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Composition:


active ingredient: Lactobacillus acidophilus, Lactobacillus rhamnosus, Streptococcus salivarius subsp. thermophilus, Lactobacillus delbrueckii subsp. bulgaricus;


1 capsule contains 2 billion or 4 billion active cells (colony-forming units (CFU)) of Lactobacillus acidophilus, Lactobacillus rhamnosus, Streptococcus salivarius subsp. thermophilus, Lactobacillus delbrueckii subsp. bulgaricus;


excipients: lactose, magnesium stearate, ascorbic acid;


capsule shell: gelatin.


Dosage form. Capsules.


Basic physical and chemical properties: cream-colored gelatin capsules; the contents of the capsule are a fine white powder with a yellowish tinge (variations to ivory and the presence of individual darker granules are possible).


Pharmacotherapeutic group. Antidiarrheal microorganisms. A combination of lactobacilli.


ATX code A07F A51.


Pharmacological properties.


Pharmacodynamics.


Lactic acid bacteria of the yogurt preparation are part of the normal human intestinal flora and play an important role in ensuring colonization resistance, immunostimulating, vitamin-forming, detoxification and digestive functions of the body. Antimicrobial activity of lactic acid bacteria is manifested against staphylococci, Proteus, enteropathogenic Escherichia coli and fungi of the genus Candida and is associated with their ability to produce lactic acid, lactocins, as well as their immunomodulatory properties, such as the ability to increase cytokine activity and stimulate phagocytosis of lymphocytes and macrophages in the intestine.


Lactobacilli of the drug yogurt affect intestinal motility, take part in the digestion of proteins, the breakdown of lactose into glucose and galactose, and contribute to the production of lactic acid.


Lactic acid bacteria reduce the pH of the intestinal contents, prevent the growth and reproduction of pathogenic and conditionally pathogenic microflora. Lactobacilli are a barrier to the penetration of sensitizing substances (endotoxins, bacterial and food allergens) from the intestines into the blood. The viability of the bacteria that make up the yogurt preparation is not disturbed when passing through the esophagus, stomach and duodenum. When incubated in a solution of gastric juice at 37 °C and PH 3 for three hours, they remained completely viable. In addition, they continued to grow in a nutrient medium containing 1% bile. All this ensures a stable passage of the bacteria that make up the yogurt preparation to the place of their action – the small and large intestines.


The colonization capacity of the yogurt preparation culture is enhanced by the combination with Streptococcus thermophilus.


Lactobacillus delbrueckii subsp. bulgaricus and Streptococcus thermophilus contain high levels of β-galactosidase. Patients with beta-galactosidase deficiency in intestinal epithelial cells are able to adsorb lactose in the presence of Lactobacillus delbrueckii subsp. bulgaricus and Streptococcus thermophilus.


Pharmacokinetics.


The active ingredients of the drug yogurt are not absorbed from the digestive tract, therefore, there are no data from pharmacokinetic studies.


Clinical characteristics.


Indications.


* Prevention and treatment of acute gastroenteritis in children and adults.


* Prevention and treatment of antibiotic-associated diarrhea in adults and children.


* In the complex therapy of allergic diseases (atopic dermatitis, food allergies).


Contraindications.


Yogurt is contraindicated in case of hypersensitivity to the active and auxiliary ingredients of the drug or to gelatin, milk or soy.


Yogurt should not be used in patients with immunodeficiency conditions such as AIDS, lymphoma, or patients with autoimmune diseases receiving injectable immunosuppressants or corticosteroids (at a dose of more than 0.5 mg/kg of body weight per day in terms of prednisone).


Yogurt should not be used in patients with short bowel syndrome due to the risk of developing D-lactate acidosis.


Interactions with other drugs and other types of interactions.


Not investigated.


Application features.


You should stop using yogurt and consult a doctor if symptoms of digestive disorders (such as diarrhea) occur, worsen, or persist for 3 days.


Do not use yogurt without a doctor's recommendation if you experience symptoms such as fever, vomiting, bloody diarrhea, or severe abdominal pain.


In some groups of patients, microbial preparations, including probiotics, can rarely cause the development of systemic infections. Although such cases have not been observed with the use of yogurt, such categories of patients should only use the drug on the recommendation of a doctor, who should weigh the risk and benefit of such use. These groups include:


* Very debilitated patients in a life-threatening state who are usually in intensive care units.


* Patients with existing catheters in the central vein, patients with myocarditis or endocarditis or after heart surgery, patients after gastrointestinal or oral surgery (including tooth extraction), as open wounds can be the entrance gate of infection.


* Patients with the presence of blood in the stool, especially children and elderly patients, as permeable intestinal barriers are potential places through which microbes can enter the bloodstream.


* Patients with significantly weakened and suppressed immune systems, including patients after stem cell or solid organ transplantation, patients receiving injectable immunosuppressants or corticosteroids for autoimmune diseases (at a dose of more than 0.5 mg/kg of body weight per day in terms of prednisone), patients after radio or chemotherapy, and patients with underdeveloped immune systems, such as premature newborns.


Since yogurt contains strains of bacteria that produce D-lactate (D-lactic acid), patients with short bowel syndrome who may develop D-lactate acidosis should avoid taking this medication.


Excipients. Because lactic acid bacteria Lactobacillus delbrueckii subsp. bulgaricus and Streptococcus thermophilus have high levels of beta-galactosidase, and patients with beta-galactosidase deficiency in intestinal epithelial cells are able to adsorb lactose in the presence of these bacteria. Therefore, patients who are intolerant to certain sugars can use yogurt, taking into account the properties of these lactic acid bacteria that make up the drug.


Use during pregnancy or lactation.


Lactobacilli are naturally present in the intestines. Yogurt can be used during pregnancy and lactation.


Ability to influence the reaction rate when driving vehicles or other mechanisms.


Yogurt does not affect the reaction rate when driving vehicles or other mechanisms.


Dosage and administration.


The drug is taken orally, with a meal, preferably simultaneously with a meal.


Children or adults who cannot swallow the capsule are advised to open the capsule and mix its contents with a small amount of food or liquid.


For the child, pour out the contents of the capsule or, if necessary, about half of the contents and mix with the food or drink intended for the child.


Doses for children:


age from 3 months to 1 year: 1-2 × 109 CFU per day;


age from 1 to 3 years: 2-4 × 109 CFU per day;


age from 3 to 12 years: 4-8 × 109 CFU per day;


For adults and children over 12 years of age: 6-12 × 109 CFU per day.


The duration of the course of application is 25-30 days. If necessary, the course can be repeated.


Children. Yogurt is used for children aged from 3 months.


Overdose.


There are no reports of overdose cases.


Adverse reactions.


Adverse reactions are very rare. Hypersensitivity reactions, rashes, and itching are possible.

Tags: Yogurt