Neazi 500mg Mediplantex tablets for acute sinusitis, sore throat, tonsils (1 blister x 3 tablets)

Infections of urethra, cervix caused by chlamydia trachomatis (without complications).

Pharmacology

azithromycin is a macrolid antibiotic that has a broader activity than erythromycin and clarithromycin. Azithromycin usually has bactericidal properties, but if high concentrations can also kill bacteria for some selective strains.

In vitro, the bactericidal properties have been seen for streptococcus pyogenes, streptococcus pneumoniae and H. Influenzae. Azithromycin inhibits protein synthesis by attaching the structure under the molecule of the ribosom 50s, just like other macrolids. Azithromycin's antibacterial activity is reduced at low pH. The drug must go into the new factory to be active against intracellular bacteria.

Effective spectrum:

Gram -positive bacteria: Azithromycin has a Vitro printing effect with In Vivo for: Streptococcus Agalactiae, Staphylococcus aureus, S. Pneumoniae, and S. Pyogenes. The minimum inhibitory concentration (mic) of azithromycin for most staphylococcus and streptococcus is similar or 2 times higher than that of Erythromycin mic; Azithromycin does not inhibit erythromycin -resistant strains.

Staphylococcus anti -methicilin staphylococcus aureus (staphylococcus epidermidis) is usually resistant to both azithromycin and erythromycin. Azithromycin does not work with intestinal bridges.

Gram -negative bacteria: Azithromycin is 2 to 8 times higher than that of erythromycin for bacteria sensitive to erythromycin: Haemophilus influenzae, parainfluenzae, and ducreyi, Moraxella Catatrhalis, Legionella Pneumophila, Neisseria Gonorrhoeae. Azithromycin also has an invitro effect on N. Meningitidis and some strains of Bordetella Pertussis and Legionella Pneumophila.

Mycobacteria: Azithromycin has the effect of printing vito and in vivo for mycobacterium avium complex. But M. tuberculosis, M. Kansasii, M. Scrofulaceum, M. Leprae resistant to azithromycin. Anaerobic bacteria: Clostridium perfringens, peptostreptococcus spp. and propionibacterium acnes, Prevotella sensitive to azithromycin.

Chlamydiae: In vitro and in vivo with Chlamydophila Pneumoniae and C.Trachomatis.

Mycoplasma: Azithromycin is often equivalent to hunger with mycoplasma pneumoniae compared to erythromycin or clarithromycin, but less effective for ureaplasma urticum compared to Clarithromycin.

Bacterial: has the effect of in vito and in vivo with Borrella Burgdorferi that causes Lyme disease, in vivo with treponema pallidum but the efficiency and safety have not been determined.

Other microorganisms: In vitro and in vivo with Toxoplasma Gondii, Entamoeba Histolytica, Plasmodium Falsiparum, Rickettsia.

Anti -drug: Macrolid -resistant bacteria can be natural or sufficient. The drug resistance is related to many factors, including the absorbent reduction factor of the bacterial cell shell or changing the ribosom 50s protein in the receptor position that reduces the macrolid's affinity attached to bacterial cells. There are cross -resistance between erythromycin, clarithromycin and azithromycin for streptococcal and staphylococcus aureus.

pharmacokinetics

absorption:

Azithromycin after oral is absorbed quickly but incomplete, biological use after taking a single dose of 500 mg (tablet) about 34 - 42%. After taking the drug, the plasma peak concentration is achieved within 2 to 3 hours.

Peak concentration in plasma is about 0.5 micrograms/ml. The food in the stomach can affect the absorption of oral azithromycin; However, the effect of food on absorption depends on the type of drug used. Food does not work much to the level of absorption when taking tablets in adults but the absorption rate may increase. But the drug concentration in plasma increases due to food not long, existing less than 4 hours.

Distribution:

The drug is distributed mainly in tissues and fluid fluid after taken. Azithromycin focuses on macrophages including polygon, single -core, macronal and macronal fibers; The rate of drug concentration in cells and outside cells exceeds 30 after 1 hour and 200 after 24 hours.

Distribution volume (VD): 23 - 31 liters/kg. Azithromycin is released slower from macrophages compared to erythromycin, so a significant concentration of azithromycin is maintained for a long time in those cells. Antibacterial effects of azithromycin related to pH. Only a very low concentration of azithromycin is in the cerebrospinal fluid when the meninges are not inflamed. Azithromycin through the placenta and distributed into the bloodstream and amniotic fluid. Azithromycin is distributed into milk.

Metabolism and elimination:

azithromycin metabolizes in the liver and eliminates mostly through bile; Only 6% are eliminated in the form of unchanged urine. Elimination in many phases, reflecting the initial distribution quickly into the tissues, followed by slow elimination. The clearance coefficient: 38 liters/hour in adults. The disposal time of the drug (T1/2): 11 - 68 hours.

Too hypersensitivity to erythromycin or any antibiotic macrolid or ketolid.

History of cholestasis/hepatic jaundice is related to the use of azithromycin before.

Be cautious when using

azithromycin is not used to treat outpatient pneumonia medium and severe pneumonia or patients are at risk of infection at hospital, immunodeficiency. These cases must be treated at the hospital.

Do not use this medication for people with liver disease, because the main excretion of the liver.

It is necessary to use carefully for people with kidney function to be harmful, with creatinine clearance ratio less than 10 mi/ min.

Although there is no report in clinical trials, when using macrolid antibiotics, there is, although very rare, arrhythmia, prolonged QT, torsion, ventricular tachycardia. It is necessary to be cautious when using azithromycin, especially when combining many drugs, for people who have heart disease.

The drug contains lactose, so it is not recommended for patients with genetic galactose tolerance, lactase deficiency or poor glucose-galactose absorption.

The ability to drive and operate machinery

should be cautious because the drug can cause unwanted effects: headache, dizziness, chicken sleep.

Pregnancy

There is no complete and controlled research data on pregnant women. In animal studies there is no evidence that causes harmful to the embryo of azithromycin. Because the safety of azithromycin when used for pregnant women is uncertain, only azithromycin should be used for pregnant women if necessary.

The period of breastfeeding

The drug has been recorded as an excretion in human milk, but there is no clinical research with good and complete control over breastfeeding women about the pharmacokinetic properties of azithromycin excretion through breast milk. Because, it is unknown whether azithromycin has unwanted effects for breastfed babies, should stop breastfeeding during treatment with azithromycin.

Risk of diarrhea, mucous fungal infection can occur with some sensitive breastfeeding babies. It is recommended not to breastfeed up to 2 days after stopping the drug. Can continue to breastfeed later.

Medicinal interaction

Conducting chicken mushrooms: Do not use simultaneously azithromycin with chicken spurs derivatives because of the ability to gradually poison Ergo.

Antacislets: When needed, azithromycin is only used at least 1 hour before or 2 hours after using antacids.

Carbamazepin: In pharmacokinetic research in healthy volunteers, no significant effect on carbamazepine concentration or their metabolic products in plasma.

cimetidine: pharmacokinetics of azithromycin does not affect if taking a dose of cimetidin before using azithromycin 2 hours.

Cyclosporin: Some macrolid antibiotics hinder the metabolism of cyclosporin, so it is necessary to monitor the concentration and adjust the dose of cyclosporin.

Digoxin: For some patients, Azithromycin can affect digoxin metabolism in the intestine. Therefore, when using these two drugs simultaneously, it is necessary to monitor the concentration of digoxin because it has the ability to increase the content of digoxin.

Methylprednisolon: Studies conducted on healthy volunteers have proved that azithromycin has no significant effect on the pharmacokinetics of MethyipredNisoion.

Theophylin: There has not been any effect on pharmacokinetics when 2 drugs azithromycin and theophylin are used in healthy volunteers, but generally should monitor theophylin concentration when using these two drugs for patients.

warfarin: has not determined the influence of azithromycin on anticoagulants of warfarin. These 2 drugs can be used at the same time, but still need to monitor the patient's blood clotting time.