Хемомицин Порошок, 20 мл, 100/5 мг/мл, для приготовления суспензии

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В высоких концентрациях оказывает бактерицидное действие."}},{"type":"paragraph","data":{"text":"Хемомицин \u003ci\u003eактивен в отношении аэробных грамположительных бактерий:\u003c/i\u003e Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus spp. групп C, F и G, Streptococcus viridans, Staphylococcus aureus; \u003ci\u003eаэробных грамотрицательных бактерий:\u003c/i\u003e Haemophilus influenzae, Moraxella catarrhalis, Bordetella pertussis, Bordetella parapertussis, Legionella pneumophila, Haemophilus ducreyi, Helicobacter pylori, Campylobacter jejuni, Neisseria gonorrhoeae и Gardnerella vaginalis; \u003ci\u003eанаэробных бактерий:\u003c/i\u003e Bacteroides bivius, Clostridium perfringens, Peptostreptococcus spp."}},{"type":"paragraph","data":{"text":"Препарат \u003ci\u003eактивен в отношении\u003c/i\u003e \u003ci\u003eвнутриклеточных микроорганизмов:\u003c/i\u003e Chlamydia trachomatis, Mycoplasma pneumoniae, Ureaplasma urealyticum, Borrelia burgdorferi, а \u003ci\u003eтакже в отношении\u003c/i\u003e Treponema pallidum."}},{"type":"paragraph","data":{"text":"К препарату \u003ci\u003eустойчивы\u003c/i\u003e грамположительные бактерии, резистентные к эритромицину."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Инфекционно-воспалительные заболевания, вызванные чувствительными к азитромицину микроорганизмами:"}},{"type":"list","data":{"style":"ordered","items":["инфекции верхних дыхательных путей и ЛОР-органов (фарингит/тонзиллит, синусит, средний отит);","инфекции нижних дыхательных путей: острый бронхит, обострение хронического бронхита, пневмония, в т. ч. вызванные атипичными возбудителями;","инфекции кожи и мягких тканей (рожа, импетиго, вторичные инфицированные дерматозы);","начальная стадия болезни Лайма (боррелиоз) — мигрирующая эритема \u003ci\u003e(erythema migrans).\u003c/i\u003e"]}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"list","data":{"style":"ordered","items":["Повышенная чувствительность к азитромицину или другим компонентам препарата;","повышенная чувствительность к эритромицину, другим макролидам, кетолидам;","одновременный прием с эрготамином, дигидроэрготамином;","нарушения функции печени тяжелой степени;","непереносимость фруктозы;","детский возраст до 6 месяцев."]}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Миастения, нарушения функции печени легкой и средней степени тяжести, терминальная почечная недостаточность с СКФ (скорость клубочковой фильтрации) менее 10 мл/мин, у пациентов с наличием проаритмогенных факторов (особенно у пожилых пациентов): с врожденным или приобретенным удлинением интервала QT, у пациентов, получающих терапию антиаритмическими препаратами классов IA (хинидин, прокаинамид) и III (дофетилид, амиодарон и соталол), цизапридом, терфенадином, антипсихотическими препаратами (пимозид), антидепрессантами (циталопрам), фторхинолонами (моксифлоксацин и левофлоксацин), с нарушениями водно-электролитного баланса, особенно в случае гипокалиемии или гипомагниемии, с клинически значимой брадикардией, аритмией сердца или тяжелой сердечной недостаточностью; одновременное применение дигоксина, варфарина, циклоспорина."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Применение при беременности возможно только в тех случаях, когда предполагаемая польза для матери превышает потенциальный риск для плода."}},{"type":"paragraph","data":{"text":"При необходимости применения в период лактации следует решить вопрос о прекращении грудного вскармливания."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Препарат принимают внутрь 1 раз/сут. за 1 час до еды или через 2 часа после еды."}},{"type":"paragraph","data":{"text":"Во флакон постепенно добавляют воды (дистиллированной или прокипяченной и охлажденной) до метки."}},{"type":"paragraph","data":{"text":"Содержимое флакона тщательно взбалтывают до получения однородной суспензии."}},{"type":"paragraph","data":{"text":"Если уровень приготовленной суспензии располагается ниже метки на этикетке флакона, повторно добавляют воду до метки и взбалтывают."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПриготовленная суспензия стабильна при комнатной температуре в течение 5 дней.\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003cb\u003eПри инфекциях верхних и нижних дыхательных путей, ЛОР-органов, кожи и мягких тканей (за исключением erythema migrans)\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eДетям: \u003c/i\u003eиз расчета 10 мг/кг массы тела 1 раз в день в течение 3 дней (курсовая доза 30 мг/кг). В зависимости от массы тела ребенка рекомендуется следующий режим дозирования:"}},{"type":"paragraph","data":{"text":"Масса телаСуточная доза (суспензия 100 мг/5 мл)< 8 кг2,5 мл (50 мг) — ½ ложечки8-14 кг5 мл (100 мг) — 1 ложечка15-24 кг10 мл (200 мг) — 2 ложечки25-34 кг12,5 мл (250 мг) — 2,5 ложечки35-45 кг17,5 мл (350 мг) — 3 ½ ложечкиболее 45 кгназначают дозы для взрослых"}},{"type":"paragraph","data":{"text":"При фарингите/тонзиллите, вызванных \u003ci\u003eStreptococcus pyogenes,\u003c/i\u003e азитромицин применяют в дозе 20 мг/кг/сут в течение 3 дней (курсовая доза 60 мг/кг). Максимальная суточная доза составляет 500 мг."}},{"type":"paragraph","data":{"text":"\u003ci\u003eВзрослым:\u003c/i\u003e 500 мг (25 мл суспензии 100 мг/5 мл) 1 раз в день в течение 3-х дней (курсовая доза 1,5 г)."}},{"type":"paragraph","data":{"text":"\u003cb\u003eПри болезни Лайма (боррелиоз) для лечения начальной стадии (erythema migrans)\u003c/b\u003e — 1 раз в сутки в течение 5 дней: в 1-й день в дозе 20 мг/кг массы тела, а затем со 2-го по 5-й день — по 10 мг/кг массы тела (курсовая доза 60 мг/кг)."}},{"type":"paragraph","data":{"text":"Рекомендуется следующий режим дозирования суспензии препарата Хемомицин у детей с \u003ci\u003eerythema migrans:\u003c/i\u003e"}},{"type":"header","data":{"text":"1-й день","level":4}},{"type":"paragraph","data":{"text":"Масса телаСуточная доза (суспензия 100 мг/5 мл)< 8 кг5 мл (100 мг) — 1 ложечка8-14 кг10 мл (200 мг) — 2 ложечки15-24 кг20 мл (400 мг) — 4 ложечки25-34 кг25 мл (500 мг) — 5 ложечек35-45 кг35 мл (700 мг) — 7 ложечек"}},{"type":"header","data":{"text":"Со 2-го до 5-й день","level":4}},{"type":"paragraph","data":{"text":"Масса телаСуточная доза (суспензия 100 мг/5 мл)< 8 кг2,5 мл (50 мг) — ½ ложечки8-14 кг5 мл (100 мг) — 1 ложечка15-24 кг10 мл (200 мг) — 2 ложечки25-34 кг12,5 мл (250 мг) — 2,5 ложечки35-45 кг17,5 мл (350 мг) — 3 ½ ложечки"}},{"type":"paragraph","data":{"text":"\u003ci\u003eПеред употреблением суспензию следует взбалтывать.\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Непосредственно после приема суспензии ребенку следует дать выпить несколько глотков жидкости (вода, чай) для того, чтобы смыть и проглотить оставшуюся в полости рта суспензию."}},{"type":"paragraph","data":{"text":"В том случае, если доза препарата была пропущена, ее необходимо, по возможности, сразу принять, а затем последующие дозы принимать с интервалом в 24 часа."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПациенты с нарушением функции почек:\u003c/i\u003e у пациентов с СКФ 10-80 мл/мин коррекции дозы не требуется."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПациенты с нарушением функции печени: \u003c/i\u003eпри применении у пациентов с нарушением функции печени легкой и средней степени тяжести коррекция дозы не требуется."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПожилые пациенты:\u003c/i\u003e коррекция дозы не требуется. У пожилых пациентов при применении азитромицина рекомендуется соблюдать особую осторожность в связи с возможным наличием проаритмогенных факторов, которые могут повышать риск развития сердечной аритмии и аритмии типа «пируэт»."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Частота побочных эффектов классифицирована в соответствии с рекомендациями Всемирной организации здравоохранения: очень часто – не менее 10%, часто – не менее 1%, но менее 10%, нечасто - не менее 0,1%, но менее 1%, редко - не менее 0,01%, но менее 0,1%, очень редко - менее 0,01%; неизвестная частота - не может быть оценена, исходя из имеющихся данных."}},{"type":"paragraph","data":{"text":"\u003ci\u003eИнфекционные заболевания:\u003c/i\u003e нечасто – кандидоз, в том числе слизистой оболочки полости рта, вагинальная инфекция, пневмония, фарингит, гастроэнтерит, респираторные заболевания, ринит, грибковая инфекция, бактериальная инфекция; неизвестная частота - псевдомембранозный колит."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны крови и лимфатической системы:\u003c/i\u003e нечасто - лейкопения, нейтропения, эозинофилия; очень редко - тромбоцитопения, гемолитическая анемия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны обмена веществ и питания:\u003c/i\u003e нечасто - анорексия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eАллергические реакции:\u003c/i\u003e нечасто - ангионевротический отек, реакция гиперчувствительности; неизвестная частота - анафилактическая реакция."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны нервной системы:\u003c/i\u003e часто - головная боль; нечасто - головокружение, нарушение вкусовых ощущений, парестезии, сонливость, бессонница, нервозность; редко - ажитация; неизвестная частота - гипестезия, тревога, агрессия, обморок, судороги, психомоторная гиперактивность, потеря обоняния, извращенное обоняние, потеря вкусовых ощущений, миастения, бред, галлюцинации."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны органа зрения:\u003c/i\u003eнечасто - нарушение зрения."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны органа слуха и лабиринтные нарушения:\u003c/i\u003e нечасто - расстройство слуха, вертиго; неизвестная частота - нарушение слуха, в том числе глухота и/или шум в ушах."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны сердечно-сосудистой системы: \u003c/i\u003eнечасто - ощущение сердцебиения, «приливы» крови к лицу; неизвестная частота - понижение артериального давления, увеличение интервала QT на электрокардиограмме, аритмия типа «пируэт», желудочковая тахикардия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны дыхательной системы:\u003c/i\u003e нечасто - одышка, носовое кровотечение."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны желудочно-кишечного тракта:\u003c/i\u003e очень часто - диарея; часто - тошнота, рвота, боль в животе; нечасто - метеоризм, диспепсия, запор, гастрит, дисфагия, вздутие живота, сухость слизистой оболочки полости рта, отрыжка, язвы слизистой оболочки полости рта, повышение секреции слюнных желез; очень редко - изменение цвета языка, панкреатит."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны печени и желчевыводящих путей:\u003c/i\u003e нечасто - гепатит; редко - нарушение функции печени, холестатическая желтуха; неизвестная частота - печеночная недостаточность (в редких случаях с летальным исходом в основном на фоне тяжелого нарушения функции печени); некроз печени, фульминантный гепатит."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны кожи и подкожных тканей: \u003c/i\u003eнечасто - кожная сыпь, зуд, крапивница, дерматит, сухость кожи, потливость; редко - реакция фотосенсибилизации, острый генерализованный экзантематозный пустулез; неизвестная частота - синдром Стивенса-Джонсона, токсический эпидермальный некролиз, мультиформная эритема, лекарственная сыпь с эозинофилией и системными проявлениями (DRESS-синдром)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны опорно-двигательного аппарата:\u003c/i\u003e нечасто - остеоартрит, миалгия, боль в спине, боль в шее; неизвестная частота - артралгия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны почек и мочевыводящих путей:\u003c/i\u003e нечасто - дизурия, боль в области почек; неизвестная частота - интерстициальный нефрит, острая почечная недостаточность."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны половых органов и молочной железы:\u003c/i\u003e нечасто - метроррагии, нарушение функции яичек."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПрочие: \u003c/i\u003eнечасто - астения, недомогание, ощущение усталости, отек, отек лица, боль в груди, лихорадка, периферические отеки."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛабораторные и инструментальные данные: \u003c/i\u003eчасто – снижение количества лимфоцитов, повышение количества эозинофилов, повышение количества базофилов, повышение количества моноцитов, повышение количества нейтрофилов, снижение концентрации бикарбонатов в плазме крови; нечасто - повышение активности аспартатаминотрансферазы, аланинаминотрансферазы, повышение концентрации билирубина в плазме крови, повышение концентрации мочевины в плазме крови, повышение концентрации креатинина в плазме крови, изменение содержания калия в плазме крови, повышение активности щелочной фосфатазы в плазме крови, повышение содержания хлора в плазме крови, повышение концентрации глюкозы в крови, увеличение количества тромбоцитов, снижение гематокрита, повышение концентрации бикарбонатов в плазме крови, изменение содержания натрия в плазме крови."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Симптомы: тошнота, временная потеря слуха, рвота, диарея."}},{"type":"paragraph","data":{"text":"Лечение: симптоматическое."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eАнтацидные препараты\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Антацидные препараты не влияют на биодоступность азитромицина, но уменьшают максимальную концентрацию в крови на 30%, поэтому препарат следует принимать, по крайней мере, за один час до или через два часа после приема этих препаратов и еды."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЦетиризин\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Одновременное применение в течение 5 дней у здоровых добровольцев азитромицина с цетиризином (20 мг) не привело к фармакокинетическому взаимодействию и существенному изменению интервала QT."}},{"type":"paragraph","data":{"text":"\u003ci\u003eДиданозин (дидезоксиинозин)\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Одновременное применение азитромицина (1200 мг/сут) и диданозина (400 мг/сут) у 6 ВИЧ-инфицированных пациентов не выявило изменений фармакокинетических показателей диданозина по сравнению с группой плацебо."}},{"type":"paragraph","data":{"text":"\u003ci\u003eДигоксин и колхицин (субстраты Р-гликопротеина)\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Одновременное применение макролидных антибиотиков, в том числе азитромицина, с субстратами Р-гликопротеина, такими как дигоксин и колхицин, приводит к повышению концентрации субстрата Р-гликопротеина в сыворотке крови. Таким образом, при одновременном применении азитромицина и дигоксина необходимо учитывать возможность повышения дигоксина в сыворотке крови."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЗидовудин\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Одновременное применение азитромицина (одноразовый прием 1000 мг и многократный прием 1200 мг или 600 мг) оказывает незначительное влияние на фармакокинетику, в том числе выведение почками, зидовудина или его глюкуронидного метаболита. Однако применение азитромицина вызывало увеличение концентрации фосфорилированного зидовудина, клинически активного метаболита в мононуклеарах периферической крови. Клиническое значение этого факта неясно."}},{"type":"paragraph","data":{"text":"Азитромицин слабо взаимодействует с изоферментами системы цитохрома Р450. Не выявлено, что азитромицин участвует в фармакокинетических взаимодействиях аналогичных эритромицину и другим макролидам. Азитромицин не является ингибитором и индуктором изоферментов цитохрома Р450."}},{"type":"paragraph","data":{"text":"\u003ci\u003eАлкалоиды спорыньи\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Учитывая теоретическую возможность возникновения эрготизма, одновременное применение азитромицина с производными алкалоидов спорыньи не рекомендуется."}},{"type":"paragraph","data":{"text":"Были проведены фармакокинетические исследования одновременного применения азитромицина и препаратов, метаболизм которых происходит с участием изоферментов системы цитохрома Р450."}},{"type":"paragraph","data":{"text":"\u003ci\u003eАторвастатин\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Одновременное применение аторвастатина (10 мг ежедневно) и азитромицина (500 мг ежедневно) не вызывало изменения концентраций аторвастатина в плазме крови (на основе анализа ингибирования ГМК-КоА-редуктазы). Однако, в пострегистрационном периоде были получены отдельные сообщения о случаях рабдомиолиза у пациентов, получающих одновременно азитромицин и статины."}},{"type":"paragraph","data":{"text":"\u003ci\u003eКарбамазепин\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"В фармакокинетических исследованиях с участием здоровых добровольцев не выявлено существенного влияния на концентрацию карбамазепина и его активного метаболита в плазме крови у пациентов, получавших одновременно азитромицин."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЦиметидин\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"В фармакокинетических исследованиях влияния разовой дозы циметидина на фармакокинетику азитромицина не выявлено изменений фармакокинетики азитромицина, при условии применения циметидина за 2 часа до азитромицина."}},{"type":"paragraph","data":{"text":"\u003ci\u003eАнтикоагулянты непрямого действия (производные кумарина)\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"В фармакокинетических исследованиях азитромицин не влиял на антикоагулянтный эффект однократной дозы 15 мг варфарина, принимаемого здоровыми добровольцами. Сообщалось о потенцировании антикоагулянтного эффекта после одновременного применения азитромицина и антикоагулянтов непрямого действия (производные кумарина). Несмотря на то, что причинная связь не установлена, следует учитывать необходимость проведения частого мониторинга протромбинового времени при применении азитромицина у пациентов, которые получают пероральные антикоагулянты непрямого действия (производные кумарина)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЦиклоспорин\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"В фармакокинетическом исследовании с участием здоровых добровольцев, которые в течение 3 дней принимали внутрь азитромицин (500 мг/сут однократно), а затем циклоспорин (10 мг/кг/сут однократно), было выявлено достоверное повышение максимальной концентрации в плазме крови (Cmax) и площади под кривой «концентрация-время» (AUC0-5) циклоспорина. Следует соблюдать осторожность при одновременном применении этих препаратов. В случае необходимости одновременного применения этих препаратов, необходимо проводить мониторинг концентрации циклоспорина в плазме крови и соответственно корректировать дозу."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЭфавиренз\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Одновременное применение азитромицина (600 мг/сут однократно) и эфавиренза (400 мг/сут) ежедневно в течение 7 дней не вызывало какого-либо клинически значимого фармакокинетического взаимодействия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eФлуконазол\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Одновременное применение азитромицина (1200 мг однократно) не меняло фармакокинетику флуконазола (800 мг однократно). Общая экспозиция и период полувыведения азитромицина не изменялись при одновременном применении флуконазола, однако при этом наблюдали снижение Cmax азитромицина (на 18%), что не имело клинического значения."}},{"type":"paragraph","data":{"text":"\u003ci\u003eИндинавир\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Одновременное применение азитромицина (1200 мг однократно) не вызывало статистически достоверного влияния на фармакокинетику индинавира (по 800 мг три раза в сутки в течение 5 дней)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eМетилпреднизолон\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Азитромицин не оказывает существенного влияния на фармакокинетику метилпреднизолона."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНелфинавир\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Одновременное применение азитромицина (1200 мг) и нелфинавира (по 750 мг 3 раза в день) вызывает повышение равновесных концентраций азитромицина в сыворотке крови. Клинически значимых побочных эффектов не наблюдалось и коррекции дозы азитромицина при его одновременном применении с нелфинавиром не требуется."}},{"type":"paragraph","data":{"text":"\u003ci\u003eРифабутин\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Одновременное применение азитромицина и рифабутина не влияет на концентрацию каждого из препаратов в сыворотке крови. При одновременном применении азитромицина и рифабутина иногда наблюдалась нейтропения. Несмотря на то, что нейтропения ассоциировалась с применением рифабутина, причинно-следственная связь между применением комбинации азитромицина и рифабутина и нейтропенией не установлена."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСилденафил\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"При применении у здоровых добровольцев не получено доказательств влияния азитромицина (500 мг/сут ежедневно в течение 3 дней) на AUC и Cmax силденафила или его основного циркулирующего метаболита."}},{"type":"paragraph","data":{"text":"\u003ci\u003eТерфенадин\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"В фармакокинетических исследованиях не было получено доказательств взаимодействия между азитромицином и терфенадином. Сообщалось о единичных случаях, когда возможность такого взаимодействия нельзя было исключить полностью, однако не было ни одного конкретного доказательства, что такое взаимодействие имело место."}},{"type":"paragraph","data":{"text":"Было установлено, что одновременное применение терфенадина и макролидов может вызвать аритмию и удлинение интервала QT."}},{"type":"paragraph","data":{"text":"\u003ci\u003eТеофиллин\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Не выявлено взаимодействие между азитромицином и теофиллином."}},{"type":"paragraph","data":{"text":"\u003ci\u003eТриазолам/мидазолам\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Значительных изменений фармакокинетических показателей при одновременном применении азитромицина с триазоламом или мидазоламом в терапевтических дозах не выявлено."}},{"type":"paragraph","data":{"text":"\u003ci\u003eТриметоприм/сульфаметоксазол\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Одновременное применение триметоприма/сульфаметоксазола с азитромицином не выявило существенного влияния на Cmax, общую экспозицию или экскрецию почками триметоприма или сульфаметоксазола. Концентрации азитромицина в сыворотке крови соответствовали выявляемым в других исследованиях."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Гиперчувствительность. Также как при применении эритромицина и других макролидов, сообщалось о редких случаях серьезных аллергических реакций, включая ангионевротический отек и анафилаксию (в редких случаях с летальным исходом), кожных реакций, включая острый генерализованный экзантематозный пустулез, синдром Стивенса-Джонсона, токсический эпидермальный некролиз (в редких случаях с летальным исходом), лекарственную сыпь с эозинофилией и системными проявлениями (DRESS-синдром). Некоторые из таких реакций, развившихся при применении азитромицина, приобретали рецидивирующее течение и требовали продолжительного лечения и наблюдения."}},{"type":"paragraph","data":{"text":"При развитии аллергической реакции препарат следует отменить и начать соответствующее лечение. Следует иметь в виду, что после отмены симптоматической терапии возможно возобновление симптомов аллергической реакции."}},{"type":"paragraph","data":{"text":"В случае пропуска приема одной дозы препарата — пропущенную дозу следует принять как можно раньше, а последующие — с перерывами в 24 ч."}},{"type":"paragraph","data":{"text":"Азитромицин следует принимать, по крайней мере, за один час до или через два часа после приема антацидных препаратов."}},{"type":"paragraph","data":{"text":"Азитромицин следует применять с осторожностью у пациентов с нарушениями функции печени легкой и средней степени тяжести из-за возможности развития фульминантного гепатита и тяжелой печеночной недостаточности."}},{"type":"paragraph","data":{"text":"При наличии симптомов нарушения функции печени, таких как быстро нарастающая астения, желтуха, потемнение мочи, склонность к кровотечениям, печеночная энцефалопатия, терапию препаратом следует прекратить и провести исследование функционального состояния печени."}},{"type":"paragraph","data":{"text":"При нарушениях функции почек: у пациентов с СКФ 10-80 мл/мин коррекции дозы не требуется; терапию препаратом Хемомицин следует проводить с осторожностью под контролем состояния функции почек у пациентов с СКФ менее 10 мл/мин."}},{"type":"paragraph","data":{"text":"Как и при применении других антибактериальных препаратов, при терапии азитромицином следует регулярно обследовать пациентов на наличие невосприимчивых микроорганизмов и признаки развития суперинфекций, в том числе грибковых."}},{"type":"paragraph","data":{"text":"Препарат не следует применять более длительными курсами, чем указано в инструкции, так как фармакокинетические свойства азитромицина позволяют рекомендовать короткий и простой режим дозирования."}},{"type":"paragraph","data":{"text":"Нет данных о возможном взаимодействии между азитромицином и производными эрготамина и дигидроэрготамина, но из-за развития эрготизма при одновременном применении макролидов с производными эрготамина и дигидроэрготамина данная комбинация не рекомендована."}},{"type":"paragraph","data":{"text":"При длительном приеме азитромицина возможно развитие псевдомембранозного колита, вызванного \u003ci\u003eClostridium difficile,\u003c/i\u003e как в виде легкой диареи, так и тяжелого колита. При развитии антибиотик-ассоциированной диареи на фоне приема препарата, а также через 2 месяца после окончания терапии следует исключить клостридиальный псевдомембранозный колит. Нельзя применять лекарственные препараты, тормозящие перистальтику кишечника."}},{"type":"paragraph","data":{"text":"При лечении макролидами, в том числе азитромицином, наблюдалось удлинение сердечной реполяризации и интервала QT, повышающих риск развития сердечных аритмий, в том числе аритмии типа «пируэт», которые могут привести к остановке сердца."}},{"type":"paragraph","data":{"text":"Следует соблюдать осторожность при применении препарата у пациентов с наличием проаритмогенных факторов (особенно у пожилых пациентов), в том числе с врожденным или приобретенным удлинением интервала QT; у пациентов, получающих терапию антиаритмическими препаратами классов IA (хинидин, прокаинамид), III (дофетилид, амиодарон и соталол), цизапридом, терфенадином, антипсихотическими препаратами (пимозид), антидепрессантами (циталопрам), фторхинолонами (моксифлоксацин и левофлоксацин), с нарушениями водно-электролитного баланса, особенно в случае гипокалиемии или гипомагниемии, с клинически значимой брадикардией, аритмией сердца или тяжелой сердечной недостаточностью."}},{"type":"paragraph","data":{"text":"Применение азитромицина может спровоцировать развитие миастенического синдрома или вызвать обострение миастении."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"В связи с возможным развитием на фоне лечения нежелательных реакций со стороны центральной нервной системы и органа зрения, необходимо соблюдать осторожность при управлении транспортными средствами и выполнении других видов деятельности, требующих повышенной концентрации внимания и быстроты психомоторных реакций."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Порошок для приготовления суспензии для приема внутрь 100 мг/5 мл."}},{"type":"paragraph","data":{"text":"11,43 г порошка во флакон темного стекла вместимостью 60 мл, укупоренный навинчивающейся, с контролем первого вскрытия пластиковой или металлической крышкой. На верхнюю сторону пластиковой крышки нанесена схема открывания флакона."}},{"type":"paragraph","data":{"text":"Флакон вместе с мерной ложкой (объемом 5 мл, с риской для объема 2,5 мл) и инструкцией по применению вкладывают в картонную пачку."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"При температуре не выше 25 ºС в потребительской упаковке."}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года. Не использовать после истечения срока годности, указанного на упаковке."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Отпускают по рецепту."}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"\n\nХемофарм А.Д. 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