Zithrolide

Zitrolide is a macrolide antibiotic with antimicrobial properties.

Indications Zithrolide

The drug is used in the treatment of various infections caused by bacteria that are hypersensitive to azithromycin. Among the diseases:

• lesions of the ENT organs, as well as the respiratory system: bronchitis with tonsillitis, otitis media, community-acquired pneumonia, and pharyngitis;
• inflammation of the skin and inside soft tissues: dermatitis, which has a secondary form of infection, impetigo, stage 1 Lyme borreliosis and secondary pyoderma;
• infections affecting the genitourinary system (uncomplicated type).

The drug can also be used as an auxiliary agent in the destruction of Helicobacter pylori microbes.

Release form

Release in capsules - in the amount of 6 pieces inside a blister cell. The pack contains 1 blister with capsules. Also released in the form of the drug Zitrolid Forte - 3 capsules inside a blister, 1 blister plate inside the pack.

Pharmacodynamics

The main element of the drug is azithromycin - an azalide that has powerful antimicrobial properties, creating large concentrations inside the lesions of microbes. The drug effectively acts against strains of pneumococci with Staphylococcus aureus, and also agalactiae streptococci with Streptococcus viridans and pyogenic streptococci, and together with this against streptococci from subclasses F and C or G.

The drug is also active against gram-negative microbes: these include strains of Moraxella catarrhalis, Ducrey's bacillus, Haemophilus influenzae, Legionella pneumophila, Parakoklyushka and Pertussis bacillus, Campylobacter jejuni with Helicobacter pylori and gonococci with Gardnerella vaginalis. Azithromycin also affects anaerobes - Peptostreptococci with Bacteroides bivius, as well as Clostridia perfringens.

The medication is effective in eliminating pathologies caused by Borrelia burgdorferi, Chlamydia trachomatis, as well as ureaplasma, mycoplasma pneumoniae and pale treponema.

Cross-resistance is observed within the group of macrolide antibiotics.

Pharmacokinetics

When taking the capsule, the active substance is quickly absorbed in the gastrointestinal tract. Azithromycin is highly stable in the acidic gastric environment. When taking the drug with food, the bioavailability index decreases slightly (as a result of taking the drug on an empty stomach, it is 37%). The drug reaches its maximum in plasma after 2.5-3 hours.

The medicine penetrates into many fluids and tissues, forming high concentrations of the active ingredient in areas of inflammation (this is facilitated by the fact that azithromycin can be synthesized with phagocytes, transporting it to areas where infectious foci are located). Although high levels of azithromycin are observed inside phagocytes, the medicine has little effect on their functional activity. The medicinal properties of the drug continue to remain in the body for 5-7 days after taking the last dose of the drug.

The drug undergoes hepatic metabolism – via demethylation processes. The breakdown products of the active substance of the drug have no medicinal activity.

The excretion of the drug occurs in 2 stages: in the 1st stage the half-life is in the range of 8-24 hours, and in the 2nd stage it is in the range of 24-72 hours.

Dosing and administration

The capsules are taken orally - swallowed without chewing. They are taken 60 minutes before meals or 120 minutes after. It is recommended to wash down the medicine with water. The daily dose of the drug is usually taken in 1 dose, and this should be done with equal intervals between doses. The dose size and duration of the course are prescribed by the doctor.

For therapy of infections inside the respiratory system (upper or lower sections), it is necessary to take (usually) 0.5 g of the drug per day. This treatment lasts 3 days, and the total dosage for the entire course is 1.5 g.

During the treatment of skin lesions with soft tissues, and at the same time the initial stage of Lyme borreliosis, 1 g of the drug is usually taken on the 1st day of the course, and then 0.5 g per day is taken. This course lasts 5 days, and the total dosage for this period is 3 g.

In the process of eliminating pathologies in the urogenital system (uncomplicated type), it is usually necessary to take a single dose of the drug in the amount of 1 g.

In case of development of ulcerative diseases inside the stomach or duodenum (caused by Helicobacter pylori), it is recommended to take 1 g of Zitrolide together with other medications (complex treatment). In this case, Azithromycin is used for 3 days.

Children weighing over 45 kg are usually prescribed the drug in dosages appropriate for adults.

If a dose is missed for any reason, the capsule should be taken as soon as possible and the next dose should be taken 24 hours after the previous dose.

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Use Zithrolide during pregnancy

Prescribing Zitrolide to pregnant women is permitted only in situations where the probable benefit to the pregnant woman outweighs the risk of negative effects on the fetus.

During the lactation period, it is necessary to stop breastfeeding for the duration of taking the drug. Resumption of breastfeeding is allowed at least 1 week after taking the last dose of the drug.

Contraindications

Main contraindications:

• It is prohibited to use in case of hypersensitivity to the component azithromycin, as well as other macrolide antimicrobial drugs;
• should not be taken if you have liver or kidney problems;
• Children under 12 years of age are prohibited from taking capsules of the medicine.

Caution should be exercised when using Zitrolide if the patient has heart rhythm disorders or if he/she is taking drugs that prolong QT values.

During the course of treatment, it is necessary to exclude any activity that requires high speed of psychomotor action and increased concentration.

Side effects Zithrolide

Taking capsules may cause some side effects:

• disorders in the hepatobiliary system, as well as the gastrointestinal tract: the occurrence of vomiting, abdominal pain, dyspepsia, diarrhea, melena, and also bloating. There may be a violation of taste buds, cholestasis or jaundice may develop, and the activity of liver enzymes may increase. In children, constipation, gastritis, and a deterioration in appetite may occur;
• manifestations in the cardiovascular system: increased heart rate, pain inside the sternum, heart rhythm disorders;
• lesions affecting the nervous system: the appearance of hyperkinesia, neurosis, severe fatigue, sleep disorders and dizziness. A feeling of severe anxiety may arise, as well as drowsiness;
• reactions of the hematopoietic system: development of eosinophilia or neutropenia (such reactions often go away on their own – approximately 2-3 weeks after completion of the course of treatment);
• dysfunction of the urogenital system: development of nephritis or thrush;
• signs of allergy: itching, erythema multiforme, photophobia and urticaria. In addition, angioedema, anaphylaxis and allergic conjunctivitis.

The use of Zitrolide may lead to hyperglycemia.

Overdose

As a result of poisoning with the drug, vomiting, headache, dyspepsia or nausea may occur, as well as temporary hearing loss (may lead to complete deafness).

The drug has no antidote. In case of overdose, gastric lavage is required, along with the use of enterosorbents. It is also necessary to stop using Zitrolide and perform symptomatic treatment (if necessary).

Interactions with other drugs

As a result of combining the drug with antacids (aluminum- or magnesium-containing), food and ethanol, a decrease in the rate of absorption, as well as the bioavailability of Zitrolide, is observed.

The combination of drugs and warfarin can potentiate the anticoagulant effect, therefore, in the case of a combination of these drugs, it is necessary to constantly monitor blood coagulation parameters.

Zitrolide in combination with digoxin increases the level of the latter in plasma.

The combination of the drug with ergotamine, as well as dihydroergotamine, can enhance their toxic properties.

The drug is capable of reducing the clearance rates of triazolam and also potentiating its pharmacological properties.

Azithromycin can increase the plasma levels of unchanged carbamazepine, as well as cyclosporine and terfenadine with bromocriptine, as well as hexobarbital and valproates with phenytoin, oral antidiabetic drugs, xanthine derivatives and ergot alkaloids with disopyramide. This occurs because azithromycin can slow down the oxidation of microsomes inside hepatocytes and inhibit the metabolism of the above drugs.

At the same time, one can expect an increase in the toxic properties and plasma levels of such agents as cycloserine, methylprednisolone and felodipine with indirect anticoagulants when combined with Zitrolide.

Concomitant use with lincosamines reduces the effect of the drug.

Chloramphenicol and tetracyclines increase the effect of the drug when used in combination.

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Storage conditions

Zitrolide must be stored under standard conditions for medicines. Temperature – in the range of 15-25°C.

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Special instructions

Reviews

Zitrolide is popular among patients – it is used to eliminate a wide variety of infections and diseases caused by them.

Based on reviews, the drug usually gives the desired result, although doctors warn that it must be taken strictly according to the application scheme, because otherwise the risk of developing negative reactions increases. Doctors especially emphasize that the capsules must be taken at least 2 hours apart from eating or taking some other drugs.

As for side effects, patients most often complained about the development (in children) of oral candidiasis, decreased appetite, constipation, gastritis, changes in taste perception, and conjunctivitis.

If we talk about the medicine Zitrolid Forte, it is also often called quite effective. One of the advantages is the convenient mode of application. The disadvantage of this drug is also the increased risk of side effects. In addition, many patients are not satisfied with the cost of the drug, because there are quite effective analogues that are much cheaper.

Shelf life

Zitrolide is permitted to be used for a period of 3 years from the date of manufacture of the medication.