Adults

One tablet (267 mg) orally once daily for 5-7 days, depending on the severity and type of infection.

Elderly

No dose adjustment is typically required based on age alone; however, monitor renal and hepatic function, especially if pre-existing impairment.

Renal_impairment

For creatinine clearance <30 mL/min, a dose reduction to 133.5 mg once daily is recommended. No dose adjustment needed for mild to moderate impairment.

Onset

Clinical effects typically observed within 1-2 hours after administration.

Excretion

Predominantly excreted via bile and feces (approximately 80%), with a minor portion eliminated renally (approximately 20%).

Half life

Approximately 10-12 hours, allowing for once-daily dosing.

Absorption

Rapidly absorbed from the gastrointestinal tract; bioavailability is approximately 60-70%. Peak plasma concentrations are reached within 2-4 hours.

Metabolism

Extensively metabolized in the liver, primarily via the CYP3A4 enzyme system.

Warfarin

May enhance the anticoagulant effect of warfarin. Close monitoring of INR is advised when co-administered.

Statins (e.g., Simvastatin)

Increased risk of myopathy and rhabdomyolysis when co-administered with statins metabolized by CYP3A4. Consider lower statin dose or alternative statin.

CYP3A4 Inhibitors (e.g., Ketoconazole)

Co-administration may increase plasma concentrations of Respiracef. Monitor for increased side effects.

Antacids (containing Aluminum or Magnesium)

May decrease the absorption of Respiracef. Administer Pulmosis-267 mg at least 2 hours before or 4 hours after antacids.