Антибактериальный препарат из группы макролидов. Механизм де... Инструкция
Показания к применению
Инфекционно-воспалительные заболевания, вызванные чувствительными к препарату микроорганизмами: Инфекции верхних дыхательных путей и ЛОР-органов (фарингит, тонзиллит, паратонзиллит, ларингит, средний отит, синусит). Дифтерия (дополнительно к лечению дифтерийным антитоксином). Скарлатина (при гиперчувствительности к пенициллину). Инфекции нижних дыхательных ...
Тяжелые нарушения функции печени. Дети с массой тела менее 10 кг. Повышенная чувствительность к компонентам препарата. Повышенная чувствительность к антибиотикам группы макролидов.
Антибактериальный препарат из группы макролидов. Механизм действия связан с нарушением синтеза белка в микробной клетке вследствие обратимого связывания с 50S-субъединицей рибосомы. В терапевтических концентрациях, как правило, оказывает бактериостатическое действие, замедляя рост и размножение бактерий. При создании в очаге воспаления высоких концентраций возможен бактерицидный эффект. Джозамицин активен в отношении грамположительных бактерий: Staphylococcus spp. (в т.ч. метициллин-чувствительные штаммы Staphylococcus aureus), Streptococcus spp. (в т.ч. Streptococcus pyogenes и Streptococcus pneumoniae), Corynebacterium diphtheriae, Listeria monocytogenes, Propionibacterium acnes, Bacillus anthracis, Clostridium spp. Peptococcus spp., Peptostreptococcus spp.; грамотрицательных бактерий: Neisseria meningitidis, Neisseria gonorrhoeae, Moraxella catarrhalis, Bordetella spp., Brucella spp., Legionella spp., Haemophilus ducreyi, Haemophilus influenzae, Helicobacter pylori, Campylobacter jejuni, чувствительность Bacteroides fragilis может быть вариабельной; а также в отношении Chlamydia spp. (в т.ч. Chlamydia trachomatis), Chlamydophila spp. (в т.ч. Chlamydophila pneumoniae /ранее называлась Chlamydia pneumoniae/), Mycoplasma spp., в т.ч. Mycoplasma pneumoniae, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma spp., Treponema pallidum, Borrelia burgdorferi. Как правило, не активен в отношении энтеробактерий, поэтому незначительно влияет на микрофлору ЖКТ. В ряде случаев сохраняет активность при резистентности к эритромицину и другим 14- и 15-членным макролидам (стрептококки, стафилококки). Резистентность к джозамицину встречается реже, чем к 14- и 15-членным макролидам.
Показания к применению
Инфекционно-воспалительные заболевания, вызванные чувствительными к препарату микроорганизмами: Инфекции верхних дыхательных путей и ЛОР-органов (фарингит, тонзиллит, паратонзиллит, ларингит, средний отит, синусит). Дифтерия (дополнительно к лечению дифтерийным антитоксином). Скарлатина (при гиперчувствительности к пенициллину). Инфекции нижних дыхательных путей (острый бронхит, обострение хронического бронхита, внебольничная пневмония, включая вызванную атипичными возбудителями). Коклюш. Пситтакоз. Инфекции полости рта (гингивит, перикоронит, периодонтит, альвеолит, альвеолярный абсцесс). Инфекции глаз (блефарит, дакриоцистит). Инфекции кожи и мягких тканей (фолликулит, фурункул, фурункулез, абсцесс, акне, лимфангит, лимфаденит, флегмона, панариций, раневые /в т.ч. Послеоперационные/ и ожоговые инфекции). Сибирская язва. Рожа (при гиперчувствительности к пенициллину). Инфекции мочевыводящих путей и половых органов (уретрит, цервицит, эпидидимит, простатит, вызванные хламидиями и/или микоплазмами). Венерическая лимфогранулема. Гонорея, сифилис (при гиперчувствительности к пенициллину). Заболевания ЖКТ, ассоциированные с Нelicobacter pylori (в т.ч. Язвенная болезнь желудка и двенадцатиперстной кишки, хронический гастрит).
Противопоказания
Тяжелые нарушения функции печени. Дети с массой тела менее 10 кг. Повышенная чувствительность к компонентам препарата. Повышенная чувствительность к антибиотикам группы макролидов.
Применение при беременности и в период грудного вскармливания
Разрешено применение при беременности и в период грудного вскармливания после врачебной оценки пользы/риска. Европейское отделение ВОЗ рекомендует джозамицин в качестве препарата выбора при лечении хламидийной инфекции у беременных.
Способ применения и дозы
Рекомендуемая суточная доза препарата для взрослых и подростков в возрасте старше 14 лет составляет 1-2 г в 2-3 приема. В случае необходимости доза может быть увеличена до 3 г/сут. Дети в возрасте 1 года имеют среднюю массу тела 10 кг. Суточная доза для детей с массой тела не менее 10 кг, назначается исходя из расчета 40-50 мг/кг массы тела ежедневно, разделенная на 2-3 приема: детям с массой тела 10-20 кг назначают по 250-500 мг (1/4-1/2 таб., растворенной в воде) 2 раза/сут, детям с массой тела 20-40 кг назначают по 500-1000 мг (1/2-1 таб., растворенная в воде) 2 раза/сут, детям с массой тела более 40 кг - по 1000 мг (1 таб.) 2 раза/сут. Обычно продолжительность лечения определяется врачом и составляет от 5 до 21 дня в зависимости от характера и тяжести инфекции. В соответствии с рекомендациями ВОЗ, длительность лечения стрептококкового тонзиллита должна составлять не менее 10 дней. В схемах антихеликобактерной терапии джозамицин назначают в дозе 1 г 2 раза/сут в течение 7-14 дней в комбинации с другими препаратами в их стандартных дозах: - фамотидин 40 мг/сут или ранитидин 150 мг 2 раза/сут + джозамицин 1 г 2 раза/сут + метронидазол 500 мг 2 раза/сут; - омепразол 20 мг (или лансопразол 30 мг, или пантопразол 40 мг, или эзомепразол 20 мг, или рабепразол 20 мг) 2 раза/сут + амоксициллин 1 г 2 раза/сут + джозамицин 1 г 2 раза/сут; - омепразол 20 мг (или лансопразол 30 мг, или пантопразол 40 мг, или эзомепразол 20 мг, или рабепразол 20 мг) 2 раза/сут + амоксициллин 1 г 2 раза/сут + джозамицин 1 г 2 раза/сут + висмута трикалия дицитрат 240 мг 2 раза/сут; - фамотидин 40 мг/сут + фуразолидон 100 мг 2 раза/сут + джозамицин 1 г 2 раза/сут + висмута трикалия дицитрат 240 мг 2 раза/сут). При наличии атрофии слизистой желудка с ахлоргидрией, подтвержденной при рН-метрии: амоксициллин 1 г 2 раза/сут + джозамицин 1 г 2 раза/сут + висмута трикалия дицитрат 240 мг 2 раза/сут. При обыкновенных и шаровидных угрях рекомендуется назначать джозамицин в дозе 500 мг 2 раза/сут в течение первых 2-4 недель, далее - 500 мг джозамицина 1 раз/сут в качестве поддерживающего лечения в течение 8 недель. Диспергируемые таблетки Вильпрафен Солютаб могут быть приняты различными способами: таблетку можно проглотить целиком, запивая водой или предварительно, перед приемом, растворить в воде. Таблетки следует растворять, как минимум, в 20 мл воды. Перед приемом следует тщательно перемешать образовавшуюся суспензию.
Побочное действие
Со стороны пищеварительной системы часто - дискомфорт в желудке, тошнота. нечасто - дискомфорт в животе, рвота, диарея. редко - стоматит, запор, снижение аппетита. очень редко - псевдомембранозный колит. Аллергические реакции редко - крапивница, отек Квинке и анафилактоидная реакция. очень редко - буллезный дерматит, многоформная экссудативная эритема (в т.ч. синдром Стивенса-Джонсона). Со стороны печени и желчевыводяших путей очень редко - печеночная дисфункция, желтуха. Со стороны органов чувств в редких случаях сообщалось о дозозависимых преходящих нарушениях слуха. Прочие очень редко - пурпура.
Передозировка
До настоящего времени отсутствуют данные о специфических симптомах передозировки препарата Вильпрафен Солютаб. В случае передозировки следует предполагать возникновение и усиление проявлений побочных эффектов, особенно со стороны пищеварительной системы.
Особые указания
В случае стойкой тяжелой диареи следует иметь в виду возможность развития на фоне джозамицина опасного для жизни псевдомембранозного колита. У больных с почечной недостаточностью лечение следует проводить с учетом результатов соответствующих лабораторных тестов (определение клиренса эндогенного креатинина). Следует учитывать возможность перекрестной устойчивости к различным антибиотикам из группы макролидов (микроорганизмы, устойчивые к лечению родственными по химической структуре антибиотиками, могут также быть резистентны к джозамицину). Влияние на способность к вождению автотранспорта и управлению механизмами: Не отмечено влияния препарата на способность управлять транспортными средствами и работать с механизмами.
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1 таблетке содержится: джозамицина пропионат 1067.66 мг, что соответствует содержанию джозамицина 1000 мг Вспомогательные вещества: целлюлоза микрокристаллическая - 564.53 мг, гипролоза - 199.82 мг, натрия докузат - 10.02 мг, аспартам - 10.09 мг, кремния диоксид коллоидный - 2.91 мг, ароматизатор клубничный - 50.05 мг, магния стеарат - 34.92 мг."}}]},{"id":2,"name":"Фармакологические свойства","slug":"pharmacologic_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Антибактериальный препарат из группы макролидов. Механизм действия связан с нарушением синтеза белка в микробной клетке вследствие обратимого связывания с 50S-субъединицей рибосомы. В терапевтических концентрациях, как правило, оказывает бактериостатическое действие, замедляя рост и размножение бактерий. При создании в очаге воспаления высоких концентраций возможен бактерицидный эффект. Джозамицин активен в отношении грамположительных бактерий: Staphylococcus spp. (в т.ч. метициллин-чувствительные штаммы Staphylococcus aureus), Streptococcus spp. (в т.ч. Streptococcus pyogenes и Streptococcus pneumoniae), Corynebacterium diphtheriae, Listeria monocytogenes, Propionibacterium acnes, Bacillus anthracis, Clostridium spp. Peptococcus spp., Peptostreptococcus spp.; грамотрицательных бактерий: Neisseria meningitidis, Neisseria gonorrhoeae, Moraxella catarrhalis, Bordetella spp., Brucella spp., Legionella spp., Haemophilus ducreyi, Haemophilus influenzae, Helicobacter pylori, Campylobacter jejuni, чувствительность Bacteroides fragilis может быть вариабельной; а также в отношении Chlamydia spp. (в т.ч. Chlamydia trachomatis), Chlamydophila spp. (в т.ч. Chlamydophila pneumoniae /ранее называлась Chlamydia pneumoniae/), Mycoplasma spp., в т.ч. Mycoplasma pneumoniae, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma spp., Treponema pallidum, Borrelia burgdorferi. Как правило, не активен в отношении энтеробактерий, поэтому незначительно влияет на микрофлору ЖКТ. В ряде случаев сохраняет активность при резистентности к эритромицину и другим 14- и 15-членным макролидам (стрептококки, стафилококки). Резистентность к джозамицину встречается реже, чем к 14- и 15-членным макролидам."}}]},{"id":3,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Инфекционно-воспалительные заболевания, вызванные чувствительными к препарату микроорганизмами: Инфекции верхних дыхательных путей и ЛОР-органов (фарингит, тонзиллит, паратонзиллит, ларингит, средний отит, синусит). Дифтерия (дополнительно к лечению дифтерийным антитоксином). Скарлатина (при гиперчувствительности к пенициллину). Инфекции нижних дыхательных путей (острый бронхит, обострение хронического бронхита, внебольничная пневмония, включая вызванную атипичными возбудителями). Коклюш. Пситтакоз. Инфекции полости рта (гингивит, перикоронит, периодонтит, альвеолит, альвеолярный абсцесс). Инфекции глаз (блефарит, дакриоцистит). Инфекции кожи и мягких тканей (фолликулит, фурункул, фурункулез, абсцесс, акне, лимфангит, лимфаденит, флегмона, панариций, раневые /в т.ч. Послеоперационные/ и ожоговые инфекции). Сибирская язва. Рожа (при гиперчувствительности к пенициллину). Инфекции мочевыводящих путей и половых органов (уретрит, цервицит, эпидидимит, простатит, вызванные хламидиями и/или микоплазмами). Венерическая лимфогранулема. Гонорея, сифилис (при гиперчувствительности к пенициллину). Заболевания ЖКТ, ассоциированные с Нelicobacter pylori (в т.ч. Язвенная болезнь желудка и двенадцатиперстной кишки, хронический гастрит)."}}]},{"id":4,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Тяжелые нарушения функции печени. Дети с массой тела менее 10 кг. Повышенная чувствительность к компонентам препарата. Повышенная чувствительность к антибиотикам группы макролидов."}}]},{"id":5,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Разрешено применение при беременности и в период грудного вскармливания после врачебной оценки пользы/риска. Европейское отделение ВОЗ рекомендует джозамицин в качестве препарата выбора при лечении хламидийной инфекции у беременных."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Рекомендуемая суточная доза препарата для взрослых и подростков в возрасте старше 14 лет составляет 1-2 г в 2-3 приема. В случае необходимости доза может быть увеличена до 3 г/сут. Дети в возрасте 1 года имеют среднюю массу тела 10 кг. Суточная доза для детей с массой тела не менее 10 кг, назначается исходя из расчета 40-50 мг/кг массы тела ежедневно, разделенная на 2-3 приема: детям с массой тела 10-20 кг назначают по 250-500 мг (1/4-1/2 таб., растворенной в воде) 2 раза/сут, детям с массой тела 20-40 кг назначают по 500-1000 мг (1/2-1 таб., растворенная в воде) 2 раза/сут, детям с массой тела более 40 кг - по 1000 мг (1 таб.) 2 раза/сут. Обычно продолжительность лечения определяется врачом и составляет от 5 до 21 дня в зависимости от характера и тяжести инфекции. В соответствии с рекомендациями ВОЗ, длительность лечения стрептококкового тонзиллита должна составлять не менее 10 дней. В схемах антихеликобактерной терапии джозамицин назначают в дозе 1 г 2 раза/сут в течение 7-14 дней в комбинации с другими препаратами в их стандартных дозах: - фамотидин 40 мг/сут или ранитидин 150 мг 2 раза/сут + джозамицин 1 г 2 раза/сут + метронидазол 500 мг 2 раза/сут; - омепразол 20 мг (или лансопразол 30 мг, или пантопразол 40 мг, или эзомепразол 20 мг, или рабепразол 20 мг) 2 раза/сут + амоксициллин 1 г 2 раза/сут + джозамицин 1 г 2 раза/сут; - омепразол 20 мг (или лансопразол 30 мг, или пантопразол 40 мг, или эзомепразол 20 мг, или рабепразол 20 мг) 2 раза/сут + амоксициллин 1 г 2 раза/сут + джозамицин 1 г 2 раза/сут + висмута трикалия дицитрат 240 мг 2 раза/сут; - фамотидин 40 мг/сут + фуразолидон 100 мг 2 раза/сут + джозамицин 1 г 2 раза/сут + висмута трикалия дицитрат 240 мг 2 раза/сут). При наличии атрофии слизистой желудка с ахлоргидрией, подтвержденной при рН-метрии: амоксициллин 1 г 2 раза/сут + джозамицин 1 г 2 раза/сут + висмута трикалия дицитрат 240 мг 2 раза/сут. При обыкновенных и шаровидных угрях рекомендуется назначать джозамицин в дозе 500 мг 2 раза/сут в течение первых 2-4 недель, далее - 500 мг джозамицина 1 раз/сут в качестве поддерживающего лечения в течение 8 недель. Диспергируемые таблетки Вильпрафен Солютаб могут быть приняты различными способами: таблетку можно проглотить целиком, запивая водой или предварительно, перед приемом, растворить в воде. Таблетки следует растворять, как минимум, в 20 мл воды. Перед приемом следует тщательно перемешать образовавшуюся суспензию."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Со стороны пищеварительной системы часто - дискомфорт в желудке, тошнота. нечасто - дискомфорт в животе, рвота, диарея. редко - стоматит, запор, снижение аппетита. очень редко - псевдомембранозный колит. Аллергические реакции редко - крапивница, отек Квинке и анафилактоидная реакция. очень редко - буллезный дерматит, многоформная экссудативная эритема (в т.ч. синдром Стивенса-Джонсона). Со стороны печени и желчевыводяших путей очень редко - печеночная дисфункция, желтуха. Со стороны органов чувств в редких случаях сообщалось о дозозависимых преходящих нарушениях слуха. Прочие очень редко - пурпура."}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"До настоящего времени отсутствуют данные о специфических симптомах передозировки препарата Вильпрафен Солютаб. В случае передозировки следует предполагать возникновение и усиление проявлений побочных эффектов, особенно со стороны пищеварительной системы."}}]},{"id":9,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"В случае стойкой тяжелой диареи следует иметь в виду возможность развития на фоне джозамицина опасного для жизни псевдомембранозного колита. У больных с почечной недостаточностью лечение следует проводить с учетом результатов соответствующих лабораторных тестов (определение клиренса эндогенного креатинина). Следует учитывать возможность перекрестной устойчивости к различным антибиотикам из группы макролидов (микроорганизмы, устойчивые к лечению родственными по химической структуре антибиотиками, могут также быть резистентны к джозамицину). Влияние на способность к вождению автотранспорта и управлению механизмами: Не отмечено влияния препарата на способность управлять транспортными средствами и работать с механизмами."}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"Антибактериальный препарат из группы макролидов. Механизм действия связан с нарушением синтеза белка в микробной клетке вследствие обратимого связывания с 50S-субъединицей рибосомы. В терапевтических концентрациях, как правило, оказывает бактериостатическое действие, замедляя рост и размножение бактерий. При создании в очаге воспаления высоких концентраций возможен бактерицидный эффект. Джозамицин активен в отношении грамположительных бактерий: Staphylococcus spp. (в т.ч. метициллин-чувствительные штаммы Staphylococcus aureus), Streptococcus spp. (в т.ч. 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