Macropen is an antibiotic from the macrolide group.
Active substance
Midecamycin.
Release form and composition
Available in the form of film-coated tablets and granules for the preparation of a suspension for oral administration.
Indications for use
Bacterial infections caused by pathogens sensitive to the drug, including:
- infections respiratory tract(bronchitis, tonsillitis, pneumonia, otitis, sinusitis);
- infections genitourinary system, in particular nonspecific urethritis;
- infections of the mucous membranes, in particular enteritis, stomatitis;
- skin and soft tissue infections.
Effective for treating the following diseases:
- trachoma;
- brucellosis;
- Legionnaires' disease;
- gonorrhea;
- syphilis;
- scarlet fever;
- diphtheria;
- whooping cough;
- rye.
The drug is also prescribed to patients who are allergic to penicillin antibiotics.
Contraindications
- increased individual sensitivity to the components of the drug;
- liver and kidney failure.
Prescribe with caution during pregnancy and lactation, or if there is a history of allergies to acetylsalicylic acid.
Instructions for use Macropen (method and dosage)
Take before meals
Adults and children weighing more than 30 kg are prescribed 400 mg (1 tablet) 3 times a day. The maximum daily dose is 1.6 g.
For children weighing less than 30 kg, the daily dose is 20-40 mg per 1 kg of body weight, divided into 3 doses; or 50 mg per 1 kg of body weight, divided into 2 doses. For severe infections, a daily dose of 50 mg per 1 kg of body weight, divided into 3 doses, is recommended.
The suspension is used to prepare the drug for children. The dosage is calculated according to the following scheme:
- up to 5 kg – 3.75 ml (131.25 mg) 2 times a day;
- up to 10 kg – 7.5 ml (262.5 mg) 2 times a day;
- up to 15 kg – 10 ml (350 mg) 2 times a day;
- up to 20 kg – 15 ml (525 mg) 2 times a day;
- up to 30 kg – 22.5 ml (787.5 mg) 2 times a day.
The course of treatment is 7-14 days, for the treatment of chlamydial infections - 14 days.
- For the prevention of diphtheria, a dose of 50 mg per 1 kg of body per day, divided into 2 doses, is indicated, the course lasts 7 days. After treatment, a control test is indicated bacteriological examination.
- To prevent whooping cough, 50 mg per kg of body weight per day is prescribed for 7-14 days, in the first 14 days from the moment of contact.
To prepare a suspension from granules, add 100 ml of boiled or distilled water to the contents of the bottle. The bottle must be closed and shaken thoroughly. Shake the prepared suspension before use.
Side effects
Macropen sometimes causes the following side effects:
- nausea, vomiting, diarrhea;
- feeling of heaviness in the epigastrium;
- loss of appetite up to the development of anorexia;
- hyperbilirubinemia;
- weakness;
- increased levels of liver enzymes;
- allergic manifestations on the skin in the form of rash, urticaria, itching.
Overdose
An overdose of Macropen can cause nausea and vomiting, while specific treatment not provided. Sorbents should be taken to accelerate the elimination of the drug and symptomatic therapy should be carried out.
Analogs
Analogs by ATX code: no.
Medicines with a similar mechanism of action (matching level 4 ATC code): Clarithromycin, Azithromycin, Josamycin.
Do not decide to change the drug on your own; consult your doctor.
pharmachologic effect
- Macropen in low doses has a bacteriostatic effect, in large doses it has a bactericidal effect. The antibiotic effect of the drug is due to the suppression of protein synthesis in bacterial cells. Active active substance, midecamycin, forms reversible bonds with the 50S subunit of the bacterial ribosomal membrane.
- Suspension and tablets are antibiotics wide range action, the effectiveness of which extends to gram-positive microorganisms: staphylococci producing and not producing penicillinase, streptococci, listeria, clostridia, corynobacteria; gram-negative microorganisms: Helicobacter, Moraxella, Campylobacter, Bacteroides, Haemophilus influenzae; intracellular microorganisms: ureaplasma, mycoplasma, chlamydia, legionella; erythromycin-resistant gram-negative bacilli: Pseudomonas aeruginosa, Escherichia coli, as well as Salmonella spp, Shigella spp and others.
- Can be used as a reserve antibiotic in the treatment of infections caused by bacteria in case of intolerance to beta-lactam antibiotics.
- When administered orally, the active active substance is quickly and completely absorbed into the gastrointestinal tract. The drug is concentrated mainly in the site of inflammation, as well as in bronchial secretions and in the skin. The drug is eliminated primarily by the liver.
special instructions
- With long-term therapy, the emergence of resistant infection is possible. Long-term diarrhea may be a sign of pseudomembranous colitis.
- With a long course of treatment, it is also recommended to monitor the activity of liver enzymes.
- Mannitol, which is included in the suspension granules, can cause diarrhea.
- If you are allergic to acetylsalicylic acid azo dye E110 in the anamnesis, an allergic reaction up to bronchospasm is possible.
- The drug does not affect the speed of psychomotor reactions.
During pregnancy and breastfeeding
During pregnancy, it is prescribed only if the expected benefit to the mother outweighs the potential risk to the fetus.
In childhood
Prescribed according to indications in a dosage corresponding to body weight and clinical picture. Tablets are contraindicated in children under 3 years of age.
In old age
Information is absent.
For liver dysfunction
Contraindicated in cases of severe liver failure. During long-term therapy, monitoring of liver enzymes is recommended.
Drug interactions
- With ergot alkaloids and carbamazepine, their effectiveness decreases and their serum concentration increases, which requires special caution.
- Slows down the elimination of cyclosporine and anticoagulants (warfarin).
- The drug does not affect the pharmacokinetics of theophylline.
Name:
Macropen
Pharmacological
action:
Macrolide antibiotic. Inhibits protein synthesis in bacterial cells.
Reversibly binds to the 50S subunit of the bacterial ribosomal membrane.
In low doses the drug has a bacteriostatic effect, in high doses it has a bactericidal effect.
Active against intracellular microorganisms: Mycoplasma spp., Chlamydia spp., Legionella spp., Ureaplasma urealyticum; gram-positive bacteria: Streptococcus spp., Staphylococcus spp., Corynebacterium diphtheriae, Listeria monocytogenes, Clostridium spp.; gram-negative bacteria: Neisseria spp., Moraxella catarrhalis, Bordetella pertussis, Helicobacter spp., Campylobacter spp., Bacteroides spp.
Pharmacokinetics
Suction
After oral administration, midecamycin is quickly and fairly completely absorbed from the gastrointestinal tract.
Cmax in the serum of midecamycin and midecamycin acetate are 0.5-2.5 µg/l and 1.31-3.3 µg/l, respectively, and are achieved 1-2 hours after oral administration.
Distribution
High concentrations of midecamycin and midecamycin acetate are created in internal organs(especially in lung tissue, parotid and submandibular glands) and skin. MIC is maintained for 6 hours.
Midecamycin binds to proteins by 47%, its metabolites by 3-29%.
Metabolism
Midecamycin is metabolized in the liver to form 2 metabolites with antimicrobial activity.
Removal
T1/2 is approximately 1 hour. Midecamycin is excreted in bile and to a lesser extent (about 5%) in urine.
Pharmacokinetics in special clinical situations
In liver cirrhosis, plasma concentrations, AUC and T1/2 increase significantly.
Indications for
application:
Infectious and inflammatory diseases caused by microorganisms sensitive to the drug:
- respiratory tract infections: tonsillopharyngitis, acute otitis media, sinusitis, exacerbation chronic bronchitis, community-acquired pneumonia (including those caused by atypical pathogens Mycoplasma spp., Chlamydia spp., Legionella spp. and Ureaplasma urealyticum);
- infections of the genitourinary system caused by Mycoplasma spp., Chlamydia spp., Legionella spp. and Ureaplasma urealyticum;
- skin infections and subcutaneous tissue;
- treatment of enteritis caused by Campylobacter spp.;
- treatment and prevention of diphtheria and whooping cough.
Mode of application:
The drug should be taken before meals.
Adults and children weighing more than 30 kg Macropen is prescribed 400 mg (1 tablet) 3 times a day. The maximum daily dose for adults is 1.6 g.
For children weighing less than 30 kg The daily dose is 20-40 mg/kg body weight in 3 divided doses or 50 mg/kg body weight in 2 divided doses, for severe infections - 50 mg/kg body weight in 3 divided doses.
The suspension is used mainly in childhood, the dosage is calculated based on the child’s weight:
- from 0 to 5 kg 3.75 ml (corresponding to 131.25 mg) twice a day;
- from 5 to 10 kg 7.5 ml (which corresponds to 262.2 mg) twice a day;
- from 10 to 15 kg 10 ml (corresponding to 350 mg) twice a day;
- from 15 to 20 kg 15 ml (which corresponds to 525 mg) twice a day; - from 20 to 25 kg 22.5 ml (corresponding to 787.5 mg) twice a day.
The duration of treatment is from 7 to 14 days, for the treatment of chlamydial infections - 14 days.
To prevent diphtheria the drug is prescribed at a dose of 50 mg/kg/day, divided into 2 doses, for 7 days. A control bacteriological study after completion of therapy is recommended.
To prevent whooping cough the drug is prescribed at a dose of 50 mg/kg/day for 7-14 days in the first 14 days from the moment of contact.
To prepare the suspension add 100 ml of boiled or distilled water to the contents of the bottle and shake well. It is recommended to shake the prepared suspension before use.
From the outside digestive system
: loss of appetite, stomatitis, nausea, vomiting, diarrhea, feeling of heaviness in the epigastrium, increased activity of liver transaminases and jaundice; in some cases, severe and prolonged diarrhea, which may indicate the development of pseudomembranous colitis.
Allergic reactions: skin rash, urticaria, itchy skin, eosinophilia, bronchospasm.
Others: weakness.
Contraindications:
Severe liver failure;
- childhood up to 3 years (for tablets);
- hypersensitivity to midecamycin/midecamycin acetate and other components of the drug.
Carefully the drug should be prescribed during pregnancy, lactation, and also if there is a history of an allergic reaction to taking acetylsalicylic acid.
As with the use of any other antimicrobial drugs, overgrowth of resistant bacteria is possible with long-term therapy with Macropen. Prolonged diarrhea may indicate the development of pseudomembranous colitis.
With long-term therapy liver enzyme activity should be monitored, especially in patients with impaired liver function.
Mannitol contained in suspension granules may cause diarrhea.
If you have a history of an allergic reaction to acetylsalicylic acid, azo dye E110 (sunset yellow dye) may cause allergic reaction up to bronchospasm.
Impact on the ability to drive vehicles and operate machinery
The effect of Macropen on the speed of psychomotor reactions and the ability to drive a car and other mechanisms has not been reported.
Interaction
other medicinal
by other means:
With the simultaneous use of Macropen with ergot alkaloids and carbamazepine, their metabolism in the liver decreases and their concentration in the serum increases. Therefore, caution should be exercised when prescribing these drugs simultaneously.
When Macropen is used simultaneously with cyclosporine and anticoagulants (warfarin), the elimination of the latter is slowed down.
Macropen does not affect the pharmacokinetic parameters of theophylline.
Pregnancy:
The use of Macropen during pregnancy is possible only if when the expected benefit to the mother outweighs the potential risk to the fetus.
Midecamycin is excreted in breast milk. When using Macropen during lactation, breastfeeding should be stopped.
Tablets should be stored in a dry place, out of reach of children, at a temperature not exceeding 25°C.
Granules for preparing the suspension should be stored at a temperature not exceeding 25°C.
Best before date- 3 years.
The prepared suspension can be used for 14 days if stored in the refrigerator and for 7 days if stored at a temperature not exceeding 25°C.
1 tablet Macropen contains:
- active ingredient: midecamycin - 400 mg;
- excipients: potassium polacrilin, magnesium stearate, talc, microcrystalline cellulose.
5 ml of ready-made suspension of Macropen granules for oral administration contains:
- active ingredient: midecamycin acetate - 175 mg;
- excipients: methyl parahydroxybenzoate, propyl parahydroxybenzoate, lemon acid, sodium hydrogen phosphate anhydrous, banana flavor, powder, sunset yellow dye FCF (E110), hypromellose, silicone defoamer, sodium saccharinate, mannitol.
APPROVED
By order of the chairman
Medical Control Committee
Ministry of Health
Republic of Kazakhstan
From "____"______________ 201__
№____________
Instructions for medical use
MACROPENE®
Macropen®
International generic name
Midecamycin
Granules for the preparation of suspension for oral administration 175 mg/5 ml
Compound
One gram of granulate contains
active substance- midecamycin acetate 200.00 mg,
Excipients: methyl parahydroxybenzoate, propyl parahydroxybenzoate, citric acid, anhydrous sodium hydrogen phosphate, banana flavor (powder), yellow iron oxide (E 172), hypromellose, silicone defoamer, sodium saccharin, mannitol.
Description
Small granules yellow color with a slight banana scent without visible impurities. After adding 100 ml of water and vigorous shaking, a yellow suspension with a slight banana smell should form.
Pharmacotherapeutic group
Antimicrobial drugs for systemic use. Macrolides.
PBX code J01FA03
Pharmacokinetics
Suction
Midecamycin is rapidly and relatively well absorbed, reaching maximum serum concentrations of 0.5 mcg/ml to 2.5 mcg/ml within 1 to 2 hours. Eating slightly reduces maximum concentrations, especially in children (4 to 16 years). Therefore, it is recommended to take midecamycin before meals.
Distribution
Midecamycin penetrates well into tissues, where it reaches more than 100% concentration than in the blood. High concentrations were found in bronchial secretions and in the skin. The volume of distribution of midecamycin acetate is large: 228 - 329 liters.
47% of midecamycin and 3 - 29% of metabolites are protein bound. Midecamycin acetate is excreted into breast milk. After a dose of 1200 mg/day, at breast milk determined by 0.4 μg/ml - 1.7 μg/ml midecamycin acetate.
Metabolism and removal
Midecamycin is primarily metabolized into active metabolites in the liver. It is excreted predominantly in bile, and only about 5% in urine.
Significant increases in maximum serum concentrations, area under the curve, and half-life may be observed in patients with cirrhosis.
Pharmacodynamics
Macropen® is a broad-spectrum macrolide antibiotic whose activity is similar to that of erythromycin.
Macropen® is active against gram-positive bacteria (staphylococci, streptococci, pneumococci, Bacillus anthracis, Corynebacterium diphtheriae, and Listeria monocytogenes), against some gram-negative bacteria (Bordetella pertussis, Campylobacter, Moraxella catarrhalis and Neisseria spp.), anaerobes (Clostridium spp. . and Bacteroides spp.) and other bacteria such as mycoplasma, ureaplasma, chlamydia and legionella.
The criteria for Macropen® regarding the interpretation of MIC (minimum inhibitory concentration) are the same as for other macrolides according to NCCLS (National Committee on Clinical Laboratory Standards) standards. Bacteria are defined as sensitive if their MIC90 ≤ 2 μg/ml, and as resistant if their MIC90 ≥ 8 μg/ml.
Metabolites have a similar antibacterial spectrum, but their effect is somewhat weaker.
Mechanism of action
Macropen® inhibits RNA-dependent protein synthesis at the stage of protein chain elongation. Midecamycin reversibly binds to the 50S subgroup and blocks the transpeptidation and/or translocation reaction. Due to the different structure of ribosomes, communication with the ribosomes of a eukaryotic cell does not occur. This is why the toxicity of macrolides to human cells low.
Like other macrolide antibiotics, Macropen® has a mainly bacteriostatic effect. However, it may also have a bactericidal effect, which depends on the type of bacterium, the drug concentration at the site of action, the size of the inoculum and the reproductive stage of the microorganism. In vitro activity is reduced in acidic conditions. If the pH value in the cultivation medium Staphylococcus aureus or Streptococcus pyogenes increases from 7.2 to 8.0, the MIC for midecamycin is two times lower. If the pH drops, the situation is reversed.
High intracellular concentrations of macrolides are achieved as a result of their good lipid solubility. This is especially important when treating infections caused by microorganisms with an intracellular development cycle, such as chlamydia, legionella and listeria. Midecamycin has been shown to accumulate in human alveolar macrophages. Midecamycin also accumulates in neutrophils. The intracellular concentration of midecamycin exceeds its extracellular concentration by more than 10 times. The accumulation of neutrophils at the site of infection may further increase the concentration of midecamycin in infected tissues.
Macropen® also affects immune functions.
Indications for use
Infections of the respiratory tract and genitourinary tract caused by mycoplasmas, legionella, chlamydia and Ureaplasma urealyticum
Infections of the respiratory tract, skin and subcutaneous tissue and all other infections caused by bacteria sensitive to midecamycin and penicillin in patients with hypersensitivity to penicillin
Enteritis caused by bacteria of the genus Campylobacter
Treatment and prevention of diphtheria and whooping cough
Directions for use and doses
To prepare the suspension, you need to open the bottle cap and add 100 ml of distilled water (you can use freshly boiled and cooled water), close the bottle cap and shake well until a homogeneous suspension is formed (about 2-3 minutes). The prepared suspension must be shaken before use. Measure out the required amount using the included measuring spoon. 1 scoop contains 175 mg of midecamycin.
The suspension must be taken before meals.
Below is the prescription regimen (daily dose 50 mg/kg body weight):
Children Suspension 175 mg/5 ml
Up to 30 kg (~10 years) 2 x 22.5 ml (787.5 mg or 4.5 scoops)
Up to 20 kg (~ 6 years) 2 x 15 ml (525 mg or 3 scoops)
Up to 15 kg (~4 years) 2 x 10 ml (350 mg or 2 scoops)
Up to 10 kg (~ 1 - 2 years) 2 x 7.5 ml (262.5 mg or 1.5 scoops)
Up to 5 kg (~ 2 months) 2 x 3.75 ml (131.25 mg, measure to 3.75 ml mark on measuring spoon))
Daily dose Macropena® is 20 - 40 mg/kg body weight, divided into three doses or 50 mg/kg body weight in two doses, in case of severe infections, 50 mg/kg body weight in three doses.
The duration of treatment is usually from 7 to 14 days. Chlamydial infections are treated for 14 days.
Side effects
Uncommon(≥1/1,000 to<1/100):
Nausea, loss of appetite, vomiting, diarrhea and stomatitis
Very rarely (<1/10 000):
Eosinophilia
Pseudomembranous colitis
Rash, hives, itching
Increased transaminase activity and jaundice
If serious side effects occur, you should stop taking the drug.
Contraindications
Hypersensitivity to the active substance or auxiliary components of the drug;
Severe liver failure
Drug interactions
Macrolides are known to interact with other medications. Macrolide antibiotics affect liver metabolism by inactivating cytochrome P450. Unlike erythromycin, Macropen® does not bind to microsomal oxidases of liver cells and does not produce stable complexes with cytochrome P450. As a result, it does not affect the pharmacokinetics of theophylline.
Macropen® may increase serum levels of cyclosporine (two-fold) and prolong the half-life and AUC (area under the curve) of carbamazepine. Caution is recommended in children taking carbamazepine or cyclosporine concomitantly, and serum levels should be monitored whenever possible.
Antimicrobial drugs of the macrolide group are highly effective and low-toxic drugs. The antibiotic Macropen ® is a frequently prescribed alternative in the treatment of acute and chronic forms of bacterial respiratory infections. Moreover, it can be used not only by adults, but also by children in the first months of life.
The medicine has minimal restrictions on use and almost does not cause negative side reactions from the body. Sold in two dosage forms - tablets and granules.
Instructions for use Macropen ® tablets, suspensions for children
The drug is very effective in treating diseases caused by pathogens that are sensitive to it, rarely causes side effects and does not require maintenance drug therapy to prevent dysbiosis and candidiasis.
Pharmacological group Macropen ®
The active substance of the drug Maropen ® is an antibiotic.
Composition of the drug
The antibiotic Macropen ® is a semi-synthetic drug whose active ingredient is the 16-membered macrolide midecamycin acetate. Natural midecamycin, produced by Streptomyces mycarofaciens, is less effective in comparison with its derivative, therefore it is used in pharmacology in the form of acetate.
It acts on infectious agents bacteriostatically (in higher doses - bactericidal) due to inhibition of protein synthesis necessary for cell development. Macropen ® syrup and tablets are characterized by a wide spectrum of antimicrobial activity, that is, they destroy different types of pathogenic microflora:
- gram-negative Neisseria, Campylobacter and Helicobacter, Moraxella, Bacteroides;
- gram-positive streptococci and staphylococci, diphtheria bacillus, clostridia and listeria;
- intracellular chlamydia, mycoplasma, ureaplasma, legionella.
When the antibiotic Macropen ® is used orally, its active substance is quickly and completely absorbed by the body, distributed throughout the tissues and organs. Metabolized in liver cells, excreted mainly in bile (urine - to a lesser extent).
Macropen ® release form
The manufacturer and license holder for the drug is the well-known Slovenian pharmaceutical concern KRKA. The product is available in two dosage forms:
- Tablets, each of which contains 400 mg of antibiotic and formative ingredients (microcrystalline cellulose, potassium polyacryline, medical talc, magnesium stearate and enteric coating components). The package consists of two blisters of 8 tablets.
- Orange granules, 20 grams per bottle. This variety is pre-diluted with water to obtain a suspension and dosed using a measuring spoon in accordance with the child’s body weight. 5 ml of the finished product contains 200 mg of midecamycin, and additional ingredients are flavoring and form-building additives.
The suspension is prescribed to children, so it has a pleasant taste and banana aroma, however, the yellow dye included in the composition can cause allergies if aspirin is intolerant. The average cost in pharmacy chains is 300-350 rubles.
Recipe for Macropen ® in Latin
Rp.: Macropen 0.4
D.t.d. No. 20.
S. 1 tablet 3 times a day.
What does Macropen ® help with?
Most often, this medicine is prescribed when the infectious agent is resistant to penicillin. Since it is non-toxic, does not cause dysbacteriosis and does not activate the growth of fungal microflora, it is used to treat patients of any age. Macropen ® antibiotic therapy has been noted to be highly effective for sinusitis and other sinusitis, sore throat and tonsillopharyngitis, and various bacterial lesions of the skin.
As a reserve drug it can be used for urogenital inflammation caused by chlamydia, myco- and ureaplasmas. Painful symptoms, as a rule, completely disappear after 2-3 days, but the full course of therapy lasts a week (in some cases, two).
Macropen ® – indications for use
This medication has a wide spectrum of antimicrobial action, therefore it can be used in several areas of medicine without first specifying the specific type of pathogen. The antibiotic is effective both in acute inflammatory processes and in cases of chronic infection:
- and – Macropen ® is used for tonsillopharyngitis, all types and average;
- lower respiratory tract - and, including those caused by atypical (mycoplasma, for example) pathogens;
- urinary and reproductive organs - - and, chlamydial infection;
- digestive system – bacterial enteritis;
- skin and subcutaneous tissue.
The instructions for use for children of the Macropen ® suspension also mention the effectiveness of prophylactic use in case of suspected infection with pathogens of whooping cough and diphtheria. If the child has been in contact with a sick person, it is recommended to immediately start taking the drug, without waiting for signs of the disease to appear. The course of antibiotic therapy is usually one week, and the daily dose of the drug is calculated according to body weight.
Contraindications Macropen ®
Since the active substance of tablets and suspensions is metabolized in liver cells, creating an additional load on this organ and an increased concentration of medicamycin in the blood, it cannot be prescribed to patients with severe liver failure. The drug is also contraindicated for persons with hypersensitivity to midecamycin acetate and any auxiliary ingredients (in the case of a suspension, to acetylsalicylic acid, for example).
The tablets are not used to treat children under three years of age. Pregnant women are allowed to use Macropen ® only if the health benefits to the expectant mother outweigh the possible teratogenic effect. If the drug is prescribed to a nursing woman, then it is temporarily necessary to switch to artificial feeding (the antibiotic penetrates into breast milk), maintaining lactation through regular pumping.
Treatment regimens and dosages
It is necessary to take the medicine before meals to improve its absorption. The instructions for use of Macropen ® 400 mg and suspension provide the following recommendations for use:
- Adults and children weighing more than 30 kg for infectious diseases should take 1 antibiotic tablet three times a day at regular intervals (maximum dose per day for adult patients is 1600 mg);
- children whose body weight is less than 30 kg receive the medicine in the form of a suspension in the amount of 20-40 mg of active substance per kilogram of weight per day. In this case, the daily dose is divided into 2 single doses (or three, if the infection is severe and the dosage is increased to 50 mg/kg).
Before the first use, the granules are diluted in a bottle with boiled or distilled water in a volume of 100 ml. For convenience, the manufacturer has provided this dosage form with a measuring spoon, which allows you to accurately measure the required dose. Indications for Macropen ® syrup for children are the same as for adults, but most often it is prescribed by pediatricians in cases of sore throat, otitis media or bronchitis.
The duration of treatment is determined by the doctor, but on average it is 1-2 weeks. If the disease is caused by chlamydia, then antibiotic therapy lasts strictly 14 days. When the use of Macropen ® is of a prophylactic nature (if diphtheria is suspected or), a weekly (sometimes a two-week course) of the drug is prescribed. In this case, the suspension is taken twice a day with a 12-hour interval, and the daily dose is determined by the child’s body weight - up to 50 mg per kilogram.
Side effects and overdose of Macropen ®
Negative responses from the body are observed very rarely. The drug has low toxicity and does not affect the composition of the intestinal microflora (that is, it does not cause dysbacteriosis). The diarrhea that sometimes occurs in children is not caused by the antibiotic, but by the laxative effect of mannitol, which is part of the suspension. The list of possible side effects includes:
Belongs to the group of antibiotics - macrolides. It is used to treat various infectious and inflammatory diseases and is a relatively safe treatment.
However, often due to intolerance to the active substance of any drug, it is necessary to replace antibiotics with other drugs. How does Macropen work and what analogues can be used instead of this medication?
One antibiotic tablet contains 400 mg of the active substance - midecamycin. The auxiliary components of Macropen include:
- Microcrystalline cellulose
- Magnesium stearate
- Potassium polacriline
- Talc
- Macrogol
- Titanium dioxide
The composition of the granules for the preparation of the suspension includes 175 mg of midecamycin acetate. Excipients include citric acid, propyl parahydroxybenzoate, sodium hydrogen phosphate, banana flavor, methyl parahydroxybenzoate, sodium saccharinate, yellow dye, hypromellose.
When Macropen is used in low dosages, a bacteriostatic effect occurs, and at higher doses the active substance has a bactericidal effect.
The drug inhibits the growth and reproduction of gram-positive and gram-negative microorganisms:
- Chlamydia
- Legionella
- Ureaplasma
- Campylobacter
- Clostridia
- Mycoplasmas
- Streptococcus
- Haemophilus influenzae
- Helicobacter
- Moraxella
The drug is absorbed quickly and excreted in bile and urine.
When is an antibiotic prescribed?
Macropen is prescribed for infectious diseases, the pathogens of which are sensitive to the active component of the antibiotic.
The remedy is effective for respiratory infections and otolaryngological diseases:
- Pneumonia
- Chronical bronchitis
- Whooping cough and diphtheria
The drug is prescribed for infectious and inflammatory diseases of the genitourinary system, skin, subcutaneous tissue, and gastrointestinal tract. This antibiotic is also used to treat patients who have an allergic reaction to penicillin antibiotics.
Rules for using the drug and its dosage
It is important to remember that only a specialist can prescribe the dosage and course of treatment. When determining the dose of the drug, the patient’s body weight is taken into account. For those weighing more than 30 kilograms, take one tablet three times a day.
For children, the drug is given in suspension or the dose of the drug is calculated up to forty milligrams per kilogram of weight, dividing this amount into three doses or up to fifty milligrams in two doses.
The course of treatment with Macropen ranges from one to two weeks.To prevent whooping cough and diphtheria, I take an antibiotic at a dosage of 50 mg per 1 kg per day, divided into two doses over seven days.Since the drug affects the liver, with long-term use of Macropen the activity of the organ’s enzymes is controlled.
To prepare a suspension, macropen, like its analogues, is dissolved in ordinary water. It is used to treat children. The dosage is as follows:
- 20-25 kg – up to 22.5 milliliters
- Up to 20 kg – 15 ml
- Up to 15 kg – 10 ml
- Up to 10 kg – 7.5 ml
- For children weighing up to 5 kg, about 3.75 ml of suspension is given.
If you take other antimicrobial drugs simultaneously with Macropen, you can provoke the development of resistance of pathogenic microorganisms to the components of the drug. When prolonged diarrhea occurs after taking an antibiotic, this may indicate the presence of pseudomembranous colitis.
It is important to remember that during antibacterial therapy you should take drugs to prevent dysbiosis - probiotics, for example, Laktovit, Linex, Normobakt, Baktisubtil.
Contraindications and side effects
Macropen, among other antibiotics, has a small list of restrictions. The main contraindications are:
- Liver pathologies.
- Hypersensitivity to the components of the antibiotic, namely midecamycin.
- Ages up to three years (use tablet form).
- Allergy to acetylsalicylic acid.
Macropen is prescribed to pregnant women with caution. It is not allowed to use the antibiotic during the period, since some of it passes into breast milk. In such cases, breastfeeding women are advised to stop breastfeeding.
The advantage of macrolide antibiotics is not only their effect on various types of microorganisms, but also minimal side effects.
In rare cases, reactions from the digestive system are possible:
- Diarrhea.
- Decreased appetite.
- Nausea.
- Vomiting.
- Discomfort in the epigastric zone.
- Jaundice.
- Tests may indicate increased bilirubin in the blood.
- If you are prone to allergies, skin rashes, hives, and itching are sometimes observed.
- If you are allergic to acetylsalicylic acid, bronchospasm may occur.
- Lethargy and general weakness may occur.
If such reactions occur, it is necessary to stop using the drug and select another antibiotic.
Drug analogues: types and uses
In terms of their composition and mechanism of action, the following drugs are completely identical to Macropen:
