Catad_pgroup Antimicrobial ( different groups)

Hemomycin lyophilisate - instructions for use

Registration number

ATX code

International nonproprietary name

azithromycin

Dosage form

lyophilisate for preparing solution for infusion.

Compound

1 bottle contains
active substance- azithromycin (in the form of azithromycin dihydrate 524.00 mg) 500 mg;
Excipients: citric acid monohydrate - 110 mg, mannitol - 146 mg, sodium hydroxide - up to pH 6.0 - 7.0.

Description

Lyophilized powder or compacted tablet mass of white or almost white.

Pharmacotherapeutic group

Antibiotic - azalide

Pharmacological properties

Pharmacodynamics
Azithromycin is a broad-spectrum bacteriostatic antibiotic from the macrolide-azalide group. Has a wide spectrum of antimicrobial action. The mechanism of action of azithromycin is associated with the suppression of protein synthesis in microbial cells. By binding to the 50S ribosomal subunit, it inhibits peptide translocase at the translation stage and suppresses protein synthesis, slowing down the growth and reproduction of bacteria. In high concentrations it has a bactericidal effect.

It is active against a number of gram-positive, gram-negative, anaerobic, intracellular and other microorganisms.

Microorganisms may initially be resistant to the action of the antibiotic or may acquire resistance to it.

Scale of sensitivity of microorganisms to azithromycin:

Microorganisms	MIC*, mg/l
	Sensitive	Sustainable
Staphylococcus
Streptococcus A, B, C, G
Streptococcus pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
Neisseria gonorrhoeae

*Minimum inhibitory concentration

In most cases, the following are sensitive to azithromycin:

• Staphylococcus aureus(methicillin-sensitive), Streptococcus pneumoniae(penicillin-sensitive), Streptococcus pyogenes, Streptococcus agalactiae, streptococci groups C, G ;
• aerobic gram-negative microorganisms: Haemophilus influenzae, Haemophilus parainfluenzae, Legionella pneumophila, Moraxella catarrhalis, Pasteurella multocida, Neisseria gonorrhoeae;
• anaerobic microorganisms: Clostridium perfringens, Fusobacterium spp., Prevotella spp., Porphyriomonas spp.,Peptostreptococcus spp.;
• other microorganisms: Chlamydia trachomatis, Chlamydia pneumoniae, Chlamydia psittaci, Mycoplasma pneumoniae, Mycoplasma hominis, Borrelia burgdorferi.

Microorganisms with acquired resistance to azithromycin:

• Streptococcus pneumoniae(penicillin-resistant).

Microorganisms that are initially resistant:

• aerobic gram-positive microorganisms: Enterococcus faecalis, Staphylococcusus spp. (methicillin-resistant staphylococci with a very high frequency have acquired resistance to macrolides);
• gram-positive bacteria resistant to erythromycin;
• anaerobes: Bacteroides fragilis.

Pharmacokinetics
Azithromycin quickly penetrates from blood plasma into tissues. Concentrating in phagocytes and without disrupting their function, azithromycin migrates to the site of inflammation, accumulating directly in infected tissues. The pharmacokinetic profile of azithromycin is characterized by low plasma concentrations and high tissue concentrations.

In healthy volunteers, with an intravenous infusion of azithromycin at a dose of 500 mg (solution concentration 1 mg/ml) for 3 hours, the maximum concentration of the drug Cmax in the blood plasma was 1.1 μg/ml, with a base concentration of 0.18 μg/ml. Similar values ​​were observed in patients with community-acquired pneumonia who received the same therapy for 2 to 5 days (Cmax 3.6 μg/ml, with a base concentration of 0.2 μg/ml).

The half-life of the drug is 65-72 hours.

Plasma protein binding decreases with increasing concentrations of azithromycin in the blood. Azithromycin has a protein binding percentage of 51 at a concentration of 0.02 μg/ml, and 7% at a concentration of 2 μg/ml.

After intravenous administration, azithromycin is distributed into most tissues and body fluids. High level The observed volume of distribution (mean 32 L/kg) and plasma clearance (10.8 ml/min/kg) suggests that the long half-life of the drug is a consequence of the accumulation of the antibiotic in tissues followed by its slow release.

Easily passes through histohematic barriers. Penetrates well into the respiratory tract, genitourinary organs and tissues, incl. prostate gland, skin and soft tissues; accumulates in an environment with low pH, in lysosomes (which is especially important for the eradication of intracellular pathogens). It is also transported by phagocytes: polymorphonuclear leukocytes and macrophages. Penetrates through cell membranes and creates high concentrations in them.

The concentration in foci of infection is significantly higher (24-34%) than in healthy tissues, and correlates with the severity of inflammatory edema. It remains in the body in effective concentrations for 5-7 days after the last dose.

The main route of biotransformation is N-demethylation in the liver.

It is excreted by the intestines, mainly unchanged. A small amount of the drug is excreted by the kidneys. On the first day, 11% is excreted by the kidneys, and after 5 days, 14% of the intravenously administered dose is excreted.

Indications for use

• Severe community-acquired pneumonia caused by Chlamydia pneumoniae, Haemophilus influenzae, Legionella pneumophila, Moraxella catarrhalis, Mycoplasma pneumoniae, Staphylococcus aureus or Streptococcus pneumoniae;
• Severe infectious and inflammatory diseases of the pelvic organs (endometritis and salpingitis) caused by Chlamydia trachomatis, Neisseria gonorrhoeae or Mycoplasma hominis.

Contraindications

• increased sensitivity to azithromycin or other components of the drug;
• hypersensitivity to erythromycin, other macrolides, ketolides;
• severe liver dysfunction;
• severe renal dysfunction (creatinine clearance less than 40 ml/min);
• Children under 16 years of age;
• Simultaneous use with ergotamine and dihydroergotamine.

Carefully

Myasthenia gravis, mild to moderate liver dysfunction, mild to moderate renal dysfunction (creatinine clearance more than 40 ml/min), in patients with proarrhythmogenic factors (especially in elderly patients): with congenital or acquired prolongation of the QT interval, in patients receiving therapy with antiarrhythmic drugs of classes IA (quinidine, procainamide) and III (dofetilide, amiodarone and sotalol), cisapride, terfenadine, antipsychotic drugs (pimozide), antidepressants (citalopram), fluoroquinolones (moxifloxacin and levofloxacin), with fluid disorders electrolyte imbalance, especially in the case of hypokalemia or hypomagnesemia, with clinically significant bradycardia, cardiac arrhythmia or severe heart failure; simultaneous use of digoxin, warfarin, cyclosporine.

Use during pregnancy and breastfeeding

The use of the drug during pregnancy is possible only in cases where the benefits of its use for the mother outweigh the possible risk to the fetus. During lactation breast-feeding suspended.

Directions for use and doses

The drug should be used only in inpatient medical institutions!
Recommended doses for intravenous administration of azithromycin in the treatment of adults and patients over 18 years of age with the following diseases:

Community-acquired pneumonia (CAP)
500 mg once a day intravenously (IV) for at least 2 days (if necessary, by the decision of the attending physician, the IV course can be extended, but should not exceed 5 days). Intravenous administration should be followed by subsequent oral administration of azithromycin in the form of a single daily dose of 500 mg until the 7-10 day total course of treatment is completed.

Infectious and inflammatory diseases of the pelvic organs
500 mg once a day intravenously for at least 2 days (IV course of treatment is no more than 5 days). Intravenous administration should be followed by subsequent oral administration of azithromycin in the form of a single daily dose of 250 mg until the 7-day total course of treatment is completed.
The timing of transition to oral treatment is determined in accordance with clinical examination data.

Patients with impaired renal function
When used in patients with mild to moderate renal impairment (creatinine clearance > 40 ml/min), no dose adjustment is required.

Patients with liver dysfunction
When used in patients with mild to moderate liver dysfunction, no dose adjustment is required.

Elderly patients
In elderly patients, no dose adjustment is required.

The solution for infusion is prepared in 2 stages:
Stage 1 - Preparation of the reconstituted solution:
add 4.8 ml of sterile water for injection to a bottle with 500 mg of the drug and shake thoroughly until the powder is completely dissolved.
1 ml of the resulting solution contains 100 mg of azithromycin.
The prepared solution remains stable for 24 hours at room temperature.

Stage 2 - breeding reconstituted solution (100 mg/ml) carried out immediately before administration in accordance with the table below.

The reconstituted solution is added to a vial with a solvent (0.9% sodium chloride solution, 5% dextrose, Ringer's solution) to obtain a final concentration of azithromycin of 1.0-2.0 mg/ml in the infusion solution.

Hemomycin solution cannot be administered intravenously or intramuscularly!

Before administration, the solution is subjected to visual inspection. If the prepared solution contains particles of the substance, it should not be used.

The prepared solution is stable at room temperature for 24 hours.

Side effect

From the nervous system: dizziness/vertigo, headache, drowsiness, cramps; hypoesthesia, peresthesia, asthenia, insomnia, fainting, aggressiveness, nervousness, agitation, delirium, hallucinations, anxiety, hyperactivity, myasthenia.

From the senses: tinnitus, reversible hearing loss up to deafness (when taking high doses for a long time), visual impairment, impaired perception of taste and smell, perversion of smell, loss of smell, loss of taste.

From the cardiovascular system: palpitations, arrhythmia, including ventricular tachycardia, increased QT interval, torsade de pointes, decreased blood pressure.

From the outside digestive system : nausea, vomiting, diarrhea, abdominal pain and cramps, loose stools, flatulence, dysphagia, dry oral mucosa, belching, ulcers of the oral mucosa, increased secretion of the salivary glands, indigestion, cholestatic jaundice, hepatitis, gastritis, changes in laboratory tests liver function tests, constipation, tongue discoloration, pseudomembranous colitis, pancreatitis, fulminant hepatitis, liver necrosis, liver failure (possibly fatal).

From the respiratory system: pneumonia, respiratory diseases, rhinitis, shortness of breath.

From the circulatory and lymphatic systems: eosinophilia, hemolytic anemia, decreased number of lymphocytes, thrombocytopenia, neutropenia, leukopenia, neutrophilia, increased number of basophils, monocytes, platelets.

Allergic reactions: hypersensitivity reaction, itching, skin rash, angioedema, urticaria, photosensitivity, anaphylactic reaction including edema (in rare cases fatal), erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis.

From the musculoskeletal system: arthralgia, osteoarthritis, myalgia.

From the outside genitourinary system : nephritis, acute renal failure, dysuria, pain in the kidneys, metrorrhagia, testicular dysfunction.

From the skin: dermatitis, dry skin, sweating.

Laboratory indicators: in blood plasma: decrease or increase in bicarbonate concentration, increase in alkaline phosphatase activity, increase in chlorine content, change in potassium content, increase in glucose concentration, change in sodium content, increase in hematocrit, increase in alanine aminotransferase activity, increase in the concentration of bilirubin, urea, creatinine.

Local reactions: pain and inflammation at the injection site.

Others: candidiasis, incl. oral cavity and genital organs, fatigue, malaise, anorexia, vaginitis, pharyngitis, facial flushing, nosebleeds, back pain, neck pain, chest pain, peripheral edema, facial edema, fever.

Overdose

Symptoms: severe nausea, temporary hearing loss, vomiting, diarrhea, abdominal pain, liver dysfunction.
Treatment: symptomatic.

Interaction with other drugs

Azithromycin does not affect the blood concentrations of carbamazepine, cimetidine, didanosine, efavirenz, fluconazole, indinavir, midazolam, theophylline, triazolam, trimethoprim/sulfamethoxazole, rifabutin, cetirizine, nelfinavir, sidenafil, atorvastatin and methylprednisolone when used together.

In pharmacokinetic studies of the effect of a single dose of cimetidine on the pharmacokinetics of azithromycin, no changes in the pharmacokinetics of azithromycin were detected when cimetidine was used 2 hours before azithromycin.

If combined use with cyclosporine is necessary, it is recommended to monitor the level of cyclosporine in the blood and adjust the dose accordingly.

When using digoxin and azithromycin together, it is necessary to monitor the concentration of digoxin in the blood, because many macrolides increase the absorption of digoxin in the intestine, thereby increasing its concentration in the blood plasma.

When used together with indirect anticoagulants (warfarin, other coumarin anticoagulants), it is recommended that patients carefully monitor prothrombin time.

The simultaneous use of terfenadine and macrolide antibiotics causes arrhythmia and prolongation of the QT interval. These data must be taken into account when using terfenadine and azithromycin together.

The simultaneous use of azithromycin (1200 mg) and nelfinavir (750 mg 3 times a day) causes an increase in the equilibrium concentration of azithromycin in the blood plasma; clinically significant side effects was not observed and no dose adjustment of azithromycin was required when used concomitantly with nelfinavir.

When used concomitantly with zidovudine, azithromycin has a minor effect on the pharmacokinetics, including renal excretion, of zidovudine and its glucuronide metabolite. However, the concentration of the active metabolite, phosphorylated zidovudine, increases in the mononuclear cells of peripheral vessels. The clinical significance of this fact has not yet been determined.

When azithromycin is used together with ergotamine and dihydroergotamine, their toxic effects (vasospasm, dysesthesia) may occur.

There have been isolated case reports of rhabdomyolysis in patients taking azithromycin and statins concomitantly.

Neutropenia has sometimes been observed with simultaneous use of azithromycin and rifabutin. Although neutropenia has been associated with the use of rifabutin, a causal relationship between the use of the combination of azithromycin and rifabutin and neutropenia has not been established.

Azithromycin weakly interacts with cytochrome P450 isoenzymes; it has not been revealed that azithromycin is involved in pharmacokinetic interactions similar to erythromycin and other macrolides; azithromycin is not an inducer or inhibitor of cytochrome P450 isoenzymes.

Pharmaceutically incompatible with heparin.

special instructions

Safety and effectiveness have not been established injection form Hemomycin in children under 18 years of age.

The drug should not be administered in longer courses than indicated in the instructions, since the pharmacokinetic properties of azithromycin allow the use of a short dosage regimen.

It is possible that superinfection (including fungal) may occur during treatment with Hemomycin (as with any antibiotic therapy).

Azithromycin should be used with caution in patients with mild to moderate hepatic impairment due to the possibility of developing fulminant hepatitis and severe liver failure.

If there are symptoms of liver dysfunction, such as rapidly increasing asthenia, jaundice, darkening of urine, tendency to bleeding, hepatic encephalopathy, drug therapy should be stopped and a study of the functional state of the liver should be performed.

Azithromycin should be used with caution in patients with mild to moderate renal impairment.

The use of azithromycin may provoke the development of myasthenic syndrome or cause an exacerbation of myasthenia gravis.

When using the drug Chemomycin, diarrhea/pseudomembranous colitis may develop due to Clostridium difficile. Therefore, patients with diarrhea should be closely monitored. The use of drugs that inhibit intestinal motility is contraindicated in the development of pseudomembranous colitis.

After discontinuation of treatment, hypersensitivity reactions may persist in some patients, which requires specific therapy under medical supervision.

Patients on a diet with limited sodium intake when treated with Hemomycin should take into account that one vial contains 6.2 mg of sodium (sodium hydroxide is an excipient).

Impact on the ability to drive vehicles and machinery
Considering the likelihood of developing side effects from the central nervous system, caution should be exercised when driving vehicles and machinery.

Release form

Lyophilisate for the preparation of solution for infusion 500 mg.
500 mg each active substance placed in a bottle of colorless glass of hydrolytic class 1, sealed with a rubber stopper and sealed with an aluminum cap with an insert in the form of a plastic disk (first opening control). 1 bottle along with instructions for use in a cardboard box.

Storage conditions

Store at temperatures from 10 to 25 °C.
Keep out of the reach of children!

Best before date

3 years.
Do not use after the expiration date stated on the package.

Vacation conditions

Dispensed by prescription.

Manufacturer

Hemofarm A.D., Serbia
26300 Vršac, Beogradski put bb, Serbia
tel.: 13/803100, fax: 13/803424

Organization receiving complaints
JSC Nizhpharm, Russia
603950, Nizhny Novgorod GSP-458, st. Salganskaya, 7.

Every mother does everything possible to ensure that her child is healthy and happy. But, unfortunately, this is not always possible. Often present in kindergarten A child with a runny nose can cause a cold in your little one. The drug market today is overflowing with various offers. But you should always approach the choice of medicine very carefully. If we are talking about antibiotics, then your care should be maximum.

Today I want to find out what are the main indications and spectrum of action of the antibiotic Hemomycin. It is quite popular among mothers. Let's find out its composition, evaluate the side effects and draw conclusions whether it is really that good. Or perhaps it would be better to choose some analogue. The price for Hemomycin suspension 200 mg for children varies from 126 rubles or 63 hryvnia. Of course, there are cheaper and more expensive drugs that are similar in composition. But for now, let's find out why Hemomycin is effective.

Hemomycin is available in four types:

• Capsules. Externally, they have a hard gelatinous light blue shell, and inside there is a white powder. There are 6 capsules in a blister, 1 blister in a package.

• Pills. Covered with a film shell, gray-blue in color, biconvex. There are usually 3 tablets in a blister, and 1 blister in a cardboard package.

• The powder from which the suspension is made. Its color is white or very close to it, with a fruity smell. The package contains a dark bottle, the weight of the powder is 10-12 g. A measuring spoon is included.

• Special form of the drug for injections.

Compound

The main active ingredient is azithromycin in the form of dihydrate. Auxiliary components are also added - corn starch, fruit flavors, sodium saccharin, calcium carbonate, sorbitol, etc.

Operating principle

Chemomycin is a broad-spectrum bactericidal antibiotic. Azithromycin inhibits protein synthesis at the cellular level in pathogenic microorganisms. As a result, it helps block the proliferation of many bacteria.

It is active in the fight against aerobic gram-positive bacteria. These include streptococci, gonococci, staphylococci, listeria. It is also active against aerobic gram-negative bacteria, anaerobic bacteria. This drug is active against intracellular microorganisms - chlamydia trachomatis, mycoplasma, ureaplasma, etc. Improvement is observed in patients whose disease was caused by obligate intrapulmonary microorganisms, for example, mycoplasma, chlamydia, legionella.

The drug does not act on gram-positive bacteria that are resistant to erythromycin.

Indications

Inflammatory and infectious diseases caused by microorganisms that are sensitive to this drug:

• Infections of the ENT organs and upper respiratory tract. These include sinusitis, otitis media and tonsillitis.

• Infections of the urogenital tract.
• Infections of the skin and soft tissues, such as impetigo, secondary infected dermatitis.
• Scarlet fever.
• Diseases of the intestines and duodenum caused by the bacterium Helicobacter pylori.
• Lower respiratory tract infections (bronchitis, bacterial pneumonia).
• Treatment for initial stage Lyme disease.

At what age can the following be allowed for use? Hemomycin can be used from six months of age.

Contraindications in children

• Hypersensitivity to macrolide antibiotics.
• Kidney and liver failure.
• Age category up to 12 years (for capsules and tablets).
• Children under 12 months of age (for a solution with a concentration of 200 mg/5 ml).
• Age up to 6 months (for a suspension with a concentration of 100 mg/5 ml).
• This drug should be prescribed and used with caution by pregnant women, with arrhythmia, and children with impaired renal and liver function.

Adverse reactions

• Allergic: itching, urticaria, conjunctivitis.
• In the central nervous system: insomnia, headache, anxiety, sleep disturbance, neurosis.
• In the digestive system: stomach pain, nausea, gastritis, flatulence, vomiting, cholestatic jaundice, candidiasis of the oral mucosa, increased liver enzymes, diarrhea or constipation, change in taste.
• From the urinary and reproductive system: nephritis, vaginal candidiasis.
• In the cardiovascular system: chest pain, rapid heartbeat.

Hemomycin 250: instructions for use and dosage for children

The instructions imply the use of this medicine once a day in between meals. Ideally, 1 hour before or 2 hours after meals. Such requirements were formed due to the fact that the active substances of the antibiotic are poorly absorbed with food.

Capsules Hemomycin 250

The recommended antibiotic dosage for children over 12 years of age for infections of the lower and upper respiratory tract, as well as soft tissues and skin, is 10 mg/kg once a day. The recommended duration of treatment is 3 days. Considering the peculiarities of the course of the disease, it is worth relying on the doctor’s prescription.

Hemomycin tablets

Can be prescribed to adults and children over 12 years of age for infections of the lower and upper respiratory tract at a dosage of 500 mg/day for 3 days.

• For acute uncomplicated urethritis, the doctor may prescribe the drug in a single dose of 1 g.
• For stomach diseases caused by the bacterium Helicobacter pylari, 1 g per day is prescribed for 3 days.

Instructions for use of Hemomycin suspension for children 200 mg/5 ml and 100 mg/5 ml

The suspension is prepared as follows: First you need to prepare the water - boil it and cool it. Pour prepared water into the bottle (or you can use distilled water) to the desired level and shake thoroughly until smooth. The suspension must be shaken before each use.

The diluted medicine can be stored at room temperature for up to 5 days. The instructions also ask you to pay attention to the fact that after using the medicine, the baby must be given a few sips of water or other liquid to completely wash it off from the mouth and get it inside.

Overdose

Symptoms of overdose may include: temporary hearing loss, nausea, vomiting, diarrhea.
In this case, it is necessary to perform gastric lavage and symptomatic therapy.

How does it interact with other drugs?

• At simultaneous use magnesium and aluminum containing Hemomycin, absorption of azithromycin is observed.
• The process of absorption of azithromycin is slowed down by ethanol and food.
• The combined use of digoxin and azithromycin significantly increases the concentration of the former.
• The drug struggles with lincosamides, cephalosporins, and antibiotics of the penicillin group.
• The main component of the antibiotic, azithromycin, is incompatible with heparin.
• But it enhances the effects of tetracyclines, sulfonamides, and streptomycin.

Conditions of storage and sale

The drug should be stored at a temperature of 15° to 25°, protected from children and direct sunlight. The shelf life is 2 years.

The drug is sold only with a doctor's prescription.

Reviews of Hemomycin suspension for children

Most often you can find positive reviews about the drug on pharmaceutical websites. This helps to form a good assessment of its effectiveness and quality. Most often, young parents write about malfunctions in the gastrointestinal tract, and this is its only disadvantage. Therefore, if any symptoms appear, you should immediately contact your doctor to adjust the dosage or even change the medication.

Zhanna:

On the 4th day of taking the antibiotic, the child showed no improvement. Sometimes they write that the effect can occur after finishing the entire course, but we did not wait for it. We went to the pediatrician for a new prescription and prescribed injections. Based on my personal experience, I can say that this antibiotic does not help everyone.

Natalia:

My daughter refused to take Hemomycin, despite the fact that she diluted it with tea and compote, and constantly spat it out. As a result, she did not drink the full portion. But I can note that in combination with other drugs there was an effect, and the cough subsided.

Alina:

He helped my child more than once in the treatment of scarlet fever, bronchitis and purulent sore throat. In addition, the price is reasonable, and you only need to use it for 3 days, and then only once a day. We had no side effects. I can confidently recommend it only after prior consultation with a doctor. One piece of advice: if you are offered Sumamed in a pharmacy, then know that there is no difference in effectiveness, but the price of the latter is almost twice as high.

Victoria:

Very effective drug. We drank it twice and were satisfied, since it did not cause any side effects, and improvement occurred by the middle of the second day. And the price is quite reasonable.

Irina:

The downside of this antibiotic for me is that after shaking, the product remains on the walls, and after that it does not reach the desired level. In this regard, it turns out that by the last dose only half the dose remains. And given that the course of administration is short, I am worried that its action will not be enough to defeat viruses. But while taking it I overcame my cold, leaving only a slight cough and runny nose. Its advantage is that Hemomycin does not affect the intestines, as happens when taking antibiotics.

Analogues

• Suprax. This is a potent third-generation antibiotic; it can be used from 6 months. It has a fairly wide spectrum of action. But it is prescribed by doctors only when less powerful drugs do not work. Its price is an order of magnitude higher than that of Hemomycin. But, at the same time, this antibiotic copes with any kind of disease, including sore throat in children.
• Zinnat. It is allowed to be used from the age of three months. This drug acts on the causative agent of infections selectively: on some people more strongly, on others less, it may not work at all.
• Amoxicillin. This drug is prescribed for any age. However, it is not very effective in the fight against certain types of staphylococci and a number of other viruses, but this antibiotic is most often prescribed for bronchitis in children.

Analogues of Hemomycin for the active substance are:

• Sumamed– sold both in tablets and capsules, and in granules for dilution with water and preparation of a suspension. Recommended for use from 6 months. As for the price, it is slightly inferior to Hemomycin.
• Ecomed. This antibiotic is also available in three of the same forms as Sumamed or Hemomycin. Can be recommended for use from 6 months.

Features of antibiotic use in children

There are several rules that must be followed when using them:

• you cannot decide to prescribe them or stop using them on your own; this must be discussed with your doctor;
• you must strictly follow the indicated dosage;
• you should not stop using the drug before the permissible period, even if you see minor improvements;
• provide the baby with bed rest;

• ventilate the room regularly;
• carry out wet cleaning;
• exclude spicy, fried, salty foods from his diet.

After taking antibiotics, you need to help restore the intestinal microflora and immunity with the help of drugs with live bacteria - probiotics. Usually the body needs 5-10 days to return to normal.

Video review of the drug

Maintaining the health of your child is one of the most important tasks of every parent. Nowadays on the pharmaceutical market you can find a huge variety of medicines. But how do you know which of them is effective and which will really help your baby? I suggest watching a video in which a specialist answers important questions and talks about all the intricacies of taking a drug such as Hemomycin.

Very important point In the formation of health and immunity in a baby, it is not only the correct lifestyle and habits, but also the period of his intrauterine life. After all, the fact that the body was saturated with essential vitamins and microelements also plays a significant role. Many doctors recommend avoiding citrus fruits during pregnancy, as they are a product that can cause allergies during this period.

Of course, 99% of mothers will not, under any circumstances, risk their health and the health of their baby. However, I can say with absolute certainty that if you feel an irresistible craving to eat a certain product, do it. Perhaps this is what your baby needs right now, and will play an important role in strengthening the health and immunity of your baby.

Share your observations on the use of the drug Hemomycin. How did your baby react to taking it, were there any side effects - tell us about it in the comments on the site! And I wish you and your baby good health!

Chemomycin is an antibacterial and bactericidal agent.

Release form and composition

Dosage forms:

• capsules 250 mg: gelatin, hard, size No. 0, light blue, with white powder inside (6 capsules in a PVC/aluminum blister, 1 blister in a cardboard box);
• 500 mg tablets, film-coated: biconvex, round; bluish-gray film coating (3 tablets in a PVC/aluminum blister, 1 blister in a cardboard box);
• powder for the preparation of a suspension for oral administration 100 mg/5 ml: white or almost white in color, with a fruity odor, the finished suspension is almost white in color and with a fruity odor (11.43 g of powder in a dark glass bottle, with a metal cap, 1 bottle and 1 measuring spoon with a volume of 5 ml, with a mark at 2.5 ml, in a cardboard box);
• powder for the preparation of a suspension for oral administration 200 mg/5 ml: white or almost white, with a fruity odor, the finished suspension is almost white and also with a fruity odor (10 g of powder in a dark glass bottle, with a plastic or metal cap, 1 bottle and 1 measuring spoon with a volume of 5 ml, with a mark at 2.5 ml, in a cardboard box);
• lyophilisate for the preparation of solution for infusion, 500 mg: a white or almost white mass pressed into a tablet or lyophilized powder.

Composition of 1 capsule:

• active substance: azithromycin – 250 mg (azithromycin dihydrate – 262.03 mg);
• auxiliary components: anhydrous lactose, corn starch, magnesium stearate, sodium lauryl sulfate;
• capsule shell: titanium dioxide (E171), blue proprietary dye, gelatin.

Composition of 1 tablet:

• active substance: azithromycin – 500 mg (azithromycin dihydrate);
• auxiliary components: silicate microcrystalline cellulose, microcrystalline cellulose, sodium carboxymethyl starch (type A), povidone, magnesium stearate, talc, colloidal silicon dioxide;
• film shell: titanium dioxide, talc, copovidone, ethylcellulose, macrogol 6000, indigo carmine (indigotine) (E132), dyes green varnish 8% [indigo carmine (indigotine) (E132)], quinoline yellow (E104).

Powder composition (100 mg/5 ml):

• active substance: azithromycin – 100 mg (azithromycin dihydrate – 104.809 mg);

Powder composition (200 mg/5 ml):

• active substance: azithromycin – 200 mg (azithromycin dihydrate – 209.6 mg);
• auxiliary components: xanthan gum, sodium saccharinate, calcium carbonate, colloidal silicon dioxide, anhydrous sodium phosphate, sorbitol, apple, strawberry, cherry flavors.

Composition of 1 bottle of lyophilisate:

• active substance: azithromycin – 500 mg (azithromycin dihydrate – 524 mg);
• auxiliary components: citric acid monohydrate, mannitol, sodium hydroxide.

Indications for use

Capsules

• infections of the upper respiratory tract, ENT organs: otitis media, pharyngitis, sinusitis, tonsillitis;
• lower respiratory tract infections: bacterial, atypical; exacerbation chronic bronchitis, acute bronchitis, pneumonia;
• infections of soft tissues and skin: erysipelas, secondary infected dermatoses, impetigo, moderate acne vulgaris;
• infectious and inflammatory diseases (caused by microorganisms sensitive to azithromycin);
• urogenital infections caused by Chlamydia trachomatis: cervicitis, urethritis;
• the initial stage of borreliosis (Lyme disease) (erythema migrans).

Tablets and powder 100 mg/5 ml and 200 mg/5 ml

• infections of the upper respiratory tract and ENT organs: otitis media, tonsillitis, sinusitis, pharyngitis, tonsillitis;
• scarlet fever;
• lower respiratory tract infections: bronchitis, atypical and bacterial pneumonia;
• infectious and inflammatory diseases caused by microorganisms sensitive to azithromycin;
• infections of soft tissues and skin: erysipelas, secondary infected dermatoses, impetigo;
• urogenital infections (cervicitis, urethritis) caused by Chlamydia trachomatis (only for tablets and powder 100 mg/5 ml);
• borreliosis (Lyme disease) at the initial stage (erythema migrans).

Additionally for tablets: prescribed as part of combination therapy for diseases of the stomach and duodenum caused by Helicobacter Pylori.

Lyophilisate

• severe community-acquired pneumonia caused by Chlamydia pneumoniae, Haemophilus influenzae, Legionella pneumophila, Moraxella catarrhalis, Mycoplasma pneumoniae, Staphylococcus aureus or Streptococcus pneumoniae;
• severe infectious and inflammatory diseases of the pelvic organs (salpingitis and endometritis) caused by Chlamydia trachomatis, Neisseria gonorrhoeae or Mycoplasma hominis.

Contraindications

Capsules

Absolute contraindications:

• increased sensitivity to any of the components of the drug;
• increased sensitivity to erythromycin and other macrolides, ketolides;
• severe impairment of liver or kidney function (creatinine clearance less than 40 ml/min);
• combined use with ergotamine and dihydroergotamine;
• age up to 12 years with body weight up to 45 kg;
• lactation period;
• glucose-galactose malabsorption, lactose intolerance, lactase deficiency (since this form release contains lactose).

• impaired renal and liver function of mild to moderate severity (creatinine clearance - more than 40 ml/min);
• myasthenia gravis;
• the presence of proarrhythmogenic factors, especially in elderly patients;
• prolongation of the QT interval (congenital or acquired);
• disturbances of water and electrolyte balance, especially with hypomagnesemia and hypokalemia with clinically significant bradycardia, arrhythmia or severe heart failure;
• pregnancy.

Film-coated tablets

Absolute contraindications:

• increased sensitivity to the components of the drug, as well as to macrolides;
• renal or liver failure;
• age up to 12 years;
• lactation period.

Relative contraindications:

• pregnancy;
• arrhythmias (due to the risk of ventricular arrhythmias and prolongation of the QT interval);

Powder 100 mg/5 ml, 200 mg/5 ml

Absolute contraindications:

• increased sensitivity to any of the components of the drug, as well as to other macrolides;
• liver or kidney failure;
• lactation period;
• age up to 6 months (powder 100 mg) and up to 12 months (powder 200 mg).

Relative contraindications:

• pregnancy;
• arrhythmias (due to the risk of ventricular arrhythmias and prolongation of the QT interval);
• severe renal or liver dysfunction in children.

Lyophilisate

Absolute contraindications:

• increased sensitivity to any of the components of the drug, as well as to macrolides;
• severe liver or kidney dysfunction;
• age up to 16 years.

Relative contraindications:

• moderate impairment of liver or kidney function;
• arrhythmias;
• predisposition to prolongation of the QT interval and arrhythmias.

During pregnancy, the drug in this form is used only in situations where the benefit of its use for the mother outweighs the risk to the fetus. If it is necessary to use the drug during lactation, breastfeeding is suspended.

Directions for use and dosage

Film-coated capsules and tablets

The drug is taken orally, 1 time per day, 1 hour before or 2 hours after meals.

Dosage regimen:

• respiratory tract infections (upper and lower): 0.5 g/day. The course of admission is 3 days. Course dose – 1.5 g;
• infections of soft tissues and skin: tablets - 1 g on the first day, then 0.5 g per day, course of administration - 5 days, course dose - 3 g; capsules – 500 mg once a day for 3 days, course dose 1.5 g;
• uncomplicated cervicitis or urethritis: 1 g once;
• initial stage of Lyme disease (borreliosis) (erythema migrans): 1 g on the first day of administration, then 0.5 g daily. The course of treatment is 5 days. Course dose – 3 g;
• as part of complex therapy for diseases of the stomach and duodenum (Helicobacter pylori): 1 g per day, for 3 days.

If a dose of the drug is missed, you need to take it as soon as possible, and take the next dose after 24 hours.

Powder for suspension for oral administration

The drug is taken orally, 1 time per day, 1 hour before or 2 hours after meals.

Add boiled and cooled or distilled water to the bottle up to the mark, shake the bottle until a homogeneous suspension is obtained. The suspension level should be at the level of the mark on the bottle. The suspension is stable for up to 5 days at room temperature.

For children with infections of soft tissues and skin (except for chronic migratory erythema), as well as the upper and lower respiratory tract: 10 mg/kg body weight 1 time per day, course of administration – 3 days. The course dose is 30 mg/kg body weight.

Daily dose of suspension (100 mg/5 ml or 200 mg/5 ml):

• with a body weight of 10–14 kg: 5 or 2.5 ml;
• with body weight 15–25 kg: 10 or 5 ml;
• with a body weight of 26–35 kg: 15 or 7.5 ml;
• with body weight 36–45 kg: 20 or 10 ml;
• over 45 kg: adult doses.

For adults:

• infections of the upper and lower respiratory tract – 0.5 g 1 time per day. The course of treatment is 3 days. Course dose – 1.5 g;
• infections of soft tissues, skin and the initial stage of Lyme disease: powder 200 mg/5 ml - 1 g on the first day of administration, then 0.5 g per day, course of treatment - 5 days, course dose - 3 g; powder 100 mg/ml – 0.5 g once a day, course of treatment – ​​3 days, course dose – 1.5 g;
• chronic migratory erythrema: on the first day 20 mg/kg body weight, then 10 mg/kg body weight. The course of treatment is 5 days. The drug should be taken 1 time per day
• infections of the urogenital tract: powder 100 mg/5 ml, it is recommended to take 1 g once.

Children with erythema migrans should take Hemomycin 100 mg/5 ml according to the following regimen:

• body weight less than 8 kg: on the first day 5 ml, then 2.5 ml;
• body weight 8–14 kg: on the first day 10 ml, then 5 ml;
• body weight 15–24 kg: on the first day 20 ml, then 10 ml;
• body weight 25–44 kg: on the first day 25 ml, then 12.5 ml.

Children with erythema migrans should take Hemomycin 200 mg/5 ml according to the following regimen:

• body weight 8–14 kg: on the first day 5 ml, then 2.5 ml;
• body weight 15–24 kg: on the first day 10 ml, then 5 ml;
• body weight 25–44 kg: on the first day 12.5 ml, then 6.25 ml.

Shake before use, and after use, give the child a little liquid to drink to wash off any remaining suspension.

If a dose of the drug is missed, it is necessary to take it as soon as possible, and take the next dose after 24 hours.

Lyophilisate for the preparation of solution for infusion

For hospital use only.

The solution is administered intravenously.

Adults and children over 16 years of age:

• community-acquired pneumonia: 0.5 g per day once, for at least 2 days. Next, the drug should be taken orally, 0.5 g once a day. The course of treatment is 7–10 days;
• infectious and inflammatory diseases of the pelvic organs: 0.5 g per day once, for at least 2 days. Then take 0.25 g orally once a day. The course of treatment is 7 days. The timing of switching to the oral form of the drug depends on data from clinical studies.

In case of moderate impairment of liver and kidney function (creatinine clearance more than 40 ml/min), no dose adjustment is required.

Method of preparing solution for infusion:

Stage 1. Preparation of the reconstituted solution. Add 4.8 ml of sterile water for injection to the bottle with the lyophilisate and shake vigorously until the drug is completely dissolved. The solution should be stored at room temperature for 24 hours.

Stage 2. Dilution of the reconstituted solution. The reconstituted solution is poured into a bottle with a solvent (for a concentration of azithromycin in an infusion solution of 1 mg/ml, 500 ml of solvent is needed, for a concentration of 2 mg/ml - 250 ml of solvent) until the final concentration of azithromycin in the infusion solution is obtained. Solvent - Ringer's solution, 0.9% sodium chloride solution, 5% dextrose solution. Dilution of the reconstituted solution should be carried out immediately before administration.

The drug should not be administered intramuscularly or intravenously.

Before administration, a visual inspection of the solution is necessary. A solution containing particles of the substance should not be used.

Side effects

Capsules

• infectious diseases: candidiasis (oral and genital mucosa), pneumonia, gastroenteritis, pharyngitis, rhinitis, respiratory diseases, pseudomembranous colitis;
• blood and lymphatic system: eosinophilia, neutropenia, leukopenia, thrombocytopenia, hemolytic anemia;
• metabolism: anorexia;
• immune system: allergic reactions, such as angioedema, anaphylactic reaction, hypersensitivity reaction;
• nervous system: headache, dizziness, paresthesia, drowsiness, taste disturbances, nervousness, insomnia, agitation, anxiety, aggression, hypoesthesia, convulsions, fainting, psychomotor hyperactivity, perversion or loss of smell, myasthenia gravis, delirium, hallucinations, loss of taste;
• organ of vision: visual impairment;
• organ of hearing and labyrinthine disorders: hearing loss, vertigo, hearing impairment (deafness, tinnitus);
• cardiovascular system: flushing of the face, palpitations, decreased blood pressure, increased QT interval on the ECG, ventricular tachycardia, pirouette-type arrhythmia;
• respiratory system: nosebleeds, shortness of breath;
• gastrointestinal tract: diarrhea, nausea, vomiting, abdominal pain, flatulence, constipation, dyspepsia, dysphagia, gastritis, bloating, belching, ulcers and dryness of the oral mucosa, increased secretion of the salivary glands, pancreatitis, discoloration of the tongue;
• liver and biliary tract: hepatitis, impaired liver function, cholestatic jaundice, liver failure (in rare cases leading to death, mainly due to severe liver dysfunction), liver necrosis, fulminant hepatitis;
• skin and subcutaneous tissues: urticaria, skin rash, itching, dermatitis, sweating, dry skin, photosensitivity, Stevens-Johnson syndrome, erythrema multiforme, toxic epidermal necrolysis;
• musculoskeletal system: myalgia, osteoarthritis, back and neck pain, arthralgia;
• kidneys and urinary tract: pain in the kidneys, dysuria, interstitial nephritis, acute renal failure;
• genitals: dysfunction of the testicles, metrorrhagia;
• other: malaise, asthenia, feeling of fatigue, facial swelling, peripheral edema, fever, chest pain;
• laboratory parameters: decrease in the number of lymphocytes, increase in the number of basophils, eosinophils, neutrophils, monocytes, changes in potassium content in the blood plasma, decrease in the concentration of bicarbonates in the blood plasma, increased activity of alanine aminotransferase, aspartaminotransferase, increase in the concentration of bicarbonates, bilirubin, urea, creatinine in the blood plasma, increased alkaline phosphatase activity in blood plasma, increased chlorine content in blood plasma, increased hematocrit, increased blood glucose concentration, change in sodium content in blood plasma, increased platelet count.

Pills

• nervous system: dizziness, anxiety, headache, drowsiness; in children – headache (with otitis media), hyperkinesia, neurosis, vertigo, sleep disturbances (less than 1%);
• allergic reactions: Quincke's edema, rash, photosensitivity;
• digestive system: increased activity of liver transaminases, cholestatic jaundice, melena, vomiting, flatulence, dyspepsia, abdominal pain, nausea, diarrhea;
• cardiovascular system: chest pain, palpitations;
• other: increased fatigue; in children – itching, conjunctivitis, urticaria.

Powder 100 mg/5 ml and 200 mg/5 ml

• digestive system: diarrhea, flatulence, nausea, abdominal pain, melena, vomiting, dyspepsia, cholestatic jaundice, increased activity of liver transaminases, oral candidiasis (extremely rare); in children - gastritis, constipation, anorexia;
• cardiovascular system: chest pain, palpitations;
• nervous system: headache, dizziness, drowsiness, vertigo; in children – headache (with otitis media), neurosis, anxiety, hyperkinesia, sleep disturbance;
• genitourinary system: nephritis, vaginal candidiasis;
• allergic reactions: photosensitivity, Quincke's edema, rash;
• other: increased fatigue; in children - urticaria, itching, conjunctivitis.

Lyophilisate

• central nervous system: dizziness, vertigo, headache, convulsions, drowsiness, asthenia, paresthesia, increased excitability, insomnia, anxiety, nervousness, aggressiveness, fainting;
• sensory organs: tinnitus, with long-term use of high doses - hearing impairment, including deafness (reversible), impaired taste, smell, vision;
• cardiovascular system: arrhythmia, ventricular tachycardia, bidirectional ventricular tachycardia, palpitations, increased QT interval, decreased blood pressure;
• digestive system: nausea, vomiting, abdominal pain, cramps, diarrhea, flatulence, loose stools, cholestatic jaundice, gastritis, hepatitis, changes in laboratory tests of liver function, constipation, discoloration of the tongue, pseudomembranous colitis, liver necrosis, pancreatitis, liver failure, sometimes with fatal outcome;
• blood and lymphatic system: neutropenia, thrombocytopenia, leukopenia, neutrophilia;
• allergic reactions: urticaria, itching, rash, angioedema, photosensitivity, anaphylactic reaction, including edema, in rare cases fatal, erythrema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis;
• musculoskeletal system: arthralgia;
• genitourinary system: acute renal failure, nephritis;
• local reactions: inflammation and painful sensations at the injection site;
• other: malaise, fatigue, candidiasis, including oral and genital, vaginitis, anorexia.

special instructions

If you need to take the drug during pregnancy, you need to carefully weigh the risks. Taking the drug is possible when the expected benefit to the mother outweighs the possible risk to the fetus. If it is necessary to take the drug during lactation, breastfeeding should be discontinued for the duration of treatment.

If a dose of the drug is missed, it is necessary to take it as soon as possible, and take the next dose after 24 hours.

In case of moderate liver dysfunction, the drug is taken with caution due to the risk of developing severe liver failure and fulminant hepatitis. If signs of liver dysfunction appear (jaundice, increasing asthenia, bleeding tendency, dark urine, hepatic encephalopathy), the drug should be stopped and the functional state of the liver examined.

In case of mild to moderate renal dysfunction (creatinine clearance more than 40 ml/min), the drug should be prescribed with caution, with regular monitoring of renal function.

When taking Hemomycin, like other antibacterial drugs, patients need regular examination for signs of superinfections, including fungal ones, as well as for the presence of microorganisms that are not susceptible to this drug.

You should not continue therapy with the drug longer than recommended in the instructions.

Long-term use of Hemomycin can cause pseudomembranous colitis (from mild diarrhea to severe colitis) caused by Clostridium difficile. If diarrhea occurs while taking Hemomycin and 2 months after taking it, clostridial pseudomembranous colitis should be excluded.

Taking macrolides, including azithromycin, may cause prolongation of the QT interval and impaired cardiac repolarization, which can lead to the development of arrhythmias, including torsade de pointes (TdP).

In the presence of proarrhythmogenic factors (congenital or acquired prolongation of the QT interval, water-electrolyte imbalance, especially hypomagnesemia, hypokalemia, clinically significant bradycardia, severe heart failure, cardiac arrhythmia, when taking antiarrhythmic drugs type IA, III, cisapride, terfenadine, antipsychotic drugs, antidepressants, fluoroquinolone) caution should be exercised when taking the drug, especially in elderly patients.

Treatment with Chemomycin may cause the development or exacerbation of myasthenia gravis.

Caution must be exercised when driving vehicles and other complex machinery while taking Hemomycin.

Hypersensitivity reactions in some cases do not go away after discontinuation of the drug and require appropriate therapy under the supervision of a physician.

There is no data on the safety and effectiveness of taking the drug in the form of a lyophilisate by children under 16 years of age.

Drug interactions

• digoxin, cyclosporine, warfarin, antiarrhythmic drugs of classes IA and III, cisapride, terfenadine, antipsychotics, antidepressants, fluoroquinolones: use with caution;
• aluminum and magnesium-containing antacids: Hemomycin should be taken 1 hour before or 2 hours after taking these drugs due to a decrease in the concentration of Hemomycin in the blood by 25%. Food slows and reduces absorption;
• anticoagulants of indirect action of the coumarin series (warfarin): it is necessary to monitor the prothrombin time, the anticoagulant effect may be enhanced;
• Digoxin: monitoring of its content in the blood is necessary due to an increase in its concentration when taken together with Hemomycin;
• ergotamine and dihydroergotamine: combined use is contraindicated due to increased toxic effects (vasospasm and dysesthesia);
• terfenadine, macrolide antibiotics: risk of arrhythmias, QT interval prolongation;
• fluconazole: the maximum concentration of azithromycin in the blood decreases by 18% (no clinical significance);
• statins: there are reports of isolated cases of rhabdomyolysis;
• rifabutin: there are reports of neutropenia (a cause-and-effect relationship has not been established);
• cyclosporine: monitoring of the concentration of cyclosporine in the blood plasma and appropriate dose adjustment are necessary;
• zidovudine: the effect on pharmacokinetics is insignificant, the concentration of the active metabolite, phosphorylated zidovudine, in peripheral blood mononuclear cells increases (the clinical significance of this fact has not been determined);
• nelfinavir and azithromycin (750 mg 3 times a day and 1200 mg, respectively): an increase in the equilibrium concentration of azithromycin in blood plasma. No dose adjustment is required;
• cytochrome P4506 isoenzymes: weak interaction;
• cimetidine when taken 2 hours before azithromycin: no changes in the pharmacokinetics of azithromycin were detected;
• carbamazepine, efavirenz, didanosine, fluconazole, indinavir, cetirizine, midazolam, theophylline, triazolam, nelfinavir, trimethoprim + sulfamethoxazole, sildenafil, atorvastatin, methylprednisolone: ​​do not interact;

Additionally for tablets and powder 100 and 200 mg/5 ml:

• triazolam: clearance decreases and the therapeutic effect of triazolam increases;
• indirect anticoagulants, cycloserine, felodipine, methylprednisolone, as well as drugs subject to microsomal oxidation (terfenadine, oral hypoglycemic agents, cyclosporine, bromocriptine, hexobarbital, carbamazepine, valproic acid, disopyramide, ergot alkaloids, phenytoin, theophylline and other xanthine derivatives): increase plasma concentration and toxicity, the elimination of these drugs slows down;
• lincosamines: reduce the effectiveness of Hemomycin;
• chloramphenicol and tetracycline: increase the effectiveness of Hemomycin;
• heparin: incompatible.

Additionally for lyophilisate:

• nelfinavir: increased incidence of side effects from azithromycin;
• cyclosporine, terfenadine, ergot alkaloids, cisapride, pimozide, quinidine, astemizole and other drugs whose metabolism occurs with the participation of the CYP3A4 isoenzyme: the possibility of inhibition of the CYP3A4 isoenzyme.

Antibiotics - macrolides and azalides.

Composition Hemomycin

The active substance is azithromycin.

Manufacturers

Hemofarm A.D. (Serbia)

pharmachologic effect

Pharmacological action - antibacterial.

Suppresses protein biosynthesis, slowing down the growth and reproduction of bacteria; at high concentrations, a bactericidal effect is possible. Stable in an acidic environment, lipophilic, quickly absorbed from the gastrointestinal tract.

The maximum concentration is created after 2-3 hours, the half-life is 68 hours.

Stable plasma levels are achieved after 5-7 days.

Easily passes histohematic barriers and enters tissues.

Concentrations in tissues and cells are 10-50 times higher than in plasma, and at the site of infection they are 24-34% higher than in healthy tissues.

A high level (antibacterial) remains in tissues for 5-7 days after the last injection.

Excreted unchanged in bile (50%) and in urine (6%). The spectrum of action is wide and includes gram-positive (Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus pyogenes, streptococci of groups C, F, G, Streptococcus viridans ), except for those resistant to erythromycin, and gram-negative (Haemophilus influenzae, Moraxella catarrhalis, Bordetella pertussis, Bordetella parapertussis, Campylobacter jejuni, Legionella pneumophila, Neisseria gonorrhoeae, Gardnerella vaginalis) microorganisms, anaerobes (Bacteroides bivius, Peptostreptococcus spp., Peptococcus, Clostridium perfringens) , chlamydia (Chlamydia trachomatis, Chlamydia pneumoniae), mycobacteria (Mycobacteria avium complex), mycoplasma (Mycoplasma pneumoniae), ureoplasma (Ureaplasma urealyticum), spirochetes (Treponema pallidum, Borrelia burgdorferi).

Side effects Hemomycin

Nausea, vomiting, abdominal pain, constipation, flatulence, diarrhea, melena, cholestatic jaundice, chest pain, palpitations, weakness, drowsiness, headache, dizziness, nephritis, vaginitis, candidiasis, neutropenia or neutrophilia, pseudomembranous colitis, photosensitivity, rash , angioedema, eosinophilia; in children, in addition, hyperkinesia, agitation, nervousness, insomnia, conjunctivitis.

Indications for use

Infections of the upper and lower respiratory tract (streptococcal pharyngitis and tonsillitis, bacterial exacerbation of chronic obstructive pneumonia, interstitial and alveolar pneumonia, bacterial bronchitis), ENT organs (otitis media, laryngitis and sinusitis), genitourinary system (urethritis and cervicitis), skin and soft tissues (erysipelas, impetigo, secondary infected dermatoses), chronic stage of erythema migrans (Lyme disease).

Contraindications Chemomycin

Hypersensitivity to macrolides, severe liver dysfunction, pregnancy, lactation.

Directions for use and dosage

The drug is taken orally 1 time / 1 hour before meals or 2 hours after meals, because When taken simultaneously with food, the absorption of azithromycin is reduced.

If you miss one dose of the drug, it should be taken as soon as possible, and subsequent doses should be taken at intervals of 24 hours.

Overdose

No information available.

Interaction

special instructions

Use with caution in cases of severe dysfunction of the liver, kidneys, and cardiac arrhythmias.

After discontinuation of treatment, hypersensitivity reactions may persist in some patients, which requires specific therapy under medical supervision.

Storage conditions

List B.

Store in a dry place, protected from light, at room temperature, out of the reach of children.

Release form: Solid dosage forms. Powder for oral use.

General characteristics. Compound:

Hard gelatin capsules, light blue, size No. 0; The contents of the capsules are white powder. 1 caps. azithromycin (in dihydrate form) 250 mg Excipients: anhydrous lactose, corn starch, sodium lauryl sulfate, magnesium stearate. Shell composition: titanium dioxide E171, patented blue dye VE131, gelatin. 6 - blisters (1) - cardboard packs. Tablets, film-coated, grayish-blue, round, biconvex. 1 tab. azithromycin (in dihydrate form) 500 mg Excipients: microcrystalline cellulose and microcrystalline silicate cellulose, sodium carboxymethyl starch (type A), povidone, magnesium stearate, talc, colloidal silicon dioxide. Shell composition: titanium dioxide, talc, copovidone, ethylcellulose, macrogol 6000, indigo carmine (indigotine) E132, green varnish dye 8%: indigo carmine (indigotine) E132, quinoline yellow E104. 3 - blisters (1) - cardboard packs. Powder for the preparation of a suspension for oral administration is white or almost white in color, with a fruity odor; the prepared suspension is almost white in color with a fruity odor. 5 ml of ready-made suspension. azithromycin (in the form of dihydrate) 100 mg Excipients: xanthan gum, sodium saccharinate, calcium carbonate, colloidal silicon dioxide, sodium phosphate anhydrous, sorbitol, cherry flavoring, apple and strawberry flavorings. 11.43 g - dark glass bottles (1) complete with a measuring spoon - cardboard packs. Powder for the preparation of a suspension for oral administration is white or almost white in color, with a fruity odor; the finished suspension is almost white in color with a fruity odor. 5 ml of ready-made suspension. azithromycin (in the form of dihydrate) 200 mg Excipients: xanthan gum, sodium saccharinate, calcium carbonate, colloidal silicon dioxide, sodium phosphate dodecahydrate, sorbitol, cherry flavoring, apple and strawberry flavorings. 10 g - dark glass bottles (1) complete with a measuring spoon - cardboard packs.

Pharmacological properties:

Broad-spectrum antibiotic. Azithromycin is a representative of a subgroup of macrolide antibiotics - azalides. In high concentrations it has a bactericidal effect. Chemomycin is active against aerobic gram-positive bacteria: Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus spp. groups C, F and G, Streptococcus viridans, Staphylococcus aureus; aerobic gram-negative bacteria: Haemophilus influenzae, Moraxella catarrhalis, Bordetella pertussis, Bordetella parapertussis, Legionella pneumophila, Haemophilus ducreyi, Helicobacter pylori, Campylobacter jejuni, Neisseria gonorrhoeae and Gardnerella vaginalis; anaerobic bacteria: Bacteroides bivius, Clostridium perfringens, Peptostreptococcus spp. The drug is active against intracellular microorganisms: Chlamydia trachomatis, Mycoplasma pneumoniae, Ureaplasma urealyticum, Borrelia burgdorferi, as well as against Treponema pallidum. Gram-positive bacteria that are resistant to erythromycin are resistant to the drug. Suction. Azithromycin is rapidly absorbed from the gastrointestinal tract, due to its stability in an acidic environment and lipophilicity. After oral administration of Chemomycin at a dose of 500 mg, the Cmax of azithromycin in the blood plasma is reached after 2.5-2.96 hours and is 0.4 mg/l. Bioavailability is 37%. Distribution. Azithromycin penetrates well into the respiratory tract, organs and tissues of the urogenital tract, into the prostate gland, into the skin and soft tissues. The high concentration in tissues (10-50 times higher than in blood plasma) and long T1/2 are due to the low binding of azithromycin to plasma proteins, as well as its ability to penetrate eukaryotic cells and concentrate in the low pH environment surrounding lysosomes. This, in turn, determines the large apparent Vd (31.1 l/kg) and high plasma clearance. The ability of azithromycin to accumulate predominantly in lysosomes is especially important for the elimination of intracellular pathogens. It has been proven that phagocytes deliver azithromycin to sites of infection, where it is released during the process of phagocytosis. The concentration of azithromycin in foci of infection is significantly higher than in healthy tissues (on average by 24-34%) and correlates with the degree of inflammatory edema. Despite its high concentration in phagocytes, azithromycin does not have a significant effect on their function. Azithromycin remains in bactericidal concentrations at the site of inflammation for 5-7 days after taking the last dose, which made it possible to develop short (3-day and 5-day) courses of treatment. Excretion. The elimination of azithromycin from blood plasma occurs in 2 stages: T1/2 is 14-20 hours in the range from 8 to 24 hours after taking the drug and 41 hours in the range from 24 to 72 hours, which allows the drug to be used once a day.

Indications for use:

Infectious and inflammatory diseases caused by microorganisms sensitive to the drug: - infections of the upper respiratory tract and ENT organs (angina, middle); - ; - infections of the lower respiratory tract (bacterial and atypical); - infections of the urogenital tract (uncomplicated and/or); - infections of the skin and soft tissues (erysipelas, secondary infected dermatoses); - Lyme disease (borreliosis) for the treatment of the initial stage (erythema migrans); - associated with Helicobacter pylori (as part of combination therapy) (for tablets).

Important! Get to know the treatment

Directions for use and dosage:

Children (the drug is approved for use starting from 6 months, depending on the dosage. See instructions):

Method of preparing a suspension for oral administration:

Water (distilled or boiled and cooled) is gradually added to the bottle to the mark, the contents of the bottle are thoroughly shaken until a homogeneous suspension is obtained. If the level of a homogeneous suspension is below the mark on the bottle label, add water again to the mark and shake. The prepared suspension is stable at room temperature for 5 days.

For infections of the upper and lower respiratory tract, skin and soft tissues (with the exception of chronic migratory erythema), the amount of the drug is taken at the rate of 10 mg per 1 kg of child weight, 1 time per day, for 3 days (course dose 30 mg/kg). Depending on the child’s body weight, the following dosage regimen is recommended:

Patient's body weight	Daily dosage (if you purchased a 100 mg/5 ml suspension)	Daily dosage (if you purchased a 200 mg/5 ml suspension)
	100 mg (5ml) - 1 spoon per day - 3 days	100 mg (2.5 ml) - ½ spoon per day - 3 days
	200 mg (10ml) - 2 spoons per day - 3 days	200 mg (5 ml) - 1 spoon per day - 3 days
	300 mg (15 ml) - 3 spoons per day - 3 days	300 mg (7.5 ml) - 1 ½ spoons per day - 3 days
	400 mg (20 ml) - 4 spoons per day - 3 days	400 mg (10 ml) - 2 spoons per day - 3 days
More than 45 kg		Prescribed doses for adults: 1 tablet 500 mg per day - 3 days

Immediately after taking the suspension, the child should be given a few sips of liquid (water, tea) to wash off and swallow the suspension remaining in the mouth.

If a dose of the drug is missed, it should be taken immediately, if possible, and then subsequent doses should be taken at intervals of 24 hours.

Adults and children over 12 years of age:

The drug is taken orally 1 time/day. 1 hour before or 2 hours after meals.

At acute infections urogenital tract and genitourinary organs (uncomplicated urethritis or cervicitis) - once 1 g.

For gastric and duodenal ulcers associated with Helicobacter pylori - 1 g per day for 3 days as part of combined anti-Helicobacter pylori therapy.

Features of application:

The drug should not be taken during meals. It is recommended to maintain an interval of at least 2 hours between taking Hemomycin and antacid medications. After discontinuation of treatment, hypersensitivity reactions may persist in some patients, which requires specific therapy and medical monitoring.

Side effects:

From the digestive system: (5%), (3%), abdominal pain (3%); 1% or less - melena, cholestatic jaundice, increased activity of liver enzymes, in children - constipation, change in taste, candidiasis of the oral mucosa. From the cardiovascular system: palpitations, chest pain (1% or less). From the side of the central nervous system: vertigo, drowsiness; in children - headache (with therapy), hyperkinesia, anxiety, sleep disturbance (1% or less). From the reproductive system: vaginal candidiasis. From the urinary system: (1% or less). Allergic reactions: rash, Quincke's edema; in children - , itching, . Other: increased fatigue, photosensitivity.

Interaction with other drugs:

With the simultaneous use of Hemomycin and antacids (aluminum- and magnesium-containing), the absorption of azithromycin slows down. Ethanol and food slow down and reduce the absorption of azithromycin. When warfarin and azithromycin were co-administered (in usual doses), no changes in prothrombin time were detected, however, given that the interaction of macrolides and warfarin may enhance the anticoagulant effect, patients need careful monitoring of prothrombin time. The combined use of azithromycin and digoxin increases the concentration of the latter. With the simultaneous use of azithromycin with ergotamine and dihydroergotamine, an increase in the toxic effect of the latter (vasospasm, dysesthesia) is observed. Co-administration of triazolam and azithromycin reduces clearance and enhances the pharmacological effect of triazolam. Azithromycin slows down the elimination and increases the plasma concentration and toxicity of cycloserine, indirect anticoagulants, methylprednisolone, felodipine, and medicines exposed to microsomal oxidation (carbamazepine, terfenadine, cyclosporine, hexobarbital, ergot alkaloids, valproic acid, disopyramide, bromocriptine, phenytoin, oral hypoglycemic agents, theophylline and other xanthine derivatives) - due to the inhibition of microsomal oxidation in hepatocytes by azithromycin. Lincosamines weaken the effectiveness of azithromycin, while tetracycline and chloramphenicol enhance them. Pharmaceutical interactions Azithromycin is pharmaceutically incompatible with heparin.

Contraindications:

— ; — ; — childhood up to 12 years (for capsules and tablets); - children up to 12 months (for suspension 200 mg/5 ml); - children up to 6 months of age (for a suspension of 100 mg/5 ml); - increased sensitivity to macrolide antibiotics. The drug should be prescribed with caution during pregnancy, with (possible ventricular arrhythmias and prolongation of the QT interval), children with severe impairment of liver or kidney function.

Overdose:

Symptoms: nausea, temporary hearing loss, vomiting, diarrhea. Treatment: symptomatic therapy.

Storage conditions:

List B. The drug should be stored out of the reach of children, protected from light, at a temperature of 15° to 25°C. Shelf life - 2 years.

Vacation conditions:

On prescription

Package:

Film-coated tablets 500 mg. There are 3 tablets in a blister, 1 blister in a cardboard box; Capsules 250 mg. There are 6 capsules in a blister, 1 blister in a cardboard box; Powder for the preparation of suspension for oral administration 100 mg/5 ml*. In a dark glass bottle. The package contains a 5 ml measuring spoon with a 2.5 ml line. *What does the dosage of 100 mg/5 ml mean: this means that every 5 ml (1 whole spoon) of the finished suspension contains 100 mg of the active substance of the antibiotic. When preparing the medicine for use in a bottle, 20 ml (4 spoons) of suspension is obtained. Thus, if your child weighs from 10 to 14 kg, then one bottle of Hemomycin, 100 mg/5 ml, will be enough for the course of treatment. Powder for the preparation of suspension for oral administration 200 mg/5 ml*. In a dark glass bottle. The package contains a 5 ml measuring spoon with a 2.5 ml line. *What does the dosage of 200 mg/5 ml mean: this means that every 5 ml (1 whole spoon) of the finished suspension contains 200 mg of the active substance of the antibiotic. When preparing the medicine for use in a bottle, 20 ml (4 spoons) of suspension is obtained. Thus, if your child weighs from 15 to 25 kg, then one bottle of Hemomycin, 200 mg/5 ml, will be enough for the course of treatment.