🐕 BISTREPEN 🐈 (Combikel, Combi-Ject)
🚑 Treatment of cats and dogs with bacterial infections of the respiratory tract (tracheitis, bronchitis, pneumonia), gastrointestinal tract, genitourinary system (cystitis, uterus), skin and connective tissue infections (wounds, abscesses, purulent arthritis, umbilical sepsis), as well as mastitis, postoperative infections caused by microorganisms sensitive to the active substances of the drug.
The drug is effective in the treatment of LEPTOSPIROSIS.
Composition of the drug:
1 ml of the drug contains:
🔹 benzylpenicillin procaine — 200 thousand. IU
🔹 dihydrostreptomycin sulfate — 200 mg
🟢 METHOD OF USE AND DOSAGE:
Before use, the suspension is shaken thoroughly and administered intramuscularly or subcutaneously once a day, the course is 3 days.
The dosage of the drug is:
dogs, cats — 1 ml per 10 kg of body weight.
⚠ If the dose exceeds 2 ml, the injection is divided into two parts and injected into different places.
Contraindication:
Do not prescribe to animals with increased sensitivity to the active substances of the drug, impaired renal function, as well as rabbits, ferrets, hamsters and gerbils.
⚠ Do not administer intravenously.
Precautions for use:
Local allergic reactions and hypersensitivity to the drug (pain and swelling) are possible.
Studies on laboratory animals did not show the teratogenic effect of the active ingredients. In the absence of studies in the target animal species, the drug is prescribed according to the benefit/risk assessment performed by the veterinarian.

⚠ Dihydrostreptomycin has the lowest nephrotoxicity among aminoglycosides, but it should not be used concurrently with other potentially nephrotoxic drugs (furasemide, ethacrynic acid), methoxyflurane and amphotericin.

Dihydrostreptomycin is a mild neuromuscular blocker, but in significant doses it can enhance the effects of other aminoglycoside antibiotics. Therefore, the drug should be used with caution in animals under anesthesia and together with magnesium and muscle relaxants.

The recommended doses and conditions of treatment should be strictly observed.

Storage conditions:
In a dry, dark place inaccessible to children, at a temperature of +2 to +8 °C. After opening the bottle, the drug should be stored in a refrigerator and used within 28 days.

Expiration date
2 years.
Description:
White or yellow liquid.
Pharmacological properties:
A complex preparation based on benzylpenicillin and dihydrostreptomycin with a broad spectrum of bactericidal action.
Benzylpenicillin procaine is an equimolecular compound of benzylpenicillin with procaine (novocaine), which provides its prolonged action. Benzylpenicillin is a bactericidal antibiotic from the penicillin series that is active against Gram-positive microorganisms — Clostridium spp., Corynebacterium spp., Erysipelothrix spp., Bacillus spp., Actinomyces spp., Listeria spp., Leptospira spp., Strephylococcus spp., Staphylococcus spp., Gram-negative microorganisms — Campylobacter spp., Haemophilus spp., Pasteurella spp., Actinobacillus spp. and some Bacteroides spp. The mechanism of action is the disruption of peptidoglycan synthesis, a mucopeptide of the cell membrane, which leads to the inhibition of the synthesis of the microorganism's cell wall, inhibiting the growth and reproduction of bacteria. Dihydrostreptomycin is an aminoglycoside antibiotic. It has a bactericidal effect on Gram-positive microorganisms — Staphylococcus spp., Gram-negative — Pasteurella spp., Salmonella spp., Escherichia coli, Klebsiella spp., Leptospira spp., Actinobacillus spp., Shigella spp., Francisella tularensis, Yersinia spp. It does not affect anaerobic microorganisms. The bactericidal effect is due to the ability to bind to the 30S subunits of bacterial ribosomes and disrupt protein synthesis. After intramuscular administration, benzylpenicillin procaine is slowly absorbed from the injection site. The maximum concentration in blood serum of 1.6-4.2 μg/ml is observed after 1.5-6 hours depending on the type of animal and slowly decreases within 16-24 hours. After administration, it enters almost all organs and tissues except for the cerebrospinal fluid, easily penetrates the placental barrier. It binds to blood serum proteins: in cattle - 28.5%, in sheep and goats - 30.4%, in pigs and dogs - 60%. It is excreted from the body in unchanged form mainly in urine (up to 90%), partly in bile and milk. Dihydrostreptomycin is rapidly absorbed after intramuscular administration. Bacteriostatic concentration in blood plasma is observed after 15-30 minutes, maximum - after 1 hour. The maximum concentration is reached: in cattle - 44-78 μg / ml, pigs - 87 μg / ml, sheep, goats - 44-70 μg / ml, dogs - 41 μg / ml, cats - 25 μg / ml and lasts for 24 -48 hours. Proteins bind up to 20-25% of dihydrostreptomycin, which is why its high concentration in the kidneys is achieved. It is excreted from the body unchanged mainly by the kidneys (over 90%), partly with bile.