Erythromycin

Active material: Erythromycin
When ATH: J01FA01
CCF: Macrolide antibiotics
When CSF: 06.07.01
Manufacturer: Synthesis of (Russia)

Pharmaceutical form, composition and packaging

Valium for drug solution for the on / in the a porous mass of white.

1 fl.
Erythromycin (in the form of phosphate)100 mg

Vials 10 ml (10) – packs cardboard.
Vials 10 ml (50) – packs cardboard.

Valium for drug of a solution for / in a porous mass of white.

1 fl.
Erythromycin (in the form of phosphate)200 mg

Vials 20 ml (10) – packs cardboard.
Vials 20 ml (50) – packs cardboard.

 

DESCRIPTION OF ACTIVE SUBSTANCES.

Pharmacological action

Macrolide antibiotics. It has a bacteriostatic effect. However, high doses against susceptible microorganisms bactericidal effect. Erythromycin binds reversibly to ribosomes of bacteria, thereby inhibiting protein synthesis.

Active against gram-positive bacteria: Staphylococcus spp. (strains, producing and not producing penicillinase), Streptococcus spp. (incl. Streptococcus pneumoniae); Gram negative bacteria: Neisseria gonorrhoeae, Haemophilus influenzae, Bordetella pertussis, Brucella spp., Legionella spp., Bacillus anthracis, Corynebacterium diphtheriae; Anaerobic bacteria: Clostridium spp.

Erythromycin is also active against Mycoplasma spp., Chlamydia spp., Spirochaetaceae, Rickettsia spp.

Erythromycin-resistant Gram-negative bacilli, incl. Escherichia coli, Pseudomonas aeruginosa, Shigella spp., Salmonella spp.

 

Pharmacokinetics

Bioavailability is 30-65%. Distributed in most tissues and body fluids. Plasma protein binding is 70-90%. It is metabolized in the liver, partial formation of inactive metabolites. T1/2 – 1.4-2 no. Excreted in the bile and urine.

Testimony

Infectious-inflammatory diseases, caused by microorganisms sensitive to erythromycin, incl. Diphtheria, pertussis, trachoma, Brucellosis, Legionnaires' disease, sore throat, scarlet fever, otitis, sinusitis, cholecystitis, pneumonia, gonorrhea, syphilis. Treatment of infectious and inflammatory diseases, caused by infection (in particular, staphylococci), penicillin-resistant, tetracycline, chloramphenicol, streptomycin.

For outdoor use: acne vulgaris.

For topical application,: infectious and inflammatory eye diseases.

 

Dosage regimen

Set individually, depending on the location and severity of the infection, susceptibility. Adults used in a daily dose of 1-4 g. Children under 3 months – 20-40 mg / kg / day; aged 4 months before 18 years – 30-50 mg / kg / day. The multiplicity of use – 4 times / day. A course of treatment – 5-14 days, Once the symptoms continue treatment for another 2 days. Get to 1 hours before meals or 2-3 hours after meals.

Topical solution lubricate the affected skin.

The ointment is applied to the affected area, and in diseases of the eye for a lower eyelid. Dose, the frequency and duration of use is determined individually.

 

Side effect

From the digestive system: nausea, vomiting, epigastric pain, cholestatic jaundice, tenesmus, diarrhea, dysbiosis; rarely – pseudomembranous enterocolitis, abnormal liver function, increase in liver transaminases, pancreatitis.

Allergic reactions: skin rash, hives, eozinofilija; rarely – anaphylactic shock.

Effects, caused by chemotherapeutic action: oral candidiasis, vaginal candidiasis.

From the senses: reversible ototoxicity – hearing loss and / or tinnitus (with high doses of – more 4 g / day).

Cardio-vascular system: rarely – tachycardia, QT prolongation on the ECG, flickering and / or atrial flutter (patients with prolonged QT interval on ECG).

Local reactions: phlebitis at the site / in the.

 

Contraindications

Jaundice history, expressed human liver, Hypersensitivity to macrolides.

 

Pregnancy and lactation

Erythromycin crosses the placental barrier, excreted in breast milk.

In the application of erythromycin during pregnancy should be evaluated estimated benefit to the mother and the potential risk to the fetus. If necessary, use during lactation should decide the issue of termination of breastfeeding.

 

Cautions

To use caution in the human liver and / or kidney.

Preparations, increases the acidity of gastric juice, and acidic drinks inactivate erythromycin. Erythromycin can not drink milk and dairy products.

 

Drug Interactions

With simultaneous use of erythromycin with theophylline, aminofillinom, caffeine marked increase in their concentration in the blood plasma and thus increases the risk of toxic effects.

Erythromycin increases the concentration of cyclosporine in the blood plasma, and may increase the risk of nephrotoxicity.

Preparations, block tubular secretion, удлиняет T1/2 Erythromycin.

Incompatible with lincomycin, clindamycin and chloramphenicol (antagonizm).

Erythromycin reduces the bactericidal effect of beta-lactam antibiotics (penicillins, cephalosporins, carbapenems).

With simultaneous use of erythromycin increases the concentration of theophylline.

When concomitantly with drugs, whose metabolism in the liver (karʙamazepina, valproic acid, geksoʙarʙitala, phenytoin, alfentanil, dizopiramida, Lovastatin, bromocriptine), may increase the concentration of drugs in plasma (It is an inhibitor of microsomal liver enzymes).

In / in the introduction of erythromycin increases the effects of ethanol (acceleration of gastric emptying and decrease the duration of alcohol in the gastric mucosa).

Erythromycin reduces the clearance of midazolam and triazolam and thus may enhance the pharmacological effects of benzodiazepines.

When concomitantly with terfenadine or astemizole may develop arrhythmias (flicker-ventricular flutter, Ventricular tachycardia, until death); with dihydroergotamine, or non-hydrogenated ergot alkaloids possible to vasoconstriction spasm, dysesthesia.

In an application slows elimination (enhances the effect of) methylprednisolone, felodipine and coumarin anticoagulants.

The joint appointment with lovastatin enhanced rhabdomyolysis.

Erythromycin increases the bioavailability of digoxin.

Erythromycin reduces the effectiveness of hormonal contraception.

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