Binocular

Binocular is a drug that has a bacteriostatic, bactericidal, and antibacterial therapeutic effect.

The drug has the ability to synthesize with the 50S subunit of human ribosomes, and at the same time inhibits protein binding that occurs inside the cells of pathogenic bacteria. The drug has a medicinal effect inside the cells of microbial pathogens, and in addition it effectively affects the extracellular environment. 

[1], [2]

Indications Binoculars

It is used for the following types of infections:

• infections of the respiratory tract (lower and upper areas) and ENT organs: sinusitis, otitis with pharyngitis, pneumonia and bronchitis;
• lesions of the subcutaneous tissue and epidermis: erysipelas or folliculitis;
• Mycobacterial pathologies provoked by M.chelonae, M.intracellulare (local or common species) with Mycobacterium avium, mycobacterium fortuitum and mycobacterium kansasi (local lesions);
• ulcers occurring in the gastrointestinal tract (destruction of H.pylori).

[3]

Release form

The release of the drug is implemented in tablets - 10 pieces inside the plates. In the box - 1 record.

[4], [5], [6]

Pharmacodynamics

Demonstrates high activity relative to some microbes:

• gram-positive (streptococci with staphylococci);
• Gram-negatives (gonococci, jejuni campylobacter, hemophilus sticks, Haemophilus parainfluenzae, Helicobacter pylori, legionella pneumophilus, etc.);
• anaerobes (clostridia, peptostreptokokki with bacteroids and peptokokki);
• other (mycobacteria, chlamydia and borrelia).

[7], [8], [9], [10]

Pharmacokinetics

The drug is absorbed at high speed inside the gastrointestinal tract. The level of bioavailability is 50% (eating food inhibits the beginning of absorption, but does not affect the values of bioavailability and the formation of an active metabolic component).

In the case of 2 times the drug intake per day (in a portion of 0.25 g), the equilibrium values of Cmax are noted after 2-3 days and on average equal to 1 μm / ml for clarithromycin, as well as 0.6 μg / ml a 14-hydroxylarithromycin metabolic element with activity. The term half-life is, respectively, 3-4th and 5-6 hours.

At high speeds it is distributed inside fluids with tissues; tissue indicators of clarithromycin (especially inside the lungs) exceed plasma several times. The substance passes inside the mother's milk.

Excretion is carried out with feces and urine (40% each).

[11], [12], [13], [14], [15]

Dosing and administration

It is required to use orally. For adults - 0.25-0.5 g 2 times a day, over a 6-14-day cycle.

For children, the dose is 7.5 mg / kg; per day you can use no more than 0.5 g of the drug. The course lasts 7-10 days.

In the case of therapy for lesions provoked by Mycobacterium avium, 1000 mg are used 2 times a day. The whole cycle lasts from six months and longer.

[26], [27], [28], [29], [30]

Use Binoculars during pregnancy

Binoculars can only be prescribed in situations where the likely benefits of using it exceed the risks of complications in a child.

Contraindications

The main contraindications:

• strong sensitivity to the components of drugs;
• disorders of renal or hepatic function in severe;
• combination with cisapride, astemizole, ergot derivatives, terfenadine or pimozide.

[16], [17], [18], [19]

Side effects Binoculars

Among the adverse events:

• problems with the work of the digestive tract: stomatitis, dyspepsia, nausea, candidiasis affecting the oral mucosa, changes in taste, vomiting, glossitis, diarrhea, changes in the shade of the teeth and tongue, as well as pain in the abdomen. In addition, cholestasis, colitis of a pseudomembranous nature, jaundice, hepatitis, an increase in the values of intrahepatic enzymes and liver failure (occasionally) are noted;
• NA dysfunction: anxiety, confusion, dizziness, insomnia, anxiety and fear, as well as headaches, disorientation, nightmares, psychosis, ear noise, depersonalization, hallucinations and paresthesias;
• disorders of CVS and blood activity (hemostasis and hematopoietic processes): leuko- or thrombocytopenia, prolongation of the QT interval, ventricular arrhythmia (also ventricular tachycardia of paroxysmal character) and ventricular fibrillation;
• allergy symptoms: anaphylaxis, anaphylactoid symptoms, urticaria, SJS and epidermal rashes;
• lesions of the urogenital system: kidney failure, tubulointerstitial nephritis and increased serum creatinine values;
• others: the development of hypoglycemia (due to the use of antidiabetic drugs for ingestion and insulin).

[20], [21], [22], [23], [24], [25]

Overdose

With intoxication, vomiting, diarrhea and nausea are noted.

Gastric lavage and symptomatic procedures are performed. Peritoneal or hemodialysis will be ineffective.

[31], [32], [33]

Interactions with other drugs

In the case of combination with cisapride, terfenadine, pimozide, ergot derivatives and astemizole, QT indications may be prolonged, and cardiac arrhythmias may occur (ventricular fibrillation or ventricular tachycardia with a paroxysmal character).

The medicine increases the blood values and potentiates the activity of drugs whose intrahepatic metabolism is realized with the help of enzymes gemoproteinovogo P450 compounds (including warfarin and other anticoagulants indirect nature, astemizole, digoxin, carbamazepine, triazolam, cyclosporine, theophylline with ergot alkaloids, cisapride, midazolam, and so on. ).

Combination with substances that slow down the action of hydroxymethylglutaryl-CoA reductase (among them, simvastatin with lovastatin), can lead to necrosis of the skeletal muscles in the active phase.

Binoculars weaken the absorption of zidovudine and reduce the level of triazolam clearance (this increases its medical effect with the appearance of confusion and drowsiness).

Ritonavir increases the plasma parameters of drugs, because of their combination can not use dosages of clarithromycin in excess of 1 g per day. Persons with kidney failure are required to reduce by 50% the portion of clarithromycin at a CC level within 30-60 ml per minute; with values below 30 ml per minute - by 75%.

If the QC values are less than 30 ml per minute, it is required to reduce the dosage by half; the course of therapy should continue for a maximum of 2 weeks.

[34], [35], [36], [37], [38], [39], [40]

Storage conditions

Binoculars must be kept out of the reach of children. The temperature level is maximum 30 ° C. It is forbidden to freeze the medicine.

[41], [42]

Shelf life

Binoculars can be used for a 24-month term from the date the drug was manufactured.

[43]

Analogs

Analogs of drugs are substances Arvitsin, Claritrosyn, Kriksan with Baktikapom, Klareksid and Bioteritsin with Klaritsinom, and in addition Zimbaktar, Klaromin and Kispar. Also on the list are Clabax, Clerimed, Mycetinum, Clarbact with Fromilidom, Clarithromycin and Klacid with Claritsit, and in addition to this, Klasine, Ekositerin, Lecoklar and Saidon Sanovel.

[44], [45], [46]