After oral administration, azithromycin is well absorbed and rapidly distributed in the body. After a single omnadren 250 dose of 500 mg the bioavailability – 37% (the effect of “first pass” through the liver), the maximum plasma concentration (0.4 mg / L) was created after 2-3 hours.
Infectious-inflammatory diseases caused by susceptible to malaria infections:
– upper respiratory tract infection and upper respiratory tract (pharyngitis / tonsillitis, sinusitis, otitis media);
– lower respiratory tract infections (acute bronchitis, exacerbation of chronic bronchitis, pneumonia, including . caused by atypical pathogens);
– skin and soft tissue infections (erysipelas, impetigo, secondarily infected dermatitis);
– the initial stage of Lyme disease (borreliosis) – erythema migrans (of erythema migrans)
– urinary tract infections caused by Chlamydia trachomatis (urethritis, cervicitis ).
– Hypersensitivity to azithromycin and other macrolides;.
– Severe liver and kidney function;
– Children under 12 years of age with a body weight less than 45 kg (for a given dosage form);
– simultaneous reception with ergotamine and dihydroergotamine;
– genetic galactose intolerance, lactase deficiency, glucose-galactose malabsorption (for a given dosage form containing lactose).
– mild dysfunction of the liver and kidneys;
– arrhythmia or predisposition to arrhythmias and prolongation of QT interval;
– co-administration of terfenadine, warfarin, digoxin.
Application of pregnancy and during breastfeeding
Azithromycin is used during pregnancy only if the expected benefit from its application exceeds the potential risk to the fetus. At the time of treatment with azithromycin breastfeeding suspended.
Dosing and Administration
Inside, 1 times a day for at least 1 hour before or 2 hours after eating. For infections of the upper and lower respiratory tract infections, upper respiratory tract, skin and soft tissues: 500 mg (2 capsules) 1 time per day for 3 days (a course dose of -1500 mg). When the erythema migrans: 1 once a day for 5 days 1 day – 1000 mg (4 capsules), and then from the 2nd to 5th day – 500 mg (2 capsules) (course dose – 3000 mg). In acute infections of urinary tract, caused by Chlamydia trachomatis: Uncomplicated urethritis / cervicitis – 1000 mg (4 capsules) once. The appointment to patients with impaired renal function:For patients with moderate renal impairment ( CC> 40 ml / min) dose adjustment is required.
Classification of adverse reactions of the frequency (the number of reported cases / number of patients): frequently (≥1 / 100, <1/10), uncommon (≥1 / 1000 and <1/100), rare (≥1 / 10,000 to <1 / 1000) and very rare (<1/10 000). On the part of the central and peripheral nervous system: rarely dizziness / vertigo, headache, convulsions, drowsiness; rarely – paresthesia, fatigue, insomnia, hyperactivity, aggressiveness, anxiety, nervousness. From the sensory organs: rarely – tinnitus, reversible hearing impairment including deafness (when taking high doses for a long time), impaired perception of taste and smell. From the digestive system: often – nausea, vomiting, diarrhea, abdominal pain; rarely – diarrhea, flatulence, indigestion, anorexia; rarely omnadren 250 – constipation, change the language of color, pseudomembranous colitis, cholestatic jaundice, hepatitis, changes in laboratory parameters of liver function; very rarely – necrosis of the liver. Since the cardiovascular system: rarely – palpitations, arrhythmia (including ventricular tachycardia), an increase in the QT interval. From the circulatory and lymphatic system: rarely thrombocytopenia, neutropenia. From the urogenital system: Jade , acute renal failure, vaginitis. From the musculoskeletal system: rarely – arthralgia. Allergic reactions: rarely – itching, skin rash; rarely – angioneurotic edema, urticaria, photosensitivity, anaphylactic reaction, mnrgoformnaya erythema, Stevens-Johnson syndrome, toxic epidermal necrolysis. Other: candidiasis.
Symptoms: nausea, temporary hearing loss, vomiting, diarrhea.
Interaction with other drugs
Antacids reduce the maximum concentration of azithromycin in blood plasma by 30%, and the drug should be taken at least one hour before or two hours after administration of these drugs and food.
Azithromycin has no effect on the concentration of carbamazepine, didanosine, rifabutyna and methylprednisolone omnadren 250 plasma blood in the joint application. It is impossible to exclude the effect of azithromycin (when taken orally) on the concentration of cimetidine, efavirenz, fluconazole, indinavir, midazolam, triazolam, trimethoprim / sulfamethoxazole in blood plasma in a joint application.
Azithromycin has no effect on the pharmacokinetics of theophylline, but when combined with other macrolides concentration of theophylline plasma can be increased.
If necessary, the joint use with cyclosporine is recommended to control the content of the latter in the blood plasma. Despite the fact that the data on the effect of azithromycin on the concentration of cyclosporine in the blood plasma have other macrolides are able to change its level in the blood plasma.
When combined with digoxin azithromycin is necessary to control the last level in the blood plasma, as many macrolides enhance the absorption of digoxin in the intestine, thereby increasing its concentration in the blood plasma.
it is recommended to carefully monitor When coadministered with warfarin prothrombin time.
It has been found that co-administration of terfenadine and macrolide class of antibiotics causes arrhythmia, and lengthening the QT interval. From this, we can not exclude the omnadren 250 aforementioned side effects when combined terfenadine and azithromycin.
Since there is a possibility of inhibiting the isozyme CYP3A4 azithromycin in parenteral form when coadministered with cycloserine, terfenadine, ergot alkaloids, cisapride, pimozide, quinidine, astemizole et al. Drugs, metabolism which is mediated by the enzyme, this possibility should be considered when assigning the interaction of azithromycin for oral administration.
when combined azithromycin did not affect the pharmacokinetic parameters of zidovudine and its metabolite – glucuronide. However, increasing the concentration of its active metabolite – phosphorylated AZT mononuclear cells in peripheral blood vessels. The clinical significance of this fact is not clear.
With the simultaneous use of macrolides with ergotamine and dihydroergotamine possible manifestation of their toxic effect.
When you miss a single dose of the drug missed dose should be taken as soon as possible, and the next – with an interval of 24 hours.
Tak like any antibiotic therapy during the treatment with azithromycin may join superinfection (including fungal).
In the treatment of pharyngitis / tonsillitis caused by Streptococcus pyogenes, as well as for prophylaxis of acute rheumatic fever, the drug of choice is usually a penicillin. Azithromycin is also active against streptococcal infection in these cases, however, is ineffective for the prevention of acute rheumatic fever.
Effects on ability to drive vehicles and other mechanisms
Azithromycin has no effect on the ability to drive vehicles and other mechanisms.
Capsules 250 mg. 6 or 10 capsules in blisters. 10 capsules in a jar or bottle of plastics. 1 jar, bottle or 1 contour cell package for 6 or 10 capsules, along with instructions for use are placed in a pile of cardboard.