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PIPEM
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- Stock: Zabrana online prodaje
- Brand: HEMOFARM-EN
- Model: BR-67164685
Pipem 200 mg was a prescription medicine supplied as hard capsules containing 200 mg of pipemidic acid. It belonged to an older group of quinolone antibacterial medicines and was previously used for certain bacterial urinary tract infections.
In 2019, the Serbian Medicines and Medical Devices Agency – ALIMS announced that marketing authorisations for medicines containing pipemidic acid, including Pipem 200 mg, would be suspended and that these medicines would be withdrawn from circulation.
Pipem must not be presented as a currently available treatment or used on the basis of an old leaflet, previous prescription or another person's experience.
Pipem 200 mg – information about a withdrawn medicine
What was Pipem formerly used for?
Before its withdrawal, Pipem was used as a urinary antibacterial medicine for certain urinary tract infections caused by susceptible bacteria. Older product information included infections of the lower urinary tract and urinary bladder.
This information is provided solely for historical and educational purposes. Pipemidic acid should not be used as current standard treatment on the basis of old recommendations.
Why was Pipem withdrawn?
A safety review of quinolone and fluoroquinolone antibiotics identified a risk of serious, prolonged, disabling and potentially irreversible adverse reactions, particularly affecting:
- tendons, muscles, joints and bones;
- the peripheral and central nervous systems;
- vision, hearing, smell and taste;
- mood, sleep, memory and concentration.
For medicines containing pipemidic acid, the benefit-risk balance was considered insufficient to justify their continued availability.
How is Pipem dosed today?
Doses printed in old leaflets must not be treated as current medical instructions. A person with symptoms of a urinary infection should be assessed by a doctor, who may request a urine culture and choose an authorised treatment according to the symptoms, test results and bacterial resistance.
Do not use capsules left over from an earlier treatment, even when the pack appears intact. The medicine may be expired, improperly stored and is no longer part of current therapeutic practice.
What should you do with an old pack?
- Do not start or continue treatment without medical assessment.
- Do not give the capsules to another person.
- Do not dispose of the medicine in wastewater or household rubbish.
- Take an unused or expired pack to a pharmacy that accepts pharmaceutical waste.
- If you have already taken a capsule, tell a doctor or pharmacist how many capsules were taken.
Who required particular caution according to the former leaflet?
Older information advised particular caution in people with:
- allergy to pipemidic acid or other quinolones;
- previous quinolone-related tendon disease;
- impaired kidney function;
- epilepsy, seizures or another neurological disorder;
- porphyria;
- glucose-6-phosphate dehydrogenase deficiency;
- increased sensitivity to sunlight or artificial UV radiation.
The medicine was not intended for children. Use during pregnancy or breastfeeding required an individual medical assessment.
Previously recognised interactions
According to the former leaflet, pipemidic acid could interact with:
- theophylline and caffeine;
- warfarin and medicines affecting blood clotting;
- non-steroidal anti-inflammatory medicines;
- antacids and products containing aluminium, magnesium, calcium or iron;
- sucralfate, cimetidine and probenecid.
Do not attempt to manage these interactions yourself. Anyone who has taken an old pack should tell a doctor or pharmacist about every medicine and supplement being used.
Previously reported side effects
Older product information listed nausea, vomiting, abdominal discomfort, appetite changes, dizziness, balance problems, rash, itching and sensitivity to sunlight.
More serious reactions included:
- tendon inflammation or rupture;
- tingling, burning, weakness or other signs of neuropathy;
- seizures, confusion or hallucinations;
- severe allergic or skin reactions;
- changes in blood cell counts;
- severe or persistent diarrhoea.
- difficulty breathing or swallowing;
- swelling of the face, lips, tongue or throat;
- severe tendon pain or swelling, particularly near the heel;
- sudden tingling, burning or weakness in the arms or legs;
- seizures, confusion, hallucinations or loss of consciousness;
- a widespread rash, blistering or peeling skin;
- severe or bloody diarrhoea.
Urinary symptoms requiring medical assessment
Burning and frequent urination are not sufficient grounds for choosing an antibiotic without examination. Medical assessment is particularly important in the presence of:
- fever or chills;
- pain in the side, back or kidney area;
- blood in the urine;
- nausea or vomiting;
- pregnancy;
- symptoms in a man or child;
- frequently recurring infections;
- worsening symptoms or failure to improve.
Composition and former pack
- Active ingredient: 200 mg of pipemidic acid per capsule.
- Pharmaceutical form: hard capsule.
- Pack size: 20 capsules in two blisters of 10.
- Manufacturer: Hemofarm A.D., Vršac, Serbia.
- ATC code: J01MB04.
- Former supply status: prescription-only medicine.
- Status: authorisation suspended and medicine withdrawn from circulation.
Pipem 200 mg must not be offered for sale or displayed as a currently available treatment. Its historical price is not relevant because the medicine was withdrawn. This page should be retained only to provide reliable information to people searching for the former medicine.
Do not treat urinary symptoms with an antibiotic left over from a previous course. The wrong antibiotic or an incomplete course may conceal symptoms, complicate diagnosis and contribute to bacterial resistance.
Products containing D-mannose, cranberry or herbal ingredients may be considered only as additional nutritional support in suitable circumstances. They do not treat a serious bacterial infection and do not replace examination, urine culture or an antibiotic when one is required.
Ljubica Barbulović, Master of Pharmacy
Related category and guide
Explore: Products supporting urinary tract health.
Read more about symptoms, diagnosis and warning signs in: Urinary tract infections – symptoms, treatment and prevention.
Related nutritional support products
Note: these supplements are not substitutes for Pipem, another antibiotic or medical treatment of a bacterial infection.
Can Pipem still be purchased?
Pipem was included in the withdrawal of medicines containing pipemidic acid and must not be presented as a medicine available through regular distribution.
May I take Pipem left over from an earlier treatment?
No. Do not use an old pack without medical assessment. Take the unused medicine to a pharmacy for appropriate disposal.
Which antibiotic replaces Pipem?
There is no automatic replacement. The choice depends on the infection site, symptoms, pregnancy status, kidney function, previous treatments and urine culture results.
Can D-mannose or cranberry replace an antibiotic?
No. They may provide additional nutritional support in selected circumstances but do not treat a serious or complicated bacterial infection.
Sources: official ALIMS communication concerning the withdrawal of pipemidic-acid medicines; an archived former Pipem 200 mg leaflet used solely for historical composition, packaging and safety information.
Sources checked: 2 August 2026.
This page is informational and does not recommend the use of a withdrawn medicine.
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