Is Zee factor capsules 250 available for children? International nonproprietary name

Antibiotics - macrolides and azalides.

Composition of Z-Factor

The active substance is azithromycin.

Manufacturers

Veropharm Belgorod branch (Russia)

pharmachologic effect

Pharmacological action - antibacterial.

Suppresses protein biosynthesis, slowing down the growth and reproduction of bacteria; at high concentrations, a bactericidal effect is possible.

Stable in an acidic environment, lipophilic, quickly absorbed from the gastrointestinal tract.

The maximum concentration is created after 2-3 hours, the half-life is 68 hours.

Stable plasma levels are achieved after 5-7 days.

Passes easily histohematic barriers and enters the tissue.

Concentrations in tissues and cells are 10-50 times higher than in plasma, and at the site of infection they are 24-34% higher than in healthy tissues.

A high level (antibacterial) remains in tissues for 5-7 days after the last injection.

Excreted unchanged in bile (50%) and in urine (6%).

The spectrum of action is wide and includes gram-positive ( Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus pyogenes, streptococci of groups C, F, G, Streptococcus viridans), except those resistant to erythromycin, and gram-negative (Haemophilus influenzae, Moraxella catarrhalis, Bordetella pertussis, Bordetella parapertussis, Campylobacter jejuni, Legionella pneum ophila, Neisseria gonorrhoeae , Gardnerella vaginalis) microorganisms, anaerobes (Bacteroides bivius, Peptostreptococcus spp., Peptococcus, Clostridium perfringens), chlamydia (Chlamydia trachomatis, Chlamydia pneumoniae), mycobacteria (Mycobacteria avium complex), mycoplasma (Mycoplasma pneumoniae), ureoplasma ( Ureaplasma urealyticum), spirochetes (Treponema pallidum, Borrelia burgdorferi).

Side effects of Zi-Factor

Nausea, vomiting, abdominal pain, constipation, flatulence, diarrhea, melena, cholestatic jaundice, chest pain, palpitations, weakness, drowsiness, headache, dizziness, nephritis, vaginitis, candidiasis, neutropenia or neutrophilia, pseudomembranous colitis, photosensitivity, rash, angioedema, eosinophilia; in children, in addition, hyperkinesia, agitation, nervousness, insomnia, conjunctivitis.

Indications for use

Infections of the upper and lower respiratory tract(streptococcal pharyngitis and tonsillitis, bacterial exacerbation of chronic obstructive pneumonia, interstitial and alveolar pneumonia, bacterial bronchitis), ENT organs ( otitis media, laryngitis and sinusitis), genitourinary system(urethritis and cervicitis), skin and soft tissues (erysipelas, impetigo, secondary infected dermatoses), chronic stage erythema migrans (Lyme disease).

Contraindications Zi-Factor

Hypersensitivity to macrolides, severe violations liver functions, pregnancy, lactation.

Overdose

No information available.

Interaction

special instructions

Use with caution in cases of severe dysfunction of the liver, kidneys, and cardiac arrhythmias.

After discontinuation of treatment, hypersensitivity reactions may persist in some patients, which requires specific therapy under the supervision of a doctor.

Storage conditions

List B.

Store in a dry place, protected from light, at room temperature, out of the reach of children.

The antimicrobial agent Zi-Factor ® belongs to antibacterial drugs group of macrolides. The drug is intended for the treatment of infectious and inflammatory processes of the respiratory system, urinary system, infections skin and other localization. Additional advantages of the drug are a variety of dosage forms, ease of use and low toxicity, so it can be used even in pediatrics.

Release form

The cost of the drug is relatively low, especially when compared with original drug- Sumamed, since the manufacturer of Zi-Factor is the Russian pharmaceutical OJSC Veropharm ®. The domestic company produces the medicine in several convenient forms:

• Tablets containing 500 mg of azithromycin, packaged in 3 pieces. Additional components in this case, these are crospovidone and povidone, calcium phosphate dihydrate, magnesium stearate, components of a special enteric coating.
• Capsules containing, in addition to 250 mg active substance, included milk sugar, PVP, Aerosil, starch, sodium lauryl sulfate. The package contains 6 or 10 capsules.
• Powdery product in 100 ml bottles, from which a suspension is prepared. 5 ml finished product contain 200 mg of antibiotic.

All dosage forms are accompanied by a detailed annotation, and the latter is also accompanied by a special convenient dosage syringe.

Recipe in Latin

Since January 2017, purchasing Zi-Factor ® tablets, like almost all other antibiotics, without being filled out by a doctor prescription form became impossible. This tightening of the rules for drug dispensing was the result of the WHO international program to combat the increasing resistance of pathogens. A correctly executed prescription, in addition to the age, full name of the patient, doctor's seal and signature, contains a record approximately like this:

Rp.: Tab. "ZI-Factor" ® 0.5

S. 1 tablet on an empty stomach every 24 hours.

What does Zi-Factor ® help with?

Spread Spectrum antimicrobial action allows this drug to be used for antibiotic therapy of a wide variety of infectious diseases. It is most often prescribed by therapists and pediatricians for the treatment of sore throat, inflammation of the larynx, lungs or bronchi. Capsules, tablets and suspensions are also effective for otitis, sinusitis, frontal sinusitis and other sinusitis, and skin infections.

The medicine also helps with inflammatory processes urogenital area, caused by sensitive bacteria. It is possible to use an antibiotic as part of a complex for Helicobacter eradication.

Indications and contraindications

Taking a drug based on azithromycin is indicated in the case of next row infectious diseases:

• infections of the respiratory tract: oropharynx - Z-factor (tonsillitis) is especially effective; bronchi, lungs, paranasal sinuses and middle ear;
• respiratory chlamydia and mycoplasmosis;
• various skin inflammations - dermatoses, impetigo, ;
• scarlet fever;
• inflammatory processes in, occurring in an uncomplicated form (and,);
• stomach and duodenal ulcers caused by bacteria;
• Lyme disease.

Contraindications

The drug should not be prescribed to children of the first year of life, nursing mothers, or persons with insufficient renal or liver function. Absolute contraindication is also intolerance macrolide antibiotics. Caution is required when prescribing the drug to pregnant women and patients with disorders heart rate, children with renal or liver failure.

Dosages

Since the food is gastrointestinal tract affects the rate of adsorption of the active substance negatively, tablets, suspension or capsules should be taken strictly one hour before meals or two after. In any case, the frequency of administration per day is 1 time, at the same time (that is, observing a 24-hour interval). This time period is explained by the peculiarities of the pharmacokinetics of the drug, which remains in the body for a long time in therapeutic concentrations.

Respiratory tract infections in adults are usually treated with a three-day course of antibiotics - 500 mg per day. If the skin or soft fabrics, the duration of therapy increases to 5 days: on the first day you need to take 2 tablets of the medicine at a time (that is, 1000 mg), and on the remaining four – 500 mg each. Borreliosis (aka Lyme disease) requires a similar treatment regimen. For urogenital infections, the doctor prescribes 1000 mg once or a five-day treatment regimen.

Children are also given the antibiotic Z-Factor only once a day, calculating the dose according to body weight: 10 mg (not ready suspension, namely the active substance) for every kilogram for 3 days. The first stage of borreliosis in young patients is treated according to a five-day regimen, when on the first day you need to take 10 mg/kg, on the remaining four days - 5 or 10. correct definition dose, the dispenser syringe included with the powder will be useful.

Use during pregnancy

Capsules or tablets are prescribed to pregnant women only when the benefit from antibiotic therapy exceeds the possible potential harm for the gestating fetus. Those who are breastfeeding should breast-feeding suspend, as azithromycin penetrates into breast milk and can negatively affect the health of the baby.

The instructions for use define the medicine “Zi-factor” as a bacteriostatic antibiotic belonging to the group of macrolides-azalides. The drug has a wide spectrum of antimicrobial effects. The mechanism of activity is associated with the suppression of protein synthesis in microbial cells, due to which the growth and reproduction of bacteria slows down. The antibiotic "Zi-factor", reviews of which are often positive from patients and specialists, is effective against intra- and extracellular gram-negative and gram-positive, as well as some anaerobic organisms. Meanwhile, pathogens may initially be resistant to the drug or acquire this resistance during the use of the drug.

Pharmacokinetic properties

The instructions for use call azithromycin the active ingredient of the drug “Zi-factor”. It is well absorbed and distributed quickly in the body. After a single dose of 500 milligrams of the drug, bioavailability is 37 percent; after two to three hours, the highest concentration is created in the plasma - 0.4 milligrams per liter. The medicine "Z-factor" penetrates through cell membranes and is transported by phagocytes to the site of infection, where it is released in the presence of the pathogen. The medication easily passes histohematic barriers. In tissues and cells, the concentration is ten to fifty times higher than that observed in plasma, while at the sites of infection it is on average 24-34 percent higher than in healthy tissues. Once in the liver, the drug is demethylated, losing activity. After administration, azithromycin in therapeutic concentration remains in the body for five to seven days and is excreted mainly unchanged by the intestines (50 percent) and kidneys (6 percent).

Indications for use

The drug is effective for infectious and inflammatory diseases caused by microorganisms susceptible to the drug. Thus, the medicine “Zi-factor” is used for sinusitis, sinusitis, tonsillitis, otitis media, pharyngitis and other pathologies of the ENT organs and upper respiratory tract. The medicine is also prescribed for diseases of the lower respiratory tract: bronchitis, pneumonia, including those caused by atypical pathogens. The instructions for use recommend using the medication “Zi-factor” for infections of soft tissues and skin: dermatoses, erysipelas, impetigo; infections genitourinary tract: cervicitis, urethritis.

Release form

The drug is produced in the form of tablets and capsules. Z-Factor tablets are biconvex, oblong, coated with a light pink coating. Packaged in blister packs of three pieces. Capsules white, hard, gelatinous; contents - a mixture of powder and granules. Packed in 6 or 10 pieces in cell blisters.

Compound

In one tablet, the active ingredient - azithromycin (in dihydrate form) - is present in an amount of 500 milligrams, and in one capsule - 250 milligrams. As auxiliary components The tablets contain povidone, magnesium stearate, sodium lauryl sulfate dihydrate, crospovidone, talc, red acid dye, hydroxypropyl methylcellulose, polysorbate. The secondary substances in the capsules are corn starch, sodium lauryl sulfate, methyl parahydroxybenzoate, milk sugar, acetic acid, Lactopress, Aerosil, magnesium stearate, povidone, titanium dioxide, gelatin and propyl parahydroxybenzoate.

Features of use, dosage

The medicine should be taken orally once a day, one hour before meals or two hours after. For infections of the respiratory tract, ENT organs, soft tissues and skin, it is prescribed daily dose 500 mg, therapy continues for three days. The course of treatment for erythema migrans is as follows: on the first day, take 1000 mg, from the second to the fifth day - 500 mg daily. For uncomplicated cervicitis or urethritis, 1000 mg of the drug should be taken once. For patients suffering from moderate renal impairment, no dose adjustment is required.

Side effects. Reviews

Regarding the occurrence negative reactions after taking the medication "Z-factor" there are different reviews. Quite often, patients complain of diarrhea, nausea, vomiting, indigestion, and drowsiness. Some patients note such side effects such as dizziness, cramps, headaches. IN in rare cases hyperactivity, nervousness, tinnitus, hearing problems, impaired perception of smell and taste are observed. The instructions for use list among the possible ones such as paresthesia, asthenia, anorexia, liver necrosis, arrhythmia, thrombocytopenia, nephritis, neutropenia, vaginitis, arthralgia, photosensitivity, angioedema, epidermal necrolysis, erythema multiforme. Some patients report the occurrence of aggressiveness and anxiety after using the drug "Z-Factor". Reviews, among other things, contain information that the medicine can provoke changes in the color of the tongue, constipation, skin rashes and itching.

Contraindications

It is forbidden to use the medication for people with hypersensitivity to macrolides or with severe kidney/liver impairment. The drug "Zi-factor" is not prescribed to children under twelve years of age. Also, women should not take the drug during the lactation period, simultaneously with dihydroergotamine and ergotamine, patients with lactase deficiency, genetic galactose intolerance, glucose-galactose malabsorption. The medication should be prescribed with caution to people suffering from moderate renal/liver dysfunction, arrhythmia or a predisposition to it. During pregnancy, the medicine is used only when the expected benefit to the mother is greater than the probable risk to the development of the fetus.

Overdose

Diarrhea, nausea, and vomiting may develop if Z-Factor is taken in excessive doses. Reviews individuals indicate the appearance of a symptom such as temporary hearing loss. In case of overdose, symptomatic therapy is prescribed.

Interaction with other drugs

Antacids reduce the concentration of azithromycin in plasma by 30 percent, so Z-Factor should be taken at least an hour before or two hours after using these drugs and food. For plasma concentrations of didanosine, methylprednisolone, carbamazepine, rifabutin at joint use azithromycin has no effect. However, its effect on the concentration of cimetidine, indinavir, triazolam, fluconazole, midazolam, efavirenz, trimethoprim cannot be excluded. If it is necessary to use the drug "Zi-factor" simultaneously with cyclosporine or digoxin, then the content of the latter in the blood plasma should be monitored, and when used together with warfarin, it is recommended carefully monitor prothrombin time. Simultaneous use azithromycin and terfenadine can lead to arrhythmia, as well as prolongation of the QT interval.

special instructions

If the patient forgot to take the medicine, it is necessary to take the missed dose as soon as possible, and subsequent doses at intervals of 24 hours. When treated with azithromycin, as with any antibiotic therapy, there is a risk of superinfection, including fungal infection. For the treatment of tonsillitis and pharyngitis caused by Streptococcus pyogenes, and for the prevention rheumatic fever Penicillin is usually prescribed. It should be noted that azithromycin is relatively effective streptococcal infection, however, it is not suitable for the prevention of rheumatic fever.

Medicine "Z-factor". Analogs

It must be said right away that the Z-Factor product is not an original drug. This is a domestic generic of the drug "Sumamed", developed in 1980 by specialists from the Croatian pharmaceutical company"Pliva" Today, there are numerous analogues of “Sumamed” on sale: along with the drug “Zi-factor”, they include such drugs as “Azitrox”, “Hemomycin”, “Azicide”, “Sumatrolide solutab”, “Zitrolide”, “ Azivok”, “Safotsid”, “Azitral”, “Sumamox”, “Sumametsin” and others. So is there a difference in what to take: the generic Z-Factor or Sumamed, which is the original drug? There is no clear answer to this question. By pharmacological properties These medicines are identical, the only difference is the manufacturer and price. However, many patients believe that an analogue is by definition worse than the original, since no steps are taken during its production. clinical researches and tests. If you focus on price, it is better to purchase the Z-Factor product: the price of six capsules averages 171-187 rubles, while for six Sumamed capsules you will have to pay 448-530 rubles.

pharmachologic effect

Antibiotic wide range actions of the azalide group. When high concentrations are created at the site of inflammation, it has bactericidal effect.

To azithromycin sensitive gram-positive cocci: Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus agalactiae, streptococci of groups C, F and G, Staphylococcus aureus, Staphylococcus viridans; gram negative bacteria: Haemophilus influenzae, Moraxella catarrhalis, Bordetella pertussis, Bordetella parapertussis, Legionella pneumophila, Haemophilus ducreyi, Campylobacter jejuni, Neisseria gonorrhoeae and Gardnerella vaginalis; some anaerobic microorganisms: Bacteroides bivius, Clostridium perfringens, Peptostreptococcus spp.. Active against Chlamydia trachomatis, Mycoplasma pneumoniae, Ureaplasma urealyticum, Treponema pallidum, Borrelia burgdoferi.

Azithromycin inactive regarding gram-positive bacteria resistant to erythromycin.

Pharmacokinetics

Suction

After oral administration, azithromycin is rapidly absorbed from the gastrointestinal tract, due to its stability in an acidic environment and lipophilicity. After taking a dose of 500 mg, the Cmax of azithromycin in the blood plasma is reached after 2.5-2.96 hours and is 0.4 mg/l. Bioavailability is 37%.

Distribution

Azithromycin penetrates well into the respiratory tract, organs and tissues of the urogenital tract (in particular, prostate gland), into the skin and soft tissues. High concentration in tissues (10-15 times higher than in blood plasma) and long T1/2 are due to the low binding of azithromycin to plasma proteins, as well as its ability to penetrate eukaryotic cells and concentrate in the low pH environment surrounding lysosomes . This, in turn, determines the large apparent Vd (31.1 l/kg) and high plasma clearance. The ability of azithromycin to accumulate predominantly in lysosomes is especially important for the elimination of intracellular pathogens. It has been proven that phagocytes deliver azithromycin to sites of infection, where it is released during the process of phagocytosis. The concentration of azithromycin in foci of infection is significantly higher than in healthy tissues (on average by 24-34%) and correlates with the degree of inflammatory edema. Despite high concentration in phagocytes, azithromycin does not have a significant effect on their function. Azithromycin remains in bactericidal concentrations at the site of inflammation for 5-7 days after administration last dose, which made it possible to develop short (3-day and 5-day) courses of treatment.

Metabolism

It is demethylated in the liver and the resulting metabolites are active.

Removal

The elimination of azithromycin from blood plasma occurs in 2 stages: T1/2 is 14-20 hours in the range from 8 to 24 hours after taking the drug and 41 hours in the range from 24 to 72 hours, which allows the drug to be used once a day.

Indications

Infectious and inflammatory diseases caused by microorganisms sensitive to the drug:

- infections of the urogenital tract (uncomplicated urethritis and/or cervicitis);

- infections of the upper respiratory tract and ENT organs (tonsillitis, sinusitis, tonsillitis, pharyngitis, otitis media);

- scarlet fever;

- infections of the skin and soft tissues (erysipelas, impetigo, secondary infected dermatoses);

- Lyme disease (borreliosis), for treatment initial stage(erythema migrans);

- stomach diseases and duodenum, associated with Helicobacter pylori(as part of combination therapy).

Dosage regimen

Orally 1 hour or 2 hours after meals 1 time/day.

For adults at infections of the upper and lower sections respiratory tract- 500 mg/day for 1 dose for 3 days (course dose - 1.5 g).

At skin and soft tissue infections- 1 g/day on the first day for 1 dose, then 500 mg/day daily from the 2nd to the 5th day (course dose - 3 g).

At acute infections genitourinary organs(uncomplicated urethritis or cervicitis) once 1 g.

At Lyme disease (borreliosis) for the treatment of the initial stage(erythema migrans) - 1 g on the first day and 500 mg daily from the 2nd to the 5th day (course dose 3 g).

At peptic ulcer stomach and duodenum associated with Helicobacter pylori, - 1 g/day for 3 days as part of combined anti-Helicobacter therapy.

For children

During treatment Lyme disease (borreliosis) for the treatment of the initial stage(erythema migrans) at children dose - 20 mg/kg on the first day and 10 mg/kg from the 2nd to the 5th day.

Side effect

From the outside digestive system: diarrhea (5%), nausea (3%), abdominal pain(3%); 1% or less - dyspepsia, flatulence, vomiting, melena, cholestatic jaundice, increased activity of liver transaminases; in children - constipation, anorexia, gastritis.

From the outside of cardio-vascular system: palpitations, pain in chest(1% or less).

From the side of the central nervous system: dizziness, headache, drowsiness; in children - headache (during treatment of otitis media), hyperkinesia, anxiety, neurosis, sleep disturbance (1% or less).

From the genitourinary system: vaginal candidiasis, jade (1% or less).

Allergic reactions: rash, photosensitivity, Quincke's edema.

Others: increased fatigue; in children - conjunctivitis, itching, urticaria.

Contraindications for use

— liver failure;

— renal failure;

- lactation (breastfeeding);

— childhood up to 12 years;

- arrhythmia (possible ventricular arrhythmias and prolongation of the QT interval);

- severe liver or kidney dysfunction in children;

— increased sensitivity to azithromycin or other macrolides.

WITH caution use the drug during pregnancy.

Use during pregnancy and breastfeeding

During pregnancy, azithromycin should be used with caution and in cases where the expected benefit of therapy for the mother significantly outweighs the potential risk to the fetus.

The drug is contraindicated for use during lactation (breastfeeding).

Use in children

The drug is contraindicated in children under 12 years of age.

For children prescribed at the rate of 10 mg/kg 1 time/day for 3 days or on the first day - 10 mg/kg, then 4 days - 5-10 mg/kg/day for 3 days (course dose - 30 mg/kg ).

Overdose

Symptoms: severe nausea, temporary hearing loss, vomiting, diarrhea.

Treatment: drug withdrawal, symptomatic therapy.

Drug interactions

Antacids (aluminum and magnesium containing), ethanol and food slow down and reduce the absorption of azithromycin.

With the simultaneous administration of warfarin and azithromycin (in moderate doses), no changes in prothrombin time were detected, however, given that the interaction of macrolides and warfarin may increase the anticoagulant effect, patients need careful monitoring of prothrombin time.

When used together with digoxin, the concentration of digoxin increases.

At simultaneous use with ergotamine and dihydroergotamine, the toxic effect (vasospasm, dysesthesia) increases.

When used simultaneously with triazolam, clearance is reduced and the pharmacological effect of triazolam is enhanced.

Azithromycin slows down the elimination and increases the plasma concentration and toxicity of cycloserine, indirect anticoagulants, methylprednisolone, felodipine, and medicines undergoing microsomal oxidation (carbamazepine, terfenadine, cyclosporine, hexobarbital, ergot alkaloids, valproic acid, disopyramide, bromocriptine, phenytoin, oral hypoglycemic agents, xanthine derivatives, including theophylline) due to the inhibition of microsomal oxidation in hepatocytes by azithromycin.

Lincosamides reduce the effectiveness of azithromycin.

Tetracycline and chloramphenicol enhance the effectiveness of azithromycin.

Conditions for dispensing from pharmacies

The drug is available with a prescription.

Storage conditions and periods

List B. The drug should be stored in a dry place, protected from light and out of reach of children, at a temperature not exceeding 25°C. Shelf life - 2 years.

Use for liver dysfunction

The drug is contraindicated in liver failure.

Use for renal impairment

The drug is contraindicated in renal failure.

special instructions

It is necessary to observe a break of 2 hours while using antacids.

After discontinuation of treatment, hypersensitivity reactions may persist in some patients, which requires specific therapy under medical supervision.

VEROPHARM Veropharm, LLC Veropharm, JSC Veropharm, PJSC

Country of origin

Russia

Product group

Antibacterial drugs

Antibiotic of the macrolide group - azalide

Release forms

• 3 - cellular contour packs (1) - cardboard packs 6 - blister contour packs (1) - cardboard packs Powder for the preparation of suspension for oral administration 200 mg/5 ml, 16.740 g (15 ml) - 1 bottle per pack.

Description of the dosage form

• capsules Powder for the preparation of suspension for oral administration from white to light yellow color, granular, with characteristic odor vanilla, cherry and banana; the prepared suspension is homogeneous, from white to light yellow in color, with a characteristic odor of vanilla, cherry and banana. Film-coated tablets

pharmachologic effect

Broad-spectrum antibiotic. It is a representative of the subgroup of macrolide antibiotics - azalides. When high concentrations are created at the site of inflammation, it has a bactericidal effect. Gram-positive cocci are sensitive to azithromycin: Streptococcus pneumoniae, St. pyogenes, St. agalactiae, group CF and G streptococci, Staphylococcus aureus, St. viridans; gram-negative bacteria: Haemophilus influenzae, Moraxella catarrhalis, Bordetella pertussis, B.parapertussis, Legionella pneumophila, H.ducrei, Campylobacter jejuni, Neisseria gonorrhoeae and Gardnerella vaginalis; some anaerobic microorganisms: Bacteroides bivius, Clostridium perfringens, Peptostreptococcus spp; as well as Chlamydia trachomatis, Mycoplasma pneumoniae, Ureaplasma urealyticum, Treponema pallidum, Borrelia burgdoferi. Azithromycin is inactive against gram-positive bacteria resistant to erythromycin. Azithromycin is rapidly absorbed from the gastrointestinal tract, due to its stability in an acidic environment and lipophilicity. After oral administration of 500 mg, the maximum concentration of azithromycin in the blood plasma is reached after 2.5-2.96 hours and is 0.4 mg/l. Bioavailability is 37%. Azithromycin penetrates well into the respiratory tract, organs and tissues of the urogenital tract (in particular, the prostate gland), skin and soft tissues. High concentration in tissues (10-50 times higher than in blood plasma) and a long period half-life is due to the low binding of azithromycin to plasma proteins, as well as its ability to penetrate eukaryotic cells and concentrate in the low pH environment surrounding lysosomes. This, in turn, determines the large apparent volume of distribution (31.1 l/kg) and high plasma clearance. The ability of azithromycin to accumulate predominantly in lysosomes is especially important for the elimination of intracellular pathogens. It has been proven that phagocytes deliver azithromycin to sites of infection, where it is released during the process of phagocytosis. The concentration of azithromycin in foci of infection is significantly higher than in healthy tissues (on average by 24-34%) and correlates with the degree of inflammatory edema. Despite its high concentration in phagocytes, azithromycin does not have a significant effect on their function. Azithromycin remains in bactericidal concentrations at the site of inflammation for 5-7 days after taking the last dose, which made it possible to develop short (3-day and 5-day) courses of treatment. It is demethylated in the liver, the resulting metabolites are not active. The elimination of azithromycin from blood plasma occurs in 2 stages: the half-life is 14-20 hours in the range from 8 to 24 hours after taking the drug and 41 hours in the range from 24 to 72 hours, which allows the drug to be used once a day

Pharmacokinetics

Rapidly absorbed from the gastrointestinal tract. Eating reduces the absorption of azithromycin. Cmax in plasma is reached after 2-3 hours. It is quickly distributed in tissues and biological fluids. 35% of azithromycin is metabolized in the liver by demethylation. More than 59% is excreted unchanged in bile, about 4.5% is excreted unchanged in urine.

Special conditions

It is necessary to observe a break of 2 hours while using antacids. After discontinuation of treatment, hypersensitivity reactions may persist in some patients, which requires specific therapy under medical supervision.

Compound

• azithromycin (dihydrate) 250 mg Excipients: lactose, corn starch, colloidal silicon dioxide (aerosil), sodium lauryl sulfate, magnesium stearate, polyvinylpyrrolidone. azithromycin (in the form of dihydrate) 500 mg Excipients: calcium phosphate dihydrate, sodium lauryl sulfate, polyvinylpyrrolidone (povidone), polyplasdon X El-10 (crospovidone), magnesium stearate. Shell composition: hydroxypropyl methylcellulose, titanium dioxide, polyvinylpyrrolidone (povidone), talc, Tween-80 (polysorbate), acid red dye.

ZI-Factor indications for use

• Infectious and inflammatory diseases caused by microorganisms sensitive to the drug: - infections of the urogenital tract (uncomplicated urethritis and/or cervicitis); - infections of the upper respiratory tract and ENT organs (tonsillitis, sinusitis, tonsillitis, pharyngitis, otitis media); - scarlet fever; - infections of the skin and soft tissues (erysipelas, impetigo, secondary infected dermatoses); - Lyme disease (borreliosis), for the treatment of the initial stage (erythema migrans); - diseases of the stomach and duodenum associated with Helicobacter pylori (as part of combination therapy).

ZI-Factor contraindications

• - liver failure; - renal failure; - lactation (breastfeeding); - children under 12 years of age; - arrhythmia (ventricular arrhythmias and prolongation of the QT interval are possible); - severe liver or kidney dysfunction in children; - hypersensitivity to azithromycin or other macrolides. Use the drug with caution during pregnancy

ZI-Factor dosage

• 200 mg/5 ml 250 mg 500 mg 500 mg

ZI-Factor side effects

• From the digestive system: nausea, vomiting, flatulence, diarrhea, abdominal pain, transient increase in the activity of liver enzymes; rarely - cholestatic jaundice. Allergic reactions: rarely - skin rash, angioedema, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis. Dermatological reactions: rarely - photosensitivity. From the side of the central nervous system: dizziness, headache; rarely - drowsiness, weakness. From the hematopoietic system: rarely - leukopenia, neutropenia, thrombocytopenia. From the cardiovascular system: rarely - chest pain. From the genitourinary system: vaginitis; rarely - candidiasis, nephritis, increased residual nitrogen urea. Other: rarely - hyperglycemia, arthralgia.

Drug interactions

Antacids (aluminum and magnesium), ethanol and food slow down and reduce absorption. When prescribing warfarin and azithromycin together (in usual doses) changes in prothrombin time were not detected, however, given that the interaction of macrolides and warfarin may increase the anticoagulation effect, patients need careful monitoring of prothrombin time. Digoxin: increased digoxin concentrations. Ergotamine and dihydroergotamine: strengthening toxic effect(vasospasm, dysesthesia). Triazolam: decreased clearance and increased pharmacological action triazolane. Slows down the excretion and increases the concentration of plasma and the toxicity of cycloserin, indirect anticoagulants, methylprednisolone, felodipine, as well as drugs subjected to microsomal oxidation (carbamazepine, terphenin, cyclosporine, hexobarbital, alkaloids of the sawnly, valproine, dysopyramida, bromemide, bromemide, bromisid. Tin, phenytoin, oral hypoglycemic agents, theophylline and other xanthine derivatives

Overdose

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

Storage conditions

• store in a dry place
• store at room temperature 15-25 degrees
• keep away from children
• store in a place protected from light

Information provided