Pipemidic Acid

These indications are based on manufacturer information for both originator and generic products. For product specific registered indications, please refer to product specific manufacturer information

Registered South African indications:

• Urethritis
• Cystitis
• Pyelonephritis
• Acute prostatitis

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Hypersensitivity to other quinolones
• Pregnancy
• Breastfeeding
• Severe renal impairment
  - Impaired renal function with a CrCl<10ml/min
• Hepatic disease or patients in whom hepatic dysfunction develops on treatment
• Children or adolescents during the growth phase
• Glucose-6-phosphate dehydrogenase deficiency

Cautions

• Elderly
• Epilepsy
• Lowered seizure threshold
• History of seizures
• Decreased cerebral blood flow
• Changes in cerebral structure
• Stroke
• Excessive sun exposure 
• Ultraviolet lamps

Forms avail. in SA and covered in this monograph: cap 

Infections caused by Gram negative organisms (excluding Serratia marcescens)

Specific doses based on individual indications

Please note the dosages below should be used in combination with regional guidelines, taking into account local antibiotic sensitivities 

Urethritis
Cystitis
Pyelonephritis
Acute prostatitis

• Oral (tab): 400mg, 12hrly; Treatment duration: 5-10days

Capsules to be taken morning and evening with meals

Following 10 days, it is advisable to change to another antibacterial agent so as to counter any possible development of resistance on the part of the micro-organisms

Not established for use in children

Pregnancy

• Contraindicated

Breastfeeding

• Contraindicated

Renal Impairment

• Severe: Contraindicated
  Patients with impaired renal function with a creatinine clearance of less than 10ml/min

Hepatic Impairment

• Hepatic disease or patients in whom hepatic dysfunction develops on treatment: Contraindicated

Elderly

• Caution; no information available 

Central Nervous System Disorders

• Dizziness
• Headache
• Insomnia
• Paraesthesia
• Seizures 

Cardiovascular Disorders

• Circulatory collapse
• Vasculitis

Gastrointestinal Disorders

• Nausea and vomiting
• Diarrhoea
• Abdominal pain

Hepatobiliary Disorders

• Increased hepatic enzymes

Genitourinary Disorders

• Increased blood urea and creatinine

Endocrine and Metabolic Disorders

• Loss of appetite

Skin and Subcutaneous Tissue Disorders

• Severe skin reactions with blistering
• Lyell’s syndrome
• Stevens-Johnson syndrome
• Petechiae

Immune, Blood and Lymphatic System Disorders

• Thrombotic thrombocytopenia purpura (in the presence of acute intermittent porphyria)
• Hypersensitivity reactions
• Photosensitisation
• Severe allergic reactions
• Anaphylactic shock 

Sensory Disorders

• Disturbed vision

• Antacids
• Magnesium, calcium or iron preparations 
• Theophylline
• Caffeine

• Hepatic function

Specific cases may require 

• Renal function

Pipemidic acid targets bacterial DNA gyrase which ultimately results in the inhibition of DNA synthesis and cell division.

Spectrum of activity: Gram-negative organisms (excluding Serratia marcescens)

Capsule 200mg

• Deblaston (Xixia Pharmaceuticals) originator