Азитромицин Капсулы, 6 шт, 250 мг

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Кажущийся объем распределения - 311 л/кг связывание с белками плазмы обратно пропорционально концентрации в крови и составляет 7-50%."}},{"type":"paragraph","data":{"text":"Азитромицин кислотоустойчив липофилен. Легко проходит через гистогематические барьеры хорошо проникает в дыхательные пути мочеполовые органы и ткани в т.ч. в предстательную железу кожу и мягкие ткани. К месту инфекции транспортируется также фагоцитами (полиморфно-ядерными лейкоцитами и макрофагами) где высвобождается в присутствии бактерий. Проникает через мембраны клеток и создает в них высокие концентрации что особенно важно для эрадикации внутриклеточно расположенных возбудителей. В очагах инфекции концентрации на 24-34% выше чем в здоровых тканях и коррелирует с выраженностью воспалительного процесса. Сохраняется в эффективных концентрациях в течение 5-7 дней после приема последней дозы."}},{"type":"paragraph","data":{"text":"В печени деметилируется образующиеся метаболиты неактивны. В метаболизме азитромицина участвуют изоферменты CYP3A4 CYP3A5 CYP3A7 ингибитором которых он является. Плазменный клиренс - 630 мл/мин: период полувыведения между 8 и 24 ч после приема - 14-20 ч длинный период полувыведения в интервале от 24 до 72 ч -41 ч."}},{"type":"paragraph","data":{"text":"Период полувыведения из тканей значительно больше. Терапевтическая концентрация азитромицина сохраняется до 5-7 дней после приема последней дозы."}},{"type":"paragraph","data":{"text":"Более 50% азитромицина выводится кишечником в неизменном виде 6% - почками. Прием пищи существенно изменяет формакокинетику: С\u003csub\u003emах\u003c/sub\u003e увеличивается (на 31%) показатель площадь под кривой \"концентрация-время\" (AUG) не изменяется."}},{"type":"paragraph","data":{"text":"У пожилых мужчин (65-85 лет) фармакокинетические параметры не меняются у женщин увеличивается С\u003csub\u003emах\u003c/sub\u003e (на 30 - 50%)."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Инфекционно-воспалительные заболевания вызванные чувствительными к препарату микроорганизмами:"}},{"type":"paragraph","data":{"text":"- инфекции верхних дыхательных путей и ЛОР-органов: фарингит тонзиллит синусит средний отит;"}},{"type":"paragraph","data":{"text":"- инфекции нижних дыхательных путей: острый бронхит обострение хронического бронхита пневмония в т.ч. вызванная атипичными возбудителями;"}},{"type":"paragraph","data":{"text":"- инфекции кожи и мягких тканей: угри обыкновенные средней степени тяжести рожа импетиго вторично инфицированные дерматозы;"}},{"type":"paragraph","data":{"text":"- начальная стадия болезни Лайма (боррелиоз) - мигрирующая эритема (erythema migrans);"}},{"type":"paragraph","data":{"text":"- инфекции мочеполовых путей вызванные Chlamydia trachomatis (уретрит цервицит)."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"- Повышенная чувствительность к азитромицину эритромицину другим антибиотикам группы макролидов или кетолидов или к другим компонентам препарата;"}},{"type":"paragraph","data":{"text":"- тяжелая печеночная недостаточность класс С по Чайлд-Пью);"}},{"type":"paragraph","data":{"text":"- детский возраст до 12 лет с массой тела менее 45 кг;"}},{"type":"paragraph","data":{"text":"- одновременный прием с эрготамином и дигидроэрготамином."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"- Миастения;"}},{"type":"paragraph","data":{"text":"- нарушения функции печени легкой и средней степени тяжести;"}},{"type":"paragraph","data":{"text":"- терминальная почечная недостаточность с СКФ (скорость клубочковой фильтрации) менее 10 мл/мин;"}},{"type":"paragraph","data":{"text":"- 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) 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":"- при совместном применении циклоспорина варфарина дигоксина."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Азитромицин при беременности и в период грудного вскармливания рекомендуется применять только в случаях когда ожидаемая польза от его приема для матери превышает потенциальный риск для плода и ребенка."}},{"type":"paragraph","data":{"text":"При необходимости применения препарата в период грудного вскармливания рекомендуется приостановить грудное вскармливание."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Внутрь 1 раз в сутки по 500 мг по крайней мере за 1 час до или через 2 часа после приема пищи."}},{"type":"paragraph","data":{"text":"Взрослым (включая пожилых людей) и детям старше 12 лет с массой тела свыше 45 кг"}},{"type":"paragraph","data":{"text":"При инфекциях верхних и нижних дыхательных путей лор-органов кожи и мягких тканей: по 500 мг 1 раз в сутки в течение 3-х дней (курсовая доза - 15 г)."}},{"type":"paragraph","data":{"text":"При угрях обыкновенных средней степени тяжести: по 2 капсулы 250 мг 1 раз в сутки в течение 3-х дней затем по 250 мг 2 раза в неделю в течение 9 дней. Курсовая доза 60 г."}},{"type":"paragraph","data":{"text":"При болезни Лайма (боррелиоз) - мигрирующей эритеме: в первый день одновременно 2 капсулы по 500 мг затем со 2-го по 5-й день по 500 мг ежедневно. Курсовая доза 30 г."}},{"type":"paragraph","data":{"text":"При инфекциях мочеполовых путей вызванных Chlamydia trachomatis (уретрит цервицит): неосложненный уретрит/цервицит - одновременно 2 капсулы по 500 мг однократно."}},{"type":"paragraph","data":{"text":"При нарушении функции почек: у пациентов с СКФ 10-80 мл/мин коррекции дозы не требуется."}},{"type":"paragraph","data":{"text":"При нарушении функции печени: при применении у пациентов с нарушением функции печени легкой и средней степени тяжести коррекции дозы не требуется."}},{"type":"paragraph","data":{"text":"Пожилые пациенты: коррекция дозы не требуется поскольку пожилые пациенты уже могут иметь текущие проаритмогенные состояния следует соблюдать осторожность при применении азитромицина в связи с высоким риском развития сердечных аритмий в том числе аритмии типа \"пируэт\"."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"В соответствии с рекомендациями ВОЗ частота побочных эффектов классифицируется: очень часто - не менее 10%;. часто - не менее 1% но менее 10%; нечасто - не менее 01% но менее 1%; очень редко - менее 001% неизвестная частота - не может быть оценена исходя из имеющихся данных."}},{"type":"paragraph","data":{"text":"Со стороны желудочно-кишечного тракта: очень часто - диарея; часто - тошнота рвота боли в животе жидкий стул гастрит дисфагия повышение секреции слюнных желез; нечасто - метеоризм расстройство пищеварения анорексия вздутие живота запор сухость слизистой оболочки полости рта отрыжка язвы слизистой оболочки полости рта; очень редко - изменение цвета языка панкреатит."}},{"type":"paragraph","data":{"text":"Со стороны обмена веществ и питания: нечасто - анорексия."}},{"type":"paragraph","data":{"text":"Аллергические реакции: нечасто - ангионевротический отек реакция гиперчувствительности; неизвестная частота - анафилактическая реакция (в редких случаях со смертельным исходом)."}},{"type":"paragraph","data":{"text":"Со стороны сердечно-сосудистой системы: нечасто - ощущение сердцебиения \"приливы\" крови к лицу; неизвестная частота - аритмия типа \"пируэт\" понижение артериального давления желудочковая тахикардия увеличение интервала QT двунаправленная желудочковая тахикардия."}},{"type":"paragraph","data":{"text":"Со стороны нервной системы: часто - головная боль; нечасто - головокружение/вертиго сонливость парастезия нервозность бессонница нарушение вкусовых ощущений; редко - ажитация; неизвестная частота - гиперактивность агрессивность беспокойство судороги обморок гипестезия потеря или извращение обоняния бред галлюцинации миастения."}},{"type":"paragraph","data":{"text":"Со стороны органов чувств: нечасто - шум в ушах вертиго нарушение зрения; неизвестная частота - обратимое нарушение слуха вплоть до глухоты (при приеме высоких доз в течение длительного времени)."}},{"type":"paragraph","data":{"text":"Со стороны дыхательной системы: нечасто - одышка носовое кровотечение."}},{"type":"paragraph","data":{"text":"Со стороны кровеносной и лимфатической систем: нечасто - нейтропения эозинофилия лейкопения; очень редко - тромбоцитопения гемолитическая анемия."}},{"type":"paragraph","data":{"text":"Со стороны опорно-двигательного аппарата: нечасто - остеоартрит миалгия боль в шее боль в спине; неизвестная частота - артралгия."}},{"type":"paragraph","data":{"text":"Со стороны мочеполовой системы: нечасто - дизурия боль в области почек; неизвестная частота - интерстициальный нефрит острая почечная недостаточность."}},{"type":"paragraph","data":{"text":"Со стороны половых органов и молочной железы: нечасто - метроррагии нарушение функции яичек."}},{"type":"paragraph","data":{"text":"Со стороны печени и желчевыводящих путей: нечасто - гепатит; редко - изменение лабораторных показателей функции печени холестатическая желтуха; неизвестная частота - печеночная недостаточность некроз печени (возможно со смертельным исходом) фульминантный гепатит."}},{"type":"paragraph","data":{"text":"Со стороны кожи и подкожных тканей: зуд кожные высыпания крапивница дерматит потливость сухость кожи; редко - фотосенсибилизация; неизвестная частота - мультиформная эритема синдром Стивенса-Джонсона токсический эпидермальный некролиз."}},{"type":"paragraph","data":{"text":"Инфекционные заболевания: нечасто - кандидоз в том числе слизистой оболочки полости рта и гениталий пневмония фарингит гастроэнтерит респираторные заболевания ринит; неизвестная частота - псевдомембранозный колит."}},{"type":"paragraph","data":{"text":"Прочие: нечасто - астения ощущение усталости недомогание отеки лица периферические отеки лихорадка боль в груди."}},{"type":"paragraph","data":{"text":"Лабораторные данные: часто - снижение количества лимфоцитов повышение количества эозинофилов повышение количества базофилов повышение количества моноцитов повышение количества нейтрофилов снижение концентрации бикарбонатов в плазме крови; нечасто - повышение активности аспартатаминострансферазы аланинаминострансферазы 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 повышение содержания хлора в плазме крови увеличение количества тромбоцитов повышение концентрации бикарбонатов в плазме крови изменение содержания натрия в плазме крови."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Симптомы: временная потеря слуха тошнота рвота диарея."}},{"type":"paragraph","data":{"text":"Лечение: симптоматическое."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Антацидные препараты"}},{"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":"Цетиризин"}},{"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":"Диданозин (дидезоксиинозин)"}},{"type":"paragraph","data":{"text":"Одновременное применение азитромицина (1200 мг/сут) и диданозина (400 мг/сут) у 6 ВИЧ-инфицированных пациентов не выявило изменений фармакокинетических показаний диданозина по сравнению с группой плацебо."}},{"type":"paragraph","data":{"text":"Дигоксин (субстраты Р-гликопротеина)"}},{"type":"paragraph","data":{"text":"Одновременное применение макролидных антибиотиков в том числе азитромицина с субстратами Р-гликопротеина такими как дигоксин приводит к повышению концентрации субстрата Р-гликопротеина в сыворотке крови. Таким образом при одновременном применении азитромицина и дигоксина необходимо учитывать возможность повышения концентрации дигоксина в сыворотке крови."}},{"type":"paragraph","data":{"text":"Зидовудин"}},{"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 задовудина 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":"Алкалоиды спорыньи"}},{"type":"paragraph","data":{"text":"Учитывая теоретическую возможность возникновения эрготизма одновременное применение азитромицина с производными алколоидов 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":"Аторвастатин"}},{"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":"Карбамазепин"}},{"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":"Циметидин"}},{"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":"Антикоагулянты непрямого действия (производные кумарина)"}},{"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":"Циклоспорин"}},{"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 (С\u003csub\u003emах\u003c/sub\u003e) 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":"Эфавиренз"}},{"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":"Флуконазол"}},{"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 С\u003csub\u003emах\u003c/sub\u003e азитромицина (на 18%) что не имело клинического значения."}},{"type":"paragraph","data":{"text":"Индинавир"}},{"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":"Метилпреднизолон"}},{"type":"paragraph","data":{"text":"Азитромицин не оказывает существенного влияния на фармакокинетику метилпреднизолона."}},{"type":"paragraph","data":{"text":"Нелфинавир"}},{"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":"Рифабутин"}},{"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":"Силденафил"}},{"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 С\u003csub\u003emах\u003c/sub\u003e силденафила или его основного циркулирующего метаболита."}},{"type":"paragraph","data":{"text":"Терфенадин"}},{"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":"Теофиллин"}},{"type":"paragraph","data":{"text":"Не выявлено взаимодействие между азитромицином и теофиллином."}},{"type":"paragraph","data":{"text":"Триазолам/мидазолам"}},{"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":"Триметоприм/сульфаметоксазол"}},{"type":"paragraph","data":{"text":"Одновременное применение триметоприма/сульфаметоксазола с азитромицином не выявило существенного влияния на С\u003csub\u003emах\u003c/sub\u003e общую экспозицию или экскрецию почками триметоприма или сульфаметоксазола. Концентрация азитромицина в сыворотке крови соответствовали выявляемым в других исследованиях."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"В случае пропуска приема антибиотика пропущенную дозу следует принять как можно раньше а последующие дозы принимать с интервалом в 24 ч."}},{"type":"paragraph","data":{"text":"Препарат следует принимать по крайней мере за 1 час до или через 2 часа после приема антацидных препаратов."}},{"type":"paragraph","data":{"text":"При наличии симптомов нарушения функции печени такие как астения желтуха потемнение мочи склонность к кровотечениям печеночная энцефалопатия терапию азитромицином следует прекратить и провести исследование функционального состояния печени."}},{"type":"paragraph","data":{"text":"При нарушениях функции почек: у пациентов с СКФ 10-80 мл/мин коррекция дозы не требуется терапию препаратом следует проводить с осторожностью под контролем состояния функции почек."}},{"type":"paragraph","data":{"text":"Азитромицин не следует применять более длительными курсами чем указано в инструкции так как фармакокинетические свойства препарата позволяют рекомендовать более короткий и простой режим дозирования."}},{"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":"Применение препарата может спровоцировать развитие миастенического синдрома или вызвать обострение миастении."}},{"type":"paragraph","data":{"text":"При длительном приеме азитромицина возможно развитие псевдомембранозного колита вызванного Clostridium difficile 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 препараты тормозящие перистальтику кишечника."}},{"type":"paragraph","data":{"text":"После отмены терапии азитромицином реакции гиперчувствительности у некоторых пациентов могут сохраняться в течение продолжительного времени и могут потребовать специфической терапии под наблюдением врача."}},{"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\"."}},{"type":"paragraph","data":{"text":"Следует соблюдать осторожность при применении препарата Азитромицин 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) III (дофетилид амиодарон соталол) цизапридом терфенадином антипсихотическими препаратами (пимозид) антидепрессантами (циталопрам) фторхинолонами (моксифлоксацин и левофлоксацин) с нарушением водно-электролитного баланса особенно в случае гипокалиемии или гипомагниемии с клинически значимой брадикардией аритмией сердца или тяжелой сердечной недостаточностью."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"В период лечения препаратом следует соблюдать осторожность при управлении транспортными средствами и занятиями другими потенциально опасными видами деятельности требующими повышенной концентрации внимания и быстроты психомоторных реакций в связи с возможностью развития нежелательных эффектов со стороны нервной системы и органа зрения."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Капсулы 250 мг и 500 мг."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"В сухом защищенном от света месте при температуре не выше 25 °С."}},{"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."}},{"type":"paragraph","data":{"text":"Не использовать после истечения срока годности."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту"}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"ООО \"Производство Медикаментов\", 346720, Ростовская обл., Аксайский район, г. Аксай, ул. Ленина, д. 43, Россия"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"ООО \"Производство Медикаментов\""}}]}],"source":null},"description_toggle":false,"short_description":"Антибактериальный препарат широкого спектра действия из группы макролидов-азалидов действует бактериостатически. Связываясь с 50S субъединицей рибосом угнетает пептидтранслоказу на стадии трансляции подавляет синтез белка замедляет рост и размножение бактерий в высоких концентрациях оказывает бактерицидный эффект. Действует на вне- и внутриклеточно расположенных возбудителей. Обладает активностью в отношении ряда грамположительных грамотрицательных анаэробов внутриклеточных и других микроорганизмов. Микроорганизмы могут быть изначально устойчивыми к действию антибиотика или могут приобретать устойчивость к нему. Чувствительны: аэробные грамположительные микроорганизмы: Staphylococcus aureus (метилциллинчувствительные) Streptococcus pneumoniae (пенициллинчувствительные) Streptococcus pyogenes; 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 burgdoferi. Умеренно чувствительны или нечувствительны: аэробные грамположительные микроорганизмы: Streptococcus pneumoniae (умеренно чувствительные или резистентные к пенициллину). Устойчивы: аэробные грамположительные микроорганизмы: Enterococcus faecalis Staphylococci spp. (метициллинустойчивые) Staphylococus aureus (включая метициллинчувствительные штаммы) Staphylococus pneumoniae Staphylococcus spp. группы А (бета-гемолитические). Азитромицин не активен в отношении штаммов грамположительных бактерий устойчивых к эритромицину. Анаэробы: Группа Bacteroides fragilis. После приема внутрь азитромицин хорошо всасывается и быстро распределяется в организме. Биодоступность после однократного приема 500 мг - 37% (эффект \"первого прохождения\" через печень) максимальная концентрация (Сmах) после перорального приема 05 г - 04 мг/л время достижения максимальной концентрации (ТСmах) - 2-3 ч. Концентрация в тканях и клетках в 10-50 раз выше чем в сыворотке крови. Кажущийся объем распределения - 311 л/кг связывание с белками плазмы обратно пропорционально концентрации в крови и составляет 7-50%. Азитромицин кислотоустойчив липофилен. Легко проходит через гистогематические барьеры хорошо проникает в дыхательные пути мочеполовые органы и ткани в т.ч. в предстательную железу кожу и мягкие ткани. К месту инфекции транспортируется также фагоцитами (полиморфно-ядерными лейкоцитами и макрофагами) где высвобождается в присутствии бактерий. Проникает через мембраны клеток и создает в них высокие концентрации что особенно важно для эрадикации внутриклеточно расположенных возбудителей. В очагах инфекции концентрации на 24-34% выше чем в здоровых тканях и коррелирует с выраженностью воспалительного процесса. Сохраняется в эффективных концентрациях в течение 5-7 дней после приема последней дозы. В печени деметилируется образующиеся метаболиты неактивны. В метаболизме азитромицина участвуют изоферменты CYP3A4 CYP3A5 CYP3A7 ингибитором которых он является. Плазменный клиренс - 630 мл/мин: период полувыведения между 8 и 24 ч после приема - 14-20 ч длинный период полувыведения в интервале от 24 до 72 ч -41 ч. Период полувыведения из тканей значительно больше. Терапевтическая концентрация азитромицина сохраняется до 5-7 дней после приема последней дозы. Более 50% азитромицина выводится кишечником в неизменном виде 6% - почками. Прием пищи существенно изменяет формакокинетику: Сmахувеличивается (на 31%) показатель площадь под кривой \"концентрация-время\" (AUG) не изменяется. У пожилых мужчин (65-85 лет) фармакокинетические параметры не меняются у женщин увеличивается Сmах(на 30 - 50%).","substance":[{"id":162,"title":"Азитромицин","title_latin":"Azithromycinum","slug":"azitromitsin_162"}],"branding":null,"valid_for_quick_buy":true,"is_available_to_delivery":false,"comments":null,"image_alt":"Азитромицин - фото упаковки","image_share":{"isTouch":{"default":"https://vseapteki.ru/cropping/thumbnails/101/84515/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/84515/share_default/"}},"diseases":[],"other_packages":[{"id":150118,"title":"Азитромицин","subtitle":{"full":"Капсулы, коробка, 3 шт, 500 мг, для приема внутрь","short":"Капсулы, 3 шт, 500 мг","package":"3 шт, 500 мг"},"prescription":true,"catalog_section_id":91,"manufacturer":{"id":2977,"title":"Производство 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