In pharmacies, they often ask for inexpensive pills for cystitis. "Negram" is one of such drugs that has an antibacterial effect and is included in the quinolone group. The drug has a bacteriostatic or bactericidal effect, which is due to the concentration of the pathogen and its sensitivity. Its effect is that by inhibiting the course of polymerization, the synthesis of bacterial DNA is suppressed.
One tablet contains five hundred milligrams of nalidixic acid, and there are also auxiliary elements such as potassium sorbate, dye E172, calcium hydrogen phosphate dihydrate, starch, gelatin, corn starch, magnesium stearate, microcrystalline cellulose. Tablets are produced in a package of five hundred milligrams and fifty six pieces. Appearance: round biconvex, the color is dark pink, on one side there is a notch. Pyelonephritis tablets should be stored in a cool place where children can not penetrate. The drug is suitable for three years.
Pharmacological action
1. Pharmacodynamic indicators. Nalidixic acid (the active substance of the Negram tablets) is a derivative of carboxylic acid, a chemotherapeutic agent related to gyrase inhibitors. It has a bactericidal effect on most gram-negative bacteria, and especially on E. Coli and species such as Enterobacter, Klebsiella and Proteus. The drug is effective in relation to salmonella and shigella.
2. Pharmacokinetic characteristics. After the preoral method of taking the drug, nalidixic acid is absorbed almost completely, while the bioavailability is ninety-six percent. The highest plasma concentration occurs one to two hours after ingestion. Nalidixic acid metabolism is carried out in the liver with the production of four metabolites. The effect of antibacterial is only hydroxyalidixic acid. Nalidixic acid penetrates heavily into organs and tissues. Most of it (about eighty to ninety percent) is excreted by the kidneys, and the rest - through the intestines. This is confirmed by the instructions for use attached to the Negram preparation.
The concentration of the pathogen and its characteristic, such as sensitivity to the components of the drug, determines the nature of the effect: bactericidal or bacteriostatic. This drug is not effective against gram-positive and anaerobic bacteria. With prolonged use, resistance to tablets may develop.
What are the indications of the Negram drug? Let's figure it out.
When to apply?
"Negram" is appointed in the following cases:
- with infectious and inflammatory disorders of the genitourinary system: urethral syndrome and urethritis, pyelonephritis, cystitis, diseases of the prostate gland;
- with infections affecting the stomach and intestines, cholecystitis;
- as a prevention of the appearance of infection during the manipulation of the surgeon on the kidneys, bladder and ureters.
Method of use
Negram tablets are used internally. For adults, the initial dose is one gram every six hours. The treatment period is one week. For maintenance, you should consume five hundred milligrams four times a day. The maximum dose in twenty-four hours is four grams, if the case is especially severe - up to six grams. Children who are not two years old are recommended an initial dose of sixty milligrams per kilogram of weight, a supporting dose of thirty milligrams, tablets should be taken every six hours.
Side effects
The following adverse reactions are possible:
1. From the side of the central nervous system: headache, drowsiness, weakness, an increase in intracranial pressure, visual defects, as well as color perception, diplopia, dysphoria, if used for a long time or in large doses, psychotic reactions and convulsions may occur.
2. From the digestive tract: nausea and vomiting, diarrhea, gastralgia, cholestasis, bleeding, changes in the activity of liver enzymes.
3. From the musculoskeletal system: myalgia, arthralgia, in children - damage to cartilage joints.
4. From the excretory system: kidney failure.
5. Allergic manifestations: urticaria, pruritus, Quincke's edema, rash.
6. Hemopoiesis defects: leukopenia, thrombocytopenia, hemolytic anemia.
7. Skin reactions: photosensitivity.
Since the use of this drug can cause so many adverse reactions, these inexpensive pills for cystitis have a number of contraindications.
To whom and in what cases is Negram contraindicated?
You can not use "Negram" with intolerance to any component of the drug, children who are under two years old, pregnant women, patients with epilepsy, atherosclerosis of the brain vessels of the head, glucose-6-phosphate dehydrogenase deficiency, liver and kidney failure.
During lactation, drinking Negram tablets is possible only in extreme cases and under the close supervision of a specialist if the mother's need for it is higher than the risk of undesirable effects in the child. When treating with this drug, nursing mothers noted changes in the color and consistency of the baby's stool. In these cases, it is recommended to give Bifidumbacterin to the child, since part of the drug enters his body along with breast milk, which means that dysbiosis can develop.
Do these pills help with pyelonephritis, and can they be given to children?
The use of "Negram" for the treatment of children
This drug is prescribed for children after they reach the age of two. At the beginning of treatment, the dose is sixty milligrams per kilogram of the child’s weight, the maintenance dosage is reduced to thirty milligrams. These calculations apply to children aged two to twelve years. The daily dose should be divided into three or four times.
Interaction with other drugs
Negram tablets can be combined with nitrofurans. But in the treatment with nitrofurasides, it is strictly contraindicated to use the drug. In addition, "Negram" is not prescribed simultaneously with anticoagulants, as this can cause bleeding of the mucous membranes of the intestines and stomach.
Overdose
Possible signs of an overdose: increased manifestation of side effects, metabolic acidosis, dyspepsia, confusion and loss of consciousness, convulsions, psychotic reactions.
In such cases, therapy is carried out by washing the stomach with a 3% sodium bicarbonate solution, symptomatic treatment and eliminating dehydration.
Negram reviews
Negram has positive reviews. Based on the information obtained during the surveys, we can talk about its high efficiency, the rapid removal of acute manifestations of inflammatory and infectious conditions. Also, as the advantages of the drug, patients call its availability and a low price, which is from 150 rubles per package. As the drawbacks of the drug, patients mention only one side effect - a drowsiness after using the drug.
Additional notes
If the course of treatment lasts more than two weeks, it is necessary to monitor liver and kidney function. If the patient has severe renal failure, it is not recommended to use Negram tablets, since it is mainly excreted in the urine, and if creatinine clearance is low, it accumulates in the body. During the treatment period, you should not be in direct sunlight. If the patient has porphyria, then nalidixic acid can contribute to the relapse of this disease. In relation to children and adolescents, the drug may affect temporary cartilage, and if signs of arthralgia appear, stop treatment.