Erythromycin-LekT, 250 mg 20 pcs

Bacteriostatic antibiotic of macrolide group. It binds irreversibly to 50S-subunit of ribosomes, which disrupts formation of peptide bonds between amino acid molecules and blocks protein synthesis in microorganisms (does not affect nucleic acid synthesis). When used in high doses depending on the type of pathogen it may show bactericidal effect.

Sensitive microorganisms are those the growth of which is inhibited when the antibiotic concentration is less than 0.5 mg/l, moderately sensitive – 1-6 mg/l, resistant – more than 6 mg/l.

The broad spectrum of antimicrobial activity of erythromycin includes:

Gram-positive microorganisms: 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. viridans group): Bacillus anthracis, Corynebacterium diphtheriae, Corynebacterium minutissimum, Listeria monocytogenes;

Literate microorganisms: Bordetella pertussis, Campylobacter jejuni, Legionella spp.(including Legionella pneumophila), Moraxella (Branhamella) catarrhalis; and other microorganisms: Mycoplasma spp. Neisseria gonorrhoeae, Haemophilus influenzae (some strains may be resistant to erythromycin but 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.

Eritromycin-resistant Gram-negative bacilli: Escherichia coli and other members of the family Enterobacteriaceae (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 of Staphylococcus aureus (MRSA) and Enterococcus spp. enterococcus microbacteria.

It is a motilin receptor agonist. It accelerates the evacuation of gastric contents by increasing the amplitude of contraction of the pylorus and improving the antral-duodenal coordination; it has prokinetic properties.

Indications

Infectious and inflammatory diseases caused by microorganisms sensitive to erythromycin: diphtheria (including bacteriocarriage), trachoma, brucellosis, legionellosis (legionnaire’s disease), erythrax, listeriosis, scarlet fever, amebic dysentery, gonorrhea; ENT organ infections (tonsillitis, otitis, sinusitis); biliary infections (cholecystitis); pertussis (including prevention); infections of upper and lower respiratory tract (tracheitis, bronchitis, pneumonia); infections of skin and soft tissues (pustular skin diseases, including juvenile acne, infected wounds, bedsores, II-III degree burns, trophic ulcers), eye mucosa infections.

Prevention of infectious complications during medical and diagnostic procedures (including preoperative preparation of the intestine, dental interventions, endoscopy, in patients with cardiac 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 urinary tract and rectum) with intolerance or ineffectiveness of tetracyclines, etc.

Active ingredient

Composition

1 tablet contains:

the active ingredient:

erythromycin 292.4 mg, in recalculation of the active ingredient 250 mg.

Auxiliary substances of the core:

Potato starch 132.9 mg,

povidone 11.2 mg,

Interaction

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

Incompatible with lincomycin, clindamycin and chloramphenicol (antagonism).

Enhances theophylline concentrations.

Accelerates nephrotoxicity of cyclosporine (especially in patients with concomitant renal failure).

Decreases clearance of triazolam and midazolam and therefore may potentiate the pharmacological effects of benzodiazepines.

Delays elimination (enhances the effect) of methylprednisolone, felodipine and coumarin-type anticoagulants.

The risk of rhabdomyolysis increases when combined with lovastatin, simvastatin and other statins.

Induces bioavailability of digoxin.

Decreases the effectiveness of hormonal contraception.

Drugs that block tubular secretion prolong the T1/2 of Erythromycin.

When co-administered with medicinal products metabolized in the liver by cytochrome P450 system (carbamazepine, valproic acid, hexobarbital, phenytoin, alfentanil, disopyramide, lovastatin, bromocriptine), the concentration of these medicinal products in plasma may increase (because erythromycin is an inhibitor of liver microsomal enzymes).

In co-administration with terfenadine or astemizole, arrhythmias (ventricular fibrillation and torsade de pointes, ventricular tachycardia, up to death), with dihydroergotamine or unhydrogenated ergot alkaloids – vasoconstriction to complete spasm, dysesthesia may develop.

If you are taking other medications, you should consult your doctor.

Directions for use

Orally (the mode of taking the drug and eating is determined by the dosage form and its resistance to gastric juice). Take the tablet 1-2 hours before a meal or 2-3 hours after a meal. The tablet must 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 doses, the maximum daily dose is 4 g.

In children over 14 years old depending on the age, body weight and severity of infection it is 30-50 mg/kg/day in 2-4 doses. In case of severe infections the dose may be doubled. For treatment of diphtheria carrier – 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.

In case of amebic dysentery in adults it is 0.25 g 4 times a day, duration of course is 10-14 days.

In legionellosis it is taken 0.5-1 g 4 times a day for 14 days.

In case of gonorrhea – 0.5 g every 6 hours for 3 days, then 0.25 g every 6 hours for 7 days.

In gastroparesis, orally (erythromycin for IV administration) 0.15-0.25 g 30 minutes before meals 3 times daily is preferred for treatment of gastroparesis.

In case of scarlet fever it is used in usual doses; treatment course should be at least 10 days.

In listeriosis – 250-500 mg 4 times a day for at least 7 days, the etiotropic therapy is carried out until the 6th-7th day of normal temperature, and in severe forms – until the 14th-21st day.

In erythrazma – 250 mg 4 times a day for 5-7 days simultaneously with external agents.

For preoperative bowel preparation to prevent infectious complications – orally, 1 g at 19 hours, 18 hours and 9 hours before surgery (total 3 g).

For prevention of streptococcal infection (tonsillitis, pharyngitis) in adults – 20-50 mg/kg/day, in children from 14 years – 20-30 mg/kg/day, the course duration – at least 10 days.

To prevent septic endocarditis in patients with cardiac defects – 1 g for adults and 20 mg/kg for children over 14 years old, 1 hour before therapeutic or diagnostic procedure, further 0.5 g for adults and 10 mg/kg for children, repeated 6 hours later.

In pertussis, 40-50 mg/kg/day for 5-14 days.

In urinary tract infections during pregnancy, 0.5 g 4 times a day for at least 7 days or (if this dose is poorly tolerated) 0.25 g 4 times a day for at least 14 days.

In adults with uncomplicated chlamydia and intolerance to tetracyclines, 0.5 g 4 times daily for at least 7 days.

Special Instructions

Laboratory measures of liver function should be monitored during long-term therapy.

Cholestatic jaundice symptoms may develop within a few days after the start of therapy, but the risk of development increases after 7-14 days of continuous therapy. The likelihood of ototoxic effects is higher in patients with renal and/or hepatic impairment and in elderly patients. Some resistant strains of Haemophilus influenzae are sensitive to simultaneous administration of erythromycin and sulfonamides.

May interfere with the determination of catecholamines in the urine and “hepatic” transaminase activity in the blood (colorimetric determination with definylhydrazine).

Do not drink milk or dairy products.

The antral and duodenal prokinetic effects of erythromycin have been proven in numerous clinical studies.

No adverse effect data on ability to drive vehicles and machinery have been identified, but patients who drive vehicles are advised to use the drug with extreme caution.

Synopsis

Contraindications

Hypersensitivity to erythromycin and other macrolides; significant hearing loss; simultaneous use of terfenadine, astemizole, pimozide, cisapride, lactation, children under 14 years (for this dosage form).

Arrhythmias (in anamnesis), increased duration of ventricular complex on electrocardiogram (prolongation of the QT interval), jaundice (in anamnesis), hepatic and/or renal failure, use during pregnancy.

Side effects

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

Digestive system disorders: nausea, vomiting, gastralgia, abdominal pain, tenesmus, diarrhea, dysbacteriosis, oral candidiasis, pseudomembranous colitis (both during and after treatment), liver dysfunction, cholestatic jaundice, increased activity of “liver” transaminases, pancreatitis.

Hearing organ disorders: decreased hearing and/or tinnitus (when used in high doses – more than 4 g/day, usually reversible).

Cardiovascular system: tachycardia, prolongation of the Q-T interval on electrocardiogram, atrial fibrillation and/or flutter (in patients with prolonged Q-T interval on electrocardiogram).

Overdose

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

Gastric lavage is effective at a dose five times the average therapeutic dose.

Hemodialysis, peritoneal dialysis, forced diuresis are ineffective.

Pregnancy use

The use of Erythromycin in pregnancy is possible only when the expected benefits to the mother exceed the potential risk to the fetus.

In lactation due to the possibility of penetration into the breast milk, Erythromycin should be refrained from breastfeeding.

Similarities