Precautions levofloxacin should be used in patients with renal insufficiency; with a deficiency of glucose-6-phosphate dehydrogenase (increased risk of hemolytic anemia); diabetes; with psychosis and other mental disorders in history; with known risk factors for primobolan depot prolongation (congenital syndrome interval, concomitant use of drugs that can prolong the interval (eg, antiarrhythmics IA and III classes, tricyclic antidepressants, macrolides, antipsychotics), elderly patients and women may be more sensitive to the drugs , lengthens the interval ); with uncorrected electrolyte disturbances (eg, hypomagnesemia, hypokalemia, hyponatremia); elderly patients; Patients with cardiac disease (eg, heart failure, myocardial infarction, bradycardia); with a predisposition to convulsive reactions (cerebral atherosclerosis, cerebrovascular accidents (in history), organic diseases of the central nervous system); hepatic porphyria; while taking drugs that reduce the seizure threshold of the brain readiness (fenbufen and other similar non-steroidal anti-inflammatory, theophylline); while taking drugs that affect the tubular secretion (such as probenecid and cimetidine).
Application of pregnancy and during breastfeeding
During pregnancy, use of the drug Fleksid ® is contraindicated.
It is not known whether levofloxacin passes into breast milk, therefore, due to the possible risk of damage to the cartilage of the growing organism tissue during treatment with the drug should decide the issue of termination of breastfeeding.
Dosing and Administration
Tablets primobolan depot should be taken once or twice a day, regardless of meals, without chewing and drinking plenty of fluids.
Can also be used for continuation of therapy in those patients who showed improvement under the initial / primary treatment levofloxacin appointed intravenously; Considering bioequivalence parenteral and oral forms of the drug can be used drug in the same dose.
The drug should be taken at least 2 hours before or 2 hours after ingestion of antacids containing magnesium and / or aluminum, iron salts, zinc salts, sucralfate or didanosine (ddI only those preparations, which contain as excipients magnesium and aluminum).
dose and duration of treatment depends on the indications for use and severity of the disease.
According to the World adverse reactions are classified according to their rate of development as follows: ; the frequency is unknown – according to available data to set the frequency of occurrence is not possible. On the part of the gastrointestinal tract (GIT) common: nausea, diarrhea, vomiting uncommon: abdominal pain, dyspepsia, flatulence, constipation, frequency is not known: diarrhea mixed with blood, which in very rare cases, it may be a symptom of enterocolitis, including pseudomembranous colitis, pancreatitis, stomatitis. On the part of the liver and biliary tract common: increased activity of “liver” transaminases, increased alkaline phosphatase and gamma-glutamyl transferase ; uncommon: increasing the concentration of bilirubin in the blood plasma, the frequency is not known: severe hepatic impairment, including cases of acute liver failure, sometimes fatal primarily in patients with severe underlying disease (eg, patients with sepsis), hepatitis, jaundice. The nervous system is often : headache, dizziness, insomniauncommon: vertigo, drowsiness, irritability, confusion, anxiety, tremor, anxiety; rare: “nightmarish” dream, paraesthesia, convulsions, depression, agitation, disorientation, psychotic reactions (eg, hallucinations, paranoia); the frequency is unknown: extrapyramidal disorders, and other disorders of coordination, dyskinesia, peripheral sensory neuropathy, peripheral sensory motor neuropathy, disturbance of the mind in violation of the behavior of self-harm, suicidal thoughts, suicide attempts, syncope, benign intracranial hypertension. from the side of feelings rare: dysgeusia (impaired taste sensitivity); rare:blurred vision (disturbance of visual perception), “ringing” in the ears of the frequency is not known: transient loss of vision, hearing loss (including hearing loss), parosmiya (impaired sense of smell), including anosmia (loss of smell), ageusia (loss of taste sensitivity).
On the part of the cardiovascular system rare: sinus tachycardia, decreased blood pressure, increased heart rate, the frequency is unknown:lengthening , ventricular arrhythmias and ventricular tachycardia type “pirouette» (torsades de pointes) predominantly in patients with risk factors for primobolan depot prolongation, ventricular tachycardia, which can lead to heart failure. On the part of the musculoskeletal system rarely: arthralgia, myalgia; rare: tendinitis, muscle weakness (of particular importance for patients with myasthenia), the frequency is not known: rhabdomyolysis, tendon rupture (eg Achilles tendon), ligament tear, muscle rupture, arthritis.
From the urinary system uncommon: hypercreatininemia; rare: acute renal failure (eg, due to . the development of interstitial nephritis) The respiratory system rare: shortness of breath; the frequency is not known: bronchospasm, hypersensitivity pneumonitis. skin and soft tissue uncommon: pruritus, rash, urticaria, rash, the frequency is not known: Stevens-Johnson syndrome, toxic epidermal necrolysis ( Lyell’s syndrome), exudative erythema multiforme, leykotsitoplastichesky vasculitis, photosensitivity reactions. immune system rare: angioneurotic edema, hypersensitivity reactions, the frequency is unknown: . anaphylactoid shock, anaphylactic shock, the part of the blood and lymphatic systemuncommon: eosinophilia, leukopenia, rarely neutropenia , thrombocytopenia, and the frequency is unknown: . hemolytic anemia, agranulocytosis, pancytopenia On the part of metabolism and nutritioninfrequent: anorexia rare: hypoglycemia (increased appetite, increased sweating, tremors, especially in patients with diabetes); very rarely attacks of porphyria (a very . rare metabolic disease) in patients who are already suffering from the disease, as evidenced by the experience of other quinolones This effect is not excluded the primobolan depot application of levofloxacin. frequency unknown: . hyperglycemia (increased blood glucose), hypoglycemic coma other rare: asthenia, fungal infection, superinfection; rare: pyrexia (fever), the frequency is not known: pain (including pain in back, chest, and extremities).