Turex

Turex is a semi-synthetic macrolide antibiotic. It is very similar in composition, chemical structure and mechanism of action to erythromycin, azithromycin, or clarithromycin. Turex prevents bacteria from growing, by interfering with their protein synthesis. Turex binds to the subunit 50S of the bacterial ribosome, and thus inhibits the translocation of peptides. Turex has similar antimicrobial spectrum as erythromycin, but is more effective against certain gram-negative bacteria, particularly Legionella pneumophila. It can treat respiratory tract, urinary and soft tissue infections. It is in the United States, but is available in Australia.

Turex is indicated for the treatment of the following types of mild to

moderately severe infections caused by or likely to be caused by susceptible

micro-organisms: • upper respiratory tract infection - acute pharyngitis, tonsillitis and

sinusitis

• dental infections

• lower respiratory tract infection - acute bronchitis; acute exacerbations

of chronic bronchitis and community acquired pneumonia

• skin and skin structure infections

• non-gonococcal urethritis.

Erythromycin belongs to the family of medicines called antibiotics. Erythromycin ophthalmic preparations are used to treat infections of the eye. They also may be used to prevent certain eye infections of newborn babies, such as neonatal conjunctivitis and ophthalmia neonatorum. They may be used with other medicines for some eye infections.

Erythromycin is available only with your doctor's prescription.

Adults: Recommended Dose: Mild to Moderate Acute Bacterial Exacerbations of COPD, Pneumonia of Mild Severity, Pharyngitis, Tonsillitis and Uncomplicated Skin and Skin Structure Infections: 500 mg as a single dose on the 1st day followed by 250 mg once daily on days 2 through 5.

Genital Ulcer Disease: 1000 mg as single dose.

Urethritis and Cervicitis: 2000 mg as single dose. Capsule should be given at least 1 hr before or 2 hrs after a meal. Azithromycin tablets can be taken with or without food.

Children: Use of azithromycin in children <6 months is not recommended.

See also:
What is the most important information I should know about Turex?

Known allergy to macrolides.

Concomitant administration of Turex with vasoconstrictive ergot (alkaloid) derivatives is contra-indicated since symptoms of ergotism have been described with other macrolides.

Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Do not use erythromycin topical to treat any skin condition that has not been checked by your doctor.

Wash your hands before and after using this medicine.

Clean and dry the skin area before you apply erythromycin topical. Spread the medicine on lightly, without rubbing it in.

Erythromycin topical is usually applied once or twice daily. Follow your doctor's instructions.

It may take up to 12 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after 6 weeks of treatment.

Store at room temperature away from moisture and heat. Keep the tube or bottle tightly closed when not in use.

The gel form of this medicine is flammable. Do not use near high heat or open flame.

Turex is used to treat ear, nose and throat infections, pneumonia (lung infection), skin infections and infections of the genitalia.

See also:
What other drugs will affect Turex?

Turex has a much lower affinity for cytochrome P450 than erythromycin, and consequently has fewer interactions. Interactions may be observed, however, with drugs that bind to alpha-1-acid glycoprotein, e.g. disopyramide. Turex does not appear to interact with oral contraceptives, prednisolone, carbamazepine, ranitidine or antacids. Theophylline. A study in normal subjects concurrently administered Turex and theophylline has shown some increase in the plasma concentration of the latter. While a change in dosage is usually not required, patients with high levels of theophylline at commencement of treatment should have levels monitored. Ergot alkaloids. Reactions of ergotism with possible peripheral necrosis have been reported after concomitant therapy of macrolides with vasoconstrictive ergot alkaloids, particularly ergotamine and dihydroergotamine. Because a clinical interaction with Turex cannot be excluded, administration of Turex to patients taking ergot alkaloids is contraindicated. Disopyramide. An in vitro study has shown that Turex can displace protein bound disopyramide; such an effect in vivo could result in increased serum levels of disopyramide. Consequently, ECG and, if possible, disopyramide serum levels should be monitored. Terfenadine. Some macrolide antibiotics (e.g. erythromycin) may increase serum levels of terfenadine. This can result in severe cardiovascular adverse events, including QT prolongation, torsades de pointes and other ventricular arrhythmias. Such a reaction has not been documented with Turex, which has a much lower affinity for cytochrome P450 than erythromycin. However, in the absence of a systematic interaction study, concomitant administration of Turex and terfenadine is not recommended. Astemizole, cisapride, pimozide. Other drugs, such as astemizole, cisapride or pimozide, which are metabolised by the hepatic isozyme CYP3A4, have been associated with QT interval prolongation and/or cardiac arrhythmias (typically torsades de pointes) as a result of an increase in their serum level subsequent to interaction with significant inhibitors of this isozyme, including some macrolide antibacterials. Although Turex has no or limited ability to complex CYP3A4 and hence to inhibit the metabolism of other drugs processed by this isozyme, a potential for clinical interaction of Turex with the above mentioned drugs cannot be either ascertained or ruled out in confidence. Thus, concomitant administration of Turex and such drugs is not recommended. Warfarin. While no interaction was observed in volunteer studies, Turex appears to interact with warfarin. Increases in prothrombin time (international normalised ratio (INR)) have been reported in patients treated concomitantly with Turex and warfarin or the related vitamin K antagonist phenprocoumon, and severe bleeding episodes have occurred as a consequence. Digoxin and other cardiac glycosides. A study in healthy volunteers has shown that Turex may increase the absorption of digoxin. This effect, common to other macrolides, may very rarely result in cardiac glycoside toxicity. This may be manifested by symptoms such as nausea, vomiting, diarrhoea, headache or dizziness. Cardiac glycoside toxicity may also elicit heart conduction and/or rhythm disorders. Consequently, in patients treated with Turex and digoxin or another cardiac glycoside, ECG and, if possible, the serum level of the cardiac glycoside should be monitored. This is mandatory if symptoms suggesting cardiac glycoside overdosage have occurred. Midazolam. Turex, like other macrolides, may increase the area under the midazolam concentration-time curve and the midazolam half-life. Thus, the effects of midazolam may be enhanced and prolonged in patients treated with Turex. There is no conclusive evidence for an interaction between Turex and triazolam. Cyclosporin. A slight increase in plasma concentrations of cyclosporin A has been observed. This does not generally necessitate altering the usual dosage.

See also:
What are the possible side effects of Turex?

Applies to benzoyl peroxide topical: topical bar, topical cream, topical foam, topical gel/jelly, topical liquid, topical lotion, topical pad, topical soap, topical solution

In addition to its needed effects, some unwanted effects may be caused by benzoyl peroxide topical (the active ingredient contained in Turex). In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking benzoyl peroxide topical:

Less common or rare:

• Painful irritation of skin, including burning, blistering, crusting, itching, severe redness, or swelling
• skin rash

• Difficult breathing
• fainting
• hives
• itching
• swelling of the eyes, face, lips, or tongue
• tightness in the throat

If any of the following symptoms of overdose occur while taking benzoyl peroxide topical, get emergency help immediately:

Symptoms of overdose:

• Burning, itching, scaling, redness, or swelling of skin (severe)

Minor Side Effects

Some of the side effects that can occur with benzoyl peroxide topical may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Less common:

• Dryness or peeling of the skin (may occur after a few days)
• feeling of warmth, mild stinging, and redness of the skin