Romycin
Generic Name
Erythromycin 250 mg Capsule
Manufacturer
Generic Pharmaceutical Company
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| romycin 250 mg capsule | ৳ 20.00 | ৳ 80.00 |
Description
Overview of the medicine
Erythromycin is a macrolide antibiotic used to treat various bacterial infections, including respiratory tract infections, skin infections, and certain sexually transmitted infections. It works by stopping the growth of bacteria.
Uses & Indications
Dosage
Adults
250 mg to 500 mg orally every 6-12 hours, depending on the severity and type of infection. The usual duration of treatment is 7-14 days.
Elderly
No specific dose adjustment is generally required for elderly patients with normal renal and hepatic function. However, caution is advised.
Renal_impairment
For mild to moderate renal impairment, no dose adjustment is typically needed. For severe renal impairment, monitoring for erythromycin toxicity is recommended.
How to Take
Take orally, preferably on an empty stomach (1 hour before or 2 hours after meals) to ensure optimal absorption. If gastrointestinal upset occurs, it may be taken with food. Swallow the capsule whole with water; do not crush or chew.
Mechanism of Action
Erythromycin binds to the 50S ribosomal subunit of susceptible bacteria, thereby inhibiting protein synthesis. This action leads to a bacteriostatic effect, preventing bacterial growth and replication.
Pharmacokinetics
Onset
Therapeutic effects typically begin within 1-2 hours of administration.
Excretion
Mainly excreted unchanged in bile. A small percentage is excreted renally (2-5%).
Half life
Approximately 1.5-2 hours, but can be prolonged in patients with hepatic impairment.
Absorption
Well absorbed orally, though absorption may be decreased by food, especially for erythromycin base. Peak plasma concentrations are reached within 1-4 hours.
Metabolism
Primarily hepatic, via the cytochrome P450 3A4 (CYP3A4) enzyme system. It is also an inhibitor of CYP3A4.
Side Effects
Contraindications
- Hypersensitivity to erythromycin or any other macrolide antibiotics
- Concurrent use with terfenadine, astemizole, cisapride, pimozide, or colchicine (due to risk of QT prolongation and life-threatening arrhythmias)
- Severe hepatic impairment
- History of cholestatic jaundice/hepatic dysfunction associated with prior erythromycin use
Drug Interactions
Digoxin
May increase serum digoxin levels, leading to digoxin toxicity.
Warfarin
May increase the anticoagulant effect of warfarin, requiring close monitoring of INR.
Theophylline
May increase serum theophylline levels, leading to toxicity.
Carbamazepine
May increase carbamazepine levels, leading to toxicity.
Oral Contraceptives
May decrease the effectiveness of oral contraceptives, requiring additional birth control methods.
Statins (e.g., Lovastatin, Simvastatin)
Increased risk of myopathy and rhabdomyolysis due to inhibition of statin metabolism by erythromycin.
Storage
Store below 30°C in a cool, dry place, away from direct sunlight and moisture. Keep out of reach and sight of children.
Overdose
Symptoms of overdose may include severe nausea, vomiting, abdominal pain, diarrhea, and reversible hearing loss. Management involves supportive care, including gastric lavage if ingested recently, and monitoring of vital signs and electrolyte balance.
Pregnancy & Lactation
Pregnancy Category B. Erythromycin is generally considered safe for use during pregnancy, but should be used only if clearly needed. It is excreted in breast milk; therefore, use with caution in nursing mothers, as it may cause gastrointestinal issues in the infant.
Side Effects
Contraindications
- Hypersensitivity to erythromycin or any other macrolide antibiotics
- Concurrent use with terfenadine, astemizole, cisapride, pimozide, or colchicine (due to risk of QT prolongation and life-threatening arrhythmias)
- Severe hepatic impairment
- History of cholestatic jaundice/hepatic dysfunction associated with prior erythromycin use
Drug Interactions
Digoxin
May increase serum digoxin levels, leading to digoxin toxicity.
Warfarin
May increase the anticoagulant effect of warfarin, requiring close monitoring of INR.
Theophylline
May increase serum theophylline levels, leading to toxicity.
Carbamazepine
May increase carbamazepine levels, leading to toxicity.
Oral Contraceptives
May decrease the effectiveness of oral contraceptives, requiring additional birth control methods.
Statins (e.g., Lovastatin, Simvastatin)
Increased risk of myopathy and rhabdomyolysis due to inhibition of statin metabolism by erythromycin.
Storage
Store below 30°C in a cool, dry place, away from direct sunlight and moisture. Keep out of reach and sight of children.
Overdose
Symptoms of overdose may include severe nausea, vomiting, abdominal pain, diarrhea, and reversible hearing loss. Management involves supportive care, including gastric lavage if ingested recently, and monitoring of vital signs and electrolyte balance.
Pregnancy & Lactation
Pregnancy Category B. Erythromycin is generally considered safe for use during pregnancy, but should be used only if clearly needed. It is excreted in breast milk; therefore, use with caution in nursing mothers, as it may cause gastrointestinal issues in the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Generally 24 to 36 months from the date of manufacture, depending on the specific product and formulation.
Availability
Pharmacies, hospitals
Approval Status
Approved by regulatory authorities
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Erythromycin has undergone extensive clinical trials since its discovery, establishing its efficacy and safety profile for a broad range of bacterial infections. Ongoing research continues to explore its potential in new applications and resistance patterns.
Lab Monitoring
- Liver function tests (for long-term therapy or in patients with pre-existing hepatic impairment)
- INR (International Normalised Ratio) if co-administered with warfarin
- Renal function tests (in patients with severe renal impairment)
Doctor Notes
- Erythromycin is a potent CYP3A4 inhibitor; consider potential drug interactions carefully, especially with drugs having narrow therapeutic indices.
- Monitor liver function in patients on prolonged therapy or with pre-existing hepatic disease.
- Advise patients on the importance of completing the full course to minimize resistance.
- Be aware of the risk of QT prolongation, particularly in patients with cardiac conditions or on other QT-prolonging drugs.
Patient Guidelines
- Take the medication exactly as prescribed by your doctor and complete the full course of treatment, even if you start to feel better.
- Do not skip doses or stop taking the medication prematurely, as this can lead to antibiotic resistance.
- Report any severe or persistent side effects, especially severe diarrhea, to your doctor immediately.
- Avoid grapefruit juice during treatment.
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 resume 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 vision changes, it is advisable to avoid these activities until you feel well.
Lifestyle Advice
- Maintain adequate hydration by drinking plenty of fluids.
- Avoid alcohol consumption during treatment, as it may exacerbate gastrointestinal side effects.
- Practice good hygiene to prevent the spread of infection.
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