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trenbolone

Broad-spectrum antibiotic, azalide, trenbolone bacteriostatic. By binding to the 50S – subunit of ribosomes, inhibits protein synthesis, inhibits the growth and reproduction of bacteria. In high concentrations it has a bactericidal effect. It works on the extra- and intracellular trenbolone pathogens.
It is active against Gram-positive microorganisms: Streptococcus spp. (groups C, F and G, except resistant to erythromycin), Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus viridans, Staphylococcus epidermidis, Staphylococcus aureus;
Gram-negative bacteria: Haemophilus influenzae, Moraxella catarrhalis, Bordetella pertussis, Bordetella parapertussis, Legionella pneumophila, Haemophilus ducreyi, Helicobacter pylori, Campylobacter jejuni , Neisseria gonorrhoeae trenbolone and Gardnerella vaginalis; Some anaerobic microorganisms: Bacteroides bivius, Clostridium perfringens, Peptostreptococcus spp .;
and intracellular pathogens: Chlamydia trachomatis, Chlamydia pneumoniae, Mycoplasma pneumoniae, Mycobacterium avium complex, Ureaplasma urealyticum, Treponema pallidum, Borrelia burgdorferi.
not active against Gram-positive bacteria resistant to erythromycin .

Pharmacokinetics of
trenbolone is rapidly absorbed from the gastrointestinal tract due to its stability in an acidic medium and lipophilicity. It is rapidly distributed throughout the body in tissues with high concentrations of antibiotic achieved. After oral administration of 500 mg of trenbolone in the maximum concentration achieved in the blood plasma of 2.5 – 2.9 hours, and 0.4 mg / l. Bioavailability is 37.5%.
trenbolone well into the respiratory tract, organs and tissues of the urogenital tract (including the prostate), the skin and soft tissue. The high concentration in tissues (10-50 times higher than in blood plasma) and a long half-life of trenbolone due to low binding to plasma proteins, and its ability to penetrate into eukaryotic cells and concentrated in a low pH environment, environmental lysosomes. This, in turn, defines a large apparent volume of distribution (31.1 l / kg) and high plasma clearance. The ability of trenbolone to accumulate mainly in lysosomes is particularly important to eliminate intracellular pathogens. It proved that phagocytes deliver trenbolone localization of infection sites where it is released in the process of phagocytosis. The concentration of trenbolone in the foci of infection was significantly higher than in healthy tissue (on average 24-34%) and correlated with the degree of inflammatory edema. trenbolone remains in bactericidal concentrations within 5-7 days after the last dose, which allowed the development of short (3 day and 5 day) treatments.
Demethylated in the liver, are not active metabolites formed.
Elimination of trenbolone from plasma passes to stage 2 : half-life of 14-20 hours in the range of 8 to 24 hours after dosing, and 41 h – in the range from 24 to 72 hours, which allows for preparation 1 time / day
is displayed with a preparation largely unchanged in bile, a small part excreted by the kidneys.

Indications
Infectious-inflammatory diseases caused by susceptible to malaria infections,
infections of the upper respiratory tract and LOP-organs (tonsillitis, sinusitis, tonsillitis, pharyngitis, otitis media);
Scarlet fever,
infections of the lower respiratory tract (bacteria, including those caused by atypical pathogens, pneumonia, exacerbation of chronic pneumonia, bronchitis),
skin and soft tissue infections (erysipelas, impetigo, secondarily infected dermatitis);
urinary tract infection (gonorrheal and negonoreyny urethritis, cervicitis);
Lyme disease (borreliosis), for the treatment of early stage ( erythema migrans); Diseases of the stomach and duodenum, associated with Helicobacter pylori (in a combination therapy).

Contraindications:
Hypersensitivity (including to other macrolides.); liver and / or kidney failure, lactation, children under three years old and / or weighing less than 25 kg.

Precautions
arrhythmia (ventricular arrhythmias and prolongation of QT interval), children with severe impairment of hepatic or renal function, pregnancy.

Pregnancy and lactation
Use of the drug during pregnancy is possible only when the intended benefits to the mother outweighs the potential risk to the fetus.
Breastfeeding (excreted in breast milk) should be discontinued, if necessary, the appointment during lactation.

Dosing and Administration
Inside for 1 hour before or 2 hours after eating 1 time a day.
Adults with infections of the upper and lower respiratory tract – 0.5 g / day for 1 reception for 3 days (course dose – 1.5 g).
When the skin and soft tissue infections – 1 g / day for the first day of the 1 reception, followed by 0.5 g / day every day from 2 to 5 day (course dose – 3 g). In acute infections, urinary organs (uncomplicated urethritis or cervicitis) – Once 1 g
When Lyme disease (borreliosis) for the treatment of stage I (erythema migrans) -1 g on the first day and 0.5 g daily, from 2 to 5 day (course dose – 3 g). In gastric ulcer and duodenal ulcer associated with Helicobacter pylori -. 1 g / day for 3 days in a combination therapy of H. pylori
Children over three years old and / or weighing more than 25 kg with infections of the upper and lower respiratory tract, skin and soft tissue administered at 10 mg / kg body weight one time daily for three days (a course dose – 30 mg / kg body weight), or the first day – 10 mg / kg body weight, followed by 4 days – 5- 10 mg / kg / day.
in the treatment of erythema migrans in children (over three years of age and / or weight of over 25 kg) the drug administered one time a day in a dose of 20 mg / kg body weight for the first day and 10 mg / kg body weight 2 to 5 days.

Side effect On the part of the gastrointestinal tract : diarrhea (5%), nausea (3%), abdominal pain (3%) 1% or less – flatulence, vomiting, melena, cholestatic jaundice, increased activity of “liver” transaminases, in children – constipation, loss of appetite, gastritis; candidiasis of the oral mucosa, changes in taste (1% or less). Since the cardiovascular system : palpitation, chest pain (1% or less). From the nervous system : headache, dizziness, drowsiness; in children – a headache (in the treatment of otitis media), hyperkinesia, anxiety, neurosis, sleep disorders (1% or less). From the urogenital system : vaginal candidiasis, nephritis (1% or less). Allergic reactions : rash, urticaria, itchy skin, angioedema; in children – conjunctivitis, pruritus, urticaria. Other : asthenia, photosensitivity.

Overdosing
Symptoms: nausea, temporary hearing loss, vomiting, diarrhea.
Treatment: gastric lavage, symptomatic therapy.

Interaction with other medicines
Antacids (aluminum and magnesium-containing), ethanol and food slow down and reduce the absorption of trenbolone.
The joint appointment of warfarin and trenbolone (in normal doses) changes in prothrombin time is not revealed, however, given that the interaction of macrolides and warfarin may increase . anticoagulation effect, patients requires careful monitoring of the prothrombin time
increases the concentration of digoxin.
Ergotamine and dihydroergotamine: increased toxic effect (vasospasm, dysesthesia).
triazolam:. decrease in clearance and an increase in the pharmacological action of triazolam
slows down and increases the plasma concentration and toxicity of cycloserine, indirect anticoagulants , methylprednisolone, felodipine, and medicines undergoing microsomal oxidation (carbamazepine, terfenadine, cyclosporine, hexobarbital, ergot alkaloids, valproate, disopyramide, bromokripin, phenytoin, oral hypoglycemic drugs theophylline. et al. xanthine derivatives) by inhibiting microsomal oxidation in hepatocytes trenbolone.
Linkozaminy weaken, tetracycline and chloramphenicol and enhance the effectiveness of trenbolone.

Cautions
Do not take with food.
When you miss taking a dose, the missed dose should be taken as soon as possible, and the next – with an interval of 24 h
is necessary to observe a break of 2 hours, while the use of antacids.
After discontinuation of treatment hypersensitivity reactions in some patients may stored, which requires a specific therapy under the supervision of a physician.

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