Vigamox after surgery. Vigamox (eye drops): instructions for use, analogues and reviews, prices in Russian pharmacies. Vigamox eye drops instructions

Vigamox - solution eye drops, with antibacterial effect for topical application. The drug containing the antibiotic moxifloxacin has a powerful bactericidal activity and is used to treat a number of inflammatory eye diseases (conjunctivitis, keratitis, etc.) caused by microorganisms sensitive to fluoroquinolones. It is also prescribed for the prevention of postoperative infections in ophthalmic surgery.

Composition and form of release

Vigamox - a solution of 0.5% eye drops, transparent sterile, each milliliter contains:

Main substance: moxifloxacin (moxifloxacin hydrochloride) - 5 mg.
Additional components: sodium chloride, hydrochloric acid, water.

Package. Polyethylene bottles with a dropper, Drop-tainer systems of 3 and 5 ml.

Pharmacological properties

Vigamox is antimicrobial agent for local use. The antibiotic of the fluoroquinolone group included in its composition, moxifloxacin, has a high bactericidal activity against a large number bacterial microflora, including staphylococci, streptococci, diphtheria pathogens, coli, salmonella, mycoplasmas, gonococci, spirochetes, chlamydia and many strains of microorganisms resistant to other groups of antibacterial substances.

After instillation, solution in small quantities able to enter the systemic circulation and breast milk, but the probability systemic action when applied according to the instructions remains negligible.

Vigamox has a fast, long-lasting effect. Start it therapeutic action falls on 10-15 minutes after application, the bactericidal effect lasts up to 8 hours.

Indications for use

Processes of inflammation of the anterior segment of the eye (conjunctivitis, blepharitis, corneal ulcer, keratitis, dacryocystitis, meibomitis, barley), which cause microorganisms sensitive to moxifloxacin.
Prevention and treatment bacterial infections resulting from eye injuries or ophthalmic operations.

Dosage and administration

A solution of Vigamox eye drops must be applied to the conjunctival cavity of the infected eye, 1 drop three times a day. Drip therapy is continued until the complete disappearance of the symptoms of the disease. The effectiveness of the application and its duration should be monitored by the attending physician.

Contraindications

Individual intolerance to antibiotics of a number of fluoroquinolones.

Side effects

Immediate allergic reactions.
Transient sensation of discomfort, burning, tingling, immediately after applying the solution.
Photophobia or tearing.
Headache, eye pain, itching, redness, small hemorrhages in the area of the mucous membrane of the eye (very rarely).

Overdose

No data available.

Drug Interactions

Not identified.

special instructions

Adequate clinical research concerning the use of Vigamox solution in pregnant women have not been carried out, therefore, its appointment in this category of patients is allowed only after a thorough assessment of the benefits and potential risks to the fetus.

Drops eye Vigamox can be used to treat elderly patients and children without adjusting the standard dosage.

The drug in some quantities is able to penetrate into breast milk, therefore, during treatment, they should stop breastfeeding.

Also, stop using contact lenses, since the use of funds contact correction in diseases of the anterior segment of the eye is prohibited.

Bacterial conjunctivitis is a serious disease that leads to inflammation of the lining of the eye. Without vision, a person cannot fully enjoy life, so it is important to treat this sense organ in a timely manner. Vigamox drops will quickly relieve redness, itching, purulent discharge, and relieve inflammation. The drug belongs to the group of fluoroquinolones, is considered an effective antibacterial agent.

Instructions for use Vigamox

Vigamox drops are an effective tool that was created to combat pathogenic microorganisms. The drug contains the antibiotic moxifloxacin, the active substance produces a bactericidal effect. Eye drops that are effective against different types microorganisms are prescribed for the treatment of bacterial conjunctivitis. The effect is noticeable already on the fifth day of treatment. The drug is produced by the international company Alcon, in Russia there is a representative office of Alcon Pharmaceuticals.

Composition and form of release

The drug is available in the form of drops, they are transparent and have no color. The volume of medicine in vials: 5 or 3 ml. The main active substance is the antibiotic moxifloxacin hydrochloride. As part of the drug:

Pharmacodynamics and pharmacokinetics

The drug contains the active substance, which is a fourth-generation fluoroquinolone. The antibiotic inhibits the activity of DNA gyrase and topoisomerase 4, which stops the reproduction of bacteria and the recombination of their DNA. Mutations in Gram-negative bacteria cause them to become resistant to this antibiotic. Cross-resistance with aminoglycosides, macrolides and beta-lactams is highly unlikely.

Gram-positive bacteria (Streptococcus pyogenes group A, Staphylococcus aureus, Streptococcus pneumoniae).
Gram-negative bacteria (Escherichia coli, Moraxella catarrhalis, Haemophilus parainfluenzae, Haemophilus influenzae, Klebsiella pneumoniae, Enterobacter cloacae).
Other types of bacteria (Mycoplasma pneumoniae, Chlamydia spp., Chlamydia pneumoniae, Mycoplasma spp.).

Laboratory studies have shown the ability of the drug to fight the following bacteria: Enterobacter sakazaki, Staphylococcus saprophyticus, Providencia rettgeri, Streptococcus milleri, Staphylococcus epidermidis, Enterobacter agglomerans, Streptococcus mitior, Staphylococcus hominis, Enterobacter aerogenes, Morganella miorganii, Enterobacter Intermedius, Staphylococcus, Str. saprophyticus agalactiae, Providencia stuartii, Streptococcus dysgalactiae, St. haemolyticus, Proteus mirabilis, Proteus vulgaris.

This group also includes anaerobes: Bacteroides distasonis, Clostridium perfringens, Porphyromonas magnus, Bacteroides ovatus, Prevotella spp., Bacteroides thetaiotaornicron, Porphyromonas anaerobius, Bacteroides fragilis, Porphyromonas asaccharolyticus, Bacteroides egg uniformerthii, Propionibacterium sppis., Bacteroides.

AT laboratory conditions the antibiotic has an inhibitory effect on such gram-negative microorganisms as: Klebsiella oxytoca, Enterobacter agglomerans, Proteus vulgaris, Bordetella pertussis, Providencia rettgeri, Enterobacter Intermedius, Providencia stuartii, Proteus mirabilis, Enterobacter aerogenes, Enterobacter sakazaki, Fusobacterium spp., Morganella burnmetti, Caxiorgani , Porphyromonas spp., Legionella pneumophila. However, there is no evidence of the ability of the drug to treat diseases caused by these pathogens.

Indications for use

Antibiotic drops are intended for the local treatment of conjunctivitis, inflammatory processes In eyes. The drug will be effective if the bacteria that provoked the disease are sensitive to the effects of moxifloxacin.

Method of application and dosage

The drug is only suitable for topical ophthalmic use. The instructions indicate the following dosage: one drop in the sore eye three times a day. The patient's well-being improves on the fifth day of taking the remedy, but the course of treatment should continue for another 2-3 days. If there is no improvement, then an ophthalmologist should be consulted. Dosage adjustment is not necessary for children (older than a year), patients with liver disease and renal insufficiency.

special instructions

If the drug is used for a long time, then other infections, including fungi, may occur. The applicator must not be contaminated, so it is important not to touch anything with the tip of the vial. After use, the bottle must be tightly closed. The drug often causes clouding in the eyes, impairs visual acuity, so it is better to refrain from driving a car or from work where you need to control any mechanisms for the duration of treatment. Severe reactions are possible, such as loss of consciousness, angioedema, so resuscitation procedures may be required.

Vigamox during pregnancy

During pregnancy, the drug is not recommended to be instilled, since there is no complete clinical picture of its use by women who are carrying a child. Reception of Vigamox is possible if there is an urgent need. The antibiotic can pass into breast milk, so for the period of treatment it is necessary to stop breastfeeding the baby.

The drug is used in pediatrics. It is allowed to treat eyes with drops for children older than a year, the dosage is the same as for adults. Newborns do not give the drug.

drug interaction

Detailed studies on how this drug interacts with other drugs have not been conducted. Other forms of release of the antibiotic moxifloxacin allow sharing with drugs such as: digoxin, probenicide, ranitidine, warfarin, theophylline, glibenclamide, oral contraceptives, agents with the P450 enzyme in metabolism. Care should be taken when using the drug together with neuroleptics, quinidine, sotalol, procainamide, erythromycin, cisapride.

Side effects of Vigamox

The drug can cause both local and systemic adverse reactions. If they occur, then it is necessary to consult an ophthalmologist for advice; if there are signs of an allergy, you should stop dripping the medicine. Listed side effects:

hyperemia, dry eyes;
pain, irritation of the mucous membrane;
edema, keratitis (inflammation of the cornea), eyelid erythema (redness), hemorrhage (subconjunctival);
clouding, erosion;
the appearance of deposits on the cornea;
purulent discharge from the eyes, photosensitivity;
endophthalmitis (inflammation with purulent discharge), blepharitis (inflammation of the edge of the eyelids, where the eyelashes are);
increased intraocular pressure;
metallic taste in the mouth (sometimes with sourness), burning;
headaches, vomiting and bouts of nausea;
discomfort in the nasopharynx, lump in the throat;
low hemoglobin;
palpitations, shortness of breath;
itching and rash on the skin, allergic manifestations;
anaphylactic shock, angioedema, collapse, loss of consciousness (rare side effects).

Contraindications

Vigamox is an effective drug that copes well with bacteria and quickly relieves inflammation, but it is not suitable for everyone. Drops cannot be used:

if there is hypersensitivity to the components of the drug or quinolones;
during pregnancy and lactation;
children under 1 year old.

Terms of sale and storage

The drug is dispensed in a pharmacy by prescription. Keep the drops out of the reach of children. Acceptable temperature for them: from 2 to 25 degrees. Shelf life: 2 years. If the medicine is opened, it should be used within a month.

Analogues

If the drug does not fit, then the doctor will help you choose an alternative option, taking into account the characteristics of the patient. You can choose from among structural analogues Vigamox (with the same active substance), and drugs with a similar therapeutic effect:

Phloxal. Active ingredient: ofloxacin (belongs to second-generation fluoroquinolones). Available form: eye drops and ointment. An antibacterial drug intended for the treatment of infectious eye diseases.
Avelox. Available form: tablets and liquid. The drug with moxifloxacin has antibacterial action. Effective for the treatment of bronchitis, pneumonia, skin infections, sinusitis.
Mofloks. Active ingredient: moxifloxacin hydrochloride. It is presented in the form of a solution for infusions (infusions). The antimicrobial drug is intended for the treatment of pneumonia, infections of the skin and abdominal cavity.
Moxifloxacin. Released form: tablets. An antibacterial and antimicrobial drug with the active ingredient moxifloxacin is intended for the treatment of tuberculosis, pneumonia, bronchitis, and skin infections.
Tevalox. Tablets with the active ingredient moxifloxacin are intended for the treatment of pneumonia, bronchitis, bacterial sinusitis.

Vigamox price

Vigamox eye drops are inexpensive, the cost of the drug is on average 200 rubles per bottle. The price may vary depending on the volume.

Among the many medicines they are the most effective remedy, according to many patients. This medicinal product helps in cases where other medicines are powerless.

Benefit and harm

Vigamox drops have an antimicrobial and bactericidal effect, while having a wide spectrum of action against various bacteria.

AT rare cases headaches may occur, as well as redness, itching, or damage to blood vessels on the surface of the mucous membrane of the eye.

In addition to such manifestations when taking the medicine, possible side effects can be swelling of the vessels, pharynx and larynx, loss of consciousness, the development of pharyngitis and shortness of breath.

In isolated situations, systemic use drug, anaphylactic shock occurs, causing a fatal reaction even after the first application.

Also, with local treatment with Vigamox drops, temporary blurred vision may appear. Such a reaction will adversely affect the ability to drive vehicles. Therefore, to restore the quality of vision, it is necessary that some time pass.

In the case when damage to the cornea occurs, therapy is immediately canceled. Complications on the eye organ after surgery mainly occurs in patients with pathologies such as changes in the cornea, diabetes, arthritis.

Development risk adverse reactions from admission this drug in such a group of people increases significantly.

The use of eye drops "Vigamox" involves wearing sunglasses to prevent increased side effects.

During the period medical therapy and after the surgical intervention contact lenses are not allowed.

While taking the drug, you can not immediately sit down behind the vehicle, since when drops get into the eye, the clarity of vision decreases. You need to wait about 30 minutes for your vision to recover.

General description of the antibacterial agent

Eye drops "Vigamox" refer to antimicrobials and belong to the group of fluoroquinolones. Medicinal products are produced in special plastic containers with a convenient top for instillation. In a carton box there is 1 vial with a medicine volume of 3 ml or 5 ml.

The main active ingredient is the antibiotic moxifloxacin. 1 ml of Vigamox contains 5 mg of moxifloxacin hydrochloride. In addition to the main component, the composition includes hydrochloric acid, sodium chloride and purified water.

The drug "Vigamox" is highly active against many gram-positive, gram-negative, anaerobic, acid-resistant and atypical bacteria. To such harmful microorganisms include streptococci, gonococci, mycoplasma, chlamydia, diphtheria bacillus.

Under the influence of the main component of the drops, the DNA gyrase of the infection and the enzyme involved in the growth of their cells are inhibited.

When taking the drug, small doses of moxifloxacin enter the general circulation and may pass into breast milk. "Vigamox" has a fairly quick effect and for a long time.

After 15 minutes after instillation, it is already observed curative result which persists for 8 hours. The time of removal of the antibiotic from the blood plasma is 13 hours.

Instructions for use and restrictions

Vigamox is prescribed for inflammation of the organ of vision caused by microorganisms sensitive to moxifloxacin. Such ailments include conjunctivitis, keratitis, barley, corneal ulcer, dacryocystitis.

Also, the use of the drug is recommended for drug therapy and for preventive measures for inflammation of the eyes of infectious etiology arising from receiving mechanical damage or after surgery.

Refraining from therapy with fluoroquinolones, in particular moxifloxacin, is recommended for those patients who have an increased individual sensitivity to the drug component.

The doctor can prescribe medicine to pregnant women only according to strict indications, when therapy with other medicines does not have the desired result. Also, during breastfeeding, you should not use drops, since the complete safety of the product has not yet been proven.

Restriction to the use of "Vigamox" is childhood up to one year.

When taking antibacterial agents, it is not allowed to take alcoholic beverages which can provide Negative influence on the outcome of therapy.

Eye drops for adults and their dosage

The drug "Vigamox" is used for local treatment. For adult patients with eye infections It is recommended to apply 1 drop 3 times a day. The course of therapy on average should be at least 3 days.

A visible improvement occurs on the 4th or 5th day, but the instillation should be continued for several more days. The duration of the prescribed treatment is determined by the ophthalmologist, based on the patient's condition and the course of the disease.

If the condition does not improve, a revision of the diagnosis and a change in the treatment regimen are required.

long systemic treatment antibacterial drug can lead to an increase in the number of microorganisms that are resistant to the main active ingredient. In this situation, the remedy is canceled, and other medicines are prescribed.

The antibiotic, which is part of the drops, does not cause a pronounced toxic effect on the body.

Therefore, when using moxifloxacin, if the dose is exceeded during instillation into the eye or the medicine is accidentally ingested, signs of overdose do not appear. If symptoms of side effects appear, the drug should be discontinued.

Useful video on the topic

Use of an antibacterial drug for children

This tool refers to the type of systemic drugs and helps in the fight against infection, which is resistant to other antibacterial agents.

For drug therapy in inflammatory eye diseases antibacterial drops"Vigamox" are also used in children's period. Age category such patients begin at one year of age. Children from this age are prescribed the same dosage as adults.

In the local treatment of eye ailments for children, "Vigamox" is instilled one drop into the eye 3 times a day. Healing process continues until complete recovery, until all signs of the disease disappear. The duration of the course of therapy is determined by the attending specialist.

The use of this antibacterial drug for the treatment of eye pathology in children requires a mandatory preliminary consultation with the attending specialist.

Like all pharmacological preparations"Vigamox" can cause unwanted reactions, which include:

discomfort in the eyes;
burning sensation;
photophobia;
profuse tearing;
deterioration in the quality of vision;
keratitis;
lack of moisture in the eyeballs.

When taking this remedy, in addition to local manifestations headaches, nausea, dry mouth, increased blood pressure may occur.

Use of conjunctivitis remedy

This drug is excellent in the treatment of bacterial conjunctivitis. Drops have a strong bactericidal effect, allowing you to deal with various types bacteria.

When treating conjunctivitis, Vigamox should be dripped 3 times a day, 1 drop in each eye. Before you start instillation of the product, you must wash your hands with soap and water. Then you should sit down or lie down with your head thrown back.

The lower eyelid should be slightly pulled down, while looking up. In this position, bring the vial to the eye and drip one drop of medicine. After blinking and if more drops get in, the rest will pour out.

When using drops, do not touch the top of the vial to any surface in order to exclude the possibility of re-infection of the eye organ. Store the medicinal product in open form can be for one month in a cool dark place.

The drug can be used in combination with some other therapeutic agents for the eyes, but with a break between doses of at least five minutes.

Upper respiratory tract treatment and care for children

The therapeutic effect of drops is not only to suppress new microbes, but also to eliminate existing microorganisms that are sensitive to this medication. The drug during therapy shows excellent performance, and is well tolerated not only by adults, but also by children.

Due to the wide area of impact, drops are also used for the nasal cavity, since the mucous membrane of the nose and eyes has an identical structure.

This similarity allows the use of this medication in otorhinolaryngology for the treatment of inflammatory and infectious pathologies in the upper respiratory tract.

Shake the bottle with liquid before use. Vigamox drops are prescribed for instillation into the nose twice a day, 2-3 drops in each nostril.

When taking the medicine, you should follow some storage rules:

the opened package is stored for no more than four weeks at temperatures up to 25 degrees Celsius;
after removing the cap from the drops, contact of the pipette with various objects should be avoided; this will help prevent contamination of the vial and pathogenic bacteria into medicine.

Medicines with a similar effect or analogues

For the treatment of inflammatory processes in the eye organ arising from bacterial infections, it is also possible to use drugs such as:

Drops "Avelox" in the composition with the active substance moxifloxacin. This product has a lot side effects and some limitations in use. Therefore, before use, be sure to read the instructions so as not to harm your health.
The drug "Albucid" contains the main component sulfacetamide. In therapeutic therapy, drops have a small number of adverse reactions, and contraindications apply to a small group of people. At a cost such medicine cheaper than Vigamox.
Eye drops "Levobaks" have the active substance levofloxacin. When instilled into the eyes, an overdose should not be allowed, since the composition of the medicine can adversely affect the human body and cause serious complications.
Levomycetin drops in the composition contain levomycetin, which performs the main therapeutic effect. Treatment of eye ailments with such a drug allows you to combine this remedy with different medicinal products. The advantage when using these drops is the minimum number of restrictions.

As a replacement for Vigamox, pharmaceutical chains also offer the following drugs:

drops "Normax" active ingredient norfloxacin, which is used for many inflammatory eye diseases, the product is safe for health, even if the dose of drops is exceeded when instilled into the eye;
eye drops"Oftakviks" with the main substance levofloxacin;
the drug "Torbex", which contains tobramycin;
the drug "Floxal" with the active ingredient ofloxacin;
drops "Ciprofarm" contain ciprofloxacin hydrochloride, and is the most accessible means for the treatment of eye ailments.

Eye drops "Nevanak"

For the treatment of inflammatory processes and pain after surgery, in particular when removing a cataract, ophthalmologists often prescribe the drug Nevanak. This remedy has an anti-inflammatory and analgesic effect.

The effect of drops is to reduce the synthesis of certain elements that affect the activation and maintenance of inflammation in the eye organ.

This eliminates pain syndrome and inflammatory swelling. The main component of the drug after application reaches a maximum concentration in the tissues after 30 minutes.

The drug "Nevanak" is intended for instillation into the eyes. The dose is 1 drop 3 times a day. Before carrying out surgery to eliminate cataracts, I begin to drip the drug a day before.

After surgery, therapy continues for two weeks. Before the beginning surgical procedure medicine in the amount of 1 drop is instilled for a maximum of two hours.

acute process of inflammation in the nasal cavity;
bronchial asthma;

Eye infections can happen not only in postoperative period when the eye is very vulnerable, but also in Everyday life, because the eyes are organs that are in direct contact with the environment. Therefore, it is very important to have in your arsenal antimicrobial agents effective and safe drug. These include Vigamox antibacterial eye drops.

Instructions for use of eye drops Vigamox recommends using them for:

bacterial conjunctivitis, blepharitis, dacryocystitis;
bacterial keratitis associated with wearing lenses;
inflammation hair follicles cilia - barley;
furunculosis or abscess of the eyelid caused by sensitive flora;
prevention of endophthalmitis;
bacterial infection choroid, vitreous body and the retina, which developed along the endogenous path;
prevention of keratitis after LASIK or other ophthalmic surgeries.

What makes Vigamox effective

The active substance of the drops is moxifloxacin hydrochloride at a concentration of 5.45 mg per 1 ml of solution, which corresponds to 5 mg of moxifloxacin in an isotonic solution with a close to neutral pH.

Thus, Vigamox eye drops are latest generation fluoroquinolone antibiotics. Their advantages include breadth antimicrobial spectrum action and ability to suppress those microorganisms that are resistant to other groups of antibiotics.

Good penetrating ability and long-term effect allow you to maintain the concentration of the drug by instilling only one drop into the affected eye three times a day. The action begins after a quarter of an hour and lasts up to eight hours. The comfort of use is due to the absence of the preservative agent benzalkonium chloride in the drops, which usually “stings” the eyes.

These drops are effective against most pathogens of infectious and inflammatory diseases in ophthalmic practice: coagulase-negative staphylococci, S. aureus, Streptococcus spp., S. pneumoniae, etc., Propionibacterium spp., Enterococcus spp., P. aeruginosa, Enterobacter aerogenes, Citrobacter spp. , E. coli, Gram-positive cocci and Corynebacterium spp.

Particularly valuable antibacterial activity against Haemophilus influenzae, pneumococcus, Klebsiella pneumonia and chlamydia, which are dangerous for children and newborns, causing them conjunctivitis and blepharitis.

Overcoming Resilience

A productive fight against the disease is impossible if the pathogen becomes insensitive to the antibacterial drug. Moreover, if the drug was used orally, then the local form of eye drops becomes ineffective. Thus, erythromycin, chloramphenicol, sulfonamides, tobramycin, gentamicin are gradually losing relevance in the fight against ophthalmic infections.

Resistance to Vigamox develops slowly

Moxifloxacin Vigamox eye drops this stage is effective drug in the fight against the spread of resistance among pathogenic bacteria to other antibiotics (penicillin group, macrolides, aminoglycosides, etc.), as well as to previous generations of fluoroquinolones. It is able to inhibit functional enzymes in bacterial cells. Due to this, DNA synthesis is disrupted, the cell stops dividing and then dies. positive moment is the selective activity of Vigamox against pathological organisms. It has no effect on human cells.

Unwanted action

Studies show that during the use of Vigamox drops, tolerance is good in most patients. Complications that may occur if drops are accidentally taken orally will be typical of all fluoroquinolones: dyspepsia, headache, tachycardia.

Locally, against the background of the use of an antibiotic, candidiasis or hypersensitivity reactions may develop - redness, burning and itching of the eyes or skin around them.

Some may experience symptoms that are characteristic of "dry eye syndrome".

Very rarely, drops provoke a defect in the corneal epithelium, edema, small hemorrhages in the conjunctiva, and blurred vision.

Reactions to Vigamox are reversible and disappear on their own when the drops are canceled.

Notes

In spite of good performance safety, Vigamox is not recommended for pregnant women, since a damaging effect on the fetus is possible. Although to local form the drug is of little use.

Regarding the use of the drug during breastfeeding should be based on the balance of benefit and risk.

Vigamox can be used in children older than 12 months

Under the supervision of an ophthalmologist, Viagmox can be used in a child older than 1 year. At the same time, the dosage and frequency of administration correspond to the "adult" scheme - drop by drop three times a day.

In case of accidental introduction of a larger amount of the drug than the instructions require, the eye should be rinsed with plenty of water.

It is also important to ensure that while using the dropper, its nose does not touch the eye or other surface, especially since you can not take the tip with your hands. After use, the bottle is closed with a cap and stored in a place protected from light at a temperature of 2 to 25°C.

All dots on Vigamox

Vigamox drops are superior to analogues in terms of the following criteria choice:

a wide range of activities;
bactericidal effect;
low resistance of microorganisms to it;
intracellular penetration;
good tolerance and mild allergy;
good compatibility with biological fluids, in particular matching the pH of the drug to the pH of the tear;
high tissue permeability achieved due to good lipo- and hydrophilicity.

pharmachologic effect

Moxifloxacin is a fourth-generation fluoroquinolone antibacterial drug with a bactericidal effect. Shows activity towards a wide range gram-positive and gram-negative microorganisms, anaerobic, acid-fast and atypical bacteria.

The mechanism of action is associated with the inhibition of topoisomerase II (DNA gyrase) and topoisomerase IV. DNA gyrase is an enzyme involved in the replication, transcription and repair of bacterial DNA. Topoisomerase IV is an enzyme involved in the cleavage of chromosomal DNA during bacterial cell division.

There is no cross-resistance with macrolides, aminoglycosides and tetracyclines. Cross-resistance has been reported between systemically administered moxifloxacin and other fluoroquinolones.

Moxifloxacin is active against most strains of microorganisms (both in vitro and in vivo):

Gram-positive bacteria: Corynebacterium spp., including Corynebacterium diphtheriae; Micrococcus luteus (including strains not susceptible to erythromycin, gentamicin, tetracycline and/or trimethoprim); Staphylococcus aureus (including strains not sensitive to methicillin, erythromycin, gentamicin, ofloxacin, tetracycline and/or trimethoprim); Staphylococcus epidermidis (including strains insensitive to methicillin, erythromycin, gentamicin, ofloxacin, tetracycline and/or trimethoprim); Staphylococcus haemolyticus (including strains insensitive to methicillin, erythromycin, gentamicin, ofloxacin, tetracycline and/or trimethoprim); Staphylococcus hominis (including strains not sensitive to methicillin, erythromycin, gentamicin, ofloxacin, tetracycline and/or trimethoprim); Staphylococcus warneri (including strains insensitive to erythromycin); Streptococcus mitis (including strains insensitive to penicillin, erythromycin, tetracycline and / or trimethoprim); Streptococcus pneumoniae (including strains that are not sensitive to penicillin, erythromycin, gentamicin, tetracycline and / or trimethoprim); Streptococcus of the viridans group (including strains insensitive to penicillin, erythromycin, tetracycline and/or trimethoprim).

Gram-negative bacteria: Acinetobacler Iwoffii; Haemophilus influenzae (including strains insensitive to ampicillin); Haemophilus parainfluenzae; Klebsiella spp.

Other microorganisms: Chlamydia trachomatis.

Moxifloxacin is active in vitro against most of the following microorganisms, but the clinical significance of these data is unknown:

Gram-positive bacteria: Listeria monocytogenes; Staphylococcus saprophyticus; Streptococcus agalactiae; Streptococcus mitis; Streptococcus pyogenes; Streptococcus groups C, G, F;

Gram-negative bacteria: Acinetobacler baumannii; Acinetobacter calcoaceticus; Citrobacter freundii; Citrobacter koseri; Enterobacter aerogenes; Enterobacter cloacae; Escherichia coli; Klebsiella oxytoca; Klebsiella pneumoniae; Moraxella catarrhalis; Morganella morganii; Neisseria gonorrhoeae; Proteus mirabilis; Proteus vulgaris; Pseudomonas stutzeri;

Anaerobic microorganisms: Clostridium perfringens; Fusobacterium spp.; Prevotella spp.; Propionibacterium acnes.

Other organisms: Chlamydia pneumoniae; Legionella pneumophila; Mycobacterium avium; Mycobacterium marinum; Mycoplasma pneumoniae.

Pharmacokinetics

When applied topically, systemic absorption of moxifloxacin occurs: C max is 2.7 ng / ml, the AUC value is 45 ng × h / ml. These values are approximately 1600 times and 1000 times less than C max and AUC after application. therapeutic dose moxifloxacin 400 mg orally. T 1/2 of moxifloxacin from plasma is about 13 hours.

Indications

— bacterial conjunctivitis caused by microorganisms sensitive to moxifloxacin.

Dosing regimen

Place. Adults and children over 1 year old instill 1 drop into the affected eye 3 times a day. Usually improvement occurs after 5 days and treatment should be continued for the next 2-3 days. If the condition does not improve after 5 days, the question of the correctness of the diagnosis and / or prescribed treatment should be raised. The duration of treatment depends on the severity of the condition and the clinical and bacteriological course of the disease.

Side effect

Local. In 1-10% of cases - pain, irritation and itching in the eye, dry eye syndrome, conjunctival hyperemia, eye hyperemia. In 0.1-1% of cases - corneal epithelial defect, punctate keratitis, subconjunctival hemorrhage, conjunctivitis, eye edema, discomfort in the eyes, blurred vision, decreased visual acuity, erythema of the eyelids, unusual sensations in the eye.

Systemic. In 1-10% of cases - dysgeusia. In 0.1-1% of cases - headache, paresthesia, decrease in blood hemoglobin, discomfort in the nose, pharyngolaryngeal pain, sensation foreign body in the throat, vomiting, increased levels of ALT and GGT.

Post-marketing experience (frequency unknown):

Local: endophthalmitis, ulcerative keratitis, corneal erosion, corneal defect formation, increased intraocular pressure, corneal opacity, corneal infiltrates, corneal deposits, allergic eye reactions, keratitis, corneal edema, photophobia, blepharitis, eyelid edema, increased lacrimation, eye discharge, foreign body sensation in the eye.

Systemic: palpitations, dizziness, shortness of breath, nausea, erythema, rash, itching of the skin, hypersensitivity.

emergence allergic reaction requires discontinuation of the drug!

Hypersensitivity reactions (anaphylaxis) have been observed in patients using systemic quinolone preparations, including moxifloxacin, including immediately after the first dose - collapse, loss of consciousness, Quincke's edema, airway obstruction, shortness of breath, pruritus, rash.

Contraindications for use

- hypersensitivity to any of the components of the drug or to other quinolones;

- the period of breastfeeding;

- children's age up to 1 year.

Use during pregnancy and lactation

There is no sufficient experience in the use of the drug during pregnancy and lactation. The use of the drug during pregnancy (category C according to FDA) is possible only if the expected therapeutic effect for the mother exceeds potential risk for fetus and child. Vigamox may pass into breast milk, and therefore, breastfeeding should be discontinued for the period of drug treatment.

Teratogenicity

In preclinical animal studies, moxifloxacin was not teratogenic at doses of 500 mg/kg/day (approximately 21,700 times the recommended dose). daily dose for a person). However, there was some decrease in fetal body weight and a delay in the development of the musculoskeletal system. Against the background of a dose of 100 mg / kg / day, an increase in the frequency of a decrease in the growth of newborns was noted.

Use in children

Overdose

In case of eye contact excess the drug is recommended to rinse the eyes with warm water.

drug interaction

Interactions of topical moxifloxacin with other medicinal products have not been studied.

Known data for oral dosage form moxifloxacin: no clinically significant drug interactions(unlike other fluoroquinolone drugs) with theophylline, warfarin, digoxin, oral contraceptives, probenecid, ranitidine and glibenclamide.

In in vitro studies, moxifloxacin does not inhibit CYP3A4, CYP2D6, CYP2C9 or CYP1A2 isoenzymes, which may indicate that moxifloxacin does not change the pharmacokinetic properties of drugs metabolized by cytochrome P450 isoenzymes.

Terms of dispensing from pharmacies

On prescription.

Terms and conditions of storage

Store at temperatures between 2 and 25°C. Keep out of the reach of children. Shelf life - 2 years.

special instructions

Severe, in some cases fatal hypersensitivity reactions (anaphylaxis) were observed in patients who used systemic quinolone drugs, sometimes immediately after taking the first dose (!).

Some reactions were accompanied by collapse, loss of consciousness, angioedema (including swelling of the larynx and / or face), airway obstruction, shortness of breath, urticaria and pruritus. In the event of the above conditions, resuscitation may be required.

Prolonged use of antibiotics can lead to overgrowth resistant microorganisms, including fungi. In the event of superinfection, it is necessary to cancel the drug and prescribe adequate therapy.

Do not touch the tip of the dropper bottle to any surface to avoid contamination of the bottle and its contents. The bottle must be closed after each use.

Pediatric use

Vigamox can be used in pediatrics in children from 1 year of age at doses similar to adults.

Influence on the ability to drive vehicles and control mechanisms

After using the drug, a temporary decrease in clarity is possible. visual perception, and until it is restored, it is not recommended to drive a car and engage in activities that require heightened attention and reactions.