Utibid (Tablets) Instructions for Use

Marketing Authorization Holder

Lupin, Ltd. (India)

ATC Code

J01MA06 (Norfloxacin)

Active Substance

Norfloxacin (Rec.INN registered by WHO)

Dosage Form

Utibid

Film-coated tablets, 400 mg: 10 or 60 pcs.

Dosage Form, Packaging, and Composition

10 pcs. – blister packs (1) – cardboard packs.
10 pcs. – blister packs (6) – cardboard packs.

Clinical-Pharmacological Group

Antibacterial drug of the fluoroquinolone group

Pharmacotherapeutic Group

Antimicrobial agent – fluoroquinolone

Pharmacological Action

A broad-spectrum antimicrobial synthetic agent of the fluoroquinolone group. It has a bactericidal effect. By suppressing DNA gyrase, it disrupts the DNA supercoiling process.

It is highly active against most gram-negative bacteria: Escherichia coli, Salmonella spp., Shigella spp., Proteus spp., Morganella morganii, Klebsiella spp. (including Klebsiella pneumoniae), Enterobacter spp., Serratia spp., Citrobacter spp., Yersinia spp., Providencia spp., Haemophilus influenzae, Pseudomonas aeruginosa, Neisseria gonorrhoeae, Neisseria meningitidis.

It is active against some gram-positive bacteria (including Staphylococcus aureus).

Anaerobic bacteria are resistant to norfloxacin, while Enterococcus spp. and Acinetobacter spp. are poorly sensitive.

It is resistant to the action of β-lactamases.

Pharmacokinetics

When taken orally, about 30-40% is absorbed; food intake reduces the rate of absorption. Plasma protein binding is 14%. Norfloxacin is well distributed in the tissues of the urogenital system. It penetrates the placental barrier. About 30% is excreted in the urine unchanged.

Indications

Infectious and inflammatory diseases caused by microorganisms sensitive to norfloxacin, including diseases of the urinary tract, prostate gland, gastrointestinal tract, gonorrhea, prevention of recurrences of urinary tract infections, bacterial infections in patients with granulocytopenia, “traveler’s diarrhea”.

ICD codes

Dosage Regimen

Administer orally with a full glass of water. Take doses at least 2 hours before or 2 hours after consuming antacids or products containing iron, zinc, magnesium, calcium, or sucralfate.

For uncomplicated urinary tract infections, the standard dose is 400 mg twice daily for 7 to 10 days.

For complicated urinary tract infections, administer 400 mg twice daily for 10 to 21 days, based on clinical response.

For prostatitis, the recommended regimen is 400 mg twice daily for 4 weeks or longer.

For gonorrhea, administer a single 800 mg dose. Concurrent treatment for possible Chlamydia trachomatis infection is recommended.

For gastrointestinal infections, including traveler’s diarrhea, the dose is 400 mg twice daily for 3 to 5 days.

For prophylaxis of recurrent urinary tract infections, a single nightly dose of 200 mg or 400 mg may be used for long-term suppression.

In patients with renal impairment, adjust the dosage. For a creatinine clearance rate of 30 mL/min/1.73 m² or greater, use the standard dose. For a clearance rate of 10-29 mL/min/1.73 m², administer 400 mg once daily. For patients on hemodialysis, administer 400 mg after each dialysis session.

The duration of therapy is individual and depends on the severity of the infection and the patient’s clinical response. Do not exceed the maximum daily dose of 800 mg.

Adverse Reactions

From the digestive system: nausea, heartburn, anorexia, diarrhea, abdominal pain.

From the CNS: headache, dizziness, feeling of fatigue, sleep disorders, irritability, feeling of anxiety.

Allergic reactions: skin rash, itching, angioedema.

From the urinary system: interstitial nephritis.

Contraindications

Pregnancy, lactation (breastfeeding), childhood and adolescence (up to 15 years), glucose-6-phosphate dehydrogenase deficiency, hypersensitivity to norfloxacin and other quinolone drugs.

Use in Pregnancy and Lactation

Norfloxacin is contraindicated during pregnancy and lactation (breastfeeding), since experimental studies have established that it causes arthropathy.

Use in Hepatic Impairment

Should be used with caution in patients with severe liver dysfunction.

Use in Renal Impairment

Should be used with caution in patients with severe renal dysfunction.

Pediatric Use

Contraindicated in childhood and adolescence (up to 15 years).

Special Precautions

Should be used with caution in patients with epilepsy, convulsive syndrome of other etiology, and with severe impairment of renal and liver function. During treatment, patients should receive a sufficient amount of fluid (under the control of diuresis).

Norfloxacin should be taken at least 2 hours before or 2 hours after taking antacids or preparations containing iron, zinc, magnesium, calcium, or sucralfate.

Drug Interactions

With simultaneous use of norfloxacin with warfarin, the anticoagulant effect of the latter is enhanced.

With simultaneous use of norfloxacin with cyclosporine, an increase in the concentration of the latter in the blood plasma is noted.

With simultaneous administration of norfloxacin and antacids or preparations containing iron, zinc, magnesium, calcium, or sucralfate, the absorption of norfloxacin is reduced due to the formation of chelates with metal ions (the interval between their intake should be at least 4 hours).

With simultaneous administration, Norfloxacin reduces the clearance of theophylline by 25%, therefore, when used simultaneously, the dose of theophylline should be reduced.

Simultaneous administration of norfloxacin with drugs that have a potential ability to reduce blood pressure may cause a sharp decrease in it. In this regard, in such cases, as well as with simultaneous administration of barbiturates and anesthetic agents, heart rate, blood pressure, and ECG parameters should be monitored. Simultaneous use with drugs that lower the epileptic threshold may lead to the development of epileptiform seizures.

Reduces the effect of nitrofurans.

Storage Conditions

Store at 2°C (36°F) to 25°C (77°F). Keep in original packaging, protected from light. Keep out of reach of children.

Dispensing Status

Rx Only

Important Safety Information

This information is for educational purposes only and does not replace professional medical advice. Always consult your doctor before use. Dosage and side effects may vary. Use only as prescribed.