Astellas Josamycin

Acute and chronic infections caused by drug-sensitive microorganisms, for example:

Infections of the upper respiratory tract and ENT organs:

pharyngitis,

otitis media,

sinusitis,

laryngitis,

tonsillitis and paratonsillitis,

diphtheria (in addition to treatment with diphtheria antitoxin), as well as scarlet fever in the case of hypersensitivity to penicillin.

Lower respiratory tract infections:

acute bronchitis,

bronchopneumonia,

pneumonia (including atypical form),

whooping cough,

psittacosis.

Dental infections:

gingivitis,

periodontal diseases.

Infections of the skin and soft tissues:

pyoderma,

furunculosis,

anthrax,

erysipelas (in case of hypersensitivity to penicillin),

blackheads,

lymphangitis,

lymphadenitis,

venereal lymphogranuloma.

Infections of the genitourinary system:

prostatitis,

pyelonephritis,

gonorrhea,

syphilis (in case of hypersensitivity to penicillin),

chlamydia, mycoplasma (including ureaplasma) and mixed infections.

Acute and chronic infections caused by drug-sensitive microorganisms, for example:

infections of the upper respiratory tract and ENT organs — angina, pharyngitis, paratonsillitis, laryngitis, otitis media, sinusitis, diphtheria (in addition to treatment with diphtheria toxoid), as well as scarlet fever in the case of hypersensitivity to penicillin,

lower respiratory tract infections — acute bronchitis, exacerbation of chronic bronchitis, pneumonia (including those caused by atypical pathogens), whooping cough, psittacosis,

dental infections — gingivitis and periodontal diseases,

infections in ophthalmology-blepharitis, dacryocystitis,

infections of the skin and soft tissues — pyoderma, furunculosis, anthrax, erysipelas (with hypersensitivity to penicillin), acne, lymphangitis, lymphadenitis, venereal lymphogranuloma,

infections of the genitourinary system — prostatitis, urethritis, gonorrhea, syphilis (with hypersensitivity to penicillin), chlamydia, mycoplasma (including ureaplasma) and mixed infections.

Inside, swallowing whole, with a small amount of water. The recommended daily dose for adults and adolescents over the age of 14 years is from 1 to 2 g of josamycin. The daily dose should be divided into 2-3 doses. The initial recommended dose is 1 g of josamycin. In the case of common and globular acne, it is recommended to prescribe josamycin at a dose of 500 mg 2 times a day for the first 2-4 weeks, then-500 mg josamycin 1 time a day as a maintenance treatment for 8 weeks. To achieve optimal serum concentrations, individual doses should be taken between meals.

Usually, the duration of treatment is determined by the doctor. In accordance with the recommendations of the World Health Organization on the use of antibiotics, the duration of treatment for streptococcal infections should be at least 10 days.

If you miss one appointment, you must immediately take a dose of the drug. However, if it is time to take the next dose, do not take the "forgotten" dose, but return to the usual treatment regimen. Do not take a double dose.

A break in treatment or premature discontinuation of the drug reduces the likelihood of treatment success.

Inside, swallowed whole, washed down with water or pre-dissolved in water. Tablets should be dissolved in at least 20 ml of water. Before taking it, the resulting suspension should be thoroughly mixed. The recommended daily dosage for adults and adolescents over the age of 14 years is from 1 to 2 g. If necessary, the dose can be increased to 3 g/day. The daily dose should be divided into 2-3 doses.

The daily dosage for children is prescribed based on the calculation of 40-50 mg/kg of body weight daily, divided into 2-3 doses.

In the case of common and globular acne — at a dose of 500 mg 2 times a day for the first 2-4 weeks, then-500 mg 1 time a day as a maintenance treatment for 8 weeks.

Usually, the duration of treatment is determined by the doctor. In accordance with the WHO recommendations on the use of antibiotics, the duration of treatment for streptococcal infections should be at least 10 days.

From the gastrointestinal tract: rarely - loss of appetite, nausea, heartburn, vomiting and diarrhea. In the case of persistent severe diarrhea, the possibility of developing life-threatening pseudomembranous colitis caused by antibiotics should be kept in mind.

Hypersensitivity reactions: in extremely rare cases, skin allergic reactions (for example, urticaria) are possible.

From the liver and biliary tract: in some cases, there was a transient increase in the activity of liver enzymes in the blood plasma, in rare cases accompanied by a violation of the outflow of bile and jaundice.

On the side of the hearing aid: In rare cases, dose-dependent transient hearing disorders have been reported.

From the gastrointestinal tract: rarely - loss of appetite, nausea, heartburn, vomiting, dysbacteriosis and diarrhea. In the case of persistent severe diarrhea, you should keep in mind the possibility of developing life-threatening pseudomembranous colitis against the background of antibiotics.

Hypersensitivity reactions: extremely rare-possible skin allergic reactions (for example, urticaria).

From the liver and biliary tract: in some cases, there was a transient increase in the activity of liver enzymes in the blood plasma, in rare cases accompanied by a violation of the outflow of bile and jaundice.

On the side of the hearing aid: In rare cases, dose-dependent transient hearing disorders have been reported.

Other: very rarely — candidiasis.

To date, there is no data on specific symptoms of poisoning. In the case of an overdose, the symptoms described in the section "Side effects", especially from the gastrointestinal tract, should be assumed.

To date, there is no data on specific symptoms of poisoning. In the case of an overdose, the symptoms described in the section "Side effects", especially from the gastrointestinal tract, should be assumed.

The drug is used to treat bacterial infections, the bacteriostatic activity of josamycin, as well as other macrolide antibiotics, is due to the inhibition of protein synthesis by bacteria. When high concentrations are created in the focus of inflammation, it has a bactericidal effect.

Josamycin is highly active against intracellular microorganisms (Chlamydia trachomatis and Chlamydia pneumoniae, Mycoplasma pneumoniae, Mycoplasma hominis, Ureaplasma urealyticum, Legionella pneumophila), gram-positive bacteria (Staphylococcus aureus, Streptococcus pyogenes and Streptococcus pneumoniae (pneumococcus), gram-negative bacteria (Neisseria meningitidis, Neisseria gonorrhoeae, Haemophilus influenzae, Bordetella pertussis, Helicobacter pylori), as well as against some anaerobic bacteria (Peptococcus, Peptostreptococcus, Clostridium perfringens).

The drug is used to treat bacterial infections, the bacteriostatic activity of josamycin, as well as other macrolides, is due to the inhibition of bacterial protein synthesis. When high concentrations are created in the focus of inflammation, it has a bactericidal effect.

Josamycin is highly active against intracellular microorganisms (Chlamydia trachomatis and Chlamydia pneumoniae, Mycoplasma pneumoniae, Mycoplasma hominis, Ureaplasma urealyticum, Legionella pneumophila), gram-positive bacteria (Staphylococcus aureus, Streptococcus pyogenes and Streptococcus pneumoniae (pneumococcus), Corynebacterium diphtheriae), gram-negative bacteria (Neisseria meningitidis, Neisseria gonorrhoeae, Haemophilus influenzae, Bordetella pertussis), and also against some anaerobic bacteria (Peptococcus, Peptostreptococcus, Clostridium perfringens). It has little effect on enterobacteria, so it does not change the natural bacterial flora of the gastrointestinal tract. It is effective for resistance to erythromycin. Resistance to josamycin develops less frequently than to other antibiotics from the macrolide group.

After oral administration, josamycin is rapidly and completely absorbed from the gastrointestinal tract. C_max josamycin in the serum is reached in 1-4 hours after taking Vilprafen. About 15% of josamycin binds to plasma proteins. Especially high concentrations of the substance are found in the lungs, tonsils, saliva, sweat and tear fluid.

Josamycin is metabolized in the liver to less active metabolites and is excreted mainly with bile. The excretion of the drug in the urine is less than 20%.

After oral administration, josamycin is rapidly and completely absorbed from the gastrointestinal tract, food intake does not affect bioavailability. C_max josamycin in serum is reached in 1-2 hours after administration. About 15% of josamycin binds to plasma proteins. Especially high concentrations of the substance are found in the lungs, tonsils, saliva, sweat and tear fluid. The concentration in sputum exceeds the concentration in plasma by 8-9 times. Accumulates in the bone tissue. Passes the placental barrier, is secreted into breast milk. Josamycin is metabolized in the liver to less active metabolites and is excreted mainly with bile. The excretion of the drug in the urine is less than 20%.

Vilprafen/other antibiotics. Since bacteriostatic antibiotics can reduce the bactericidal effect of other antibiotics, such as penicillins and cephalosporins, the co-administration of josamycin with these types of antibiotics should be avoided. Josamycin should not be administered in conjunction with lincomycin, because there may be a mutual decrease in their effectiveness.

Wilprafen/xanthine. Some representatives of macrolide antibiotics slow down the elimination of xanthines (theophylline), which can lead to possible intoxication. Clinical and experimental studies indicate that josamycin has less effect on the release of theophylline than other macrolide antibiotics.

Vilprafen/antihistamines. After the combined administration of josamycin and antihistamines containing terfenadine or astemizole, there may be a slowdown in the elimination of terfenadine and astemizole, which, in turn, can lead to the development of life-threatening cardiac arrhythmias.

Vilprafen/ergot alkaloids. There are individual reports of increased vasoconstriction after co-administration of ergot alkaloids and macrolide antibiotics. There was one case of a patient's lack of tolerance to ergotamine when taking josamycin.

Therefore, the concomitant use of josamycin and ergotamine should be accompanied by appropriate patient monitoring.

Vilprafen/cyclosporine. The combined administration of josamycin and cyclosporine may cause an increase in the level of cyclosporine in the blood plasma and the creation of a nephrotoxic concentration of cyclosporine in the blood. You should regularly monitor the concentration of cyclosporine in the plasma.

Vilprafen/digoxin. With the combined administration of josamycin and digoxin, it is possible to increase the level of the latter in the blood plasma.

Vilprafen/hormonal contraceptives. In rare cases, the contraceptive effect of hormonal contraceptives may be insufficient during treatment with macrolides. In this case, it is recommended to additionally use non-hormonal contraceptives.

Other antibiotics. Since bacteriostatic antibiotics can reduce the bactericidal effect of other antibiotics, such as penicillins and cephalosporins, the co-administration of josamycin with these types of antibiotics should be avoided. Josamycin should not be administered in conjunction with lincomycin, because there may be a mutual decrease in their effectiveness.

Xanthines. Some representatives of macrolide antibiotics slow down the elimination of xanthines (theophylline), which can lead to possible intoxication. Clinical and experimental studies indicate that josamycin has less effect on theophylline release than other macrolide antibiotics.

Antihistamines. After the combined administration of josamycin and antihistamines containing terfenadine or astemizole, there may be a slowdown in the elimination of terfenadine and astemizole, which in turn can lead to the development of life-threatening cardiac arrhythmias.

Ergot alkaloids. There are individual reports of increased vasoconstriction after co-administration of ergot alkaloids and macrolide antibiotics. There was one case of a patient's lack of tolerance to ergotamine when taking josamycin. Therefore, the concomitant use of josamycin and ergotamine should be accompanied by appropriate monitoring of patients.

Cyclosporine. The combined administration of josamycin and cyclosporine may cause an increase in the level of cyclosporine in the blood plasma and the creation of a nephrotoxic concentration of cyclosporine in the blood. You should regularly monitor the concentration of cyclosporine in the plasma.

Digoxin. With the combined administration of josamycin and digoxin, it is possible to increase the level of the latter in the blood plasma.

Hormonal contraceptives. In rare cases, the contraceptive effect of hormonal contraceptives may be insufficient during treatment with macrolides. In this case, it is recommended to additionally use non-hormonal contraceptives.