The drug Nevigramon with antibacterial and bactericidal action

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Manufacturers: Chinoin Pharmaceutical and Chemical Works Private Co. Ltd.

Active ingredients

• Nalidixic acid

Disease class

• Cholecystitis
• Diarrhea and gastroenteritis of suspected infectious origin
• Urinary tract infection without established localization

Clinical and pharmacological group

• Not indicated. See instructions

Pharmacological action

• Antibacterial
• Bactericidal
• Bacteriostatic

Pharmacological group

• Quinolones/fluoroquinolones

Composition and pharmacological action

Classified as a drug of combined action, it has:

• antibacterial;
• bactericidal effect;

Basically, the mechanism of action is fully disclosed; it is due to the effect on membrane connections of gram-negative microorganisms.

Provided that they are sensitive to the main active ingredient - nalidixic acid, the concentration of which is 500 mg.

A feature of Nevigramon is considered to be the inability to act on Pseudomonas aeruginosa, since this bacterium is insensitive to the drug component.

Other features of the drug:

• used in the treatment of children;
• successfully prescribed to pregnant women;
• with long-term use, dose adjustment is required;
• During a course of treatment, bacteria may lose sensitivity to the drug.

If the medication is prescribed as part of preventive treatment (usually after surgery), then the minimum dosage is determined. During long-term use, control:

• Composition of urine;
• blood.

Nevigramon has a toxic effect on the liver and kidneys, but the effect appears only with long-term use, which means that if the drug was prescribed in a course, it is necessary to undergo regular tests and monitor the condition of biological fluids (blood and urine).

A feature of the drug is considered to be its high efficiency, but this indicator is regarded as relative, since at the time of treatment it may turn out that Nevigramon has stopped working.

Bacteria quickly adapt and get used to the components of the product; for this reason, when carrying out therapy, it is necessary to carefully monitor the composition of the product and submit it for bacterial culture. This will help track the effectiveness of therapy and adjust it at the right time.

special instructions

If arthralgia develops, Nevigramon should be discontinued.

During therapy, exposure to direct sunlight should be avoided; if photosensitivity occurs, therapy should be interrupted. Nevigramon should also be discontinued if symptoms of psychosis, increased intracranial pressure, or other toxic manifestations appear.

Bacterial resistance to Nevigramon usually develops within the first 48 hours. Cross-resistance has been observed between nalidixic acid and other quinolone derivatives (eg, oxolinic acid, cinoxacin).

When testing urine using methods based on copper reduction (for example, using Fehling's or Benedict's solutions), it is possible to obtain a false positive reaction for glucose. Therefore, during therapy it is recommended to use specific glucose oxidase research methods.

False values ​​can also be obtained during the determination of 17-ketosteroids and ketogenic steroids in urine when performing tests based on the measurement of vanillylmandelic acid in urine. In these cases, the Porter-Silber test can be used for 17-hydroxycorticosteroids.

When using Nevigramon, care must be taken when driving vehicles and performing potentially dangerous types of work that require the patient to have increased concentration and rapid psychomotor reactions.

Indications for use

If we talk about urological diseases, then the list of indications can include some diseases:

• various urinary tract infections;
• pyelonephritis (subject to sensitivity of the pathogen to the drug);
• surgical interventions on the kidneys and ureters (as part of the prevention of infection);
• pyelitis (if it is caused by gram-positive microorganisms).

The list can include various inflammatory and infectious diseases, but only on the condition that they are caused by microorganisms sensitive to the drug.

But most often the medication in capsule form is prescribed to patients who have undergone surgery on the kidneys or ureter. In this case, timely antibacterial therapy will help reduce the risks associated with the recovery process after surgical manipulation.

There are other diseases that can be regarded as indications for the use of Nevigramon:

• cholecystitis;
• infectious diseases of the digestive system.

Analogs

To replace the drug, you can choose antibacterial agents with the same or different component composition, but with a similar effect. These include medications:

• Palin is an antibiotic from the quinolone group, capsules based on pipemidic acid;
• Pimidel are antibacterial capsules containing pipemidic acid as an active ingredient.

Contraindications for use

The drug should not be taken if there are contraindications, these include:

• children under 2 years of age;
• pregnancy in the 1st trimester;
• hypersensitivity or increased susceptibility to the components of the product;
• cerebral atherosclerosis (in severe stage);
• severe disturbances in the functioning of the liver and kidneys.

Since the medication has a toxic effect on the kidneys and liver, even with long-term use, Nevigramon should not be used if there are severe pathologies of these organs. In this case, even if taken correctly, the risk of developing unwanted side effects increases significantly.

Pharmacodynamics and pharmacokinetics

The active substance of the antibiotic composition, nalidixic acid, has a pronounced antibacterial effect against bacteria escherichia coli, proteus, salmonella, shigella, and strains of Pseudomonas aeruginosa. Its mechanism of operation is based on the selective suppression of bacterial DNA synthesis. The drug has bactericidal or bacteriostatic effects. With longer exposure to the drug, bacterial protein and RNA synthesis is inhibited.

The active substance is rapidly absorbed, undergoes partial metabolism in the liver, and is quickly excreted by the kidneys. Nalidixic acid has 90% bioavailability and is metabolized to form the active metabolite hydroxynalidixic acid. It also exhibits antibacterial activity and has 30% bioavailability in the blood and 85% in the urine.

Hypdroxinalidixic acid reaches its maximum concentration two hours after taking the tablets on an empty stomach. The half-life is 1-2.5 hours, sometimes it can extend to 6-7 hours. 93% of nalidixic and 63% of hydroxynalidixic acids are bound to plasma proteins. 4% of the dose is excreted in feces.

Dose and course of treatment

The average duration of treatment is 7 days, after a week the medication is discontinued. The optimal dosage is 1 g. 3-4 times a day.

If therapy is carried out on a long-term basis, the dosage is adjusted, it is reduced to 500 mg 4 times a day.

During pregnancy and breastfeeding

During breastfeeding in women (lactation), the drug is not prescribed. If necessary, the child is transferred to artificial feeding, and then Nevigramon is prescribed in the dosage indicated above (for adults).

During pregnancy, the dosage is determined individually; if indicated, it is kept to a minimum. Due to the sensitivity of the body.

Children and newborns

The drug is not used for newborn children; it is prescribed only to children over 2 years of age. In this case, the dosage of the drug is calculated individually. The optimal dose is 60 mg per 1 kg of weight, 3-4 doses per week.

It is advisable that the dosage be calculated by a doctor, otherwise there is a high probability of an overdose.

Nevigramon price

The cost of Nevigramon depends on the pricing policy of the selling company and the accepted markup. In Moscow, the price of the product will be:

Side effects

Against the background of incorrect use of the drug, there is a high probability of developing the following side effects:

• seizures, headaches, drowsiness, changes in visual acuity (deterioration);
• hemolytic anemia, thrombophlebitis;
• bleeding in the stomach or intestines, diarrhea, nausea, vomiting;
• allergic reactions of the body: skin rash, itching, swelling of the skin, etc.

The drug affects various body systems: central nervous system organs, heart and blood vessels, gastrointestinal tract organs, etc. Therefore, various side effects may occur.

Drug interactions

When Nevigramon is used together with certain medications, the following effects may occur:

• Oral anticoagulants (warfarin, bis-hydroxycoumarin): enhancing their effect (if combination therapy is necessary, the prothrombin time or the international normalization index (INR) must be monitored, and a change in the dose of the anticoagulant may also be required);
• Other antibacterial compounds, especially tetracycline, nitrofurantoin, chloramphenicol: may inhibit the effect of nalidixic acid;
• Probenecid: suppression of the secretion of nalidixic acid in the renal tubules, reducing its effectiveness against infections of the genitourinary system and increasing the likelihood of systemic side effects;
• Melphalan: development of gastrointestinal toxicity.

Reviews and reviews from doctors

Despite the high effectiveness of the drug, there are not so many reviews about its use, both from doctors and from patients. Doctors note the good effectiveness of therapy, but prefer to prescribe medications to patients, albeit less effective, but cheaper.

In practice, the drug was used several times (2–3), no more. Nevigramon performed well; a 7-day course of treatment was enough to relieve urethritis and prostatitis. I chose this particular medicine out of necessity. I subsequently used it one more time and was pleased with the result.

Semendyaev R.I. Urologist.

I used Nevigramon 2 times and prescribed it to patients undergoing treatment in a hospital. At the same time, she constantly monitored the condition of the patients. The therapy was successful, but due to the high cost, not all patients are ready to purchase such a medication. Adding to this the possibility of bacteria developing resistance and the likelihood of side effects, the conclusion is that treatment with such a drug should be carried out only if there is an urgent need.

Shatokhina I. V.

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