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Roxithromycin (Rulide)
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Roxithromycin

Roxithromycin is part of the family of medications known as macrolide antibiotics and is commonly used in the treatment of bacterial infections. Roxithromycin is generically prescribed as roxithromycin and can cause life threatening heart complications in patients who also take pimozide, astemizole, cisapride, ergot medications, and terfenadine. Roxithromycin is an ineffective treatment option for patients suffering from infections caused by a virus or bacterium.

Other names for this medication:
Biaxsig, Remora, Roxitromicina, Rulid, Rulide

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Also known as:  Rulide.

Description

Each Roxithromycin tablet contains either 150mg or 300mg of the active ingredient roxithromycin. Each tablet also contains: hydroxypropylcellulose, poloxamer, povidone, colloidal anhydrous silica, magnesium stearate (470), purified talc (553), maize starch, hypromellose, anhydrous glucose, titanium dioxide (171), propylene glycol (1520). Roxithromycin does not contain gluten, sucrose, lactose, tartrazine or any other azo dyes.

Dosage

Roxithromycin is typically prescribed for a period of 7 to 14 days and patients should take the medication for as long as it has been prescribed to prevent the infection from returning even if they become asymptomatic. Patients should not however, take doses larger than has been prescribed as this can result in an overdose. Overdosing requires immediate medical intervention and may present with symptoms which include abdominal pain, nausea, diarrhea, vomiting, and a general and prolonged feeling of illness.

Overdose

Immediately telephone your doctor or pharmacist. Do this even if there are no signs of discomfort or poisoning.

Storage

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F) away from moisture, light and heat. Do not store in the bathroom. Keep in a tight, light-resistant container. Keep out of the reach of children.

Side effects

The most common side effects associated with Roxithromycin are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

The safety of roxithromycin has not been demonstrated in patients with impaired hepatic or renal function. Caution should be exercised if roxithromycin is administered to patients with impaired hepatic or renal function. If administered to patients with severe impaired hepatic function (eg. hepatic cirrhosis with jaundice and/or ascites), consideration should be given to reducing the daily dosage to half the usual dosage.

Prolonged or repeated use of antibiotics including roxithromycin may result in superinfection by resistant organisms. In the event of superinfection, roxithromycin should be discontinued and appropriate therapy instituted.

When indicated, incision, drainage or other appropriate surgical procedures should be performed in conjunction with antibiotic therapy.

Antibiotic associated pseudomembranous colitis has been reported with many antibiotics. A toxin produced by Clostridium difficile appears to be the primary cause. The severity of the colitis may range from mild to life threatening. It is important to consider this diagnosis in patients who develop diarrhoea or colitis in association with antibiotic use (this may occur up to several weeks after cessation of antibiotic therapy). Mild cases usually respond to drug discontinuation alone. However, in moderate to severe cases, appropriate therapy with a suitable oral antibacterial agent effective against Clostridium difficile should be considered. Fluids, electrolytes and protein replacement therapy should be provided when indicated.

Roxithromycin, like erythromycin, has been shown in vitro to elicit a concentration - dependent lengthening in cardiac action potential duration. Such an effect is manifested only at supra – therapeutic concentrations. Accordingly, the recommended doses should not be exceeded. In certain conditions macrolides, including roxithromycin, have the potential to prolong the QT interval. Therefore roxithromycin should be used with caution in patients with congenital prolongation of the QT interval, with ongoing proarrhythmic conditions (ie uncorrected hypokalemia or hypomagnesaemia, clinically significant bradycardia), and in patients receiving Class IA and III antiarrhythmic agents.

roxithromycin dose

Total dispensing data from local pharmacies for the months of June to October in 2000 and 2001, covering the six antibiotics considered most likely to be used for URTIs (amoxycillin, amoxycillin/clavulanic acid, cefaclor, doxycycline, erythromycin and roxithromycin).

roxithromycin antibiotics

In our randomized, placebo-controlled double-blind study, 28 patients with the confirmed diagnosis of MS [61% relapsing-remitting MS (RR-MS), 32% secondary chronic-progressive MS (SP-MS) and 7% primary chronic progressive MS (PP-MS)] were treated over a time period of 12 months with three cycles of a 6-week oral antibiotic therapy with roxithromycin (300 mg per day) or placebo.

roxithromycin dosage child

The study group included 42 patients (23 females, 19 males, mean age 64 +/- 3.5 yr). In 39 cases (93%) bacterial dermohypodermitis was located on the lower limb with a potential skin portal in 36 cases (86%). Sample culture, direct immunofluorescence or serology findings demonstrated presence of streptococci in 33 cases (79%). Nasal, intergluteal or potential portal were identified in 19 patients (45%) including 16 with demonstrated presence of streptococci. The rate of cure after oral pristinamycin did not vary significantly between carriers (79%) an non-carriers (91%) of Staphylococcus aureus. Drainage of a localized abscess was successful in 5 of 6 patients after initial failure of antibiotic treatment; 4 of them were carriers of S. aureus.

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Specimens were collected from 6161 subjects in seven centers and examined by the Gen-Probe method.

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The removal of seven pharmaceuticals and two fragrances in the biological units of various full-scale municipal wastewater treatment plants was studied. The observed removal of pharmaceuticals was mainly due to biological transformation and varied from insignificant (<10%, carbamazepine) to>90% (ibuprofen). However, no quantitative relationship between structure and activity can be set up for the biological transformation. Overall, it can be concluded that for compounds showing a sorption coefficient (K(d)) of below 300 L kg(-1), sorption onto secondary sludge is not relevant and their transformation can consequently be assessed simply by comparing influent and effluent concentrations. The two fragrances (HHCB, AHTN) studied were mainly removed by sorption onto sludge. For the compounds studied, comparable transformation and sorption was seen for different reactor types (conventional activated sludge, membrane bioreactor and fixed bed reactor) as well as for sludge ages between 10 and 60-80 days and temperatures between 12 degrees C and 21 degrees C. However, some significant variations in the observed removal currently lack an explanation. The observed incoming daily load of iopromide and roxithromycin in medium-sized municipal wastewater treatment plants (up to 80,000 population equivalents) is generated by only a small number of patients: the consequences for representative 24h composite sampling are discussed. Generally, the paper presents a method for setting up mass balances for micropollutants over entire wastewater treatment plants, including an estimation of the accuracy of the quantified fate (i.e. removal by sorption and biological transformation).

roxithromycin 150 mg treatment

No statistically significant changes in the chemiluminescence response of the whole blood were noted following in vitro treatment with 0, 2, 10, 25, or 50 micrograms/ml of erythromycin, josamycin, miomycin, roxithromycin, and spiramycin. These results suggest that these macrolide antibiotics are unlikely to impair the phagocytizing abilities of human neutrophils, in agreement with previous findings indicating their lack of influence upon neutrophil chemotaxis.

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RP 59500 is a 30:70 mixture of RP 57669 and RP 54476. The activity of RP 59500 and its two components against Gram-positive and Gram-negative organisms was compared with that of clarithromycin, roxithromycin, azithromycin and rokitamycin. RP 59500 inhibited 90% of erythromycin-susceptible and resistant Staphylococcus aureus and coagulase-negative staphylococci at less than or equal to 1 mg/L (range 0.06-2 mg/L). Both inducibly and constitutively-resistant strains of S. aureus, as well as strains resistant to rifampicin, gentamicin and ciprofloxacin, were inhibited. Streptococcus pyogenes, including erythromycin-resistant isolates, and group C and G streptococci were inhibited by 0.5 mg/L. Streptococcus pneumoniae and viridans group streptococci were inhibited by 1 mg/L. The MIC90 was 4 mg/L for Haemophilus influenzae and 1 mg/L for Moraxella catarrhalis. RP 59500 did not inhibit Enterobacteriaceae or Pseudomonas aeruginosa. The activity of RP 59500 against streptococci was less than that of the four other macrolides. Clostridium perfringens strains were highly susceptible, as were Bacteroides spp. RP 59500, when combined with ciprofloxacin, cefotaxime or gentamicin, did not have altered activity against susceptible species or alter the activity of the other component of the combination against susceptible species. MBCs in serum were increased two- to four-fold for S. pyogenes, S. pneumoniae and S. aureus, compared with MBCs in broth, but RP 59500 was as active at pH 6 as at pH 7, and there was not an appreciable inoculum effect. RP 59500 has potential use as an agent against inducibly and constitutively erythromycin-resistant isolates of Gram-positive species and selected anaerobic organisms.

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We investigated the activity of roxithromycin (RU 965) and gamma interferon alone and in combination in a murine model of toxoplasmic encephalitis. Roxithromycin at a dosage of 35 or 50 mg per mouse per day decreased mortality. Gamma interferon alone significantly prolonged time to death. When combined, the two agents were remarkably synergistic.

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roxithromycin 50 mg oral suspension 2015-09-11

The carriage rate of S. pneumoniae in the 3 centers varied from 44.9% to 66.0% (mean, 55.9%). Susceptibility testing was performed with 305 (74.4%) of 410 isolates. Only Flagyl 400mg Dosage 23 (7.5%) of 305 pneumococcal isolates were penicillin-intermediate (range, 2.8 to 12.8%) with no penicillin-resistant strains. All tested pneumococci were susceptible to amoxicillin/clavulanate. Macrolides possessed comparable activity against S. pneumoniae, at 4.6% resistant strains for both erythromycin (range, 1.1 to 17.1%) and clarithromycin (range, 1.7 to 17.1%). The highest level of resistance was observed with TMP-SMX, 53.4% (range, 43.8 to 70.9%). Of 23 strains 20 (87.0%) with intermediate resistance to penicillin were serotyped. The most prevalent serotype was 14 (5 isolates), followed by serogroups 19 (4) and 23 (4).

roxithromycin tablet uses 2015-03-08

VEGF mRNA and its protein were constitutively expressed in HPDL cells, and the level of expression was Cephalexin Tablets markedly enhanced by stimulation with TNF-alpha. RXM strongly inhibited the expression of VEGF mRNA and the production of VEGF. Furthermore, RXM suppressed activation of transcription factors AP-1 and SP-1, which were critical factors in VEGF transcription, in TNF-alpha-stimulated HPDL cells.

roxithromycin tablets ip 150 mg 2015-12-18

Fourteen-membered macrolides, such as roxithromycin, have been Azithral 3 Tablets reported to exhibit other pharmacological activity including anti-asthmatic effects, besides antibiotic activity.

roxithromycin sandoz 150 mg ja alkoholi 2016-07-11

Human epithelial cell lines (Ca9 Ceftinex Tablet Yan Etkileri -22, TU4, SCCTF and HSC-3) were plated in tissue culture dishes. Then, the culture supernatants and sediments were collected and the production of MMP-13 was analysed using enzyme-linked immunosorbent assay; the expression of MMP-13 mRNA and runt-related gene 2 mRNA was assessed using reverse transcriptase-polymerase chain reaction (RT-PCR) and real-time RT-PCR. We also studied the effect of Runx2 short interfering RNA (siRNA) on the induction of MMP-13.

roxithromycin 300 mg and alcohol 2015-05-16

To determine the prevalence of trachoma and to measure the impact of the SAFE strategy (World Health Organization GET 2020 Dalacin 100 Mg Clindamycin strategy) for treating trachoma in the Gwembe District of Southern Zambia.

roxithromycin dispersible tablets 2016-12-10

Drug-induced QT prolongation usually leads to torsade de pointes (TdP), thus for drugs in the early phase of development this risk should be evaluated. In the present study, we demonstrated a visualized transgenic zebrafish as an in vivo high-throughput model to assay the risk of drug-induced QT prolongation. Zebrafish larvae 48 h post-fertilization expressing green fluorescent protein in myocardium were incubated with compounds reported to induce QT prolongation or block the human ether-a-go-go-related gene (hERG) K⁺ current. The compounds sotalol, indapaminde, erythromycin, ofoxacin, levofloxacin, sparfloxacin and roxithromycin were additionally administrated by microinjection into the larvae yolk sac. The ventricle heart rate was recorded using the automatic monitoring system after Klabax 250 Mg Comprimate Prospect Pret incubation or microinjection. As a result, 14 out of 16 compounds inducing dog QT prolongation caused bradycardia in zebrafish. A similar result was observed with 21 out of 26 compounds which block hERG current. Among the 30 compounds which induced human QT prolongation, 25 caused bradycardia in this model. Thus, the risk of compounds causing bradycardia in this transgenic zebrafish correlated with that causing QT prolongation and hERG K⁺ current blockage in established models. The tendency that high logP values lead to high risk of QT prolongation in this model was indicated, and non-sensitivity of this model to antibacterial agents was revealed. These data suggest application of this transgenic zebrafish as a high-throughput model to screen QT prolongation-related cardio toxicity of the drug candidates.

roxithromycin ear infection 2015-10-16

The prevention of cerebral toxoplasmosis and of Pneumocystis carinii pneumonia is an essential objective in the management of patients infected with HIV. Given that roxithromycin is active in vitro against Toxoplasma gondii and that in 1989 Dolermann reported the effective treatment of P. carinii respiratory infections with erythromycin, a randomized pilot study was undertaken in 52 patients infected with HIV. Patients were treated with either: a monthly dose of pentamidine aerosol (300 mg); roxithromycin once a week (300 mg t.i.d.); or a combination of pentamidine aerosol and roxithromycin. Intention to treat analysis was applied to these 52 Mahacef 250 Mg patients, all of whom received at least one treatment dose. Five out of 18 patients treated with pentamidine aerosol, 1/17 patients treated with pentamidine aerosol + roxithromycin and none of the 17 patients treated with roxithromycin developed cerebral toxoplasmosis (p = 0.038). P. carinii pneumonia was diagnosed in one patient in the pentamidine aerosol-treated group, in one patient treated with roxithromycin and in none of the patients treated with pentamidine aerosol + roxithromycin (non-significant difference). Four cases of Mycobacterium tuberculosis and Mycobacterium avium-intracellulare infection were seen in the pentamidine aerosol-treated group (p = 0.028) and none in the roxithromycin groups. Adverse events leading to the discontinuation of treatment occurred in 5/34 (14.7%) patients treated with roxithromycin. Nausea, abdominal pain and raised transaminases occurred in four patients and a skin allergy in the final patient. Roxithromycin appears to be effective in the prevention of pulmonary pneumocystis infection and of cerebral toxoplasmosis in HIV-infected patients. However, these results require confirmation in a larger study.

roxithromycin while breastfeeding 2016-08-25

292 patients were randomised to one of three treatments for 12 weeks: roxithromycin 300 mg daily and doxycycline 100 mg daily (n = 101); roxithromycin 300 mg daily (n = 97); or matching placebos (n = 94). There were no differences in the annualised moderate and severe exacerbation rates after treatment with roxithromycin/doxycycline (2.83 (95 % CI 2.37-3.40)) or roxithromycin only (2.69 (2.26-3.21)) compared to placebo (2.5 (2.08-3.03)) (p = 0.352 and p = 0.5832 respectively). Furthermore, there were no differences in the annualised exacerbation rates during 12-week treatment with roxithromycin/doxycycline (1.64 (95 % CI 1.17-2.30)), roxithromycin only (1.75 (1.24-2.41)) or placebo (2.23 (1.68-3.03)) (p = 0.1709 and p = 0.2545 respectively). There were also no significant differences between groups for spirometry or quality of life scores over either the 12- Metronidazol 500 Mg Ovulos week treatment or 48-week post-treatment periods. Both active treatments were associated with nausea but otherwise adverse events were comparable among treatment groups.

roxithromycin drug action 2015-03-08

Although chloramphenicol and doxycycline have been used for the treatment of scrub typhus, a Suprax Overdose difficulty exists in determining which drug to use in treating children because of such potential complications as aplastic anemia or tooth discoloration. We evaluated the effect of roxithromycin, a macrolide antibiotic, on scrub typhus in children.