Acid is rapidly absorbed from the gastro-intestinal tract is partially metabolized in the liver and rapidly excreted through the kidneys. Bioavailability is 96%. Unmodified nalidixic acid appears in the urine together with its active metabolite gidroksinalidiksovoy acid which has antibacterial activity similar to the parent compound.
Testosterone cypionate reviews acid cross the placenta, and small amounts of it appear in human milk.
Known hypersensitivity to nalidixic acid or other components of the preparation.
Epilepsy, Parkinson’s disease, cerebral atherosclerosis (severe).
Renal and / or hepatic insufficiency.
Deficiency of glucose-6-phosphate dehydrogenase.
Children under 12 years old.
The first trimester of pregnancy.
Be wary appoint persons in the period from 12 to 18 years (see. “Special instructions”).
Pregnancy and breastfeeding Pregnancy The safety of nevigramon during pregnancy has not been established. So use the drug during pregnancy should be only if the expected benefit outweighs the potential risk, especially in the first trimester of pregnancy (nalidixic acid crosses the placenta and affects the tissue of the developing cartilage) and in the last month of testosterone cypionate reviews pregnancy, due to the consequences for the newborn : significant increase in nalidixic acid in the blood of the newborn immediately after birth. breastfeeding Since nalidixic acid penetrates into breast milk, it is contraindicated during lactation.
Dosage and administration :
The average dose for adults (including elderly) is 4 g (2 capsules (1 g) – 4 times daily) for a period of at least 7 days. If the application is required to continue the drug, the dose may be reduced to one capsule (0.5 g) – 4 times per day. For children older than 12 years (weighing more than 40 kg) is recommended daily dose of 50 mg / kg, divided into 3-4 receptions. Nevigramon capsules should be taken one hour before meals.
Side effects Effects on the central nervous system: Drowsiness; weakness; headache; . dizziness There are rare reports of toxic psychosis, increased intracranial pressure, or convulsions (in the presence of predisposing diseases – epilepsy, cerebral arteriosclerosis). individual cases of paralysis of the sixth cranial nerve have been described. The mechanism of these reactions is not known, but the signs and symptoms they usually pass quickly without consequences after discontinuation of the drug. The effect on vision blurred vision (diplopia, blurred vision, difficulty focusing) and color perception. Usually these effects disappear quickly with dose reduction or withdrawal of the drug. Gastrointestinal complaints, epigastric pain, nausea, vomiting and diarrhea. Allergic reactions Rash, pruritus, urticaria, eosinophilia, arthralgia with stiffness and swelling of joints, rarely – angioedema, anaphylactic shock and anaphylactoid reactions. skin reactions reactions sensitivity: redness and appearance of bubbles on the skin, extending completely over a period of two weeks to two months after discontinuation of nalidixic acid; however, possible re occurrence of bubbles when exposed to sunlight or become damaged skin up to three months after discontinuation of the drug. Others are rare cholestasis, paresthesias, metabolic acidosis, thrombocytopenia, leucopenia or haemolytic anemia, occasionally accompanied by a deficiency of glucose-6-phosphate dehydrogenase. Such side effects as dysphoria and myalgia were noted for nevigramon ®
Patients who took doses higher than recommended, can be observed: toxic psychosis, convulsions, increased intracranial pressure, or metabolic acidosis. Also, after an overdose may include: nausea, vomiting, and lethargy.
In the case of overdose symptoms it is recommended close medical supervision of the patient in the hospital. Treatment should wear symptomatic and supportive in nature.
The interaction with other drugs
Nalidixic acid can enhance the effect of oral anticoagulants, such as warfarin or bis-hydroxycoumarin as a result of competitive binding to plasma proteins. In the case of simultaneous application requires appropriate control of the prothrombin time or international normalization index (INR), and may need to change the dose of anticoagulant.
As for the manifestation of the antibacterial action of nalidixic acid is a prerequisite multiplication of bacterial cells, the effect of nalidixic acid can be inhibited in the presence of other antibacterial compounds especially bacteriostatic agents, such as tetracycline, chloramphenicol or nitrofurantoin (the latter is an antagonist of nalidixic acid in vitro).
probenecid inhibits secretion of nalidixic acid in the renal tubules and may reduce its efficacy against infections of the genitourinary system, increasing at the same time the risk of systemic side effects. The combined use of nalidixic acid and melphalan was accompanied by gastrointestinal toxicity.
Laboratory tests: If the urine of patients receiving nevigramon ® , using methods based on the reduction of copper, such as Benedict or Fehling’s solutions, a false positive reaction to glucose may be obtained. It is therefore recommended to apply the specific glucose oxidase methods.
Spurious values may be obtained by determining the 17-keto steroids and ketogenic in urine in analysis based on the measurement in urine vanillylmandelic acid. In such cases, you can use the Porter-Zilber test for 17-gidroksikortikosteroidov.
is shown that nalidixic acid and related compounds cause erosion in the cartilage of joints and other signs of arthropathy in most animals have not reached puberty. Prior to clarify the clinical significance of this phenomenon, caution should be exercised in the appointment of nalidixic acid to persons under 18 years of age. If manifested arthralgia, treatment nalidixic acid should be discontinued.
Patients should be warned about the need to avoid direct sunlight, and in the development of sensitivity treatment nevigramon ® should be discontinued.
Caution should testosterone cypionate reviews be exercised and stop treatment if the patient develops signs or symptoms of increased intracranial pressure , psychosis or other toxic manifestations.
If develop bacterial resistance to nalidixic acid, it usually occurs within the first 48 hours. Observed cross-resistance among nalidixic acid and other quinolone derivatives such as oxolinic acid, cinoxacin.
Effects on ability to drive and other mechanisms
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