Levomycetin, 3% 25 ml

Levomycetin is an antimicrobial effective against a wide range of Gram-positive and Gram-negative microorganisms. It has a pronounced bacteriostatic action, in high concentrations against some strains it shows bactericidal action.

The mechanism of action is based on the ability to bind with 50S-subunit of bacterial ribosomes and inhibit protein synthesis in bacterial cells. Escherichia coli, Shigella spp. (including Shigella dysenteria), Salmonella spp., Streptococcus spp. (including Streptococcus pneumoniae), Neisseria spp., Proteus spp., Ricketsia spp., Treponema spp. and Chlamydia trachomatis are sensitive to the action of Levomycin. In addition, the drug is effective for diseases caused by some strains of Pseudomonas aeruginosa. The action of the drug does not cover fungi, protozoa and strains of Mycobacterium tuberculosis.

Resistance of microorganisms to levomycetin develops slowly. After oral administration the drug is quickly absorbed in the gastrointestinal tract. Bioavailability with oral administration reaches 80%. Peak plasma concentrations are observed 1-3 hours after oral administration and therapeutically significant concentrations are retained in plasma for 4-6 hours, after parenteral administration – for 8-12 hours.

The degree of binding of chlorpheniramine to plasma proteins is about 50%. Levomycetin penetrates through the blood-placental and blood-encephalic barrier, is excreted with breast milk. It is metabolized in the liver, excreted mainly by the kidneys, some part of the drug is excreted by the intestine. The elimination half-life is 1.5-3.5 hours.

In patients with impaired renal function the half-life is prolonged to 3-4 hours; in patients with hepatic impairment – up to 11 hours.

Indications

Bacterial eye infections, including conjunctivitis, keratitis, keratoconjunctivitis, blepharitis, episcleritis, scleritis

Active ingredient

Composition

Active ingredient:

Chloramphenicol

How to take, the dosage

Topically, 0.25% aqueous solution – 1-2 drops in conjunctival sac every 1-4 hours (conjunctival sac usually holds only 1 drop); eye liniment 1% (about 1 cm) – put behind the eyelid every 3 hours.

Special Instructions

Due to high toxicity it is not recommended to use unnecessarily for treatment and prevention of trivial infections, colds, influenza, pharyngitis, bacturia.

Severe complications of the hematopoietic system, as a rule, are associated with the use of high doses (more than 4 g/day) for a long time. Systematic monitoring of peripheral blood counts is necessary during treatment.

In fetus and newborn children the liver is not developed enough to bind chloramphenicol and the drug may accumulate in toxic concentration and lead to “gray syndrome”, therefore in children in the first months of life the drug is prescribed only with vital signs.

Patients who have previously been treated with cytostatic drugs or radiation therapy are to be treated with caution.

Contraindications

Hypersensitivity, blood disorders, acute intermittent porphyria, marked renal and hepatic dysfunction, glucose-6-phosphate dehydrogenase deficiency, psoriasis, eczema, fungal skin diseases, period of infancy (up to 4 weeks) and early childhood.

Side effects

Gastrointestinal organs: dyspepsia, nausea, vomiting, diarrhea, irritation of the mucous membranes of the mouth and pharynx, dysbacteriosis.

Cardiovascular system and blood (hematopoiesis, hemostasis): leukopenia, thrombocytopenia, reticulocytopenia, hypogemoglobinemia, agranulocytosis, aplastic anemia.

Nervous system and sensory system disorders: psychomotor disorders, depression, mental disorders, delirium, optic neuritis, visual and auditory hallucinations, taste disorders, decreased acuity of hearing and vision, headache.

Allergic reactions: skin rash, urticaria, angioedema.

Other: dermatitis, secondary fungal infection, cardiovascular collapse (in children under 1 year).

In application to the skin and conjunctival use: local allergic reactions.

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