Sumamed - instructions for use, analogs, reviews and release forms (forte, 125 mg and 500 mg tablets, 250 mg capsules, suspension, injections) drugs for the treatment of angina, pneumonia and other infections in adults, children and pregnancy

In this article, you can read the instructions for using the drug Sumamed. There are reviews of visitors to the site - consumers of this medication, as well as opinions of specialists on the use of Sumamed in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Sumamed in the presence of existing structural analogs. Use for the treatment of angina, bronchitis, pneumonia and other infectious diseases in adults, children,as well as during pregnancy and lactation. Methods of preparing the suspension. Effect of alcohol on simultaneous use of the drug.

Sumamed - bacteriostatic antibiotic of a wide spectrum of action from the group of macrolides-azalides. The mechanism of action of Azithromycin (the active substance of the drug Sumamed) is associated with the suppression of protein synthesis of a microbial cell. By binding to the 50S subunit of the ribosome, it inhibits the peptidranslokase at the translation stage and suppresses protein synthesis, slowing the growth and multiplication of bacteria. In high concentrations has a bactericidal effect.

Microorganisms may initially be resistant to the action of the antibiotic or may acquire resistance to it.

In most cases, the drug Sumamed is active against aerobic Gram-positive and Gram-negative bacteria, anaerobic bacteria, other microorganisms: Chlamydia trachomatis, Chlamydia pneumoniae, Chlamydia psittaci, Mycoplasma pneumoniae, Mycoplasma hominis, Borrelia burgdorferi.

Pharmacokinetics

After oral administration, azithromycin is well absorbed and quickly distributed in the body. It is transported by phagocytes to the site of infection, where it is released in the presence of bacteria. Easily penetrates through the histohematological barriers and enters the tissues.Concentration in tissues and cells is 10-50 times higher than in plasma, and in the focus of infection - 24-34% more than in healthy tissues. In the liver, demethylated, losing activity. The therapeutic concentration of azithromycin is maintained up to 5-7 days after the last dose. Azithromycin is excreted, basically, in unchanged form - 50% through the intestine, 6% by the kidneys.

Indications

Infectious-inflammatory diseases caused by microorganisms sensitive to the preparation:

• infections of the upper respiratory tract and ENT organs (pharyngitis / tonsillitis, sinusitis, otitis media);
• infection of the lower respiratory tract (acute bronchitis, exacerbation of chronic bronchitis, pneumonia, including those caused by atypical pathogens);
• diseases of the stomach and duodenum, associated with Helicobacter pylori (for the powder);
• infections of the skin and soft tissues (acne of medium severity, erysipelas, impetigo, secondarily infected dermatoses);
• the initial stage of Lyme disease (borreliosis) - migrating erythema (erythema migrans);
• urinary tract infections caused by Chlamydia trachomatis (urethritis, cervicitis).

Forms of release

Tablets coated with a film membrane 125 mg and 500 mg.

Capsules 250 mg.

Lyophilizate for solution for infusion (injections) 500 mg.

Powder for the preparation of suspension for ingestion 100 mg / 5 ml.

Instructions for use and dosage

The drug is administered orally once a day, at least 1 hour before or 2 hours after a meal. Tablets are taken without chewing.

Adults (including the elderly) and children over 12 years of age with a body weight of more than 45 kg of the drug is prescribed in the form of tablets and capsules.

Children aged 6 months and older should be given the drug in the form of a suspension for oral administration, children aged 3 years and older can also be prescribed in the form of 125 mg tablets. The drug in the form of tablets 125 mg is dosed taking into account the body weight of the child.

For infections of the ENT organs, upper and lower respiratory tracts, skin and soft tissues (with the exception of chronic migrating erythema), adults and children over 12 years of age with a body weight of more than 45 kg are prescribed a dose of 500 mg once a day for 3 days, dose - 1.5 g. Children aged 6 months and older are prescribed at the rate of 10 mg / kg body weight once a day for 3 days, the course dose is 30 mg / kg.

In diseases of the stomach and duodenum associated with Helicobacter pylori, the drug is prescribed in the form of powder at a dose of 1 gv day for 3 days in combination with antisecretory drugs and other medications.

With migratory erythema, the drug is prescribed 1 time per day for 5 days. Adults and children over 12 years of age with a body weight of more than 45 kgnaznachayut on the 1st day - 1 g, then from 2 to 5 days - 500 mg; course dose - 3 g. Children aged 6 months and older are prescribed on the 1st day at a dose of 20 mg / kg of body weight and then from 2 to 5 days - daily at a dose of 10 mg / kg of body weight, the course dose of 60 mg / kg.

For acne vulgaris of medium severity, the course dose is 6.0 g. Adults and children over 12 years of age weighing more than 45 kg are given a dose of 500 mg once a day for 3 days, then 500 mg once a week for 9 weeks. The first weekly dose should be taken 7 days after the first daily dose (the 8th day from the start of treatment), the subsequent 8 weekly doses should be taken at intervals of 7 days.

For sexually transmitted infections, for treatment of uncomplicated urethritis / cervicitis caused by Chlamydia trachomatis, the drug is prescribed at a dose of 1 year; for the treatment of complicated long-flowing urethritis / cervicitis caused by Chlamydia trachomatis, appoint 1 g3 times with an interval of 7 days (1, 7, 14 days), the course dose is 3 g.

For patients with moderate impaired renal function (CK> 40 mL / min) dose adjustment is not required.

How to dilute and take a suspension

In a vial containing 17 gypsum, 12 ml of distilled or boiled water are added. The volume of the obtained suspension is 23 ml. Shelf life of the prepared suspension is 5 days. Before taking the contents of the vial thoroughly shake until a homogeneous suspension. Immediately after taking the suspension, the child is allowed to drink a few sips of tea in order to wash off and swallow the remaining amount of the suspension in the oral cavity.

After use, the syringe is disassembled and washed with running water, dried and stored in a dry place together with the preparation.

Sumamed forte (in the form of a suspension)

Inside, 1 time per day, at least 1 hour before or 2 hours after meals.

In case of infection of the upper and lower respiratory tract, skin and soft tissues (with the exception of chronic migrating erythema), a total dose of 30 mg / kg, i.е. at 10 mg / kg once a day for three days.

With chronic migratory erythema, the total dose of the drug is 60 mg / kg: on the 1st day - once 20 mg / kg; in the following days (from the 2nd to the 5th) - 10 mg / kg.

With stomach and duodenal ulcers associated with Helicobacter pylori: 20 mg / kg once daily in combination with an antisecretory agent and other medications as directed by a physician.

In the event that the dose of the drug has been missed, it is necessary, if possible, to take it immediately, and then the subsequent dose - with an interval of 24 hours.

In cases of sexually transmitted infections

Uncomplicated urethritis / cervicitis -1 g, once.

Method of preparing the suspension

To prepare 15 ml of the suspension (nominal volume), it is necessary to add 8 ml of water to the vial containing 800 mg of azithromycin (the actual volume is 20 ml of the suspension).

To prepare 30 ml of the suspension (nominal volume), 14.5 ml of water should be added to the vial containing 1400 mg of azithromycin (the actual volume is 35 ml of the suspension).

To prepare 37.5 ml of the suspension (nominal volume), it is necessary to add 16.5 ml of water to the vial containing 1700 mg of azithromycin (the actual volume is 42.5 ml of the suspension).

Each vial should contain suspensions of 5 ml more than the course dose for more complete extraction of the drug from the vial.

Shelf life of the prepared suspension is 5 days, at a temperature not higher than 25 ° C.

Using the syringe for metering, measure the required amount of water, add to the vial of powder. Before taking the contents of the vial thoroughly shake until a homogeneous suspension.

To dispense the finished suspension, use a syringe or a measuring spoon.

Immediately after taking the suspension, the child is allowed to drink a few sips of tea or juice in order to wash off and swallow the remaining amount of the suspension in the oral cavity.

After use, the syringe is disassembled and washed with running water, dried and stored together with the preparation.

Side effect

• thrombocytopenia, neutropenia, eosinophilia;
• dizziness;
• headache;
• drowsiness;
• convulsions;
• insomnia;
• hyperactivity, aggressiveness, anxiety, nervousness;
• noise in ears;
• reversible hearing loss down to deafness (when taken in high doses for a long time);
• a violation of the perception of taste and smell;
• palpitation;
• arrhythmia, including ventricular tachycardia;
• nausea, vomiting;
• diarrhea, constipation;
• abdominal pain and spasms;
• flatulence;
• anorexia;
• hepatitis;
• itching, skin rashes;
• angioedema;
• hives;
• anaphylactic reaction (in rare cases, fatal);
• joint pain;
• vaginitis;
• candidiasis.

Contraindications

• severe violations of the liver and kidneys;
• lactation period (breastfeeding);
• simultaneous administration with ergotamine and dihydroergotamine;
• increased sensitivity to antibiotics of the macrolide group;
• children under 12 years of age and body weight less than 45 kg (for capsules and tablets 500 mg);
• children under 3 years (for tablets 125 mg).

Application in pregnancy and lactation

In pregnancy, the use of the drug is possible only if the potential benefit of therapy for the mother exceeds the possible risk to the fetus.

If you need to use the drug during lactation, breastfeeding should be discontinued.

special instructions

If you miss one dose of the drug - the missed dose should be taken as soon as possible, and the next - with interruptions of 24 hours.

Just like with any antibiotic therapy, with the treatment of azithromycin, it is possible to attach superinfection (including fungal).

In the treatment of pharyngitis / tonsillitis caused by Streptococcus pyogenes, as well as for the prevention of acute rheumatic fever, the drug of choice is usually penicillin. Azithromycin is also active against streptococcal infection in these cases, but is ineffective in preventing the development of acute rheumatic fever.

The patient should be warned about the need to inform the doctor of anyeffect.

There was a negative effect of joint intake of Sumamed and alcohol (hepatotoxic effect).

Influence on ability to drive vehicles and mechanisms

The drug does not affect the ability to drive vehicles and other activities that require a high concentration of attention and speed of psychomotor reactions.

Drug Interactions

Antacids do not affect the bioavailability of azithromycin, but reduce Cmax in the blood by 30%, so Sumamed should be taken at least 1 hour before or 2 hours after taking these drugs and food.

With simultaneous use of azithromycin does not affect the concentration of carbamazepine, didanosine, rifabutin and methylprednisolone in the blood.

In case of parenteral administration Sumamed does not influence the plasma concentrations of cimetidine, efavirenz, fluconazole, indinavir, midazolam, theophylline, triazolam, trimethoprim / sulfamethoxazole in the case of combined therapy, however, this interaction should not be excluded when Sumamed is administered orally.

Azithromycin does not affect the pharmacokinetics of theophylline, but when combined with other macrolides, the concentration of theophylline in the blood plasma may increase.

If it is necessary to share with cyclosporine, it is recommended to monitor the content of cyclosporine in the blood. Despite the fact that there is no data on the effect of azithromycin on the change in the concentration of cyclosporine in the blood, other representatives of the macrolide class are able to change its concentration in the blood plasma.

With the joint administration of Digoxin and Sumamed, it is necessary to control the concentration of digoxin in the blood. many macrolides increase the absorption of digoxin from the intestine, thereby increasing its concentration in the blood plasma.

If it is necessary to share with warfarin, careful monitoring of prothrombin time is recommended.

It was found that simultaneous reception of terfenadine and antibiotics of the macrolide class causes arrhythmia and lengthening of the QT interval. Proceeding from this, it is impossible to exclude the development of these complications with the joint administration of terfenadine and azithromycin.

With the joint administration of azithromycin and zidovudine, azithromycin does not affect the pharmacokinetic parameters of zidovudine in the blood plasma or on excretion by the kidneys of its and its metabolite glucuronide.Nevertheless, the concentration of the active metabolite - phosphorylated zidovudine - increases in mononuclear cells of peripheral vessels. The clinical significance of this fact is not clear.

With the simultaneous administration of macrolides with ergotamine and dihydroergotamine, their toxic effect is possible.

Analogues of medicinal product Sumamed

Structural analogs for the active substance:

• Azivok;
• Azimycin;
• Azitral;
• Azitroxy;
• Azithromycin;
• Azithromycin Forte;
• Azithromycin dihydrate;
• AsitRus;
• AzitRus forte;
• Azicid;
• Vero-Azithromycin;
• Zetamax retard;
• ZI-Factor;
• Zitnob;
• Zitrolide;
• Zitrolid forte;
• Zitrocin;
• Sumazid;
• Sumaclide;
• Sumamed forte;
• Sumamecin;
• Sumamecin forte;
• Sumamox;
• Sumatrolide solute;
• Tremak-Sanovel;
• Hemomycin;
• Ecomed.

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