Tsifran or Tsifran st which is better - myLor. When the doctor prescribes Tsifran st

"Cifran ST" is a combination drug with the active substances tinidazole and ciprofloxacin. It is intended for the treatment of the gastrointestinal tract and mixed infections, the development of which was facilitated by aerobes and anaerobes.

Several forms of the drug “Cifran” are being manufactured. Forms of release of the drug - coated tablets, eye drops, solution for infusion.

Tinidazole is formed from imidazole. The tool has an antimicrobial and antiprotozoal effect, is used for diseases caused by anaerobes.

Ciprofloxacin is an antibiotic with a wide range of actions. Aerobes are sensitive to it (most of the aerobes, which are gram-positive, gram-negative).

Both the original and analogues of "Cifran ST" effectively cope with the tasks.

Pharmacodynamics

Tinidazole, which has an effect on anaerobes, is effective in treating the affected lung and organs located in oral cavity, in the peritoneum and pelvis.

Manifestations of allergies and other undesirable effects, changes in laboratory parameters, and various disorders in the hematopoietic system are possible.

Drug interactions

"Cifran ST" (similar to active components) should not be combined with Ethionamide. The drug is combined with some antibiotics and sulfonamides.

When used with Phenobarbital, an acceleration of metabolism is observed. The drug enhances the effect of ethanol and anticoagulants.

special instructions

During therapy, you should be under the influence as little as possible. sun rays. It is prohibited to engage in activities that, when treated with the drug, may threaten health (requires attentiveness, rapid manifestation of motor and mental reactions). During therapy, it is necessary to monitor peripheral blood.

Analogues, reviews, price

When prescribing "Cifran ST" analogues, the price is important for patients. The most commonly used are tablets. The cost of tablets containing 250 and 300 mg of the main components is approximately 36-460 rubles, the price of tablets containing 500 and 600 mg of the main components is about 79-500 rubles.

What can replace Cifran ST? Russian analogues are cheaper. The original drug can be replaced, for example, with “Ciprofloxacin” (10-25 rubles). From Indian analogues, you can choose “Tanidazole + Ciprofloxacin” or “Ciprolet A” (150-325 rubles). It is these drugs that are mainly used to replace Tsifran ST.

Judging by the reviews, original drug copes well with colds, especially if the disease is advanced. When used in the first days menstrual cycle it allows you to cure many female inflammation. "Tsifran ST" quickly alleviates the patient's condition.

Basically, the antibiotic is used after operations and in cases where serious inflammation occurs in the body, which does not disappear for a long time, since there are many side effects. In reviews, buyers note that the analogues are no less effective and are easier to tolerate.

The drug "Cifran ST" is taken only after examination and prescription by a doctor. You should not self-medicate, as the consequences can be serious.

International name

Ciprofloxacin (Ciprofloxacin)

Group affiliation

Antimicrobial agent, fluoroquinolone

Dosage form

Concentrate for solution for infusion, solution for infusion, solution for infusion [in sodium chloride solution 0.9%], solution for injection, tablets, film-coated tablets, film-coated tablets of extended release, see. Also:
Tsifran; eye drops, eye and ear drops, ear drops, eye ointment

pharmachologic effect

A broad-spectrum antimicrobial agent, a fluoroquinolone derivative, suppresses bacterial DNA gyrase (topoisomerases II and IV, responsible for the process of supercoiling of chromosomal DNA around nuclear RNA, which is necessary for reading genetic information), disrupts DNA synthesis, growth and division of bacteria; causes pronounced morphological changes (including cell wall and membranes) and rapid death of the bacterial cell.

It has a bactericidal effect on gram-negative organisms during the period of rest and division (since it affects not only DNA gyrase, but also causes lysis of the cell wall), on gram-positive microorganisms - only during the period of division.

Low toxicity for the cells of the macroorganism is explained by the absence of DNA gyrase in them. While taking ciprofloxacin, there is no parallel development of resistance to other actibiotics that do not belong to the group of gyrase inhibitors, which makes it highly effective against bacteria that are resistant, for example, to aminoglycosides, penicillins, cephalosporins, tetracyclines and many other antibiotics.

Gram-negatives are sensitive to ciprofloxacin. aerobic bacteria: enterobacteria (Escherichia coli, Salmonella spp., Shigella spp., Citrobacter spp., Klebsiella spp., Enterobacter spp., Proteus mirabilis, Proteus vulgaris, Serratia marcescens, Hafnia alvei, Edwardsiella tarda, Providencia spp., Morganella morganii, Vibrio spp ., Yersinia spp.), other gram-negative bacteria (Haemophilus spp., Pseudomonas aeruginosa, Moraxella catarrhalis, Aeromonas spp., Pasteurella multocida, Plesiomonas shigelloides, Campylobacter jejuni, Neisseria spp.), some intracellular pathogens - Legionella pneumophila, Brucella spp. , Chlamydia trachomatis, Listeria monocytogenes, Mycobacterium tuberculosis, Mycobacterium kansasii, Corynebacterium diphtheriae;

Gram-positive aerobic bacteria: Staphylococcus spp. (Staphylococcus aureus, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus saprophyticus), Streptococcus spp. (Streptococcus pyogenes, Streptococcus agalactiae).

Most staphylococci resistant to methicillin are also resistant to ciprofloxacin. The sensitivity of Streptococcus pneumoniae, Enterococcus faecalis, Mycobacterium avium (located intracellularly) is moderate (high concentrations are required to suppress them).

Resistant to the drug: Bacteroides fragilis, Pseudomonas cepacia, Pseudomonas maltophilia, Ureaplasma urealyticum, Clostridium difficile, Nocardia asteroides. Not effective against Treponema pallidum.

Resistance develops extremely slowly, since, on the one hand, after the action of ciprofloxacin there are practically no persistent microorganisms left, and on the other hand, bacterial cells do not have enzymes that inactivate it.

Indications

Bacterial infections caused by susceptible microorganisms: diseases respiratory tract– acute and chronic (in the acute stage) bronchitis, pneumonia, bronchiectasis, cystic fibrosis;

ENT infections – otitis media, sinusitis, frontal sinusitis, mastoiditis, tonsillitis, pharyngitis;

kidney infections and urinary tract– cystitis, pyelonephritis;

infections of the pelvic organs and genital organs - prostatitis, adnexitis, salpingitis, oophoritis, endometritis, tubular abscess, pelvioperitonitis, gonorrhea, chancroid, chlamydia;

infections abdominal cavity – bacterial infections Gastrointestinal tract, biliary tract, peritonitis, intraperitoneal abscesses, salmonellosis, typhoid fever, campylobacteriosis, yersiniosis, shigellosis, cholera;

infections of the skin and soft tissues - infected ulcers, wounds, burns, abscesses, phlegmon;

bones and joints – osteomyelitis, septic arthritis;

sepsis; infections due to immunodeficiency (occurring during treatment with immunosuppressive drugs or in patients with neutropenia);

prevention of infections surgical interventions Oh.

Contraindications

Hypersensitivity, childhood(up to 18 years - until the process of skeletal formation is completed), pregnancy, lactation period. With caution. Severe atherosclerosis of cerebral vessels, violation cerebral circulation, mental illness, epilepsy, epileptic syndrome, severe renal and/or liver failure, elderly age.

Side effects

From the outside digestive system: nausea, diarrhea, vomiting, abdominal pain, flatulence, loss of appetite, cholestatic jaundice (especially in patients with past diseases liver), hepatitis, hepatonecrosis.

From the outside nervous system: dizziness, headache, fatigue, anxiety, tremor, insomnia, nightmares, peripheral paralgesia (anomaly in the perception of pain), increased sweating, increase intracranial pressure, confusion, depression, hallucinations, as well as other manifestations of psychotic reactions (occasionally progressing to states in which the patient can harm himself), migraine, fainting, thrombosis of cerebral arteries.

From the senses: disturbances of taste and smell, visual impairment (diplopia, changes in color vision), tinnitus, hearing loss.

From the cardiovascular system: tachycardia, disorders heart rate, decreased blood pressure.

From the outside hematopoietic system: leukopenia, granulocytopenia, anemia, thrombocytopenia, leukocytosis, thrombocytosis, hemolytic anemia.

Laboratory indicators: hypoprothrombinemia, increased activity of liver transaminases and alkaline phosphatase, hypercreatininemia, hyperbilirubinemia, hyperglycemia.

From the urinary system: hematuria, crystalluria (primarily with alkaline urine and low diuresis), glomerulonephritis, dysuria, polyuria, urinary retention, albuminuria, urethral bleeding, hematuria, decreased nitrogen excretory function of the kidneys, interstitial nephritis.

Allergic reactions: itchy skin, hives, blistering accompanied by bleeding, and the appearance of small nodules that form scabs, drug fever, pinpoint hemorrhages on the skin (petechiae), swelling of the face or larynx, shortness of breath, eosinophilia, increased photosensitivity, vasculitis, erythema nodosum, exudative erythema multiforme (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome).

Other: arthralgia, arthritis, tenosynovitis, tendon ruptures, asthenia, myalgia, superinfections (candidiasis, pseudomembranous colitis), “flushes” of blood to the face.

Application and dosage

Orally, 0.25 g 2-3 times a day, for severe infections - 0.5-0.75 g 2-3 times a day.

For urinary tract infections - 0.25-0.5 g 2 times a day; course of treatment – ​​7-10 days.

For uncomplicated gonorrhea – 0.25-0.5 g once; when combined gonococcal infection with chlamydia and mycoplasma - 0.75 g every 12 hours for 7-10 days.

For chancroid - 0.5 g 2 times a day for several days.

For meningococcal carriage in the nasopharynx - once, 0.5 or 0.75 g.

At chronic carriage salmonella – orally, 0.25 g 4 times; course of treatment – ​​up to 4 weeks. If necessary, the dosage can be increased to 0.5 g 3 times a day.

For pneumonia, osteomyelitis - orally, 0.75 g 2 times a day. The duration of treatment for osteomyelitis can be up to 2 months.

For gastrointestinal infections caused by Staphylococcus aureus - 0.75 g every 12 hours for 7-28 days.

Treatment should be continued for at least 3 more days after body temperature normalizes or clinical symptoms disappear.

With a glomerular filtration rate (CC 31-60 ml/min/1.73 sq.m or serum creatinine concentration from 1.4 to 1.9 mg/100 ml), the maximum daily dose is 1 g. With a glomerular filtration rate below 30 ml/min/1.73 sq.m. m or serum creatinine concentration above 2 mg/100 ml maximum daily dose – 0.5 g.

If the patient is undergoing hemodialysis or peritoneal dialysis – 0.25-0.5 g/day, but the drug should be taken after the hemodialysis session.

For severe infections (for example, recurrent cystic fibrosis, infections of the abdominal cavity, bones and joints) caused by Pseudomonas or staphylococci, with acute pneumonia caused by Streptococcus pneumoniae and chlamydial infections genitourinary tract the dose should be increased to 0.75 g every 12 hours.

The tablets should be swallowed whole with a small amount of liquid after meals. When taking the tablet on an empty stomach, the active substance is absorbed faster.

IV drip: infusion duration is 30 minutes at a dose of 0.2 g and 60 minutes at a dose of 0.4 g. Ready-to-use infusion solutions can be combined with a 0.9% NaCl solution, Ringer's solution and Ringer-lactate, 5 and 10% solution dextrose, 10% fructose solution, as well as a solution containing 5% dextrose solution with 0.225-0.45% NaCl solution.

For uncomplicated urinary tract infections, infections lower sections respiratory tract single dose – 0.2 g; for complicated infections upper sections urinary tract, for severe infections (including pneumonia, osteomyelitis) single dose - 0.4 g. If necessary, IV treatment of particularly severe ones, life-threatening or recurrent infections caused by Pseudomonas, staphylococci or Streptococcus pneumoniae, the dose can be increased to 0.4 g with a frequency of administration up to 3 times a day. The duration of treatment for osteomyelitis can reach up to 2 months.

For chronic carriage of salmonella - 0.2 g 2 times a day; course of treatment – ​​up to 4 weeks. If necessary, the dosage can be increased to 0.5 g 3 times a day.

For acute gonorrhea – 0.1 g once.

For the prevention of infections during surgical interventions - 0.2-0.4 g 0.5-1 hour before surgery; if the operation lasts more than 4 hours, it is re-administered in the same dose.

Average duration of treatment: 1 day – for acute uncomplicated gonorrhea and cystitis; up to 7 days - for infections of the kidneys, urinary tract and abdominal cavity, during the entire period of the neutropenic phase - in patients with weakened body defenses, but no more than 2 months - for osteomyelitis and 7-14 days - for all other infections. At streptococcal infections due to the danger of late complications, as well as for chlamydial infections, treatment should continue for at least 10 days. In patients with immunodeficiency, treatment is carried out throughout the entire period of neutropenia.

Treatment should be continued for at least 3 more days after body temperature normalizes or clinical symptoms disappear.

With a glomerular filtration rate (CK 31-60 ml/min/1.73 m2 or serum creatinine concentration from 1.4 to 1.9 mg/100 ml), the maximum daily dose is 0.8 g.

With a glomerular filtration rate (CK below 30 ml/min/1.73 m2 or serum creatinine concentration above 2 mg/100 ml), the maximum daily dose is 0.4 g.

For elderly patients, the dose is reduced by 30%.

For peritonitis, it is permissible to use intraperitoneal administration of infusion solutions at a dose of 50 mg 4 times a day per 1 liter of dialysate.

After IV use, you can continue treatment orally.

special instructions

With simultaneous intravenous administration of ciprofloxacin and drugs for general anesthesia from the group of barbituric acid derivatives, constant monitoring of heart rate, blood pressure, and ECG is required.

To avoid the development of crystalluria, it is unacceptable to exceed the recommended daily dose; sufficient fluid intake and maintaining an acidic urine reaction are also necessary.

During treatment, you should refrain from potentially active activities dangerous species activities that require increased attention and speed of mental and motor reactions.

Patients with epilepsy, a history of seizures, vascular diseases And organic lesions brain, due to the threat of development adverse reactions on the part of the central nervous system, ciprofloxacin should be prescribed only for “vital” indications.

If it occurs during or after treatment for severe and prolonged diarrhea the diagnosis of pseudomembranous colitis should be excluded, which requires immediate discontinuation of the drug and the appointment of appropriate treatment.

If pain in the tendons or the first signs of tenosynovitis appear, treatment should be stopped (individual cases of inflammation and even tendon rupture have been described during treatment with fluoroquinolones).

During the treatment period, contact with direct sunlight should be avoided.

Interaction

Due to a decrease in the activity of microsomal oxidation processes in hepatocytes, it increases the concentration and lengthens T1/2 of theophylline (and other xanthines, such as caffeine), oral hypoglycemic drugs, indirect anticoagulants, and helps reduce the prothrombin index.

When combined with other antimicrobial drugs (beta-lactam antibiotics, aminoglycosides, clindamycin, metronidazole), synergism is usually observed; can be successfully used in combination with azlocillin and ceftazidime for infections caused by Pseudomonas spp.; with mezlocillin, azlocillin and other beta-lactam antibiotics - for streptococcal infections; with isoxazolepenicillins and vancomycin – with staphylococcal infections; with metronidazole and clindamycin - for anaerobic infections.

It enhances the nephrotoxic effect of cyclosporine, there is an increase in serum creatinine; in such patients it is necessary to monitor this indicator 2 times a week.

When taken simultaneously, it enhances the effect of indirect anticoagulants.

Oral administration together with Fe-containing drugs, sucralfate and antacid drugs containing Mg2+, Ca2+ and Al3+ leads to a decrease in the absorption of ciprofloxacin, so it should be prescribed 1-2 hours before or 4 hours after taking the above drugs.

NSAIDs (excluding ASA) increase the risk of seizures.

Didanosine reduces the absorption of ciprofloxacin due to the formation of complexes with it with the Al3+ and Mg2+ contained in didanosine.

Metoclopramide accelerates absorption, which leads to a decrease in the time to reach its Cmax.

Co-administration of uricosuric drugs leads to a slower elimination (up to 50%) and an increase in plasma concentrations of ciprofloxacin.

The infusion solution is pharmaceutically incompatible with all infusion solutions and drugs that are physico-chemically unstable when acidic environment(pH infusion solution ciprofloxacin – 3.9-4.5). Do not mix the solution for intravenous administration with solutions having a pH greater than 7.

Reviews about the medicine Tsifran: 5

Helped with boils, so as not to lead to surgery (cutting out an abscess-ulcer), just be sure to drink it for 5 days (1 piece every 12 hours, this is important!)

Polina, 05/16/2017, age: 33

The pharmacy advises me to take Tsifran instead of Monural, which the doctor prescribed for me for cystitis. They say it’s the same thing, but here it’s not even in analogues. Who's wrong?

07/26/2017, age: 64

The price difference with analogues is not big, is it worth taking the risk? My father once drank Tsifran while he was being treated with Smartprost, and it helped a lot. Despite the fact that prostatitis is considered an intractable disease.

Tamil, 09/19/2017, age: 58

In fact, simple medications will also help with physiotherapy, so with Smartprost you can safely take analogues instead of Tsifran. Much depends on what you are being treated with in addition to the antibiotic.

Albert, November 30, 2017, age: 49

What nonsense? What do antibiotics and smrtprost have to do with it? It's not related at all. But it’s risky to take analogues, not because they won’t help, but because the side effects can be terrible.

Write your review

Do you use Cifran as an analogue or vice versa its analogues?

Tsifran ST (tinidazole + ciprofloxacin) is a combined antibacterial drug. Used for the treatment of combined aerobic and anaerobic invasions, as well as bacterial invasions of the gastrointestinal tract ( chronic inflammation sinus sinuses, abscess pneumonia, pyothorax, infections that develop when the anatomical barriers of the gastrointestinal tract are violated, gynecological infections, infections after surgical interventions, purulent-necrotic process in bone tissue, dermatological infections, oral infections, amoebic and/or bacterial diarrhea and dysentery) . Anaerobes - clostridia, bacteroides, peptococci and peptostreptococci - are sensitive to tinidazole. In most cases, in the presence of an anaerobic infection, aerobes are also present in the lesion, therefore, to increase efficiency, an antibacterial drug effective against aerobes is added. In Cifran ST, this is ciprofloxacin, to which aerobes such as coli, Klebsiella, Salmonella, Yersinia, Shigella, Haemophilus influenzae, Neisseria, Mycoplasma, Vibrio cholerae, Staphylococcus, Streptococcus, Chlamydia, Mycoplasma, Legionella, Mycobacterium tuberculosis. Tinidazole and ciprofloxacin are rapidly absorbed from the gastrointestinal tract. Maximum concentrations Both substances are observed 1-2 hours after administration. The half-life of tinidazole is 12-14 hours. The drug has good penetrating power.

It is excreted mainly in urine and in small quantities in feces. The presence of food contents in the gastrointestinal tract slows down the absorption of ciprofloxacin. Half-life is 3.5-4.5 hours. Cifran ST is not used in persons with individual intolerance to tinidazole and/or ciprofloxacin, as well as any other fluoroquinolone or imidazole antibiotics, or organic lesions of the nervous system. In pediatrics, Tsifran ST is not used. It is not recommended to use the drug in pregnant women and nursing mothers. The optimal time to take the drug is after meals. The structure of the tablet does not imply its breaking, chewing or any other violation of integrity. The tablet should be taken with a sufficient amount of water so that it can easily reach the site of absorption. The frequency of taking the drug is twice a day. The number of tablets per dose is determined by the dose of the drug: 2 tablets (for a dose of 250/300 mg) and 1 tablet (for a dose of 500/600 mg). During the course of medication, it is recommended to avoid long stay in the sun to avoid phototoxicity reactions (if any have developed, pharmacotherapy should be interrupted immediately). Cifran ST is strongly not recommended to be combined with the use of alcohol, because. ethanol in combination with tinidazole can provoke gastrointestinal spasms and dyspeptic reactions in the form of nausea and vomiting. During the drug course, it is recommended to periodically do a blood test.

Pharmacology

Combined drug. Tinidazole is an antiprotozoal and antimicrobial agent, an imidazole derivative, is effective against anaerobic microorganisms such as Clostridium difficile, Clostridium perfringens, Bacteroides fragilis, Peptococcus and Peptostreptococcus anaerobius.

Ciprofloxacin is a broad-spectrum antibiotic that is active against most aerobic gram-positive and gram-negative microorganisms, such as Escherichia coli, Klebsiella spp., Salmonella typhi and other strains of Salmonella, Proteus mirabilis, Proteus vulgaris, Yersinia enterocoilitica, Pseudomonas aeruginosa, Shigella flexneri, Shigella sonnei , Haemophilus ducreyi, Haemophilus influenzae, Neisseria gonorrhoeae, Moraxella catarrhalis, Vibrio cholerae, Bacteroides fragilis, Staphylococcus aureus (including methicillin resistant strains), Staphylococcus epidermidis, Streptococcus pyogenes, Streptococcus pneumoniae, Mycoplasma, Legionella and Mycobacterium tuberculosis.

Pharmacokinetics

Both ciprofloxacin and tinidazole are well absorbed from the gastrointestinal tract after oral administration. The time to reach Cmax for each component is 1-2 hours. The drug quickly penetrates the body tissues, reaching high concentrations there. It is found in high concentrations in saliva, nasal and bronchial secretions, semen, lymph, peritoneal fluid, bile and prostate secretions.

Bioavailability of tinidazole is 100%, protein binding is 12%. T 1/2 - 12-14 hours. Tinidazole penetrates into cerebrospinal fluid in a concentration equal to that in plasma, and is reabsorbed into renal tubules. Tinidazole is excreted into bile in concentrations slightly below 50% of its plasma concentration. About 25% is excreted unchanged in the urine, 12% in the form of metabolites. Minor amounts are excreted in the feces.

The bioavailability of ciprofloxacin is about 70%. Concomitant food intake slows down absorption. Communication with proteins - 20-40%. Ciprofloxacin penetrates well into body fluids and tissues: lungs, skin, fat, muscle and cartilage tissue, and bone tissue and organs of the urinary system, including the prostate gland. Ciprofloxacin is partially metabolized in the liver. T 1/2 - about 3.5-4.5 hours, can be extended with severe renal failure and in elderly patients. About 50% is excreted unchanged in the urine, 15% is excreted in the form of active metabolites (including oxoprofloxacin). The rest is excreted in bile, partially reabsorbed. About 15-30% of ciprofloxacin is excreted in the feces.

Release form

10 pieces. - contour cell packaging (1) - cardboard packs
10 pieces. - contour cell packaging (10) - cardboard packs.

Dosage

Inside, after meals, with plenty of water. Do not break, chew, or crush the tablet.

Overdose

Treatment: induction of vomiting, gastric lavage. Symptomatic, supportive therapy (including adequate hydration of the body). There is no specific antidote.

Interaction

Tinidazole.

Enhances the effect of indirect anticoagulants (to reduce the risk of bleeding, the dose is reduced by 50%) and the effect of ethanol (disulfiram-like reactions).

Compatible with sulfonamides and antibiotics (aminoglycosides, erythromycin, rifampicin, cephalosporins).

Phenobarbital speeds up metabolism.

Ciprofloxacin.

Due to a decrease in the activity of microsomal oxidation processes in hepatocytes, it increases the concentration and lengthens T1/2 of theophylline (and other xanthines, including caffeine), oral hypoglycemic drugs, indirect anticoagulants, and helps reduce the prothrombin index.

When combined with other antimicrobial drugs (beta-lactam antibiotics, aminoglycosides, clindamycin, metronidazole), synergism is usually observed.

Enhances the nephrotoxic effect of cyclosprorine, there is an increase in serum creatinine, in such patients it is necessary to monitor this indicator 2 times a week.

Oral administration together with iron-containing drugs, sucralfate and antacid drugs containing magnesium, calcium, aluminum salts leads to a decrease in the absorption of ciprofloxacin, so it should be prescribed 1-2 hours before or 4 hours after taking the above drugs.

NSAIDs (except acetylsalicylic acid) increase the risk of developing seizures.

Didanosine reduces the absorption of ciprofloxacin due to the formation of complexes with the magnesium and aluminum ions contained in didanosine.

Metoclopramide accelerates absorption, which leads to a decrease in the time to reach Cmax.

Joint reception with uricosuric drugs leads to a slower elimination (up to 50%) and an increase in the plasma concentration of ciprofloxacin.

Side effects

From the digestive system: loss of appetite, dryness of the oral mucosa, “metallic” taste in the mouth, nausea, vomiting, diarrhea, abdominal pain, flatulence, cholestatic jaundice (especially in patients with previous liver diseases), hepatitis, hepatonecrosis.

From the central nervous system and peripheral nervous system: headache, dizziness, fatigue, impaired coordination of movements (including locomotor ataxia), dysarthria, peripheral neuropathy, rarely - convulsions, weakness, tremor, insomnia, increased intracranial pressure, confusion. , depression, hallucinations, as well as other manifestations of psychotic reactions, migraine, thrombosis of cerebral arteries.

From the senses: disturbances of taste and smell, visual impairment (diplopia, changes in color vision), tinnitus, hearing loss.

From the outside of cardio-vascular system: tachycardia, arrhythmia, decreased blood pressure, fainting.

From the hematopoietic organs: leukopenia, granulocytopenia, anemia (including hemolytic), thrombocytopenia, leukocytosis, thrombocytosis.

From the urinary system: hematuria, crystalluria (with an alkaline reaction of urine and decreased diuresis), glomerulonephritis, dysuria, polyuria, urinary retention, decreased nitrogen excretory function of the kidneys, interstitial nephritis.

Allergic reactions: skin itching, urticaria, skin rash, drug fever, petechiae, swelling of the face or larynx, shortness of breath, eosinophilia, photosensitivity, vasculitis, erythema nodosum, erythema multiforme exudative (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome).

Laboratory indicators: hypoprothrombinemia, increased activity of liver transminases and alkaline phosphatase, hypercreatininemia, hyperbilirubinemia, hyperglycemia.

Other: arthralgia, arthritis, tenosynovitis, tendon ruptures, asthenia, myalgia, superinfections (candidiasis, pseudomembranous colitis), flushing of the face, increased sweating.

Indications

Mixed infections caused by sensitive anaerobic and aerobic microorganisms:

• chronic sinusitis;
• lung abscess;
• empyema;
• intra-abdominal infections;
• inflammatory gynecological diseases;
• postoperative infections with the possible presence of aerobic and anaerobic bacteria;
• chronic osteomyelitis;
• skin and soft tissue infections;
• skin ulcers in diabetic foot;
• bedsores;
• Oral infections (including periodontitis and periostitis).

  Diarrhea or dysentery of amoebic or mixed (amebic and bacterial) etiology.

Contraindications

• hypersensitivity (including to fluoroquinolone or imidazole derivatives);
• blood diseases (history);
• oppression of bone marrow hematopoiesis;
• acute porphyria;
• organic diseases of the central nervous system;
• age under 18 years;
• pregnancy;
• lactation period.

Carefully: severe atherosclerosis cerebral vessels, cerebrovascular accident, mental illness, epilepsy, history of seizures, severe renal and/or liver failure, old age.

Features of application

Use during pregnancy and breastfeeding

The use of the drug during pregnancy is not recommended. Tinidazole may be carcinogenic and mutagenic. Ciprofloxacin penetrates the placental barrier.

Tinidazole and ciprofloxacin are excreted in breast milk. Therefore, if it is necessary to use the drug during lactation, breast-feeding should be stopped.

Use for liver dysfunction

With caution: severe liver failure.

Use for renal impairment

With caution: severe renal failure.

Use in children

Contraindicated in children and adolescence up to 18 years old.

Use in elderly patients

With caution: old age.

special instructions

It is recommended to avoid excessive exposure to radiation sunlight during treatment. If photosensitivity reactions occur, you should immediately stop using the drug.

When using tinidazole (imidazole derivative), it is possible (rarely) to develop generalized urticaria, swelling of the face and larynx, decreased blood pressure, bronchospasm and dyspnea. Therefore, patients with hypersensitivity to other imidazole derivatives may develop cross-sensitivity to tinidazole; the development of a cross-allergic reaction to ciprofloxacin is also possible in patients with hypersensitivity to other fluoroquinolone derivatives. The possibility of cross-allergic reactions should be taken into account.

To avoid the development of crystalluria, the recommended daily dose should not be exceeded; sufficient fluid intake and maintaining an acidic urine reaction are also necessary. Causes dark coloration of urine, which has no clinical significance.

For patients with epilepsy, a history of seizures, vascular diseases and organic brain damage, due to the risk of developing adverse reactions from the central nervous system, the drug should be prescribed only for health reasons.

If severe and prolonged diarrhea occurs during or after treatment, the diagnosis of pseudomembranous colitis should be excluded, which requires immediate discontinuation of the drug and the appointment of appropriate treatment.

If pain appears in the tendons or when the first signs of tenosynovitis appear, treatment should be stopped.

During treatment, peripheral blood patterns should be monitored.

During treatment, you should refrain from engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Cifran is an antibacterial drug belonging to the group of quinolones (fluoroquinolones).

Pharmacological action of Tsifran

According to the instructions, Tsifran is an antimicrobial drug broad action. The main active ingredient of the drug Cifran is ciprofloxacin. The basis of the action of this drug is the inhibition of bacterial enzymes and disruption of their DNA synthesis. Cifran also has a bactericidal effect on the cell membrane of harmful microorganisms. Cifran exhibits its effect on bacteria that are both in the reproduction stage and in the dormant stage.

Cifran is active against gram-negative and gram-positive bacteria; the drug also exhibits its effect against intracellular bacteria. However anaerobic bacteria Resistant to Cifran.

The use of Tsifran does not disrupt the natural microflora of the vagina and intestines.

Forms of release of Tsifran

The pharmaceutical industry produces three dosage forms of Cifran. These are tablets that weigh 250 and 500 mg. The tablets are coated with a special coating. Sold in cardboard packs of 10 or 100 pieces.

In pharmacies you can purchase a solution for infusion that contains ciprofloxacin in the amount of 2 mg per 1 ml of the drug. The bottle contains 100 ml of solution, it is packed in a box.

Another dosage form of Cifran is eye drops containing 3 mg of ciprofloxacin in 1 ml. Drops are sold in a dark bottle, packed in a cardboard box.

Indications for use of Tsifran

According to the instructions, Cifran is used to treat infectious and inflammatory diseases. It can be used for infections genitourinary system, including cystitis, prostatitis; for respiratory tract infections, including bronchopneumonia, pneumonia, bronchitis in acute form, pleurisy, lung abscess. Indications for Cifran recommend this drug for use in gonorrhea, pharyngitis, urethritis, infections of the ENT organs, otitis and sinusitis. The drug is effectively used for infections of soft tissues and skin, for the treatment of infected wounds, and for infectious eye diseases. Treatment with Cifran is also indicated for infections of the joints and bones, various infections in immunocompromised patients. According to the instructions, Cifran is used to prevent postoperative complications.

Contraindications

Treatment with Cifran is contraindicated if the patient has hypersensitivity to quinols, including ciprofloxacin. The drug should not be taken during pregnancy or breastfeeding. Tsifran is also contraindicated for patients under 12 years of age. Patients who have chronic diseases, as well as cerebrovascular accidents, epilepsy and epileptic syndrome, Cifran should be taken under the close supervision of a physician. Treatment with Cifran is also indicated for elderly patients with caution and under medical supervision.

Analogues of Tsifran

Analogs of Cifran, which are identical in action and composition, include the drugs Basijen, Quipro, Alcipro, Quintor and others. If the patient decides to use Cifran analogues, then it is necessary to consult a doctor.

Directions for use and dosage

The dosage during treatment with Tsifran is determined by the doctor individually. Many aspects are taken into account here: the severity of the disease, the weight and age of the patient, the type of pathogen, kidney function, and the presence of other diseases. Children over 12 years of age take Cifran in the amount of 5-10 mg per kilogram of body weight per day. This dose must be divided into two doses. It is recommended to take the tablets before meals.

Intravenous infusions are administered twice a day in an amount of 200 mg, if there are diseases urinary system and infections of the lower extremities. The drug must be administered slowly. For bacteremia, the dose is 400 mg, given twice a day every 12 hours. If the patient has kidney problems, then the dose of Tsifran is reduced by half. Sometimes, after using Cifran in the form of infusions, the patient is recommended to take another course of drug tablets.

Treatment with Tsifran should be carried out for at least 5-7 days. The doctor determines a more precise course of treatment.

Indications for Tsifran recommend the drug for treatment infectious diseases eyes, in this case eye drops are used. Drops should be used every four hours. It is necessary to instill one or two drops into the lower conjunctival sac of the affected eye. In severe cases of the disease, Cifran drops should be instilled every hour, two drops until improvement occurs.

Side effects of Tsifran

The use of the drug Cifran may cause side effects of different nature. Patients sometimes experience abdominal pain, flatulence, vomiting, nausea, heart rhythm disturbances, and tachycardia. Also during treatment there are headaches, tremors of the limbs, depression, general weakness, increased sweating, disturbances of taste, smell, vision. The drug can also cause allergic reactions in the form of urticaria, rash, pinpoint hemorrhages on the skin, and allergic fever. With strong side effects You should consult a doctor for advice.

Conditions and periods of storage of Tsifran

Tsifran must be stored in a dry place, out of reach of children. Storage temperature should not exceed 25 degrees Celsius.

The drug can be used for two years from the date of release.

Tsifran can be purchased in pharmacies with a doctor's prescription.

It is a broad-spectrum antimicrobial drug produced by a company of Indian origin. According to the instructions for use, this antibiotic has a pronounced bactericidal therapeutic effect against a number of pathogenic microorganisms.

After entering the digestive system, Cifran is quickly absorbed into the blood. Its therapeutic effect occurs within 1.5 - 2 hours after administration. The medicine is excreted unchanged in urine and feces.

Cifran is produced, analogues of which have identical therapeutic effect, in the form of enteric-coated oral tablets. The main active ingredient of the drug is ciprofloxacin.

According to statistics, when orally Tsifran tablets, analogues of which will be presented below, the bioavailability of the drug is more than 97%, which is an excellent indicator.

The price of Tsifran in pharmacies is on average 420 rubles for 1 pack of tablets. This cost is quite high, but it is fully compensated by the effectiveness of the drug against various infectious and microbial pathologies. This must also be taken into account if you want to select cheaper analogues.

Are there any domestic

Tsifran, whose analogues do not have significant differences in their composition, currently has no domestic analogues. Thus, if it is necessary to prescribe similar antibiotics, the attending physician can select a drug with a different one for the patient. active substance or give preference to foreign analogues of the product.

It is important to note that all combination medications based on ciprofloxacin are produced by Indian companies. Most vivid examples complete analogues Cifran can be called drugs Tsiprolet, Ranbaxy and Zoxan.

Tsifran, just like its analogs, is prescribed by a doctor if a patient is diagnosed with various inflammatory or infectious lesions in the tissues. Thus, this group of drugs will be effective in acute poisoning, diseases of the digestive system, allergic reactions and ARVI.

Additional indications for which Cifran and its analogues will be effective are:

• Diseases of the ENT system (otitis, pharyngitis, laryngitis).
• The period after a recent surgical intervention.
• Prevention of infectious lesions after childbirth.
• Development of sepsis as a result of injury.
• Infections in the genitourinary system.

Moreover, Cifran analogues can be used in for preventive purposes for those patients who experience a sharp decrease in immunity and loss of the body’s ability to resist infectious lesions.

Analogues are cheaper

A drug that has the same pharmacological properties The same as Tsifran, but at the same time less expensive, is Zoksan. The price for it is 300 rubles for 1 package. Due to the identical composition and concentration of the main active substance, Zoksan has the same list of repentances for use.

One Zoxan tablet contains 500 ml of ciprofloxacin. Moreover, the antibiotic has a pronounced antimicrobial effect, which affects the DNA structure of pathogenic bacteria in the human body.

It should be noted that Zoxane does not destroy stability in intestinal microflora, therefore, after taking it, patients do not develop dysbiosis, diarrhea and others frequent consequences from antibiotic treatment. This difference makes Zoxan better than most Tsifran analogues.

In addition, the following analogues will cost less than Cifran:

• Tsiprolet.
• Digital ST.
• Zindolin.

Comparative characteristics of popular analogues

One of the popular analogs of Cifran is Ciprofloxacin. It is important to know that Cifran and Ciprofloxacin have a completely identical effect on the patient’s body. Thus, both of these drugs can replace each other and treat the same diseases. At the same time, these drugs are intended for the treatment of adult patients and children from six years of age. These antibiotics are not prescribed to children under this age. If necessary, the observing pediatrician should select a safer antibacterial drug for the child.

Both of these antibiotics have wide range actions, however, Tsifran is considered more effective, since it belongs to the second generation drugs.

Another frequently used analogue of Tsifran is Amoxiclav. This drug has a combined therapeutic antimicrobial effect. It has two release forms: suspension and tablets.

Unlike Cifran, Amoxicillin contains clavunic acid, which makes it easier for patients to tolerate treatment with the drug.

It is also worth noting that, unlike Amoxiclav, Tsifran is more effective in treating acute infectious lesions.

Additional drugs that are also considered analogues of Cifran are:

• Betaciprol (more often used for bacterial lesions).
• Basijen (prescribed to quickly suppress bacterial outbreaks in the body).
• Afenoesin. It has a good effect on diseases caused by pathogenic microbes.

The difference between Tsifran OD and Tsifran ST

Cifran ST- This combination drug, which is based on the substance tinidazole. This antibiotic effective against various anaerobic types pathogens. At the same time, Cifran ST is intended to be prescribed only for those diseases that were caused by gram-negative types of bacteria.

Digital OD- it's the same effective antibiotic, however, its main difference from Cifran ST is that it does not contain tinidazole, while being a 100% ciprofloxacin-based product. Also, Tsifran OD does not have therapeutic activity against anaerobic foci of infections.