Vilprafen

Vilprafen is an antibacterial drug intended for systemic use.

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

Indications Vilprafen

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 infections of the urogenital system.

Vilprafen can be prescribed to people with an allergy to penicillin.

Release form

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

Pharmacokinetics

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

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

Josamycin metabolism processes are realized inside the liver; excretion occurs with bile at a low rate. Less than 15% is excreted with urine.

Dosing and administration

The serving size for an adult is 3-4 tablets (1-2 g) in 2-3 doses. In case of severe disorders, the serving size can be increased to 3+ g.

Children over 5 years of age should take 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 determined by the doctor; WHO recommends using antibiotics for at least 10 days when treating streptococcal infections.

• Application for children

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

Use Vilprafen during pregnancy

There is limited information regarding the use of josamycin during pregnancy. Animal testing has not shown teratogenicity or developmental delays when using the drug in therapeutic doses. Vilprafen is prescribed during pregnancy or suspected pregnancy only in situations where the likely benefit to the woman is more expected than the risks of complications to the fetus.

Josamycin is excreted in breast milk, so before using the drug during breastfeeding, you should consult a doctor. There is information that many macrolides, including josamycin, are excreted in breast milk, although the volumes received by the child are quite low. The main risk is a disorder of the intestinal microflora of the infant. Breastfeeding during therapy is acceptable. But if the child develops symptoms associated with the gastrointestinal tract (diarrhea, intestinal candidiasis), the use of the drug or breastfeeding should be discontinued.

Contraindications

Main contraindications:

• severe intolerance to the active ingredient and other substances of the drug;
• severe dysfunction of the biliary tract and liver;
• use together with pimozide, ergotamine, colchicine, dihydroergotamine, as well as cisapride and ivabradine;
• use during lactation in mothers who use cisapride.

Side effects Vilprafen

Side effects include:

• disorders associated with the gastrointestinal tract: the development of stomatitis, vomiting, gastralgia, flatulence, as well as nausea, diarrhea, abdominal pain, constipation and abdominal discomfort is possible;
• disorders of nutritional processes and metabolism: loss of appetite and anorexia are possible;
• systemic manifestations: swelling of the face may occur;
• invasions and infections: pseudomembranous colitis may occur;
• immune damage: 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 multiforme, SJS, purpura, cutaneous vasculitis, bullous dermatitis, urticaria and other epidermal signs (maculopapular and erythematous rashes) may develop, as well as TEN and Quincke's edema;
• symptoms related to hepatobiliary function: liver disorders and jaundice are possible, which may manifest as cholestatic signs with a moderate form of liver damage. 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 be observed, including abdominal pain, diarrhea and nausea.

Symptomatic actions are performed.

Interactions with other drugs

Since bacteriostatic antibiotics can weaken the bactericidal activity of cephalosporins and penicillin, it is necessary to avoid the combined use of josamycin with these antibiotics. Also, the drug is not used with lincomycin, since they mutually weaken each other's therapeutic effectiveness.

Some macrolides may reduce the rate of xanthine elimination (e.g. theophylline), which may lead to poisoning. Testing has shown that josamycin has less effect on theophylline excretion than other macrolide antibiotics.

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

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

Administration of the drug with cyclosporine may increase the plasma values of the latter, which forms nephrotoxic indicators of cyclosporine in the blood. It is necessary to constantly monitor the plasma level of cyclosporine.

The combination of the drug with digoxin may increase the plasma level of the latter.

Rarely, the use of macrolides may reduce the contraceptive activity of hormonal contraception. In such cases, non-hormonal contraceptives should be used.

Storage conditions

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

Shelf life

Vilprafen can be used within a 4-year period from the date of sale of the therapeutic substance.