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Indications and Dosage
Oral
Pulmonary infections, Skin and soft tissue infections Adult: 500 mg once daily as enteric-coated tablets.
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Contraindications
Hypersensitivity. Patients who previously developed liver disorders while receiving the drug.
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Special Precautions
Hepatic or renal impairment; prolongation of QT interval; porphyria; pregnancy; lactation.
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Adverse Reactions
GI disturbances; hypersensitivity reactions; reversible hearing loss; cholestatic jaundice; CV effects; myasthenia-like syndrome; Stevens-Johnson syndrome; toxic epidermal necrolysis.
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Drug Interactions
Drugs known to prolong QT interval; digoxin; oral contraceptives; cimetidine.
Potentially Fatal: Ventricular arrhythmias with astemizole, terfenadine and cisapride. |
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Lab Interference
May interfere with measurements of urinary catecholamines A-hydroxycorticosteroids. False elevation of serum AST values when measured colorimetrically.
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Action
Description:
Mechanism of Action: Dirithromycin is a prodrug of erythromyclamine, which binds reversibly to 50s ribosomal subunit causing blockade of transpeptidation/translocation reactions, inhibition of protein synthesis and thus inhibition of cell growth. Spectrum of activity includes many gram-positive and some gram-negative bacteria, as well as mycoplasmas, spirochetes, chlamydias and rickettsias. Pharmacokinetics: Absorption: Readily absorbed after oral admin; undergoes rapid non-enzymatic hydrolysis to its active metabolite erythromycylamine. Bioavailability: About 10%. Distribution: Widely distributed and tissue concentrations exceed those in plasma. Protein binding:15-30%. Excretion: Largely excreted unchanged in the bile with only about 2% in the urine. Mean plasma half-life: About 8 hr. |
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MIMS Class
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