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Antibiotic hemomycin in tablets and suspensions - composition, indications for use, side effects, analogues and price. Hemomycin lyophilisate - instructions for use Description and composition

Hemomycin - the latest description of the drug, you can read contraindications, side effects, prices in pharmacies for Hemomycin. Reviews of Hemomycin -

Broad-spectrum antibiotic.
Drug: CHEMOMYCIN
Active substance of the drug: azithromycin
ATX coding: J01FA10
KFG: Antibiotic of the macrolide group - azalide
Registration number: P No. 013856/01
Registration date: 10/15/07
Owner reg. cert.: HEMOFARM A.D. (Serbia)

Hemomycin release form, drug packaging and composition.

Hard gelatin capsules, light blue, size No. 0; The contents of the capsules are white powder. Capsules 1 capsule. azithromycin (dihydrate form) 250 mg
Excipients: anhydrous lactose, corn starch, sodium lauryl sulfate, magnesium stearate.
Shell composition: titanium dioxide E171, patented blue dye VE131, gelatin.
6 pcs. - blisters (1) - cardboard packs.
Tablets, film-coated, grayish-blue, round, biconvex. Film-coated tablets 1 tab. azithromycin (dihydrate form) 500 mg
Excipients: microcrystalline cellulose and microcrystalline silicate cellulose, sodium carboxymethyl starch (type A), povidone, magnesium stearate, talc, colloidal silicon dioxide.
Shell composition: titanium dioxide, talc, copovidone, ethylcellulose, macrogol 6000, indigo carmine (indigotine) E132, green varnish dye 8%: indigo carmine (indigotine) E132, quinoline yellow E104.
3 pcs. - blisters (1) - cardboard packs.
Powder for the preparation of a suspension for oral administration is white or almost white in color, with a fruity odor; the prepared suspension is almost white in color with a fruity odor. Powder 5 ml of ready-made suspension. azithromycin (dihydrate form) 100 mg
Excipients: xanthan gum, sodium saccharinate, calcium carbonate, colloidal silicon dioxide, anhydrous sodium phosphate, sorbitol, cherry flavoring, apple and strawberry flavorings.
11.43 g - dark glass bottles (1) complete with a measuring spoon - cardboard packs.
Powder for the preparation of a suspension for oral administration is white or almost white in color, with a fruity odor; the finished suspension is almost white in color with a fruity odor. Powder 5 ml of ready-made suspension. azithromycin (dihydrate form) 200 mg
Excipients: xanthan gum, sodium saccharinate, calcium carbonate, colloidal silicon dioxide, sodium phosphate dodecahydrate, sorbitol, cherry flavoring, apple and strawberry flavorings.
10 g - dark glass bottles (1) complete with a measuring spoon - cardboard packs.

The description of the drug is based on the officially approved instructions for use.

Pharmacological action Chemomycin

Broad-spectrum antibiotic. Azithromycin is a representative of a subgroup of macrolide antibiotics - azalides. In high concentrations it has a bactericidal effect.
Chemomycin is active against aerobic gram-positive bacteria: Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus spp. groups C, F and G, Streptococcus viridans, Staphylococcus aureus; aerobic gram-negative bacteria: Haemophilus influenzae, Moraxella catarrhalis, Bordetella pertussis, Bordetella parapertussis, Legionella pneumophila, Haemophilus ducrei, Helicobacter pylori, Campylobacter jejuni, Neisseria gonorrhoeae and Gardnerella vaginalis; anaerobic bacteria: Bacteroides bivius, Clostridium perfringens, Peptostreptococcus spp; intracellular pathogens:
The drug is active against intracellular microorganisms: Chlamydia trachomatis, Mycoplasma pneumoniae, Ureaplasma urealyticum, Borrelia burgdorferi, as well as against Treponema pallidum.
Gram-positive bacteria that are resistant to erythromycin are resistant to the drug.

Pharmacokinetics of the drug.

Suction
Azithromycin is rapidly absorbed from the gastrointestinal tract, due to its stability in an acidic environment and lipophilicity. After oral administration of Chemomycin at a dose of 500 mg, the Cmax of azithromycin in the blood plasma is reached after 2.5-2.96 hours and is 0.4 mg/l. Bioavailability is 37%.
Distribution
Azithromycin penetrates well into the respiratory tract, organs and tissues of the urogenital tract, into the prostate gland, into the skin and soft tissues. The high concentration in tissues (10-50 times higher than in blood plasma) and long T1/2 are due to the low binding of azithromycin to plasma proteins, as well as its ability to penetrate eukaryotic cells and concentrate in the low pH environment surrounding lysosomes. This, in turn, determines the large apparent Vd (31.1 l/kg) and high plasma clearance. The ability of azithromycin to accumulate predominantly in lysosomes is especially important for the elimination of intracellular pathogens. It has been proven that phagocytes deliver azithromycin to sites of infection, where it is released during the process of phagocytosis. The concentration of azithromycin in foci of infection is significantly higher than in healthy tissues (on average by 24-34%) and correlates with the degree of inflammatory edema. Despite its high concentration in phagocytes, azithromycin does not have a significant effect on their function.
Azithromycin remains in bactericidal concentrations at the site of inflammation for 5-7 days after taking the last dose, which made it possible to develop short (3-day and 5-day) courses of treatment.
Removal
The elimination of azithromycin from blood plasma occurs in 2 stages: T1/2 is 14-20 hours in the range from 8 to 24 hours after taking the drug and 41 hours in the range from 24 to 72 hours, which allows the drug to be used once a day.

Indications for use:

Infectious and inflammatory diseases caused by microorganisms sensitive to the drug:
- infections of the upper respiratory tract and ENT organs (tonsillitis, sinusitis, tonsillitis, otitis media);
- scarlet fever;
- infections of the lower respiratory tract (bacterial and atypical pneumonia, bronchitis);
- infections of the urogenital tract (uncomplicated urethritis and/or cervicitis);
- infections of the skin and soft tissues (erysipelas, impetigo, secondary infected dermatoses);
- Lyme disease (borreliosis) for the treatment of the initial stage (erythema migrans);
- diseases of the stomach and duodenum associated with Helicobacter pylori (as part of combination therapy) (for tablets).

Dosage and method of administration of the drug.

The drug is taken orally 1 time/day 1 hour before meals or 2 hours after meals, because When taken simultaneously with food, the absorption of azithromycin is reduced.
If you miss one dose of the drug, it should be taken as soon as possible, and subsequent doses should be taken at intervals of 24 hours.
Capsules
For adults with infections of the upper and lower respiratory tract, Hemomycin is prescribed 500 mg (2 caps.) per day for 3 days; course dose - 1.5 g.
For infections of the skin and soft tissues, 1 g (4 caps.) is prescribed on the 1st day, then 500 mg (2 caps.) daily from days 2 to 5; course dose - 3 g.
For acute uncomplicated urethritis or cervicitis, a single dose of 1 g (4 caps.) is prescribed.
For Lyme disease (borreliosis), for the treatment of the initial stage (erythema migrans), 1 g (4 capsules) is prescribed on the 1st day and 500 mg (2 capsules) daily from the 2nd to the 5th day (course dose - 3 G).
For diseases of the stomach and duodenum associated with Helicobacter pylori, 1 g (4 capsules) per day is prescribed for 3 days as part of combined anti-Helicobacter pylori therapy.
For children over 12 years of age with infections of the upper and lower respiratory tract, skin and soft tissues, the drug is prescribed at the rate of 10 mg/kg 1 time/day for 3 days (course dose - 30 mg/kg) or on the first day - 10 mg/kg. kg, then 4 days - 5-10 mg/kg/day.
When treating erythema migrans - 20 mg/kg on day 1 and 10 mg/kg from days 2 to 5.
Pills
For adults and children over 12 years of age, for infections of the upper and lower respiratory tract, 500 mg/day is prescribed for 3 days; course dose - 1.5 g.
For infections of the skin and soft tissues, 1 g/day is prescribed on the first day, then 500 mg daily from days 2 to 5; course dose - 3 g.
For acute uncomplicated urethritis or cervicitis, a single dose of 1 g is prescribed.
For Lyme disease (borreliosis) for the treatment of the initial stage (erythema migrans), the drug is prescribed at a dose of 1 g on the 1st day and 500 mg daily from the 2nd to the 5th day; course dose - 3 g.
For diseases of the stomach and duodenum associated with Helicobacter pylori, 1 g/day is prescribed for 3 days as part of combination anti-Helicobacter pylori therapy.
Suspension 200 mg/5 ml and 100 mg/5 ml
For children over 12 months, a suspension of 200 mg/5 ml is used, for children over 6 months, a suspension of 100 mg/5 ml is used.
For children with infections of the upper and lower respiratory tract, infections of the skin and soft tissues (with the exception of chronic migratory erythema), Hemomycin in the form of a suspension is prescribed at a rate of 10 mg/kg body weight for 3 days.
Recommended dosage regimens for Hemomycin depending on the child’s body weight and suspension concentration are presented in the following table. Body weight Daily dose (suspension 200 mg/5ml) Daily dose (suspension 100 mg/5ml) 10-14 kg 2.5 ml (100 mg) - 1/2 measure. spoons 5 ml (100 mg) - 1 measure. spoon 15-25 kg 5 ml (200 mg) - 1 measure. spoon 10 ml (200 mg) - 2 measures. spoons 26-35 kg 7.5 ml (300 mg) - 1 and 1/2 measure. spoons 15 ml (300 mg) - 3 measures. spoons 36-45 kg 10 ml (400 mg) - 2 measures. spoons 20 ml (400 mg) - 4 measures. spoons over 45 kg prescribe doses for adults prescribe doses for adults
Adults with infections of the upper and lower respiratory tract are prescribed 500 mg/day for 3 days; course dose - 1.5 g. For infections of the skin and soft tissues, as well as for Lyme disease (borreliosis) for the treatment of the initial stage (erythema migrans), 1 g / day is prescribed on the 1st day, then 500 mg daily from 2 to 5 days. th day; course dose - 3 g.
For chronic migratory erythema - prescribed on day 1 at a dose of 20 mg/kg body weight, then from days 2 to 5 - 10 mg/kg body weight.
For infections of the urogenital tract, the drug is prescribed to children under 8 years of age with a body weight of more than 45 kg at a dose of 10 mg/kg once.
Recommended dosage regimens for Hemomycin in the treatment of erythema migrans in children, depending on body weight and suspension concentration, are presented in the following table.
Day 1 Body weight Daily dose (suspension 200 mg/5ml) Daily dose (suspension 100 mg/5ml)< 8 кг - 5 мл (100 мг) — 1 мерн. ложка 8-14 кг 5 мл (200 мг) — 1 мерн. ложки 10 мл (200 мг) — 2 мерн. ложки 15-24 кг 10 мл (400 мг) — 2 мерн. ложки 20 мл (400 мг) — 4 мерн. ложки 25-44 кг 12.5 мл (500 мг) — 2 и1/2 мерн. ложки 25 мл (500 мг) — 5 мерн. ложек
From 2 to 5 days Body weight Daily dose (suspension 200 mg/5ml) Daily dose (suspension 100 mg/5ml)< 8 кг - 2.5 мл (50 мг) — 1/2 мерн. ложки 8-14 кг 2.5 мл (100 мг) — 1/2 мерн. ложки 5 мл (100 мг) — 1 мерн. ложки 15-24 кг 5 мл (200 мг) — 1 мерн. ложка 10 мл (200 мг) — 2 мерн. ложки 25-44 кг 6.5 мл (250 мг) — 1 и1/4 мерн. ложки 12.5 мл (250 мг) — 2.5 мерн. ложки
Rules for preparing the suspension
Add water (distilled or boiled and cooled) to the bottle containing the powder to the mark. The contents of the bottle are thoroughly shaken until a homogeneous suspension is obtained. The prepared suspension is stable at room temperature for 5 days.
The suspension should be shaken before use.
Immediately after taking the suspension, the child should be given a few sips of liquid (water, tea) to wash off and swallow the suspension remaining in the mouth.

Side effects of Hemomycin:

From the digestive system: diarrhea (5%), nausea (3%), abdominal pain (3%); 1% or less - dyspepsia, vomiting, flatulence, melena, cholestatic jaundice, increased activity of liver enzymes, in children - constipation, anorexia, gastritis, changes in taste, candidiasis of the oral mucosa.
From the cardiovascular system: palpitations, chest pain (1% or less).
From the central nervous system: dizziness, headache, vertigo, drowsiness; in children - headache (during treatment of otitis media), hyperkinesia, anxiety, neurosis, sleep disturbance (1% or less).
From the reproductive system: vaginal candidiasis.
From the urinary system: nephritis (1% or less).
Allergic reactions: rash, Quincke's edema; in children - conjunctivitis, itching, urticaria.
Other: increased fatigue, photosensitivity.

Contraindications to the drug:

Liver failure;
- renal failure;
- children under 12 years of age (for capsules and tablets);
- children up to 12 months (for a suspension of 200 mg/5 ml);
- children up to 6 months of age (for a suspension of 100 mg/5 ml);
- increased sensitivity to macrolide antibiotics.
The drug should be prescribed with caution during pregnancy, with arrhythmias (possible ventricular arrhythmias and prolongation of the QT interval), and in children with severe impairment of liver or kidney function.

Use during pregnancy and lactation.

During pregnancy, Chemomycin is prescribed only when the expected benefit of therapy for the mother outweighs the potential risk to the fetus.
If it is necessary to use the drug during lactation, the issue of stopping breastfeeding while using the drug should be decided.

Special instructions for the use of Hemomycin.

The drug should not be taken during meals.
It is recommended to maintain an interval of at least 2 hours between taking Hemomycin and antacid medications.
After discontinuation of treatment, hypersensitivity reactions may persist in some patients, which requires specific therapy and medical monitoring.

Drug overdose:

Symptoms: nausea, temporary hearing loss, vomiting, diarrhea.
Treatment: gastric lavage, symptomatic therapy.

Interaction of Hemomycin with other drugs.

With the simultaneous use of Hemomycin and antacids (aluminum- and magnesium-containing), the absorption of azithromycin slows down.
Ethanol and food slow down and reduce the absorption of azithromycin.
When warfarin and azithromycin were co-administered (in usual doses), no changes in prothrombin time were detected, however, given that the interaction of macrolides and warfarin may enhance the anticoagulant effect, patients need careful monitoring of prothrombin time.
The combined use of azithromycin and digoxin increases the concentration of the latter.
With the simultaneous use of azithromycin with ergotamine and dihydroergotamine, an increase in the toxic effect of the latter (vasospasm, dysesthesia) is observed.
Co-administration of triazolam and azithromycin reduces clearance and enhances the pharmacological effect of triazolam.
Azithromycin slows the elimination and increases the plasma concentration and toxicity of cycloserine, indirect anticoagulants, methylprednisolone, felodipine, as well as drugs subject to microsomal oxidation (carbamazepine, terfenadine, cyclosporine, hexobarbital, ergot alkaloids, valproic acid, disopyramide, bromocriptine, phenytoin, oral hypoglycemic ical agents, theophylline and other xanthine derivatives) - due to the inhibition of microsomal oxidation in hepatocytes by azithromycin.
Lincosamines weaken the effectiveness of azithromycin, while tetracycline and chloramphenicol enhance them.
Pharmaceutical interactions
Pharmaceutically, azithromycin is incompatible with heparin.

Terms of sale in pharmacies.

The drug is available with a prescription.

Terms of storage conditions for the drug Hemomycin.

List B. The drug should be stored out of the reach of children, protected from light, at a temperature of 15° to 25°C. Shelf life: 2 years.

Excipients: anhydrous lactose - 163.6 mg* (151.57 mg), corn starch - 47 mg, sodium lauryl sulfate - 0.94 mg, magnesium stearate - 8.46 mg.

* the amount of anhydrous lactose depends on the activity of the active substance.

Shell composition: titanium dioxide (E171) - 1.44 mg, patented blue dye V (E131) - 0.0164 mg, gelatin - up to 96 mg.

6 pcs. - blisters (1) - cardboard packs.

Film-coated tablets grayish-blue, round, biconvex.

1 tab.
azithromycin (dihydrate) 500 mg

Excipients: microcrystalline silicate cellulose - 69 mg, microcrystalline cellulose - 57 mg, sodium carboxymethyl starch (type A) - 46 mg, - 24 mg, magnesium stearate - 10 mg, talc - 10 mg, colloidal silicon dioxide - 1 mg.

Shell composition: titanium dioxide - 10.58 mg, talc - 9.57 mg, copovidone - 4.95 mg, ethylcellulose - 4.95 mg, macrogol 6000 - 1.32 mg, (indigotine) E132 - 1.22 mg, green lacquer dye 8% (indigocarmine (indigotine) E132, quinoline yellow E104) - 0.41 mg.

3 pcs. - blisters (1) - cardboard packs.

Excipients: xanthan gum - 20.846 mg, sodium saccharinate - 4.134 mg, calcium carbonate - 162.503 mg, colloidal silicon dioxide - 26.008 mg, sodium phosphate anhydrous - 17.259 mg, sorbitol - 2145.682 mg, apple flavor - 3.303 mg, strawberry flavor - 8.159 mg, cherry flavor - 12.096 mg.

11.43 g - dark glass bottles (1) complete with a measuring spoon (volume 5 ml, with a line for a volume of 2.5 ml) - cardboard packs.

Powder for suspension for oral administration white or almost white in color, with a fruity odor; the prepared suspension is almost white in color, with a fruity odor.

Excipients: xanthan gum, sodium saccharinate, calcium carbonate, colloidal silicon dioxide, anhydrous sodium phosphate, sorbitol, apple flavor, strawberry flavor, cherry flavor.

10 g - dark glass bottles (1) complete with a measuring spoon (volume 5 ml, with a line for a volume of 2.5 ml) - cardboard packs.

pharmachologic effect

Broad-spectrum antibiotic. Azithromycin is a representative of a subgroup of macrolide antibiotics - azalides. In high concentrations it has a bactericidal effect.

Pharmacokinetics

Suction

Azithromycin is rapidly absorbed from the gastrointestinal tract, due to its stability in an acidic environment and lipophilicity. After oral administration of Chemomycin at a dose of 500 mg, the Cmax of azithromycin in the blood is reached after 2.5-2.96 hours and is 0.4 mg/l. Bioavailability is 37%.

Distribution

Azithromycin penetrates well into the respiratory tract, organs and tissues of the urogenital tract, into the prostate gland, into the skin and soft tissues. High concentration in tissues (10-50 times higher than in blood plasma) and long T1/2 are due to the low binding of azithromycin to plasma proteins, as well as its ability to penetrate eukaryotic cells and concentrate in the low pH environment surrounding lysosomes . This, in turn, determines the large apparent Vd (31.1 l/kg) and high plasma clearance. The ability of azithromycin to accumulate predominantly in lysosomes is especially important for the elimination of intracellular pathogens. It has been proven that phagocytes deliver azithromycin to sites of infection, where it is released during the process of phagocytosis. The concentration of azithromycin in foci of infection is significantly higher than in healthy tissues (on average by 24-34%) and correlates with the degree of inflammatory edema. Despite its high concentration in phagocytes, azithromycin does not have a significant effect on their function.

Azithromycin remains in bactericidal concentrations at the site of inflammation for 5-7 days after taking the last dose, which made it possible to develop short (3-day and 5-day) courses of treatment.

Metabolism

In the liver, azithromycin is demethylated, the resulting metabolites are inactive.

Removal

The elimination of azithromycin from blood plasma occurs in 2 stages: T1/2 is 14-20 hours in the range from 8 to 24 hours after taking the drug and 41 hours in the range from 24 to 72 hours, which allows the drug to be used once a day.

Indications

Infectious and inflammatory diseases caused by microorganisms sensitive to the drug:

  • infections of the upper respiratory tract and ENT organs (tonsillitis, sinusitis, tonsillitis, otitis media);
  • scarlet fever;
  • infections of the lower respiratory tract (bacterial, including those caused by atypical pathogens, pneumonia, bronchitis);
  • infections of the urogenital tract (uncomplicated urethritis and/or cervicitis);
  • infections of the skin and soft tissues (erysipelas, impetigo, secondary infected dermatoses);
  • Lyme disease (borreliosis) for the treatment of the initial stage (erythema migrans);
  • diseases of the stomach and duodenum associated with Helicobacter pylori (as part of combination therapy) (for tablets and capsules).

Contraindications

  • liver failure;
  • renal failure;
  • children under 12 years of age (for capsules and tablets);
  • children up to 12 months (for suspension 200 mg/5 ml);
  • children up to 6 months (for suspension 100 mg/5 ml);
  • hypersensitivity to macrolide antibiotics.

WITH caution the drug should be prescribed during pregnancy, for arrhythmias (possible ventricular arrhythmias and prolongation of the QT interval), for children with severe impairment of liver or kidney function.

Dosage

The drug is taken orally 1 time/day 1 hour before meals or 2 hours after meals, because When taken simultaneously with food, the absorption of azithromycin is reduced.

If you miss one dose of the drug, it should be taken as soon as possible, and subsequent doses should be taken at intervals of 24 hours.

Capsules

For adults at Chemomycin is prescribed 500 mg (2 capsules) per day for 3 days; course dose - 1.5 g.

At Prescribe 1 g (4 caps.) on the 1st day, then 500 mg (2 caps.) daily from 2 to 5 days; course dose - 3 g.

At Prescribe 1 g (4 caps.) once.

At Lyme disease(borreliosis) for the treatment of the initial stage (erythema migrans) is prescribed 1 g (4 capsules) on the 1st day and 500 mg (2 capsules) daily from the 2nd to the 5th day (course dose - 3 g).

At , prescribed 1 g (4 caps.) per day for 3 days as part of combined anti-Helicobacter therapy.

Children over 12 years old at infections of the upper and lower respiratory tract, skin and soft tissues the drug is prescribed at the rate of 10 mg/kg 1 time/day for 3 days (course dose - 30 mg/kg) or on the first day - 10 mg/kg, then 4 days - 5-10 mg/kg/day.

At treatment of erythema migrans- 20 mg/kg on the first day and 10 mg/kg from days 2 to 5.

Pills

Adults and children over 12 years old at infections of the upper and lower respiratory tract prescribed 500 mg/day for 3 days; course dose - 1.5 g.

At skin and soft tissue infections Prescribe 1 g/day on the first day, then 500 mg daily from days 2 to 5; course dose - 3 g.

At acute uncomplicated urethritis or cervicitis prescribed once in a dose of 1 g.

At Lyme disease(borreliosis) for the treatment of the initial stage (erythema migrans) the drug is prescribed in a dose of 1 g on the 1st day and 500 mg daily from the 2nd to the 5th day; course dose - 3 g.

At diseases of the stomach and duodenum associated with Helicobacter pylori, prescribed 1 g/day for 3 days as part of combined anti-Helicobacter therapy.

Suspension 200 mg/5 ml and 100 mg/5 ml

U children over 12 months a suspension of 200 mg/5 ml is used, children over 6 months- suspension 100 mg/5 ml.

For children at infections of the upper and lower respiratory tract, skin and soft tissue infections(with the exception of chronic migratory erythema) Chemomycin in the form of a suspension is prescribed at the rate of 10 mg/kg body weight 1 time/day for 3 days (course dose - 30 mg/kg).

For adults at infections of the upper and lower respiratory tract prescribed 500 mg 1 time/day for 3 days; course dose - 1.5 g.

At infections of the urogenital tract the drug is prescribed adults in a dose of 1 g once; children under 8 years old with body weight over 45 kg- 10 mg/kg once.

At chronic migratory erythema prescribed 1 time/day for 5 days: adults- 1 g/day on the 1st day for 1 dose, then 500 mg/day daily from days 2 to 5, course dose - 3 g; children- on day 1 at a dose of 20 mg/kg body weight, then from days 2 to 5 - 10 mg/kg body weight.

1st day

2-5th day

Rules for preparing the suspension

Water (distilled or boiled and cooled) is gradually added to the bottle containing the powder until the mark is reached. The contents of the bottle are thoroughly shaken until a homogeneous suspension is obtained.

If the level of the prepared suspension is below the mark on the bottle label, add water again to the mark and shake.

The prepared suspension is stable at room temperature for 5 days.

The suspension should be shaken before use.

Immediately after taking the suspension, the child should be given a few sips of liquid (water, tea) to wash off and swallow the suspension remaining in the mouth.

Side effects

From the digestive system: diarrhea (5%), nausea (3%), abdominal pain (3%); 1% or less - dyspepsia, vomiting, flatulence, melena, cholestatic jaundice, increased activity of liver enzymes, in children - constipation, anorexia, gastritis.

From the cardiovascular system: palpitations, chest pain (1% or less).

From the side of the central nervous system: dizziness, headache, vertigo, drowsiness; in children - headache (during treatment of otitis media), hyperkinesia, anxiety, neurosis, sleep disturbance (1% or less).

From the reproductive system: vaginal candidiasis.

From the urinary system: jade (1% or less).

Allergic reactions: rash, Quincke's edema; in children - conjunctivitis, itching, urticaria.

Other: increased fatigue, photosensitivity.

Overdose

Symptoms: nausea, temporary hearing loss, vomiting, diarrhea.

Treatment: gastric lavage, symptomatic therapy.

Drug interactions

With the simultaneous use of Hemomycin and antacids (aluminum- and magnesium-containing), the absorption of azithromycin slows down.

Ethanol and food slow down and reduce the absorption of azithromycin.

When warfarin and azithromycin were co-administered (in usual doses), no changes in prothrombin time were detected, however, given that the interaction of macrolides and warfarin may enhance the anticoagulant effect, patients need careful monitoring of prothrombin time.

The combined use of azithromycin and digoxin increases the concentration of the latter.

With the simultaneous use of azithromycin with ergotamine and dihydroergotamine, an increase in the toxic effect of the latter (vasospasm, dysesthesia) is observed.

Co-administration of triazolam and azithromycin reduces clearance and enhances the pharmacological effect of triazolam.

Azithromycin slows the elimination and increases the plasma concentration and toxicity of cycloserine, indirect anticoagulants, methylprednisolone, felodipine, as well as drugs subject to microsomal oxidation (carbamazepine, terfenadine, cyclosporine, hexobarbital, ergot alkaloids, disopyramide, bromocriptine, phenytoin, oral hypoglycemic agents, theophylline and other xanthine derivatives) - due to the inhibition of microsomal oxidation in hepatocytes by azithromycin.

Lincosamines weaken the effectiveness of azithromycin, while tetracycline and chloramphenicol enhance them.

Pharmaceutical interactions

Pharmaceutically, azithromycin is incompatible with heparin.

special instructions

The drug should not be taken during meals.

After discontinuation of treatment, hypersensitivity reactions may persist in some patients, which requires specific therapy and medical monitoring.

Pregnancy and lactation

During pregnancy, Chemomycin is prescribed only when the expected benefit of therapy for the mother outweighs the potential risk to the fetus.

If it is necessary to use the drug during lactation, the issue of stopping breastfeeding while using the drug should be decided.

Caution is required when prescribing the drug to patients with severe liver dysfunction (especially children). Contraindicated in liver failure.

Conditions for dispensing from pharmacies

The drug is available with a prescription.

Storage conditions and periods

List B. The drug should be stored out of the reach of children, protected from light, at a temperature of 15° to 25°C. Shelf life for tablets and powder is 2 years; for capsules - 3 years.

After oral administration, the therapeutic effect is observed within a few hours. The highest concentrations are recorded precisely at the site of inflammation. Available in several dosage forms. Can be used in pediatrics.

Dosage form

Chemomycin is a drug that has a pronounced bacteriostatic effect. By influencing microorganisms, the drug effectively fights many infections. The drug is available in several dosage forms. Highlight:

  1. Capsules – hard, gelatin. They are light blue in color and size #0. The capsules contain white powder.
  2. Tablets are round, biconvex. On top they are covered with a film shell, which has a grayish-blue color.
  3. Powder for preparing a suspension. Available in bottles. A measuring spoon is included with the medicine.
  4. Solution for infusion. Contained in a bottle. The medicine is packed in a cardboard box.

Dosage forms intended for oral administration are available in blisters of 3 or 6 tablets or capsules, respectively. The medicine is placed in a cardboard box in which it is sold. In addition to the blister, the package contains instructions for use of the drug. All dosage forms of the drug are supplemented by instructions.

Description and composition

The main active ingredient of the drug is. By influencing pathogenic microorganisms, it stimulates the termination of protein synthesis in the cell. This results in the microbe being unable to grow and reproduce. If the product is used in high doses, it destroys bacteria.

Additional components of the product depend on the dosage form in which the drug is produced:

  1. The capsules contain anhydrous lactose, corn starch, sodium lauryl sulfate, magnesium stearate.
  2. In tablets - microcrystalline silicate cellulose, microcrystalline cellulose, sodium carboxymethyl starch, povidone, magnesium stearate, talc, colloidal silicon dioxide.
  3. Powder for preparing the suspension - xanthan gum, sodium saccharinate, calcium carbonate, colloidal silicon dioxide, anhydrous sodium phosphate, sorbitol, apple flavor, strawberry flavor, cherry flavor.

A whole list of microorganisms are sensitive to the drug. The list includes:

  • staphylococci;
  • gonococci;
  • streptococci;
  • meningococci;
  • listeria.

The drug has an effect on intrapulmonary microorganisms that cause atypical symptoms. If the virus is resistant to, it will also be resistant to Hemomycin. The drug is capable of destroying intracellular pathogens, as well as Haemophilus influenzae.

The drug is well absorbed in the digestive tract. After taking the drug, its maximum concentration in the blood will be observed after 3 hours. The drug has high permeability. It easily enters the tissues of the respiratory and genitourinary systems. Macrophages capture the active substance of the drug and deliver it directly to the site of inflammation. There the active substances are released.

Metabolization of 3 parts of the drug occurs in the liver. The remaining amount of the drug is excreted unchanged along with urine and bile. The action takes place within 3 days after consumption.

Pharmacological group

The drug is an antibiotic of the macrolide group - azalide.

Indications for use

for adults

Hemomycin can help with a whole list of diseases:

  • Lyme disease;
  • skin infections;
  • upper and lower respiratory tract infections;
  • sinusitis;
  • stomach diseases caused by viruses;
  • soft tissue infections;
  • chlamydia;
  • mycoplasmosis;

for children

Chemomycin is actively used in pediatrics. It can be used after the child reaches 6 months of age. The drug is prescribed for diseases that are caused by bacteria that are sensitive to the drug.

In childhood, only suspensions are used. Medicine in the form of tablets or capsules can only be prescribed to patients over 12 years of age.

Use of the drug during pregnancy is permitted, but with extreme caution. The harm and benefits of the medicine are taken into account. If the use of the drug is necessary during lactation, breastfeeding is interrupted. The drug is prescribed in the presence of diseases caused by bacteria sensitive to the drug.

Contraindications

The use of the product is strictly contraindicated in the following situations:

  • in the presence of liver and kidney failure;
  • during lactation;
  • there is increased sensitivity to macrolides;
  • for serious arrhythmias.

Taking tablets and capsules is allowed only from 12 years of age. The suspension can be used by children aged 6 months.

Applications and dosages

for adults

The dosage of the drug depends on the problem for which it is prescribed. If the product is used:

  1. To combat microorganisms in peptic ulcers and chronic gastritis, you need to take 1 g of the drug every day. The duration of treatment is 3 days.
  2. For respiratory tract infections, you need to take 1 tablet or 2 capsules once a day. The duration of treatment is 3-6 days and depends on the severity of the disease.
  3. For treatment, the drug is used intravenously. The procedure is repeated for several days at the beginning of treatment, and then extended to 10 days. At the end of treatment, tablets or capsules are used.
  4. For severe pelvic infections, the drug is prescribed as part of a complex treatment. In this case, 500 mg of the substance is administered intravenously.
  5. If you are fighting uncomplicated urethritis or urethritis, prescribe 2 tablets or 4 capsules of the drug. The reception is performed once and is not repeated.

for children

Age restrictions in childhood directly depend on the dosage form of the drug. The suspension is allowed to be used from 6 months, and tablets and capsules - from 12 years. The dose is determined taking into account the child’s weight and diagnosis. If the drug is prescribed to combat:

  1. For pathologies of the urinary system, the dose should be 10 mg/kg body weight. Admission is carried out once.
  2. For infections of the respiratory system and diseases of the ENT organs, you need to take 10 mg/kg of body weight per day. The duration of the course is 3 days.
  3. For skin diseases, on the first day a medication is prescribed at the rate of 20 mg/kg of the child’s weight. In the next 4 days, the dose is reduced to 10 mg/kg of the child’s weight.

If the child weighs more than 45 kg, an adult dose is prescribed.

for pregnant women and during lactation

Taking the drug during pregnancy is possible only in extreme cases. The dose of the medicine and the specifics of its administration are determined by the doctor. Self-prescription of medication is strictly not recommended.

Side effects

Chemomycin is considered one of the most toxic antibiotics. Its use causes a whole list of side effects. After using the product, the patient may experience the following symptoms:

  1. From the nervous system - irritability, dizziness, anxiety, excitability or lethargy, sleep disturbances, headache.
  2. On the skin – dermatitis, itching.
  3. From the eyes - Quincke's edema, conjunctivitis, anaphylaxis (in rare cases).
  4. From the gastrointestinal tract - loss of appetite, appearance of nausea, constipation, diarrhea, flatulence.
  5. From the liver - due to stagnation of bile, jaundice may occur.

Sometimes fungal diseases of the mucous membranes occur. The drug has photosensitizing activity. While consuming it, experts advise staying away from direct sunlight.

Interaction with other drugs

Mix the drug with other medications with caution. Thus, during the course of treatment the consumption of alcohol and alcohol is strictly prohibited. If you use antacids, their effects will reduce the activity of the drug. The drug can enhance the effect of sulfonamides, tetracyclines and streptomycin. The medication increases concentration:

  • lovastatin;
  • cyclosporines;
  • theophylline;
  • hexobarbital;
  • valproic acid;
  • felodipine;
  • phenytoin;
  • bromocriptine;
  • oral hypoglycemic drugs.

If you use Hemomycin together with Triazolam and Midazolam, it will delay their removal from the body. When using the drug with Diergotamine and Ergotamine, severe vasospasm and sensitivity disorders may occur.

The possibility of using Hemomycin together with other drugs should be determined by a doctor.

special instructions

The drug should not be taken with food. It is better to perform the action before or after eating.

Hypersensitivity reactions may persist in some patients after treatment has been discontinued. Its presence requires specific therapy and medical monitoring.

Overdose

Exceeding the prescribed dose may cause an overdose. The condition has the following symptoms:

  • temporary hearing loss;
  • diarrhea;
  • nausea.

If symptoms of drug overdose are observed, gastric lavage is performed. If indicated, symptomatic therapy is carried out.

Storage conditions

The drug is released strictly according to prescription. The product can be stored for 2 years in the form of powder or tablets and for 3 years in the form of capsules.

The medication should be kept out of the reach of children. It is necessary to ensure that it is not exposed to direct sunlight. It is better to store the medicine in a dark place at a temperature of 15 to 25 degrees Celsius.

Analogs

There are many analogues of Hemomycin on sale:

  1. is an original medicine based on , which has proven its effectiveness in clinical trials and laboratory studies. The drug is produced in dispersed and regular tablets, capsules, granules for the preparation of a suspension for oral administration, and a lyophilisate from which an infusion solution is made. This diversity allows you to select the optimal dosage form for use in all categories of patients, including children, pregnant and lactating women.
  2. belongs to macrolide antibiotics and is a substitute for Hemomycin in the clinical and pharmacological group. It is available in tablets, lyophilisate for preparing a solution for injection into a vein, external and ophthalmic ointment. The drug can be used in pediatric practice and for the treatment of pregnant women.
  3. is a substitute for Hemomycin in the therapeutic group. The drug is produced in tablets (they can be prescribed to children from 3 years of age) and granules for making an oral suspension, which can be given from birth. The medication can be used according to strict indications throughout pregnancy.
  4. belongs to the tetracycline group of antibiotics. It has a wide spectrum of antimicrobial activity. Capsules are allowed to be used for infectious diseases by children over 12 years of age, injection forms are allowed from 8 years of age. An antibiotic should not be prescribed to pregnant women, as it may cause problems.

Drug price

The cost of Hemomycin is on average 228 rubles. Prices range from 111 to 346 rubles.

Name:

Hemomycin

Pharmacological
action:

Broad spectrum antibiotic. Azithromycin is a representative of a subgroup of macrolide antibiotics - azalides. In high concentrations it has a bactericidal effect.
Chemomycin is active against aerobic gram-positive bacteria: Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus spp. groups C, F and G, Streptococcus viridans, Staphylococcus aureus; aerobic gram-negative bacteria: Haemophilus influenzae, Moraxella catarrhalis, Bordetella pertussis, Bordetella parapertussis, Legionella pneumophila, Haemophilus ducreyi, Helicobacter pylori, Campylobacter jejuni, Neisseria gonorrhoeae and Gardnerella vaginalis; anaerobic bacteria: Bacteroides bivius, Clostridium perfringens, Peptostreptococcus spp.
The drug is active against intracellular microorganisms: Chlamydia trachomatis, Mycoplasma pneumoniae, Ureaplasma urealyticum, Borrelia burgdorferi, as well as against Treponema pallidum.
Gram-positive bacteria that are resistant to erythromycin are resistant to the drug.

Pharmacokinetics
Suction
Azithromycin is rapidly absorbed from the gastrointestinal tract, due to its stability in an acidic environment and lipophilicity.
After oral administration of Chemomycin at a dose of 500 mg, the Cmax of azithromycin in the blood plasma is reached after 2.5-2.96 hours and is 0.4 mg/l. Bioavailability is 37%.
Distribution
Azithromycin penetrates well into the respiratory tract, organs and tissues of the urogenital tract, into the prostate gland, into the skin and soft tissues.
The high concentration in tissues (10-50 times higher than in blood plasma) and long T1/2 are due to the low binding of azithromycin to plasma proteins, as well as its ability to penetrate eukaryotic cells and concentrate in the low pH environment surrounding lysosomes. This, in turn, determines the large apparent Vd (31.1 l/kg) and high plasma clearance.
The ability of azithromycin to accumulate predominantly in lysosomes is especially important for the elimination of intracellular pathogens.
It has been proven that phagocytes deliver azithromycin to sites of infection, where it is released during the process of phagocytosis. The concentration of azithromycin in foci of infection is significantly higher than in healthy tissues (on average by 24-34%) and correlates with the degree of inflammatory edema.
Despite its high concentration in phagocytes, azithromycin does not have a significant effect on their function.
Azithromycin remains in bactericidal concentrations at the site of inflammation for 5-7 days after taking the last dose, which made it possible to develop short (3-day and 5-day) courses of treatment.

Metabolism
In the liver, azithromycin is demethylated, the resulting metabolites are inactive.
Removal
The elimination of azithromycin from blood plasma occurs in 2 stages: T1/2 is 14-20 hours in the range from 8 to 24 hours after taking the drug and 41 hours in the range from 24 to 72 hours, which allows the drug to be used once a day.

Indications for
application:

Infectious and inflammatory diseases caused by microorganisms sensitive to the drug:
- infections of the upper respiratory tract and ENT organs (tonsillitis, sinusitis, tonsillitis, otitis media);
- scarlet fever;
- infections of the lower respiratory tract (bacterial, including those caused by atypical pathogens, pneumonia, bronchitis);
- infections of the urogenital tract (uncomplicated urethritis and/or cervicitis);
- infections of the skin and soft tissues (erysipelas, impetigo, secondary infected dermatoses);
- Lyme disease (borreliosis) for the treatment of the initial stage (erythema migrans);
- diseases of the stomach and duodenum associated with Helicobacter pylori (as part of combination therapy) (for tablets and capsules).

Mode of application:

The drug is taken orally 1 time/day 1 hour before meals or 2 hours after meals, because When taken simultaneously with food, the absorption of azithromycin is reduced.
If you miss one dose of the drug, it should be taken as soon as possible, and subsequent doses should be taken at intervals of 24 hours.
Capsules
For adults with infections of the upper and lower respiratory tract, Hemomycin is prescribed 500 mg (2 caps.) per day for 3 days; course dose - 1.5 g.
For infections of the skin and soft tissues, 1 g (4 caps.) is prescribed on the 1st day, then 500 mg (2 caps.) daily from days 2 to 5; course dose - 3 g.
For acute uncomplicated urethritis or cervicitis, a single dose of 1 g (4 caps.) is prescribed.
For Lyme disease (borreliosis), for the treatment of the initial stage (erythema migrans), 1 g (4 capsules) is prescribed on the 1st day and 500 mg (2 capsules) daily from the 2nd to the 5th day (course dose - 3 G).
For diseases of the stomach and duodenum associated with Helicobacter pylori, 1 g (4 capsules) per day is prescribed for 3 days as part of combined anti-Helicobacter pylori therapy.
For children over 12 years of age with infections of the upper and lower respiratory tract, skin and soft tissues, the drug is prescribed at the rate of 10 mg/kg 1 time/day for 3 days (course dose - 30 mg/kg) or on the first day - 10 mg/kg kg, then 4 days - 5-10 mg/kg/day.
When treating erythema migrans - 20 mg/kg on the first day and 10 mg/kg from days 2 to 5.

Pills
For adults and children over 12 years of age, for infections of the upper and lower respiratory tract, 500 mg/day is prescribed for 3 days; course dose - 1.5 g.
For infections of the skin and soft tissues, 1 g/day is prescribed on the first day, then 500 mg daily from days 2 to 5; course dose - 3 g.
For acute uncomplicated urethritis or cervicitis, a single dose of 1 g is prescribed.
For Lyme disease (borreliosis) for the treatment of the initial stage (erythema migrans), the drug is prescribed at a dose of 1 g on the 1st day and 500 mg daily from the 2nd to the 5th day; course dose - 3 g.
For diseases of the stomach and duodenum associated with Helicobacter pylori, 1 g/day is prescribed for 3 days as part of combination anti-Helicobacter pylori therapy.

Suspension 200 mg/5 ml and 100 mg/5 ml
For children over 12 months, a suspension of 200 mg/5 ml is used, for children over 6 months, a suspension of 100 mg/5 ml is used.
For children with infections of the upper and lower respiratory tract, infections of the skin and soft tissues (with the exception of chronic migratory erythema), Chemomycin in the form of a suspension is prescribed at the rate of 10 mg/kg body weight 1 time/day for 3 days (course dose - 30 mg/kg body weight). kg).
For children under 12 years of age, use a special scheme to determine the required dosage:
- Body weight (kg): 10-14. The daily dose is 100 mg, the required number of measuring spoons (100 mg / 200 mg) is 1 measuring spoon of a suspension of 100 mg / 5 ml or 0.5 spoons of a suspension of 200 mg / 5 ml.
- Body weight (kg): 15-25. The daily dose is 200 mg, the required number of measuring spoons (100 mg / 200 mg) is 2 tablespoons of a suspension of 100 mg / 5 ml or 1 measuring spoon of a suspension of 200 mg / 5 ml.
- Body weight (kg): 26-35. Daily dose 300 mg, 3 spoons of suspension of 100 mg/5 ml or 1.5 spoons of suspension of 200 mg/5 ml.
- Body weight (kg): 36-45. Daily dose 400 mg, 4 scoops of suspension 100 mg / 5 ml or 2 scoops of suspension 200 mg / 5 ml.
- Body weight (kg): more than 45. Adult dosages are prescribed. Adult dosage forms are prescribed.

Adults with infections of the upper and lower respiratory tract are prescribed 500 mg 1 time / day for 3 days; course dose - 1.5 g.
For infections of the urogenital tract, the drug is prescribed to adults in a dose of 1 g once; children under 8 years of age with a body weight of more than 45 kg - 10 mg/kg once.
For chronic migratory erythema, it is prescribed 1 time/day for 5 days: adults - 1 g/day on the 1st day for 1 dose, then 500 mg/day daily from days 2 to 5, course dose - 3 g; children - on the 1st day at a dose of 20 mg/kg body weight, then from the 2nd to the 5th day - 10 mg/kg body weight.

Rules for preparing the suspension
Water (distilled or boiled and cooled) is gradually added to the bottle containing the powder until the mark is reached. The contents of the bottle are thoroughly shaken until a homogeneous suspension is obtained.
If the level of the prepared suspension is below the mark on the bottle label, add water again to the mark and shake.
The prepared suspension is stable at room temperature for 5 days.
The suspension should be shaken before use.
Immediately after taking the suspension, the child should be given a few sips of liquid (water, tea) to wash off and swallow the suspension remaining in the mouth.

Side effects:

Most mild to moderate adverse reactions are reversible after discontinuation of Hemomycin.
From the side of the central nervous system
Uncommon: dizziness, drowsiness, headache, convulsions, taste disturbance, syncope.
Rarely - insomnia, hyperactivity, increased fatigue, paresthesia, asthenia.
Mental disorders
Rarely - aggressiveness, agitation, anxiety and nervousness.
From the side of the hearing organ
Rarely, macrolide antibiotics may cause hearing loss. Hearing impairment, deafness, and ringing in the ears have been reported in some patients treated with azithromycin. Most of these cases are associated with experimental studies in which azithromycin was used in high doses for an extended period. According to research reports, in most cases the disorders were reversible.
From the cardiovascular system
Rarely - hypertension, tachycardia, arrhythmia, including ventricular tachycardia (which was observed with the use of other macrolides). Increased QT interval and arrhythmia such as torsades de pointes.

From the gastrointestinal tract
Often - nausea, vomiting, diarrhea, abdominal pain.
Uncommon: loose stools, flatulence, indigestion, anorexia, dyspepsia.
Rarely - constipation, discoloration of the tongue, pancreatitis. Cases of pseudomembranous colitis were recorded.
From the hepatobiliary system
Rarely - hepatitis and cholestatic jaundice.
Very rarely - hepatic necrosis, liver failure.
From the skin and subcutaneous tissue
Uncommon: itching, rash.
Rarely - angioedema, urticaria, photosensitivity, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis.
From the musculoskeletal system
Uncommon: arthralgia.

From the blood and lymphatic system
Uncommon: neutropenia.
Rarely - neutrophilia, eosinophilia, thrombocytopenia.
From the urinary system
Rarely - interstitial nephritis, acute renal failure.
From the reproductive system
Uncommon: vaginitis.
Changes in laboratory parameters
Increased levels of AST, ALT, creatinine, LDH, bilirubin and alkaline phosphatase. Such pathological changes in laboratory parameters are reversible and return to normal after discontinuation of the drug. Most mild to moderate adverse reactions are reversible after discontinuation of Hemomycin.

Contraindications:

Liver failure;
- renal failure;
- children under 12 years of age (for capsules and tablets);
- children up to 12 months (for suspension 200 mg/5 ml);
- children up to 6 months of age (for a suspension of 100 mg/5 ml);
- increased sensitivity to macrolide antibiotics.
Carefully the drug should be prescribed during pregnancy, for arrhythmias (ventricular arrhythmias and prolongation of the QT interval are possible), when prescribing the drug to patients with severe impairment of liver or kidney function (especially children).

In patients with mild to moderate hepatic impairment, no dose adjustment is necessary. However, since the liver is the main route of elimination of azithromycin, caution should be exercised when prescribing azithromycin to patients with liver failure or when used concomitantly with hepatotoxic substances.
Azithromycin is not prescribed to patients with severe liver failure.
In patients treated with azithromycin, Severe allergic reactions may rarely occur such as: angioedema, anaphylactic reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis.
If such reactions occur, use of the drug should be stopped and symptomatic treatment prescribed. In some patients, symptoms of allergic reactions may reappear as soon as symptomatic therapy is stopped, even without further use of azithromycin. Such patients require long-term observation and symptomatic treatment.

Oral use of Azithromycin not advisable in patients with severe forms of pneumonia or with risk factors such as cystic fibrosis, hospital-acquired infection, suspected bacteremia, elderly patients or patients with severe pathological conditions (immunodeficiencies or functional asplenia).
As with the use of other antibiotics, constant monitoring of the patient is recommended due to the possible development of superinfection caused by resistant microorganisms, including fungi.
Prescription of other macrolide antibiotics can cause prolongation of the repolarization phase and QT interval, which is a risk factor for the development of arrhythmias and torsades de pointes. A similar effect may occur when azithromycin is administered to patients at increased risk of QT prolongation.

The drug should not be taken during meals.
It is recommended to maintain an interval of at least 2 hours between taking Hemomycin and antacid medications.
Hemomycin should not be taken with alcohol. After the child has swallowed the suspension, it is imperative to give him a few sips of water (this will reduce the likelihood of developing oral candidiasis).
After discontinuation of treatment, hypersensitivity reactions may persist in some patients, which requires specific therapy and medical monitoring.
The ability to influence reaction speed when driving vehicles or operating machinery.
There is no evidence that Hemomycin affects the ability to drive vehicles and other mechanisms. But if adverse reactions from the central nervous system (drowsiness, dizziness) occur, it is recommended to refrain from driving vehicles and operating machinery.

Interaction
other medicinal
by other means:

Concomitant use of azithromycin with antacids does not affect the bioavailability of azithromycin however, the Cmax of azithromycin in blood plasma is reduced by 30%. Therefore, Hemomycin should be taken 1 hour before or 2 hours after using antacids.
Most of the interactions that are possible with macrolide antibiotics (for example, erythromycin, clarithromycin) have not yet been described with azithromycin.
It is assumed that azithromycin does not affect the cytochrome P450 enzyme system and therefore there is no indirect interaction with drugs through this system.
But it must be borne in mind that azithromycin and other macrolide antibiotics have similar pharmacological effects and the possibility of a similar interaction cannot be ruled out. Patients using azithromycin simultaneously with digoxin, ergotamine or dihydroergotamine and with drugs that are metabolized by the CYP isoenzyme (cyclosporine, hexobarbital, terfenadine and phenytoin) require constant monitoring, since this increases the concentration of these drugs in the blood plasma, as well as the risk of developing side effects of these drugs drugs.
Such interactions have not been reported with azithromycin, but have been reported with other macrolide antibiotics.
Monitoring of prothrombin time is recommended in all patients using azithromycin concomitantly with warfarin. Clinical practice has shown that the simultaneous use of macrolide antibiotics and warfarin was associated with an increase in the anticoagulant effect.

Azithromycin has little effect on the pharmacokinetics of atorvastatin, and therefore no dose adjustment is required. However, in patients with long-term use of lovastatin, the use of oral azithromycin (250 mg for 5 days) may accelerate the development of rhabdomyolysis.
Concomitant use of azithromycin and nelfinavir increases the concentration of azithromycin in blood plasma.
Although no dose adjustment of azithromycin is necessary, patients require constant monitoring to prevent the development of side effects of azithromycin, such as abnormal liver enzymes or hearing impairment.
When used in therapeutic doses, azithromycin has minimal effect on the pharmacokinetics of the following drugs: indinavir, zidovudine, didanosine, triazolam, midazolam, carbamazepine, cetirizine, trimethoprim, sulfamethoxazole, fluconazole, rifabutin, sildenafil and theophylline. The simultaneous use of efavirenz or fluconazole with azithromycin has a minor effect on the pharmacokinetics of azithromycin and does not require dose adjustment.
Antibiotics of the macrolide group may inhibit the metabolism of pimozide, which increases the plasma concentration of unchanged pimozide.
Since such disturbances in the pharmacokinetics of pimozide may cause QT and QTc prolongation, pimozide should not be co-administered with macrolide antibiotics.
Prescribe azithromycin with caution to patients taking other drugs that may prolong the QT interval (quinidine, cyclophosphamide, cisapride, ketoconazole, terfenadine, haloperidol, lithium).

Pregnancy:

During pregnancy, Chemomycin is prescribed only when the expected benefit of therapy for the mother outweighs the potential risk to the fetus.
If it is necessary to use the drug during lactation, the issue of stopping breastfeeding while using the drug should be decided.

Overdose:

Symptoms: nausea, temporary hearing loss, vomiting, diarrhea.
Treatment: gastric lavage, symptomatic therapy.

Release form:

Hemomycin capsules hard gelatin, light blue, size No. 0; contents of capsules - white powder, 6 pcs. in a blister.
Hemomycin tablets, covered with a film shell of a grayish-blue color, round, biconvex, 3 pcs. in a blister.
Hemomycin powder for the preparation of suspension for oral administration 100 mg/5 ml and 200 mg/5 ml white or almost white in color, with a fruity odor; the prepared suspension is almost white in color, with a fruity smell in a bottle complete with a measuring spoon.

Storage conditions:

The drug should be stored out of the reach of children, protected from light, at a temperature of 15° to 25°C.
Shelf life for tablets and powder is 2 years; for capsules - 3 years.

1 capsule Hemomycin contains:
- active ingredient: azithromycin dihydrate - 262.03 mg, which corresponds to the content of azithromycin - 250 mg;
- excipients: anhydrous lactose - 163.6 mg (151.57 mg), corn starch - 47 mg, sodium lauryl sulfate - 0.94 mg, magnesium stearate - 8.46 mg.

1 tablet Hemomycin contains:
- active ingredient: azithromycin (in the form of dihydrate) - 500 mg;
- excipients: microcrystalline silicate cellulose - 69 mg, microcrystalline cellulose - 57 mg, sodium carboxymethyl starch (type A) - 46 mg, povidone - 24 mg, magnesium stearate - 10 mg, talc - 10 mg, colloidal silicon dioxide - 1 mg.

5 ml of ready-made Hemomycin suspension(from 100 mg/5 ml powder) contains:
- active ingredient: azithromycin dihydrate - 104.809 mg, which corresponds to the content of azithromycin - 100 mg;
- excipients: xanthan gum - 20.846 mg, sodium saccharinate - 4.134 mg, calcium carbonate - 162.503 mg, colloidal silicon dioxide - 26.008 mg, sodium phosphate anhydrous - 17.259 mg, sorbitol - 2145.682 mg, apple flavor - 3.303 mg, strawberry flavor - 8.159 mg, cherry flavor - 12.096 mg.

Antibiotics - macrolides and azalides.

Composition Hemomycin

The active substance is azithromycin.

Manufacturers

Hemofarm A.D. (Serbia)

pharmachologic effect

Pharmacological action - antibacterial.

Suppresses protein biosynthesis, slowing down the growth and reproduction of bacteria; at high concentrations, a bactericidal effect is possible. Stable in an acidic environment, lipophilic, quickly absorbed from the gastrointestinal tract.

The maximum concentration is created after 2-3 hours, the half-life is 68 hours.

Stable plasma levels are achieved after 5-7 days.

Easily passes histohematic barriers and enters tissues.

Concentrations in tissues and cells are 10-50 times higher than in plasma, and at the site of infection they are 24-34% higher than in healthy tissues.

A high level (antibacterial) remains in tissues for 5-7 days after the last injection.

Excreted unchanged in bile (50%) and in urine (6%). The spectrum of action is wide and includes gram-positive (Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus pyogenes, streptococci of groups C, F, G, Streptococcus viridans ), except those resistant to erythromycin, and gram-negative (Haemophilus influenzae, Moraxella catarrhalis, Bordetella pertussis, Bordetella parapertussis, Campylobacter jejuni, Legionella pneumophila, Neisseria gonorrhoeae, Gardnerella vaginalis) microorganisms, anaerobes (Bacteroides bivius, Peptostreptococcus spp., , Clostridium perfringens) , chlamydia (Chlamydia trachomatis, Chlamydia pneumoniae), mycobacteria (Mycobacteria avium complex), mycoplasma (Mycoplasma pneumoniae), ureoplasma (Ureaplasma urealyticum), spirochetes (Treponema pallidum, Borrelia burgdorferi).

Side effects Hemomycin

Nausea, vomiting, abdominal pain, constipation, flatulence, diarrhea, melena, cholestatic jaundice, chest pain, palpitations, weakness, drowsiness, headache, dizziness, nephritis, vaginitis, candidiasis, neutropenia or neutrophilia, pseudomembranous colitis, photosensitivity, rash , angioedema, eosinophilia; in children, in addition, hyperkinesia, agitation, nervousness, insomnia, conjunctivitis.

Indications for use

Infections of the upper and lower respiratory tract (streptococcal pharyngitis and tonsillitis, bacterial exacerbation of chronic obstructive pneumonia, interstitial and alveolar pneumonia, bacterial bronchitis), ENT organs (otitis media, laryngitis and sinusitis), genitourinary system (urethritis and cervicitis), skin and soft tissues (erysipelas, impetigo, secondary infected dermatoses), chronic stage of erythema migrans (Lyme disease).

Contraindications Chemomycin

Hypersensitivity to macrolides, severe liver dysfunction, pregnancy, lactation.

Directions for use and dosage

The drug is taken orally 1 time / 1 hour before meals or 2 hours after meals, because When taken simultaneously with food, the absorption of azithromycin is reduced.

If you miss one dose of the drug, it should be taken as soon as possible, and subsequent doses should be taken at intervals of 24 hours.

Overdose

No information available.

Interaction

special instructions

Use with caution in cases of severe dysfunction of the liver, kidneys, and cardiac arrhythmias.

After discontinuation of treatment, hypersensitivity reactions may persist in some patients, which requires specific therapy under medical supervision.

Storage conditions

List B.

Store in a dry place, protected from light, at room temperature, out of the reach of children.