Medomycin

Medomycin is a semi-synthetic tetracycline; it is a bacteriostatic antibiotic and has a wide range of therapeutic activity.

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Indications Medomycin

It is used for the treatment of certain infectious and inflammatory diseases that arise under the influence of sensitive bacteria:

• respiratory system (tracheitis with pharyngitis, pulmonary abscess, bronchitis, acute or chronic, lobar pneumonia, bronchopneumonia and pyothorax);
• ENT organs (for example, sinusitis with otitis, as well as tonsillitis, etc.);
• urogenital system (pyelonephritis or urethritis, endometritis with cystitis, gonorrhea, prostatitis, endocervicitis and urethrocystitis, as well as the urogenital form of mycoplasmosis and orchiepididymitis in the acute stage);
• Gastrointestinal tract and biliary tract (cholangitis with cholecystitis, as well as gastroenterocolitis, shigellosis and traveler's diarrhea);
• soft tissues and epidermis (abscesses and panaritiums with phlegmon and furunculosis, as well as wounds and burns of an infected nature, etc.);
• eye infections;
• pian, syphilis, rickettsiosis with yersiniosis, as well as legionellosis and chlamydia, which have different localizations (this includes proctitis with prostatitis);
• coxiellosis, Bull fever and typhus (this includes its tick-borne, rash and relapsing forms), Lyme borreliosis stage 1, as well as malaria, shigellosis, amebiasis, tularemia, ray-fungal disease and cholera;
• for complex treatment it is used for water fever, trachoma, ornithosis and granulocytic ehrlichiosis;
• osteomyelitis and brucellosis with whooping cough;
• peritonitis, sepsis, and also septic form of endocarditis in the subacute stage.

It is also used to prevent the occurrence of:

• purulent complications after surgical procedures;
• malaria caused by the activity of Plasmodium falciparum;
• diseases during short-term travel (less than 4 months) in areas where strains resistant to pyrimethamine-sulfadoxine or chloroquine are widespread.

Release form

The drug is released in capsules of 0.1 g, in the amount of 10 pieces, packed in a blister plate. Inside the box there is 1 such plate.

Pharmacodynamics

After the drug enters the cell, it affects the activity of pathogens located there. It inhibits protein binding processes inside bacterial cells and destroys chains of transport RNA-aminoacyl with the membrane of the 30S ribosome subunit.

The following are highly sensitive to the drug:

• Gram-positive bacteria: staphylococci (including epidermal and golden), streptococci (including pneumococci), as well as listeria and clostridia;
• Gram-negative bacteria: Haemophilus influenzae, meningococcus, gonococcus, Escherichia coli, Klebsiella, Shigella, Salmonella with Enterobacter, Yersinia, dysentery amoeba, bacteroides and treponemas (including strains that are resistant to other antibiotics (such as modern cephalosporins with penicillins)). Haemophilus influenzae (91-96%) and intracellular pathogenic microbes have the highest sensitivity.

Doxycycline demonstrates therapeutic activity against most bacteria that cause dangerous infectious diseases: legionella with rickettsia, anthrax, plague and tularemia microorganisms, cholera vibrio with brucellae, and also bacteria that cause glanders and chlamydia (microbes that cause trachoma, ornithosis or venereal granuloma). At the same time, it does not affect most strains of proteus, fungi and Pseudomonas aeruginosa.

The drug suppresses intestinal flora less than other tetracycline antibiotics, and also has a more complete absorption and a longer duration of action. The antibacterial activity of doxycycline is higher than that of natural tetracyclines. Compared with oxytetracycline and tetracycline, the drug has a more pronounced medicinal effect and a long-lasting effect, which develop even with therapy using dosages ten times lower in size. The drug has cross-resistance to penicillins and other tetracyclines.

Pharmacokinetics

When taken orally, the drug is almost completely absorbed in the gastrointestinal tract. Food intake has little effect on the absorption rates of doxycycline.

It is widely distributed in tissue fluids. Protein synthesis in plasma is 80-95%. Half-life is approximately 12-22 hours.

Excretion of the unchanged substance is 40% via urine; however, the majority of the portion is excreted via bile with feces.

Dosing and administration

The drug is administered intravenously in severe stages of diseases of a purulent-septic nature, when it is necessary to quickly achieve high drug levels in the blood, as well as in situations where it is difficult to administer the drug orally. It is necessary to transfer the patient to the use of drugs orally as soon as possible.

The drug is administered intravenously through a dropper - a solution prepared ex tempore is used. In this case, 0.1 or 0.2 g of the substance is diluted in injection water (5-10 ml), after which this liquid is added to a 0.9% NaCl solution or 5% dextrose solution (0.25 or 0.5 l). The substance content in the infusion fluid should not exceed 1 mg / ml or be less than 0.1 mg / ml. The duration of the infusion depends on the portion size (0.1 or 0.2 g) and is within 1-2 hours (rate - 60-80 drops / minute). During the infusion, the solution should be protected from any light (both electric and sunlight). This type of therapy with intravenous administration should last 3-5 days, and in case of good tolerance, it can last up to 7 days, after which the patient is transferred (if necessary) to oral use.

For the treatment of inflammations developing in women in the pelvic area (acute form), 0.1 g of the drug is administered at intervals of 12 hours (often Medomycin is combined with 3rd generation cephalosporins). Then the treatment continues with oral use of doxycycline - in a dose of 0.1 g 2 times a day, for 14 days.

Orally, children weighing more than 45 kg and adults should take an average of 0.2 g per day (divided into 2 doses - 0.1 g 2 times per day), then switch to taking 0.1 g per day (in 1-2 doses). In case of infections affecting the urinary organs and having a chronic form, it is necessary to take 0.2 g of the drug per day throughout the course.

During the treatment of gonorrhea, one of the following methods is used:

• in case of acute urethritis, occurring without complications - 500 mg of the substance is taken per course (for the 1st dose - 300 mg, and for the 2nd and 3rd - 100 mg with an interval of 6 hours). A method can be used with the use of the drug at 0.1 g per day until complete recovery occurs (for women), or 0.1 g 2 times a day for 7 days (for men);
• for gonorrhea with complications, 800-900 mg is taken for the entire cycle, divided into 6-7 doses (300 mg for the first dose, and then the remaining 6, with intervals of 6 hours).

During therapy for syphilis, 300 mg of the drug is taken per day for a period of at least 10 days (orally or intravenously).

In case of infections (caused by the activity of Chlamydia trachomatis) affecting the rectum, urinary tract and cervix, and occurring without complications, it is necessary to use 0.1 g of the drug 2 times a day for at least 1 week.

For infections affecting the male genitalia, you need to take 100 mg of the medicine (2 times a day) for 4 weeks.

When treating chloroquine-resistant malaria, 200 mg of the drug is taken per day for 7 days (in combination with schizontocidal drugs (quinine)). To prevent malaria, 100 mg of the drug should be taken once a day 1-2 days before the trip, and then daily during it and for 4 weeks after its completion. For a child over 8 years old, the daily dose is 2 mg/kg.

To prevent traveler's diarrhea, take 200 mg of Medomycin on the first day of the trip (1 time or 2 times (in a 100 mg dose) per day), and later 100 mg 1 time per day for the entire duration of your stay in the dangerous region (maximum 21 days).

In the treatment of water fever, the drug is taken orally in a dose of 100 mg, 2 times a day for 1 week. To prevent the development of this pathology, 200 mg of the drug is used 1 time per week during the entire time of presence in the dangerous area, and then another 200 mg at the end of the trip.

To prevent infections after a medical abortion, you need to take 100 mg of the substance 60 minutes before the abortion, and then another 200 mg half an hour after the procedure.

To treat acne, take 100 mg of the medication daily over a 6-12 week cycle.

Adults are allowed to take no more than 300 mg of the substance per day. In case of severe infections caused by gonococci, up to 600 mg of the drug per day can be taken.

Children weighing less than 45 kg (9-12 years old) can take an average of 4 mg/kg on the first day, and later - 2 mg/kg per day (1-2 doses). If the infections are severe, the drug should be prescribed in a dose of 4 mg/kg at intervals of 12 hours.

If the patient has severe liver failure, it is necessary to reduce the daily dosage of the drug, because with such disorders doxycycline gradually accumulates in the body, which causes the risk of developing hepatotoxicity.

Use Medomycin during pregnancy

Medomycin should not be used during lactation or pregnancy, because doxycycline inhibits the process of osteogenesis, weakens the strength of the bones in the fetus and destroys the processes of healthy dental development (hypoplasia affecting the enamel and incurable changes in the shade of the teeth).

If therapy is required during lactation, breastfeeding should be discontinued for the duration of treatment.

Contraindications

Main contraindications:

• presence of intolerance to tetracyclines;
• severe renal or hepatic dysfunction;
• leukopenia or porphyria;
• myasthenia (with intravenous injection).

Side effects Medomycin

The use of the medication may provoke the development of side effects:

• signs from the digestive function: nausea, glossitis, anorexia, diarrhea, enterocolitis, vomiting, and also dysphagia or pseudomembranous colitis;
• symptoms of an allergic or dermatological nature: Quincke's edema, exacerbation of SLE, urticaria, anaphylactic reactions, photosensitivity, exfoliative dermatitis, maculopapular or erythematous rashes and pericarditis;
• liver dysfunction: liver dysfunction (after prolonged use of drugs or in people with liver or kidney failure);
• disorders affecting kidney function: increased levels of residual urea nitrogen caused by the anti-anabolic effect of drugs;
• lesions affecting the hematopoietic system: neutro- or thrombocytopenia, eosinophilia and hemolytic anemia, as well as decreased prothrombin levels;
• dysfunction of the nervous system: benign increase in ICP values (vomiting, anorexia, swelling in the optic nerve area and headaches) and vestibular disorders (feeling of instability or dizziness);
• Thyroid problems: People who have used doxycycline for a long time may experience a treatable dark brown discoloration of the thyroid tissue;
• lesions of the epidermis and teeth: inhibition of osteogenesis processes and disruption of healthy development of teeth in a child (irreversible change in the shade of teeth and the appearance of hypoplasia in the enamel area);
• other: development of candidiasis (glossitis, vaginitis, stomatitis or proctitis) as a sign of superinfection.

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Overdose

Manifestations of intoxication: potentiation of negative symptoms caused by liver damage – fever, azotemia, vomiting, increased transaminase activity, jaundice and increased PT values.

To eliminate disorders, gastric lavage is performed; the patient also needs to drink a lot of fluids. If necessary, vomiting is induced, activated carbon and osmotic laxatives are given. Symptomatic measures are also carried out. Peritoneal dialysis or hemodialysis sessions will be ineffective.

Interactions with other drugs

Magnesium-, aluminum- and calcium-containing antacids, baking soda, iron medications and magnesium-containing laxatives weaken the absorption of doxycycline, which is why these drugs should be taken at intervals of 3 hours.

When combined with anticoagulants, their dosage sometimes needs to be reduced, because tetracyclines inhibit the activity of prothrombin within the plasma.

The combined use of Medomycin with antibiotics from the bactericidal group (cephalosporin or penicillin) that destroy the binding of cell membranes leads to a weakening of the medicinal effectiveness of the latter.

When used together with doxycycline, the reliability of hormonal contraception for oral administration is weakened. In addition, the frequency of acyclic bleeding increases (if OCs containing estrogen are used).

When the drug is combined with barbiturates, phenytoin, ethyl alcohol, carbamazepine, rifampicin, primidone and other drugs that stimulate the oxidation of microsomes, its metabolism accelerates, while the values in the blood plasma decrease.

Combination with bismuth drugs may cause decreased absorption of the drug.

The combination of the drug with cyclosporine increases the plasma levels of the latter.

Taking methoxyflurane with tetracyclines can cause fatal renal toxicity.

Zinc reduces drug absorption.

Combination with retinol leads to an increase in intracranial pressure.

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Storage conditions

Medomycin should be kept in a dark and dry place at a temperature of maximum 25°C.

Shelf life

Medomycin can be used within 4 years from the date of manufacture of the drug.

Application for children

It is prohibited to prescribe doxycycline in pediatrics (children under 8 years of age), because tetracyclines (which includes doxycycline) lead to long-term changes in the shade of teeth, inhibition of longitudinal growth of skeletal bones and enamel hypoplasia in this group of patients.

Analogues

Analogues of the drug are Vibramycin, Oletetrin, Unidox with Doxycycline, Tetracycline and Doxy, as well as Doxibene, Tetracycline hydrochloride, Doxycycline hydrochloride and Metacycline hydrochloride.