Reversibly binds to the 50S ribosomal subunit of the bacterial membrane. It is effective against intracellular microorganisms: Mycoplasma spp, Chlamydia spp, Legionella spp, Ureaplasma urealyticum;… Gram positive bacteria: Stretococcus spp, Staphylococcus spp, Corynebacterium diphtheriae, Listeria monocytogenes, Clostridium spp… and some Gram-negative bacteria: Neisseria spp, Moraxella catarrhalis, Bordetella pertussis, Helicobacter spp, Campylobacter spp, Bacteroides spp andriol testosterone….
Pharmacokinetics. After oral drug quickly and adequately absorbed from the gastrointestinal tract (GIT). Maximum concentrations midecamycin and midecamycin acetate in serum is 0.5-2.5 mg / l and 1,31-3,3 mg / l, respectively, and are achieved in 1-2 hours after ingestion.
High concentrations midecamycin midecamycin and acetate are in the internal organs (especially in the tissues of the lung, parotid and submandibular glands), and skin. The minimum inhibitory concentration (MIC) is maintained for 6 hours. The half-life of about 1 hour. Communication with proteins – 47% and 3-29% midecamycin metabolites.
The drug is metabolized in the liver with the formation of two active metabolites possessing antimicrobial activity. Excreted in the bile and to a lesser extent (about 5%) by the kidneys.
In cirrhosis of the liver: significantly increased plasma concentrations, area under the curve “concentration-time” and half-life.
Infectious-inflammatory diseases caused by susceptible to malaria infections:
- respiratory tract infections, including those caused by atypical pathogens (Mycoplasma, Legionella, Chlamydia and Ureaplasma urealyticum): tonzillofaringit, acute otitis media, sinusitis, acute exacerbations of chronic bronchitis, community-acquired pneumonia;
- urinary tract infections, caused by pathogens: Mycoplasma, Legionella, Chlamydia and Ureaplasma urealyticum;
- infections of the skin and subcutaneous tissue;
- for the treatment of enteritis caused by bacteria of the genus Campylobacter,
- treatment and prevention of diphtheria and pertussis.
- Hypersensitivity to midecamycin / midecamycin acetate and any other components of the drug;
- severe hepatic impairment;
- Children up to age 3 years (for tablets).
Precautions: pregnancy and lactation, the presence of an allergic reaction to acetylsalicylic acid.
Pregnancy and lactation
Use of the drug during pregnancy is indicated only in cases where the potential benefit to the mother outweighs risk to the fetus.
Nursing mothers should stop breast-feeding during treatment Makropenom, since the drug is excreted into breast milk.
Dosing and Administration
Inside should be taken before meals.
Adults and children weighing more than 30 kg: 1 tablet of 400 mg three times a day. The maximum daily dose midecamycin for adults is 1600 mg. Children weighing less than 30 kg: midecamycin andriol testosterone daily dose is 20 – 40 mg / kT body weight, divided into 3 doses, or 50 mg / kg body weight, divided into 2 doses. Midecamycin daily dose in severe infections – 50 mg / kg body weight, divided into three portions.
From the gastrointestinal tract: . Loss of appetite, stomatitis, nausea, vomiting and diarrhea, feeling of heaviness in the epigastrium, increased activity of “liver” transaminases and hyperbilirubinemia, jaundice,
severe and prolonged diarrhea can occur in rare cases, which may indicate the development of pseudomembranous colitis.
Allergic reactions: skin rash, urticaria, pruritus, eosinophilia, bronchospasm.
No reported cases of serious overdose caused Makropenom.
Possible symptoms: nausea, vomiting. Treatment: symptomatic.
Interaction with other drugs
At the same time taking ergot alkaloids or carbamazepine with Makropenom reduced their metabolism in the liver and increased serum concentrations. Therefore, while taking these medications should be careful.
It has no effect on the pharmacokinetic parameters of theophylline.
When using macrofoams with cyclosporine or anticoagulant (warfarin) last excretion slows down.
When long-term therapy is to be monitored the activity of hepatic enzymes, particularly in patients with impaired liver function.
As with any other antimicrobial agents, long-term treatment can lead to excessive growth of resistant bacteria. Prolonged diarrhea may indicate the development of pseudomembranous colitis.
Mannitol contained in Makropene (granules for suspension for oral administration) may be the cause of diarrhea.
If you have an allergic reaction to acetylsalicylic acid, azo dye E software (dye sunset yellow E110) may cause allergic reaction until bronchospasm.
Effects on ability to drive a car or other mechanisms
Reported macrofoams influence on physiological reactions and the ability to drive a car and other mechanisms.
Tablets, film-coated, 400 mg. By 8 tablets in the blister. 2 blisters in cardboard pack together with instructions for use. The granules for suspension for oral administration, 175 mg / 5 ml. 20 g of granules in dark glass bottles (type III) with aluminum cap to control the first opening. 1 bottle complete with a dosing spoon made of polypropylene in a carton pack with instructions for use.
Tablets, film-coated , stored in a dry place at a temperature no higher than 25 ° C. The granules for suspension kept at andriol testosterone a temperature no higher than 25 ° C. The prepared slurry is suitable for 14 days in the refrigerator or 7 days at a temperature no higher than 25 ° C. Keep out of reach of children.