Zitrolex

Zitroleks is a macrolide antibiotic with a wide range of activity against pathogenic microbes.

Indications of the zitroleksa

A medicine is used to eliminate pathologies that are of an infectious nature - caused by bacteria that have a sensitivity to the active component of drugs:

• respiratory system (upper and lower divisions), as well as ENT organs: diseases in acute form - such as pharyngitis, sinusitis with tonsillitis, bronchitis and otitis media. In addition, inflammation of the lungs and chronic bronchitis at the stage of exacerbation;
• subcutaneous tissue and skin surface: erysipelas or impetigo;
• organs of urination and genitals: nonspecific acute forms or gonococcal / chlamydial cervicitis, colpitis or urethritis.

Release form

Release in capsules: 250 mg (6 such capsules inside the blister) or 500 mg (3 such capsules inside the blister). In the package - 1-2 blister plates with capsules.

Pharmacodynamics

Azithromycin is included in a new macrolide subcategory - it is an azalide agent. It is synthesized with a bacterial ribosome of type 70S - more specifically, with its 50S subunit. As a result, protein synthesis dependent on RNA is inhibited and inhibition of the processes of reproduction and growth of pathogenic microorganisms occurs. Large concentrations of drugs can provide bactericidal effects.

Among the bacteria sensitive to the drug:

• cocci of the Gram-positive group - penicillin-sensitive pneumococci, methicillin-sensitive staphylococcus aureus, and pyogenic streptococci from subgroup A;
• germs of the gram-negative group - moraxelly catarrils, gonococci, hemophilic rods and Haemophilus parainfluenzae, legionella pneumophilia, gardnerelli vaginalis, ureaplasma and pasteutella of the multocida with Chlamydia trachomatis;
• individual anaerobes - part of the bacteroid subunit fragigis, prevotella, some fusobacterial species, and in addition Peptostreptococcus species, clostridium perfringence and Porphyromonas spp .;
• aerobes of the gram-positive group - fecal enterococci.

Pharmacokinetics

Absorption of the drug occurs inside the gastrointestinal tract and is carried out quite quickly - due to the fact that azithromycin has lipophilicity, and besides it is stable in acidic environment. It is necessary to take into account that food weakens the absorption of matter. The plasma maximum of the drug is observed after a lapse of 2-3 hours after the use of the capsule. The bioavailability index is 37%.

Distribution within the body occurs quickly. Inside tissues, the accumulation of drugs is very high - it is approximately 50 times higher than the existing plasma values of the main component of the drug. This allows us to conclude that azithromycin has a high level of synthesis with tissues.

The level of protein binding inside the plasma varies according to the plasma indices of the substance - within the range of 12-52% at the corresponding serum concentration level of 0.5-0.05 μg / ml. The average value of the distribution volume in the conditions of the equilibrium level of drugs is 31.1 l / kg.

Plasma removal of the drug is carried out in 2 stages: the half-life is 14-20 hours with an interval of 8-24 hours after the use of the medicinal capsule, and also the 41-hour hour with an interval of 24-72 hours. Such indicators allow you to dispense one-time (per day) drug use.

Excretion occurs predominantly with bile - the drug is mainly excreted unchanged. During the first week, about 6% of the dose taken is excreted unchanged in the urine.

Dosing and administration

Capsules Zitroles take either 1 hour before eating, or after a minimum of 120 minutes after this. For a day you need to perform a one-time drug reception.

When treating infectious diseases affecting the respiratory system with ENT organs, or penetrating into the soft tissues with the skin surface (excluding erythema migratory type), it is required to consume 0.5 grams of medication (3-day cycle of admission) of the treatment course.

To eliminate the migrating form of erythema, the drug is drunk for 5 days (everyday one-time use): on the 1st day - the intake of the 1st g of the drug, and then - 0.5 g during the 2-5th days.

When therapy is used to eliminate infectious STDs, one-time administration of 1 g of medication is required.

To eliminate some of the diseases developing in the area of the 12-intestine and stomach, the drug is used, combining with other drugs, and take 1 gm per day during the 3-day cycle.

To eliminate common acne, it is necessary to take a total of 6 grams of medication for the course of treatment. The scheme usually looks like this: during the first 3 days, you should take 0.5 g once a day. Next, during the next 9 weeks, take 0.5 g of the drug once a week.

If the dose was missed, you should use this capsule as soon as possible, and use all subsequent supplements, observing the intervals of 24 hours.

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Use of the zitroleksa during pregnancy

Pregnant is not prescribed Zitrolex. An exception may be situations where the use of a medicine is dictated by life indications.

If the medicine should be taken with lactation, it is required to refuse breastfeeding for this period of time.

Contraindications

The main contraindications:

• hypersensitivity to azithromycin, as well as other elements of the drug or any antibiotic from the category of ketolides with macrolides;
• it is forbidden to combine with ergot alkaloids;
• the reception in severe forms of disorders in the work of the kidney or liver;
• it is forbidden to appoint children whose weight is less than 45 kg.

Side effects of the zitroleksa

Taking capsules sometimes causes various side effects:

• systemic blood flow: mild transitory neutropenia, and in addition thrombocytopenia;
• lesions of central nervous system: headaches, fainting, vertigo, insomnia or a feeling of drowsiness. In addition, the appearance of paresthesias, disorders of olfactory or taste sensations, as well as asthenia;
• manifestations of the psyche: occasionally there are feelings of severe anxiety, as well as aggressiveness, nervousness or anxiety, and in addition hyperactivity;
• disorders of auditory function: ear ringing, noticeable hearing impairment or complete deafness (most of such disorders are cured);
• problems with the work of SSS: heart rhythm disturbance or arrhythmia due to the development of ventricular tachycardia. In addition, sometimes there is ventricular fibrillation, prolongation of the QT-interval, and in addition, pain in the sternum and a decrease in blood pressure;
• lesions of the digestive tract: the appearance of abdominal cramps or pains, nausea, loose stools and diarrhea, and in addition dyspeptic manifestations, vomiting or constipation. Anorexia, gastritis with pancreatitis, and, in addition, bloating, worsening of appetite and change in the shade of the tongue may occur. Occasionally there is colitis of pseudomembranous type;
• hepatic disorders: rarely in patients there is hepatitis or intrahepatic cholestasis or moderately increases the activity of liver transaminases (a treatable disorder). Individual marking of hepatic dysfunction (occasionally causes death) or hepatitis necrotic type;
• skin lesions: rashes with hives and itching, photosensitivity, Quincke edema, TEN, erythema multiforme and Stevens-Johnson syndrome;
• reactions of organs of the ODA: development of arthralgia;
• damage to the organs of urination: acute stage of kidney failure, and in addition tubulointerstitial nephritis;
• disorders of reproductive function: the appearance of vaginitis;
• other: the development of anaphylaxis (this includes puffiness, which occasionally leads to death) or candidiasis.

Overdose

Among the manifestations of intoxication: nausea, transient loss of hearing, diarrhea or severe vomiting.

When developing an overdose it is required to use activated charcoal, as well as to perform standard procedures of symptomatic therapy.

Interactions with other drugs

Antacids (aluminum, magnesium and calcium containing), ethyl alcohol and food weaken the degree and reduce the rate of absorption of the drug, so you need to use these drugs separately - 1 hour before or 2 hours later.

Lincosamides are reduced, and chloramphenicol with tetracycline increases the effect of Zitroleks.

The drug has no pharmaceutical compatibility with the substance of heparin.

It is required to use the drug with caution in people who already use other drugs that can extend the QT interval.

It is necessary to monitor the patient's condition when taking drugs with cyclosporine, ergot derivatives, terfenadine, and in addition with carbamazepine and theophylline with digoxin. This is necessary due to the fact that macrolides can potentiate the effects of the above medicines.

Azithromycin decreases the rate of excretion, and also increases the toxic properties and plasma values of anticoagulants of indirect action.

Carefully you need to combine the medicine with zidovudine, as well as nelfinavir, because macrolides enhance the properties of these substances.

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Storage conditions

Zitrox should be stored in places that are inaccessible to small children. The temperature in the storage room is a maximum of 25 ° C.

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Shelf life

Zitrox can be used in the period of 3 years from the date of release of this medication.