DRUGS & SUPPLEMENTS

Z Plus L

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Z Plus L uses

Z Plus L consists of Amoxicillin, Cloxacillin, Lactobacillus Sporogenes.

Amoxicillin:


Pharmacological action

Z Plus L is an antibiotic of group semisynthetic penicillins a wide spectrum of action. It is a 4-hydroxyl analog of ampicillin. It has bactericidal action. Z Plus L (Amoxicillin) is active against aerobic gram-positive bacteria: Staphylococcus spp. (except strains producing penicillinase), Streptococcus spp; aerobic gram-negative bacteria: Neisseria Gonorrhoeae, Neisseria Meningitidis, Escherichia Coli, Shigella spp., Salmonella spp., Klebsiella spp.

Microorganisms producing penicillinase is resistant to Z Plus L (Amoxicillin).

In combination with metronidazole Z Plus L (Amoxicillin) is active against Helicobacter Pylori. It is believed that inhibits the development of Z Plus L (Amoxicillin) resistance of Helicobacter pylori to metronidazole.

There is a cross-resistance between amoxycillin and ampicillin.

The spectrum of antibacterial action while expanding the application of Z Plus L (Amoxicillin) and beta-lactamase inhibitor clavulanic acid. This combination increased the activity of Z Plus L (Amoxicillin) against Bacteroides spp., Legionella spp., Nocardia spp., Pseudomonas (Burkholderia) Pseudomallei. However, Pseudomonas Aeruginosa, Serratia Marcescens, and many other gram-bacteria are resistant.

Pharmacokinetics

When Z Plus L (Amoxicillin) administered orally Z Plus L (Amoxicillin) rapidly and completely absorbed from the gastrointestinal tract and is not destroyed in the acidic environment of the stomach. Cmax of Z Plus L (Amoxicillin) in the blood plasma is reached after 1-2 h. When increasing doses of 2 times the concentration also increased by 2 times. In the presence of food in the stomach does not reduce the overall removals. Similar concentrations of Z Plus L (Amoxicillin) reached in the blood when administered orally, IV and IM.

The binding of Z Plus L (Amoxicillin) to plasma proteins is about 20%.

Widely distributed in tissues and body fluids. Reported high concentrations of Z Plus L (Amoxicillin) in the liver.

T1/2 from the plasma is 1-1.5 h. About 60% of the dose adopted by mouth, is excreted unchanged in the urine by glomerular filtration and tubular secretion, with a dose of 250 mg of Z Plus L (Amoxicillin) concentration in urine exceeds 300 micrograms / ml. A number of Z Plus L (Amoxicillin) is determined in feces.

T1/2 for Newborns and the elderly can be longer.

In renal insufficiency T1/2 may be 7-20 hours.

In small quantities Z Plus L (Amoxicillin) penetrates through BBB in inflammation of the pia mater.

Z Plus L (Amoxicillin) is removed by hemodialysis.

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Why is Z Plus L prescribed?

For use Z Plus L (Amoxicillin) as monotherapy and in combination with clavulanic acid: an infectious-inflammatory diseases caused by susceptible microorganisms, including bronchitis, pneumonia, tonsillitis, pyelonephritis, urethritis, infections of the gastrointestinal tract, gynecological infections, infections of the skin and soft tissue, listeria, leptospirosis, gonorrhea.

For use Z Plus L (Amoxicillin) in combination with metronidazole: chronic gastritis in acute, peptic ulcer and duodenal ulcer in acute, associated with Helicobacter Pylori.

Dosage and administration

Individual. For oral single dose for adults and children over 10 years is 250-500 mg, in case of serious illness - up to 1 g. For children aged 5-10 years, a single dose of 250 mg in age from 2 to 5 years - 125 mg for children aged under 2 years of daily dose is 20 mg / kg. For adults and children interval is 8 h. In the treatment of acute uncomplicated gonorrhea - 3 g once (in combination with probenecid). Patients with impaired renal function in creatinine clearance 10-40 ml / min interval between doses should be increased to 12 h and if creatinine clearance is less than 10 ml / min interval between doses should be 24 hours.

When parenteral use in adults IM - 1 g 2 times / day, IV (with normal renal function) - 2.12 g / day. Children IM 50 mg / kg / day, single dose - 500 mg, the frequency of administration - 2 times / day; IV - 100-200 mg / kg / day. Patients with impaired renal function the dose and the interval between the injections need to be adjusted in accordance with the values of creatinine clearance.

Z Plus L (Amoxicillin) side effects, adverse reactions

Allergic reactions: urticaria, erythema, edema Quincke, rhinitis, conjunctivitis, rarely - fever, joint pain, eosinophilia, in rare cases - anaphylactic shock.

Side effects associated with chemotherapy effect: possible development of super-infection (particularly in patients with chronic diseases or low resistance of the organism).

With prolonged use at high doses: dizziness, ataxia, confusion, depression, peripheral neuropathy, seizures.

Mostly when Z Plus L (Amoxicillin) used in combination with metronidazole: nausea, vomiting, anorexia, diarrhea, constipation, epigastric pain, glossitis, stomatitis; rarely - hepatitis, pseudomembranous colitis, allergic reactions (urticaria, angioedema), interstitial nephritis, a violation of hematopoiesis.

Mostly when Z Plus L (Amoxicillin) used in combination with clavulanic acid: cholestatic jaundice, hepatitis, rarely - erythema multiforme, toxic epidermal necrolysis, exfoliative dermatitis.

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Contraindications

Infectious mononucleosis, lymphatic leukemia, severe gastrointestinal infections, accompanied by diarrhea or vomiting, respiratory viral infection, allergic diathesis, bronchial asthma, hay fever, sensitivity to penicillin and / or cephalosporins.

For use in combination with metronidazole: diseases of the nervous system; hemodyscrasia, lymphocytic leukemia, an infectious mononucleosis; Hypersensitivity to nitroimidazole derivatives.

For use in combination with clavulanic acid: a history of instructions for liver problems and jaundice, associated with the reception of Z Plus L in combination with clavulanic acid.

Using during pregnancy and breastfeeding

Z Plus L (Amoxicillin) crosses the placenta, in small amounts excreted in breast milk.

If necessary the use of Z Plus L (Amoxicillin) during pregnancy should carefully weigh the potential benefits of therapy for the mother and the potential risk to the fetus.

With careful use Z Plus L (Amoxicillin) during lactation (breastfeeding).

Special instructions

With caution used in patients prone to allergic reactions.

Z Plus L in combination with metronidazole is not recommended to use in patients younger than 18 years should not be used for liver diseases.

In the combined therapy with metronidazole is recommended not to drink alcohol.

Precautionary measures

Treatment must continue 48-72 hours after the disappearance of clinical signs of disease, with streptococcal infections - 10 days.

During the course treatment is necessary to control the state functions of hematopoiesis, liver and kidneys.

Perhaps the development of superinfection due to growth insensitive to the drug microflora. In the case of superinfection requires removal of Z Plus L (Amoxicillin) and the corresponding change in antibiotic therapy. When treating patients with bacteremia may develop bacteriolysis reaction (reaction of Jarisch-Herxheimer).

Patients who have an increased sensitivity to penicillin, may be cross-allergic reactions to cephalosporin antibiotics.

In the treatment of mild diarrhea at the background of the treatment should be avoided antidiarrhoeal drugs that reduce intestinal motility; can use kaolin or attapulgite containing antidiarrhoeal stuff. Patients with severe diarrhea should consult a doctor.

With simultaneous use of Z Plus L (Amoxicillin) and oral contraceptives estrogensoderzhaschih and Z Plus L (Amoxicillin) should if possible to use additional methods of contraception.

Z Plus L drug interactions

Z Plus L (Amoxicillin) may decrease the effectiveness of contraceptives for oral administration.

With the simultaneous use of Z Plus L (Amoxicillin) with bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, vancomycin, rifampicin) appears synergies; with bacteriostatic antibiotic (including macrolides, chloramphenicol, lincosamides, tetracyclines, sulphonamide) - antagonism.

Z Plus L (Amoxicillin) increases the effects of indirect anticoagulants inhibiting intestinal microflora, reduces the synthesis of vitamin K and prothrombin index.

Z Plus L (Amoxicillin) reduces the effect of drugs, in the process of metabolism that produce PABA.

Probenecid, diuretics, allopurinol, phenylbutazone, NSAIDs decrease the tubular secretion of Z Plus L (Amoxicillin), which can be accompanied by an increase in its concentration in blood plasma.

Antacids, glucosamine, laxatives, aminoglycosides, slow down and reduce, and ascorbic acid increases the absorption of Z Plus L (Amoxicillin).

With the combined use of Z Plus L (Amoxicillin) and clavulanic acid pharmacokinetics of both components unchanged.

Z Plus L in case of emergency / overdose

Symptoms: nausea, vomiting, diarrhea, disruption of water and electrolyte balance (as a result of vomiting and diarrhea); for prolonged use at high doses - neurotoxic reactions and thrombocytopenia (these phenomena are reversible and disappear after drug withdrawal).

Treatment: gastric lavage, the prescription of activated charcoal, saline laxatives, correction of water and electrolyte balance; hemodialysis.

Cloxacillin:



NADA 055-058, Approved by FDA

Caution:

Federal law restricts this drug to use by or on the order of a licensed veterinarian.

Description:

Z Plus L (Cloxacillin) (cloxacillin benzathine) for Intramammary Infusion into the Dry Cow is a product which provides bactericidal activity against gram-positive bacteria. The active agent, Z Plus L (Cloxacillin) benzathine, is a sparingly soluble salt of the semisynthetic penicillin, Z Plus L (Cloxacillin). Z Plus L (Cloxacillin) is a derivative of 6-aminopenicillanic acid, and therefore is chemically related to other penicillins. It has, however, the antibacterial properties described below, which distinguish it from certain other penicillins.

Each 10 mL disposable syringe contains Z Plus L (Cloxacillin) benzathine equivalent to 500 mg of Z Plus L (Cloxacillin) activity in a stable peanut oil gel. This product was manufactured by a non-sterilizing process.

Storage:

Do not store above 25°C (77°F). Do not freeze.

Action:

In the non-lactating mammary gland, Z Plus L (Cloxacillin) (cloxacillin benzathine) provides bactericidal levels of the active antibiotic, Z Plus L (Cloxacillin), for a prolonged period of time. This prolonged activity is due to the low solubility of the Z Plus L (Cloxacillin) benzathine and to the slow-release oil-gel base. This prolonged contact between the antibiotic and the pathogenic organism enhances the probability of a bacteriological cure.

Z Plus L (Cloxacillin) is not destroyed by the enzyme, penicillinase, and therefore, is active against penicillin-resistant strains of Staphylococcus aureus. It is also active against non-penicillinase-producing Staphylococcus aureus as well as Streptococcus agalactiae.

The class disc, Methicillin 5 mcg, should be used to estimate the in vitro susceptibility of bacteria to Z Plus L (Cloxacillin).

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Indications:

For the treatment of mastitis in dairy cows during the dry period.

Z Plus L (Cloxacillin) has been shown by extensive clinical studies to be efficacious in the treatment of mastitis in dry cows, when caused by Streptococcus agalactiae and Staphylococcus aureus including penicillin-resistant strains.

Treatment of the dry cow with Z Plus L (Cloxacillin) is indicated in any cow known to harbor any of these organisms in the udder at drying off, or which has had repeated attacks of mastitis during the previous lactation, or is affected with mastitis at drying off, if caused by susceptible organisms.

Dosage for Dry Cows:

Infuse the contents of one syringe (10 mL) into each quarter following the last milking. See Directions for Use.

Directions for Use:

Z Plus L (Cloxacillin) (cloxacillin benzathine) is for use in dry cows only. Administer immediately after the last milking. Use no later than 30 days prior to calving.

Completely milk out all four quarters. The udder and teats should be thoroughly washed with warm water containing a suitable dairy antiseptic and dried, preferably using individual paper towels. Carefully scrub the teat end and orifice with 70% alcohol, using a separate swab for each teat. Allow to dry.

Z Plus L (Cloxacillin) is packaged with the Opti-Sert® Protective Cap.

For partial insertion: Twist off upper portion of the Opti-Sert Protective Cap to expose 3–4 mm of the syringe tip.

For full insertion: Remove protective cap to expose the full length of the syringe tip.

Insert syringe tip into the teat canal and expel the entire contents of syringe into the quarter. Withdraw the syringe and gently massage the quarter to distribute the medication.

Do not infuse contents of the mastitis syringe into the teat canal if the Opti-Sert Protective Cap is broken or damaged.

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Precautions:

Because it is a derivative of 6-aminopenicillanic acid, Z Plus L (Cloxacillin) has the potential for producing allergic reactions. Such reactions are rare; however, should they occur, the subject should be treated with antihistamines or pressor amines, such as epinephrine.

Residue Warnings:

1. For use in dry cows only.

2. Not to be used within 30 days of calving.

3. Any animal infused with this product must not be slaughtered for food until 30 days after the latest infusion.

How Supplied:

Z Plus L (Cloxacillin) (cloxacillin benzathine) Intramammary Infusion is supplied as 10 mL syringes containing 500 mg of Z Plus L (Cloxacillin) activity per syringe. One display carton contains 12 syringes. One pail contains 144 syringes.

NDC 0010-4720-01 - 10 mL syringe

NDC 0010-4720-02 - 12 syringes

NDC 0010-4720-03 - 144 syringes

Opti-Sert is a registered trademark of Zoetis W LLC - used under license.

Z Plus L (Cloxacillin) is a registered trademark of Boehringer Ingelheim Vetmedica, Inc.

© 2014 Boehringer Ingelheim Vetmedica, Inc. All Rights Reserved.

Made in Italy

Manufactured for:

Boehringer Ingelheim Vetmedica, Inc.

St. Joseph, MO 64506 U.S.A.

51729292

472001-03

Z Plus L pharmaceutical active ingredients containing related brand and generic drugs:

infoActive ingredient is the part of the drug or medicine which is biologically active. This portion of the drug is responsible for the main action of the drug which is intended to cure or reduce the symptom or disease. The other portions of the drug which are inactive are called excipients; there role is to act as vehicle or binder. In contrast to active ingredient, the inactive ingredient's role is not significant in the cure or treatment of the disease. There can be one or more active ingredients in a drug.


Z Plus L available forms, composition, doses:

infoForm of the medicine is the form in which the medicine is marketed in the market, for example, a medicine X can be in the form of capsule or the form of chewable tablet or the form of tablet. Sometimes same medicine can be available as injection form. Each medicine cannot be in all forms but can be marketed in 1, 2, or 3 forms which the pharmaceutical company decided based on various background research results.
Composition is the list of ingredients which combinedly form a medicine. Both active ingredients and inactive ingredients form the composition. The active ingredient gives the desired therapeutic effect whereas the inactive ingredient helps in making the medicine stable.
Doses are various strengths of the medicine like 10mg, 20mg, 30mg and so on. Each medicine comes in various doses which is decided by the manufacturer, that is, pharmaceutical company. The dose is decided on the severity of the symptom or disease.


Z Plus L destination | category:

infoDestination is defined as the organism to which the drug or medicine is targeted. For most of the drugs what we discuss, human is the drug destination.
Drug category can be defined as major classification of the drug. For example, an antihistaminic or an antipyretic or anti anginal or pain killer, anti-inflammatory or so.


Z Plus L Anatomical Therapeutic Chemical codes:

infoA medicine is classified depending on the organ or system it acts [Anatomical], based on what result it gives on what disease, symptom [Therapeutical], based on chemical composition [Chemical]. It is called as ATC code. The code is based on Active ingredients of the medicine. A medicine can have different codes as sometimes it acts on different organs for different indications. Same way, different brands with same active ingredients and same indications can have same ATC code.


Z Plus L pharmaceutical companies:

infoPharmaceutical companies are drug manufacturing companies that help in complete development of the drug from the background research to formation, clinical trials, release of the drug into the market and marketing of the drug.
Researchers are the persons who are responsible for the scientific research and is responsible for all the background clinical trials that resulted in the development of the drug.


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References

  1. Dailymed."AMOXIL (AMOXICILLIN) TABLET [DIRECT RX]". https://dailymed.nlm.nih.gov/dailym... (accessed August 28, 2018).
  2. Dailymed."CLOXACILLIN SODIUM: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailym... (accessed August 28, 2018).
  3. Dailymed."AMOXICILLIN; CLAVULANATE POTASSIUM: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailym... (accessed August 28, 2018).

Frequently asked Questions

Can i drive or operate heavy machine after consuming Z Plus L?

Depending on the reaction of the Z Plus L after taken, if you are feeling dizziness, drowsiness or any weakness as a reaction on your body, Then consider Z Plus L not safe to drive or operate heavy machine after consumption. Meaning that, do not drive or operate heavy duty machines after taking the capsule if the capsule has a strange reaction on your body like dizziness, drowsiness. As prescribed by a pharmacist, it is dangerous to take alcohol while taking medicines as it exposed patients to drowsiness and health risk. Please take note of such effect most especially when taking Primosa capsule. It's advisable to consult your doctor on time for a proper recommendation and medical consultations.

Is Z Plus L addictive or habit forming?

Medicines are not designed with the mind of creating an addiction or abuse on the health of the users. Addictive Medicine is categorically called Controlled substances by the government. For instance, Schedule H or X in India and schedule II-V in the US are controlled substances.

Please consult the medicine instruction manual on how to use and ensure it is not a controlled substance.In conclusion, self medication is a killer to your health. Consult your doctor for a proper prescription, recommendation, and guidiance.

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Review

sDrugs.com conducted a study on Z Plus L, and the result of the survey is set out below. It is noteworthy that the product of the survey is based on the perception and impressions of the visitors of the website as well as the views of Z Plus L consumers. We, as a result of this, advice that you do not base your therapeutic or medical decisions on this result, but rather consult your certified medical experts for their recommendations.

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The information was verified by Dr. Arunabha Ray, MD Pharmacology

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