Lekoklar

Lecoclar is a systemic antibacterial drug from the macrolide category.

Indications Lekoklara

Used for such disorders:

• infections affecting the upper region of the respiratory tract (acute otitis media, acute streptococcal tonsillofaringitis and acute sinusitis );
• lesions of the lower region of the respiratory system (having a bacterial nature of acute bronchitis or exacerbation of its chronic stage, and in addition, outpatient pneumonia (with atypical pneumonia));
• infection of the subcutaneous layer and epidermis;
• infections of mycobacterial origin, triggered by the activity of bacteria MAC, mycobacterium kansasi, marine mycobacteria and Hansen's bacilli;
• an ulcer in the gastrointestinal tract associated with exposure to Helicobacter pylori (it is recommended to combine with other medications).

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Release form

The release of the therapeutic agent is realized in tablet form - 10 or 14 pieces inside the plate (volume 0.25 g), as well as 14 pieces inside the package (volume 0.5 g).

Pharmacodynamics

Clarithromycin is a semi-artificial macrolide antibiotic. The antimicrobial effect of the substance is provided by slowing down the protein binding inside the bacterial cells, which leads to the development of a deficiency in the main microbial proteins, due to which their normal vital activity is disrupted.

Clarithromycin, like other macrolides, is characterized by a bacteriostatic effect, but at the same time it is able to demonstrate bactericidal activity.

The substance has a therapeutic effect on the following bacteria:

• microbes gram (+): staphylococci with streptococci, corynebacteria and listeria monocytogenes;
• Gram bacteria (-): Ducrey sticks, meningococci, campylobacter with gonococci, hemophilic sticks, multitocide pasteurella, Helicobacter pylori with moraxella catarallis and Bordeurfere Borrelia with bacteria Borde-Zhang;
• anaerobes: peptococci, Clostridium perfringens, eubacteria with propionibacteria, and Bacteroides melaninogenicus;
• intracellular microbes: legionella pneumophilus, mycoplasma pneumonia, ureaplasma urealiticum, Chlamydia trachomatis with Toxoplasma gondii, and in addition chlamydophilia pneumonia and all mycobacteria, excluding Koch sticks.

The range of antibacterial activity of clarithromycin is similar to erythromycin, and in addition, it demonstrates the effect on atypical mycobacteria.

There is a high level of cross-resistance of microbes to clarithromycin with erythromycin.

Pharmacokinetics

Clarithromycin demonstrates stability while staying inside the acidic gastric environment; has good absorption. Food does not change the degree of absorption of a substance, but its rate may decrease.

About 20% of the applied component is immediately converted to the substance 14-hydroxylarithromycin, which has a similar clarithromycin effect. The element quickly goes inside the tissue with fluids. Typically, tissue indicators of drugs 10 times its serum values.

The drug is actively involved in hepatic metabolic processes occurring with the help of hemoprotein P450. There are less than 7 metabolic products of the element.

Excreted in the form of metabolic products or unchanged with urine; its smaller part is excreted through the digestive tract. Approximately 20-30% of the drug is excreted unchanged along with urine.

The half-life of the drug is equal to 3-4 hours in the case of using a portion of 0.25 g with 12-hour intervals, and 5-7 hours when using a dosage of 0.5 g at 12-hour intervals.

Dosing and administration

The pill is swallowed whole, washed down with ordinary water.

Adolescents from 12 years of age, as well as adults, should consume 0.25-0.5 g of the substance 2 times a day for a 1-2-week period. Clinical tests have shown that a shorter therapeutic cycle that lasts 5-6 days is also effective with otitis media or acute bronchitis.

People with HIV or infection that has developed due to the activity of the M.avium complex should be used daily for 1000-2000 mg of drugs. An adult per day can use no more than 2000 mg of Lecoklar.

The schemes used in the treatment of adults:

• with tonsillopharyngitis, it is necessary to apply 0.25 g of the substance at 12-hour intervals, for 10 days;
• in the acute stage of sinusitis - 0.5 g each at 12-hour intervals, for a period of 14 days;
• during exacerbation of chronic bronchitis or home pneumonia (provoked by pneumococcus, mycoplasma pneumonia or moraxella catarallis), 0.25 g of the drug is used at 12-hour intervals in the period of 1-2 weeks (for home pneumonia provoked by hemophilus bacillus, during periods of time with the same frequency is applied to 0.5 g of the drug);
• with the defeat of the epidermis and its structures - 0.25 g of the drug at 12-hour intervals, within 7-14 days;
• treatment of Helicobacter pylori (combined) - 0.25 g 2 times a day or 0.5 g 3 times a day, in a 2-week period.

People with impaired renal activity in severe (CC values - below 30 ml / minute) are required to halve the dose of drugs (or 2 times longer intervals between use).

Use Lekoklara during pregnancy

Information regarding the safety of using Lekoclar in pregnant or lactating women is not available. Clarithromycin, like other macrolides, is able to stand out with mother's milk.

With an already existing pregnancy, its planning, or conception during therapy, the patient must notify the doctor, because clarithromycin can be prescribed to pregnant and lactating women only in exceptional situations, taking into account its benefits and possible negative impact.

Contraindications

The main contraindications:

• severe intolerance associated with clarithromycin or other macrolides;
• severe liver disease;
• use together with cisapride, terfenadine or pimozide.

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Side effects Lekoklara

Most of the negative symptoms that occurred when using drugs were temporary or mild. Disorders in the gastrointestinal tract (nausea, stomach pain, digestive disorders and diarrhea) or headaches are often observed. Perhaps the development of glossitis or stomatitis, disorder of taste receptors and the appearance of signs of intolerance (anaphylaxis, rashes, and, individually, SJS). There have also been few reports of symptoms in the CNS area (anxiety or confusion, dizziness, nightmares, and insomnia).

Intrahepatic cholestasis is extremely rare, or the activity of hepatic enzymes increases.

The use of clarithromycin (similarly to erythromycin) can lead to ventricular arrhythmias (this also includes ventricular tachycardia and pirouette tachycardia in individuals with prolonged QT-interval values).

Overdose

Too large portions of the drug mainly lead to a feeling of confusion, headaches and dysfunction of the gastrointestinal tract.

It is required to perform gastric lavage in the period up to 2 hours from the moment of use of the drug.

Interactions with other drugs

Clarithromycin is involved in intrahepatic metabolic processes, where it slows down the activity of certain enzymes of the hemoprotein P450. These processes, in which other medications are involved (with the help of this enzyme system), can slow down with an increase in their values inside the serum, which can cause intoxication.

The combination of medication with pimozide, and in addition cisapride and terfenadine is prohibited.

You can not combine the drug with digoxin, dihydroergotamine, as well as astemizole.

In the case of simultaneous administration with clarithromycin of cyclosporine, bismuth nitrate, benzodiazepines, and in addition ranitidine, saquinavir, carbamazepine with rifabutin, warfarin, theophylline with tacrolimus and zidovudine, the therapy process should be carefully monitored. It is recommended to monitor the serum indicators of these drugs, the dosages of which may be too small.

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Storage conditions

Lecoclar is required to be kept in a place closed from the penetration of small children. The temperature level is maximum 25 ° С.

Shelf life

Lecoclar can be used for a 2-year term since the release of the therapeutic drug.

Application for children

There is no evidence of the ability to effectively and safely use the drug in infants up to six months of age.

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Analogs

Analogues of the medication are Arvicin, Clabacax, Binocular with Arvicin retard, Clarbact, Claritrosyn and Vero-Clarithromycin with Clarithromycin, and besides Klacid, ClaroSip, Claritsin, Klasine with Claritsit and Saidon-Sanovel. The list also includes Clerimed, Fromilid, Claromin with Crixane and Ecozetrin.

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