PIPEMID ® Pipemidic acid

PIPEMID © is a drug based on pipemidic acid trihydrate

THERAPEUTIC GROUP: Antibiotics- Antiinfectives for the treatment of acne

IndicationsAction mechanismStudies and clinical effectiveness Usage and dosage instructionsWarnings Pregnancy and lactationInteractionsContraindicationsUndesirable effects

Indications PIPEMID ® Pipemidic acid

PIPEMID ® is indicated in the treatment of urinary tract infections both acute and chronic.

Therefore this drug is used successfully in the treatment of cystitis, urethritis, pyelonephritis, prostatitis and in the prophylaxis of post-operative urinary tract infections.

Mechanism of action PIPEMID ® Pipemidic acid

PIPEMID ® is an antibiotic containing pipemidic acid, a first generation fluoroquinolone active both against Gram negative and Gram positive bacteria.

Its therapeutic action, particularly concentrated at the level of the urinary tract, where it is possible to find the active form in therapeutically effective concentrations, is linked to the ability to inhibit certain enzymes such as DNA-gyrase and DNA topoisomerase, thus preventing DNA duplication and consequently the bacterial proliferation.

Despite the excellent therapeutic activity, dose dependent, which allows to carry out the biological activity also relatively low concentrations, different bacteria have implemented resistance mechanisms based on mutations of the target enzymes, alteration of the expression of membrane carrier necessary to guarantee intracellular penetration of the antibiotic and expression of efflux pumps capable of eliminating the active principle from the cytoplasmic environment, which significantly reduce the antimicrobial efficacy of the therapy.

After its therapeutic action, pipemidic acid is eliminated mainly with urine and to a small extent, following hepatic metabolism, via the bile.

Studies carried out and clinical efficacy

1. THE LOW EFFECTIVENESS OF PIPEMIDIC ACID IN SMALL PATIENTS

Study demonstrating the poor efficacy of pipemidic acid in the treatment of acute urinary tract infections in children.

It is from these studies that the poor prescriptive appropriateness of this active ingredient emerges in a pediatric clinic

2. THE PIPEMIDIC ACID AGAINST MULTIRESISTIC GERMANS

A dated work that nevertheless emphasizes the effectiveness of pipemidic acid treatment in controlling urinary tract infections sustained by multi-resistant microorganisms such as E.Coli and Proteus.

3. THE PIPEMIDIC ACID IN THE PREVENTION OF THE CYSTITES

Work demonstrating how the use of pipemidic acid can be effective in reducing the recurrence rate of recurrent cystitis in young women, subjected to prophylactic antibiotic treatment

Method of use and dosage

PIPEMID ®

Capsules for oral administration of 400 mg of pipemidic acid.

In order to optimize the effectiveness of antibiotic therapy, it is recommended to take two capsules a day, preferably in the morning and evening after meals, for the necessary period defined by the doctor.

Warnings PIPEMID ® Pipemidic acid

The use of first-generation fluoroquinolones as urinary antiseptics has proved particularly effective and generally well tolerated.

Despite this premise it is always necessary to consult your doctor before undertaking any antibiotic therapy, especially during contextual pharmacological therapies or in the presence of liver and kidney diseases.

During therapy with PIPEMID ® it would also be important to avoid exposure to ultraviolet rays due to the risk of hypersensitivity, and therefore of side effects such as bullous dermatitis.

PREGNANCY AND BREASTFEEDING

The absence of clinical trials able to fully characterize the safety profile of pipemidic acid on the unborn child, suggest the use of PIPEMID ® exclusively in cases of real need and only under the strict supervision of a specialist doctor.

Interactions

Pharmacokinetic studies show that the presence of divalent cations such as those present in antacids containing magnesium and aluminum rather than in oral preparations based on calcium, iron or zinc, or even milk and derivatives can form chelated complexes with fluoroquinolones, reducing their intestinal absorption.

Interactions with glibenclamide are also documented, in which the risk of hypoglycemia, H2 antagonists and probenecid which reduces tubular excretion was increased.