Binoclar

Binocular is a medicine with bacteriostatic, bactericidal and antibacterial therapeutic effects.

The drug has the ability to synthesize with the 50S subunit of human ribosomes, and at the same time inhibits protein binding that occurs inside the cells of pathogenic bacteria. The drug has a medicinal effect inside the cells of pathogenic microbes, and in addition, it effectively affects the extracellular environment.

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Indications Binoclara

It is used for the following types of infections:

• infections of the respiratory tract (lower and upper areas) and ENT organs: sinusitis, otitis with pharyngitis, pneumonia and bronchitis;
• lesions of subcutaneous tissues and epidermis: erysipelas or folliculitis;
• mycobacterial pathologies caused by M.chelonae, M.intracellulare (local or widespread varieties) with Mycobacterium avium, Mycobacterium fortuitum and Mycobacterium kansashi (local lesions);
• ulcers that occur in the gastrointestinal tract (destruction of H.pylori).

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Release form

The release of the medicinal product is realized in tablets - 10 pieces inside the plates. In the box - 1 plate.

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Pharmacodynamics

Demonstrates high activity against some microbes:

• gram-positive (streptococci with staphylococci);
• gram-negative (gonococci, Campylobacter jejuni, Haemophilus influenzae, Haemophilus parainfluenzae, Helicobacter pylori, Legionella pneumophila, etc.);
• anaerobes (clostridia, peptostreptococci with bacteroides and peptococci);
• others (mycobacteria, chlamydia and borrelia).

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Pharmacokinetics

The drug is absorbed at high speed in the gastrointestinal tract. The bioavailability level is 50% (eating food slows down the onset of absorption, but does not affect the bioavailability values and the formation of the active metabolic component).

In case of 2-times intake of the drug per day (in a portion of 0.25 g), equilibrium indicators of Cmax are observed after 2-3 days and on average equal 1 mcg/ml for clarithromycin, and 0.6 mcg/ml for the active metabolic element 14-hydroxyclarithromycin. The half-life is, respectively, 3-4 and 5-6 hours.

It is distributed at high speed within fluids with tissues; tissue indices of clarithromycin (especially within the lungs) exceed plasma indices several times. The substance passes into breast milk.

Excretion occurs with feces and urine (40% each).

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Dosing and administration

It is required to be taken orally. For adults – 0.25-0.5 g 2 times a day, during a 6-14 day cycle.

For children, the dose is 7.5 mg/kg; no more than 0.5 g of the medicine can be used per day. The course lasts 7-10 days.

In case of therapy for lesions caused by Mycobacterium avium, 1000 mg is taken twice a day. The entire cycle lasts from six months or longer.

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Use Binoclara during pregnancy

Binoclar can only be prescribed in situations where the likely benefit from its use outweighs the risks of complications for the child.

Contraindications

Main contraindications:

• severe sensitivity to drug components;
• severe renal or hepatic dysfunction;
• combination with cisapride, astemizole, ergot derivatives, terfenadine or pimozide.

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Side effects Binoclara

Side effects include:

• problems with the gastrointestinal tract: stomatitis, dyspepsia, nausea, candidiasis affecting the oral mucosa, changes in taste, vomiting, glossitis, diarrhea, changes in the shade of teeth and tongue, as well as pain in the abdominal area. In addition, cholestasis, pseudomembranous colitis, jaundice, hepatitis, increased values of intrahepatic enzymes and liver failure (rarely) are noted;
• dysfunction of the nervous system: anxiety, confusion, dizziness, insomnia, anxiety and fear, as well as headaches, disorientation, nightmares, psychosis, tinnitus, depersonalization, hallucinations and paresthesia;
• disorders of the cardiovascular system and blood (hemostasis and hematopoietic processes): leukopenia or thrombocytopenia, prolongation of the QT interval, ventricular arrhythmia (also paroxysmal ventricular tachycardia) and ventricular fibrillation;
• signs of allergy: anaphylaxis, anaphylactoid symptoms, urticaria, SJS and epidermal rashes;
• urogenital system lesions: renal failure, tubulointerstitial nephritis and increased serum creatinine levels;
• others: development of hypoglycemia (in connection with the use of antidiabetic drugs for oral administration and insulin).

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Overdose

In case of intoxication, vomiting, diarrhea and nausea are observed.

Gastric lavage and symptomatic procedures are performed. Peritoneal or hemodialysis will be ineffective.

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Interactions with other drugs

In case of combination with cisapride, terfenadine, pimozide, ergot derivatives and astemizole, prolongation of QT values may occur, and cardiac arrhythmias (ventricular fibrillation or ventricular tachycardia of a paroxysmal nature) may also occur.

The drug increases blood values and potentiates the activity of drugs whose intrahepatic metabolism is carried out with the help of enzymes of the hemoprotein compound P450 (among them warfarin and other indirect anticoagulants, astemizole, digoxin with carbamazepine, triazolam, cyclosporine, theophylline with ergot alkaloids, cisapride, midazolam, etc.).

Combination with substances that inhibit the action of hydroxymethylglutaryl-CoA reductase (including simvastatin and lovastatin) may lead to necrosis of skeletal muscles in the active phase.

Binocular reduces the absorption of zidovudine and decreases the clearance rate of triazolam (this enhances its medicinal effect with the appearance of confusion and drowsiness).

Ritonavir increases plasma levels of the drug, which is why clarithromycin doses exceeding 1 g per day cannot be used in combination. Individuals with renal impairment require a 50% reduction in the clarithromycin dose at CC levels of 30-60 ml per minute; at values below 30 ml per minute – by 75%.

If the CC values are less than 30 ml per minute, the dosage should be halved; the course of therapy should last a maximum of 2 weeks.

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Storage conditions

The binoculars must be stored in a place inaccessible to children. The temperature level is a maximum of 30°C. It is prohibited to freeze the medicine.

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Shelf life

Binocular can be used for a period of 24 months from the date of manufacture of the medicine.

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Analogues

The analogs of the drug are Arvicin, Clarithrosin, Kriksan with Bakticap, Clarexid and Biotericin with Claricin, as well as Zimbactar, Claromin and Kispar. Also on the list are Klabax, Clerimed, Mycetinum, Clarbact with Fromilid, Clarithromycin and Klacid with Claricit, as well as Klasine, Ecozitrin, Lekoklar and Seidon-Sanovel.

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