PIPRAM ® is a pipemidic acid-based drug
THERAPEUTIC GROUP: Antibacterial for systemic use
Indications PIPRAM ® Pipemidic acid
PIPRAM ® is indicated in the treatment of urinary tract infections, both high and low, sustained by microorganisms sensitive to pipemidic acid.
Mechanism of action PIPRAM ® Pipemidic acid
Pipemidic acid, the active ingredient of PIPRAM ®, is an antimicrobial chemotherapy which belongs structurally to the category of quinolones, particularly used in the clinical setting in the treatment of urinary tract infections.
These indications arise from the particular pharmacokinetic profile of pipemidic acid, which taken orally and absorbed by the gastrointestinal tract, through the circulatory stream reaches the renal environment unaltered, being filtered at the glomerular level.
The persistence in the urinary level allows pipemidic acid to carry out its antibiotic action by inhibiting the activity of enzymes such as DNA gyrase and DNA topoisomerase, normally involved in the replication mechanisms of bacterial DNA, therefore in proliferative ones.
In this way the antibacterial activity is thus realized, supported also by the control of the diffusion of the resistance mechanisms put in place by the pipemidic acid through the inhibition of the diffusion of the plasmid DNA.
Studies carried out and clinical efficacy
ANTIBIOTIC THERAPY AND DRUG RESISTANCE
Pak J Pharm Sci. 2013 Jan; 26: 11-5.
Current efficacy of antibiotics against Klebsiella isolates from urine samples - a multi-centric experience in Karachi.
Abdullah FE, Mushtaq A, Irshad M, Rauf H, Afzal N, Rasheed A.
Interesting study that demonstrates how the inappropriate use of antibiotics can lead to the appearance of microbial strains, isolated from the urine, generally resistant to different antibiotics.
It is therefore suggested, even in the case of pipemidic acid therapy, to carry out a culture test with an antibiogram before administering the drug.
GENOTOXIC POTENTIAL OF PIPEMIDIC ACID
Arch Med Res. 1998 Autumn; 29: 235-40.
Genotoxic evaluation of norfloxacin and pipemidic acid with the Escherichia coli Pol A- / Pol A + and the ames test.
Arriaga-Alba M, Barrón-Moreno F, Flores-Paz R, García-Jiménez E, Rivera-Sánchez R.
Important work that focuses on the study of the genotoxic potential of some antibiotics, including pipemidic acid induced in the various cells.
The study demonstrates how in certain cases, it would be appropriate to consider the potential genotoxicity among the side effects of therapy, generally determined by the pro-oxidant load of the drug.
DETECTION OF PIPEMIDIC ACID AND DEFINITION OF DOSAGES
J Clin Lab Anal. 2010; 24: 327-33.
Simultaneous determination of proline and pipemidic acid in human urine by capillary electrophoresis with electrochemiluminescence detection.
Sun H, Li L, Su M.
Technical study that evaluates the use of new detection systems for pipemidic acid in urine. These works are important to better clarify the pharmacokinetic characteristics of the active ingredient and the consequent definition of the dosages to be used.
Method of use and dosage
PIPRAM ®
Hard capsules of 400 mg of pipemidic acid.
PIPRAM ® based therapy should be defined by your physician based on the clinical characteristics of the patient.
In general, the assumption of 400 mg of pipemidic acid twice a day and preferably after meals, should guarantee a regression of the symptoms in a few days of therapy.
In order to avoid the possible occurrence of relapses, it would be advisable to prolong the therapy for a few days after the disappearance of the symptoms.
Warnings PIPRAM ® Pipemidic acid
Like any antibiotic therapy, medical supervision and a careful check-up to evaluate the possible presence of conditions incompatible with the therapy itself is also necessary for that based on pipemidic acid.
The photosensitizing power of the active ingredient could expose the skin of patients treated and exposed to ultraviolet radiation to the risk of burns and dermatological reactions.
We also recall the ability, albeit rare, of quinolones to cause tendonitis in particularly susceptible patients such as the elderly.
PREGNANCY AND BREASTFEEDING
Given the absence of clinical trials able to accurately reveal the safety profile of pipemidic acid on the fetus accidentally exposed to the drug, it is advisable to avoid the use of PIPRAM ® during pregnancy and in the subsequent breastfeeding period.
In cases of necessity, close supervision by your gynecologist is necessary.
Interactions
Although the use of PIPRAM ® is generally safe and devoid of clinically relevant interactions, in order to ensure the maximum efficacy of the therapy it would be advisable to avoid the simultaneous intake of preparations, foods and active ingredients containing divalent metals, such as magnesium, aluminum, calcium, iron and zinc known the chelating qualities of the latter against pipemidic acid.
Different studies, although still experimental, also show pharmacological interactions of pipemidic acid with erythromycin, glibenclamide, probenecid and H2 antagonists.
Contraindications PIPRAM ® Pipemidic acid
The use of PIPRAM ® is contraindicated in patients hypersensitive to the active substance or to any of its excipients and in pediatric age.
Undesirable Effects - Side Effects
The use of PIPRAM ®, especially when prolonged over time, could lead to the onset of nausea, vomiting, diarrhea, abdominal pain, dyspepsia and only rarely more serious side effects such as pseudomembranous colitis or adverse reactions of a dermatological and hepatotoxic nature.
Note
PIPRAM ® is a drug subject to mandatory medical prescription.
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