pharmachologic effect
Antimicrobial drug for topical use.
It has antiprotozoal, antifungal and antibacterial effects. Nifuratel, a nitrofuran derivative, is highly active against
a number of bacteria, fungi and protozoa (including Trichomonas vaginalis).
Nystatin is an antifungal antibiotic of the polyene group. By binding to sterols in the cell membrane of fungi, it disrupts its permeability, which leads to cell death. Highly active against
Candida albicans.
The combination of nifuratel and nystatin allows one to achieve a more pronounced antifungal effect and significantly expand the spectrum of antimicrobial action. The high efficiency and low toxicity of the components of the drug determine a wide range of its clinical use in the treatment of vaginitis of mixed etiology, in particular, use for the prevention of mycoses caused by the specific treatment of trichomoniasis.
Macmiror complex does not disturb the physiological flora, which allows you to avoid the development of dysbacteriosis and quickly restore vaginal normocenosis.
McMirror
McMirror
® (lat.
macmiror
®) is an antimicrobial, antiprotozoal and antifungal agent (antibiotic). The active ingredient is nifuratel. Macmiror is sold in Russia in the form of film-coated tablets. One tablet of Macmiror contains 200 mg of nifuratel. According to the pharmacological index, Makmiror belongs to the group “Other synthetic antibacterial agents”, according to the ATC - to the group “G01 Antiseptics and antimicrobials for the treatment of gynecological diseases” and has the code “G01AX05 nifuratel”.
Indications for use of Macmiror
Macmiror is indicated for intestinal amebiasis, giardiasis, Helicobacter pylori
-associated diseases of the gastrointestinal tract: gastric and/or duodenal ulcers, gastritis, etc., vulvovaginal infections caused by pathogens sensitive to the drug (Trichomonas, chlamydia, fungi of the genus
Candida
, listed below bacteria), urinary tract infections caused by microbes sensitive to the drug (including pyelonephritis, urethritis, cystitis, pyelitis).
Macmiror - antibiotic
Macmiror is active against the following bacteria: Enterococcus faecalis, Enterococcus faecium, Staphylococcus aureus, Bacillus subtilis , Escherichia coli, Shigella flexneri, Shigella sonnei, Salmonella typhi, Salmonella typhimurium, Salmonella enteritidis, Klebsiella spp., Enterobacter spp., Serratia spp., Citrobacter spp., Morganella spp., Rettgerella spp., Pragia fontium, Budvicia aquatica, Rachnella aquatilis, Acinetobacter spp.
, other atypical enterobacteria,
Helicobacter pylori
, especially strains resistant to metronidazole.
Nifuratel is less active against bacteria Proteus mirabilis, Proteus vulgaris
and
Pseudomonas aeruginosa
.
Macmiror is active against fungi of the genus Candida
and protozoa amoebae, lamblia and vaginal trichomonas.
On the website gastroscan.ru in the literature catalog there is a section “Antibiotics used in the treatment of gastrointestinal diseases”, containing articles on the use of antimicrobial agents in the treatment of diseases of the digestive tract.
Macmiror in Helicobacter pylori eradication schemes
Helicobacter pylori
for gastric ulcers, duodenal ulcers, atrophic gastritis, MALToma and gastric resection after gastric cancer .
The first-line eradication regimens recommended by Maastricht include the antibiotic clarithromycin and metronidazole. In recent years in Russia, resistance of Helicobacter pylori
to clarithromycin has reached 28–29%, and to metronizalol - 55%.
Therefore, there was a need to replace these antibiotics in eradication therapy with others (Minushkin O.N. et al., Shcherbakov P.L.). The Scientific Society of Gastroenterologists of Russia recommends the use of nifuratel (that is, makmiror - the only medicine in Russia with the active substance nifuratel) as a replacement for these two antibiotics of the Maastricht regimens (see Standards for the diagnosis and treatment of acid-dependent and Helicobacter pylori-associated diseases (4th Moscow agreement), adopted by the 10th Congress of the NGR on March 5, 2010) in the schemes of the first and second lines of eradication of Helicobacter pylori: Line 1. Option 1.
One of the proton pump inhibitors in a standard dosage (omeprazole 20 mg, lansoprazole 30 mg, pantoprazole 40 mg, esomeprazole 20 mg or rabeprazole 20 mg 2 times a day), amoxicillin (500 mg 4 times a day or 1000 mg 2 times a day) and Macmiror (400 mg nifuratel 2 times a day) for 10–14 days.
Line 1. Option 2.
The drugs used in the first option (one of the PPIs in a standard dosage, amoxicillin and Macmiror) with the addition of a fourth component - bismuth tripotassium dicitrate 120 mg 4 times a day or 240 mg 2 times a day for 10-14 days.
Line 1. Option 3 (in the presence of atrophy of the gastric mucosa with achlorhydria, confirmed by pH-metry).
Amoxicillin (500 mg 4 times a day or 1000 mg 2 times a day), Macmiror (400 mg 2 times a day) and bismuth tripotassium dicitrate (120 mg 4 times a day or 240 mg 2 times a day) for 10–14 days .
Line 2
(used if therapy according to one of the first-line regimens has not led to success)
.
Option 2. One of the standard dosage PPIs, amoxicillin (500 mg 4 times a day or 1000 mg 2 times a day), Macmiror (400 mg 2 times a day), bismuth tripotassium dicitrate (120 mg 4 times a day or 240 mg 2 times a day) for 10–14 days.
When eradicating Helicobacter pylori
in children with autoimmune gastritis complicated by active Epstein-Barr viral infection, it is recommended to replace amoxicillin in eradication regimens with Macmiror at an age-specific dosage of 15 mg per kg of child weight 2 times a day (G.V. Volynets).
Other medicines containing the active ingredient nifuratel
In Russia, besides Macmiror, no other drugs with the active ingredient nifuratel are registered. Macmiror Complex - a medicine with the combined active ingredient nystatin + nifuratel is not used in gastroenterology.
General information
The manufacturer of Macmiror is Doppel Farmaceutici, Italy. Macmiror has contraindications, side effects and application features; consultation with a specialist is necessary. Back to section
Instructions for use / dosage
The drug is intended for topical use for gynecological or venereal diseases.
Vaginal suppositories
1 vaginal suppository is administered daily in the evening before bed for 8 days or as recommended by your doctor. If necessary, treatment can be repeated after menstruation.
To achieve the maximum therapeutic effect, the suppository should be inserted into the upper part of the vagina.
Suppositories are not used for treatment in children. For this category of patients, it is recommended to use vaginal cream complete with an applicator (graduated syringe).
Vaginal cream
Prescribe 2.5 g of cream 1-2 times a day. (morning or evening) for 8 days.
The required dose of cream should be administered using a graduated applicator.
Instructions for use of the graduated applicator
Screw the graduated applicator onto the tube of cream. Take the required amount of cream (in accordance with the scale lines indicating the amount in grams) by pressing on the tube. Disconnect from the tube, insert into the vagina, squeeze out the contents of the applicator, pressing on the rod.
The presence of a special nozzle allows you to introduce the cream without damaging the hymen. To do this, you need to remove the cannula from the top of the shaft and screw it onto the head of the syringe from the opposite side before inserting the cream into the vagina.
Macmiror
Release form, composition and packaging
White film-coated, biconvex tablets. 1 tab. nifuratel 200 mg. Excipients: gelatin, magnesium stearate, titanium dioxide, sucrose, talc, starch, polyethylene glycol 6000, gum arabic, magnesium carbonate, wax.
Clinical and pharmacological group: Antibacterial drug, nitrofuran derivative.
pharmachologic effect
Broad-spectrum antimicrobial agent, nitrofuran derivative. Highly active against a number of bacteria (including against Helicobacter pylori and Papiliobacter spp.), fungi and protozoa (including against the causative agents of intestinal amebiasis and giardiasis. It has low toxicity.
It is especially effective against Helicobacter pylori strains resistant to metronidazole in chronic diseases of the upper digestive tract in children and adults. It is the drug of choice for the treatment of salmonellosis, shigellosis and other intestinal bacterial infections. Nifuratel is excreted primarily by the kidneys, providing an antibacterial effect in the urinary tract. The drug is used for the treatment of urinary tract diseases, as well as for preoperative preparation.
Pharmacokinetics
After taking the drug orally, nifuratel is quickly absorbed from the gastrointestinal tract. Penetrates through the BBB and placental barriers and is excreted in breast milk. Biotransformed in the liver and muscle tissue. Completely excreted in urine (30-50% unchanged).
Indications
- chronic inflammatory diseases of the upper gastrointestinal tract associated with Helicobacter pylori;
- intestinal amebiasis;
- giardiasis;
- urinary tract infections caused by microorganisms sensitive to the drug;
- vulvovaginal infections caused by pathogens sensitive to the drug (Trichomonas, Candida fungi, bacteria).
Dosage regimen
- For infections caused by Helicobacter pylori, adults are prescribed Macmiror 400 mg (2 tablets) 2-3 times a day; For children, the recommended dose is determined at the rate of 15 mg/kg body weight 2 times a day. Duration of treatment: 7 days.
- For intestinal amebiasis, adults are prescribed 400 mg (2 tablets) 2-3 times a day; children - at a dose of 10 mg/kg 3 times a day. Duration of treatment is 10 days.
- For giardiasis, adults are prescribed 400 mg (2 tablets) 2-3 times a day; children - at a dose of 15 mg/kg 2 times a day. Duration of treatment: 7 days.
- For urinary tract infections in adults, depending on the severity of the disease, the drug is prescribed at 600-1200 mg (3-6 tablets)/day for 7-14 days; For children, the recommended dose is 30-60 mg/kg, divided into 2 doses.
- For vaginal infections, adults: 200 mg (1 tablet) 3 times a day for 7 days (both sexual partners should take the drug); For children, the recommended daily dose is 10 mg/kg body weight, divided into 2 doses; duration of treatment is 10 days.
Side effect
From the digestive system: nausea, vomiting, bitterness in the mouth, diarrhea, heartburn, gastralgia. Allergic reactions: skin rash, itching.
Contraindications
- hypersensitivity to the components of the drug.
Pregnancy and lactation
The use of the drug during pregnancy is possible only under strict indications, if the expected benefit to the mother outweighs the potential risk to the fetus, because nifuratel penetrates the placental barrier.
If it is necessary to use the drug during lactation, the issue of stopping breastfeeding should be decided, because nifuratel is excreted in breast milk.
special instructions
When treating vaginal infections, local therapy is carried out simultaneously with taking the drug Macmiror orally. If only Macmiror is prescribed for oral administration, then the dose of the drug is increased to 800-1200 mg/day (4-6 tablets). During the treatment period you should abstain from sexual intercourse.
Overdose
To date, no cases of overdose of the drug Macmiror have been described.
Drug interactions
Macmiror enhances the antifungal effect of nystatin when used together.
Storage conditions and periods
The drug should be stored in a place protected from light, out of reach of children, at a temperature not exceeding 25°C. Shelf life: 5 years.
Pharmacodynamics and pharmacokinetics
Is Macmiror an antibiotic or not?
Active ingredient from the group of nitrofurans . Shows antibacterial activity against gram-positive and -negative bacteria. It is also a good antifungal and antiprotozoal agent.
Inhibits the processes of division and reproduction of amoebas, lamblia and other protozoa , aerobic and anaerobic .
The following are sensitive to the drug: Papiliobacter , Enterococcus faecalis, Helicobacter pylori, Enterococcus faecium, Escherichia coli, Trichomonas vaginalis, Atopobium vaginae, Bacillus subtilis, Shigella flexneri, various strains of Salmonella, Enterobacter sph., Citrobacter spp., Staphylococcus aureus, Rettgerella spp., Budvicia aquatic, Poliindustria chimica.
The drug has the ability to be metabolized in the muscles and liver tissues, excreted in milk during breastfeeding, and pass the hemoplacental barrier. About half of nitrofuratel passes through the excretory system (mainly the kidneys).
McMirror price (where to buy)
The average price of Macmiror tablets in Russia is 539 rubles for 10 tablets of 400 mg. The cost of the medicine in Novosibirsk is 520 rubles for 20 pieces. You can buy tablets in Moscow for 600 rubles.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Macmiror Complex cream vaginal.
30gDoppel Pharmaceutical S.r.L. RUR 789 order - Macmiror tablets p.p.o. 200 mg 20 pcs. Doppel Pharmaceutical S.r.L.
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Pharmacy24
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PaniPharmacy
- Macmiror tablets Macmiror tablets. By. 200 mg No. 20 Italy, Doppel Farmaceutici
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