Pharmacodynamics and pharmacokinetics
Pharmacodynamics
The antibiotic Macropen belongs to the group of macrolides . By inhibiting the synthesis of proteins in microbial cells, it has a bacteriostatic effect in small doses, and a bactericidal effect . Its effectiveness has been noted against gram-positive (clostridium, streptococcus, listeria, staphylococcus, corynobacteria), gram-negative (campylobacter, moraxella, Haemophilus influenzae, Helicobacter, bacteroides) bacteria , as well as intracellular microorganisms (mycoplasma, chlamydia, ureaplasma).
Pharmacokinetics
After administration, it is quickly and completely absorbed from the gastrointestinal tract. The maximum concentration of the drug in the serum is after 1–2 hours. At this level, the concentration remains for up to 6 hours. Eating slightly reduces the concentration of the drug in the blood, so it is recommended to take it before meals. The highest concentrations are created in the lungs, parotid gland and skin.
The drug is metabolized in the liver and excreted in the bile and kidneys (to a lesser extent).
Indications for use
Infections caused by microorganisms sensitive to the drug:
- respiratory tract infections ( tonsillitis, pharyngitis, otitis media, sinusitis, bronchitis, pneumonia );
- urinary tract infections caused, among other things, by mycoplasma, ureaplasma, chlamydia;
- infections of mucous membranes and skin;
- enteritis caused by Campylobacter;
- diphtheria and whooping cough ;
- treatment of patients who cannot tolerate penicillin antibiotics.
Instructions for use Macropen (Method and dosage)
Macropen has two forms of release - tablets and suspension , which is prepared from granules by adding water.
Macropen tablets, instructions for use
Macropen is prescribed every 8 hours.
Adults and children (body weight 30 kg or more) - 400 mg 3 times. For adults, the daily dose (maximum) is 1600 mg.
Children weighing less than 30 kg - 20–40 mg/kg, dividing the daily dose into 3 times. The daily dose for severe infections can be 50 mg/kg, also divided by 3 times.
Macropen suspension, instructions for use
This form of release is used in childhood. Depending on the child’s body weight, the dosage is calculated and taken 2 times a day:
- from 0 to 5 kg -3.75 ml of suspension 2 r/s;
- from 5 to 10 kg -7.5 ml of suspension 2 r/s;
- from 10 to 15 kg - 10 ml of suspension 2 r/s;
- from 15 to 20 kg - 15 ml of suspension 2 r/s;
- from 20 to 25 kg—22.5 ml of suspension 2 r/s.
To prepare the suspension, add 100 ml of water to the granules in the bottle. The course of treatment with Macropen is 7-10 days, and in the case of chlamydial infection, 14 days.
The answer to the question of what Macropen tablets are for is that this antibiotic is prescribed for any infections, but most often for respiratory tract infections . It is effective in 90% of patients with tonsillopharyngitis , acute otitis media and sinusitis , chronic bronchitis and pneumonia . Due to its low toxicity and high efficiency, Macropen is used in newborns in the treatment of chlamydial respiratory tract infection .
There is a high effectiveness of using this drug for angina . Since the antibiotic is broad-spectrum, the infection of the nasopharynx is quickly suppressed, and the symptoms of the disease are stopped. Macropen for angina is prescribed 400 mg 3 times a day.
Macropen is also widely used for sinusitis .
And depending on the severity of this disease, the dose in adults can be 1200 mg - 1600 mg per day. With timely administration of Macropen for sinusitis, the likelihood of complications is reduced and in many cases, therapeutic puncture of the maxillary sinus can be avoided.
Rules for prescribing antibacterial agents
Macropen contains an antibiotic, which, like other antibacterial drugs, has a systemic effect on the patient’s body. Therefore, it should only be used when prescribed by a qualified physician.
Self-administration of an antibiotic may not only not give the expected positive effect, but also lead to the development of side effects.
In addition, there are a number of conditions in which the use of drugs from a number of macrolides is strictly prohibited.
It is also necessary to make sure that the child has a bacterial infection before prescribing Macropen. Quite often, antibacterial agents are mistakenly used for viral or fungal pathologies, and then they are ineffective.
Therefore, it is first necessary to conduct a thorough interview with the parents and a physical examination of the child. Additionally, the following examinations are prescribed:
- general blood test (for bacterial pathology - leukocytosis, neutrophilia, increased number of young cell forms and erythrocyte sedimentation rate, monocytosis is possible);
- general urine analysis;
- biochemical blood test (appearance of inflammatory proteins);
- X-ray examination of the chest cavity and skull (if sinusitis, bronchitis and pneumonia are suspected) and computed tomography.
The key study to determine the cause of the pathological process is bacteriological. To carry it out, it is necessary to collect sputum, pleural fluid, blood or a smear from the posterior wall of the nasopharynx.
It allows you to reliably determine which microorganism caused the disease, as well as what drugs it is sensitive to. This research method is the gold standard for diagnosis.
Its only drawback is the fact that the results of the bacteriological analysis are received by the doctor only on the 3-4th day. Therefore, initial antibiotic therapy should be empirical and based on the recommendations of domestic and European pediatricians.
Macropen for children
In pediatric practice, this drug is considered the most effective and safest antibiotic. Pediatricians encounter virtually no side effects.
Macropen does not cause dysbiosis , which often occurs when other antibiotics are prescribed. Antifungal agents are not prescribed when using this drug (only in weakened infants). Macropen for children is available in a form convenient for administration - the prepared suspension has a pleasant taste, so there are no problems during treatment. This is also evidenced by reviews from parents who note the effect of treatment in cases where penicillin antibiotics are no longer effective.
Contraindications
- Severe liver failure;
- Age up to 3 years (for tablets);
- Hypersensitivity to the components of the product.
You should take the drug with extreme caution if you have a history of an allergic reaction to acetylsalicylic acid, since the sunset yellow dye can provoke an allergic reaction, including bronchospasm.
During pregnancy, use is possible only if the expected benefit from the drug outweighs the potential threat from side effects. Due to the fact that Macropen is excreted in breast milk, breastfeeding should be interrupted while taking the drug.
Interaction
When using the drug with carbamazepine , its transformation in the liver decreases and, accordingly, the concentration in the serum increases, which increases the risk of the toxic effects of the latter: urinary retention, ataxia, convulsions .
When using Macropen with warfarin , the risk of bleeding increases, with cyclosporine - the risk of nephrotoxicity, with ergometrine and ergotamine - peripheral vascular spasm ( ischemia and possible gangrene of the extremities).
special instructions
As with the use of any other antimicrobial drugs, overgrowth of resistant bacteria is possible with long-term therapy with Macropen. Prolonged diarrhea may indicate the development of pseudomembranous colitis.
During long-term therapy, liver enzyme activity should be monitored, especially in patients with impaired liver function.
The effect of Macropen on the speed of psychomotor reactions and the ability to drive a car and other mechanisms has not been reported.
Macropen's analogs
Level 4 ATC code matches:
Ecositrin
Azicine
Rovamycin
AzitRus
Safocid
Clarithromycin
Sumamed Forte
Klarbakt
Azithromycin
Azitro Sandoz
Sumamed
ZI-Factor
Azitral
Azimed
Azicide
Spiramycin-Vero
Zitrolide
Ecomed
Klacid SR
Klacid
There are no analogues for the active substance. Analogues of Macropen belonging to the same pharmacological group (second generation macrolides): Clarithromycin, Azithromycin, Josamycin.
The price of analogues Clarithromycin 500 mg No. 14 is 311 – 456 rubles. (manufactured by Pliva), designed for a 7-day course of treatment.
Azithromycin capsules 500 mg No. 3 - 85 -99 rub. (Obolenskoye FP Russia), designed for a 3-day course of treatment.
Reviews about Macropen
Reviews about Macropen are in most cases positive . Most of them are about the use of the drug for sinusitis. High efficiency is noted - in many cases, with timely administration of the drug, the patient's condition quickly improves, and puncture can be dispensed with. Duration of treatment is from 7 to 14 days. It is important to complete the course of treatment, otherwise the “hidden” infection may become chronic.
A large number of reviews about the use of the suspension for children. Parents are satisfied with the results of the treatment: it quickly and effectively helps with coughs, especially prolonged ones. Since the treatment lasted up to 10 days, the child was given probiotics ( Linex , Bactisubtil ) in parallel. Some noted the appearance of adverse reactions in children: nausea, lethargy, vomiting. In such cases, Macropen was canceled. In any case, there is no point in drawing conclusions that the drug is not effective. It depends on the individual characteristics of the organism.
Side effects
- Allergic reactions: skin itching, urticaria, skin rash, bronchospasm, eosinophilia;
- Digestive system: nausea, loss of appetite, diarrhea, vomiting, feeling of heaviness in the epigastrium, stomatitis, hyperbilirubinemia, jaundice, increased activity of liver transaminases; in some cases - prolonged and severe diarrhea;
- Other: weakness.
There are no reports of severe overdose caused by taking the drug. Possible symptoms of this condition may be vomiting and nausea; therapy is symptomatic.
Macropen price, where to buy
This drug can be found in any pharmacy. By purchasing Macropen tablets, the price of which in Moscow pharmacies varies and ranges from 268 to 376 rubles. for 16 capsules, you can make a request on the Internet and choose a more acceptable option. The price of Macropen suspension is from 270 rubles. up to 306 rub.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Macropen granules for Prig Susp.
for internal approx. 175 mg/5 ml 115 ml JSC KRKA, d.d., Novo mesto 506 rub. order
Pharmacy Dialogue
- Macropen (tab. 400 mg No. 16)KPKA
RUB 385 order
- Macropen (susp. 175 mg/5 ml 115 ml)KPKA
RUR 567 order
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Pharmacy24
- Macropen 175 mg/5 ml 115 ml granules
96 UAH. order - Macropen 400 mg No. 16 tablets KRKA, d.d., Novo Mesto, Slovenia/Merck KGaA i Co., Werk Spital, Austria
106 UAH order
PaniPharmacy
- Macropen tablets Macropen tablets. p/o 400 mg No. 16 Slovenia, KRKA dd Novo Mesto
116 UAH order
- Macropen liquid Macropen granules for suspension 175 mg/5 ml 115 ml Slovenia, KRKA dd Novo Mesto
120 UAH order
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