Lecoclar

Lecoclar is a systemic antibacterial drug from the macrolide category.

Indications Lecoclara

It is used for the following disorders:

• infections affecting the upper respiratory tract (acute otitis media, streptococcal tonsillopharyngitis and acute sinusitis );
• lesions of the lower respiratory tract (acute bronchitis of bacterial origin or exacerbation of its chronic stage, as well as outpatient pneumonia (along with atypical pneumonia));
• infections of the subcutaneous layers and epidermis;
• mycobacterial infections caused by the activity of MAC bacteria, Mycobacterium kansashi, marine mycobacterium and Hansen's bacillus;
• ulcer in the gastrointestinal tract associated with the effects of Helicobacter pylori (recommended in combination with other medicinal substances).

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Release form

The therapeutic agent is released in tablet form - 10 or 14 pieces inside a plate (volume 0.25 g), as well as 14 pieces inside a package (volume 0.5 g).

Pharmacodynamics

Clarithromycin is a semi-artificial macrolide antibiotic. The antimicrobial effect of the substance is provided by slowing down protein binding inside bacterial cells, which leads to the development of a deficiency of essential microbial proteins, due to which their normal vital activity is disrupted.

Clarithromycin, like other macrolides, is characterized by a bacteriostatic effect, but at the same time it is capable of demonstrating bactericidal activity.

The substance has a therapeutic effect on the following bacteria:

• Gram(+) microbes: staphylococci with streptococci, corynebacteria and listeria monocytogenes;
• Gram(-) bacteria: Ducray bacilli, meningococci, campylobacter with gonococci, hemophilic bacilli, pasteurella multocida, helicobacter pylori with moraxella catarrhalis and borrelia burgdorferi with Bordet-Gengou bacteria;
• anaerobes: peptococci, clostridia perfringens, eubacteria with propionibacteria, and Bacteroides melaninogenicus;
• intracellular microbes: Legionella pneumophila, Mycoplasma pneumoniae, Ureaplasma urealyticum, Chlamydia trachomatis with Toxoplasma gondii, as well as Chlamydophila pneumoniae and all mycobacteria, excluding Koch's bacillus.

The range of antibacterial activity of clarithromycin is similar to that of erythromycin, and in addition it demonstrates activity against atypical mycobacteria.

A high level of cross-resistance of microbes to clarithromycin and erythromycin is observed.

Pharmacokinetics

Clarithromycin is stable in the acidic environment of the stomach; it is well absorbed. Food does not change the degree of absorption of the substance, but its rate may decrease.

About 20% of the applied component is immediately converted into the substance 14-hydroxyclarithromycin, which has an effect similar to clarithromycin. The element quickly passes into tissues with fluids. Usually, tissue indicators of the drug are 10 times higher than its serum values.

The drug is actively involved in liver metabolic processes that occur with the help of hemoprotein P450. There are less than 7 metabolic products of the element.

It is excreted as metabolic products or unchanged in the urine; a smaller portion is excreted through the gastrointestinal tract. Approximately 20-30% of the drug is excreted unchanged in the urine.

The half-life of the drug is 3-4 hours when using a 0.25 g dose at 12-hour intervals, and 5-7 hours when using a 0.5 g dose at 12-hour intervals.

Dosing and administration

The tablet is swallowed whole with plain water.

Teenagers aged 12 and over, as well as adults, should take 0.25-0.5 g of the substance 2 times a day for a 1-2 week period. Clinical tests have shown that a shorter therapeutic cycle of 5-6 days is also effective for otitis media or acute bronchitis.

People with HIV or infection caused by M.avium complex should use 1000-2000 mg of the drug per day. An adult can use no more than 2000 mg of Lecoclar per day.

Schemes used in therapy in adults:

• for tonsillopharyngitis, it is necessary to use 0.25 g of the substance at 12-hour intervals for 10 days;
• in the acute stage of sinusitis - 0.5 g of the drug at 12-hour intervals for a period of 14 days;
• in case of exacerbation of chronic bronchitis or home pneumonia (caused by pneumococcus, mycoplasma pneumoniae or moraxella catarrhalis), 0.25 g of the drug is used at 12-hour intervals for a period of 1-2 weeks (in case of home pneumonia caused by Haemophilus influenzae, 0.5 g of the drug is used with the same frequency over a similar period of time);
• in case of damage to the epidermis and its structures - 0.25 g of the medication at 12-hour intervals, within 7-14 days;
• treatment of Helicobacter pylori (combined) – 0.25 g 2 times a day or 0.5 g 3 times a day, over a 2-week period.

People with severe renal impairment (CC values below 30 ml/minute) need to reduce the dose of the drug by half (or extend the intervals between doses by 2 times).

Use Lecoclara during pregnancy

There is no information regarding the safety of Lecoclar in pregnant or breastfeeding women. Clarithromycin, like other macrolides, can be excreted in breast milk.

If a patient is already pregnant, planning a pregnancy, or becomes pregnant during therapy, the patient should notify the doctor, because clarithromycin can be prescribed to pregnant and lactating women only in exceptional situations, taking into account its benefits and possible negative effects.

Contraindications

Main contraindications:

• severe intolerance associated with clarithromycin or other macrolides;
• liver diseases of a severe nature;
• use together with cisapride, terfenadine or pimozide.

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Side effects Lecoclara

Most of the negative symptoms that occurred when using the drug were temporary or mild. Often, there are gastrointestinal disorders (nausea, stomach pain, digestive disorders and diarrhea) or headaches. The development of glossitis or stomatitis, taste bud disorders and signs of intolerance (anaphylaxis, rashes and, rarely, SJS) are possible. There have also been isolated reports of symptoms in the central nervous system (feeling of anxiety or confusion, dizziness, nightmares and insomnia).

Intrahepatic cholestasis or increased activity of liver enzymes occurs extremely rarely.

The use of clarithromycin (and similarly erythromycin) may lead to ventricular arrhythmia (this also includes ventricular tachycardia and torsades de pointes in some individuals with prolonged QT interval values).

Overdose

Too large doses of the drug generally result in a feeling of confusion, headaches and gastrointestinal dysfunction.

Gastric lavage must be performed within 2 hours of taking the drug.

Interactions with other drugs

Clarithromycin is involved in intrahepatic metabolic processes, where it slows down the activity of individual enzymes of the hemoprotein P450. These processes, in which other medications participate (with the help of this enzyme system), can slow down with an increase in their values in the serum, which can lead to intoxication.

The combination of the drug with pimozide, as well as cisapride and terfenadine, is prohibited.

The drug should not be combined with digoxin, dihydroergotamine, or astemizole.

In case of simultaneous administration of clarithromycin with cyclosporine, bismuth nitrate, benzodiazepines, as well as ranitidine, saquinavir, carbamazepine with rifabutin, warfarin, theophylline with tacrolimus and zidovudine, the therapy process should be closely monitored. It is recommended to monitor serum levels of these drugs, the dosages of which may be too small.

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Storage conditions

Lecoclar must be stored in a place closed to small children. Temperature level – maximum 25°C.

Shelf life

Lecoclar can be used for a 2-year period from the date of release of the therapeutic drug.

Application for children

There is no data on the possibility of effectively and safely using the drug in infants under six months of age.

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Analogues

The analogs of the drug are Arvicin, Klabax, Binoklar with Arvicin retard, Clarbact, Clarithrosin and Vero-Clarithromycin with Clarithromycin, as well as Klacid, ClaroSip, Claricin, Klasine with Claricit and Seidon-Sanovel. The list also includes Clerimed, Fromilid, Claromin with Crixane and Ecozitrin.

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