Biseptol dosage. Biseptol - a modern take on a long-familiar antibacterial drug

Biseptol is the most popular "branded" antibacterial drug from the Polish pharmaceutical plant "Polfa", designed to fight mild and moderate infections of the respiratory, urinary and digestive tract. This is a combined medicine, which contains two active components: sulfamethoxazole and trimethoprim. Sulfamethoxazole, which is structurally similar to para-aminobenzoic acid (PABA) and is captured by the microbe instead of it, interferes with the synthesis of dihydrofolic acid in the cells of microorganisms, preventing PABA from being incorporated into its molecule. Trimethoprim, in turn, potentiates the action of sulfamethoxazole, disrupting the formation of the active form of folic acid - tetrahydrofolic acid, which is responsible for protein metabolism and bacterial cell division. Thus, the combination of sulfamethoxazole and trimethoprim (known as co-trimoxazole) has a dual blocking effect on the metabolism of infectious agents.

Biseptol has a bactericidal effect, i.e. it completely and irreversibly reduces the microbial “livestock”. Its activity is manifested in relation to the following disturbers of the normal balance intestinal microflora: Staphylococcus spp., Streptococcus spp. (including the species pneumoniae), Neisseria spp. (including meningitidis and gonorrhoeae species, Escherichia coli, Salmonella spp. (including typhi and paratyphi species), Haemophilus influenzae (including ampicillin-resistant strains), Bacillus anthracis, Vibrio cholerae, Nocardia asteroides, Lcardia asteroides spp.

Enterococcus faecalis, Bordetella pertussis, Proteus spp., Klebsiella spp., Francisella tularensis, Pasteurella spp., Mycobacterium spp. (including Mycobacterium leprae), Citrobacter, Brucella spp., Entérobacter spp., Providencia, Legionella pneumophila, certain types Pseudomonas, Yersinia spp., Serratia marcescens, Morganella spp., Shigella spp., Chlamydia spp. (Including trachomatis and psittaci species), Toxoplasma gondii, pathogenic fungi, Leishmania spp., Actinomyces israelii, Histoides immitis. Biseptol does not act on Pseudomonas aeruginosa, Corynebacterium spp., Mycobacterium tuberculosis, Leptospira spp., Treponema spp., As well as viruses. As a mediated negative impact of this drug on the body, one can mention the inhibition of the vital activity of Escherichia coli, which leads to the suppression of the synthesis of B vitamins, but the same can be said about other antibacterial drugs with an identical spectrum of action.

Biseptol is available in the form of a suspension for oral administration and in tablets. The duration of its therapeutic effect is 7 hours. Dosage regimen and duration antibacterial therapy determined by the attending physician. Long-term (more than 1 month) intake of the drug determines mandatory monitoring of blood parameters, because a number of reversible hematological changes are possible

Pharmacology

Co-trimoxazole is a combined antimicrobial drug consisting of sulfamethoxazole and trimethoprim in a 5: 1 ratio.

Sulfamethoxazole, which is structurally similar to para-aminobenzoic acid (PABA), disrupts the synthesis of dihydrofolic acid in bacterial cells, preventing the incorporation of PABA into its molecule. Trimethoprim enhances the effect of sulfamethoxazole, disrupting the reduction of dihydrofolic acid to tetrahydrofolic acid, the active form of folic acid responsible for protein metabolism and microbial cell division.

Both components, therefore, disrupt the formation of folic acid, which is necessary for the synthesis of purine compounds by microorganisms, and then nucleic acids(RNA and DNA). This disrupts the formation of proteins and leads to the death of bacteria. In vitro is a bactericidal preparation wide range action, however sensitivity may vary by geographic location.

Typically sensitive pathogens (minimum inhibitory concentration (MIC) less than 80 mg / L for sulfamethoxazole): Moraxella (Branhamella) catarrhalis, Haemophilus influenzae (beta-lactamase-forming and beta-lactamase-forming strains), Haemophilus parainfluen coli, including Escherbacteriosis strains spp. (including Citrobacter freundii), Klebsiella spp. (including Klebsiella pneumoniae, Klebsiella oxytoca), Enterobacter cloaceae, Enterobacter aerogenes, Hafnia alvei, Serratia spp. (including Serratia marcescens, Serratia liquefaciens), Proteus mirabilis, Proteus vulgaris, Morganella morganii. Shigella spp. (including Shigella flexneri. Shigella sonnet). Yersinia spp. (including Yersinia enterocolitica), Vibrio cholerae, Edwardsiella tarda, Alcaligenes faecalis, Burkholderia (Pseudomonas) cepacia, Burkholderia (Pseudomonas) pseudomallei.

Also, Brucella spp .. Listeria monocytogenes, Nocardia asteroides, Pneumocystis carinii, Cyclospora cayetanensis can be sensitive.

Partially sensitive pathogens (IPC 80-160 mg / l for sulfamethoxazole): coagulase-negative strains of Staphylococcus spp. (including methicillin-sensitive and methicillin-resistant strains of Staphylococcus aureus). Streptococcus pneumoniae (penicillin-susceptible and penicillin-resistant strains), Haemophilus ducreyi, Providencia spp. (including Providencia rettgeri), Salmonella typhi. Salmonella enteritidis, Slenotrdphomonas maltophilia (formerly Xanthomonas maltophilia), Acinetobacter Iwoffii, Acinetobacter baumanii, Aeromonas hydrophila.

Resistant pathogens (MIC more than 160 mg / l for sulfamethoxazole): Mycoplasma spp., Mycobacterium tuberculosis, Treponema pallidum, Pseudomonas aeruginosa.

If the drug is prescribed empirically, it is necessary to consider local peculiarities drug resistance of possible causative agents of a specific infectious disease. For infections that can be caused by partially susceptible microorganisms, it is recommended to conduct a sensitivity test to exclude the resistance of the pathogen.

Pharmacokinetics

When taken orally, absorption is fast and almost complete - 90%. After a single dose of 160 mg trimethoprim + 800 mg sulfamethoxazole, the C max of trimethoprim is 1.5-3 μg / ml, and sulfamethoxazole is 40-80 μg / ml. C max in blood plasma is achieved after 1-4 hours; the therapeutic level of concentration is maintained for 7 hours after a single dose. With repeated administration with an interval of 12 hours, the minimum equilibrium concentrations are stabilized in the range of 1.3-2.8 μg / ml for trimethoprim and 32-63 μg / ml for sulfamethoxazole. C ss of the drug is achieved within 2-3 days.

It is well distributed in the body. Vd trimethoprim is about 130 liters, sulfamethoxazole - about 20 liters. Penetrates the blood-brain barrier, placental barrier and into breast milk. In the lungs and urine, it creates concentrations exceeding the content in plasma. Trimethoprim slightly better than sulfamethoxazole penetrates into non-inflamed tissue prostate, semen, vaginal secretions, - saliva, healthy and - inflamed lung tissue, bile, while both components of the drug penetrate into the cerebrospinal fluid and aqueous humor of the eye equally. Large amounts of trimethoprim and slightly smaller amounts of sulfamethoxazole enter the interstitial and other extravasal body fluids from the bloodstream, while the concentrations of trimethoprim and sulfamethoxazole exceed the MIC for most pathogenic microorganisms... Plasma protein binding - 66% for sulfamethoxazole, for trimethoprim - 45%. Metabolized in the liver. Some metabolites have antimicrobial activity. Sulfamethoxazole is metabolized primarily by N4-acetylation and, to a lesser extent, by conjugation with glucuronic acid. It is excreted by the kidneys in the form of metabolites (80% within 72 hours) and unchanged (20% sulfamethoxazole, 50% trimethoprim); a small amount - through the intestines. Both substances, as well as their metabolites, are excreted by the kidneys, as by glomerular filtration, and tubular secretion, as a result of which the concentration of both active substances in urine is much higher than in blood.

T 1/2 sulfamethoxazole - 9-11 hours, trimethoprim - 10-12 hours, in children - significantly less and depends on age: up to 1 year - 7-8 hours, 1-10 years - 5-6 hours.

In elderly patients and / or patients with impaired renal function (creatinine clearance (CC) 15-20 ml / min) T 1/2 increases, which requires dose adjustment.

Release form

Suspension for oral administration is white or light cream in color, with a strawberry smell.

Excipients: macrogol glyceryl hydroxystearate, magnesium aluminosilicate, sodium carmellose, citric acid monohydrate, methylhydroxybenzoate, propylhydroxybenzoate, sodium saccharinate, sodium hydrogen phosphate dodecahydrate, maltitol, strawberry flavor, propylene glycol, purified water.

80 ml - dark glass bottles (1) - cardboard packs.

Dosage

Inside, after ingestion of food with a sufficient amount of liquid.

Adults and children over 12 years old: 960 mg every 12 hours; in severe infections - 1440 mg every 12 hours; with infection urinary tract- 10-14 days, with exacerbation of chronic bronchitis - 14 days, with travelers' diarrhea and shigellosis - 5 days. The minimum dose and dose for long-term treatment (more than 14 days) is 480 mg every 12 hours.

Children: from 2 months (or 6 weeks at birth from mothers with HIV infection) to 5 months - 120 mg each, from 6 months to 5 years - 240 mg each, from 6 to 12 years old - 480 mg every 12 hours, which approximately corresponds to a dose of 36 mg / kg per day.

The course of treatment for urinary tract infections and acute otitis media - 10 days, shigellosis - 5 days. For severe infections, the dose for children can be increased by 50%.

At acute infections the minimum duration of treatment is 5 days; after the symptoms disappear, therapy is continued for 2 days. If, after 7 days of therapy, clinical improvement does not occur, the patient's condition should be re-evaluated for possible correction of treatment.

Chancre 960 mg every 12 hours; if after 7 days the healing of the skin element does not occur, the therapy can be extended for another 7 days. However, the lack of effect may indicate the resistance of the pathogen.

For women with acute uncomplicated urinary tract infections, a single dose of 1920-2880 mg is recommended, if possible in the evening after meals or before bedtime.

In pneumonia caused by Pneumocystis carinii - 30 mg / kg 4 times / day with an interval of 6 hours for 14-21 days.

For the prevention of pneumonia caused by Pneumocystis carinii, adults and children over 12 years old - 960 mg / day. For children under 12 years old - 450 mg / m 2 every 12 hours for 3 consecutive days every week. Total daily dose should not exceed 1920 mg. In this case, you can use the following instructions: for 0.26 m 2 of the body surface - 120 mg, respectively, for 0.53 m 2 - 240 mg, for 1.06 m 2 - 480 mg.

For other bacterial infections, the dose is selected individually depending on age, body weight, renal function and the severity of the disease, for example, with nocardiosis in adults - 2880-3840 mg / day for at least 3 months (sometimes up to 18 months). The course of treatment for acute brucellosis is 3-4 weeks, with typhoid and paratyphoid fever - 1-3 months.

Overdose

Symptoms: nausea, vomiting, intestinal colic, dizziness, headache, drowsiness, depression, fainting, confusion, fever, hematuria, crystalluria; with prolonged overdose - thrombocytopenia, leukopenia, megaloblastic anemia, jaundice.

Treatment: gastric lavage, forced diuresis, acidification of urine increases the excretion of trimethoprim, intramuscularly - 5-15 mg / day of calcium folinate (eliminates the effect of trimethoprim on the bone marrow), if necessary - hemodialysis.

Interaction

Increases the anticoagulant activity of indirect anticoagulants (dose adjustment of the anticoagulant), as well as the effect of hypoglycemic drugs and methotrexate (competes for protein binding and renal transport of methotrexate, increasing the concentration of free methotrexate).

Reduces the intensity of hepatic metabolism of phenytoin (lengthens its T 1/2 by 39%), increasing its effect and toxic effect.

With the simultaneous use of co-trimoxazole with pyrimethamine in doses exceeding 25 mg / week, the risk of developing megaloblastic anemia increases.

Diuretics (usually thiazides and in elderly patients) increase the risk of thrombocytopenia.

May increase serum digoxin concentrations, especially in elderly patients, monitoring of serum digoxin concentrations is necessary.

The effectiveness of tricyclic antidepressants in combination with co-trimoxazole may be reduced.

Patients receiving co-trimoxazole and cyclosporine after kidney transplantation may experience a reversible deterioration in renal function, manifested by an increase in creatinine levels.

Medicines that inhibit bone marrow hematopoiesis increase the risk of myelosuppression.

At joint application co-trimoxazole with indomethacin may increase the concentration of sulfamethoxazole in the blood.

One case of toxic delirium after simultaneous reception co-trimoxazole and amantadine.

When used simultaneously with ACE inhibitors, especially in elderly patients, hyperkalemia may develop.

Trimethoprim, inhibiting the transport system of the kidneys, increases the AUC of dofetilide by 103% and Cmax of dofetilide by 93%. With increasing concentration, dofetilide can cause ventricular arrhythmias with prolonged QT interval, including pirouette-type arrhythmias. The simultaneous administration of dofetilide and trimethoprim is contraindicated.

Side effects

From the nervous system: headache, dizziness, aseptic meningitis, peripheral neuritis, convulsions, ataxia, ringing in the ears, depression, hallucinations, apathy, nervousness.

From the respiratory system: pulmonary infiltrates: eosinophilic infiltrate, allergic alveolitis (cough, shortness of breath).

From the side digestive system: nausea, vomiting, loss of appetite, diarrhea, gastritis, abdominal pain, glossitis, stomatitis, cholestasis, increased activity of hepatic transaminases, hepatitis (including cholestatic), hepatonecrosis, vanishing bile duct syndrome (ductopenia), hyperbilirubinemia , pseudomembranous colitis, acute pancreatitis.

From the side of hematopoiesis: leukopenia, neutropenia, thrombocytopenia, hypoprothrombinemia, agranulocytosis, anemia (megaloblastic, hemolytic / autoimmune or aplastic), methemoglobinemia, eosinophilia.

From the urinary system: interstitial nephritis, impaired renal function, hematuria, increased blood urea, hypercreatininemia, toxic nephropathy with liguria and anuria, crystalluria.

From the musculoskeletal system: arthralgia, myalgia, rhabdomyolysis (mainly in AIDS patients).

Allergic reactions: fever, angioedema, itching, photosensitivity, skin rash, urticaria, exudative erythema multiforme (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome), exfoliative dermatitis, allergic myocarditis, hyperektiva , sclera, anaphylactic / anaphylactoid reactions, serum sickness, hemorrhagic vasculitis (Schönlein-Henoch purpura), periarteritis nodosa, lupus-like syndrome.

Others: hyperkalemia (mainly in AIDS patients in the treatment of pneumocystis pneumonia), hyponatremia, hypoglycemia, weakness, fatigue, insomnia, candidiasis.

Indications

Infectious and inflammatory diseases caused by microorganisms sensitive to the drug:

respiratory tract infections: chronic bronchitis (exacerbation), pneumocystis pneumonia (treatment and prevention) in adults and children;
ENT infections: otitis media(in children);
urinary tract infections: urinary tract infections, chancre;
gastrointestinal infections: typhoid fever, paratyphoid fever, shigellosis (caused by susceptible strains Shigella flexneri and Shigella sonnei);
travelers' diarrhea due to enterotoxic strains of Escherichia coli, cholera (in addition to fluid and electrolyte replacement);
other bacterial infections(a combination with antibiotics is possible): nocardiosis, brucellosis (acute), actinomycosis, osteomyelitis (acute and chronic), South American blastomycosis, toxoplasmosis (as part of complex therapy).

Contraindications

hepatic and / or renal failure (creatinine clearance less than 15 ml / min);
aplastic anemia, B 12 -deficient anemia, agranulocytosis, leukopenia;
deficiency of glucose-6-phosphate dehydrogenase;
simultaneous reception with dofetilide;
lactation period;
children's age up to 2 months or up to 6 weeks at birth from a mother with HIV infection;
hypersensitivity to sulfonamides, trimethoprim and / or to other components of the drug.

With caution: impaired function thyroid gland, heavy allergic reactions history, bronchial asthma, folic acid deficiency, porphyria, pregnancy.

Application features

Application during pregnancy and lactation

During pregnancy, the drug should be prescribed only if the expected benefit from its use exceeds possible risk for the fetus, since both trimethoprim and sulfamethoxazole cross the placental barrier and, thus, can affect the metabolism of folic acid.

In late pregnancy, the use of the drug should be avoided due to possible risk development of nuclear jaundice in newborns.

Due to the fact that trimethoprim and sulfamethoxazole penetrate into breast milk, the use of co-trimaxozole during lactation is contraindicated.

Pregnant women receiving the drug are advised to prescribe 5 mg of folic acid per day.

Application for violations of liver function

Contraindicated:

liver failure.

Application for impaired renal function

Contraindicated:

renal failure (creatinine clearance less than 15 ml / min).

Application in children

Contraindicated:

children up to 2 months of age or up to 6 weeks at birth from a mother with HIV infection.

special instructions

Co-trimoxazole should be prescribed only in cases where the advantage of such combination therapy over other antibacterial monopreparations outweighs the potential risk.

Since the sensitivity of bacteria to antibacterial drugs in vitro varies in different geographic areas and over time, local characteristics of bacterial sensitivity should be taken into account when choosing a drug.

With long courses of treatment, regular blood tests are necessary, since there is a possibility of hematological changes (most often asymptomatic). These changes can be reversible with the appointment of folic acid (3-6 mg / day), which does not significantly violate the antimicrobial activity of the drug.

Particular caution should be exercised when treating elderly patients or patients with suspected baseline folate deficiency.

Folic acid administration is also advisable for long-term treatment in high doses.

With a significant decrease in the number of any blood cells, the drug should be canceled.

It is also inappropriate to use during treatment foodstuffs containing large amounts of PABA - green parts of plants ( cauliflower, spinach, legumes), carrots, tomatoes.

With long courses (especially with renal failure), it is necessary to regularly carry out general analysis urine and monitor kidney function.

The likelihood of toxic and allergic complications of sulfonamides increases significantly with a decrease in the filtration function of the kidneys. At the first appearance of a skin rash or any other severe adverse reaction, the drug should be discontinued.

In case of a sudden appearance or increase in cough or shortness of breath, the patient should be re-examined and the question of stopping the drug treatment should be considered.

Excessive sun and ultraviolet radiation should be avoided.

The risk of side effects is significantly higher in AIDS patients.

Cases of pancytopenia have been described in patients taking co-trimoxazole.

Trimethoprim has a low affinity for human dehydrofolate reductase, but can increase the toxicity of methotrexate, especially in the presence of other risk factors such as old age, hypoalbuminemia, renal impairment, depression bone marrow... Similar adverse reactions more likely if methotrexate is given in high doses. For the prevention of myelosuppression, it is recommended to prescribe to such patients folic acid or calcium folinate.

Trimethoprim interferes with phenylalanine metabolism, but this does not affect patients with phenylketonuria, provided that an appropriate diet is followed.

Patients whose metabolism is characterized by "slow acetylation", more

The duration of treatment should be as short as possible, especially in elderly and senile patients.

Co-trimoxazole and, in particular, its constituent trimethoprim can affect the results of determining the concentration of methotrexate in serum, carried out by the method of competitive binding to proteins using bacterial dihydrofolate reductase as a ligand. However, when determining methotrexate by radioimmunoassay, interference does not occur.

Trimethoprim and sulfamethoxazole can affect the results of the Jaffe reaction (determination of creatinine by reaction with picric acid in an alkaline medium), while in the range normal values the results are overestimated by about 10%.

Influence on the ability to drive vehicles and use mechanisms

Given the possibility of significant side effects, during the period of treatment, care must be taken when driving vehicles and engaging in potentially hazardous activities that require increased concentration of attention and speed of psychomotor reactions.

If the microbial infection is mild, therapy can be used instead of antibiotic treatment sulfa drugs... One of popular remedies this group is Biseptol in tablet form.

Biseptol - what kind of medicine?

Biseptol is an agent of the sulfonamide group with a complex composition. In 480 mg tablets, there are 80 mg of trimethoprim (an antibiotic that works only by the bacteriostatic mechanism of action of ka sulfanilamide) and 400 mg of sulfamethoxazole (sulfanilamide). The drug is also available with a dosage of 120, 240 mg.

This pharmacological combination has another name - co-trimoxazole.

Also tablets include additional substances - magnesium stearate, starch, talc, propylene glycol. The drug is very inexpensive - 100 rubles / 28 tablets. There are other dosage forms on sale. This is a suspension (syrup) for children from 3 months, a solution for infusion (used from birth, in a premature baby - from 2 months).

This medicine belongs to combined antibacterial agents, it can be taken with a whole range of microbial pathologies. Sulfamethoxazole interferes with the formation of acids essential for bacteria, which are part of bacterial cells. Trimethoprim is an "enhancer" of the action of sulfamethoxazole, preventing acid molecules from being reduced. As a result, protein metabolism in microbial cells is disrupted, their division stops. In the form of tablets, Biseptol helps against diseases that are caused by:

The medicine works great against protozoa - plasmodia, toxoplasma, against a number of pathogenic fungi. Treponema, corynebacter, leptospira and all viruses do not respond to therapy with this drug, as do mycobacterium tuberculosis.

Indications of the drug

The drug helps against most microbial diseases caused by bacteria sensitive to it. For adults and children, the drug is most often prescribed for ENT diseases, respiratory tract damage. Biseptol is recommended for coughs, sore throats, otitis media, sinusitis. It is also prescribed for pneumonia, tracheitis and bronchitis, in complex therapy - for lung abscess, empyema. The medicine is indicated for chronic form bronchitis and even severe Pneumocystis pneumonia in immunocompromised people.

Biseptol is also prescribed for scarlet fever in children.

Infections of the urinary system, genital area are also successfully treated with this tool. These include:

If diseases of the peritoneal organs are also caused by microbes, Biseptol is prescribed for their acute and chronic course to relieve inflammation. Among them are typhoid, paratyphoid, cholera, unclear genesis diarrhea. With the help of Biseptol, they treat dysentery, salmonellosis (in the form of carriage), gastroenteritis and cholecystitis. Prescribe a medicine for soft tissue damage, skin with pyoderma, boils, purulent rash, wounds, abscesses. The tablets are taken after operations, in complex therapy for malaria and whooping cough.

Contraindications and side effects

The drug is contraindicated in pregnancy, especially in the early stages, during lactation. In pill form, it is not prescribed for children under 3 years of age. Other contraindications:

In patients with a lack of vitamin B9 in the body, while taking it, there is a high risk of developing serious anemia. With caution, therapy is carried out for pathologies of the thyroid gland, with asthma.

The drug inhibits growth colibacillus in the intestine, which disrupts the production of B vitamins.

More often Biseptol is well tolerated, but side effects are still possible. Headaches, neuritis, dizziness may develop, sometimes they are noted depressive states, tremor. Some patients develop respiratory disorders, bronchospasm. There is also a risk of developing:

In the most severe and rare cases, hepatitis, pulmonary infiltrates, pancreatitis, anemia and blood disorders, nephritis are possible.

Exact instruction

Drink Biseptol after meals (in order to avoid damage to the gastrointestinal tract), washed down with plenty of water. The dose is set strictly individually, especially for children from 3 years old. At 3-5 years old, it is recommended to take 240 mg twice a day, from 6 to 12 years old, they give 480 mg twice. How much and with what frequency to drink the medicine, the doctor decides and depending on the type of disease:

The course for infections of the bronchi, respiratory system can be 2 weeks, as with others serious illnesses... In milder cases, the course lasts 5-10 days. If required, under the supervision of a physician, the dose is increased by 30-50%, but only for the first 5-7 days. If the course is more than 5 days, it is imperative to take blood tests to prevent the consequences (anemia and others). If there are any changes in therapy, folic acid is administered at 5-10 mg / day.

Analogs, what else should you know?

There are a number of analogues from the group of sulfonamides, but it is strictly forbidden to replace drugs on your own - they can have different effects.

Various infectious and inflammatory diseases of organs cause significant discomfort to patients. They demand special attention due to the fact that the acute phase lasts for a very short time, and with insufficient or incorrect treatment, they quickly turn into a chronic one with blurred signs and implicit symptoms.

In contact with

Subsequently, complications arise, an adhesive process develops with a further deterioration in body functions. To avoid such situations, the modern domestic and foreign pharmaceutical industry offers a significant range of effective anti-inflammatory drugs.

The honorary place of the leader has been successfully occupied and retained for many years by the drug Biseptol 480 tablets.

Instructions for use, tablets and suspensions for use in the field of pediatrics allow us to talk about its broadest possibilities.

In domestic pharmacies, it can be purchased without a doctor's prescription, but it is still recommended to consult a specialist beforehand. Each pack contains 14 tablets. Manufacturer - Pabianitsky Pharmacological Plant, company Polfa A.T. Poland.

Biseptol antibiotic or not quite

Biseptol has excellent therapeutic effect, however, not everyone knows what it is based on. Most patients who are first recommended this anti-inflammatory drug are interested in the problem: Is Biseptol an antibiotic or just an anti-inflammatory drug? There is no definite answer to this question. The situation becomes diverse due to the fact that biseptol is characterized by a bright clinical orientation of an antibacterial nature. Nevertheless, Biseptol cannot be called a pure antibiotic, since it has a pronounced parallel cytostatic effect.

Impact medication is not based on the total destruction of pathological bacteria and microorganisms. Specificity of the drug action in the fact that further reproduction of colonies of pathogenic microflora becomes impossible. This pharmacological effect has both positive factors and negative aspects:

Clinicians consider the main advantage to be a mild therapeutic effect on the inflammation focus, in which segment or organ it would not be. How active is biseptol, what does it help, and how toxic is it? First of all, this is the treatment of all, without exception. infectious pathologies... A loyal effect on the human body eliminates the toxic effects of a shock nature and significant therapeutic loads inherent in antibacterial treatment.
The negative side of the use of Biseptol 480 is its use for long courses for the purpose of total sanitation of organs and systems, foci of the disease in order to avoid possible relapses.

Important! Based on the analysis of all positive and negative factors, as well as the characteristics of the disease, the doctor makes a decision on the appointment of the drug Biseptol in tablets with a certain dosage.

About analogues and composition

In essence, Biseptol 480 belongs to the group of sulfonamides, it is a combined antimicrobial drug consisting of sulfamethoxazole and trimethoprim.

The peculiarity of sulfamethoxazole, which is similar in form to PABA, is that the synthesis of dihydrofolic acid in the cells of pathological microorganisms is disrupted, actively preventing the incorporation of PABA into the molecule.

Trimethoprim is assigned the role of catalyst and enhancer of the main drug. Pharmacodynamics determines the composition and effect of sulfamethoxazole, as a violation of the reduction of DHF acid in THF, the active form of folic acid, which is responsible for protein metabolism, division and reproduction of microbial cells. The most susceptible to the drug are hemolytic strains of microorganisms sensitive to penicillin.

Long-term research and fruitful work of specialists in various branches of pharmacology make it possible to produce not only Biseptol, but also analogues that differ in a different spectrum of therapeutic effects. The main analogue of Biseptol is Sulfadimethoxin - a permanent inhabitant of almost every home pharmacy. More modern means is a group of medicines consisting of Bactrim, Berlocid 240, Berlocid 480, Groseptol, Duo-Septol, a segment of medicines Co-trimoxazole, Metosulfabol, Oriprim, and other drugs.

Side effects, their effect on the body

Biseptol, like any other potent drug, has side effects. They are few in number, but they still occur when patients apply. These include the following disorders:

Central nervous system: manifestation of dizziness, headaches, symptoms of apathy, depression, peripheral inflammation of the main nerves, signs of aseptic meningitis;
Respiratory system: the appearance of coughing, choking, bronchial spasms, the appearance of pulmonary infiltrates;
In the digestive system, symptoms of nausea, vomiting, diarrhea, gastritis, stomatitis, glossitis, cholestasis, hepatitis, pancreatitis, pseudomembranous enterocolitis may occur;
Urinary excretion is impaired in the form of polyuria, hematuria, crystalluria, toxic nephropathy, accompanied by oligo- or anuria.

When taking the pills, disturbances in the blood picture, the occurrence of allergic reactions, urticaria, angioedema are possible.

Dosages and features of admission to adults

What does the medicine help for? Clinicians consider Biseptol 480 a truly unique and versatile drug, which is equally active in diseases in adults and children.

For Biseptol tablets, the dosage and amount for the course administration are accurately and with all the details described in the leaflet - instructions attached to each package.

First of all, the medicine is used for the treatment of various inflammatory processes, among which:

Diseases genitourinary system, various forms of cystitis, urethritis, pyelonephritis, pyelitis, prostatitis, gonorrhea in men and women, lymphogranuloma venereum.
Respiratory system infections - acute and chronic bronchitis, bronchopneumonia, bronchiectasis, lobar pneumonia... The use of Biseptol 480 is effective for angina, laryngitis, sinusitis, otitis media.
Treating infections of the digestive system. The remedy is prescribed for cholera, dysentery, typhoid fever, with the elimination of the carriage of salmonellosis.

A lasting effect can be obtained with furunculosis, acne, pyoderma, and other diseases that are caused by bacteria sensitive to the drug.

How to take for adults Biseptol? This is a separate issue. Usually, the dosage is calculated on an individual basis. According to the instructions for the standard scheme, reception is carried out as follows:

1 tablet 2 times a day, interval 12 hours in acute forms of respiratory diseases;
2 tablets, 2 doses per day for cutaneous forms of infection;
Reception of 2 tablets 3 times a day, the course is 10 days.

If there is no dosage for your disease in the instructions, then you should check it with your doctor.

In this case, there are certain features of the appointment of tablets. For example, Biseptol during pregnancy and its analogues during the period of feeding the child are almost never prescribed by doctors. This is due to the fact that the constituent elements of the drug can have a negative effect on the intrauterine development of the fetus, and get into breast milk. At urgent need the use of Biseptol in medical practice, the doctor recommends that the mother make a decision to refuse breastfeeding.

Important! Particular care should be taken if the patient has a history of such chronic pathologies as bronchial asthma, thyroid disorders and neoplasms of a different nature. In clinical practice, it is noted high level the tolerance of the drug, but possible individual reactions should not be rejected.

How to take Biseptol tablets with contraindications

The drug Biseptol is distinguished by significant loyalty, but according to the recommendations that are present in the instructions, you shouldn't be treated with it in the following cases:

With megaloblastic anemia in the presence of folic acid deficiency, with aplastic anemia, B12-deficiency anemia, agranulocytosis, leukopenia;
With a deficiency of glucose compounds with 6-phosphate dehydrogenase;
In case of childhood hyperbilirubinemia;
Presence of hepatic or renal failure, where creatinine clearance is more than 15 ml / min.

Babies under the age of six are not prescribed 480 mg tablets.

How to take Biseptol tablets with increased susceptibility? Doctors recommend reducing the dose by half, or even three times.

The highlight is categorical prohibition of appointment Biseptol for premature babies, newborns and infants up to two months of age.

Caution requires the use of the drug if the patient suffers from a deficiency of folic acid, impaired liver and kidney function.

Characteristics of biseptol and its active substance

In pediatrics experts recommend the appointment of Biseptol as a powder - crushed tablets and suspensions, which contributes to better absorption of the drug. Biseptol and its active ingredient are quite active in children's organisms. Dosage by age group next:

From three to five years, 240 mg is prescribed twice a day;
From six to twelve years old, the standard dose is 480 mg twice daily.

Biseptol instruction

Output

The safest form for babies is a suspension, separately produced for the smallest patients. It is easy and accessible for parents to calculate the dosage themselves, based on the attached instructions. The form is excellently tolerated, does not cause nausea, vomiting, dizziness.

Biseptol ® is a fully synthesized combined remedy, which has antimicrobial action and contains in its composition. The latter belongs to the group of sulfonamides.

Their use in medical practice for several decades has provoked the emergence of many strains resistant to these drugs. Combined drugs, of which Biseptol is a representative, were called upon to overcome this resistance.

Sulfonamides are able to integrate into the structure of the pathogen, thereby disrupting metabolic processes and affecting the reproduction and growth of microorganisms.

Biseptol ® is one of the most commonly prescribed drugs with infectious lesions of the genitourinary system.

It is used as a prophylaxis against Pneumocystis pneumonia, which is often diagnosed in patients with acquired immune deficiency syndrome (AIDS). Biseptol is indicated for diseases of bacterial etiology, the causative agents of which are:

streptococci (ovoid asporogenic gram + bacteria);
staphylococci (motionless gram + cocci);
meningococcus (gram-diplococci that cause meningococcal infection);

gonococcus (gram aerobic bacteria that causes gonorrhea);
Escherichia coli (a gram-rod-shaped bacterium common in the lower intestine);
salmonella (a non-spore-bearing bacterium in the form of rods);
cholera vibrio (gram is a mobile bacterium of the genus vibrios);
anthrax bacillus (anthrax causative agent);
Pfeiffer's wand (immobile gram-bacteria);
listeria (gram + rod-shaped bacteria);
nocardia (gram + immobile aerobic bacteria);
pertussis bacillus (small immobile non-spore-forming gram-coccobacilli affecting the epithelium of the bronchi);
fecal enterococcus (opportunistic pathogen);
as well as Klebsiella, Pasteurella multicide, Proteus, Francisela, Brucella, Mycobacterium, Citrobacter, Enterobacter, Legionella pneumophila, Providence, Serratia Marcescens, Shigella, Yersinia, Morganella, Pneumocystis, Chlamydia, Toxophilus psoriasis, Chlamydia, Toxoplusitis, Chlamydia

The antimicrobial effect does not apply to corynebacteria, Pseudomonas aeruginosa, Koch's bacillus, treponema pallidum, leptospira and viruses.

Pharmacological group

Pharmacological group of the drug - combined sulfa antibiotics.

Recipe for Biseptol ® in Latin

Rp .: Biseotoli 0.48
D.t.d. No. 20.
S. 1 tablet four times a day.

Biseptol ® instructions for use of tablets for adults

Biseptol is taken orally or practiced intravenous injection... Drugs are taken after meals and washed down with plenty of water. Infections occurring in acute form, are treated for at least five days.

Disease	Dosage	Duration of treatment
Gonorrhea	Ten tables. 480 milligrams each	One day. The tablets are taken in the morning and evening hours.
Acute uncomplicated urinary tract infections	Four tables. 480 milligrams each	Three days. Preferably taken at night
Pneumocystis pneumonia (most often diagnosed in debilitated neurons)	Sulfamethoxazole up to 0.1 g / kg body weight and trimethoprim up to 0.02 g / kg	Every six hours. Course duration - two weeks
Severe infection	480 milligrams three times a day	—
Chronic form	480 milligrams twice a day	—

Annotation to Biseptol ®

The bactericidal effect is based on the ability of the active active ingredient to block the synthesis of folate in the cells of foreign agents. Sulfamethoxazole affects the production of dihydrofolic acid, and trimethoprim prevents dihydrofolic acid from converting to tetrahydrofolic. The latter is the active form of folic acid and is responsible for protein metabolism and microbial cell division.

When taken orally, sulfamethoxazole and trimethoprim are completely absorbed from the gastrointestinal tract. Maximum concentration components are noted after 60-240 minutes. Trimethoprim penetrates well into cells and tissue barriers - into the lungs, bile, saliva, phlegm, seminal and cerebrospinal fluid, the secret of the vagina.

Plasma protein binding for trimethoprim is 50 percent, for sulfamethoxazole 66 percent. Biological T1 / 2 for the first substance takes from 9 to 16 hours, for the second - about 10 hours. Elderly patients and those with abnormalities in renal function increase the elimination half-life, therefore, in in this case dosage adjustment is indispensable.

Sulfamethoxazole and trimethoprim cross the placental barrier. Both substances are found in breast milk. The drug is eliminated by the kidneys.

Photo of the packaging of Biseptol® in tablets of 120 mg

With prolonged (more than 30 days) courses of treatment, it is necessary to regularly monitor blood counts, since the likelihood of hematological changes is high. The latter are reversible in the appointment of vitamin B9 (Folic acid). Biseptol is prescribed with caution to persons suffering from folate deficiency. Folic acid is also indicated for long-term treatment and at high dosages.

To prevent crystalluria, it is necessary to maintain a sufficient amount of excreted urine. In case of impaired renal filtration, the risk of toxic reactions increases.

During therapy, you should not eat foods that contain para-aminobenzoic acid (legumes, spinach, tomatoes). Ultraviolet radiation should be avoided during therapy.

As for the interaction with other drugs, Biseptol inhibits the intestinal microflora, which reduces the effectiveness of oral contraception... Derivatives of salicylic acid (acetylsalicylic acid, methyl salicylate, analgin, sodium salicylate) enhance the action. The combination with diuretics is dangerous because the risk of thrombocytopenia increases. Biseptol, taken together with barbiturates, increases the manifestations of vitamin B9 deficiency.

Dosage of Biseptol ® for parenteral administration

Intravenous injections are given every twelve hours (maximum 1920 milligrams). For maximum effect, a constant serum concentration of trimethoprim should be maintained at 5 micrograms.

In malaria, the causative agent of which is the plasmodium falciparum, intravenous injections are given for two days (1920 milligrams twice a day). With renal failure, half the standard dose is prescribed for three days and then only half of the standard dose.

Biseptol 480 is intended exclusively for intravenous administration. The duration of the administration is 60-90 minutes. At severe course diseases, the dosage is doubled.

Biseptol ® indications for use

Biseptol relieves infections that are localized:

in the respiratory tract: acute and chronic, bronchiectasis, pneumocystosis, pleural empyema;
in the gastrointestinal tract: typhoid fever, shigellosis, angiocholitis;
in ENT organs: , ;
in the urinary system: donovanosis, inguinal lymphogranulomatosis, chancroid,;
on skin: acne;
in the musculoskeletal system: last-line drug for osteomyelitis.

The chemotherapeutic agent demonstrates high rates of effectiveness in the treatment of acute brucellosis, nocardiosis, septicemia and Gilchrist's blastomycosis.

What are the contraindications for Biseptol?

Biseptol is not prescribed in the following cases:

hypersensitivity to sulfonamides and other auxiliary components in the composition;
violation of one or more functions of the liver and kidneys;
a decrease in the level of leukocytes;
decreased platelet count;
a decrease in the number of leukocytes;
pernicious anemia;
pregnancy;
breast-feeding;
aplastic anemia;
insufficiency of G-6-FDG;
pneumocystosis;
the suspension is contraindicated in children under three months old;
intramuscular administration is not performed in patients under six years of age;
hyperbilirubinemia in childhood.

The drug should be taken with caution in old age, with vitamin B9 deficiency, bronchial asthma, seasonal allergic rhinoconjunctivitis, atopic eczema and thyroid pathologies. Biseptol is able to increase symptoms in patients with porphyrin disease. The use of an antibacterial chemotherapy drug is contraindicated in severe heart failure, impaired hematopoiesis and increased bilirubin concentration.

Side effects from taking Biseptol ®

Subject to the dosage prescribed in the official instructions, the drug is well tolerated by the body. When taking Biseptol, most often occur skin rashes and disorders of the digestive tract. In patients with hypersensitivity to the components of the drug, allergic reactions appear: heat, Quincke's edema and pulmonary eosinophilia, which is manifested by shortness of breath.

Patients may experience the following side effects during treatment with Biseptol:

skin reactions, which often disappear after drug withdrawal: increased sensitivity of the body to ultraviolet light, polymorphic, malignant exudative erythema, acute or toxic epidermal necrolysis, hemorrhagic vasculitis;
gastrointestinal tract: hepatitis, stool disorders (diarrhea), cholestatic syndrome, glossitis, increased levels of liver enzymes, in patients with severe chronic and immune diseases, acute pancreatitis is often diagnosed;
change in blood count: a decrease in the level of leukocytes in general cellular composition blood count, a decrease in the number of neutrophils, a lowered platelet count, neutropenia, folic acid deficiency, aplastic anemia, an increase in the concentration of methemoglobin, Werlhof's disease;
urinary tract: tubulointerstitial nephritis, elevated level creatinine, salt diathesis,
central nervous system: meningeal syndrome, impaired coordination of movements, hallucinatory conditions;
musculoskeletal system: muscle and joint pain;
metabolism: Biseptol should be taken with caution in potassium metabolism disorders.

In patients not suffering from diabetes mellitus, in the first days of therapy, there is a decrease in the concentration of glucose in the blood. Hypoglycemia also occurs in people with kidney and liver disease. The cause of this pathological condition may be inadequate nutrition.

The frequency of adverse drug reactions is significantly higher in patients with acquired immune deficiency syndrome. Severe and serious side effects (up to death) most often occur in old age and in patients with concomitant pathologies.
Biseptol® during pregnancy

As a result of clinical studies, it was revealed that the active components of this chemotherapeutic drug are able to overcome the placental barrier, therefore, treatment with Biseptol is inappropriate during pregnancy. If a woman takes drugs during lactation, then she should stop breastfeeding.

Treatment with this drug refers to teratogenic factors, since Biseptol® negatively affects embryonic development and can provoke a miscarriage or premature birth... Komarovsky E.O. believes that Biseptol ® should never be taken in the first trimester (3-10 weeks) of pregnancy.

It is considered safer for pregnant women the following drugs:

(azalide, which slows down the growth and reproduction of bacteria);
(semi-synthetic broad-spectrum antibiotic, related to);
(bactericidal, antibacterial agent broad spectrum inhibiting transpeptidase);
(sbeta-lactam antibiotics that inhibit the synthesis of the peptidoglycan layer);
(binding to the 50S-subunit of ribosomes);
uroseptics (create a sufficient concentration of active substances in the urine and tissues of the genitourinary system).

It should be borne in mind that azithromycin and erythromycin can only be taken in the second trimester.

Biseptol® suspension for children: instructions for use and other dosage forms

In the UK, Biseptol is prescribed only from the age of twelve.

Photo of the packaging of Biseptol ® in the form of a suspension

In Russia and the CIS countries, the drug is widely used in pediatric practice, pediatricians prescribe it even to young children. The basic rule of Biseptol therapy is strict adherence to the dosage.

Treatment takes about four days on average. Chronic diseases require a longer course of treatment. While taking Biseptol, the child's body must receive a sufficient amount of fluid. It is also necessary to adjust the diet: to give up the use of flour products, sweets, chocolate and some vegetables (cabbage, carrots, tomatoes).

Disease	Dosage	Duration of treatment
Prevention of recurrence of urinary tract infections (up to 12 years)	12 milligrams	Three months to a year
Brucellosis	—	About one month
Typhoid fever	—	Up to three months
Cystitis	480 milligrams twice a day	Three days
Gonococcal pharyngitis	4320 milligrams	Five days
Pneumocystis pneumonia	120 mg / kg / day The interval is six hours.	Two weeks

Pregnancy

Biseptol® is not used to treat pregnant or breastfeeding women. If it is necessary to prescribe Biseptol® during breastfeeding, breastfeeding is temporarily stopped during antibiotic therapy.

Alcohol and Biseptol®

Sulfamethoxazole + Trimethoprim is categorically incompatible with alcohol. For the period of treatment with Biseptol, it is necessary to stop drinking alcohol.

Alcohol intake against the background of antibiotic therapy with Biseptol increases the risk of side effects from taking sulfomethoxazole with trimethoprim, and also increases the load on the liver and aggravates the manifestations of dysbiosis.

Is Biseptol antibiotics or not? The medicine does not belong to a number of antibiotics. Antimicrobial properties are assigned to it. The complex medication Biseptol based on sulfamethoxazole and trimethoprim fights streptococci, pneumococci, salmonella, gonococci, chlamydia, and some groups of fungi. The description for the medication notes that the drug has no effect on viruses, Pseudomonas aeruginosa and the causative agent of tuberculosis.

The drug stops the production of folic acid, which is so necessary for the development and reproduction of microbes. The incoming components interact well with each other and enhance the action of each other.

The drug Biseptol is relatively quickly and almost completely absorbed from the digestive tract, and begins to act within a couple of hours after administration. The maximum effect in the body lasts for 6 hours. The rest of the medicine is excreted by the kidneys along with the urine.

To understand whether Biseptol is an antibiotic, you need to understand its effect on the body. The drug belongs to the synthetically derived group antimicrobial agents... Synthetics are not considered antibiotics. Biseptol manifests its effect in the blood and purulent foci. They carry out treatment courses infectious diseases when antibacterial medications are undesirable or contraindicated.

Biseptol has a varied and convenient release form for the individual case of treating the disease. It is produced in the form of tablets, suspension and solution for injection. You can choose a convenient dosage, which is prescribed by your doctor.

Reviews of the drug from users are mostly positive. It is noted that an improvement in the condition occurs after taking one dose. There are no problems with the treatment of children. Has a sweet taste and pleasant smell. Many patients note that "I drank Biseptol for chronic bronchitis and after a week the symptoms disappeared, and after two weeks I forgot about the disease." Negative reviews are associated with the development of side effects. The most common symptoms are nausea and vomiting.

Help Cases

When to take Biseptol and what does it help? Common indications for the use of Biseptol include:

pathological processes occurring in the bronchi and lungs, for example, bronchitis, pneumonia, lung abscess;
inflammatory diseases of the ENT organs, for example, sinusitis, otitis media, sinusitis;
Biseptol 480 quickly relieves intestinal infections (copes with dysentery, salmonellosis, cholera);
pathological processes occurring in the organs of the urinary and reproductive system, for example, pyelonephritis, cystitis, prostatitis;

helps with gonorrhea;
purulent lesions of the skin, for example, furunculosis;
inflammatory processes in the structures of the brain;
used for toxoplasmosis, malaria, scarlet fever.

Contraindications for Biseptol include serious illness heart and blood vessels, diseases of the hematopoietic organs, hepatic and renal failure. Do not give to children under three months old, those who were born prematurely.

Biseptol during pregnancy and breastfeeding should not be drunk. As a result, there may be problems intrauterine development, premature birth and even unauthorized termination of pregnancy.

In Biseptol 480, in the instructions for use, the item on side effects that adversely affect the state of the body notes the following points:

while taking it, nausea and even vomiting, loose stools, poor appetite, pain in different parts abdomen, hepatitis, pancreatitis;
pain in the head, dizziness, apathy, irritability appear;
sometimes there are attacks of choking, coughing, shortness of breath;
a rash can be seen on the skin;
blood levels of sodium, potassium and sugar may decrease;
pain in muscles and joints.

Treatment should be carried out under the supervision of a specialist and blood counts should be constantly checked. Side effects most often disappear at the end of the course. The reason to stop treatment is skin rash and diarrhea.

Overdose symptoms are nausea, turning into vomiting, pain in the abdomen, head, dizziness, lack of appetite, loss of consciousness. In this case, they urgently stop taking the drug, do the gastric lavage.

Important rules

How to take Biseptol to get maximum performance and avoid unpleasant reactions? Instructions for the use of Biseptol indicate that it is recommended to take the medicine after, with a glass of boiled water. Do not drink Biseptol tablets with milk, as the product reduces its effectiveness. You need to drink at least 2 liters of water per day. This will avoid the appearance of side effects.

Annotation for the use of the medication indicates the mandatory adherence to the diet. Protein food slows down the absorption of the drug and reduces its effectiveness. You can not use easily digestible foods (baked goods, vegetables, dried fruits) before taking the medicine. Active ingredients do not have time to be absorbed into the bloodstream and, together with feces, go outside.

Biseptol and alcohol are two incompatible things. Drinking alcohol increases the risk of developing allergic manifestations and reduces the effectiveness of treatment. The risk of poisoning increases, against the background of which hepatitis is detected.

Biseptol should be taken with extreme caution in patients with bronchial asthma and other severe forms of allergies (hay fever, atopic dermatitis). Under strict control, a medication is prescribed for patients with thyroid diseases. It is not recommended to take it concurrently with some drugs, so the doctor needs to be warned about them.

Taking diuretics increases the risk of bleeding and changes in blood composition.

If Biseptol 480 mg has to be drunk for a long time or there are changes in the blood, folic acid is prescribed in parallel at 5-10 mg per day.

Dosing of the drug

How to drink Biseptol to get a positive result and not harm your health? The dosage for patients over 12 years old is equal to one tablet of 960 mg (or two mg). It must be taken in the morning and in the evening. Depending on the course of the disease, treatment can last from one to two weeks. For adults, the dosage may be reduced to 480 mg. The suspension is prescribed in 20 ml. It is necessary to drink the medicine at an interval of 12 hours.

The children's version is presented with a suspension and sweet syrup. Instructions for use for children assumes strict adherence to the prescribed doses. school age prescribed in a dosage of 480 mg or 5 ml of syrup twice a day. preschool age prescribed in a dosage of 240 mg or 2.5 ml.

Biseptol contains trimethoprim and sulfamethoxazole. Instructions for using the Biseptol suspension suggest giving the composition to babies with diseases from three months. Up to six months of age, the dosage is 2.5 ml. In the future, the dosage can be increased to 5 ml. Biseptol suspension for children from 4 to 6 years old can be given in 5 - 10 ml. The medicine is given to the child after breakfast and dinner.

The instruction for the Biseptol suspension for children says that the duration of treatment is 10-14 days. The child swallows the medicine without problems, since it has pleasant taste... The set includes a convenient measuring spoon.

After a year, it is allowed to treat Biseptol syrup. Up to two years, 120 mg of the drug is given twice a day, from 2 to 6 years, the dosage is increased to 180 - 240 mg. Syrup for children from 6 years old is prescribed 240 - 480 mg of syrup.

The use of 240 mg tablets is allowed only after two years. Injections are allowed after 6 years.

The duration of treatment for children is five days and two more days after recovery. It is impossible to independently increase or decrease the prescribed doses, especially in the case of treating patients in childhood.

Knowing all the features of the use of the drug Biseptol 480, you can avoid the development of undesirable reactions, achieve a speedy recovery. You can not use the medicine on your own, without examination and doctor's recommendations.