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INTRODUCTION
ZIL O TABLET is a combination of Ornidazole and Ofloxacin which belongs to the group of medicines called Antibiotics. ZIL O TABLET is used to treat various bacterial infections involving the blood (such as septicemia), brain (such as meningitis), lungs (such as pneumonia, bronchitis), ear and nose (such as sinusitis), urinary tract (such as cystitis), genital infections (including both the male and female genital organs), wound (post-operative infections), reproductive system (such as puerperal sepsis, septic abortion and endometritis) and stomach (such as peritonitis).
ZIL O TABLET is also used as prophylaxis to prevent bacterial infections during surgical interventions (particularly involving the colon and in gynaecological operations).
Before initiating the treatment with ZIL O TABLET, your doctor may recommend you to take relevant medical tests to understand your existing condition and to properly use this medicine.
Before taking ZIL O TABLET inform your doctor if have heart disease (such as irregular heartbeat, valve disorder, poor heart function), kidney diseases (such as kidney failure or kidney injury), inflammation of the intestine, fits/seizure, autoimmune disease (such as multiple sclerosis), muscle-weakening diseases (such as myasthenia gravis), weak tendons (tendonitis, tendon rupture, rotator cuff), nerve pain (neuropathy), liver disease, psychiatric illness or emotional imbalances.
ZIL O TABLET is not recommended for use in pregnant and breastfeeding women. ZIL O TABLET is not recommended for use in children and adolescents (under 18 years of age) and it should be used with caution in elderly patients.
The common side effects of taking ZIL O TABLET are nausea, vomiting, diarrhea, headache, itching and changes in taste sensation. Consult your doctor immediately if any of the side effects worsen during or after treatment with ZIL O TABLET.
USES OF ZIL O TABLET
To treat bacterial infections such as:
- lungs infections (Ex. pneumonia, bronchitis)
- sinus infections
- urinary tract infections
- meningitis
- septicemia
- puerperal sepsis, septic abortion and endometritis
- peritonitis
- post-operative wound infections
- gonorrhoea and some other genital infections (both the male and female genital organs)
- prophylaxis during surgical interventions (particularly involving the colon and in gynaecological operations)
HOW ZIL O TABLET WORKS
ZIL O TABLET is a combination of Ornidazole and Ofloxacin where Ornidazole kills parasites and bacteria that live in the absence of oxygen by generating harmful molecule which damages the DNA of the parasites and bacteria and ofloxacin is a quinolone antibiotic that kills bacteria by inhibiting the synthesis of bacterial DNA, hence helps to treat various infections.
DIRECTIONS FOR USE
Take ZIL O TABLET as directed 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, duration and frequency of ZIL O TABLET for you depending on your age, body weight and disease condition.
SIDE EFFECTS OF ZIL O TABLET
COMMON
- headache, dizziness
- nausea, vomiting
- diarrhea
- itching
- sleep problems
- external genital itching in women
- vaginal inflammation
- changes in taste sensation
UNCOMMON
- stomach pain or discomfort
- dry mouth
- loss of appetite
- fungal infection
- agitation, restlessness
- burning or irritation of the eye
- cough and inflamed sore nose or throat
- spinning sensation of the head (vertigo)
RARE
- fast heartbeat
- drowsiness
- confusion, nightmare
- decrease in blood sugar levels
- depression or hallucination (feeling or hearing things not there)
- changes in sensation of smell
- shortness of breath or wheezing
- excessive sweating
- feeling faint, lightheadedness due to low blood pressure
- hives
- rash with pimples
- pain or swelling around joints (tendonitis)
- excessive sweating, hot flushes
Stop taking ZIL O TABLET and contact your doctor immediately if you experience any of the following side effects:
- severe allergic reactions (such as skin rash, itching, swelling of the face, lips, tongue and other parts of the body, difficulty in breathing or wheezing, blisters on the skin, sore throat, fever, headache)
- painful skin rashes with blisters and peeling or scaling of the skin in conditions such as steven-johnson syndrome and toxic epidural necrolysis
- abnormal heartbeat
- changes in behavior, psychosis, depression, hallucination, disorientation or fainting
- impaired vision or hearing
- severe fever, body chills or muscle pain
- swelling or rupture of tendons
- numbness or tingling sensation of the skin
- abnormal bleeding
- abnormal body movements like fits or seizure
- severe loose stools or diarrhea
- difficulty in passing urine or urine discoloration
- loss of consciousness
- abnormal body sugar level
- pain, burning, numbness and/or weakness especially in the feet and legs or hands and arms which indicates nerve damage
- stomach pain, itching, dark urine or yellowish discoloration of the skin and in the white part of the eye (jaundice)
HOW TO MANAGE SIDE EFFECTS
Diarrhea
Drink lot of fluids such as water or fruit juices to keep yourself hydrated. Avoid taking any medicine on your own for treating diarrhea. Consult your doctor if the symptom did not improve.
Dry Mouth
Sip water regularly and other sugar free liquids. Do not use mouthwashes that contain alcohol because they can make your mouth dry, use mouthwash that is used only for dry mouth. Limit your caffeine intake. Avoid smoking or using tobacco products. Consult your doctor if the symptom does not improve.
Headache
Drink ample amount of water and avoid skipping meals. Get adequate rest. Try to be relaxed and stress free. Apply pain relieving balm on your forehead if necessary. Consult your doctor if the symptom does not improve.
Nausea And Vomiting
Take ZIL O TABLET with or just after meals. Stick to simple meals. Avoid eating oily, fried or spicy foods. Do not lie down or sleep immediately after eating. Consult your doctor if the symptom does not improve.
WARNING & PRECAUTIONS
PREGNANCY
ContraindicatedZIL O TABLET is not recommended for use in pregnant women. Also, consult your doctor if you are suspecting or planning for pregnancy before taking ZIL O TABLET.
BREASTFEEDING
ContraindicatedZIL O TABLET is not recommended for use in breastfeeding women. Consult your doctor for advice before taking ZIL O TABLET.
DRIVING AND USING MACHINES
Use with CautionDo not drive or operate any machines after taking ZIL O TABLET if you feel dizzy, tired, sleepy, temporary loss of consciousness, less alert, spinning sensation of head, impaired vision, shivering, abnormal body movements and seizure/fits.
ALCOHOL
Consult your doctorDo not consume alcohol while taking ZIL O TABLET as it may aggravate your symptoms such as sleepiness, dizziness and eyesight problems.
KIDNEY
Use with CautionZIL O TABLET should be taken with caution in patients with kidney disease or problems. Consult your doctor for advice before taking ZIL O TABLET.
LIVER
Use with CautionZIL O TABLET should be taken with caution in patients with liver disease. Consult your doctor for advice before taking ZIL O TABLET.
ALLERGY
ContraindicatedDo not take ZIL O TABLET if you are allergic to Ofloxacin or Ornidazole. Also, inform your doctor if you are allergic to other quinolone antibiotics such as ciprofloxacin, norfloxacin.
HEART DISEASE
Use with CautionZIL O TABLET should be taken with caution in patients with leaking heart valves (heart valve regurgitation), endocarditis (infection of the heart), irregular or slow heartbeat, family history of prolonged QT interval, weak heart (heart failure), history of heart attack (myocardial infarction). Consult your doctor for advice before taking ZIL O TABLET.
USE IN PEDIATRICS
ContraindicatedZIL O TABLET is not recommended for use in children and adolescents under 18 years of age. Consult your child’s doctor for advice.
USE IN GERIATRICS
Use with CautionZIL O TABLET should be used with caution in elderly patients. Your doctor will decide the dose, duration and frequency of ZIL O TABLET depending on the severity of your existing condition and other comorbidity conditions.
OTHERS
ZIL O TABLET is not recommended for use if you:
- have epilepsy or at risk of fits
- have any pre-exisiting central nervous system (CNS) disorders
- have history of inflammation and swelling of the tendons (tendonitis) especially after the treatment with quinolone antibiotics such as ciprofloxacin, norfloxacin or nadifloxacin
- are suffering from or have a family history of glucose-6-phosphate dehydrogenase deficiency (an inherited disorder that affects the red blood cells)
Before taking ZIL O TABLET, inform your physician if you:
- have an enlargement or bulge of a large blood vessel (aortic aneurysm or large vessel peripheral aneurysm)
- experienced a previous episode of aortic dissection (a tear in the aorta wall)
- have a family history of aortic aneurysm or aortic dissection
- have other risk factors or predisposing conditions (Ex. connective tissue disorders such as marfan syndrome or ehlers- danlos syndrome, turner syndrome, sjogren’s syndrome (an inflammatory autoimmune disease)
- have vascular disorders such as takayasu arteritis, giant cell arteritis, behcet’s disease and high blood pressure or atherosclerosis, rheumatoid arthritis
- have or ever had a history of mental illness
- have salt imbalance in the blood (especially low level of potassium or magnesium in the blood)
- illness of the nervous system called myasthenia gravis (muscle weakness)
- are diabetic or suffer from low blood sugar
- have due to urine tests for porphyrin (a pigment in the blood) or for opiates (strong painkillers)
INTERACTIONS
A. Drug-Drug interactions:
Before taking ZIL O TABLET, inform your doctor if you are taking any of the following medicines:
- antipsychotics such as olanzapine, clozapine (used to treat psychosis)
- cyclosporin (used to prevent organ rejection after transplant)
- quinidine, hydroquinidine, disopyramide, amiodarone, sotalol, dofetilide, ibutilide, pentoxifylline (used to treat irregular heart rhythm)
- lithium or tricyclic antidepressants such as clomipramine, amitriptyline (used to treat depression)
- macrolides such as erythromycin, clarithromycin, azithromycin (used to treat bacterial infection)
- vecuronium bromide (used to relax muscles)
- phenytoin, phenobarbital (used to treat epilepsy)
- didanosine (used in the treatment of HIV infection)
- furosemide (used to treat body fluid retention)
- sucralfate, cimetidine (used to treat stomach ulcer)
- antacids containing magnesium or aluminium (used for indigestion)
- corticosteroids such as prednisolone, dexamethasone (used to treat inflammation)
- non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac (used to pain and inflammation)
- theophylline (used to treat asthma)
- insulin, glibenclamide (used to treat diabetes)
- probenecid (used to treat gout)
- methotrexate (used for rheumatism)
- warfarin, acenocoumarin, phenprocoumon (used to treat or prevent blood clot)
- medicines or dietary supplements that contain iron (for anemia) or zinc
- herbal medicines
Overdosage:
If you or anyone else accidentally takes too much of ZIL O TABLET, consult your doctor immediately or visit the nearby hospital. Overdosage symptoms of ZIL O TABLET include confusion, dizziness, loss of consciousness, seizure or fit and nausea.
SYNOPSIS
| Drug | : | Ornidazole and Ofloxacin |
| Pharmacological Category | : | Nitroimidazole and Fluoroquinolones |
| Therapeutic Indication | : | Various bacterial infections |
| Dosage Forms | : | Tablet, Capsule, Infusion, Injection, Syrup, Oral Suspension |
MORE INFORMATION
- Keep ZIL O TABLET out of reach from children
- Store ZIL O TABLET at room temperature
FAQs ABOUT ZIL O TABLET
Q: Can [GBBNKEYWORD] be used by pregnant women?
A: ZIL O TABLET is not recommended for use in pregnant women. However, consult your doctor for advice before taking ZIL O TABLET, as your doctor may outweigh the risks and benefits during life-threatening situations for use.
Q: Does ZIL O TABLET cause diarrhea?
A: Yes, ZIL O TABLET may cause side effects like diarrhea. Drink lot of fluids such as water or fruit juice to keep yourself hydrated. Avoid taking any medicine on your own to treat diarrhea. Consult your doctor immediately if the symptoms worsen or persists during treatment with ZIL O TABLET.
Q: Can ZIL O TABLET cause tendon weakness?
A: ZIL O TABLET can increase the risk of tendon weakness or rupture. Stop taking ZIL O TABLET and consult your doctor immediately if you experience symptoms like tendon pain in joints, swelling, hearing or feeling a snap or pop in a tendon area, bruising right after an injury in a tendon area, unable to move the affected area or bear weight, etc.
Q: Is ZIL O TABLET safe to use in patients with heart problems?
A: ZIL O TABLET should be used with caution if you have heart disease such as irregular heartbeat, poor functioning of the heart, heart attack, poor blood supply to the heart. Your doctor will study your existing heart condition and recommend relevant tests to outweigh the benefits to risks before suggesting you ZIL O TABLET. If you experience any symptoms such as abnormal heartbeat, sweating, severe loose stools and dizziness after taking ZIL O TABLET consult your doctor immediately. Also, inform your doctor of the medications you are taking to treat your heart or other conditions.
Q: Is ZIL O TABLET safe for use in diabetic patients?
A: ZIL O TABLET should be used with caution if you are having diabetes as this medicine may alter your body’s sugar level. Your doctor may suggest monitoring your body sugar level periodically. Consult your doctor for advice during treatment with ZIL O TABLET.
REFERENCES
1. KD. Tripathi. Antimicrobial drugs, antiamoebic and other antiprotozoal drugs. Essentials of medical pharmacology. 8th Edition. 2019. Page – 763 & 897.
2. A. Soni, M. Chaudhary, A. Tamta, R. Sehgal, S.M. Shrivastava and V.K. Dwivedi. Science Alert. Therapeutic Efficacy of Ofloxacin and Ornidazole vs Mebatic: Toxicity Profile and Antioxidant Defense Study. [Revised in 2009] [Accessed on 3rd May 2022] https://scialert.net/fulltext/?doi=jp.2009.79.86
3. David G. Bailey, George Dresser and J. Malcolm O. Arnold, MB. National Library of Medicine (NIH). Grapefruit–medication interactions: Forbidden fruit or avoidable consequences. [Revised in 18th October 2018] [Accessed on 3rd May 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3589309/
4. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG). National Library of Medicine (NIH). Using medication: Using antibiotics correctly and avoiding resistance. [Revised in 13th December 2013] [Accessed on 3rd May 2022] https://www.ncbi.nlm.nih.gov/books/NBK361005
5. Teva Pharma (New Zealand) Limited, Inc. Medsafe. Ornidazole 500 mg, film coated tablet. [Revised in 18th October 2018] [Accessed on 3rd May 2022] https://www.medsafe.govt.nz/profs/Datasheet/a/arrowornidazoletab.pdf
6. Gerard Laboratories. Electronic Medicines Compendium (EMC). [Revised in November 2021] [Accessed on 3rd May 2022] https://www.medicines.org.uk/emc/files/pil.8481.pdf
7. Dr Reddy's Laboratories Limited. Ofloxacin tablet. DailyMed; National Library of Medicine; National Institute of Health. [Revised in December 2018] [Accessed on 3rd May 2022] https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=1d19a6db-6da5-e7de-f929-2d18bdfa2cf5&type=display#war
USEFUL DIAGNOSTIC TESTS
- Complete blood count
- Liver function test
- Kidney function test
- Bacterial Culture sensitivity test
AUTHOR DETAILS
Written By Dr. R. Dinesh John Rajkumar, Pharm.D
Last updated on 24 Feb 2023 | 09:49 AM(IST)
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