Efizol

Pharmacological properties

efizol is a combined preparation with a well-defined local antiseptic, antibacterial and antifungal effect. used for sore throat. exhibits mainly bacteriostatic (according to some data - bactericidal) action against a number of gram-positive and gram-negative microorganisms, including antibiotic-resistant strains. efizol is most effective at alkaline ph value (as an environment in the oral cavity). Dequalinium chloride is a local antiseptic of the quinoline group. it is a bis-quaternary quinoline with antiseptic and bacteriostatic effects.

Dequalinium chloride has:

• antiseptic effect, mainly local;
• antibacterial action - mainly with respect to gram-negative and gram-positive microorganisms, mainly against pyogenic pathogens and strains resistant to antibiotics (pyogenic streptococci, Borrelia, etc.);
• antifungal effect - mainly against Candida albicans, some species of Trychophyton and epidermophytes. No activity against Mycobacterium. The antibacterial effect due to the denaturation of proteins and enzymes of pathogens by dissolution and depolymerization, as well as glycolysis and inactivation of dehydrogenases, is a reversible effect, however, prolonged contact with the pathogen inactivates them irreversibly, which leads to disruption of protein synthesis at the level of ribosomes, cell membrane cytolysis. The surface-active cationic effect underlies the bacteriostatic activity of the drug, which is more pronounced in relation to gram-positive than gram-negative microorganisms.

Ascorbic acid, which is part of Efizol, acts on intracellular oxidation and reduction processes; it increases the synthesis of specific antibacterial antitoxins and improves the functions of the reticuloendothelium, reduces the permeability of cell membranes, improves the condition of the capillaries of the vascular wall and limits exudative, inflammatory and allergic reactions.

The resistance of microorganisms to the drug develops slowly, with prolonged use (more than 15–20 days). Resistance develops faster with respect to penicillin, streptomycin and sulfonamide-resistant microorganisms, and to a lesser extent with respect to gram-positive microorganisms and fungi.

Pharmacokinetics Efizol has a local antiseptic effect in the oral cavity. Quickly absorbed in the digestive tract. Distributed by diffusion through the liver, lungs, kidneys. Long excretion (with urine and feces).

Indications

Local antiseptic treatment of inflammatory processes of the oral cavity and throat caused by drug-sensitive pathogens (catarrhal, ulcerative, fibrous gingivitis, aphthous stomatitis, candidiasis (thrush), pharyngitis, tonsillitis, laryngitis and glossitis);

in the complex treatment of more severe throat infections in combination with antibiotics and sulfonamides;

prevention of infections before and after surgery in the mouth and throat.

Application

Adults and children over 4 years of age are prescribed 1 tablet for resorption every 2-3 hours (no more than 8-10 tablets per day). do not chew the tablets. after taking efizol, the patient is not recommended to eat and drink for 30 minutes.

Treatment is recommended to continue for another 1-2 days after the disappearance of the symptoms of the disease. The total duration of treatment should not exceed 5-7 days (there is a danger of impaired development of normal bacterial flora in the oral cavity and throat).

Children. The drug in this dosage form is not used in children under the age of 4 years due to the risk of aspiration.

Contraindications

Hypersensitivity to active substances or to any of the excipients.thrombosis, tendency to thrombosis, thrombophlebitis, severe kidney disease, diabetes mellitus, fructose intolerance, lappase lactase deficiency or glucose-galactose malabsorption syndrome. allergy to quaternary ammonium compounds (e.g. benzalkonium chloride).

Side effects

The drug is usually well tolerated, there have been no reports of serious side effects. however, the following adverse drug reactions associated with dequalinium chloride are possible:

from the digestive tract: nausea, vomiting, burning sensation and irritation in the throat, dry mouth, dysbiosis of the oral cavity (with prolonged use in high doses);

other: allergic reactions are very rarely possible;

local reactions: in rare cases, namely with abuse, ulcers and necrosis may occur.

The following adverse reactions associated with ascorbic acid are possible:

from the immune system: allergic reactions, including rash, itching, angioedema, urticaria; sometimes - anaphylactic shock in the presence of sensitization;

on the part of the skin and subcutaneous tissue: eczema;

from the cardiovascular system: AH;

on the part of the nervous system: increased irritability, sleep disturbance, headache, sensation of heat, increased fatigue;

with prolonged use in high doses (more than 1 g of ascorbic acid per day), the following are possible: damage to the insular apparatus of the pancreas (hyperglycemia, glucosuria) and impaired glycogen synthesis until diabetes mellitus appears; myocardial dystrophy, thrombocytosis, hyperprothrombinemia, erythrocytopenia, neutrophilic leukocytosis; in patients with deficiency of glucose-6-phosphate dehydrogenase, blood cells can cause erythrocyte hemolysis; dysbiosis of the oral cavity; irritation of the mucous membrane of the digestive tract, heartburn, vomiting, diarrhea, damage to the glomerular apparatus of the kidneys. Crystalluria, the formation of urate, cystine and / or oxalate calculi in the kidneys and urinary tract, renal failure, impaired metabolism of zinc, copper.

special instructions

Due to the lack of an analgesic component in the preparation, it is not advisable to use it in inflammatory processes accompanied by severe sore throat. in the presence of the main clinical symptoms of generalization of the infection, it is necessary to consult a doctor who will prescribe systemic antibacterial treatment. if any side effects occur, the drug should be discontinued. simultaneous use with other drugs for local treatment should be carried out with caution, under the supervision of a physician.

Absorption of ascorbic acid may be impaired with intestinal dyskinesia, enteritis and achilia.

It is used with caution in patients with glucose-6-phosphate dehydrogenase deficiency.

Ascorbic acid as a reducing agent can affect the results of laboratory tests, for example, in determining the blood levels of glucose, bilirubin, transaminase activity, LDH.

When taking ascorbic acid more than 1 g / day and prolonged use, which exceeds the recommended daily dose and duration of treatment with Efizol more than 3 times, it is necessary to monitor renal function and blood pressure, as well as pancreatic function. Use the drug with caution in patients with a history of kidney disease.

In urolithiasis, the daily dose of ascorbic acid should not exceed 1 g, since there is a risk of the formation of calcium-oxalate stones when using ascorbic acid in high doses in patients prone to kidney stones. In patients with galactosemia, the drug should be used with caution.Since ascorbic acid increases iron absorption, its use in high doses, more than 1 g, can be dangerous for patients with hemochromatosis, thalassemia, polycythemia, leukemia and sideroblastic anemia. In patients with a high iron content in the body, the drug should be used in recommended doses.

High doses of the drug should not be prescribed to patients with increased blood coagulation.

Use during pregnancy and lactation. During pregnancy and lactation, the drug is used with caution, under the supervision of a doctor, strictly observing the recommended doses.

The ability to influence the reaction rate when driving vehicles or working with other mechanisms. The drug does not affect the performance of work requiring increased attention (driving and working with other mechanisms).

Interactions

The antibacterial activity of dequalinium chloride decreases with the simultaneous use of detergents, such as toothpaste.

The absorption of ascorbic acid is reduced with the simultaneous use of oral contraceptives, the use of fruit or vegetable juices, alkaline drinking. Oral ascorbic acid increases the absorption of penicillin, tetracycline, iron, and also promotes the absorption of aluminum in the intestine, which should be taken into account when treating with antacids containing aluminum.

Ascorbic acid reduces the effectiveness of heparin and indirect anticoagulants, increases the risk of crystalluria during treatment with salicylates. The simultaneous administration of ascorbic acid and deferoxamine increases the tissue toxicity of iron, especially in the heart muscle, which can lead to decompensation of the circulatory system. Ascorbic acid can be taken only 2 hours after injection of deferoxamine.

Long-term administration of high doses of ascorbic acid by persons who are treated with disulfiram inhibits the disulfiram-alcohol reaction. High doses of ascorbic acid reduce the effectiveness of tricyclic antidepressants, antipsychotics - phenothiazine derivatives, tubular reabsorption of amphetamine, and impair kidney secretion of mexiletine.

Ascorbic acid increases the overall clearance of ethyl alcohol. Quinoline drugs, calcium chloride, salicylates, corticosteroids with prolonged use reduce the reserves of ascorbic acid in the body.

With simultaneous administration with sodium polystyrenesulfonate (a tool for the treatment of hyperkalemia), the development of severe necrotic lesions of the skin and mucous membranes, especially the gastrointestinal tract, is likely.

Overdose

Strengthening the manifestations of adverse reactions. ascorbic acid is well tolerated. it is a water-soluble vitamin; its excess is excreted in the urine. however, prolonged use of vitamin C in high doses may inhibit the function of the insular apparatus of the pancreas, which requires monitoring the state of the latter. an overdose can lead to changes in the renal excretion of ascorbic and uric acid during acetylation of urine with a risk of precipitation of oxalate calculi.

The use of the drug in high doses can lead to vomiting, nausea or diarrhea, which disappear after its withdrawal. The treatment is symptomatic.

Storage conditions

In the original packaging at a temperature not exceeding 25 ° c.