Roksitromitsin

When ATH:
J01FA06

Characteristic.

Semi-synthetic macrolide antibiotic for oral use.

Pharmacological action.
Antibacterial, bacteriostatic.

Application.

Infectious-inflammatory disease, caused by microorganisms sensitive to roxithromycin: infections of the upper and lower respiratory tract and ENT (tonsillitis, pharyngitis, sinusitis, scarlet fever, Diphtheria, pertussis, otitis media, pneumonia, bacterial infections in patients with COPD, bronchitis and acute exacerbation of chronic, panʙronxiolit, bronchiectasis), genitourinary system (uretrit, endometritis, cervicitis, vaginitis, incl. genital infections, except for gonorrhea), skin and soft tissue (mug, flegmona, boils, folliculitis, impetigo, pyoderma), oral (periodontitis), bones (periostitis, chronic osteomyelitis), erythema migrans, trachoma, Brucellosis). Prevention of meningococcal meningitis in people, have been in contact with sick. Prevention of bacteremia in patients with endocarditis after dental surgery.

Contraindications.

Hypersensitivity (incl. to other macrolides), infancy (to 2 Months), concomitant use of ergotamine or dihydroergotamine (cm. "Interaction").

Restrictions apply.

Expressions of the liver.

Pregnancy and breast-feeding.

It should not be prescribed during pregnancy (roxithromycin safety for the fetus a person is not defined). At the time of treatment should stop breastfeeding (It passes into breast milk).

Side effects.

From the digestive tract: nausea, vomiting, anorexia, constipation / diarrhea (very rarely with blood), abdominal pain, flatulence, transient increase in liver transaminases and alkaline phosphatase, cholestatic hepatitis or hepatocellular acute hepatitis, symptoms of pancreatitis, pseudomembranous enterocolitis.

From the nervous system and sensory organs: dizziness, headache, weakness, malaise, blurred vision, changes in taste and / or smell, noise in ears, paresthesia.

Allergic reactions: itch, rash, dermahemia, hives, eczema, angioedema, bronchospasm, anaphylactic shock.

Other: development of superinfection, candidiasis of mouth and vagina, eozinofilija, giperkreatininemiя, pigmentation nogtey.

Cooperation.

It increases the absorption of digoxin. In a joint application with warfarin increases PV. Increases in AUC and T_1/2 midazolama (amplification and prolongation of efficacy). Increases in plasma concentration of theophylline, Cyclosporin A (It does not require correction dosing regimen). Increases toxicity of ergotamine and ergotaminopodobnyh vasoconstrictor (It increases the risk of ergotism limbs and tissue necrosis). May displace from its association with plasma proteins dizopiramid, resulting in an increase in the free fraction of blood (ECG monitoring is recommended and, possibly, determine the level of serum disopyramide). May increase serum concentrations of terfenadine, astemizola, cisapride, pimozida, which leads to a lengthening of the QT interval and / or severe arrhythmias.

Interaction with carbamazepine, ranitidine, antaцidami, oral contraceptives were found.

Overdose.

Treatment: gastric lavage, simptomaticheskaya therapy. The specific antidote is absent.

Dosing and Administration.

Inside, adults - 300 mg / day in 1-2 reception; children 5-8 mg/kg/day 2 admission (no more 10 days). Course duration depends on indication for use, severity of infection and the activity of the pathogen (5-12 days for respiratory diseases and ENT to 2-2.5 months in chronic osteomyelitis; If chlamydial and mycoplasmal pneumonia — 14 days, When legionelleznoj pneumonia — to 21 day).

In older patients, dosage and daily dosage not changed roxithromycin. In violation of liver and kidney function may require dose reduction. In severe liver failure — 150 mg 1 once a day.

Precautions.

When administered to patients with hepatic impairment should be careful, conduct a dose adjustment, monitor liver function. The joint appointment of terfenadine, astemizola, cisapride, pimozide need to monitor ECG.

Due to the possibility of dizziness, caution is required while driving and operating machinery.

Cooperation