O2 TABLET – IS IT SAFE? USES, SIDE EFFECTS, DOSAGE
What is O2 tablet?
O2 tablet is an antibiotic used to treat bacterial and fungal infections as well as a few sexually transmitted diseases. It is part of the class of drugs called Fluoroquinolones. It is available in form of tablets for oral consumption.
It is manufactured by Medley Pharmaceuticals.
O2 TABLET – IS IT SAFE? USES, SIDE EFFECTS, DOSAGE
What is the Generic name(s)?
How does it work?
What are its uses?
Who should not use O2 tablet?
How effective is this medicine?
Is it addictive?
What is the dosage?
How to use it?
What if I miss a dose?
What to do in case of overdosage?
What to do if there is an allergic reaction?
What are the side effects?
Does this medicine has any drug interactions?
Can it be taken with food?
Precautions
Is it safe to use if I am pregnant?
Is it safe to use if I am breastfeeding?
Can this medicine be given to children and infants?
Is this medicine available as over the counter product?
Frequently asked questions
Reference
What is the Generic name(s)?
The generic names are Ofloxacin and Ornidazole.
Here is its general composition:
- Ofloxacin – 200 mg
- Ornidazole – 500 mg
The strengths of each ingredient may vary.
How does it work?
The tablet is effective in both gram-positive and gram-negative bacteria.
Ofloxacin hinders with replication of bacteria in the body by stopping cell division of the bacteria’s DNA. This is done by inhibiting DNA gyrase enzyme of bacteria which is essential for DNA repair, replication, recombination and transcription, leading to expansion and destabilisation of DNA causing cell death. This inhibits their survival and growth in the human body. This action is useful in treating bacterial infections.
Ornidazole is effective in killing parasites like certain strains of anaerobic bacteria and protozoa. This action is very helpful in treating infections in the genital area, stomach, urinary tract, bladder and intestines. It is also helpful in treating infections occurring after a surgical procedure.
What are its uses?
Some of its main indications are:
- Protozoan infections
- Pyelonephritis (kidney infection) and Cystitis (bladder infection) – caused by Klebsiella pneumonia, Escherichia coli, Enterococci and Pseudomonas aeruginosa
- Periodontitis
- Nongonococcal Urethritis (Inflammation of Urethra) – Caused by Klebsiella, E.coli and Pseudomonas Aeuginosa
- Respiratory infections
- Tuberculosis
- Typhoid fever
- Gingivitis
- Urinary tract infections
- Skin infections like wound infection, Cellulitis and superficial abscess– Caused by Streptococcus pyogenes and Staphylococcus Aureus
- Pelvic inflammatory disease
- Vaginal infections
- Infections due to surgical procedures
- Eye and ear infections
- Prostatitis (inflammation of prostate gland) – Caused by Pseudomonas, E.coli and Enterococcus species.
- Pneumonia with cystic fibrosis (a disease which facilitates the growth of mucus in the lungs) – Caused by Haemophilus Influenzae and Staphylococcus Aureus.
- Community-acquired pneumonia- Caused by Streptococcus pneumoniae and Haemophilus Influenzae
- Plague
- Infections of urethra, cervix, and bladder caused by Neisseria Gonorrhoeae and Chlamydia Trachomatis.
- Joint infection- Caused by Pseudomonas aeruginosa and Enterobacter Cloacae
- Chronic bronchitis- Caused by Streptococcus pneumoniae, Haemophilus influenzae and Mycoplasma Pneumoniae
- Sexually transmitted diseases like Chlamydia, gonococcal infections caused by Chlamydia trachomatis and Neisseria Gonorrhoeae respectively.
- Amoebic dysentery
- Anaemia
- Sinusitis
- Throat infection
Also the treatment of Gastro-intestinal problems like:
- Acute or infectious diarrhoea
- Stomach Infection
- Intestinal infection
Who should not use O2 tablet?
O2 tablets are contraindicated in patients with:
- Hypersensitivity to the active ingredients
- Epilepsy
- Myaestina gravis
- Tendinitis or tendon rupture
- Nerve disorders like peripheral neuropathy
- Bursitis
- Glucose 6-phosphate (G6PD) deficiency
- Conditions which have increased the risk of seizures
- Renal insufficiency
- History of ventricular arrhythmias, QT prolongation and proarrhythmic conditions like myocardial ischemia (acute) and bradycardia.
How effective is this medicine?
O2 tablets are very effective in treating bacterial infections provided it is taken as per instructions and dosage prescribed by the doctor. Its onset of action is within 1 to 2 hours after consuming the dose. Its effect lasts for around 12 to 20 hours. It is more effective if the dose taken periodically is spaced evenly and taken at the same time every day for the complete duration of the treatment.
Is it addictive?
This medicine does not have any habit-forming tendencies.
What is the dosage?
The dosage is decided depending on the weight, age and health condition of the individual.
General dosage: One O2 tablet taken two times a day. Duration will be decided by the doctor.
The dosages may differ in different infections and will be prescribed accordingly by the doctor.
Dosage considerations:
For patients with liver cirrhosis:
Elimination of the drug will be reduced in patients with liver impairments like this. Therefore the dosage should not exceed the one prescribed by the doctor.
For patients with damaged renal functions:
- The dose should be adjusted in these patients. The creatinine clearance should be less than 50 mL/min.
- After the loading dose, the maintenance dose should be the same for patients who have a creatinine clearance of 20-50 mL/min.
- For patients having a creatinine clearance less than 20 mL/min, the maintenance dose is half the recommended loading dose.
- For women, the value of the dose should be calculated as 0.85 times the value recommended for men.
How to use it?
Take the medication strictly under the guidelines given by the doctor. Swallow the tablet (interval between two doses should be 12 hours). Do not bite or crush it and then consume it. It should be consumed either with food or immediately after food. It is advised to consume plenty of fluids to prevent the concentration of urine.
What if I miss a dose?
Usually missing one dose does not cause any damage. Take the missed dose when remembered. Do not take it if the next dose is due soon. Do not consume a double dose as it will lead to the adverse effects of overdosage.
What to do in case of overdosage?
The symptoms of overdose will depend upon the duration of the drug course, the product used and if any other drugs are taken with it. Common symptoms of overdosage are:
- Slurring of speech
- Hot and cold flashes
- Swelling of face
- Disorientation
- Numbness of face
Call for medical help as soon as these symptoms are seen. Treatment can include inducing emesis, use of cathartics, pumping out the medicine by placing a tube in the stomach (gastric lavage) and giving activated charcoal.
The symptomatic care may include:
- Giving fluids intravenously (i.v).
- Monitoring the patient for severe conditions like seizures.
What to do if there is an allergic reaction?
O2 tablets are harmful to patients with allergies to ornidazole or ofloxacin or other medicines belonging to the classification of anti-microbial agents, Nitroimidazole or Quinolone (they are called nalidixic acid, moxifloxacin, norfloxacin, levofloxacin and ciprofloxacin). Signs of allergic reaction are:
- Trouble in breathing or wheezing
- Itching
- Blue or grey skin
- Swelling of tongue, lips, throat, face, feet and hands
- Chest tightness
- A bad Cough
- Severe dizziness
- A rise in heart rate
- Seizures
Stop taking the medication in case these symptoms appear and rush to the emergency room. The treatment given would be a dose of epinephrine and various other resuscitative treatments like intravenous fluids, airway management, oxygen, corticosteroids, anti-histamines and pressor amines.
What are the side effects?
Side effects are possible but they do not always occur in all the patients. Some of these will be rarely seen but can be serious.
The commonly reported side effects are:
- A headache
- Nausea
- Diarrhoea
- Dry mouth
- Abdominal pain
- Trouble in sleeping
- Abnormal taste sensation
- Bruising
- Vaginitis
- Photosensitivity
- Vomiting
- Eosinophilia
- Hallucinations
- Tendon damage and rupture
- Tremors
- Vertigo
- Tiredness
- Loss of appetite
- Fits
- Tingling or numbing sensation in the skin
- Light-headedness
- Fever with chills
- Shaking of hands and feet
- Red spots on the skin
Serious side effects to be reported immediately to the doctor are:
- Symptoms of liver damage like stomach pain, severe vomiting, nausea, uncanny tiredness and yellowing of skin and signs and darkening of the urine.
- Any impairment in vision or eyes.
- Fainting
- Symptoms of kidney problem like a change in the amount of urination.
- Signs of early bruising and bleeding.
- Sign of another infection like fever and sore throat for a longer length of time.
- Hearing changes
- Irregular or fast heart rate.
- Pain or swelling in the joints.
Does this medicine has any drug interactions?
O2 tablet interacts with the following drugs:
- Blood thinners like Warfarin, Acenocoumarol, etc.
- Quinidine
- Drugs metabolized by enzymes of the cytochrome P450
- Hydroquinidine
- Anti-psychotics
- Sotalol
- Tricyclic depressants
- Azithromycin
- Non-steroidal anti-inflammatory drugs (NSAID’s)
- Multivitamins
- Anti-diabetic medications(e.g Insulin, Glibenclamide/Glyburide, etc)
- Cimetidine
- Dofetilide
- Acetaminophen
- Muscle relaxants like Vecuronium bromide
- Ibutilide
- Multivitamins
- Disopyramide
- Amiodarone
- Antacids
- Theophylline
- Saquinavir
- Metrizamide
- Medicines containing Levofloxacin
Can it be taken with food?
O2 tablet can be taken with or without food but is advised to be consumed with food as it prevents stomach upset. But do not take milk or other dairy products with it. Always consult with the doctor for absolute clarity on its usage.
What are the precautions I need to take?
- Before using this medicine, inform your doctor about your entire medical history including allergies, kidney or liver problems, heart diseases, mental or mood disorders, brain tumors (or any other condition with risk of seizures), peripheral neuropathy(or any other nerve damage disease), tendon problems (e.g Rheumatoid Arthritis), any organ’s transplant, etc.
- Inform your doctor if you plan on conceiving or if already pregnant and plan on breastfeeding.
- Tell the doctor about all the current medications you have been taking. It entails all the herbal and ayurvedic supplements, over the counter (OTC) drugs, vitamins, etc.
- Long use of this medication can lead to thrush (itching and redness in the vagina or mouth) and a new yeast infection. Maintain good oral care. Report to the doctor if you see signs like a white patch in your mouth or any abnormal vaginal discharge.
- Be cautious if the patient has conditions like kidney damage, multiple sclerosis, etc.
- If antacids are to be consumed, take a gap of at least 2 hours before and after taking this medicine.
- Do not take the medicine if the packaging is torn or looks tampered with.
- If you have diabetes, check your blood sugar level regularly and inform your doctor the results. Watch for symptoms like increased urine formation or thirst which might be signs of high sugar level (hyperglycemia).
- Limit your time in the sun to prevent sunburn. When stepping out in the sunlight, use sunscreen and wear clothing which will not expose skin directly to sun or UV light. Do not use a tanning bed or booth or a sun lamp.
- Eat meals on a regular schedule and do not skip it to prevent low sugar levels in non-diabetics.
- Also to prevent low sugar, carry glucose tablets or drink soda (non-diet) or fruit juice or eat honey, candy, table sugar.
- If you get loose motions, yoghurt or other probiotics can be consumed to treat that.
- Do not have any vaccination or immunization (such as the vaccine for typhoid) done as it can be rendered useless by O2 tablet.
- Do not use this medicine if you have severe constipation or if there is blood in your stools.
Is it safe to use if I am pregnant?
The drug has been declared category C by US FDA. It means that there are adverse effects in the fetus in studies done on animals. However, there no well-controlled studies performed on humans to confirm the risks. Therefore the drug will be prescribed to a pregnant woman if it’s absolutely necessary and the benefits outweigh the potential risks. Please consult with your doctor and follow his/her advice strictly.
Is it safe to use if I am breastfeeding?
In females who are lactating, a single dose of the medicine taken orally resulted in its concentration in milk that was same as those found in blood plasma. Therefore it is usually not recommended in lactating women since there is a possibility of an effect of the drug on the child’s development, especially on the bones. So, discuss in detail with the doctor. In cases where the doctor prescribes the tablet when no other alternative is possible, avoid breastfeeding the infant for at least 4-6 hours after consuming O2 tablet. Monitor undesirable effects in the baby like a diaper rash and diarrhoea.
Can this medicine be given to children and infants?
O2 tablet is not usually given to children under the age of 12 years. Children are more prone to the side effects of tablet especially tendon/joint problems. It has been concluded that this medicine can cause osteochondrosis and arthropathy (arthrosis) in young ones of many animal species. Always consult your paediatrician regarding the usage of this medicine for your kids.
Is this medicine available as over the counter product?
O2 tablet is available only with a prescription, it is not an OTC (over the counter) drug.
Frequently asked questions
Q: Can it be taken with alcohol?
O2 tablet can interact with alcohol leading to disulfiram reactions. This will give rise to symptoms like nausea, chest pain, tachycardia (increased heart rate), irritation in the stomach, thirst, flushing and fall in blood pressure. Also, other side effects of consuming these tablets like drowsiness and dizziness will be intensified with alcohol. Avoid consuming it for at least 48 hours after treatment. Do not operate any heavy machinery while/after consuming this medicine.
Q: Can O2 tablets be given to treat viral infections?
It is strictly advised to not use it for viral infections like cold or flu as it is an antibiotic and is used to treat bacterial infections.
Q: How should the tablet be stored?
- Keep it out of reach from children.
- The tablets should be stored at ROOM TEMPERATURE (15-30 degrees).
- The placed to be stored should away from moisture, direct heat and sunlight.
- Do not keep it in a bathroom.
- Do not freeze the medicine.
Q: Can I stop taking O2 when I feel better?
No. Just because the symptoms of the condition have reduced doesn’t mean that all the bacteria are killed. The infection will spread again if the medicines are stopped abruptly. Complete the course with accurate dosages. Consult your doctor to discuss the progress in treating the condition.
Reference
Wikipedia page on Quinolone antibiotic
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