Renicin

Renicin is an antimicrobial drug with a systemic type of action. It belongs to the group of macrolide drugs. Its active ingredient is roxithromycin, a semi-artificial macrolide antibiotic.

The antibacterial spectrum of the substance roxithromycin includes both gram-negative and -positive anaerobes with aerobes. [ 1 ]

The medicinal substance has bacteriostatic activity. Its properties include slowing down the processes of protein binding inside the walls of pathogenic microbes. [ 2 ]

Indications Renicin

It is used in case of infections associated with bacteria that are sensitive to roxithromycin:

• lesions in the upper respiratory tract ( active sinusitis or infections affecting the throat);
• infections of odontogenic nature;
• otitis media;
• lesions of the lower respiratory tract (bronchitis or pneumonia);
• infections associated with the epidermis and subcutaneous tissues;
• infections in the urogenital tract;
• whooping cough or diphtheria;
• common acne;
• active gastroenterocolitis and general infections associated with Campylobacter jejuni;
• ulcers in the gastrointestinal tract and chronic gastritis caused by Helicobacter pylori (in combination treatment);
• lesions associated with the influence of legionella, mycoplasma or chlamydia;
• other bacterial infections associated with the activity of microbes sensitive to roxithromycin in individuals with diagnosed penicillin intolerance;
• prevention of the development of rheumatism.

Release form

The drug is released in the form of tablets with a volume of 0.15 or 0.3 g.

Pharmacodynamics

Sensitivity to roxithromycin is demonstrated by:

• aerobes - staphylococci (including strains resistant to methicillin) with streptococci, meningococci, corynebacteria, gonococci and Helicobacter pylori, as well as Listeria monocytogenes, Gardnerella vaginalis with Legionella pneumophila, wax bacilli, Moraxella catarrhalis and whooping cough bacilli. Strains of Haemophilus influenzae have variable sensitivity;
• anaerobes – peptococci, Clostridia perfringens, Bacteroides oralis, peptostreptococci with B.melaninogenicus, Propionibacterium acnes with eubacteria and B.ureolyticus.

Clostridia difficile and Bacteroides fragilis are often resistant to roxithromycin. [ 3 ]

The drug has an effect on Mycoplasma pneumoniae, Ureaplasma urealyticum, Rickettsia rickettsii, Chlamydia trachomatis, and Rickettsia connorii.

Pharmacokinetics

Roxithromycin is absorbed without complications, reaching plasma Cmax values of 6-8 μg/ml after 2 hours from the moment of oral administration of a 0.15 g dose.

The medicine penetrates well into fluids and tissues (tonsils with lungs and prostate), as well as macrophages.

The antibiotic undergoes partial intrahepatic metabolism processes; most of it is excreted with feces (about 50%), in an unchanged state (another part is excreted in the form of metabolic elements). About 12% is excreted through the kidneys, and another 15% through the lungs. The biological half-life of roxithromycin is quite long, which allows taking the drug 1-2 times a day.

When administered orally at a dose of 2.5 mg/kg, levels of roxithromycin in excess of the MIC persist in the serum for at least 12 hours.

Dosing and administration

Adults (weight over 40 kg) are often prescribed 0.3 g of the drug per day - 1 tablet of 0.15 g with 12-hour breaks or 1 tablet of 0.3 g with 24-hour intervals; the drug should be taken 15 minutes before meals. Therapy lasts 5-10 days, taking into account medical indications and clinical response. In case of streptococcal throat lesions, the therapeutic cycle should last at least 10 days. Some patients with urogenital infections of non-gonococcal origin may need a course of about 20 days for final recovery.

People with liver/kidney failure (creatinine clearance values below 0.25 ml/s) are required to take 1 tablet of 0.15 g once a day before meals.

Children are prescribed 5-8 mg/kg per day, administered in 2 equal portions. The treatment cycle usually lasts 5-10 days. In case of streptococcal throat infections, such a cycle is at least 10 days. It is forbidden to administer dosages to a child that exceed the standard, as well as to conduct therapy longer than 10 days.

• Application for children

Not for use by persons under 3 years of age.

Use Renicin during pregnancy

Roxithromycin may be used in the 2nd and 3rd trimesters of pregnancy only if there are strict indications, under constant medical supervision. The drug is not used in the 1st trimester.

Renicin is excreted in breast milk, which is why it cannot be used during lactation. If taking the antibiotic is extremely important for the mother, breastfeeding must be stopped for the duration of therapy.

Contraindications

Contraindicated in cases of intolerance associated with roxithromycin or any other element of the drug, as well as with any macrolide.

Side effects Renicin

Side effects occur only occasionally and even more rarely require discontinuation of treatment. Gastrointestinal disturbances (vomiting, cramps, loss of appetite, constipation or diarrhea, flatulence and nausea) may occur. Epidermal signs of intolerance (rashes, urticaria or itching) and fever may develop occasionally. Temporary increases in bilirubin or intrahepatic enzyme levels are possible.

Liver dysfunction is observed sporadically and is a temporary side effect.

Occasionally, dizziness, tachycardia, tinnitus and headaches also occur.

Overdose

Macrolide poisoning usually causes vomiting with nausea. Liver damage occasionally develops.

If disorders develop, gastric lavage and symptomatic procedures must be performed. Renicin has no antidote.

Interactions with other drugs

Roxithromycin is prohibited to be used together with substances that contain ergotamine and other ergot alkaloids, because ergotamine can provoke a severe form of ischemia and arterial spasm.

The combined use of the drug and theophylline may provoke a minor clinical increase in serum values of the latter.

Roxithromycin should be combined with cyclosporine, cisapride, warfarin, as well as terfenadine and astemizole with great caution.

Renicin in combination with rifampicin demonstrates synergism.

Combination with chemotherapeutic agents or antibiotics may lead to the development of antagonistic or synergistic effects, which is why it is necessary to determine the effect for each microorganism separately.

Storage conditions

Renicin must be stored in a place out of the reach of small children, at temperatures up to 250C.

Shelf life

Renicin can be used within a 36-month period from the date of manufacture of the medicinal substance.

Analogues

Analogues of the drug are Xitrocin, Roxid and Remora with Roxilide, as well as Roxigexal and Roxisandoz.