Wilprafen

Wilprafen is an antibacterial drug that is intended for systemic use.

The active element of the drug, josamycin, is a macrolide antibiotic. It has a wide range of therapeutic activities. It has a powerful effect on gram-negative as well as-positive bacteria, including anaerobes of the obligate type. In addition, the drug demonstrates pronounced medicinal activity against chlamydia with mycoplasma. [1]

Indications Wilprafen

It is used for infections associated with the activity of bacteria sensitive to josamycin: infections of the respiratory tract and ENT organs, dental lesions, infections in the subcutaneous layer and epidermis, as well as infection of the urogenital system .

Wilprafen can be prescribed to people who are allergic to penicillin .

Release form

The release of the therapeutic substance is made in the form of tablets - 10 pieces inside the cell plate; inside the pack - 1 such plate.

Pharmacokinetics

When administered orally, the drug is absorbed at a high rate inside the gastrointestinal tract. Plasma values Cmax are noted after 1 hour from the moment of application. After 45 minutes from the moment of taking 1 g of drugs, the average plasma level of josamycin is 2.4 mg / l. [2]

The active ingredient passes well through biological membranes and accumulates inside various tissues (lymphatic and lung), organs of the urinary system, palatine tonsils, soft tissues and epidermis. Protein synthesis is no more than 15%. [3]

The metabolic processes of josamycin are realized inside the liver; excretion occurs with bile at a low rate. Less than 15% is excreted in the urine.

Dosing and administration

Serving size for an adult is 3-4 tablets (1-2 g) for 2-3 uses. For severe violations, the portion can be increased to 3+ g.

Children over 5 years of age should be used 40-50 mg / kg per day (the dosage is divided into several applications).

The tablets are swallowed whole, without chewing, and washed down with plain water. Vilprafen should be used between meals.

The duration of therapy is often chosen by the doctor; WHO recommends using antibiotics for the treatment of streptococcal infections for a period of at least 10 days.

• Application for children

The medication is prescribed for children over the age of 5, since it is impossible to find the optimal dosage of josamycin tablets for young people.

Use Wilprafen during pregnancy

There is only limited information regarding the use of josamycin during pregnancy. Testing with animals did not show teratogenicity or developmental delay when using drugs in therapeutic dosages. Wilprafen is prescribed during pregnancy or suspicion of it only in situations where the likely benefit for the woman is more expected than the risks of complications in the fetus.

Josamycin is excreted in mother's milk, therefore, before using drugs for HB, it is necessary to consult a doctor. There is evidence that many macrolides, including josamycin, are excreted in breast milk, although its volumes received by a child are rather low. The main risk is a disorder of the intestinal microflora of infants. Breastfeeding during therapy is acceptable. But when the child has symptoms associated with the work of the gastrointestinal tract (diarrhea, intestinal candidiasis), the use of drugs or breastfeeding should be canceled.

Contraindications

The main contraindications:

• severe intolerance to the active element and other substances of the drug;
• pronounced dysfunctions of the gastrointestinal tract and liver;
• use together with pimozide, ergotamine, colchicine, dihydroergotamine, as well as cisapride and ivabradine;
• appointment during lactation to mothers who use cisapride.

Side effects Wilprafen

Among the side signs:

• disorders associated with the work of the gastrointestinal tract: it is possible to develop stomatitis, vomiting, gastralgia, flatulence, and in addition nausea, diarrhea, abdominal pain, constipation and abdominal discomfort;
• disorders of the processes of nutrition and metabolism: impairment of appetite and anorexia are possible;
• systemic manifestations: swelling of the face may occur;
• invasions and infections: colitis of the pseudomembranous type may be observed;
• immune lesions: symptoms of intolerance may appear, including Quincke's edema and shock, as well as anaphylactic symptoms, serum sickness, dyspnea, itching and urticaria;
• problems in the subcutaneous layer and epidermis: erythema polyform, SS, purpura, cutaneous vasculitis, bullous-type dermatitis, urticaria and other epidermal signs (maculopapular and erythematous rashes) may develop, and besides this, TEN and Quincke's edema;
• symptoms associated with hepatobiliary function: hepatic disorders and jaundice are possible, which can manifest as cholestatic signs with a moderate form of hepatic lesion. Hepatitis of the cholestatic or cytolytic type may also develop and the activity of alkaline phosphatase and liver transaminases may increase.

Overdose

In case of poisoning, gastrointestinal dysfunction may occur, including abdominal pain, diarrhea and nausea.

Symptomatic actions are performed.

Interactions with other drugs

Since antibiotics of the bacteriostatic type are capable of weakening the bactericidal activity of cephalosporins and penicillin, it is necessary to abandon the combined use of josamycin with these antibiotics. Also, the drug is not used with lincomycin, since they mutually weaken the therapeutic efficacy of each other.

Certain macrolides can reduce the rate of elimination of xanthines (for example, theophylline), which can lead to poisoning. In testing, it was found that josamycin has less effect on theophylline excretion than other macrolide antibiotics.

The combined use of Vilprafen with antihistamines containing astemizole or terfenadine can cause a decrease in the rate of excretion of these elements, which can lead to life-threatening cardiac arrhythmias.

There are separate reports on the potentiation of the vasoconstrictor effect when macrolides are combined with ergot alkaloids. There is information about the patient's lack of tolerance to ergotamine when using josamycin. In this regard, such substances should only be taken under constant supervision.

The introduction of a drug with cyclosporine can increase the plasma values of the latter, which forms the nephrotoxic parameters of cyclosporin inside the blood. It is necessary to constantly monitor the plasma level of cyclosporine.

The combination of the drug with digoxin can increase the plasma index of the latter.

Occasionally, when using macrolides, the contraceptive activity of hormonal contraception may be weakened. In such cases, non-hormonal contraceptives should be used.

Storage conditions

Wilprafen should be stored in a dark place out of the reach of small children. Temperature indicators - no more than 25 ° С.

Shelf life

Wilprafen can be applied within a 4-year term from the date of marketing of the therapeutic substance.