Rime-O

Rime-O

Cefixime (200 mg), Ofloxacin (200 mg)

Rime-O Tablet is a combination medicine that is used to treat various types of bacterial infections. It fights against the microorganisms to prevent their growth and further spread of the infection.

Cefixime is an oral third-generation cephalosporin antibiotic. It is used to treat gonorrhoea, tonsillitis, and pharyngitis. It works by stopping the growth of bacteria. This antibiotic treats only bacterial infections. It will not work for viral infections.

Ofloxacin belongs to the class of drugs known as fluoroquinolone antibiotics. It works by killing bacteria or preventing their growth. However, this medicine will not work for colds, flu, or other viral infections.

Mechanism of Action:

Cefixime- binds to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall, thereby inhibiting the third and final phase of bacterial cell wall synthesis. Cell lysis is then mediated by bacterial cell wall autolytic enzymes such as autolysins; cefixime may interfere with an autolysin inhibitor.

Ofloxacin– is a quinolone antimicrobial agent. Inhibition of bacterial topoisomerase IV and DNA gyrase (both of which are type II topoisomerases), enzymes required for DNA replication, transcription, repair and recombination.

Pharmacodynamics

is an orally-active cephalosporin antibiotic which has in vitro bactericidal activity against a wide variety of gram-positive and gram-negative organisms including Streptococcus pneumoniae, Streptococcus pyogenes, Escherichia coli, Proteus mirabilis, Haemophilus influenzae, Cefixime (Rime-O) is stable in the presence of β-lactamase enzymes.

 Most strains of enterococci and staphylococci  are resistant to Cefixime (Rime-O). In addition, most strains of Enterobacter and Pseudomonas, Bacteroides fragilis, Listeria monocytogenes and Clostridia are resistant to Cefixime (Rime-O).

Pharmacokinetic Properties:

Cefixime binds one or more of the penicillin-binding proteins (PBPs) that inhibit the final transpeptidation step of peptidoglycan synthesis in the bacterial cell wall, thus inhibiting biosynthesis and inhibiting cell wall assembly that results in the death of bacterial cells.

  • Absorption: Only 40–50% is absorbed by the GI tract (oral); The rate may decrease when taken with food. More absorption from oral suspension than tablets.
  • Distribution: Bile, urine (high concentration); Crosses the placenta. Protein-binding: 65%.
  • Excretion: 20% of an oral dose excreted through the urine unchanged; 60% non-elimination; Some of the bile is excreted through the faeces. Largely removed by dialysis.

 Ofloxacin

  • Absorption: Ofloxacin is rapidly and completely absorbed after oral administration.
  • Distribution: It is widely distributed in the body.
  • Metabolism: It undergoes lethal metabolism.
  • Excretion: The drug is excreted mainly through urine.

 Precautions:

1.Avoid using for an extended period of time because it may cause rash and diarrhoea.

2.Even if you feel good, don’t skip any of the dosages and complete the entire course of medication treatment.

3.Diarrhoea may occur as a side effect, but it should subside once your course is finished. If it does not stop or if you find blood in your stools, contact your doctor.

4.If you develop rash, itchy skin, swelling of the face and mouth, or difficulty while breathing, stop taking this tablet and contact your doctor right away.

5.In patients with kidney disease, this should be used with caution, dosage may need to be adjusted.

6.In patients with liver disease, tablets should be used with caution, dosage may need to be adjusted.

Breastfeeding:

It is safe to take Rime 200 Tablet while breastfeeding. According to human studies, the drug does not pass into the breastmilk in significant amounts and is not harmful to the baby.

Fertility:

Animal studies have failed to reveal evidence of foetal loss or impaired fertility up to 400 times the recommended dose of humans; However, the incidence of miscarriage was increased at levels reaching maternal toxicity. There are no controlled data in human pregnancy.

 Uses:

  • Typhoid fever– is a bacterial infection caused by Salmonella Typhi. This bacteria is spread through contaminated food or water by a human carrier. Rime O tablet is used to treat typhoid fever. Symptoms may include high fever, loss of appetite, constipation, diarrhoea, vomiting, etc.
  • Urinary Tract Infection– are the most common infections in humans and women are at greater risk of getting this infection. UTIs are caused by bacteria and in some cases, viruses or fungi. Rime O tablet is used to treat urinary tract infections caused by bacteria.

Side effects:

Abdominal pain, Black or tarry stools, Diarrhoea, Fever, Painful urination, Decreased appetite, Joint pain, Change in taste, Excessive air or gas in stomach, Swelling of face, lips, eyelids, tongue, hands and feet, Dizziness, Acid or sour stomach, Heartburn.

Dosage:

1.Adults and children above 12 years of age and weighing more than 50 kilograms (kg)—400 milligrams (mg) once a day or 200 mg every 12 hours.

2.Children 6 months to 12 years of age—Dose is based on body weight and must be determined by your doctor. The dose is usually 8 milligrams (mg) per kilogram (kg) of body weight per day, taken as a single dose or divided in two doses (4 mg/kg every 12 hours).

3.Infants up to 6 months of age—Use and dose must be determined by your doctor.

Duration of action:

Rime O tablet starts showing its effects within 2 hours of taking it.

The effect of Rime O tablet lasts for about 16-20 hours.

Adverse Reaction:

1.Adverse drug reactions include diarrhoea, indigestion, nausea, and vomiting.

2.Hypersensitivity reactions such as skin rashes, hives, and Stevens-Johnson syndrome have been     reported.

3.Although thrombocytopenia has been reported for many cephalosporins, it has not been reported for cefixime.

4.There is no specific antidote for Cefixime overdose.

5.Gastric lavage may be performed.

6.Dialysis will not remove significant amounts of Cefixime.

 Storage:

Store in a closed container at room temperature, away from heat, moisture, and direct light.

Keep away from children.

Overdosage:

Never take more than the prescribed dose. Seek emergency medical attention if you suspect that you might have taken an overdose of Rime O tablet.

Contraindications:

Pseudomembranous colitis, thrombocytopenia, thrombophlebitis, leukopenia, seizures, flatulence, dizziness, headache, nausea, vomiting, anorexia, diarrhoea, abdominal pain, urticaria, pruritus, dyspepsia, hypersensitivity.

 Warnings:

  • Take Rime O tablet with or without food.
  • Never take more than the prescribed dose.
  • Do not take antacids within 2 hours of taking Rime O as they affect its absorption.
  • Keep away from the reach of children and pets.
  • Ensure that unused medicine is disposed of properly.
  • Do not give your medicine to other people even if their condition appears to be the same as yours.

Pregnancy:

Not recommended to use in pregnancy as this medicine may affect the developing joints of your foetus. Your doctor may prescribe this medicine if the benefits outweigh the risks.