Grammidin

Grammidin is a combination drug containing the antibiotic gramicidin C and the antiseptic cetylpyridinium chloride. Gramicidin C is a cyclic peptide antibiotic that is used to treat infections caused by susceptible microorganisms and is effective as an antibiotic in topical applications, such as sore throats and pharyngitis (Geppe et al., 2020). Cetylpyridinium chloride acts as an antiseptic, killing bacteria and keeping the area of application clean (Rembe et al., 2019). This combination makes grammidin effective in the treatment and prevention of infections in the mouth and throat.

Indications Grammidina

1. Throat: Grammidin can be recommended for the treatment of various throat infections such as pharyngitis, laryngitis, tonsillitis and sore throat. It helps reduce inflammation, soreness and irritation in the throat caused by bacterial infections.
2. Oral cavity: The drug can be used to treat stomatitis (inflammation of the oral mucosa), gingivitis (inflammation of the gums) and other infections of the oral cavity. It helps fight bacteria that can cause these conditions and improves overall oral health.
3. Prevention: Grammidin can also be used to prevent infections of the throat and mouth, especially in people at increased risk of infection, for example, from contact with infectious agents or after surgery in the throat.

Release form

1. Garge: This is a liquid that you dilute in water and use to gargle.
2. Lozenges: These are tablets that dissolve in the mouth. They usually contain active ingredients and additives to relieve sore throats and inhibit bacteria.
3. Sprays: This is a form that is usually applied directly to the back of the throat using a spray bottle.

Pharmacodynamics

1. Gramicidin C dihydrochloride:

   • Gramicidin C is an antimicrobial agent that is commonly used to fight bacterial infections in the mouth and throat.
   • It acts by destroying bacterial cells by disrupting the cytoplasmic membrane, resulting in the death of the bacteria.
   • Gramicidin C is effective against a wide range of bacteria, including gram-positive and gram-negative organisms.

2. Cetylpyridinium chloride:

   • Cetylpyridinium chloride is an antiseptic and antimicrobial agent that is also widely used to treat various infections of the mouth and throat.
   • It has the properties of a disinfectant and works by destroying the cell membrane of bacteria and viruses.
   • Cetylpyridinium chloride also has antifungal properties and may be effective in fighting fungal infections.

Pharmacokinetics

In general, the pharmacokinetics of both active components can be described as follows:

1. Gramicidin C dihydrochloride: Gramicidin C is an antibacterial substance that is commonly used to treat infections in the mouth and throat. After application, it can be adsorbed on the mucous membrane and have a local antimicrobial effect against various types of bacteria.
2. Cetylpyridinium chloride: This is another antiseptic that is often used to fight bacteria and fungi in the mouth. After application, it can also be adsorbed on the mucous membrane and provide a local antimicrobial effect.

Dosing and administration

1. Rinse solution:

   • Dissolve the specified amount of the drug in 15-30 ml of warm water.
   • Rinse with the solution for 30 seconds to 1 minute.
   • Repeat the procedure 3-4 times a day or as recommended by your doctor.
   • Do not swallow the solution.

2. Lozenges:

   • Allow the tablet to dissolve in your mouth.
   • Usually one tablet is dissolved every 2-3 hours, but follow the directions on the package or your doctor's recommendations.
   • Avoid swallowing the tablets whole.

3. Sprays:

   • Spray the indicated amount of spray into the back of your throat.
   • Use as needed, usually 3-4 times daily or as recommended by a physician.

Use Grammidina during pregnancy

Like other medications, it is important to discuss the use of Grammidin during pregnancy with your doctor. Your doctor will be able to assess the risks and benefits for you and your baby based on your individual situation.

Usually, when prescribing medications during pregnancy, the doctor seeks to minimize the use of drugs to the minimum necessary to avoid potential risks to the development of the child. However, in some cases, if the benefits of using the drug outweigh the potential risks, the doctor may recommend its use.

Contraindications

1. Hypersensitivity or allergic reaction: People with a known allergy to gramicidin C, cetylpyridinium chloride or other components of the drug should avoid its use.
2. Children under 12 years of age: Some forms of Grammidin are not recommended for children under 12 years of age without medical advice.
3. Pregnancy and breast-feeding: If you are pregnant or breast-feeding, consult your doctor before using Grammidin to make sure it is safe.
4. Long-term use: Grammidin should not be used for a long time without a doctor's advice, as this may lead to the development of drug resistance or other problems.
5. Use in patients with thyroid diseases: Use with caution in patients with thyroid diseases, as some components of the drug may affect thyroid function.

Side effects Grammidina

Grammidin is usually well tolerated, but like any medicine, it can cause side effects. Based on research data, side effects of Grammidin, which contains gramicidin C and cetylpyridinium chloride, are rare and usually mild.

One multicenter study evaluating the effectiveness of Grammidin spray in children with non-streptococcal acute tonsillopharyngitis reported no adverse effects associated with pharmacotherapy (Geppe et al., 2020).

It is important to note that the drug is applied topically and its systemic exposure is minimal, which may contribute to the low likelihood of adverse reactions. However, if unusual symptoms or allergic reactions occur, it is recommended to stop using the drug and seek medical attention.

Overdose

Overdose symptoms may vary depending on many factors, including the amount of drug taken and the individual's body. These may include nausea, vomiting, dizziness, abnormal heart rhythms, itching or burning in the throat, allergic reactions, and other unpleasant symptoms.

Interactions with other drugs

1. Other antimicrobials: When used simultaneously with other antimicrobials, especially topical ones, their effects may be enhanced or weakened due to possible competitive action or interaction at the level of adsorption.
2. Anesthetics for local use: The anesthetic effect may be enhanced when used simultaneously with anesthetics for local use.
3. Medicines that reduce stomach acidity: Since Grammidin is used topically in the mouth, changes in stomach acidity should not usually have a significant effect on its effectiveness or interactions with other medications.
4. Systemic antifungal or antibiotic drugs: Although Grammidin is applied topically, systemic effects may occur due to the adsorption of its components into the bloodstream through the mucous membrane. In such cases, it is important to be careful when using systemic antifungal or antibiotic drugs to prevent possible unwanted interactions.