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INTRODUCTION
CO2 TABLET is a combination of Cefixime and Ofloxacin which belongs to the group of medicines called Antibiotics. It is used in adults to treat typhoid fever (infection caused by Salmonella typhi, accompanied by high fever, stomach pain, headache and diarrhea).
CO2 TABLET is also used to treat bacterial infections of the respiratory tract (Ex. tonsillitis, pharyngitis and bronchitis), middle ear (otitis media), reproductive organs (gonorrhea) and urinary tract.
Before taking CO2 TABLET, inform your doctor if you have any heart, liver or kidney problems, diabetes or fits. CO2 TABLET should be used with caution in pregnant and breastfeeding women so, consult your doctor before taking it.
Avoid consumption of alcohol during treatment with CO2 TABLET, as it may impair your ability to concentrate and react. The most common side effects of taking CO2 TABLET are indigestion, nausea, stomach pain, vomiting, diarrhea gas, etc. Consult your doctor immediately if any of the symptoms worsen.
USES OF CO2 TABLET
CO2 TABLET treats typhoid fever and bacterial infections that occur in:
- Respiratory tract (Ex. tonsillitis, pharyngitis and bronchitis)
- Middle ear
- Reproductive tract (gonorrhea)
- Urinary tract
HOW CO2 TABLET WORKS
CO2 TABLET kills the infecting bacteria where Cefixime interferes with the formation of bacterial cell walls and forms holes in them and Ofloxacin inhibits a bacterial enzyme involved in repairing and replicating the DNA (genetic material) of bacteria, thus making the organism unable to reproduce or repair themselves.
DIRECTIONS FOR USE
Take CO2 TABLET as advised by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. Your doctor will decide the correct dose and duration of CO2 TABLET for you depending upon your age, body weight and disease condition. Do not stop taking CO2 TABLET unless your doctor advises you to stop.
SIDE EFFECTS OF CO2 TABLET
COMMON
- indigestion, stomach pain
- nausea, vomiting
- diarrhea, gas
UNCOMMON
- irritated or burning eyes
- headaches, sleep disturbances like difficulty sleeping (insomnia)
- dizziness, spinning sensations
- agitation, restlessness
- nasopharyngitis (cough and inflamed sore nose or throat)
- fungal infection
- skin rash or itching
- failure to respond to the treatment
RARE
- loss of appetite
- fast heartbeat
- drowsiness
- confusion, anxiety, nightmares, seeing, feeling or hearing things that are not there, depression, mental illness
- sense of taste or smell lost or altered
- shortness of breath or wheezing
- excessive sweating and hot flushes
- light-headedness which may be due to low blood pressure
- hives, rash with pimples
Stop taking CO2 TABLET and contact your doctor immediately if you experience any of the following side effects:
- allergic reaction (rash, joint pain, swallowing or breathing problems, swollen lips, face, throat or tongue)
- signs of liver disease (loss of appetite, yellow skin and eyes, dark urine, itching or tender stomach)
- pseudomembranous colitis (severe watery diarrhoea that will not stop, weakness, fever)
- inflammation of the bowel (severe watery diarrhoea, which may have blood in it, possibly with stomach cramps and fever)
- swelling of the tendons (pain, tenderness, sometimes restricted movement)
- numbness or tingling in the hands, touch sensitivity, numbness or weakness of the arms and legs
- blurred, double or altered colour vision
- serious skin reactions (Ex. toxic epidermal necrolysis, Stevens-Johnson syndrome, drug rash with eosinophilia and systemic symptoms (DRESS))
- convulsive fits
- changes in the way your kidneys work
HOW TO MANAGE SIDE EFFECTS
Nausea:
Take CO2 TABLET with or just after meals. Stick to simple meals. Avoid eating oily or spicy foods. If nausea persists, contact your doctor.
Vomiting:
Get adequate rest. Drink lots of fluids, especially water. Have small sips if you feel sick. Eat when you feel like eating – you don't have to eat or avoid any specific foods. Do not take any medicine for vomiting without your doctor's consultation. If vomiting does not get better, contact your doctor.
Diarrhea:
Drink lots of fluids, like water or fruit juice to maintain hydration. Check with your doctor before taking any medicine for diarrhea. If diarrhea does not get better, contact your doctor.
Stomach pain:
Try to rest and relax. Eat and drink slowly or try eating smaller meals more frequently. Keep a heat pad on your stomach. If your stomach still aches, contact your doctor.
Indigestion:
Raise your head and shoulders up while sleeping to prevent stomach acid from coming up. Do not eat 3 to 4 hours before going to sleep and avoid tea, coffee, cola or alcohol. If indigestion does not improve, contact your doctor.
Dizziness:
Lie down until dizziness is improved, then get up slowly. Don’t hurry and move slowly and carefully. Get adequate rest. Drink plenty of water and other fluids. Avoid coffee, cigarettes, alcohol and drugs. If dizziness persists, consult your doctor.
Skin rash:
Avoid hot showers because hot water can further irritate your skin. Do not scratch the affected area. Use protective clothing when going outdoors. Regularly moisturize your skin. Consult your doctor if your skin rash gets worse.
WARNING & PRECAUTIONS
PREGNANCY
CO2 TABLET should be used with caution in pregnant women. Consult your doctor for advice.
BREASTFEEDING
CO2 TABLET should be used with caution in breastfeeding women. Consult your doctor for advice.
DRIVING AND USING MACHINES
Do not drive or operate any machines if you experience fits, confusion, feeling less alert or aware of things than usual, unusual muscle movements or stiffness after taking CO2 TABLET.
ALCOHOL
Avoid consumption of alcohol during treatment with CO2 TABLET, as it may impair your ability to concentrate and react.
KIDNEY
CO2 TABLET should be taken with caution if you have kidney problems. Consult your doctor for advice.
LIVER
CO2 TABLET should be taken with caution if you have liver problems. Consult your doctor for advice.
ALLERGY
Do not take CO2 TABLET if you are allergic to Cefixime, Ofloxacin, other quinolone or cephalosporin antibiotics or any of the other ingredients of this medicine.
HEART DISEASE
CO2 TABLET should be taken with caution if you have aortic aneurysm or large vessel peripheral aneurysm (an enlargement or "bulge" of a large blood vessel), aortic dissection (a tear in the aorta wall), leaking heart valves, any vascular disorders, history of heart attack, weak heart, problems with your heartbeat or any other heart problems. Consult your doctor for advice.
OTHERS
Do not take CO2 TABLET if you:
- have epilepsy or any risk of having fits
- have a history of tendonitis (inflammation and swelling of the tissue that connects bones to muscles)
- or any of your family members have glucose-6-phosphate dehydrogenase deficiency (a genetic disorder that affects the red blood cells)
Before taking CO2 TABLET, inform your physician if you:
- have a history of mental illness
- have salt imbalance in the blood (particularly low potassium or magnesium levels in the blood)
- are a female
- have diabetes
- have myasthenia gravis (muscle weakness)
- have phenylketonuria (a birth defect that causes an amino acid called phenylalanine to accumulate in the body)
Use in Paediatrics:
CO2 TABLET is not recommended for use in children and adolescents (younger than 18 years of age). Consult your child’s doctor for advice.
Use in Geriatrics:
CO2 TABLET should be used with caution in the elderly (above 60 years of age). Consult your doctor for advice.
INTERACTIONS
A. Drug-Drug interactions:
Before taking CO2 TABLET, inform your doctor if you are taking any of the following medicines:
- medicines used to thin the blood (Ex. warfarin, heparin)
- methotrexate (used in cancer treatment)
- medicines or dietary supplements containing iron or zinc
- medicines used to relieve acidity or stomach ulcers (Ex. aluminium hydroxide, magnesium carbonate, sucralfate, cimetidine)
- medicines used to control high blood sugar levels (Ex. glibenclamide, metformin)
- medicines used to reduce pain (Ex. ibuprofen, diclofenac)
- medicines used to treat inflammatory conditions (Ex. hydrocortisone, prednisolone)
- theophylline (used for breathing problems)
- certain vaccines and herbal preparations
- probenecid (used to treat gout)
- furosemide (used in heart conditions)
- didanose (used in HIV treatment)
Overdosage:
If you or anyone else accidentally take too much of CO2 TABLET, consult your doctor immediately or visit the nearby hospital.
SYNOPSIS
| Drug | : | Cefixime, Ofloxacin |
| Pharmacological Category | : | Cephalosporins, Fluoroquinolones |
| Therapeutic Indication | : | Bacterial infections |
| Dosage Forms | : | Tablet |
MORE INFORMATION
- Keep CO2 TABLET out of reach of children
- Store at room temperature
FAQs ABOUT CO2 TABLET
Q: Can CO2 TABLET be given to children?
A: No. CO2 TABLET is not recommended for children and adolescents below 18 years of age. Consult your child’s doctor for advice. The doctor will decide an appropriate dose or recommend a suitable alternative treatment for your child.
Q: What if I forget to take a dose of CO2 TABLET?
A: If you forget to take a dose of CO2 TABLET, take it as soon as you remember. However, omit the missed dose if it's almost time for the next one. Do not take CO2 TABLET two times to make up for the missed dose.
Q: Can I stop taking CO2 TABLET if I feel better?
A: Do not stop taking CO2 TABLET without talking to your doctor, even if you feel better, as the infection may come back or get worse again. Consult your doctor for further advice.
Q: Can CO2 TABLET be taken in pregnancy?
A: CO2 TABLET should be used with caution in pregnancy. If you are pregnant, think you may be pregnant or are planning to get pregnant, consult your doctor before taking CO2 TABLET.
Q: Can I take other medicines with CO2 TABLET?
A: Before taking CO2 TABLET, inform your doctor if you are taking, have taken, or might take any other medicine, including prescription, over the counter or any herbal medicine, as these might cause serious side effects by interacting with each other.
REFERENCES
1. KD. Tripathi. Antimicrobial drugs. Essentials of Medical Pharmacology. Eighth edition. 2019. Page – 763, 778.
2. Tiwaskar M. Cefixime-ofloxacin Combination in the Management of Uncomplicated Typhoid Fever in the Indian Community Setting. NIH National Library of Medicine, National center for biotechnology information. Pubmed.gov. March 2019. [Accessed on 6th January 2023]. https://pubmed.ncbi.nlm.nih.gov/31304712/
3. Bakthavatchalam YD, Kumar DT, Tayubi IA, et al. In vitro efficacy and in silico analysis of cefixime-ofloxacin combination for Salmonella Typhi from bloodstream infection. NIH National Library of Medicine, National center for biotechnology information. Pubmed.gov. September 2017. [Accessed on 6th January 2023]. https://pubmed.ncbi.nlm.nih.gov/28650129/
4. Gerard Laboratories. Electronic Medicines Compendium (EMC). [Revised in June 2022] [Accessed on 6th January 2023]. https://www.medicines.org.uk/emc/files/pil.8480.pdf
5. Lupin Limited. U.S. Food and Drugs Administration. [Revised in March 2017] [Accessed on 6th January 2023]. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/202091s005,203195s006lbl.pdf
6. Malik Lifesciences Pvt. Ltd. Omnix O Tablets (Cefixime + Ofloxacin). [Revised in December 2019] [Accessed on 6th January 2023]. https://www.ciplamed.com/content/omnix-o-tablets
7. Alpha Drugs. Sefmax-O (Cefixime + Ofloxacin). [Accessed on 6th January 2023]. https://www.alphadrug.in/product/cefixime-and-ofloxacin-tablets/
8. Advacare Pharma. Cefox Care (Cefixime 200mg + Ofloxacin 200 mg tablet). [Accessed on 6th January 2023]. https://www.advacarepharma.com/en/pharmaceuticals/cefixime-ofloxacin-tablets
USEFUL DIAGNOSTIC TESTS
- Complete blood count
AUTHOR DETAILS
Written By Dr. Jeenal Rajani, Pharm.D.
Last updated on 10 Jan 2023 | 04:55 PM(IST)
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