Tri tren side effects – bacteriostatic antibiotic with broad-spectrum macrolide-azalide. It has a wide spectrum of antimicrobial action. The mechanism of action of tri tren side effects is associated with the suppression of the microbial cell protein synthesis. By binding to the 508-subunit of ribosomes, inhibits peptidtranslokazu on broadcast stage and inhibits protein synthesis, slowing the growth and reproduction of bacteria. In high concentrations it has a bactericidal effect.
It has activity against a number of Gram-positive, Gram-negative, anaerobic, and other intracellular microorganisms.
Microorganisms can initially be resistant to the antibiotic, or may acquire resistance to it. In most cases, the sensitive microorganism
- Gram-positive aerobes
Staphylococcus aureus – metitsillinchuvstvitelngy, Streptococcus pneumoniae -penitsillinchuvstvitelny, Streptococcus pyogenes
- Gram-negative aerobic
Haemophilus influenzae, Haemophilus parainfluenzae, Legionella pneumophila , Moraxella catarrhalis, Pasteurella multocida, Neisseria gonorrhoeae
Clostridium perfringens, Fusobacterium spp., Prevotella spp., Porphyriomonas spp.
- Other microorganisms
Chlamydia trachomatis, Chlamydia phneumoniae, Chlamydia psittaci , Mycoplasma pneumoniae, Mycoplasma hominis, Borrelia burgdorferi
Organisms capable of developing resistance to tri tren side effects
Streptococcus pneumoniae penitsillinustoychivy initially resistant organisms Gram-positive aerobes Enterococcus faecalis, Staphylococci (methicillin-resistant staphylococci exhibit a very high degree of resistance to macrolides). Gram-positive bacteria resistant to erythromycin. Anaerobes Bacteroides fragilis
After oral administration, tri tren side effects is well absorbed and rapidly distributed in the body. After a single dose of 500 mg bioavailability – 37% (the effect of “first pass”), maximum concentration (0.4 mg / ml) in the blood through 2-3 hours, apparent volume of distribution of 31.1 l / kg, protein binding back proportion and concentration in blood is 7-50%. It penetrates through the cell membrane (effective for infections caused by intracellular pathogens). Transported by phagocytes to the site of infection, which is released in the presence of bacteria. Gistogematicalkie barriers tri tren easily passes and enters the tissue. Concentration in tissues and cells 10-50 times higher than in plasma, and the source of infection – by 24-34% higher than in healthy tissues.
In tri tren side effects very long half-life of – 35-50 hour half-life of tissue significantly. more. Therapeutic concentrations of tri tren side effects remains until 5-7 days after the last dose. tri tren side effects is substantially unaltered – 50% intestine, 6% – kidneys. The liver demethylated losing activity.
Infectious-inflammatory diseases caused by susceptible to malaria infections:
- infections of the upper respiratory tract and upper respiratory tract (sinusitis, tonsillitis, pharyngitis, otitis media);
- infections of the lower respiratory tract: acute bronchitis, exacerbation of chronic bronchitis, pneumonia, including those caused by atypical pathogens;
- infections of skin and soft tissues (erysipelas, impetigo, secondarily infected dermatitis, acne vulgaris of moderate severity);
- the initial stage of Lyme disease (borreliosis) – erythema migrans (erythema migrans);
- urinary tract infections caused by Chlamidia trachomatis (urethritis, cervicitis).
Hypersensitivity to macrolide antibiotics group, severe hepatic and / or renal insufficiency, children under 12 years (with a body weight less than 45 kg), breastfeeding, concomitant use with ergotamine and dihydroergotamine.
Moderate violation of liver and kidney function, arrhythmia or predisposition to arrhythmias and prolongation of the interval QT, with a joint appointment terfenadine, warfarin, digoxin.
Pregnancy and lactation
In pregnancy, the drug is prescribed only when the expected benefit to the mother outweighs the potential risk to the fetus.
If necessary, use during lactation should decide the issue of termination of breastfeeding at the time of the drug.
Dosage and administration
Inside, 1 times a day for at least 1 hour or for 2 hours after after eating. Adults (including the elderly) and children over 12 years weighing more than 45 kg.
When infections of the upper and lower respiratory tract, upper respiratory tract, skin and soft tissue – 0.5 g / day for 1 reception for 3 days ( course dose – 1.5 g).
If erythema migrans (Lyme disease) for the treatment of stage I – 1 times per day for 5 days: day 1 – 1.0 g, then from the 2nd to the 5th day – 0.5 grams daily (course dose – 3 g).
Acne is common – 6g course dose 0.5 g / day for 1 reception for 3 days, followed by 0.5 g / day 1 time per week for 9 weeks. The first weekly pill must be taken within 7 days after the first daily pill (8 day from the beginning of treatment), the next 8 weekly tablets – with an interval of 7 days.
For infections of urinary tract, caused by Chlamidia trachomatis (uncomplicated urethritis or cervicitis) – Once 1 g .
Appointment of patients with impaired renal function: for patients with moderate renal impairment (creatinine clearance> 40 ml / min) dose adjustment is not necessary.
Side effects: the part of the circulatory and lymphatic systems . Thrombocytopenia, neutropenia Part of the central nervous system: dizziness / vertigo, headache, seizures, drowsiness, paresthesia, fatigue, insomnia, hyperactivity, aggressiveness, anxiety, nervousness. From the senses: the noise ears, reversible hearing impairment including deafness (when taking high doses for a long time), impaired perception of taste and smell. On the part of the cardiovascular system: heart rate, arrhythmia, ventricular tachycardia, increase the interval QT, bidirectional ventricular tachycardia. From the gastrointestinal:nausea, vomiting, diarrhea, abdominal pain / cramps, bloating, indigestion, anorexia, constipation, change the language of color, pseudomembranous colitis, cholestatic jaundice, hepatitis, changes in laboratory parameters of liver function, liver failure, liver necrosis (possibly fatal). Allergic reactions: itching, skin rash, angioedema, rash, photosensitivity, anaphylactic reactions, including edema (in rare cases with fatal outcome), erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis. from the musculoskeletal skeletal system: arthralgia. From the urogenital system: nephritis, acute renal failure. Other: vaginitis, candidiasis.
Overdosing Symptoms: nausea, temporary hearing loss, vomiting, diarrhea. Treatment: administration of activated charcoal, gastric lavage, symptomatic therapy.
The interaction with other drugs
Antacids do not affect the tri tren side effects bioavailability, but reduce the maximum concentration of tri tren side effects in blood plasma by 30%, and the drug should be taken at least one hour before or two hours after administration of preparataov and food.
tri tren side effects does not affect the concentration of carbamazepine, didanosine, rifabutin in the blood of methylprednisolone when used together.
For parenteral administration, tri tren side effects does not affect the concentration of cimetidine, efavirenz, fluconazole, indinavir, midazolam, triazolam, trimethoprim / sulfamethoxazole in the blood when used together, but should not be ruled out possibility of interactions at the appointment of tri tren side effects for oral administration.
tri tren side effects has no effect on the pharmacokinetics of theophylline, but when coadministered with other macrolides theophylline concentration in plasma can be raised.
if necessary, the joint use with cyclosporin, it is recommended to control the content of cyclosporine in the blood. Despite the fact that the data on the influence of tri tren side effects on a change in the blood concentration of cyclosporine no other members of the macrolide class capable of changing its level in the blood plasma. When co-administered tri tren side effects digoxin and digoxin is necessary to control the blood, as many macrolides digoxin enhance absorption in the gut, thereby increasing its concentration in blood plasma. If necessary, co-administration with warfarin is recommended careful monitoring of the prothrombin time.
It has been found that co-administration of terfenadine and macrolide class of antibiotics causes arrhythmias and prolongation of QT interval. From this, we can not exclude the above complications during coadministration of terfenadine and tri tren side effects.
Since there is a possibility of inhibiting the isozyme CYP3A4 tri tren side effects in parenteral form when coadministered with cyclosporine, terfenadine, ergot alkaloids, cisapride, pimozide, quinidine, astemizole and other drugs, metabolism which occurs with this enzyme, the possibility should be considered when assigning such interaction tri tren side effects for oral administration.
when co-administered tri tren side effects and zidovudine, tri tren side effects does not affect the pharmacokinetic parameters of AZT in the blood plasma or its renal excretion and its glucuronide metabolite. However, increasing the concentration of the active metabolite – phosphorylated AZT multinucleated cells in peripheral blood vessels. The clinical significance of this fact is not clear.
In simultaneous reception of macrolides with ergotamine and dihydroergotamine possible manifestation of their toxic effect (vasospasm, dysesthesia).
in the case of missing a single dose of the drug – the missed dose should be taken as soon as possible, and the next – with an interval of 24 hours.
As during any antibiotic therapy in the treatment with tri tren side effects, perhaps joining superinfection (including fungal).
tri tren side effects should be take at least one hour before or two hours after ingestion of antacids.
The effect on the ability to drive vehicles and mechanisms. In the period of treatment should refrain from driving motor vehicles and activities potentially hazardous activities tren side effects that require high concentration and psychomotor speed reactions.
tablets, film-coated, 500 mg
3 tablets in blister PVC / PVDC and aluminum foil printed lacquered film, a blister is placed in a cardboard box with instructions for use.