Zitrolide analogues are cheap. Zitrolide: a drug for the treatment of infectious inflammations

Antibiotics - macrolides and azalides.

Composition of Zitrolide

The active substance is azithromycin.

Manufacturers

Valenta Pharmaceutics (Russia), Schelkovsky Vitamin Plant (Russia)

pharmachologic effect

Pharmacological action - antibacterial.

Suppresses protein biosynthesis, slowing down the growth and reproduction of bacteria; at high concentrations, a bactericidal effect is possible.

Stable in an acidic environment, lipophilic, rapidly absorbed from the gastrointestinal tract.

The maximum concentration is created in 2-3 hours, the half-life is 68 hours.

A stable plasma level is reached after 5-7 days.

It easily passes histohematic barriers and enters the tissues.

Concentrations in tissues and cells are 10-50 times higher than in plasma, and in the focus of infection - 24-34% higher than in healthy tissues.

A high level (antibacterial) persists in the tissues for 5-7 days after the last injection.

It is excreted in the bile (50%) unchanged and in the urine (6%).

The spectrum of action is wide and includes gram-positive (Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus pyogenes, streptococci of groups C, F, G, Streptococcus viridans), except for those resistant to erythromycin, and gram-negative (Haemophilus influenzae, Moraxella catarrhalis, Bordetella pertussis , Bordetella parapertussis, Campylobacter jejuni, Legionella pneumophila, Neisseria gonorrhoeae, Gardnerella vaginalis) microorganisms, anaerobes (Bacteroides bivius, Peptostreptococcus spp., Peptococcus, Clostridium perfringens), chlamydia (Chlamydia trachomatis, Chlamydia pneumoniae), myco bacteria (Mycobacteria avium complex), mycoplasmas (Mycoplasma pneumoniae), ureoplasma (Ureaplasma urealyticum), spirochetes (Treponema pallidum, Borrelia burgdorferi).

Side effects of Zitrolid

Nausea, vomiting, abdominal pain, constipation, flatulence, diarrhea, melena, cholestatic jaundice, chest pain, palpitations, weakness, drowsiness, headache, dizziness, nephritis, vaginitis, candidiasis, neutropenia or neutrophilia, pseudomembranous colitis, photosensitivity, rash, angioedema, eosinophilia; in children, in addition, hyperkinesia, agitation, nervousness, insomnia, conjunctivitis.

Indications for use

upper and lower infections respiratory tract(streptococcal pharyngitis and tonsillitis, bacterial exacerbation of chronic obstructive pneumonia, interstitial and alveolar pneumonia, bacterial bronchitis), ENT organs ( otitis media, laryngitis and sinusitis), genitourinary system (urethritis and cervicitis), skin and soft tissues (erysipelas, impetigo, secondary infected dermatoses), chronic stage erythema migrans (Lyme disease).

Contraindications Zitrolid

Hypersensitivity to macrolides, severe violations liver function, pregnancy, lactation.

Method of application and dosage

Inside, once a day for adults with infections of the respiratory tract and soft tissues:

• on the 1st day - 0.5 g/su,
• from the 2nd to the 5th day - 0.25 g / day.

For infections of the genitourinary system:

• acute uncomplicated infection caused by N. gonorrhoeae, Chlamydia trachomatis and with a combination of these pathogens - 1 g / day (once or 0.5 g 2 times a day); in other cases course dose rises to 3 years.

For Lyme disease:

• on the 1st day - 1 g/su,
• from the 2nd to the 5th day - 0.5 g / day.

The course of treatment is usually 5 days.

Children:

• on the 1st day - 10 mg/kg/su,
• then - 5 mg / kg (from the 2nd to the 5th day) or 10 mg / kg (on the 2nd and 3rd days).

Overdose

No information.

Interaction

special instructions

Use with caution in severe violations of the liver, kidneys, cardiac arrhythmias.

After discontinuation of treatment, hypersensitivity reactions may persist in some patients, which requires specific therapy under medical supervision.

Storage conditions

List B.

Store in a dry, dark place at room temperature, out of the reach of children.

In this article, you can read the instructions for use medicinal product Zitrolide. Reviews of site visitors - consumers are presented this medicine, as well as the opinions of specialist doctors on the use of Zitrolid in their practice. A big request to actively add your reviews about the drug: did the medicine help or not help get rid of the disease, what complications were observed and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Zitrolid in the presence of existing structural analogues. Use for the treatment of tonsillitis, sinusitis and pneumonia in adults, children, as well as during pregnancy and lactation. The composition and interaction of the drug with alcohol.

Zitrolide- an antibiotic of the macrolide group, is a representative of the azalide subgroup. Possesses a wide range antimicrobial action. When creating high concentrations in the focus of inflammation, it has a bactericidal effect.

The drug is active against gram-positive cocci: Streptococcus pneumoniae (streptococcus), Streptococcus pyogenes, Streptococcus agalactiae, streptococci of groups C, F and G, Streptococcus viridans, Staphylococcus aureus (staphylococcus); Gram-negative bacteria: Haemophilus influenzae, Moraxella catarrhalis, Bordetella pertussis, Bordetella parapertussis, Helicobacter pylori (Helicobacter), Legionella pneumophila, Haemophilus ducreyi, Campylobacter jejuni, Neisseria gonorrhoeae, Gardnerella vaginalis; anaerobic microorganisms: Bacteroides bivius, Clostridium perfringens, Peptostreptococcus spp.

Also active against: Chlamydia trachomatis (chlamydia), Mycoplasma pneumoniae (mycoplasma), Ureaplasma urealyticum (ureaplasma), Treponema pallidum, Borrelia burgdoferi.

Zitrolide is not active against Gram-positive bacteria resistant to erythromycin.

Compound

Azithromycin + excipients.

Pharmacokinetics

When taken orally, Zitrolide is rapidly absorbed from the gastrointestinal tract, due to its stability in an acidic environment and lipophilicity. Bioavailability is 37%. Azithromycin penetrates well into the respiratory tract, organs and tissues of the urogenital tract (in particular, into prostate), into the skin and soft tissues. The ability of azithromycin to accumulate predominantly in lysosomes is especially important for the elimination of intracellular pathogens. It has been proven that phagocytes deliver azithromycin to the sites of infection, where it is released during phagocytosis. The concentration of azithromycin in the foci of infection is significantly higher than in healthy tissues (on average by 24-34%) and correlates with the severity inflammatory process. Despite the high concentration in phagocytes, azithromycin does not significantly affect their function. Azithromycin remains at bactericidal concentrations in the inflammatory focus for 5-7 days after the last dose, which made it possible to develop short (3-day and 5-day) courses of treatment. Azithromycin is demethylated in the liver to inactive metabolites.

Indications

Infectious and inflammatory diseases caused by microorganisms sensitive to the drug:

• infections of the upper respiratory tract and ENT organs (including tonsillitis, pharyngitis, sinusitis, tonsillitis, otitis media);
• infections of the lower respiratory tract (including bacterial and atypical pneumonia, bronchitis);
• scarlet fever;
• infections of the skin and soft tissues (including erysipelas, impetigo, secondarily infected dermatoses);
• infections of the genitourinary system (including uncomplicated urethritis and / or cervicitis);
• Lyme disease (borreliosis) - for treatment initial stage(erythema migrans);
• diseases of the stomach and duodenum associated with Helicobacter pylori (as part of combination therapy).

Release form

Capsules 250 mg and 500 mg Zitrolide Forte (sometimes erroneously called tablets).

Instructions for use and dosing regimen

Zitrolid and Zitrolid Forte are taken orally 1 time per day 1 hour before meals or 2 hours after meals.

Adults with infections of the upper and lower respiratory tract are prescribed 500 mg per day for 3 days; the course dose is 1.5 g.

For infections of the skin and soft tissues, 1 g is prescribed on the 1st day and 500 mg daily from the 2nd to the 5th day (course dose - 3 g).

At acute infections of the genitourinary system (uncomplicated urethritis or cervicitis) is prescribed once 1 g.

In Lyme disease (borreliosis), for the treatment of stage 1 (erythema migrans), 1 g is prescribed on the 1st day and 500 mg daily from the 2nd to the 5th day (course dose - 3 g).

At peptic ulcer stomach and duodenum associated with Helicobacter pylori, the drug is prescribed 1 g per day for 3 days as part of combination therapy.

Children Zitrolid and Zitrolid Forte are prescribed at the rate of 10 mg/kg of body weight 1 time per day for 3 days or on the 1st day - 10 mg/kg, then for 4 days - 5-10 mg/kg per day in within 3 days (course dose - 30 mg/kg).

In Lyme disease (borreliosis), for the treatment of the initial stage of erythema migrans, children are prescribed at a dose of 20 mg / kg on the 1st day and 10 mg / kg from the 2nd to the 5th day.

Side effect

• diarrhea;
• nausea, vomiting;
• abdominal pain;
• dyspepsia;
• flatulence;
• melena;
• constipation;
• anorexia;
• gastritis;
• taste change;
• feeling of heartbeat;
• chest pain;
• dizziness;
• headache;
• drowsiness;
• anxiety;
• neurosis;
• sleep disturbance;
• vaginal candidiasis;
• nephritis;
• rash;
• photosensitivity;
• angioedema;
• conjunctivitis;
• hives.

Contraindications

• severe liver failure;
• severe renal failure;
• lactation period ( breast-feeding);
• children's age up to 3 years, up to 12 years for Zitrolid Forte;
• hypersensitivity to azithromycin or other macrolides.

Use during pregnancy and lactation

During pregnancy, Zitrolid and Zitrolid Forte should be used with caution and in cases where the expected benefit of therapy for the mother significantly outweighs the potential risk to the fetus.

The drug is contraindicated for use during lactation (breastfeeding). If it is necessary to use Zitrolid and Zitrolid Forte during lactation, it is recommended to suspend breastfeeding for the duration of treatment.

Use in children

Contraindicated in children under 3 years of age, up to 12 years of age for Zitrolid Forte.

special instructions

It is necessary to observe a break of 2 hours with the simultaneous use of antacids.

After discontinuation of treatment, hypersensitivity reactions may persist in some patients, which requires specific therapy under medical supervision.

drug interaction

Antacids (aluminum- and magnesium-containing), ethanol (alcohol) and food slow down and reduce the absorption of azithromycin.

With the simultaneous administration of warfarin and azithromycin (at usual doses), no change in prothrombin time was detected, however, given that the interaction of macrolides and warfarin may increase the anticoagulant effect, patients need careful monitoring of prothrombin time.

At joint application with digoxin, the concentration of digoxin increases.

With simultaneous use with ergotamine and dihydroergotamine, their toxic effect (vasospasm, dysesthesia) is enhanced.

With simultaneous use with triazolam, clearance decreases and increases pharmachologic effect triazolam.

Zitrolide slows down the excretion and increases the plasma concentration and toxicity of cycloserine, indirect anticoagulants, methylprednisolone, felodipine, as well as drugs undergoing microsomal oxidation (carbamazepine, terfenadine, cyclosporine, hexobarbital, ergot alkaloids, valproic acid, disopyramide, bromocriptine, phenytoin, oral hypoglycemic agents , xanthine derivatives, including theophylline) due to the inhibition of microsomal oxidation in hepatocytes by azithromycin.

Lincosamines weaken the effectiveness of azithromycin.

Tetracycline and chloramphenicol increase the effectiveness of azithromycin.

Analogues of the drug Zitrolid

Structural analogues for the active substance:

• Azivok;
• Azilide;
• Azimicin;
• Azitral;
• Azitrox;
• Azithromycin;
• Azithromycin Forte;
• AzitRus;
• Azicide;
• Vero Azithromycin;
• Zetamax retard;
• Zitnob;
• Zitrocin;
• Sumazid;
• Sumaclid;
• Sumamed;
• sumamecin;
• sumamecin forte;
• Sumamox;
• Sumatrolide solutab;
• Tremak Sanovel;
• Hemomycin;
• Ecomed.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases that the corresponding drug helps with and see the available analogues for the therapeutic effect.

Sumamed - 360 rub. EXPENSIVE Azitral - 273 rub. EXPENSIVE Azitrox - 194 rub. CHEAPER Azithromycin - 26 rub. CHEAPER AzitRus — 106 rub. CHEAPER Azicide - 325 rub. EXPENSIVE Zetamax retard — 565 rub. EXPENSIVE ZI-Factor - 203 rub. CHEAPER

Hemomycin - 334 rub. EXPENSIVE Ecomed - 312 rub. EXPENSIVE

This table is built on the basis of data collected from the resources of pharmaceutical companies that produce these drugs. The average prices for drugs with a minimum dosage dispensed from Russian pharmacies in 2020 are indicated. Why analogues are cheaper than Zitrolid For manufacturing chemical formula A new drug takes a lot of time and money to be tested. Then pharmaceutical company buys a patent, then spends money on advertising and puts it on sale. The manufacturer puts high price on the drug in order to quickly recoup the investment. Other medicines similar in composition, less well-known but time-tested remain many times cheaper. Share your experience

Have you had any side effects after using Zitrolide?

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How to save How to spot a fake not to buy counterfeit drug, you need to carefully look at your purchase.
How to choose The recommended analogues from the table include preparations with the most suitable and similar content active substance used in Zitrolide. For each of these drugs, average prices for the minimum retail dosage are given, regularly updated to reflect market conditions. There are contraindications! Please consult with your doctor before changing any medication. Follow the dosage prescribed by your doctor! The drugs should not be used later than the date indicated on their packaging.

• Antibiotic Zitrolide includes active substance azithromycin . Additional components: microcrystalline cellulose, magnesium stearate. The capsules consist of gelatin, quinoline yellow, Ponceau 4R, titanium dioxide, azorubine.
• Zitrolide Forte contains as an active ingredient azithromycin dihydrate . Additional substances: microcrystalline cellulose, magnesium stearate. The capsule body consists of titanium dioxide and gelatin. Cap includes Sunset yellow dye, gelatin, titanium dioxide.

Release form

pharmachologic effect

This medicine is antibacterial agent systemic action.

Pharmacodynamics and pharmacokinetics

The drug acts like antibacterial agent . It is active towards:

• Gram-positive cocci : Streptococcus pneumoniae, St. agalactiae, Staphylococcus aureus, St. pyogenes, group streptococci CF and G, St. viridans;
• some anaerobic microorganisms : Clostridium perfringens, Peptostreptococcus spp., Bacteroides bivius;
• gram-negative bacteria : Haemophilus influenzae, Bordetella pertussis, Legionella pneumophila, Campylobacter jejuni, Gardnerella vaginalis, Moraxella catarrhalis, B. parapertussis, H. ducreyi, Neisseria gonorrhoeae;
• Mycoplasma pneumoniae, Chlamydia trachomatis, Ureaplasma urealyticum, Borrelia burgdorferi, Treponema pallidum.

Does not affect gram-positive bacteria that are resistant to.

The drug is rapidly absorbed from the gastrointestinal tract. The bioavailability of the drug is 37%. The maximum concentration is reached after 150 minutes. It penetrates well into the tissues of the urogenital tract, respiratory tract, soft tissues and skin.

Side effects

Adverse reactions when using the drug may be as follows:

• CNS: increased arousal, vertigo , excessive fatigue;
• gastrointestinal tract: nausea, pain in a stomach, jaundice , cholestasis , vomiting, increased activity AST And ALT , as well as the level ;
• : skin rash, ;
• CCC: pain in the chest, palpitations;
• genitourinary system: nephritis , vaginal ;
• others: photosensitivity , transient neutrophilia , eosinophilia , with injections are possible bronchospasm , inflammation and pain at the injection site.

In rare cases, there is a change in the color of the tongue, tinnitus, reversible hearing loss (up to deafness), pseudomembranous , liver, liver failure , .

IN childhood possible:, nervousness, hyperkinesia , anxiety, decrease , candidomycosis oral mucosa, gastritis .

Application instruction of Zitrolid (Way and dosage)

When using the drug Zitrolide instructions for use recommends swallowing the capsules whole one hour before meals or 2 hours after it. It is advisable to take the medicine with water. The daily dosage is usually taken in one dose. It is recommended to do this every day at the same time. The duration of therapy and the exact dosages are determined by a specialist and depend on the nature of the disease.

When infectious diseases respiratory tract shows the use of 500 mg / day. The course of treatment is 3 days.

In acute uncomplicated diseases of the genitourinary system, 1 g of the drug is taken once.

In case of infectious diseases of the skin and soft tissues, as well as at the beginning Lyme disease usually take 1 g of Zitrolid on the first day, and then 500 mg for another 4 days.

When that are caused Helicobacter pylori should be taken, as a rule, daily 1 g of the drug along with other drugs. The course is designed for 3 days.

Instructions for use Zitrolide Forte reports that the drug is usually taken in the following dosages:

• infections of the respiratory tract, skin, soft tissues, ENT organs - 500 mg / day for three days;
• acute infections urinary organs- 1 g once;
• pneumonia - 500 mg once a day for 7-10 days immediately after the end of the use of the IV form;
• acne - 500 mg once a day for three days, then at the same dosage, but once a week for 9 weeks. The first weekly dosage is applied 7 days after the first daily dosage, then an interval of 7 days between doses is observed;
• - 1 g on the first day and 500 mg / day for another 4 days.

For children weighing more than 45 kg, the same dosages are shown as for adults.

If the required dose of the drug is missed, it must be taken as soon as the patient remembers this. The next dosage is taken a day later.

Overdose

Possible in case of overdose nausea, vomiting, hearing loss, headaches, dyspepsia.

Interaction

Do not use Zitrolid in conjunction with ergot alkaloids .

Antacids containing calcium, magnesium or aluminum, as well as ethanol, slow down and reduce the degree of absorption azithromycin . Requires a two-hour interval between doses.

The toxic effect is enhanced under the influence of Zitrolide. And when combined with it, it is recommended to control prothrombin time .

The drug also increases the level of , reduces clearance and increase the effect Triazolam .

When interacting with ,

Drugs. It is characterized by bacteriostatic antimicrobial action: it blocks the ability of bacteria to reproduce. If a high concentration of the active substance is created in the pathological focus, then it acquires a bactericidal effect - all bacteria located on different stages growth. The antibiotic, binding to the ribosome of bacteria, inhibits protein synthesis in the cells of pathogenic microorganisms, which causes their death.

Many patients are wondering which medicine is better to use: zitrolide or macropen ? Both drugs belong to macrolides, but differ in active substances. The active substance of Zitrolide ® is, a - medicamicin. Since Zitrolide ® belongs to medicines with prolonged action, then most doctors and their patients prefer it, especially if the lower and upper respiratory tract are infected.

The active substance enters the respiratory tract, duodenum, organs of the urinary and reproductive systems and remains in the pathological focus for up to a week. Therefore, patients are prescribed short (three- or five-day) courses of therapy.

Zitrolide ® , as stated in the instructions for use, is taken orally daily (preferably at the same time) 60 minutes before meals or a couple of hours after it. But best effect can be achieved if you drink the medicine on an empty stomach.

Pharmacological group

Main active substance Zitrolide (azithromycin) is an azalide-macrolide antibiotic.

Release form of zitrolide ®

Zitrolide ® is produced in encapsulated form of 250 milligrams and in the form of Zitrolide Forte 500 milligrams.

Photo of packaging Zitrolid ® Forte in the form of tablets of 500 mg

Composition of Zitrolide ® 500

The active ingredient of the antibiotic is azithromycin. It also contains magnesium stearate and microcrystalline cellulose. In the manufacture of the shell, gelatin, titanium dioxide, and pigments are used.

Mechanism of action

Azithromycin has a detrimental effect on:

• gram-positive cocci (gonococci, streptococci, staphylococci) - these bacteria are round in shape, stained purple;
• gram-negative bacteria (helicobacter pylori, gardnerella, legionella) - when stained, they become pink;
• anaerobic microorganisms - do not need oxygen;
• clostridia;
• chancroid;
• hemophilic bacillus;
• whooping cough and parapertussis.

The drug is useless in cases where the body is infected with gram-positive bacteria that are not affected by erythromycin.

Zitrolid ® is often prescribed if the patient is allergic to penicillin.

Studies have shown that in most cases, pathogens develop immunity to antibiotics of the macrolide group, which weakens the effect of drugs and makes it difficult to obtain the desired effect. Azithromycin has a significant advantage over them, because due to its rapid absorption, it does not allow pathogenic microorganisms to acquire immunity.

The active substance is almost instantly absorbed from digestive system and after 2.5-3 hours it penetrates into the blood plasma. The bioavailability of the drug is 37%. Azithromycin quickly enters the respiratory tract , duodenum, prostate, skin and is evenly distributed in the tissues, where its content increases tenfold compared to plasma.

The active substance is broken down in the liver, forming inactive decay products that are excreted naturally.

Indications, contraindications

The antibiotic zitrolide ® is used to combat inflammatory diseases infectious genesis.

It deals with:

• diseases of the upper and lower respiratory tract (especially often the drug is attributed to and);
• pathologies ( , );
• dermatological problems (, dermatoses, pyoderma, streptoderma,);
• ailments of the urinary and genital areas (, urethritis);
• ( , chancroid, );
• pathologies affecting the stomach and duodenum associated with;
• borreliosis or Lyme disease (it is also called Lyme borreliosis - systemic disease striking skin covering, nervous, musculoskeletal and circulatory systems.

You can not take the drug with:

• individual intolerance to macrolides;
• serious pathologies of the liver and kidneys;
• taking ergotamine;
• breastfeeding;
• less than three years old (for forte - less than 12 years old). For the treatment of children younger age suspension is recommended.

With arrhythmia and a moderate weakening of the efficiency of the kidneys and liver, as well as in the treatment of warfarin, the medication is taken under the strict supervision of a physician.

Zitrolide ® is prescribed to pregnant women only when the expected benefit from the use of the drug significantly outweighs possible risk for the unborn child, since azithromycin is able to overcome the placental barrier.

If there is a need to use the medicine during lactation, then you will have to temporarily stop breastfeeding the baby.

Zitrolide ® should not be used together with antacid medicines (they treat gastritis and peptic ulcer).

The antibiotic does not affect the concentration of attention and the speed of psychomotor reactions.

Dosage of Zitrolide ®

Adults who are affected by the lower or upper respiratory tract, drink the medicine for three days, 500 milligrams each.

With dermatological problems, the treatment course is designed for five days. On the 1st day, they drink 1 gram of the drug, then - 500 milligrams each.

Acute infections in the urinary and genital organs are eliminated by taking 1 gram of the drug three times every 24 hours. In the case of an uncomplicated infection, a single dose of the drug is sufficient. If necessary, the doctor may prescribe a single injection of 500 milligrams of the active substance into a vein, after which 500 milligrams of the drug will need to be taken for a week.

Zitrolide ® is able to cure borreliosis only at the first stages of development. At the same time, they drink 1 gram of the drug on the 1st day, after which they drink 500 milligrams each for four days.

Peptic ulcer disease affecting the duodenum and stomach, if provoked by helicobacter pylori, is treated with combined treatment, including a three-day intake of 1 gram of zitrolide. If antacids are used at the same time, then you will need to take a two-hour break between medications.

Features of the treatment of children

When treating children, the dose is calculated depending on body weight (10 milligrams of medication will be needed per kilogram of weight). If the child weighs more than 45 kilograms, then the dosage calculated for adults is used. The doctor may change the dose, taking into account the stage and severity of the disease, as well as general state child's health.

Children usually take tablets for 3 days. If necessary, the doctor may prescribe a 5-day therapy for the child. In such cases, on the 1st day, take 10 milligrams per kilogram of weight, and on the 2nd, 3rd, 4th and 5th - 5-10 each.

To cope with borreliosis in children at the beginning of its development, you will need to take 20 milligrams of an antibiotic per kilogram of body weight on the 1st day and 10 milligrams on the following four days.

Inflammation of the lungs in babies is treated by administering the drug intravenously daily for two days at an age dose. Then, for 7-10 days, the baby is given the drug orally.

If the patient, due to forgetfulness or because of being busy, did not take the pill on time, then it should be taken as soon as possible. Next reception medicines are produced in a day.

Side effects

Despite the high effectiveness of the drug, it should be taken with caution, as it can have side effects.

First of all, azithromycin affects nervous system, causing migraines, dizziness, hyperkinesia, anxiety and neurosis, drowsiness or insomnia, weakness and rapid fatigue. When exposed to the organs of the digestive tract, pain in the stomach, nausea and vomiting, bloating, or constipation appear, the taste changes, appetite weakens or disappears, the activity of liver enzymes increases, sometimes gastritis or jaundice develops. When exposed to genitourinary system vaginitis, nephritis, can be diagnosed.

Occasionally observed allergic manifestations: , itching and burning, urticaria, Quincke's edema, photosensitivity, conjunctivitis and even anaphylactic shock. Possible pain in the chest area, anorexia, palpitations, short-term hearing loss, reversible changes in blood counts. If the dosage or regimen is not observed, the heart rhythm is disturbed.