Composition
1 tablet contains:
Active ingredient:
erythromycin 292.4 mg, based on the Active ingredient 250 mg
. excipients of the core:
potato starch 132.9 mg,
povidone 11.2 mg,
polysorbate-80 9.0 mg,
calcium stearate 4.5 mg
. excipients: :
acetylphthalylcellulose 13.5 mg,
macrogol-6000 1.0 mg,
titanium dioxide 4.0 mg,
castor oil 4.0 mg
Pharmacological action
Bacteriostatic antibiotic from the macrolide group. Reversibly binds to the 50SC ribosomal subunit, which disrupts the formation of peptide bonds between amino acid molecules and blocks the synthesis of microbial proteins (does not affect the synthesis of nucleic acids). When used in high doses, depending on the type of pathogen, it can show a bactericidal effect.
Sensitive microorganisms include those whose growth is delayed at an antibiotic concentration of less than 0.5 mg/l, moderately sensitive – 1-6 mg/l, and resistant – more than 6 mg/l.
The broad spectrum of antimicrobial action of erythromycin includes:
gram-positive microorganisms: Â Staphylococcus spp., producing and non-producing penicillinase, including Staphylococcus aureus (except strains resistant to methicillin MRSA); Streptococcus spp. (including Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus spp. of the viridans group): Bacillus anthracis, Corynebacterium diphtheriae, Corynebacterium minutissimum, Listeria monocytogenes;
gram-negative microorganisms: Bordetella pertussis, Campylobacter jejuni, Legionella spp (including Legionella pneumophila), Moraxella (Branhamella) catarrhalis; and other microorganisms: Â Mycoplasma spp. (including Neisseria gonorrhoeae, Haemophilus influenzae (some strains may be resistant to erythromycin, but are sensitive to other macrolide antibiotics);
other microorganisms:  Chlamydia spp. (including Chlamydia trachomatis), Mycoplasma spp. (including Mycoplasma pneumoniae), Ureaplasma urealyticum, Treponema spp., Propionibacterium acnes, Entamoeba histolytica.
Erythromycin-resistant gram-negative bacilli:  Escherichia coli and other representatives of the Enterobacteriaceae family (Klebsiella spp., Proteus spp., Shigella spp., Salmonella spp. and others); Pseudomonas aeruginosa; Acinetobacter spp. And other non-fermenting bacteria, as well as anaerobic bacteria (Bacteroides spp., including Bacteroides Iragilis), methicillin-resistant strains Staphylococcus aureus (MRSA) and enterococci Enterococcus spp., microbacteria.
It is a motilin receptor agonist. Accelerates the evacuation of gastric contents by increasing the amplitude of pyloric contraction and improving antral-duodenal coordination, has prokinetic properties.
Indications
Infectious and inflammatory diseases caused by microorganisms sensitive to erythromycin: diphtheria (including bacterial carriers), trachoma, brucellosis, legionellosis (legionnaires ‘ disease), erythrasma, listeriosis, scarlet fever, amoebic dysentery, gonorrhea; ENT infections (tonsillitis, otitis media, sinusitis); biliary tract infections (cholecystitis); whooping cough (including prevention); upper and lower respiratory tract infections lower respiratory tract infections (tracheitis, bronchitis, pneumonia); skin and soft tissue infections (pustular skin diseases, including juvenile acne, infected wounds, bedsores, burns of II-III degrees, trophic ulcers), infections of the eye mucosa.
Prevention of infectious complications in medical and diagnostic procedures (including preoperative bowel preparation, dental interventions, endoscopy, in patients with heart defects).
Prevention of exacerbations of streptococcal infection (tonsillitis, pharyngitis) in patients with rheumatism.
Urogenital infections in pregnant women caused by Chlamydia trachomatis; uncomplicated chlamydia in adults (with localization in the lower genitourinary tract and rectum) with intolerance or ineffectiveness of tetracyclines, etc.
Use during pregnancy and lactation
The use of Erythromycin during pregnancy is possible only if the expected benefit to the mother exceeds the potential risk to the fetus.
During lactation, due to the possibility of penetration into breast milk, you should refrain from breast-feeding when using Erythromycin.
Recommendations for use
Inside (the mode of taking the drug and eating is determined by the dosage form and its resistance to the effects of gastric juice). Take the tablet 1-2 hours before meals or 2-3 hours after meals. The tablet should not be divided and chewed. A single dose for adults is 250-500 mg. The average daily dose for adults is 1-2 g in 2-4 divided doses, the maximum daily dose is 4 g.
Children from 14 years of age, depending on age, body weight and severity of infection-30-50 mg / kg / day in 2-4 doses. In case of severe infections, the dose may be doubled. For the treatment of diphtheria carriers – 0.25 g 2 times a day.
The course dose for the treatment of primary syphilis is 30-40 g, the duration of treatment is 10-15 days.
For amoebic dysentery, adults – 0.25 g 4 times a day, the course duration is 10-14 days.
With legionellosis-0.5-1 g 4 times a day for 14 days.
For gonorrhea-0.5 g every 6 hours for 3 days, then 0.25 g every 6 hours for 7 days.
With gastroparesis-inside (for the treatment of gastroparesis, erythromycin for intravenous use is more preferable),0.15-0.25 g 30 minutes before meals 3 times a day.
For scarlet fever – in normal doses, the course of treatment is at least 10 days.
With listeriosis-250-500 mg 4 times a day for at least 7 days, etiotropic therapy is carried out up to 6-7 days of normal temperature, and in severe forms – up to 14-21 days.
With erythrasma – 250 mg 4 times a day for 5-7 days simultaneously with external remedies.
For preoperative bowel preparation to prevent infectious complications – inside,1 g for 19 hours,18 hours and 9 hours before the operation (total of 3 g).
For the prevention of streptococcal infection (with tonsillitis, pharyngitis), adults – 20-50 mg / kg / day, children from 14 years-20-30 mg / kg/day, the course duration is at least 10 days.
For the prevention of septic endocarditis in patients with heart defects – 1 g for adults and 20 mg / kg for children over 14 years of age,1 hour before the treatment or diagnostic procedure, then 0.5 g for adults and 10 mg / kg for children, again after 6 hours.
For whooping cough – 40-50 mg / kg / day for 5-14 days.
For urogenital infections during pregnancy-0.5 g 4 times a day for at least 7 days or (if such a dose is poorly tolerated) 0.25 g 4 times a day for at least 14 days.
In adults with uncomplicated chlamydia and tetracycline intolerance-0.5 g 4 times a day for at least 7 days.
Contraindications
Hypersensitivity to erythromycin and other macrolides; significant hearing loss; concomitant use of terfenadine, astemizole, pimozide, cisapride, lactation, children under 14 years of age (for this dosage form).
With caution:
Arrhythmias (in the anamnesis), increased duration of the ventricular complex on the electrocardiogram (prolongation of the QT interval), jaundice (in the anamnesis), hepatic and/or renal failure, use during pregnancy.
Side effects
Allergic reactions: urticaria, other forms of skin rash, eosinophilia, anaphylactic shock.
From the digestive system: nausea, vomiting, gastralgia, abdominal pain, tenesmus, diarrhea, dysbiosis, oral candidiasis, pseudomembranous colitis (both during and after treatment), impaired liver function, cholestatic jaundice, increased activity of “liver” transaminases, pancreatitis.
From the side of the hearing organ: hearing loss and / or tinnitus (when used in high doses-more than 4 g / day, usually reversible).
From the cardiovascular system: tachycardia, prolongation of the Q-T interval on the electrocardiogram, atrial fibrillation and/or flutter (in patients with an extended Q-T interval on the electrocardiogram).
Interaction
Reduces the bactericidal effect of beta-lactam antibiotics (penicillins, cephalosporins, carbopenems).
Incompatible with lincomycin, clindamycin and chloramphenicol (antagonism).
Increases the concentration of theophylline.
Increases the nephrotoxicity of cyclosporine (especially in patients with concomitant renal insufficiency).
Reduces the clearance of triazolam and midazolam, and therefore may enhance the pharmacological effects of benzodiazepines.
Slows down the elimination (enhances the effect) of methylprednisolone, felodipine and coumarin anticoagulants.
When combined with lovastatin, simvastatin and other statins, the risk of rhabdomyolysis increases.
Increases the bioavailability of digoxin.
Reduces the effectiveness of hormonal contraception.
Drugs that block tubular secretion lengthen T%^% 1/2 of Erythromycin.
When combined with drugs that are metabolized in the liver by the cytochrome P450 system (carbamazepine, valproic acid, hexobarbital, phenytoin, alfentanyl, disopyramide, lovastatin, bromocriptine), the concentration of these drugs in plasma may increase (since erythromycin is an inhibitor of microsomal liver enzymes).
When combined with terfenadine or astemizole, arrhythmia may develop (flickering and fluttering of the ventricles, ventricular tachycardia, up to a fatal outcome), with dihydroergotamine or non – hydrogenated ergot alkaloids-vasoconstriction to complete spasm, dysesthesia.
If you are taking other medications, you should consult your doctor.
Overdose
Symptoms:Â impaired liver function, up to acute liver failure, hearing loss.
Treatment:Â activated carbon, careful monitoring of the state of the respiratory system (if necessary – performing artificial ventilation of the lungs), acid-base state and electrolyte metabolism, electrocardiogram.
Gastric lavage is effective when taking a dose five times higher than the average therapeutic dose.
Hemodialysis, peritoneal dialysis, and forced diuresis are ineffective.
Description
Tablets are round, biconvex, covered with an enteric film coating, white or grayish-white in color, on a cross-section the core is white or white with a yellowish tinge of color.
Special instructions
With long-term therapy, it is necessary to monitor laboratory parameters of liver function.
Symptoms of cholestatic jaundice may develop a few days after the start of therapy, but the risk increases after 7-14 days of continuous therapy. The probability of developing an ototoxic effect is higher in patients with renal and/or hepatic insufficiency, as well as in elderly patients. Some resistant strains of Haemophilus influenzae are sensitive to simultaneous use of erythromycin and sulfonamides.
It may interfere with the determination of catecholamines in the urine and the activity of “hepatic” transaminases in the blood (colorimetric determination using definylhydrazine).
Do not wash it down with milk or dairy products.
Numerous clinical studies have demonstrated the antral and duodenal prokinetic effects of erythromycin.
Influence on the ability to drive vehicles and mechanisms:
Data on the negative effect on the ability to drive vehicles and mechanisms have not been identified, but patients driving vehicles are recommended to use the drug with extreme caution.
Storage conditions
Store in a dark place, at a temperature not exceeding 25 °C.
Keep out of the reach of children.
Shelf
life is 2 years. Do not use after the expiration date.
Active ingredient
Erythromycin
Conditions of release from pharmacies
By prescription
Purpose
For adults as directed by your doctor
Indications
Skin infections, Sinusitis, Pyoderma, Pneumonia, Acne, Sore Throat, Whooping cough, Otitis media, Bronchitis, Purulent wounds
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Side effects of Erythromycin-LekT pills 250mg, 20pcs.
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