Erythromycin, pills 250mg, 20pcs – Irbit

Composition

1 tablet contains 250 mg of erythromycin.

Auxiliary substances:

povidone – 9.45 mg,

crospovidone-13.5 mg,

calcium stearate-4.14 mg,

talc-10.35 mg,

potato starch – up to 450 mg kernel weight.

Shell composition:

cellacefate 16.2 mg, titanium dioxide 0.8 mg, castor oil 3 mg

Pharmacological action

A bacteriostatic antibiotic from the macrolide group, reversibly binds to the 50S ribosomal subunit in its donor part, 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, it may have a bactericidal effect. The spectrum of action includes gram-positive (Staphylococcus spp., producing and non-producing penicillinase, including Staphylococcus aureus; Streptococcus spp. Streptococcus pneumoniae, Streptococcus pyogenes), alpha-hemolytic streptococcus (Viridans group ), Bacillus anthracis, Corynebacterium diphtheriae, Corynebacterium minutissimum) and gram-negative microorganisms (Neisseria gonorrhoeae, Haemophilus influenzae, Bordetella pertussis, Brucella spp., Legionella spp., including Legionella pneumophila) and other microorganisms: Mycoplasma spp. (including Mycoplasma pneumoniae), Chlamydia spp. (including Chlamydia trachomatis), Treponema spp., Rickettsia spp., Entamoeba histolytica, Listeria monocytogenes.

Gram-negative bacilli are stable: Escherichia coli, Pseudomonas aeruginosa, as well as Shigella spp., Salmonella spp. and others. The sensitive group includes microorganisms whose growth is delayed at an antibiotic concentration of less than 0.5 mg/l, medium — sensitive — 1-6 mg/l, moderately resistant and resistant-6-8 mg/l.

Indications

Bacterial infections caused by sensitive microflora:

• diphtheria (including bacteriocarrier);
• pertussis (including prevention);
• trachoma;
• brucellosis;
• Legionnaires ‘ disease;
• erythrasma;
• listeriosis;
• scarlet fever;
• amebic dysentery;
• gonorrhea;
• conjunctivitis of the newborn;
• pneumonia in children;
• urinary infections in pregnant women caused by Chlamydia trachomatis;
• primary syphilis (in patients allergic to penicillins);
• uncomplicated chlamydia in adults (localized in the lower urinary tract and rectum) in case of intolerance or ineffectiveness of tetracycline;
• infections of ENT organs (tonsillitis, otitis, sinusitis);
• infection of the biliary tract (cholecystitis);
• infections of the upper and lower respiratory tract (tracheitis, bronchitis, pneumonia);
• infections of skin and soft tissues (pustular skin diseases, including acne, infected wounds, bedsores, burns of II-III degree, trophic ulcers);
• infections of the mucous membrane of the eye;
• the prevention of complications of streptococcal infection (tonsillitis, pharyngitis) in patients with rheumatism;
• prevention of infectious complications in medical and diagnostic procedures (including preoperative bowel preparation, dental interventions, endoscopy, in patients with heart defects).

Contraindications

• hypersensitivity;
• hearing loss;
• concomitant use of terfenadine or astemizole;
• lactation.

With caution:  arrhythmias (in the anamnesis); prolongation of the QT interval; jaundice (in the anamnesis); liver failure; renal failure.

Side effects

Hypersensitivity reactions:  allergic skin reactions (urticaria, other forms of rash), eosinophilia; rarely-anaphylactic shock.

Nausea, vomiting, gastralgia, tenesmus, abdominal pain, diarrhea, dysbiosis; rarely – oral candidiasis, pseudomembranous enterocolitis (both during and after treatment), impaired liver function, cholestatic jaundice, increased activity of hepatic transaminases, pancreatitis, hearing loss and/or tinnitus (with high doses — more than 4 g/day, hearing loss after drug withdrawal is usually reversible).

Rarely-tachycardia, prolongation of the QT interval on the ECG, ventricular arrhythmias, including ventricular tachycardia (such as “pirouette”) in patients with an extended QT interval.

Interaction

Drugs that block tubular secretion lengthen the T_1/2 of erythromycin.

Incompatible with lincomycin, clindamycin and chloramphenicol (antagonism).

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

When taken concomitantly with drugs that are metabolized in the liver (theophylline, 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).

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.

When taken simultaneously with terfenadine or astemizole — the possibility of arrhythmia, with dihydroergotamine or non-hydrogenated ergot alkaloids – vasoconstriction to spasm, dysesthesia.

Slows down the elimination (enhances the effect) of methylprednisolone, felodipine and coumarin anticoagulants.

When co-administered with lovastatin, rhabdomyolysis increases.

Increases the bioavailability of digoxin.

Reduces the effectiveness of hormonal contraception.

How to take, course of use and dosage

Inside.

A single dose for adults and adolescents over 14 years of age is 250-500 mg, daily-1-2 g. The interval between doses is 6 hours. In severe infections, the daily dose can be increased to 4 g.

Children from 4 months to 18 years, depending on age, body weight and severity of infection-30-50 mg / kg / day in 2-4 doses; children of the first 3 months of life-20-40 mg / kg/day. In the case of more severe infections, the dose may be doubled.

For the treatment of diphtheria carriers — 250 mg 2 times / 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 — 250 mg 4 times/day, children-30-50 mg / kg / day; the course duration is 10-14 days.

For legionellosis-500 mg-1 g 4 times / day for 14 days.

With gonorrhea-500 mg every 6 hours for 3 days, then-250 mg every 6 hours for 7 days.

Preoperative bowel preparation for prevention of infectious complications — inside, by 1 g 19 h,18 h and 9 h before the operation (only 3 grams).

To prevent streptococcal infection (when tonsillitis, pharyngitis)adults — 20 to 50 mg/kg/day, children — 20-30 mg/kg/day, the duration of the course 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,1 hour before the treatment or diagnostic procedure, then 500 mg 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 pneumonia in children — 50 mg / kg / day in 4 doses, for at least 3 weeks. For urogenital infections during pregnancy-500 mg 4 times/day for at least 7 days or (if such a dose is poorly tolerated) — 250 mg 4 times/day for at least 14 days.

In adults with uncomplicated chlamydia and tetracycline intolerance-500 mg 4 times / day for at least 7 days.

Overdose

Symptoms:  impaired liver function, up to acute liver failure, hearing loss.

Treatment:  activated charcoal, careful monitoring of the respiratory system. Gastric lavage is effective when taking a dose five times higher than the average therapeutic dose. 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 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 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).

Storage conditions

List B. Store in a dry place, protected from light, out of reach of children, at a temperature not exceeding 25°C.

Shelf life

2 years

Active ingredient

Erythromycin

Conditions of release from pharmacies

By prescription

Dosage form

Tablets

Indications

Sinusitis, Sore Throat, Vaginal Infections, Pneumonia, Otitis Media, Gastrointestinal Infections