С осторожностью: синдром удлиненного интервала QT, хроническая почечная недостаточность (КК более 40 мл/мин), печеночная недостаточность (класс А по шкале Чайлд-Пью), миастения, одновременный прием с терфенадином, варфарином, дигоксином, лекарственными средствами, удлиняющими интервал QT.
Противопоказания
Гиперчувствительность к азитромицину, другим макролидам или к другим компонентам препарата
Одновременное применение с производными спорыньи
Тяжелая печеночная недостаточность (класс В и С по шкале Чайлд-Пью)
Тяжелая почечная недостаточность (КК менее 40 мл/мин)
Детский возраст до 6 месяцев
С осторожностью: синдром удлиненного интервала QT, хроническая почечная недостаточность (КК более 40 мл/мин), печеночная недостаточность (класс А по шкале Чайлд-Пью), миастения, одновременный прием с терфенадином, варфарином, дигоксином, лекарственными средствами, удлиняющими интервал QT.
Применение при беременности и в период грудного вскармливания
Применение препарата во время беременности возможно только в тех случаях, когда предполагаемая польза для матери превышает потенциальный риск для плода.; При необходимости применения препарата в период лактации следует решить вопрос о прекращении грудного вскармливания.
Способ применения и дозы
Препарат назначают внутрь, 1 раз/сут, по крайней мере, за 1 ч до или через 2 ч после еды.; Взрослым (включая пожилых пациентов) и детям старше 12 лет с массой тела свыше 45 кг; При инфекциях верхних и нижних дыхательных путей, ЛОР-органов, кожи и мягких тканей назначают по 500 мг (2 таб.) 1 раз/сут в течение 3 дней (курсовая доза 1.5 г).; При начальной стадии болезни Лайма 1 раз/сут в течение 5 дней: 1-й день - 1.0 г (4 таб.), затем со 2-го по 5 день - по 500 мг (2 таблетки) (курсовая доза 3.0 г).; При неосложненных инфекциях мочеполовых путей, вызванных Chlamydia trachomatis (уретрит, цервицит) - 1 г (4 таб.) однократно.; При угревой сыпи курсовая доза составляет 6 г; по 500 мг (2 таб.) 1 раз/сут в течение 3 дней, затем по 500 мг 1 раз в неделю в течение 9 недель.; Детям с 6 месяцев до 12 лет; При инфекциях дыхательных путей, ЛОР-органов, кожи и мягких тканей назначают из расчета 10 мг/кг массы тела 1 раз/сут в течение 3 дней (курсовая доза 30 мг/кг).; При стрептококковом фарингите препарат назначают из расчета 10-20 мг/кг 1 раз/сут в течение 3 дней.; При начальной стадии болезни Лайма: в 1-й день в дозе 20 мг/кг массы тела и затем со 2 по 5-й день - ежедневно в дозе 10 мг/кг массы гела (курсовая доза 60 мг/кг).; Для пациентов с умеренными нарушениями функции почек (КК > 40 мл/мин) коррекция дозы не нужна.; Диспергируемые таблетки могут быть приняты различными способами: таблетку можно проглотить целиком, запивая водой или предварительно, перед приемом, растворить в воде. Таблетки следует растворять как минимум в 50 мл воды. Перед приемом следует тщательно перемешать образовавшуюся суспензию.
Побочное действие
Со стороны системы кроветворения: лимфоцитопения, зозинофилия, лейкопения, тромбоцитопения, транзиторная нейтропения, гемолитическая анемия.; Со стороны нервной системы: головокружение, вертиго, сонливость, головная боль, судороги, парестезия, гипостезия, астения, бессонница, гиперактивность, агрессивность, беспокойство, тревога, нервозность.; Со стороны органов чувств: нарушение слуха, глухота, звон в ушах, извращение вкуса или обоняния, снижение остроты зрения.; Со стороны сердечно-сосудистой системы: ощущение сердцебиения, снижение АД, аритмия (в т.ч. желудочковая тахикардия, аритмии типа "пируэт"), удлинение интервала QT.; Со стороны пищеварительной системы: тошнота, рвота, диарея, абдоминальная боль или спазмы в животе, неоформленный стул, метеоризм, нарушение пищеварения, гастрит, анорексия, запор, изменение цвета языка, псевдомембранозный колит, гепатит, холестатическая желтуха, нарушение функциональных проб печени, некроз печени и печеночная недостаточность (вплоть до летального исхода), панкреатит, фульминантный гепатит.; Дерматологические реакции: зуд и сыпь, ангионевротический отек, крапивница, фотосенсибилизация, многоформная эритема, синдром Стивенса-Джонсона, токсический эпидермальный некролиз, анафилактические реакции.; Со стороны опорно-двигательного аппарата: артралгия.; Со стороны мочеполовой системы: вагинит, интерстициальный нефрит, острая почечная недостаточность.; Со стороны лабораторных показателей: повышение концентрации в сыворотке крови билирубина, мочевины, креатинина, ионов калия, снижение концентрации бикарбонатов в сыворотке крови.; Прочие: кандидоз, боль в груди, периферические отеки, обмороки, обострение миастении gravis, недомогание, гипергликемия.
Передозировка
Симптомы: временная потеря слуха, тошнота, рвота, диарея.; Лечение: прием активированного угля, поддержание жизненно важных функций организма
Особые указания
В случае пропуска приема одной дозы препарата пропущенную дозу следует принять как можно раньше, а последующие - с перерывами в 24 ч.; При фарингите и тонзиллите, вызванном Streptococcus pyogenes, антибиотиками выбора являются пенициллины. Эффективность азитромицина для профилактики ревматической лихорадки неизвестна.; Принимать с осторожностью пациентам с печеночной недостаточностью (класс А по шкале Чайлд-Пью) из-за возможности развития фульминантного гепатита и тяжелой печеночной недостаточности у таких пациентов. При наличии симптомов нарушения функции печени (быстро нарастающая астения, желтуха, потемнение мочи, склонность к кровотечениям, печеночная энцефалопатия) терапию азитромицином следует прекратить и провести исследование функционального состояния печени.; При почечной недостаточности (КК более 40 мл/мин) применение азитромицина следует проводить под контролем функции почек.; При применении азитромицина, также как и при применении других антибиотиков, существует риск развития суперинфекции (в т.ч. грибковой).; При длительном приеме азитромицина возможно развитие псевдомембранозного колита, вызванного Clostridium difficile. При развитии диареи на фоне приема азитромицина, а также через 2 месяца после окончания терапии, следует исключить клостридиальный псевдомембранозный колит. В легких случаях достаточно отмены лечения и применения ионообменных смол (колестирамин, колестипол). В тяжелых случаях показано возмещение потери жидкости, электролитов и белка, назначение ванкомнцина, бацитрацина или метронидазола. Нельзя применять лекарственные средства, тормозящие перистальтику кишечника.; Поскольку возможно удлинение интервала QT у пациентов, получавших макролиды, включая азитромицин, при применении азитромицина следует соблюдать осторожность у пациентов с известными факторами риска удлинения интервала QT: пожилой возраст, нарушение электролитного баланса (гипокалиемия, гипомагниемия), синдром врожденного удлинения интервала QT, заболевания сердца (сердечная недостаточность, инфаркт миокарда, брадикардия), одновременный прием лекарственных средств, способных удлинять интервал QT (в т.ч. антиаритмические лекарственные средства IA и III классов, трициклические и тетрациклические антидепрессанты, нейролептики, фторхинолоны).; При применении азитромицина возможно развитие миастенического синдрома или обострение миастении.; Влияние на способность к вождению автотранспорта и управлению механизмами; В случае возникновения побочных реакций со стороны нервной системы пациентам рекомендуется воздержаться от управления автомобилем и другими механизмами, а также соблюдать осторожность при занятии видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций.
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(в форме дигидрата) 250 мг; Вспомогательные вещества: целлюлоза микрокристаллическая 225.9 мг, кросповидон 60.3 мг, крахмал прежелатинизированный 67.0 мг, ароматизатор черносмородиновый 5.0 мг, магния стеарат 6.0 мг, натрия сахаринат 15.0 мг, ванилин 1.5 мг, кремния диоксид коллоидный 24.0 мг."}}]},{"id":2,"name":"Фармакологические свойства","slug":"pharmacologic_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Азитромицин - макролидный антибиотик группы азалидов. Обратимо связываясь с 50S-субъединицей рибосом бактериальных клеток, нарушает транслокацию растущей полипептидной цепи из аминоацильного участка в пептидильный, что приводит к подавлению синтеза белка в бактериальных клетках.; К препарату чувствительны: аэробные грамположительные микроорганизмы - Staphylococcus aureus (метициллинчувствительные), Streptococcus pneumoniae (пенициллинчувствительные), Streptococcus pyogenes, Streptococcus группы А, В, С, G; аэробные грамотрицательные микроорганизмы - Haemophilus influenzae, Haemophilus parainfluenzae, Legionella pneumophila, Moraxella catarrhalis, Pasteurella multocida, Neisseria gonorrhoeae; анаэробные микроорганизмы - Clostridium perfringens, Fusobacterium spp., Prevotella spp., Porphyromonas spp.; прочие - Chlamydia trachomatis, Chlamydia pneumoniae, Chlamydia psittaci, Mycoplasma pneumoniae, Mycoplasma hominis, Borrelia burgdorferi. Умеренно чувствительны или нечувствительны: аэробные грамположительные микроорганизмы - Streptococcus pneumoniae (умеренно чувствительные или резистентные к пенициллину).; Устойчивы аэробные грамположительные микроорганизмы - Enterococcus faecalis, Staphylococcus spp. (метициллинустойчивые); анаэробы: группа Bacteroides fragilis, Streptococcus pneumoniae, бета-гемолитические Streptococcus spp. группы A, Enterococcus faecalis и Staphylococcus aureus (включая метициллинустойчивые штаммы), резистентные к эритромицину и прочим макролидам, линкозамидам устойчивы и к азитромицину."}}]},{"id":3,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Инфекционно-воспалительные заболевания, вызванные чувствительными к азитромицину микроорганизмами:"}},{"type":"list","data":{"style":"unordered","items":["Инфекции верхних дыхательных путей и ЛOP-органов (фарингит, тонзиллит, синусит, средний отит)","Инфекции нижних дыхательных путей (острый бронхит, обострение хронического бронхита, внебольничная пневмония, в т.ч. вызнанная атипичными возбудителями)","Инфекции кожи и мягких тканей (угри обыкновенные средней степени тяжести, рожа, импетиго, вторично инфицированные дерматозы)","Начальная стадия болезни Лайма (боррелиоз) - мигрирующая эритема (erythema migrans)","Неосложненные инфекции мочеполовых путей, вызванные Chlamydia trachomatis (уретрит, цервицит)"]}},{"type":"paragraph","data":{"text":"С осторожностью: синдром удлиненного интервала QT, хроническая почечная недостаточность (КК более 40 мл/мин), печеночная недостаточность (класс А по шкале Чайлд-Пью), миастения, одновременный прием с терфенадином, варфарином, дигоксином, лекарственными средствами, удлиняющими интервал QT."}}]},{"id":4,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"list","data":{"style":"unordered","items":["Гиперчувствительность к азитромицину, другим макролидам или к другим компонентам препарата","Одновременное применение с производными спорыньи","Тяжелая печеночная недостаточность (класс В и С по шкале Чайлд-Пью)","Тяжелая почечная недостаточность (КК менее 40 мл/мин)","Детский возраст до 6 месяцев"]}},{"type":"paragraph","data":{"text":"С осторожностью: синдром удлиненного интервала QT, хроническая почечная недостаточность (КК более 40 мл/мин), печеночная недостаточность (класс А по шкале Чайлд-Пью), миастения, одновременный прием с терфенадином, варфарином, дигоксином, лекарственными средствами, удлиняющими интервал QT."}}]},{"id":5,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Применение препарата во время беременности возможно только в тех случаях, когда предполагаемая польза для матери превышает потенциальный риск для плода.; При необходимости применения препарата в период лактации следует решить вопрос о прекращении грудного вскармливания."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Препарат назначают внутрь, 1 раз/сут, по крайней мере, за 1 ч до или через 2 ч после еды.; Взрослым (включая пожилых пациентов) и детям старше 12 лет с массой тела свыше 45 кг; При инфекциях верхних и нижних дыхательных путей, ЛОР-органов, кожи и мягких тканей назначают по 500 мг (2 таб.) 1 раз/сут в течение 3 дней (курсовая доза 1.5 г).; При начальной стадии болезни Лайма 1 раз/сут в течение 5 дней: 1-й день - 1.0 г (4 таб.), затем со 2-го по 5 день - по 500 мг (2 таблетки) (курсовая доза 3.0 г).; При неосложненных инфекциях мочеполовых путей, вызванных Chlamydia trachomatis (уретрит, цервицит) - 1 г (4 таб.) однократно.; При угревой сыпи курсовая доза составляет 6 г; по 500 мг (2 таб.) 1 раз/сут в течение 3 дней, затем по 500 мг 1 раз в неделю в течение 9 недель.; Детям с 6 месяцев до 12 лет; При инфекциях дыхательных путей, ЛОР-органов, кожи и мягких тканей назначают из расчета 10 мг/кг массы тела 1 раз/сут в течение 3 дней (курсовая доза 30 мг/кг).; При стрептококковом фарингите препарат назначают из расчета 10-20 мг/кг 1 раз/сут в течение 3 дней.; При начальной стадии болезни Лайма: в 1-й день в дозе 20 мг/кг массы тела и затем со 2 по 5-й день - ежедневно в дозе 10 мг/кг массы гела (курсовая доза 60 мг/кг).; Для пациентов с умеренными нарушениями функции почек (КК \u003e 40 мл/мин) коррекция дозы не нужна.; Диспергируемые таблетки могут быть приняты различными способами: таблетку можно проглотить целиком, запивая водой или предварительно, перед приемом, растворить в воде. Таблетки следует растворять как минимум в 50 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 системы кроветворения: лимфоцитопения, зозинофилия, лейкопения, тромбоцитопения, транзиторная нейтропения, гемолитическая анемия.; Со стороны нервной системы: головокружение, вертиго, сонливость, головная боль, судороги, парестезия, гипостезия, астения, бессонница, гиперактивность, агрессивность, беспокойство, тревога, нервозность.; Со стороны органов чувств: нарушение слуха, глухота, звон в ушах, извращение вкуса или обоняния, снижение остроты зрения.; Со стороны сердечно-сосудистой системы: ощущение сердцебиения, снижение АД, аритмия (в т.ч. желудочковая тахикардия, аритмии типа \"пируэт\"), удлинение интервала QT.; Со стороны пищеварительной системы: тошнота, рвота, диарея, абдоминальная боль или спазмы в животе, неоформленный стул, метеоризм, нарушение пищеварения, гастрит, анорексия, запор, изменение цвета языка, псевдомембранозный колит, гепатит, холестатическая желтуха, нарушение функциональных проб печени, некроз печени и печеночная недостаточность (вплоть до летального исхода), панкреатит, фульминантный гепатит.; Дерматологические реакции: зуд и сыпь, ангионевротический отек, крапивница, фотосенсибилизация, многоформная эритема, синдром Стивенса-Джонсона, токсический эпидермальный некролиз, анафилактические реакции.; Со стороны опорно-двигательного аппарата: артралгия.; Со стороны мочеполовой системы: вагинит, интерстициальный нефрит, острая почечная недостаточность.; Со стороны лабораторных показателей: повышение концентрации в сыворотке крови билирубина, мочевины, креатинина, ионов калия, снижение концентрации бикарбонатов в сыворотке крови.; Прочие: кандидоз, боль в груди, периферические отеки, обмороки, обострение миастении gravis, недомогание, гипергликемия."}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Симптомы: временная потеря слуха, тошнота, рвота, диарея.; Лечение: прием активированного угля, поддержание жизненно важных функций организма"}}]},{"id":9,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"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.; При фарингите и тонзиллите, вызванном Streptococcus pyogenes, антибиотиками выбора являются пенициллины. Эффективность азитромицина для профилактики ревматической лихорадки неизвестна.; Принимать с осторожностью пациентам с печеночной недостаточностью (класс А по шкале Чайлд-Пью) из-за возможности развития фульминантного гепатита и тяжелой печеночной недостаточности у таких пациентов. При наличии симптомов нарушения функции печени (быстро нарастающая астения, желтуха, потемнение мочи, склонность к кровотечениям, печеночная энцефалопатия) терапию азитромицином следует прекратить и провести исследование функционального состояния печени.; При почечной недостаточности (КК более 40 мл/мин) применение азитромицина следует проводить под контролем функции почек.; При применении азитромицина, также как и при применении других антибиотиков, существует риск развития суперинфекции (в т.ч. грибковой).; При длительном приеме азитромицина возможно развитие псевдомембранозного колита, вызванного Clostridium difficile. При развитии диареи на фоне приема азитромицина, а также через 2 месяца после окончания терапии, следует исключить клостридиальный псевдомембранозный колит. В легких случаях достаточно отмены лечения и применения ионообменных смол (колестирамин, колестипол). В тяжелых случаях показано возмещение потери жидкости, электролитов и белка, назначение ванкомнцина, бацитрацина или метронидазола. Нельзя применять лекарственные средства, тормозящие перистальтику кишечника.; Поскольку возможно удлинение интервала QT у пациентов, получавших макролиды, включая азитромицин, при применении азитромицина следует соблюдать осторожность у пациентов с известными факторами риска удлинения интервала QT: пожилой возраст, нарушение электролитного баланса (гипокалиемия, гипомагниемия), синдром врожденного удлинения интервала QT, заболевания сердца (сердечная недостаточность, инфаркт миокарда, брадикардия), одновременный прием лекарственных средств, способных удлинять интервал QT (в т.ч. антиаритмические лекарственные средства IA и III классов, трициклические и тетрациклические антидепрессанты, нейролептики, фторхинолоны).; При применении азитромицина возможно развитие миастенического синдрома или обострение миастении.; Влияние на способность к вождению автотранспорта и управлению механизмами; В случае возникновения побочных реакций со стороны нервной системы пациентам рекомендуется воздержаться от управления автомобилем и другими механизмами, а также соблюдать осторожность при занятии видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций."}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"Азитромицин - макролидный антибиотик группы азалидов. 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