Mutaflor

Pharmacological properties

The active ingredient is a strain of non-pathogenic bacteria of human origin, which belong to the species escherichia coli (e. coli), in a lively and reproducible form: e. coli, nissle strain 1917. Using special adhesive organelles (f-1a, f-1c and curly fimbria type), the strain has the ability to attach to the colon mucosa and form microcolonies in the form of a biofilm. due to the presence of flagella, bacteria are inherent in mobility, which gives them an advantage in colonizing the colon. the effects of the drug mutaflor (e. coli strain nissle 1917) were determined in experiments in vitro and in vivo, as well as in clinical studies. The following effects and mechanisms of action are established:

antimicrobial properties (antagonism): E. coli, strain NISSLE 1917, forms antimicrobial substances (microcins) and numerous iron-binding systems (siderophores), which, on the one hand, are responsible for direct antagonism against pathogens, as well as for the stability of the strain, the duration of which exceeds the duration of the actual oral administration of the drug. In addition, the strain has an inhibitory effect on the invasion of enteroinvasive pathogens into the mucous membrane of the large intestine;

stabilization of the mucous barrier of the colon. In experiments on cell cultures of E. coli colonic epithelial cells, NISSLE strain 1917 demonstrated the ability to stabilize the barrier function of the epithelium and normalize the increased permeability of the intestinal mucosa as a whole. This strengthening of the barrier function is a consequence of the stimulation of the synthesis of fixing protein (ZO-2) and the formation of strong intercellular contacts with it.

Immunostimulating properties. In vitro experiments indicate the immunomodulating properties of E. coli, strain NISSLE 1917. The use of the drug in inflammatory bowel diseases reduces the level of migration of new activated T-lymphocytes into the focus of inflammation.

Anti-inflammatory properties. Mutaflor has an anti-inflammatory effect. The anti-inflammatory properties of E. coli strain NISSLE 1917 were established both in in vitro experiments with human epithelial cells and in vivo.

Prokinetic properties. E. coli strain NISSLE 1917 during the metabolism synthesizes short-chain fatty acids, which are necessary for optimal energy balance of the mucous membrane of the colon. They stimulate the motility of the colon and blood flow in its mucous membrane and enhance the absorption of sodium and chlorine ions. Stimulation of motility, which probably occurs under the influence of acetic acid of bacterial origin, plays an important role in the treatment of chronic constipation.

Effect on metabolism. The strain contained in the drug Mutaflor, takes part in numerous metabolic processes and is able to catabolize various carbohydrates, sugar alcohols, amino acids and other substrates, while consuming oxygen. The anaerobic environment in the lumen of the colon, created in this way, is maintained for a long time, which is extremely important for the stability of the intestinal ecosystem.

Pharmacokinetics Due to their shell, Mutaflor capsules are resistant to the action of gastric juice and do not dissolve to the terminal portion of the small intestine. Since the active active substance (E. coli strain NISSLE 1917) is komensal, it quickly colonizes the large intestine without being absorbed or metabolized. It is excreted from the intestines along with feces.

Indications

Chronic constipation ulcerative colitis in remission.

Application

The entire daily dose should be taken with meals, preferably with breakfast, with plenty of fluids. do not chew the capsules.

Adults and children over 15 years old

With ulcerative colitis: during the first 4 days - 1 capsule per day, then 2 capsules per day.Mutaflor should be taken for a long time to prevent relapse of ulcerative colitis. The experience of using the drug for more than 12 months with ulcerative colitis is absent.

For chronic constipation: in the first 4 days - 1 capsule per day, from the 5th day - 2 capsules per day. For chronic constipation, Mutaflor can be taken for 6 weeks. The maximum dose is 4 capsules per day. If the disease is noted in the history for many years, Mutaflor can be used periodically as a prophylactic.

Children. Use in children over the age of 15 years.

Contraindications

Hypersensitivity to the ingredients of the drug.

Side effects

The drug is well tolerated. unwanted effects by frequency of occurrence are classified into the following categories: very often (≥1 / 10), often (≥1 / 100, 1/10), infrequently (≥1 / 1000, 1/100), rarely (≥1 / 10,000 , 1/1000), very rarely (1/10 000), including individual messages.

From the digestive tract: at the beginning of therapy often - bloating; very rarely - changes in the consistency of the stool or its frequency, abdominal pain, flatulence, diarrhea, nausea or vomiting.

From the skin: very rarely - rash, erythema and peeling of the skin, allergic reactions.

From the side of the central nervous system: isolated reports of the occurrence of a headache.

special instructions

Use during pregnancy or lactation. e. coli strain nissle 1917 is a commensal bacterium that is present in the human intestine and is not absorbed, does not affect the course of pregnancy and the period of breastfeeding, so there are no warnings regarding its use.

The ability to influence the reaction rate when driving vehicles or other mechanisms. Not found.

Interactions

Antibiotics that are prescribed to influence gram-negative bacteria, as well as sulfonamides, can reduce the effectiveness of the drug mutaflor.

Overdose

There is no evidence of an overdose of the drug.

Storage conditions

At a temperature of 2–8 ° c.