Erythromycin (When ATH J01FA01)
When ATH:
J01FA01
Characteristic.
A white crystalline powder, odorless, bitter taste. It is soluble in water, well - alcohol. Hygroscopic.
Pharmacological action.
Antibacterial.
Application.
Infections of upper and lower respiratory tract, SARS, purulent-inflammatory diseases of the skin and its appendages, Diphtheria, erythrasma, gonorrhea, syphilis, Listeriosis, Legionnaires' disease, prevention and treatment of rheumatism intolerant of beta-lactam antibiotics; Ophthalmic ointment-conjunctivitis, .Aloe, trachoma.
Contraindications.
Hypersensitivity, liver disease, pregnancy, lactation.
Side effects.
Diarrhoeal disorders (nausea, vomiting, abdominal pain, and others.), abnormal liver function, generalized seizures, hallucinations, disturbances of consciousness, dizziness, reversible hearing loss, ventricular tachycardia, QT prolongation.
Cooperation.
Potentiates the effects and toxicity of antihistamines, ergot alkaloids, theophylline and benzodiazepines, digoksina, antykoahulyantov type of indirect action, karʙamazepina, cyclosporine, geksoʙarʙitala, phenytoin, dizopiramida, lovastatin and bromocriptine.
Overdose.
Symptoms: abnormal liver function, up to acute liver failure, and hearing loss.
Treatment: gastric lavage, diurez, gemo- E pyeritonyealinyi dialysis. Produced constant monitoring of vital functions (ECG, electrolyte composition of blood).
Dosing and Administration.
Inside, for 1.5-2 hours before delivery; adult: 250-500 mg 4 once a day; The highest single dose 500 mg, daily - 2 g; children: from 1 Year to 3 years - 400 mg / day, from 3 to 6 years is 500-750 mg/day, from 6 to 8 years - 750 mg / day, from 8 to 12 years — to 1 g / day, dividing by 4 admission.
B / introduce adults and children at the rate of 15-20 mg/kg/day as a continuous or intermittent infusion. In severe cases it is possible to use higher dosage is 4 g / day. Outwardly, 2 times a day lubricated solution affected skin, ointment applied to the affected area, in diseases of the eye for a lower or upper eyelid 3-5 times a day.
Precautions.
The use of erythromycin, comprising a benzene, for / in the injection is sometimes accompanied by the development of a fatal gasping syndrome in children, as well as acute hepatitis drug in adults and children.
Cooperation
Active substance | Description of interaction |
Aminofillin | FKV. FMR. Against the backdrop of slowing biotransformation of erythromycin and intensified action. |
Bromocriptine | FKV. FMR: synergism. Against the background of erythromycin (slows the biotransformation) enhances the effect of, incl. the likelihood and severity of side. |
Sodium valproate | FKV. FMR: synergism. Against the background of erythromycin (reduces the activity of CYP450) increasing the concentration in blood and enhanced effect. |
Valproic Acid | FKV. FMR: synergism. Against the background of erythromycin (reduces the activity of CYP450) increasing the concentration in blood and enhanced effect. |
Warfarin | FKV. FMR: synergism. Against the background of erythromycin (slows the biotransformation) enhanced (especially in elderly patients) effect. |
Digoxin | FKV. FMR. Against the background of erythromycin (inhibits CYP450, and moreover, It inhibits the activity of microorganisms, destroying digoxin in the lower intestine) increases the concentration in the blood and increases the risk of glycoside intoxication. |
Itraconazole | FKV. Against the background of erythromycin (slows the biotransformation) increased plasma concentrations of. |
Carbamazepine | FKV. FMR: synergism. Against the background of erythromycin (CYP3A4 inhibitor) zamedlyaetsya biotransformation, enhances the effect of, incl. the risk and severity of side. |
Klindamiцin | In vitro show antagonism with clindamycin. Combined use not recommended. |
Lincomycin | FMR. Against the background of erythromycin (lincomycin displaces from its connection with the 50S-subunit of the bacterial ribosome) reduced antibacterial effect. |
Lovastatin | FKV. FMR: synergism. Against the background of erythromycin (CYP450 system blocks) zamedlyaetsya biotransformation, increasing blood levels, enhances the effect of, incl side; the combined use increases the risk of myopathy. |
Midazolam | FKV. FMR. Against the background of erythromycin (blocks biotransformation) Lowering, increases (prolonged) effect. |
Nevirapine | FKV. On the background of erythromycin increases the equilibrium concentration in plasma. |
Repaglinide | FKV. Against the background of erythromycin (slows the biotransformation) the effect can be enhanced. |
Siʙutramin | FKV. Against the background of erythromycin (inhibits microsomal oxidation) decreases clearance and increases (insignificantly) AUC. |
Simvastatin | FKV. FMR. Against the background of erythromycin (CYP3A4 inhibitor) zamedlyaetsya biotransformation, increasing the concentration in the tissues, enhanced effect, It increases the risk and severity of adverse events, in particular myopathies. |
Sparfloxacine | FMR. Increases (mutually) the risk of QT prolongation and arrhythmia type twist of points; concurrent use is not recommended . |
Theophylline | FKV. FMR: synergism. Against the background of erythromycin (slows the biotransformation) enhances the effect of, incl. the likelihood and severity of side. |
Tinidazol | Strengthens (mutually) effect. |
Fexofenadine | FKV. Against the background of erythromycin (slows the biotransformation) increased plasma levels. |
Phenytoin | FKV. FMR: synergism. Against the background of erythromycin (blocks biotransformation) enhances the effect of, incl. the likelihood and severity of side. |
Chloramphenicol | FMR. Against the background of erythromycin (displace chloramphenicol from its connection with the 50S-subunit of the bacterial ribosome) reduced antibacterial effect. |
Cetirizine | It does not change significantly (mutually) effect; permissible combined use. |
Cyclosporine | FKV. FMR: synergism. Against the background of erythromycin (slow destruction) enhances the effect of, including side. |
Eʙastin | FKV. FMR. Increases (mutually) the risk of QT prolongation with possible development of fatal ventricular disorders; combined use is not recommended. |