COMPOSITION: Each enteric-coated tablet contains: Erythromycin stearate 500mg.
Erythromycin, a bacteriostatic antibiotic, may be bactericidal in high concentrations or when used against highly susceptible organisms. It is thought to penetrate the bacterial cell membrane and to reversibly bind to the bacterial ribosomes so that translocation of peptides is prevented and subsequent protein synthesis is inhibited.
Erygyl is indicated for: • Bronchitis • Severe campylobacrer enteritis • Chanchroid • Diphtheria • Legionnaires disease and other Iegionella infections, neonatal conjuctivitis, pertussis, pneumonia; sinusitis and trench fever. Erygyl is used as an alternative to penicillin in penicillin – allergic patients with various conditions including – anthrax, actinomycosis, leptospirosis, listeriosis, mouth infections, otitis media, pelvic inflammatory disease caused by Neisseria gonorrhoea, pharyngitis, prevention of perinatal streptococcal infections, rheumatic fever, and infection in splenectomised patients, and staphylococcal and streptococcal skin infections.
Erygyl should be avoided in those known to be hypersensitive to it or in those who have previously developed jaundice. It has also been associated-with acute-attacks of porphyria and should therefore be avoided in porphyric patients.
Erygyl like other macrolides have the potential to interact with a Iarge number of drugs through their action on hepatic cytochrome-P450 isoenzymes, particularly CYPA2 and CYP 3A4. Macrolides inhibit drug metabolism by microsomal cytochromes by competitive inhibition and by formation of inactive complexes, such interactions can result in severe adverse effects, including ventricular arrhythmias with astemizole, cisapride and terfenadine.
Macrolides have been reported rarely to prolong QT interval and should be used with care with other drugs known to have this effect.
Erygyl increase the plasma concentration of the following alfentanil, carbamazepine, valproate, loratidine, mizolastine, clozapine, digoxin, ciclosporin, corticosteroids, bromocriptine, theophyline, therefore concomitant administration with Erygyl should be avoided. Erygyl should not be given concomitantly with Ergotamine and Ergometrine because of the risk of ergotism. Cimetidine increase plasma concentration of Erygyl leading to increase risk of toxicity, including Deafness, avoid concomitant use.
Erygyl should be used with care in patients with existing liver disease or hepatic impairment. It may also aggravate muscle weakness-in patient with myasthenia. It should be used with care in patients with history of arrhythmias or a prolonged QT interval. It should also be used with caution in pregnancy and breast feeding.
Erygyl is generally well tolerated and serious adverse effects are rare. Gastro intestinal disturbances such as abdominal discomfort and cramp. nausea, vomiting and diarrheoa are common after oral use. These effects are dose related and appear to be more common than-in older subjects. Supra infection With resistant organisms may occur and pseudomembranous colitis has been reported. Hypersensitivity bas been reported, through uncommon, this include pruritus, urticaria, and skin rash as well as occasional cases of anaphylaxis and hepatotoxicity. Other effects are reversible hearing loss which has been reported after large doses, chloestatic jaundice, cardiac effects ‘(including chest pain and arrhythmias) myasthenia-. like syndrome, Stevens – Johnson syndrome and toxic epidermal necrolysis.
OVERDOSAGE AND TREATMENT:
Symptom of overdosage include nausea, vomiting, diarrhea and acute pancreatitis. Overdosage can be treated with activated charcoal within 1- hour of ingestion; if appropriate, symptomatic and supportive measures may be employed.
DOSAGE AND ADMINSTRATION:
For Oral use
? Adult and Child over 8 years: 250 to 500mg every 6 hours or 0.5 to 1g every 12-hours up to 4g daily in severe infections.
? Child up to 2 years: I 25rng every 6 hours
? 2-8 years: 250mg every 6 hours-doses doubled for severe infections,
? Early syphilis: 500mg 4 times daily for 14 days,
? Uncomplicated genital chlamydia, non-gonococcal urethritis: 500mg twice daily for 14days,
PRESENTATION: Erygyl is available in a box of 10 tablets
Tell your Doctor or Pharmacist if you notice any undesirable symptoms, even those not mentioned in this writeup.