Erythrokem 250

Description

Erythrokem 250 Tablet (Erythromycin)

Indications:

• Susceptible Infections
• Respiratory Tract Infections (Upper and Lower)
• Bronchitis
• Pneumonia (including Mycoplasma pneumoniae)
• Sinusitis
• Pharyngitis
• Pertussis (Whooping Cough)
• Skin and Soft Tissue Infections
• Chlamydial Infections (including Urogenital infections during pregnancy, uncomplicated urethral, endocervical, or rectal infections)
• Gonococcal Infections (uncomplicated urethral, endocervical, or rectal infections, and in penicillinase-producing N. gonorrhoeae (PPNG))
• Syphilis (early: primary, secondary, or latent syphilis of <1 year duration)
• Diphtheria (as an adjunct to antitoxin)
• Legionnaire’s Disease
• Trench Fever
• Chancroid
• Enteritis (Severe or chronic diarrhea)
• Acne Vulgaris
• Rheumatic Fever (prophylaxis)
• Neonatal Conjunctivitis (due to Chlamydia trachomatis or Neisseria gonorrhoeae)
• Bacterial Endocarditis (prophylaxis in certain procedures)

Dosage and Administration:

• Adults:
  • General Susceptible Infections: Usually 250 mg every 6 hours, or 500 mg every 12 hours. May increase up to 4 g/day, according to the severity of the infection.
  • Upper Respiratory Tract Infections of mild to moderate severity: 250 to 500 mg four times a day for 10 days.
  • Lower Respiratory Infections of mild to moderate severity: 250 to 500 mg four times a day for 10 days.
  • Respiratory Tract Infections due to Mycoplasma pneumoniae: 500 mg every 6 hours for 5 to 10 days; treat severe infections for up to 3 weeks.
  • Skin and Soft Tissue Infections of mild to moderate severity: 250 to 500 mg four times a day for 10 days.
  • Pelvic Inflammatory Diseases (PID), acute due to Neisseria gonorrhoeae: 500 mg four times a day for 10 to 14 days.
  • Urogenital Infection during pregnancy caused by Chlamydia trachomatis: 500 mg four times daily for 7 days or 250 mg four times daily for 14 days.
  • Urethral, endocervical, or rectal infections, uncomplicated: 500 mg four times daily for 7 days or 250 mg four times daily for 14 days.
  • Non-gonococcal urethritis: 500 mg four times daily for at least 7 days.
  • Neisseria gonorrhoeae: Uncomplicated urethral, endocervical or rectal infections and in penicillinase-producing N. gonorrhoeae (PPNG): 500 mg four times a day for 7 days.
  • Early Syphilis (primary, secondary, or latent syphilis of < 1 year duration): 500 mg four times a day for 14 days.
  • Severe or Chronic Diarrhea: 500 mg four times a day for 7 days.
  • Rheumatic Fever (prophylaxis): 250 mg twice daily.
  • Bacterial Endocarditis (prophylaxis): 1 g 2 hours prior to procedures, then 500 mg 6 hours after the initial dose.
  • Acne: 500 mg twice daily for 3 months, then reduced to 250 mg twice daily for another 3 months.
• Children:
  • Oral: 50 mg/kg/day, administered every 6-8 hours.
• Hepatic Impairment: Use with caution.
• Renal Impairment: Dose adjustment is generally not necessary.

Method of Administration: Should be taken on an empty stomach, ideally at least 30 minutes and preferably 2 hours before meals, for optimal absorption.

• For Oral Suspension (if applicable to other forms of Erythromycin): To reconstitute, add 77 mL of water and shake vigorously to make 100 mL of suspension.

Contraindications:

• Hypersensitivity to erythromycin or any macrolide antibiotic.
• Porphyria.
• Hepatic impairment (especially with erythromycin estolate).
• Pregnancy (relative contraindication for certain forms or indications, consult healthcare professional).

Precautions:

• Increased risk of cholestatic hepatitis when treatment duration is greater than 10 days or in patients with a previous history of erythromycin usage.
• History of hepatic disorders, arrhythmias, or prolonged QT interval.
• Monitor liver function during treatment.
• Avoid erythromycin estolate in patients with liver impairment.
• Caution when using erythromycin lactobionate in patients with severe renal impairment.
• May aggravate muscle weakness in patients with myasthenia gravis.
• Lactation: Erythromycin is distributed in breast milk; use with caution. The AAP categorizes it as compatible with breastfeeding.

Pregnancy and Lactation:

• Pregnancy: Use with caution; consult a healthcare professional.
• Lactation: Distributed in breast milk; use with caution. The AAP categorizes it as compatible with breastfeeding.

Interactions:

• May decrease plasma levels of valproic acid, potentially increasing the risk of seizures.
• Increased plasma concentrations with probenecid.
• (Note: Erythromycin is a strong CYP3A4 inhibitor and has numerous significant drug interactions not listed in the original text, such as with statins, warfarin, carbamazepine, digoxin, and others. A comprehensive list would be much longer.)

Adverse Effects:

• Common (1-10%): Abdominal pain (8%), headache (8%), nausea (8%), diarrhea (7%), rash (3%), vomiting (3%), dyspepsia (2%), flatulence (2%), pain (2%), pruritus (1%), pseudomembranous colitis.
• Frequency Not Defined / Less Common: Hypertrophic pyloric stenosis (especially in infants), anaphylaxis, fever, mild allergic reactions, urticaria, skin eruptions, tinnitus.
• Rare (<1%): Cholestatic hepatitis, confusion, hallucinations, hearing loss, hypotension, nervous system effects including seizures, Torsade de pointes, ventricular tachycardia, vertigo.
• Potentially Fatal: Hepatotoxicity, cholestatic jaundice, raised serum transaminases, eosinophilia.

Mechanism of Action: Erythromycin inhibits bacterial protein synthesis by irreversibly binding to the 50S ribosomal subunit. This binding blocks the transpeptidation or translocation reactions of susceptible organisms, resulting in stunted cell growth and ultimately bacterial cell death.

Notes: Erythrokem 250mg Tablet is manufactured by Alkem Laboratories Ltd. Its generic name is Erythromycin. Erythrokem 250 is available in Nepal.

Disclaimer: This information is not intended for diagnosis, medical advice, or treatment and should not be considered a substitute for the exercise of professional judgment by a qualified healthcare provider.