Erythromycin, pills 250 mg, 20 pcs.

Composition

Erythromycin 250 mg.

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 subunit of ribosomes 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 not producing penicillinase, including Staphylococcus aureus, Streptococcus spp (including 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.

Resistant gram-negative bacilli: Escherichia coli, Pseudomonas aeruginosa, as well as Shigella spp., Salmonella spp. and others.

It is a motilin receptor agonist. Accelerates the evacuation of gastric contents by increasing the amplitude of pyloric contraction and improving antral-duodenal coordination.

Indications

Bacterial infections caused by sensitive microflora: diphtheria (including bacterial transmission), whooping cough (including prevention), 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) uncomplicated chlamydia in pregnant women adults(with localization in the lower genitourinary tract and rectum) with intolerance or ineffectiveness of tetracyclines, etc. ; ENT infections (tonsillitis, otitis media, sinusitis); biliary tract infections (cholecystitis); upper and lower respiratory tract infections (tracheitis, bronchitis, pneumonia); skin and soft tissue infections (pustular skin diseases, including juvenile acne, infected wounds, bedsores, burns II-III art., trophic ulcers).

Prevention of exacerbations 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).

It is a reserve antibiotic for the treatment of bacterial infections caused by strains of gram-positive pathogens (in particular, staphylococci) resistant to penicillin.

Erythromycin is the drug of choice in patients with hypersensitivity to penicillins.

Use during pregnancy and lactation

It is not recommended to use Erythromycin in pregnant and breast-feeding women only if the expected benefit exceeds the potential harm.

Due to the possibility of penetration into breast milk, you should refrain from breast-feeding when prescribing erythromycin.

Contraindications

• hypersensitivity to macrolide antibiotics or to any other substance included in the preparation,
• concomitant use of terfenadine or astemizole,
• significant hearing loss.

Use with caution in patients with functional liver disorders, arrhythmia (in the anamnesis), prolongation of the QT interval, jaundice (in the anamnesis), hepatic or renal insufficiency, during lactation.

Side effects

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

Diarrhea that occurs during treatment with erythromycin should be reported to your doctor, as this may be a symptom of pseudomembranous enterocolitis.

During prolonged or repeated treatment with erythromycin, a superinfection caused by drug-resistant bacteria or fungi may develop.

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

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

Allergic reactions: urticaria, other forms of skin rash, eosinophilia, rarely-anaphylactic shock.

Other adverse events that may occur after taking erythromycin: agranulocytosis, nervous system disorders (dizziness, confusion, hallucinations), nightmares.

Interaction

Incompatible with lincomycin, clindamycin and chloramphenicol (antagonism). Reduces the bactericidal effect of beta-lactam antibiotics (penicillins, cephalosporins, carbopenems). Increases theophylline content.

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, bromocreptin), 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 concomitantly with terfenadine or astemizole – the possibility of arrhythmia (flickering and fluttering of the ventricles, ventricular tachycardia, up to death), 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, it increases rhabdomyolysis.

Increases the bioavailability of digoskin.

Reduces the effectiveness of hormonal contraception.

How to take, course of administration and dosage

The drug should be taken orally on an empty stomach or 1 hour before meals.

The tablet should not be divided and chewed.

Erythromycin should be taken at least 2-3 more days after the symptoms disappear. For infections caused by Group A streptococci, erythromycin should be taken for at least 10 days.

Doses

The dose depends on clinical and microbiological studies, as well as on the general condition of the patient.

The average daily dose for adults is 1-2 g in 2-4 divided doses, the maximum daily dose is 4 g.

Children under 18 years of age, depending on age, body weight and severity of infection-30-50 mg / kg / day in 2-4 doses. For 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, children-30-50 mg / kg / 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.

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-20-30 mg / kg / day, the course duration is at least 10 days.

For prophylactic 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 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.

Overdose

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

Treatment: activated charcoal, careful monitoring of the state of the respiratory system (if necessary, artificial ventilation of the lungs), acid-base state and electrolyte metabolism, electrocardiography. Hemodialysis, peritoneal dialysis, and forced diuresis are ineffective.

Special instructions

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 administration 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).

Newborns receiving erythromycin have a high risk of developing pylorostenosis. Numerous clinical studies have demonstrated the antral and duodenal prokinetic effects of erythromycin.

During long-term treatment with erythromycin, it is necessary to monitor laboratory parameters of liver function.

Use cautiously in patients treated simultaneously with drugs whose metabolism occurs with the participation of cytochrome P-450-dependent monooxidases.

Broad-spectrum antibiotics (e. g. macrolides, semisynthetic penicillins, cephalosporins) can sometimes cause pseudomembranous colitis. Suppression of normal bacterial flora in the intestine contributes to the development of Clostridium difficile bacillus, whose toxins cause clinical symptoms of pseudomembranous colitis. Therefore, patients who have developed diarrhea during antibiotic treatment or immediately after its withdrawal should not be treated themselves, but should consult a doctor.

If pseudomembranous colitis is confirmed, you should immediately stop taking erythromycin and start appropriate treatment. In mild cases, it is sufficient to cancel the drug, in more severe cases, it is necessary to take metronidazole or vancomycin. It is contraindicated to take medications that inhibit intestinal motility or other anti laxative agents

Storage conditions

Store at temperatures up to 25°C. Protect from moisture. Keep out of reach of children.

Shelf

life is 3 years.

Active ingredient

Erythromycin

Conditions of release from pharmacies

By prescription

Dosage form

Tablets

Purpose

For adults as prescribed by a doctor, Pregnant women as prescribed by a doctor, Children as prescribed by a doctor, Children over 3 years of age

Indications

Chlamydia, Infectious diseases, Urinary tract infections, Pneumonia, Tonsillitis, Eye infections, Cholecystitis, Tracheitis, Sinusitis, Sore throat, Purulent wounds, Bronchitis, Acne, Whooping cough, Sinusitis, Pyoderma, Biliary tract infections, Pharyngitis

Weight

Weight: 20 g.