In this article, we consider the instructions for use and reviews for the Azitral tool.
The drug is an antibiotic belonging to the number of azalides, which produces a bactericidal effect and has a wide range of effects. The main active ingredient can easily enter the tissues, cells and body fluid. An excellent clinical effect of therapy is most often achieved on the fifth day of treatment. Azithromycin, which is an active substance, inhibits the growth of bacteria, and also slows down the rate of their reproduction. When a high concentration is achieved, the manifestation and bactericidal properties of the agent are obtained.
The main component quickly penetrates into all organs and tissues from plasma. Its concentration in tissues is 50 times higher than in plasma. In addition, the active substance has another distinguishing feature - it accumulates mainly in lysosomes, due to which pathogens inside the cell die.
Analogs of Azitral also operate. We will not consider instructions for applying to them.
pharmachologic effect
The drug "Azitral" is an antimicrobial drug. Its composition includes such an active component as azithromycin. This medicinal substance is part of a subgroup of azalides, a group of macrolides. The drug is an antibiotic, characterized by a wide spectrum of exposure, which has a pronounced bactericidal effect. The mechanism of its influence is based on the ability to interact with the ribosomal bacterial 50S subunit and inhibit protein synthesis dependent on RNA.
Due to the inhibition of the protein synthesis of bacteria, the agent slows down their reproduction and growth, and in a large dosage it damages the cell membrane, due to which the bacteria die. Instructions for use with Azitral confirms this.
Gram-negative and gram-positive anaerobic and aerobic microorganisms are sensitive to the drug, including:
- aerobic gram-positive bacteria (in addition to methicillin-resistant and erythromycin-resistant strains): Streptococcus spp., Staphylococcus spp. (including Staphylococcus aureus);
- aerobic gram-negative bacteria: Campylobacter jejuni, Bordetella pertussis, Neisseria gonorrhoeae, Bordetella parapertussis, Neisseria meningitidis, Moraxella catarrhalis, Escherichia coli, Gardnerella vaginalis, Helicobacter pylori.
In addition, they are sensitive to the effects of the drug Legionella pneumophila, Haemophilus ducreyi, Haemophilus parainfluenzae, Haemophilus influenzae. It is also effective in infectious diseases caused by strains of Yersinia spp., Salmonella spp. and Shigella spp.
Strains such as Enterococcus faecalis are resistant to the drug. The following anaerobic bacteria are also sensitive to the action of the active component: Bacteroides bivius, Clostridium perfringens spp., Peptostreptococcus spp. and Peptococcus spp. Azithromycin is active against strains of Mycoplasma pneumoniae, Listeria monocitogenes, Chlamydia trachomatis, Ureaplusma urealyticum, Chlamydia pneumoniae, Treponema pallidum, Borrelia burgdorferi, Mycobacteria avium complex.
After oral administration, the drug is perfectly absorbed in the digestive tract. The culmination of the concentration of the main active substance in the plasma is observed 2-3 hours after oral administration. What else does the instruction for use with Azitral 500 mg tell us?
Eating food reduces the absorption rate of the drug. Azithromycin is especially strongly concentrated in all biological fluids and tissues of the human body. The drug is characterized by a low level of communication with plasma proteins. It accumulates in leukocytes and lysosomes with further release, so that it is possible to use the drug in short courses.
The medicine does not affect the functional phagocytic activity. The concentration of the main component in the focus of inflammation is higher than it is in healthy tissues. Concentrations of equal weight in blood plasma are reached after 5-7 days of treatment. The drug is characterized by excretion from the blood plasma in two phases: the half-life of the first phase is 14-20 hours, of the second phase - 41 hours. If the treatment course is three days, then the highest concentrations of the active substance remain for 5-7 days after the last dose of the drug.
Metabolism is carried out in the liver, metabolites that are inactive from a pharmacological point of view are formed. It is mainly excreted with bile, and only a small amount of the drug is excreted through the kidneys.
Pharmacokinetics
According to the instructions for use with Azitral, azithromycin is absorbed from the gastrointestinal tract at a high rate, which depends on its lipophilicity and resistance of the substance to an acidic environment. After the use of the drug "Azitral" in a dosage of 500 mg, the maximum concentration of the active component in the blood plasma is observed after about 2.5 hours, equal to 0.4 milligrams per liter. Bioavailability is 37%.
Azithromycin penetrates perfectly into the respiratory tract and organs, into urogenital and soft tissues, into the epidermis. High tissue concentration (10-50 times greater than in blood plasma) and a long half-life are determined by a low rate of azithromycin binding to blood plasma proteins and its ability to enter eukaryotic cells, as well as concentrate in a low pH environment that surrounds lysosomes.
The ability of the main active substance to accumulate to a greater extent in lysosomes is especially significant for the elimination of pathogens within the cell. It is proved that azithromycin is delivered to places of infectious localization, where it is released during phagocytosis. Its concentration in the foci of inflammation is much greater than in healthy tissues (approximately 24-34 percent) and correlates with the severity of edema. Although the concentration of the substance in the phagocytes is high, azithromycin does not produce a strong effect on their activity.
The active component is stored in the focus of inflammation in bactericidal concentrations for 5-7 days after the last dose, and this makes it possible to develop short treatment courses (three and five days).
Demethylates in the liver, forming inactive metabolites.
When is it used?
Instructions for use with "Azitral" indicates that the drug is most often prescribed if the patient has infectious and inflammatory diseases that were caused by bacteria that are sensitive to this drug:
- The infectious process in the ENT organs is pharyngitis, otitis media of unknown origin, sinusitis, tonsillitis, tracheitis, tonsillitis.
- Bronchitis, which occurs in a chronic and acute form, is not hospital bacterial pneumonia.
- Infections of the skin - erysipelas, impetigo, dermatoses, caused by a secondary infection.
- Cervicovaginitis (inflammation in the uterine cervix), salpingitis (damage to the uterine tubes), prostatitis, urethritis.
- Infectious pathologies of the genitourinary system.
- With shigellosis, salmonellosis, diphtheria.
- Complex for gastric ulcer of bacterial origin.
- The medicine has been used successfully in the treatment of oral infections.
- For the treatment of chlamydia, mycoplasmosis and ureoplasmosis.
Indications for Azitral are indicated in the instructions for use.
The composition of the drug
The main active ingredient in the macrolide antibiotic is azithromycin. However, there are other auxiliary ingredients in the preparation. For example, gelatin, magnesium stearate, pure water, corn starch, titanium dioxide, methyl paraben and other complex and simple substances, there are twelve components in total. This is stated in the instructions for use. The price, reviews and analogues of Azitral will be presented below.
Healing characteristics
Azitral is an antibiotic of general effect. Due to its ability to accumulate in leukocytes and lysosomes, the drug has a good and long-lasting effect after a treatment course. It is recommended to use this remedy in short courses, since with the usual three-day treatment period, about 5-6 days are enough to completely leave the body.
Instructions for use with Azitral for children will also be considered.
Release Forms
This antibiotic is available in capsules (most often blue, 250 and 500 milligrams), as well as white round tablets in the same volume (their diameter is about five millimeters). There are no marks on them - this is an ordinary white tablet with a bitter taste. In a pack of three to twelve pieces.
Mode of application
Indications "Azitral" and use in the instructions are described in detail. It is advisable to take the drug separately from food intake: one hour before a meal or two hours after. The capsule or tablet is taken whole (it can not be crushed in any case), swallowed, washed down with milk or drinking water.
The next technique is preferably carried out no earlier than a day after the previous one. The tablet during this time will reach the infectious focus and begin to localize it.
The duration of administration and dosage are determined by a specialist. The more serious the disease, the longer the therapeutic course and recovery continue. Treatment in children is faster compared to adult patients.
However, in any case, the course usually lasts three days: 500 milligrams are taken per day, but there are exceptions. If an adult has migratory chronic erythema, 1000 milligrams should be prescribed.
With angina and other infectious inflammations of the respiratory system, patients weighing 45 kilograms or more need to drink one tablet per day for three days. In total, you need to take 1.5 grams.
With pathologies of the genitourinary system - one gram (two capsules or tablets) once.
If the patient has Lyme disease (exclusively in the first stage!) - one gram (two capsules or tablets) on the first day, and then 500 mg. A total of three grams.
So we are informed by the instructions for use for Azitral. Analogs and reviews are presented below.
During pregnancy and lactation
A medicine can very rarely be prescribed to pregnant women and nursing mothers only when the intended benefits of taking the drug are higher than the possible risk to the fetus. In this case, the treatment course can be continued. If the drug is taken during the lactation period, it is better to stop breastfeeding before the end of the therapeutic course.
This is confirmed by the instruction. Analogs of Azitral should be selected by a doctor.
What are the contraindications?
The drug is not recommended for use by people with high sensitivity to azithromycin and other auxiliary components, children under one year of age, as well as:
- patients with severe hepatic or renal failure;
- patients with lactose intolerance or its lack;
- during the lactation period or during pregnancy;
- with the use of dihydroergotamine and ergotamine.
Precautionary measures
As indicated in the instructions for use with "Azitral", the patient must observe a break of at least two hours between the use of different antacids. In addition, after the abolition of the treatment course, some people may remain hypersensitive to certain active components of the drug. That is why specific therapy is required under the supervision of a competent specialist.
Drug interaction
With simultaneous use with antacids containing magnesium and aluminum, ethanol and food, a decrease and slowdown in azithromycin absorption is observed. Admission along with warfarin in the correct dosage does not cause any changes in the prothrombin period. In this case, the interaction of warfarin and macrolides can cause an increase in the anticoagulant effect, in connection with which it is necessary to control prothrombin time. The simultaneous use of digoxin increases the concentration in the body of the latter.
This is indicated in the instructions for use with Azitral. Price and analogues are of interest to many patients.
Admission along with dihydroergotamine (dysesthesia and vasospasm) and with ergotamine can cause an increase in toxic effects. Concomitant use with triazolam reduces excretion and increases its pharmacological effects. When taken together with cycloserine, felodipine, methylprednisolone, indirect type anticoagulants, it is able to increase the concentration of the drug in the blood plasma, slow down its excretion and affect the toxicity of these drugs. Azithromycin can also slow down the excretion, increase the toxicity of theophylline, carbamazepine, oral hypoglycemic agents, terfenadine, bromocriptine, cyclosporine, disopyramide, phenytoin hexobarbital, valproic acid, ergot alkaloids, and increase the content in the blood serum.
Concomitant use with lincosamines reduces the effectiveness of azithromycin, and with chloramphenicol and tetracyclines increases the effect of azithromycin.
Feasible side effects
According to the instructions for use and reviews of "Azitral", the side effects of this drug are divided into several types.
- Digestive: these include effects associated with the digestive system. Basically, it is vomiting and nausea, abdominal pain, diarrhea. There are also more rare effects: jaundice, flatulence, dyspepsia. In addition, gastritis, anorexia, or constipation can occur, especially in small patients.
- Cardiovascular: the heartbeat intensifies, pain of a paroxysmal nature occurs in the chest.
- CNS: headaches, drowsiness, irritability, anxiety is observed in children, more rarely sleep disturbances.
- Genitourinary system: vaginal candidiasis, nephritis.
- Allergic reactions (the most dangerous group by their effects): Quincke's edema (can lead to the death of the patient), rash.
- Other symptoms: increased fatigue in children and adults, conjunctivitis in small patients, etc.
Before use, it is necessary to study the instructions for use with Azitral 500 mg.
Overdose
If an overdose of azithromycin occurs, the following short-term effects may appear: very severe diarrhea and nausea, hearing loss, vomiting.
If you take too high a dosage of tablets or capsules, which is twice or more than normal, you should consult a doctor as soon as possible to avoid an allergic reaction. It can cause Quincke's edema. Before the arrival of specialists, you should drink plenty of water to reduce the effectiveness of chemical reactions that occur in the patient's body.
What else can you learn from the instructions for use with Azitral (azithromycin)?
Alcohol Compatibility
In the instructions that are attached to the antibiotic, there is no paragraph on the characteristics of the interaction of Azitral and alcohol. However, it was established with accuracy that they should not be combined in any case. Alcoholic beverages very much reduce the ability of the active ingredient to diffuse into the blood plasma, and therefore affect the therapeutic effectiveness.
The use of the drug along with alcohol can cause the infectious agents to create a mechanism due to mutations that will be resistant to low concentrations of the active substance. In this case, it will be necessary to prescribe an even more serious antibiotic, which can stop the development and growth of both pathogenic strains and indigenous microflora. As a result, dysbiosis develops, and human immunity is weakened.
In addition, simultaneous use will increase the effect on the liver, where detoxification is carried out, and both substances are destroyed. The consequence is toxic poisoning, a weakening of the person’s resistance to pathogens, and overall health and the degree of the disease worsen. It also describes instructions for use with Azithral (azithromycin).
Terms and conditions of storage
The drug should be stored in a place that is sufficiently protected from direct sunlight. Indoor humidity should not exceed the norm. In addition, it is necessary to take care of the lack of free access for children to the drug.
Both tablets and capsules of the drug can be stored for no more than three years, as indicated in the instructions for use for Azitral. We will consider the price, reviews, analogues below.
Analogs
Medicines having a similar composition:
- "Azivok" - an antibacterial and bactericidal drug;
- "Zitnob" - is prescribed for the treatment of various infectious diseases;
- "Sumazid" - inflammation of the ENT organs, as well as the upper parts of the respiratory system, stomach ulcers, infections affecting the pelvis;
- "Sumamed" - produces a bactericidal effect, a drug for the treatment of infectious diseases caused by bacteria that are sensitive to the drug;
- “Hemomycin” is a drug with a wide range of effects on the infectious focus.
special instructions
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Penicillins are the preferred antibiotics for pharyngitis and tonsillitis caused by Streptococcus pyogenes. When therapy is stopped, some patients may have hypersensitive reactions, and therefore this category of people requires special treatment under strict medical supervision. The effectiveness of the main substance for prophylactic purposes in order to avoid rheumatic fever has not been determined. Excessive dosage of azithromycin can affect a person's ability to drive vehicles or complex mechanisms.
This is reported in the instructions for use for Azitral. According to reviews, the price of the product is quite acceptable.
Cost
The cost of the drug is an average of 200-270 rubles. It depends on the region and pharmacy network, as well as the number of tablets in the package.
Reviews
Experts prescribe the drug "Azitral" for effective antibiotic therapy of various infectious pathologies. The main advantage of the drug is the lack of need for long-term courses, safety for adult patients.
Many patients note that cessation of the drug does not immediately stop undesirable effects. Symptomatic additional treatment is needed.
The omission of one tablet should be filled sooner, without deviating from the dosage regimen prescribed by the doctor.
The drug "Azitral" is one of the few that can be safely used for skin infections - boils, pyoderma and impetigo. As noted in the comments by patients, it is very convenient to use. It is important to take it in the correct dosage, and it is better not to prescribe it without permission, without consulting a doctor.
Doctors note that "Azitral" is an effective antibiotic of a wide spectrum of effects, successfully used in the pathology of the genitourinary and respiratory systems.
It is noted that with an advanced disease, something stronger should be selected. In rare cases, side effects occur, but not as is the case with other antibiotics.
The article presented instructions for use, price and reviews of "Azitral".