Meroclav 250 mg

Indication:

Meroclav 250 mg is indicated for the treatment of-

• Upper Respiratory Tract Infections: Sinusitis, tonsillitis, and otitis media.
• Lower Respiratory Tract Infections: Acute bronchitis, acute exacerbations of chronic bronchitis, and pneumonia.
• Urinary Tract Infections: Cystitis, pyelonephritis, and urethritis.
• Skin and Soft Tissue Infections: Furunculosis, pyoderma, and impetigo where resistant bacteria are suspected.
• Switch Therapy: Often used as a step-down therapy from injectable cefuroxime to oral form.

Dogase & Adminstration:

Adults (Oral):

• General Infections: 250 mg (cefuroxime) twice daily.
• Severe Infections/Pneumonia: 500 mg (cefuroxime) twice daily.
• Uncomplicated UTI: 125–250 mg twice daily.

Children (Oral – Based on BNFC):

• 3 months to 12 years: Dosage is calculated based on the Cefuroxime component, typically 10–15 mg/kg twice daily.
• Maximum Dose: Should not exceed 500 mg of Cefuroxime per day for children unless specified.

Administration: Must be taken with or immediately after food to enhance absorption and reduce gastrointestinal side effects. Tablets should be swallowed whole.

”রেজিস্ট্রার চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন”

Pharmacology:

• Mechanism of Action:  Cefuroxime: It is a bactericidal agent that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs). This leads to the disruption of peptidoglycan synthesis, resulting in bacterial cell lysis.
  • Clavulanic Acid: Many bacteria produce an enzyme called beta-lactamase, which destroys cephalosporins. Clavulanic acid is a “suicide inhibitor” that binds irreversibly to these enzymes, protecting Cefuroxime from degradation and extending its spectrum of activity against resistant strains.
• Pharmacodynamics: The combination is effective against a wide range of Gram-positive and Gram-negative organisms, including H. influenzae and Moraxella catarrhalis that produce beta-lactamase.
• Pharmacokinetics: Cefuroxime Axetil is absorbed from the GI tract and hydrolyzed to active cefuroxime. Clavulanic acid is also well absorbed. Both reach peak serum levels in 2-3 hours and are excreted primarily via kidneys.

Side Effects:

• Common: Diarrhea (more common due to clavulanic acid), nausea, vomiting, and abdominal pain.
• Others: Candidiasis (fungal overgrowth), skin rash, and transient increase in liver enzymes.

Drug Interaction:

• Probenecid: Competes for renal tubular secretion, increasing cefuroxime levels.
• Oral Contraceptives: May reduce the efficacy of birth control pills.
• Antacids/H2 Blockers: May reduce the absorption of cefuroxime axetil.

Pregnancy & Lactation:

• Pregnancy: Generally considered safe (Category B), but use only if the benefit outweighs the risk.
• Lactation: Both components are excreted in breast milk in small amounts. Monitor the infant for diarrhea or thrush.

Over Dosage:

May cause cerebral irritation and seizures. Treatment is symptomatic. Cefuroxime can be removed by hemodialysis.

Therapeutic Class:

Second-generation Cephalosporin with Beta-lactamase Inhibitor.

Storage Conditions:

Store below at 30°C  temperature in a dry place. Away from light and out of reach of children. Do not use the medication after its expiration date.