Ermac
Generic Name
Erythromycin
Manufacturer
Eskayef Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| ermac 125 mg suspension | ৳ 84.74 | N/A |
Description
Overview of the medicine
Ermac 125 mg Suspension is a macrolide antibiotic used to treat various bacterial infections, including respiratory tract infections, skin infections, and certain sexually transmitted diseases.
Uses & Indications
Dosage
Adults
Typical dose: 250-500 mg every 6-12 hours, up to 4 g/day depending on severity. For suspension, dosage needs to be calculated based on mL per dose.
Elderly
Similar to adult dosage; caution and monitoring recommended in patients with impaired hepatic function.
Renal_impairment
No dosage adjustment is usually necessary for mild to moderate renal impairment. For severe impairment, monitor for toxicity due to potential accumulation.
How to Take
Shake the bottle well before each use. Administer orally, with or without food. Use a calibrated measuring spoon or cup for accurate dosing.
Mechanism of Action
Erythromycin inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit, thereby blocking the translocation step of protein elongation. This prevents bacteria from multiplying.
Pharmacokinetics
Onset
Within 1-2 hours after oral administration.
Excretion
Primarily excreted in bile and feces, with only a small portion (2-5%) excreted in the urine.
Half life
Approximately 1.5-2 hours in adults with normal renal function.
Absorption
Well absorbed orally, but absorption is variable and affected by food; acid-labile, hence often formulated as enteric-coated tablets or ester forms.
Metabolism
Extensively metabolized in the liver, primarily by the cytochrome P450 3A4 (CYP3A4) enzyme system.
Side Effects
Contraindications
- Hypersensitivity to erythromycin or any other macrolide antibiotics.
- Concomitant use with terfenadine, astemizole, cisapride, pimozide, or ergot alkaloids due to risk of serious and life-threatening arrhythmias (e.g., QT prolongation, Torsades de Pointes).
Drug Interactions
Digoxin
Increased serum digoxin levels, potentially leading to toxicity.
Warfarin
Increased anticoagulant effect, leading to a higher risk of bleeding. Monitor INR closely.
Theophylline
Increased serum concentration of theophylline, potentially leading to toxicity. Monitor theophylline levels.
Carbamazepine
Increased carbamazepine levels, leading to toxicity.
Statins (e.g., Simvastatin, Lovastatin)
Increased risk of myopathy, including rhabdomyolysis, due to inhibition of statin metabolism. Avoid co-administration.
Terfenadine, Astemizole, Cisapride, Pimozide
Increased risk of QT prolongation and potentially fatal arrhythmias. Concomitant use is contraindicated.
Storage
Store dry powder at room temperature (15-30°C) away from moisture. Once reconstituted, store as directed on the label (e.g., at room temperature or refrigerated, typically for up to 7-14 days). Do not freeze.
Overdose
Symptoms of overdose may include nausea, vomiting, abdominal cramps, diarrhea, and reversible hearing loss. Treatment is supportive and symptomatic; gastric lavage may be considered in acute overdose.
Pregnancy & Lactation
Pregnancy Category B. Erythromycin is generally considered safe for use during pregnancy, but it should be used only if clearly needed. Erythromycin is excreted in breast milk; use with caution in nursing mothers, considering the potential risks to the infant.
Side Effects
Contraindications
- Hypersensitivity to erythromycin or any other macrolide antibiotics.
- Concomitant use with terfenadine, astemizole, cisapride, pimozide, or ergot alkaloids due to risk of serious and life-threatening arrhythmias (e.g., QT prolongation, Torsades de Pointes).
Drug Interactions
Digoxin
Increased serum digoxin levels, potentially leading to toxicity.
Warfarin
Increased anticoagulant effect, leading to a higher risk of bleeding. Monitor INR closely.
Theophylline
Increased serum concentration of theophylline, potentially leading to toxicity. Monitor theophylline levels.
Carbamazepine
Increased carbamazepine levels, leading to toxicity.
Statins (e.g., Simvastatin, Lovastatin)
Increased risk of myopathy, including rhabdomyolysis, due to inhibition of statin metabolism. Avoid co-administration.
Terfenadine, Astemizole, Cisapride, Pimozide
Increased risk of QT prolongation and potentially fatal arrhythmias. Concomitant use is contraindicated.
Storage
Store dry powder at room temperature (15-30°C) away from moisture. Once reconstituted, store as directed on the label (e.g., at room temperature or refrigerated, typically for up to 7-14 days). Do not freeze.
Overdose
Symptoms of overdose may include nausea, vomiting, abdominal cramps, diarrhea, and reversible hearing loss. Treatment is supportive and symptomatic; gastric lavage may be considered in acute overdose.
Pregnancy & Lactation
Pregnancy Category B. Erythromycin is generally considered safe for use during pregnancy, but it should be used only if clearly needed. Erythromycin is excreted in breast milk; use with caution in nursing mothers, considering the potential risks to the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years for unopened product. Reconstituted suspension usually has a shelf life of 7-14 days at room temperature or refrigerated, depending on specific formulation.
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Erythromycin has been subject to extensive clinical trials since its discovery, demonstrating its efficacy and safety in various bacterial infections. Ongoing research may explore new applications or improved formulations.
Lab Monitoring
- Liver function tests (LFTs) should be monitored periodically during prolonged therapy or in patients with pre-existing hepatic impairment.
- INR should be closely monitored if co-administered with warfarin.
- ECG monitoring may be advisable in patients with risk factors for QT prolongation.
Doctor Notes
- Emphasize to patients the critical importance of completing the full course of therapy to ensure eradication of infection and prevent resistance.
- Be vigilant for potential drug interactions, especially with narrow therapeutic index drugs and QT-prolonging agents.
- Advise patients to report any severe abdominal pain, persistent diarrhea, or signs of jaundice immediately.
Patient Guidelines
- Complete the entire prescribed course of medication, even if symptoms improve, to prevent recurrence and development of antibiotic resistance.
- Shake the suspension well before each dose.
- Use the provided measuring device for accurate dosing.
- Do not share this medicine with others, even if they have similar symptoms.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Erythromycin generally does not impair the ability to drive or operate machinery. However, if you experience side effects like dizziness or blurred vision, avoid these activities until you feel well.
Lifestyle Advice
- Maintain good personal hygiene to prevent the spread or recurrence of infections.
- Drink plenty of fluids to stay hydrated, especially if experiencing diarrhea or vomiting.
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