by a doctor and is available with a prescription.

Description and composition

The medicine is available in tablets coated with an orange film coating. They are capsule-shaped and have a dividing line on one side. On the fracture you can see a mass of yellowish-cream color.

The medication contains ornidazole and ofloxacin as active ingredients.

In addition to them, the tablets contain the following additional substances:

• MCC;
• Aerosil;
• E572;
• carboxymethyl starch and croscarmellose sodium;
• talc;
• hypromellose;
• E 104.

Release form, packaging and components

Combiflox goes on sale in tablet form, coated with an orange film coating. The shape of the pills is capsule-shaped. There is an oblong dividing strip at the top. If you break the tablet in half, you can see the inside is creamy yellow.

Each pill contains ofloxacin and ornidazole 200 mg/500 mg.

Additional components are:

The film coating contains orange opadry, which gives the tablets a pleasant taste and hue. The medicine is sold in blisters packed in a cardboard box. Then the cardboard pack will contain 1 or 2 blisters (10 pills each).

Pharmacological group

The effect of the drug is explained by the active ingredients included in the composition.

Ornidazole is an antiprotozoal and antibacterial agent that is a derivative of 5-nitroimidazole. Its action is associated with the reduction of the 5-nitro group of ornidazole by intracellular transport proteins of anaerobic bacteria and protozoa. The reduced 5-nitro group of ornidazole interacts with DNA cells of pathogenic agents, blocking the synthesis of their nucleic acids, as a result of which the bacteria die.

It is active against the following microorganisms:

• vaginal trichomonas;
• intestinal lamblia;
• dysenteric amoeba;
• bacteroids, including bacteroids fragilis, tetiotaomicron, vulgatus;
• fusobacteria;
• clostridia.

Aerobes are insensitive to ornidazole.

Ofloxacin is a broad-spectrum antibacterial agent that belongs to the fluoroquinolones. It acts on the bacterial DNA gyrase enzyme, which is responsible for the supercoiling and stability of the bacterial DNA, as a result of which they die. It has a bactericidal effect.

Ofloxacin is active against the following microorganisms:

• Staphylococcus aureus, saprophytic or epidermal Staphylococcus;
• streptococcus pneumoniae, pyogenic streptococci;
• acinetobacter;
• whooping cough stick;
• Citrobacter freundi;
• Escherichia coli and hemophilus influenzae;
• Enterobacter aerogenes and cloaca;
• Ducray's wand;
• Klibsiella oxytoca and pneumonia;
• Moraxella catharalis;
• Morganella blinka;
• gonococci;
• Proteus mirabilis and vulgaris;
• the providence of Röttger and Stewart;
• Pseudomonas aeruginosa (quickly develop resistance);
• serracia marcescens;
• Clostridia perfringens;
• chlamydia;
• Gardnerella vaginalis;
• mycoplasma;
• ureaplasma;
• legionella pneumophila.

After oral administration, the drug is quickly absorbed from the digestive tract. The bioavailability of ornidazole is 90%, its binding to proteins is 13%, ofloxacin is 95%, and its binding to proteins is 25%. The maximum concentration of ofloxacin is reached after 1-2 hours, for ornidazole - 3 hours.

The drug penetrates most internal organs, passes through the blood-brain and placental barrier, and is excreted in breast milk.

Passing through the liver, the medication is metabolized. It is excreted from the body mainly through the kidneys and to a lesser extent through the intestines. Therefore, with pathology of the liver and kidneys, the rate of drug elimination may slow down.

Ofloxacin does not accumulate in the body, ornidazole accumulates.

Best before date

The use of the drug is permitted for three years from the date of release.

The instructions for use recommend using the drug Combiflox for the treatment of a wide range of diseases of infectious origin. This drug has antibacterial activity against many gram-negative and gram-positive microorganisms. Combiflox is a derivative of 5-nitroimidazole and belongs to the group of fluoroquinolones. It has contraindications and can have a lot of side effects on the human body. To ensure that treatment with the drug does not lead to undesirable consequences, it should be used only as prescribed by a qualified specialist.

Indications for use

for adults

The drug is used:

• for mixed bacterial infections caused by drug-sensitive gram-positive and gram-negative bacteria, in association with anaerobic microorganisms and protozoa;
• infections of the abdominal organs, biliary and urinary tracts (urethritis, cystitis), kidneys (pyelonephritis), genital organs and pelvic organs (inflammation of the uterus, fallopian tubes, ovaries, cervix, peri-uterine tissue, prostate, testicle and its epididymis, colpitis) .

for children

The drug is contraindicated in patients under 18 years of age.

for pregnant women and during lactation

The medication should not be taken to treat pregnant women or breastfeeding women.

Contraindications

The drug should not be administered to patients who have the following pathologies:

• epilepsy, including a history;
• individual intolerance to the composition of the medication, other fluoroquinolones and imidazole derivatives;
• decreased seizure threshold, including those that occurred after traumatic brain injury, stroke, inflammation in the central nervous system;
• tendon damage that occurred during previous fluoroquinolone therapy.

The medication should be prescribed with caution if the patient has the following diseases:

• atherosclerosis of cerebral vessels;
• history of cerebrovascular accident;
• liver pathologies, including liver failure, hepatic porphyria;
• chronic renal failure;
• organic pathologies of the central nervous system, including multiple sclerosis;
• myasthenia gravis;
• deficiency of glucose-6-phosphate dehydrogenase;
• myasthenia gravis;
• predisposition to seizures;
• diabetes;
• history of psychosis and other mental disorders;
• heart pathologies (decreased heartbeat, myocardial infarction, heart failure);
• congenital prolongation of the QT interval;
• disturbance of the water-salt balance, for example, with a decrease in the level of potassium and magnesium in the blood;
• alcohol addiction.

The drug should be prescribed with caution to elderly people, as well as to patients taking drugs for general anesthesia from the barbiturate group, which lower blood pressure and prolong the QT interval, such as:

• antiarrhythmic drugs IA and III classes;
• macrolide antibiotics;
• antifungal agents;
• antipsychotic drugs;
• tricyclics;
• tetracyclic antidepressants;
• some antiallergic drugs, including astemizole, ebastine, terfenadine.

Cautions

The drug belongs to the group of antibiotics, so it has contraindications. It should not be prescribed if the patient suffers from epilepsy or inflammatory diseases of the central nervous system. The tablets are not prescribed to pregnant women and children under 18 years of age. In case of hypersensitivity to one of the components of the drug, it is indicated to replace therapy.

The antibiotic Combiflox is contraindicated while breastfeeding. If there is an urgent need to prescribe the drug, stop breastfeeding for the entire course of therapy and for another 3 days after it.

Under the strict supervision of a doctor, it is prescribed to patients who have diseases of the blood vessels, heart, liver, and central nervous system. People with diabetes, myasthenia gravis, and alcoholism should take the pills with caution. These medications are rarely prescribed in old age.

Side effects may occur during treatment:

• stool disorder (diarrhea or constipation), intestinal dysbiosis, nausea, bloating and abdominal pain, colitis, loss of appetite, dry mouth;
• cough, difficulty breathing, chest pain, rash, itching on the skin and genitals;
• urinary retention, kidney problems;
• arrhythmia, changes in blood pressure readings;
• muscle pain and weakness;
• changes in blood parameters: anemia, leukopenia;
• decreased hearing acuity, imbalance;
• drowsiness, irritability, insomnia, nightmares, anxiety, headaches, dizziness.

Combiflox can cause bleeding from the nasal passages, jaundice, weight loss, dermatitis, nephritis.

If the dosage has not been observed or therapy has been prolonged, there is a risk of developing signs of overdose. I am worried about constant drowsiness, nausea and even vomiting. Loss of consciousness may occur, depression and convulsions may develop. Treatment is aimed at eliminating symptoms, gastric lavage helps. For seizures, you should take the medicine Diazepam.

Applications and dosages

for adults

You need to take the medicine one hour before a meal or 2 hours after it. The tablet should be swallowed whole with plenty of water.

It is recommended to take the medicine 1 tablet 2 times a day for 7-10 days.

For patients suffering from chronic renal failure with a creatinine clearance of 20 to 50 ml per minute, the medication is prescribed at a dose of 200 mg (calculated according to ofloxacin) once a day, with a glomerular filtration rate of less than 20 ml per minute, for peritoneal dialysis and hemodialysis, the drug is prescribed at a dose of 200 mg once every 48 hours.

Patients suffering from liver failure can be prescribed no more than 2 tablets per day (400 mg ofloxacin).

for children

The drug is not used in patients under 18 years of age.

for pregnant women and during lactation

After transferring the baby to artificial feeding during lactation, the medicine is taken as usual.

Pharmacokinetic effects

Pharmacokinetic effects play a big role during therapy, because due to some diseases of internal organs, a person may have contraindications to the use of this medicine. Pharmacokinetics is based on several factors:

Suction

Considering that the active components penetrate into the human body orally, absorption occurs through the digestive system. Then ofloxacin and ornidazole are absorbed by the body by more than 90% during the first 3 hours after taking the tablet.

Distribution

The active components of the tablets are distributed in apparent volume in a volume of 100 liters. Antiprotozoal substances are distributed and distributed to the following structures of the body:

Also, substances easily penetrate into milk (during lactation) and to the fetus, through the placenta, so before using an antibiotic, women should be checked for pregnancy.

Elimination and Metabolism

The metabolism and elimination of ofloxacin and ornidazole are slightly different:

The substance, ofloxacin, remains in the body for 1-2 days, as studies of patients’ urine show. That is why the drug is prescribed to people with liver or kidney failure with caution!

Side effects

During therapy, the drug is used as usual:

• stomach pain, decreased appetite, loose stools, nausea, vomiting, constipation, bloating, abdominal pain, increased activity of liver enzymes, increased bilirubin levels, cholestatic jaundice, dry oral mucosa, colitis, including pseudomembranous and hemorrhagic, hepatitis;
• headaches, dizziness, insomnia, nightmares and intense dreams, drowsiness, nervousness, uncertainty of movement, trembling of individual parts of the body, convulsions, impaired consciousness and coordination of movement, agitation, temporary loss of consciousness, intracranial hypertension, depression, hallucinations, phobias, extrapyramidal syndromes , epileptic seizures, numbness and paresthesia of the limbs, anxiety, psychotic reactions that are accompanied by suicidal tendencies, sensory and sensorimotor peripheral neuropathy;
• muscle and joint pain, inflammation and tendon rupture, tenosynovitis,
• muscle rigidity and weakness, rhabdomyolysis, pain in the limbs;
• disturbances in color perception, taste, smell, hearing and balance;
• double vision;
• increased heart rate, prolongation of the QT interval, increased or decreased blood pressure, collapse, ventricular arrhythmia;
• allergies, which manifest as skin itching, rash, urticaria, Quincke's edema, fever, eosinophilia, bronchospasm, pneumonitis and nephritis, exudative erythema multiforme, Lyell's syndrome, photosensitivity, vasculitis, anaphylaxis, itching of the external genitalia in women;
• pinpoint hemorrhages, papular rashes with crusts, bullous hemorrhagic dermatitis;
• reduction of all blood elements;
• increased levels of creatinine and urea, acute renal failure, acute tubulointerstitial nephritis, impaired renal function, urinary retention, dysuria;
• intestinal dysbiosis, superinfection, decreased blood sugar (in patients with diabetes), vaginitis;
• pain in the chest, fatigue, impotence;
• photosensitivity;
• vaginal discharge;
• nosebleeds;
• thirst;
• weight loss;
• pharyngitis, rhinitis, non-productive cough.

In patients with porphyria, exacerbation of the disease is possible during therapy.

Instructions for use of Combiflox

Directions for use and dosage

Combiflox is taken orally, 1 hour before meals or 2 hours after meals, with a sufficient amount of water. Combiflox should not be broken, chewed or destroyed. The recommended dose is 1 tablet 2 times a day for 7-10 days.

• Dosage regimen for chronic renal failure (dose calculation based on ofloxacin): for CL 50-20 ml/min – 200 mg 1 time every 24 hours, for CL less than 20 ml/min, for hemodialysis, peritoneal dialysis – 200 mg 1 time every 48 hours.
• For liver failure, the maximum daily dose is 2 tablets (400 mg ofloxacin).

Compound

• active ingredient: Ornidazole 500 mg, Ofloxacin 200 mg;
• excipients: microcrystalline cellulose 238 mg, sodium carboxymethyl starch 15 mg, croscarmellose sodium 10 mg, colloidal silicon dioxide 10 mg, talc 9 mg, magnesium stearate 12 mg, hypromellose 3.5 mg, quinoline yellow dye 0.1 mg;
• film composition: opadry orange 27 mg.

The structural formula of Ornidazole is C7H10ClN3O3. Photo: wikipedia.org The structural formula of Ofloxacin is C18H20FN3O4. Photo: wikipedia.org

Indications for use

• mixed bacterial infections caused by sensitive gram-positive and gram-negative microorganisms, in association with anaerobic microorganisms and/or protozoa;
• infectious and inflammatory diseases of the abdominal cavity and biliary tract, kidneys (pyelonephritis), lower urinary tract (cystitis, urethritis), genital and pelvic organs (endometritis, salpingitis, oophoritis, cervicitis, parametritis, prostatitis, colpitis, orchitis, epididymitis) .

Contraindications

• epilepsy (including history);
• decreased seizure threshold (including after traumatic brain injury, stroke or inflammatory processes in the central nervous system);
• tendon damage due to previous fluoroquinolone treatment;
• age under 18 years;
• pregnancy;
• lactation period;
• hypersensitivity to ofloxacin, ornidazole, other fluoroquinolones and imidazole derivatives, components of the drug.

Side effects

• From the digestive system: gastralgia, loss of appetite, nausea, vomiting, diarrhea, constipation, flatulence, abdominal pain, increased activity of “liver” transaminases, hyperbilirubinemia, cholestatic jaundice, pseudomembranous colitis, dry oral mucosa, colitis (including including hemorrhagic), hepatitis.
• From the nervous system: headache, dizziness, insomnia, nervousness, uncertainty of movements, tremors, convulsions, numbness and paresthesia of the extremities, intense dreams, “nightmarish” dreams, anxiety, state of excitation, phobias, depression, confusion, hallucinations, increased intracranial pressure, insomnia, nervousness, drowsiness, epileptic seizures, extrapyramidal disorders, psychotic reactions with suicidal tendencies, sensory or sensorimotor peripheral neuropathy, impaired motor coordination, temporary loss of consciousness.
• From the musculoskeletal system: tendonitis, myalgia, arthralgia, tenosynovitis, tendon rupture, pain in the limbs, muscle rigidity, rhabdomyolysis, muscle weakness.
• From the senses: impaired color perception, diplopia, taste disturbances, perversion of taste sensations, disturbances of smell, hearing and balance.
• From the cardiovascular system: tachycardia, increase or decrease in blood pressure, collapse, prolongation of the QT interval, ventricular arrhythmia, incl. ventricular tachysystolic arrhythmia of the “pirouette” type.
• Allergic reactions: skin rash, itching, urticaria, allergic pneumonitis, allergic nephritis, eosinophilia, fever, angioedema, bronchospasm; exudative erythema multiforme (including Stevens-Johnson syndrome) and toxic epidermal necrolysis (Lyell's syndrome), photosensitivity, vasculitis, anaphylactic shock, itching of the external genitalia in women.
• From the skin: pinpoint hemorrhages (petechiae), bullous hemorrhagic dermatitis, papular rash with crust, indicating vascular damage (vasculitis).
• From the hematopoietic organs: leukopenia, agranulocytosis, anemia (including aplastic and hemolytic), thrombocytopenia, pancytopenia.
• From the urinary system: acute interstitial nephritis, impaired renal function, hypercreatininemia, increased urea concentration, dysuria, urinary retention, acute renal failure.
• Other: intestinal dysbiosis, superinfection, hypoglycemia (in patients with diabetes), vaginitis, chest pain, fatigue, asthenia, general weakness, photosensitivity, vaginal discharge, nosebleeds, thirst, weight loss, pharyngitis, rhinitis, dry cough, acute attack of porphyria (in patients with porphyria).

pharmachologic effect

Combiflox is a combination drug, the effect of which is determined by the components included in its composition.

Ornidazole is an antiprotozoal and antimicrobial agent, a derivative of 5-nitroimidazole. The mechanism of action is the biochemical reduction of the 5-nitro group of ornidazole by intracellular transport proteins of anaerobic bacteria and protozoa. The reduced 5-nitro group of ornidazole interacts with DNA in microbial cells, inhibiting the synthesis of their nucleic acids, which leads to the death of bacteria.

Combiflox is active against Trichomonas vaginalis, Giardia lamblia, Entamoeba histolytica, as well as anaerobes Bacteroides spp. (including Bacteroides fragilis, Bacteroides distasonis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacteroides vulgatus), Fusobacterium spp., Clostridium spp. Aerobic microorganisms are not sensitive to ornidazole.

Ofloxacin is a broad-spectrum antimicrobial agent from the group of fluoroquinolones that acts on the bacterial enzyme DNA gyrase, which ensures supercoiling, etc. stability of bacterial DNA (destabilization of DNA chains leads to their death). Has a bactericidal effect.

The antimicrobial spectrum includes gram-positive aerobes: Staphylococcus aureus (methicillin-sensitive), Staphylococcus epidermidis (methicillin-sensitive), Staphylococcus saprophyticus, Streptococcus pneumoniae (penicillin-sensitive), Streptococcus pyogenes.

Gram-negative aerobes: Acinetobacter calcoaceticus, Bordetella pertussis, Citrobacter freundii, Citrobacter koseri, Enterobacter aerogenes, Enterobacter cloacae, Escherichia coli, Haemophilus ducreyi, Haemophilus influenzae, Klebsiella oxytoca, Moraxella catarrhalis, Morganella morganii, Klebsiella pneumoniae, Neisseria gonorrhoeae , Proteus mirabilis, Proteus vulgaris , Providencia rettgeri, Providencia stuartii, Pseudomonas aeruginosa (quickly develop resistance), Serratia marcescens.

Anaerobes: Clostridium perfringens.

Other: Chlamydia trachomatis, Chlamydia pneumoniae, Gardnerella vaginalis, Legionella pneumophila, Mycoplasma hominis, Mycoplasma pneumoniae, Ureaplasma urealyticum.

In most cases insensitive: Nocardia asteroides, anaerobic bacteria (including Bacteroides spp., Peptococcus spp., Peptostreptococcus spp., Eubacterium spp., Fusobacterium spp., Clostridium difficile), Enterococcus spp., most Streptococcus spp., not acts on Treponema pallidum.

Precautionary measures

With caution: cerebral atherosclerosis, cerebral circulatory disorders (history), chronic renal failure, liver disease, liver failure, organic diseases of the central nervous system (including multiple sclerosis), predisposition to convulsive reactions, myasthenia gravis, hepatic porphyria, deficiency glucose-6-phosphate dehydrogenase, diabetes mellitus, congenital long QT syndrome, heart disease (heart failure, myocardial infarction, bradycardia), history of psychosis and other mental disorders; simultaneous use of drugs that prolong the QT interval (class IA and III antiarrhythmics, tricyclic and tetracyclic antidepressants, neuroleptics, macrolides, antifungals, some antihistamines, including astemizole, terfenadine, ebastine), drugs for general anesthesia from the group of barbiturates, drugs blood pressure lowering agents; electrolyte imbalance (for example, with hypokalemia, hypomagnesemia), old age, alcoholism.

Use of Combiflox during pregnancy and breastfeeding

The use of the drug during pregnancy and lactation is contraindicated. If it is necessary to use the drug during lactation, breastfeeding should be stopped.

Use for liver dysfunction

In patients with impaired liver function, monitoring of plasma concentrations of ofloxacin is necessary.

Use for renal impairment

In patients with impaired renal function, monitoring of plasma concentrations of ofloxacin is necessary.

Use of Combiflox in children

Contraindicated under 18 years of age.

Use in elderly patients

With caution in old age.

special instructions

• It is not recommended to be exposed to sunlight or ultraviolet rays (mercury-quartz lamps, solarium).
• To prevent urine hyperconcentration and subsequent crystalluria, adequate hydration is recommended during treatment.
• In case of side effects from the central nervous system, allergic reactions, pseudomembranous colitis, or development of symptoms of peripheral neuropathy, discontinuation of the drug is necessary.
• Rarely, tendinitis can lead to tendon rupture (mostly the Achilles tendon), especially in older patients. If signs of tendinitis occur, you should immediately stop treatment, immobilize the Achilles tendon and consult an orthopedist. During the treatment period, ethanol should not be consumed.
• When using the drug, women are not recommended to use sanitary tampons due to the increased risk of developing thrush.
• During treatment, the course of myasthenia gravis may worsen and attacks of porphyria may increase in predisposed patients.
• When used simultaneously with drugs that prolong the QT interval, class IA and III antiarrhythmics, tricyclic and tetracyclic antidepressants, antipsychotics, macrolides, antifungals, some antihistamines, incl. astemizole, terfenadine, ebastine) systematic ECG monitoring is necessary.
• May lead to false negative results in the bacteriological diagnosis of tuberculosis (prevents the isolation of Mycobacterium tuberculosis).
• In patients with impaired liver or kidney function, monitoring of plasma concentrations of ofloxacin is necessary. In severe renal failure, the risk of toxic effects increases (reducing dose adjustment is required).
• When using the drug, both while taking it and 2-3 weeks after stopping treatment, diarrhea caused by Clistridium difficile (pseudomembranous colitis) may develop. In mild cases, it is sufficient to discontinue treatment and use ion exchange resins (colestyramine, colestipol); in severe cases, replacement of loss of fluid, electrolytes and protein, and the appointment of vancomcin, bacitracin or metronidazole are indicated.
• You should not use medications that inhibit intestinal motility.
• During the treatment period, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Interaction with other drugs

Ofloxacin can cause:

• a decrease in the clearance of theophylline by 25% (when prescribed in combination, the dosage of theophylline must be reduced);
• increasing plasma levels of glibenclamide;
• increased serum concentrations of cyclosporine.

Cimetidine, furosemide, methotrexate and medications that block tubular secretion increase the level of ofloxacin in the blood plasma.

When prescribing indirect anticoagulants in combination, it is necessary to monitor the state of the blood coagulation system.

When prescribed with NSAIDs, nitroimidazole derivatives, methylxanthines, the likelihood of neurotoxic effects, including seizures, increases.

When combined with GCS, the likelihood of tendon rupture increases, especially in people of the older age group.

When prescribed with medications that alkalinize urine (carbonic anhydrase blockers, sodium bicarbonate, citrates), the likelihood of crystalluria and a nephrotoxic reaction increases. When ofloxacin is prescribed in combination with hypoglycemic medications, hypo- or hyperglycemia may occur, so it is necessary to monitor the glucose level in the blood plasma.

When prescribed with medications that prolong the QT interval, the risk of QT prolongation increases. Foods and antacids that contain aluminum, calcium, magnesium, and iron ions reduce the absorption of ofloxacin because they form insoluble complexes. Therefore, the interval between taking them and taking Combiflox should be at least 2 hours.

Ornidazole enhances the effect of indirect coumarin anticoagulants. It prolongs the muscle relaxant effect of vecuronium bromide.

special instructions

During therapy, it is undesirable to be exposed to natural and artificial ultraviolet rays.

To prevent hyperconcentration of urine and subsequent crystalluria, sufficient fluids should be consumed during therapy.

Treatment should be interrupted if adverse reactions from the central nervous system, allergies, pseudomembranous colitis, or peripheral neuropathy occur.

In rare cases, tendon inflammation can cause tendon rupture. The Achilles tendon is most often affected and mainly in older people. Therefore, if symptoms of tendinitis appear, therapy should be immediately interrupted, the Achilles tendon immobilized, and a consultation with an orthopedist should be consulted.

During treatment you should refrain from drinking ethyl alcohol.

Women are not recommended to use sanitary tampons during therapy due to the high risk of thrush.

During treatment, a worsening of myasthenia gravis may occur, and in predisposed patients, attacks of porphyria may become more frequent.

When prescribing medications that prolong the QT interval during Combiflox therapy, you need to periodically do an ECG in order to promptly detect abnormalities in the heart.

During treatment, false negative results may be observed in the bacteriological diagnosis of tuberculosis.

In patients with liver and kidney pathologies, it is necessary to monitor the level of ofloxacin in the body. In severe renal failure, the likelihood of toxic effects increases.

During therapy, as well as 2-3 weeks after its completion, diarrhea may occur, which is caused by Clistridium difficile, that is, pseudomembranous colitis will develop. If the disease is mild, it is enough to interrupt therapy and use ion exchange resins, such as cholestyramine, colestipol. In severe cases, drugs are prescribed to replenish the loss of fluid, electrolytes and proteins, vancomcin, bacitracin and metronidazole are prescribed.

It is forbidden to take medications that inhibit intestinal motility.

During treatment, you must be careful when driving.

Compatibility of Combiflox and alcohol

Experts have proven that not all antibiotics are prohibited from being combined with alcohol consumption. However, medications that are derivatives of 5-nitromidazole, such as Combiflox, absolutely exclude the possibility of combining alcohol and tablets.

Drinking alcohol while taking Combiflox can cause the following undesirable consequences:

In this case, alcoholic drinks have a toxic effect on the liver, which leads to its excess load. This can lead to liver dysfunction. In rare cases, experts noted the occurrence of angioedema and anaphylactic shock that appears as a result of drinking alcohol. Therefore, during treatment and 2-3 days after its completion, it is highly not recommended to drink alcohol.

Overdose

If recommended dosages are exceeded, the following signs of overdose may appear:

• dizziness;
• disturbance of consciousness;
• epileptiform seizures;
• lethargy;
• depression;
• disorientation;
• drowsiness;
• inflammation of peripheral nerves;
• vomit.

The antidote is unknown; the victim’s stomach is washed and symptomatic therapy is prescribed. For convulsions, diazepam is prescribed.

Analogs

You can replace Combiflox with the following drugs:

1. Gairo is an antiprotozoal drug, the therapeutic effect of which is explained by ornidazole. It is produced in tablets, approved for patients over 3 years of age, including pregnant women. Breastfeeding should be interrupted during treatment.
2. Tiberal is a Turkish drug that is a partial analogue of Combiflox. It is produced in tablets, which are approved for use as an antiprotozoal agent in children over 3 years of age, women expecting a child and breastfeeding.
3. Oflo contains ofloxacin as an active ingredient. The medication is available in tablets and solution for intravenous infusion. It should not be prescribed to patients under 18 years of age, pregnant or breastfeeding women.
4. Tsifran ST is a substitute for the drug Combiflox in the pharmacological group. It is produced in tablets that have antiprotozoal and antibacterial effects. They are contraindicated for persons under 18 years of age, pregnant women and breastfeeding women.
5. Tsiprolet A is a combined Indian drug that is a substitute for Combiflox in its therapeutic group. The medicine is produced in tablets that are contraindicated for children, women expecting a child and breastfeeding.

It is permissible to take an analogue of Combiflox instead of the drug after consultation with a specialist, since medications have their own indications and contraindications and provoke other undesirable reactions.