Azax

Azax is an antibacterial drug used orally.

Indications Azax

The drug is prescribed to eliminate infectious pathologies of various localizations caused by pathogenic microbes that are sensitive to azithromycin. Among them:

• infectious pathologies in the ENT organs, and along with them the respiratory tract - such as chronic or acute bronchitis, as well as pharyngitis with laryngitis or sinusitis, viral pneumonia or inflammation of the middle ear;
• infections of organs in the genitourinary system: diseases such as prostatitis, endocervicitis, colpitis, bacterial urethritis (also gonorrheal urethritis);
• infectious processes in the skin and soft tissues: furunculosis, tick-borne borreliosis (stage 1), pyoderma, erysipelas, and also relapse in patients suffering from dermatitis.

[ 1 ]

Release form

Available in tablet form. One blister contains 1 or 3 tablets. One package contains 1 blister strip.

Pharmacodynamics

The active substance of the drug is azithromycin. It is a semi-synthetic antibiotic that is formed as a result of the penetration of a nitrogen atom into a 14-membered lactone ring, as a result of which it turns into a non-lactone. In this case, this compound becomes resistant to acid.

Azithromycin is an antimicrobial drug from the azalide subgroup, which is included in the macrolide category. The drug, like many other macrolide drugs, does not have a toxic effect on the body. The active substance of the drug has a wide range of action, has a mainly bacteriostatic effect, but in large doses can acquire bactericidal properties relative to individual strains.

The effect of the drug is due to its ability to slow down protein synthesis (changes the ribosomal 50S substance, which leads to the development of the process of suppression of peptide translocase). Due to the slowdown in protein synthesis, bacterial cells lose the ability to subsequently reproduce and grow. The drug is effective against both intracellular pathogens and external ones.

Azithromycin is quite effective against strains of the following pathogenic microbes:

Gram-positive aerobes, including β-lactamase-producing strains: Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Streptococcus agalactiae, Streptococcus pyogenes, Streptococcus viridans, group C Streptococcus, group F Streptococcus, and group G Streptococcus.

Gram-negative aerobes: Ducray bacillus, Haemophilus influenzae, Haemophilus parainfluenzae, Campylobacter jejuni, Escherichia coli, Gardnerella vaginalis, Legionella pneumophila, whooping cough, Bordetella parapertussis, Moraxella catarrhalis, gonococcus, Yersinia, Shigella, and Salmonella.

Gram-negative anaerobes: Clostridia perfringens, peptostreptococci, and Bacteroides bivius.

In addition, the drug effectively fights infections caused by strains of Chlamydia pneumoniae, Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma pneumoniae, Borrelia burgdorferi, pale treponema, and Listeria monocytogenes.

The following microbe strains are resistant to the effects of drugs: acinetobacter, pseudomonads and enterobacteria.

Azithromycin has cross-resistance to erythromycin.

In addition to the antimicrobial effect, the active component of Azax has pronounced anti-inflammatory and immunomodulatory properties.

[ 2 ], [ 3 ], [ 4 ]

Pharmacokinetics

After oral administration, the drug is quickly absorbed from the gastrointestinal tract, its active component is not exposed to the acidic gastric environment. The bioavailability of the substance is approximately 37%, it reaches the peak plasma concentration 3 hours after taking the drug. The level of binding to plasma proteins is quite low. In tissues, azithromycin is contained in higher concentrations than in plasma. The medicinal concentration of the active component is observed inside the organs of the lower and upper respiratory tract, in soft tissues, prostate, skin and joints, as well as other tissues with organs.

The half-life is 15-20 hours. One week after the final use of the drug, medicinal concentrations of the active component can be determined in tissues.

Elimination occurs primarily through the liver. The substance is excreted unchanged from the body. A small amount of the drug may also be found in the urine.

[ 5 ], [ 6 ], [ 7 ]

Dosing and administration

The duration of the treatment course, as well as the dosage, is determined by the attending physician - the figures are individual for all patients. They depend on the patient's body's reaction, as well as the nature of the pathology.

The medicine is usually taken before meals (60 minutes) or after meals (120 minutes). The tablet must be swallowed whole, without chewing, with water. If necessary, it is allowed to split the tablet in half. It is recommended to take the medicine at the same time of day.

For the treatment of infectious pathologies in the respiratory tract, as well as ENT organs - the dosage for children from 15 years old, as well as adults is 500 mg once a day. The duration of the course is 3 days.

For the treatment of infectious pathologies within the genitourinary system, the dosage for children over 15 years of age, as well as adults, is 1000 mg per dose.

For the treatment of tick-borne borreliosis, Azax is prescribed in an initial dosage of 1000 mg, and then the dose is reduced to 500 mg, which should be taken every 24 hours. The duration of the treatment course is 5 days.

[ 12 ], [ 13 ]

Use Azax during pregnancy

The drug is prohibited to use during pregnancy. If it is necessary to prescribe it during the lactation period, it is necessary to stop breastfeeding for the duration of treatment.

Contraindications

Among the contraindications of the drug:

• individual hypersensitivity to the active components of the drug, as well as drugs from the macrolide category;
• Prohibited for persons under 15 years of age.

It should be prescribed with great caution to people with arrhythmia or renal/hepatic insufficiency.

[ 8 ]

Side effects Azax

Taking the medicine may cause the following side effects:

• CNS and PNS organs: headaches or dizziness, feeling of drowsiness, severe fatigue, cramps, and in addition to this, the development of tremors of the limbs. Also, some patients experienced the development of a feeling of nervousness or anxiety, and in addition, causeless aggression;
• cardiovascular and hematopoietic systems: thrombocytopenia, as well as leukopenia, development of tachycardia, arrhythmia, or cardialgia, decreased blood pressure;
• gastrointestinal tract and liver: vomiting with nausea, pain in the epigastric region, bowel disorders, loss of appetite, increased activity of liver enzymes, problems with the process of bile outflow, development of hepatitis or pseudomembranous colitis;
• allergies: itching or rashes on the skin, photosensitivity, development of urticaria or anaphylactoid reactions, including angioedema and anaphylaxis;
• Others: hearing impairment, in addition to this, dysfunction of taste buds, thrush, and in addition, joint pain.

[ 9 ], [ 10 ], [ 11 ]

Interactions with other drugs

When the drug is taken simultaneously with antacids, as well as histamine (H2) receptor blockers, no significant changes in azithromycin levels in plasma are observed, but in the case of combined use of these drugs, it is still recommended to maintain at least a 2-hour interval between uses.

In case of simultaneous administration of Azax with warfarin, theophylline, carbamazepine, and in addition terfenadine, phenytoin, as well as triazolam and ergotamine, the effect of these drugs is enhanced. Because of this, when they are used simultaneously, the dosages should be adjusted.

Azithromycin in combination with cyclosporine and digoxin enhances the effectiveness of the latter.

Storage conditions

The medicine must be kept in conditions suitable for most medications - a place closed from moisture and sunlight. The temperature must be maintained within 15-25 degrees.

[ 14 ]

Shelf life

Azax must be used within 2 years from the date of release of the drug.

[ 15 ], [ 16 ]