Erythromycin lyophilizate, vials 100mg 50pcs

Composition

Active ingredient:  erythromycin phosphate (in terms of erythromycin) 100 mg.

Indications

Bacterial infections caused by sensitive pathogens: diphtheria (including bacterial carriers) whooping cough trachoma brucellosis legionnaires ‘ disease erythrasma listeriosis scarlet fever amoebic dysentery gonorrhea; genitourinary infections in pregnant women caused by Chlamydia trachomatis; primary syphilis (in patients with penicillin allergy) ENT infections (tonsillitis otitis sinusitis); biliary tract infections (cholecystitis); upper and lower respiratory tract infections (tracheitis, bronchitis, pneumonia); skin and soft tissue infections (infected wounds, pressure sores, burns of the II-III st trophic ulcers).

Prevention of infectious complications in medical and diagnostic procedures (including preoperative bowel preparation dental interventions endoscopy in patients with heart defects).

Gastroparesis (including gastroparesis after vagotomy, diabetic gastroparesis and gastroparesis associated with progressive systemic sclerosis).

Use during pregnancy and lactation

The use of the drug during pregnancy is possible only in cases where the intended benefit to the mother exceeds the potential risk to the fetus.

If it is necessary to use the drug during lactation, the question of stopping breastfeeding should be decided.

Contraindications

Hypersensitivity significant hearing loss concomitant use of terfenadine or astemizole during lactation.

With caution:

Arrhythmias (in the anamnesis) prolongation of the QT interval jaundice (in the anamnesis) hepatic and / or renal failure pregnancy.

Side effects

From the gastrointestinal tract: nausea vomiting gastralgia abdominal pain tenesmus diarrhea dysbiosis rarely-oral candidiasis pseudomembranous enterocolitis impaired liver function cholestatic jaundice increased activity of “liver” transaminases pancreatitis.

Newborns receiving erythromycin have a high risk of developing pylorostenosis.

From the side of the hearing organs:  ototoxicity: hearing loss and / or tinnitus (usually reversible when used in high doses – more than 4 g/day).

From the cardiovascular system: rarely-tachycardia prolongation of the QT interval on the ECG atrial fibrillation and/or flutter (in patients with an extended QT interval on the ECG).

Allergic reactions:  urticaria skin rash eosinophilia rarely – anaphylactic shock.

Local reactions:  phlebitis at the site of intravenous use.

Interaction

Reduces the bactericidal effect of beta-lactam antibiotics (penicillins, cephalosporins, carbopenems). Increases the concentration of theophylline.

Intravenous use of erythromycin enhances the effect of ethanol (accelerating gastric emptying and reducing the duration of action of ethanol dehydrogenase in the gastric mucosa).

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 co-administered with lovastatin, the risk of rhabdomyolysis increases.

Increases the bioavailability of digoxin.

Reduces the effectiveness of hormonal contraception.

Drugs that block tubular secretion extend the half-life of erythromycin.

When taken concomitantly with drugs that are metabolized in the liver (carbamazepine valproic acid hexobarbital phenytoin alfentanyl disopyramide lovastatin bromocriptine), the concentration of these drugs in plasma may increase (it is an inhibitor of microsomal liver enzymes).

When taken concomitantly with terfenadine or astemizole, arrhythmia may develop (flickering and fluttering of the ventricles, ventricular tachycardia up to death) with dihydroergotamine or non – hydrogenated ergot alkaloids-vasoconstriction to a spasm of dysesthesia.

Incompatible with lincomycin clindamycin and chloramphenicol (antagonism).

How to take, course of use and dosage

Intravenous slowly (for 3-5 minutes) or drip. Intravenous drip use of the drug is preferable and safer.

A single dose of the drug for adults is 02 g daily 06 g In severe cases of infection, the daily dose can be increased to 1 g, then the drug is administered 4 times a day (every 6 hours). Children from 4 months to 18 years, depending on the age of body weight and severity of infection-30-50 mg / kg / day (for 2-4 injections); children of the first 3 months of life-20-40 mg / kg/day. In case of severe infections, the dose may be doubled.

For intravenous jet use, the drug is dissolved in water for injection or 09% sodium chloride solution at the rate of 5 mg per 1 ml of solvent.

For intravenous drip use, it is dissolved in 09% sodium chloride solution or 5% dextrose solution to a concentration of 1 mg / ml and administered at a rate of 60-80 drops/min. Intravenously administered for 5-6 days (until a clear therapeutic effect occurs), followed by switching to oral use.

With good tolerability and the absence of phlebitis and periflebitis, the course of intravenous use can be extended to 2 weeks (no more).

In case of renal insufficiency, there is no need to adjust the dose of the drug.

Overdose

Symptoms:  nausea diarrhea stomach discomfort; dizziness (especially in patients with hepatic or renal insufficiency); impaired liver function up to acute liver failure rarely-hearing impairment.

Treatment:  careful monitoring of the state of the respiratory system (if necessary – performing artificial ventilation of the lungs), acid-base state and electrolyte metabolism of the ECG. It is necessary to conduct symptomatic therapy. Hemodialysis peritoneal dialysis and forced diuresis are ineffective.

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 starting 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 diphenylhydrazine).

Storage conditions

Store in a dry place protected from light at a temperature not exceeding 25 °C.

Keep out of reach of children.

Shelf

life is 4 years.

Do not use after the expiration date indicated on the package.

Active ingredient

Erythromycin

Conditions of release from pharmacies

By prescription

Dosage form

infusion solution