► Azycine (azithromycin) - Practical Medicine

Azycine (azithromycin) - coated tablets

The name of the preparation Character; dose; package Manufacturer Price 100% Price after refund In which pharmacy?
Azycyna coated tablets; 250 mg; 6 tables Polfa Pabianice S.A. 22.49 17.94
Azycyna coated tablets; 500 mg; 12 tables Polfa Pabianice S.A. 61.50 Check
Azycyna coated tablets; 500 mg; 3 tables Polfa Pabianice S.A. 13.41 8.86
Azycyna coated tablets; 500 mg; 6 tables Polfa Pabianice S.A. 18.99

Note: reimbursed drug prices are in line with the regulations in force from July 1, 2018.

The preparation contains the substance:azithromycin

The drug is available on prescription

What is Azycine?

An antibacterial drug for general use. Macrolide antibiotic used to treat bacterial infections.

What does Azycine contain and how does it work?

The active substance is Azithromycin . It is an antibiotic from the group of macrolides, included in the new generation of these antibiotics, a semi-synthetic derivative of Erythromycin . Azithromycin has been developed to avoid some of the disadvantages of erythromycin. The mechanism of its action, common for the whole group of macrolides, consists in inhibiting the synthesis of bacterial proteins. This is done by blocking bacterial ribosomes, cell structures necessary for protein synthesis. This prevents growth and multiplication of bacterial cells. Azithromycin, like other antibiotics from the group of macrolide antibiotics, is classified as a bacteriostatic substance (under certain conditions also acts bactericidal), with a broad spectrum of action. After oral administration, azithromycin is well absorbed and rapidly excreted from serum to tissues. It accumulates in phagocytes that MIG rate to the site of infection, which increases the distribution of the drug to the tissues involved in the inflammatory process. Azithromycin is characterized by a high concentration in infected tissues and a long half-life, which makes it possible to shorten the treatment time to 1-5 days.

When to use Azycine?

The preparation is indicated for the treatment of the following infections caused by azithromycin-sensitive organisms:
· Upper respiratory tract infection: streptococcal sore throat and / or tonsillitis, in case of contraindications to the use of penicillin, sinusitis
· Otitis media
· Lower respiratory tract infection: community-acquired pneumonia with mild or moderate severity that can be treated with oral preparations, interstitial pneumonitis
· Uncomplicated skin and soft tissue infections: rose, impetigo, secondary purulent dermatitis; erythema migrans (the initial period of Lyme disease); additionally (indication only for a 500 mg dose): acne vulgaris (Acne vulgaris) of moderate intensity - only in adults
· Sexually transmitted diseases: uncomplicated, non-tuberculous urethritis and cervicitis caused by chlamydia.

When not to use this preparation?

Unfortunately, even if there are indications to use the preparation, it can not always be used. You can not use the product if you are allergic (you are hypersensitive) to any of the ingredients or other macrolide antibiotics.

When should you take special care with Azycine?

Certain diseases and other circumstances may constitute a contraindication to use or indication to change the dosage of the preparation. In some situations it may be necessary to carry out specific check-ups.
Do not use the preparation in people with severe liver disease. There are no studies on the use of the preparation in this group of patients. If hepatic dysfunction occurs during treatment, a physician should be consulted who may recommend discontinuation of the product in case of severe hepatic impairment.
The use of macrolide antibiotics (including the preparation) can rarely be associated with severe hypersensitivity reactions, including life threatening reactions such as angioneurotic edema or Anaphylactic reactions . Some of these reactions may be recurrent and require longer follow-up and treatment.
The preparation should not be used ambulatory in the case of severe pneumonia, with additional risk factors when hospitalization or parenteral antibiotics are required.
Azithromycin is effective in the treatment of streptococcal throat infections, its effectiveness in the prevention of acute rheumatic fever has not been proven (the drug of choice is usually penicillin).
In the case of sexually transmitted diseases, your doctor will normally recommend that you perform appropriate laboratory tests to confirm or rule out a parallel infection with a syphilis or gonorrhea. The preparation used for non-genital urethritis may mask or delay the onset of symptoms of gonorrhea or syphilis.
The use of antibiotics may cause excessive development of resistant bacteria and fungi. During the treatment period, it is recommended to observe whether there are symptoms of new infections. If new bacterial or fungal infections (eg yeast infections) appear during the application period, a doctor should be consulted immediately.
If diarrhea occurs during or after treatment, do not treat it yourself, but consult a physician. There is a risk of pseudomembranous colitis, sometimes with a serious, life-threatening course. Its clinical symptoms (such as watery stools with blood and mucus, blunt, spilled or colic stomach ache, fever, periodic pressure on the stool) are caused by the wormClostridium difficile, which can multiply in the conditions of disturbance of the normal bacterial flora in the gut. The use of drugs that inhibit intestinal motility is contraindicated in this case. If necessary, the doctor will apply appropriate pharmacological treatment.
Caution should be exercised because treatment with macrolide antibiotics may result in prolongation of the QT interval in ECG and the risk of arrhythmias, includingtorsade de pointes. This action of azithromycin can not be ruled out, especially in patients with risk factors. Do not use the product if there are risk factors such as: prolonged QT interval in ECG, reduced heart rate (bradycardia), severe heart failure , arrhythmia, decreased potassium or Magnesium , or other electrolyte disturbances, and if you are ill use drugs that prolong the QT interval, including antiarrhythmics (class IA and III), cisapride, terfenadine.
Do not use the preparation in parallel with ergot derivatives (eg ergotamine), due to the risk of poisoning.
If the preparation is used in patients with neurological or mental disorders, care should be taken.
The preparation should not be used to treat infected burn wounds.

Does this preparation affect the ability to drive vehicles?
There are no data on the effect of the preparation on the ability to drive and use machines / machines. The preparation may cause side effects such as dizziness and convulsions that may impair your ability to drive or use machines / machines.

Dosage of Azycine

The preparation is a granules for oral suspension or coated tablets. If you have any doubts regarding the use of the preparation, consult a physician. The doctor will select the dosage individually depending on the indication, the severity of the infection, the sensitivity of the microorganisms and the patient's condition. In certain special patient groups, additional dosage adjustment is necessary.
The dosage of the 500 mg film-coated tablet formulation is shown below. This form of the preparation is recommended for use in adults and children weighing more than 45 kg.
Adults and children with a body weight greater than 45 kg:
- respiratory tract infections, skin and soft tissue infections (with the exception of erythema migrans): 500 mg once daily for 3 days
- erythema migrans: on the first day a single dose of 1 g, then from 2 to 5. 500 mg once daily
- sexually transmitted diseases: 1 g each
Elderly patients do not need to adjust their dosage.
Dosage preparation in the form of granules for the preparation of an oral suspension:
Usually 10 mg / kg body weight is used once daily for 3 days; Exception is the dosage in the treatment of erythema migrans (the first symptom of Lyme disease): on the first day 20 mg / kg body weight is used in a single dose, followed by 10 mg / kg body weight once daily for 4 consecutive days (from 2 to 5 day).
For children weighing more than 45 kg, the dosage is the same as for adults.
In the case of mild to moderate renal dysfunction (creatinine clearance greater than 40 ml / min), no dosage adjustment is necessary. There are no data on the use of the preparation in people with a creatinine clearance less than 40 ml / min, and caution is advised in such cases.
In the case of mild to moderate hepatic impairment, no dosage adjustment is necessary. Do not use in patients with severe hepatic impairment.
Method of administration:
The preparation in the form of tablets is intended for oral use. The tablets can be taken regardless of meals, once a day. The tablets should be swallowed whole (tablets should not be divided).
The preparation in the form of granules for preparation of the suspension is intended for oral use. Granules should be mixed with the appropriate amount of water indicated in the package leaflet (shake the bottle) in order to obtain a homogeneous suspension. The prepared suspension should be taken once a day, at least 1 hour before or 2 hours after a meal. Shake before use. The suspension should be administered using the syringe or measuring spoon provided with the package. After administration, the suspension should be drunk with tea or juice so that the medicine does not stay in the mouth.

Can Azycine be used during pregnancy and breastfeeding?

During pregnancy, do not use any medicine without consulting your doctor!
It is very important that before using any medicine during pregnancy or breastfeeding, consult a physician and explain beyond any doubt the potential risks and benefits associated with the use of the drug. If you are pregnant or plan to become pregnant, please inform the doctor prescribing the prescription for this medicine.
The use of the preparation during pregnancy is only allowed if the doctor deems it absolutely necessary, and other alternative preparations are not available.
Azithromycin is excreted in breast milk. It is recommended that you do not breastfeed during the use of the preparation and for 2 days after its use. Then, consult your doctor and determine if breastfeeding can be continued.

Can I use other preparations in parallel?

Tell your doctor about all medicines you have recently taken, including those that are over the counter. In particular, inform your doctor if you use:
· Drugs that may cause QT prolongation in the ECG (including class IA antiarrhythmics eg disopyramide and class III, eg Amiodarone )
· terfenadine
· cisapride
· theophylline
· Antacids
· Ergotamine derivatives (derivatives of ergot)
· Digoxin
· cyclosporine
· nelfinavir
· Anticoagulants (derivatives of coumarin, eg Warfarin )
· Didanosine or rifabutin
· Zidovudine.
Do not co-administer drugs that prolong the QT interval in ECG recording, including class IA antiarrhythmics (eg disopyramide) and class III (eg amiodarone), terfenadine and cisapride, in addition to azithromycin. There may be: QT prolongation, ventricular arrhythmias and dangerous type disorderstorsades de pointes. Caution should be exercised when using theophylline in parallel, as other macrolide antibiotics interacted with theophylline, which was accompanied by symptoms of increased plasma concentration.Antacids may affect the absorption of azithromycin and should therefore be taken at least one hour before or two hours after taking an antacid. Do not use the preparation in parallel with ergot derivatives (preparations containing ergotamine or its derivatives), due to the risk of poisoning, manifested by peripheral vasospasm and ischemia. The preparation may cause an increase in the blood level of digoxin used in parallel; in patients who use digoxin in parallel, the doctor will usually recommend monitoring its concentration in the blood. Azithromycin may increase the toxicity of cyclosporin. If it is necessary to use it in parallel, your doctor will probably recommend monitoring blood levels of ciclosporin and adjust the dose accordingly. Caution should be exercised when using drugs metabolized with the use of cytochrome P450 3A4 isoenzyme (eg quinidine, astemizole, pimozide, cisapride, carbamazepine), as it can not be ruled out that azithromycin inhibits the enzyme's activity. Nelfinavir may increase the exposure to azithromycin (the risk of increased side effects). Azithromycin enhances the effects of anticoagulants of coumarin derivatives (eg warfarin); During the antibiotic period, your doctor will probably recommend regular monitoring of blood clotting parameters. If necessary, your doctor will adjust the dosage of these medicines. The parallel use of azithromycin and rifabutin may be accompanied by a decrease in neutrophil counts, or neutrophils, although no causation has been confirmed with the use of azithromycin. Azithromycin may increase the concentration of zidovudine in some peripheral blood cells.
There was no clinically significant interaction between azithromycin and Atorvastatin , zafirlukast, triazolam and midazolam.

What side effects can occur?

Like all medicines, Azycline can cause side effects, although it will not occur in all patients using this medicine. Remember that the expected benefits of using the drug are usually greater than the damage resulting from the occurrence of side effects.
The following side effects may be present: nausea, vomiting, diarrhea, abdominal pain, bloating, digestive disorders, anorexia, constipation, discoloration of the tongue, pseudomembranous enteritis (manifested by diarrhea), tarry stools, increased liver enzymes or increased bilirubin, rarely abnormal liver function (hepatitis, cholestatic jaundice, hepatic necrosis and hepatic failure, rarely leading to death), pancreatitis (rare), headache and dizziness, drowsiness, insomnia, convulsions, taste, smell, hearing disorders, visual disturbances, balance, fainting, excessive mobility, nervousness, fatigue and weakness (asthenia), tingling and numbness (paresthesia), aggressive behavior, anxiety, anxiety, chest pain, palpitations, arrhythmia, risk of QT interval prolongation in the ECG and rhythm type disorderstorsade de pointes, rarely interstitial nephritis, nephritis, acute renal failure , Arthra lgia, thrombocytopenia, neutropenia / leukopenia (decrease in the number of neutrophils ie neutrophils / white blood cells or leukocytes), superinfection with resistant bacteria and yeasts (inflammation of the mucous membranes and skin, vaginitis) ). Possible hypersensitivity reactions (including severe anaphylactic reactions) such as pruritus, rash, urticaria, hypersensitivity of the skin to light, angioedema (possible swelling of the mouth, tongue, throat, larynx impeding breathing), hypotension, dyspnoea, increased heart rate (tachycardia), anaphylactic shock, and severe skin reactions such as erythema multiforme, Stevens and Johnson syndrome, melanotic toxic necrosis. If you experience the first symptoms of any of the above hypersensitivity reactions, please consult your doctor immediately.

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