Levomycetin Reneval, eye drops 0.25% 10 ml

Pharmacotherapeutic group: antibiotic.

The ATX code: S01AA01

Pharmacological action

Pharmacodynamics

Bacteriostatic broad spectrum antibiotic, disrupts protein synthesis in microbial cell (having fat-solubility, penetrates through the cell membrane of bacteria and reversibly binds with 50S subunit of bacterial ribosomes, where transfer of amino acids to growing peptide chains is delayed, which leads to disruption of protein synthesis). Effective against strains of bacteria resistant to penicillin, tetracyclines, sulfonamides. Active against Escherichia coli, Haemophilus influenzae, Klebsiella pneumoniae, some species of Enterobacter and Neisseria, Staphylococcus aureus, Streptococcus spp. (including Streptococcus pneumoniae, Streptococcus haemolyticus), Moraxella lacunata, rickettsia and mycoplasmas.

It is not effective against acid-fast bacteria, anaerobes, Acinetobacter spp., Pseudomonas aeruginosa, Serratia marcescens.

Pharmacokinetics

Instillation of the drug into the conjunctival sac produces therapeutic concentrations in the aqueous humor of the eye, cornea, iris, vitreous body; it does not penetrate into the lens. Partially enters the systemic bloodstream. It is excreted mainly by kidneys as inactive metabolites and partially by intestine.

Indications

Bacterial infections of the eye caused by sensitive microflora:

– conjunctivitis;

– keratitis;

– blepharitis;

– blepharoconjunctivitis;

– keratoconjunctivitis;

– neuroparalytic keratitis in the presence of secondary bacterial infection.

Active ingredient

Chloramphenicol

Composition

Active ingredient:

Chloramphenicol – 2.5 mg

Excipients:

boric acid – 18.0 mg

sodium tetraborate decahydrate – 3.0 mg

water for injection – up to 1 ml

How to take, the dosage

Topically. In adults and children, 1-2 drops every 1-4 hours into the conjunctival sac. The recommended course of treatment is 7-10 days. It is possible to extend the course of treatment by doctor’s prescription.

Interaction

Simultaneous use with drugs that suppress hematopoiesis (sulfonamides, cytostatics), affect the metabolism in the liver, or radiation therapy increases the risk of side effects.

In concomitant use with erythromycin, clindamycin, lincomycin mutual weakening of action is noted due to the fact that chloramphenicol may displace these drugs from bound state or prevent their binding to 50S subunit of bacterial ribosomes. When administered with oral hypoglycemic agents it is noted that their action is increased due to inhibition of their metabolism in the liver and increase of their concentration in plasma.

Chloramphenicol inhibits cytochrome P450 enzyme system, therefore concomitant use with phenobarbital, phenytoin, indirect anticoagulants decreased metabolism of these drugs, slowed excretion and increased their plasma concentrations are noted. Reduces the antibacterial effect of penicillins and cephalosporins.

Special Instructions

There are isolated reports of the development of bone marrow hypoplasia after using ophthalmic forms (systematic monitoring of the peripheral blood picture is required during treatment).

After autopsy use within 14 days.

Synopsis

A clear colorless or slightly yellowish liquid.

Contraindications

Hypersensitivity to the components of the drug; suppression of medullary hematopoiesis; acute intermittent porphyria; glucose-6-phosphate dehydrogenase deficiency; hepatic and/or renal failure; pregnancy, lactation; period of newborn infancy (up to 4 weeks).

With caution

Diseases of the skin (psoriasis, eczema, fungal lesions); early childhood; patients who have previously received treatment with cytostatic drugs or radiation therapy.

Side effects

Local allergic reactions. With long-term use: reticulocytopenia, leukopenia, granulocytopenia, thrombocytopenia, erythrocytopenia; rarely – aplastic anemia, agranulocytosis; secondary fungal infection.

Overdose

There are no data on overdose of the drug.

Pregnancy use

The use of the drug is contraindicated during pregnancy and while breastfeeding.

Similarities

Levomycetin Actitab