DORITHRICIN instructions for use

A sore throat that occurs due to inflammatory and infectious diseases of a cold nature is an unpleasant symptom that every person encounters repeatedly throughout life. Most often, such diseases (acute respiratory infections, acute respiratory viral infections, tonsillitis, pharyngitis, tonsillitis, laryngitis) develop due to a decrease in the body's defenses as a result of stress, overwork, hypovitaminosis, and some chronic diseases. has been successfully used to treat sore throat and suppress inflammation .

The product effectively relieves pain and eliminates discomfort in just a few days.

What it is

Dorithricin is a local antibiotic that is produced in Germany and has an anesthetic and antiseptic effect. Thanks to its complex composition, it suppresses the growth of bacterial colonies, fungi and other pathogenic microorganisms, and blocks their reproduction.

The drug effectively relieves unpleasant symptoms that often accompany bacterial and viral infections. Already on day 3, pain and discomfort disappear. Does not affect the microflora of the stomach and intestines.

Contraindications

Absolute:

• significant hearing loss;
• concomitant therapy with terfenadine, pimozide, cisapride, astemizole;
• lactation period;
• age up to 14 years;
• hypersensitivity to other macrolides or components of the drug.

Erythromycin-LekT 250 mg tablets should be used with caution in case of liver and/or renal failure, increased duration of the ventricular complex (prolongation of the QT interval) on the electrocardiogram (ECG), a history of arrhythmia, a history of jaundice, during pregnancy and in old age.

Benefits of Dorithricin Tablets

The product has a number of positive qualities and advantages when compared with other drugs for the treatment of sore throat:

• fast action;
• long-term effect of use;
• no side effects when used correctly;
• does not cause resistance;
• pain relief without the “freezing” effect;
• wide spectrum of action (against gram-negative and gram-positive bacteria, viruses and fungi);
• local action;
• preventing the spread of infection;
• immunomodulatory properties;
• does not accumulate in the body;
• ease of use.

Pharmacological properties

Pharmacodynamics

The active component of Erythromycin-LekT is erythromycin, the first antibiotic of the macrolide class, which has a bacteriostatic effect. The wide spectrum of activity of the drug is due to its ability to bind to the 50S subunit of ribosomes, which leads to disruption of the formation of peptide compounds between amino acid molecules and blocking the synthesis of microbial proteins. Erythromycin does not affect the synthesis of nucleic acids. High doses can have a bactericidal effect on some types of pathogens.

The following microbes exhibit sensitivity to Erythromycin-LekT:

• gram-positive microorganisms: Streptococcus spp. (speciales), including Streptococcus spp. viridans groups, Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus spp. (penicillinase-producing and non-penicillinase-producing), including Staphylococcus aureus (except methicillin-resistant strains), Corynebacterium minutissimum, Corynebacterium diphtheriae, Listeria monocytogenes, Bacillus anthracis;
• gram-negative microorganisms: Campylobacter jejuni, Bordetella pertussis, Legionella spp. (including Legionella pneumophila), Moraxella (Branhamella) catarrhalis, Neisseria gonorrhoeae, Haemophilus influenzae;
• other microorganisms: Treponema spp., Chlamydia spp. (including Chlamydia trachomatis), Mycoplasma spp. (including Mycoplasma pneumoniae), Ureaplasma urealyticum, Entamoeba histolytica, Propionibacterium acnes.

Microorganisms are considered sensitive if their growth slows down when the concentration of erythromycin in the blood plasma is less than 0.5 mg/l, moderately sensitive - 1-6 mg/l, resistant - more than 6 mg/l.

Gram-negative rods exhibit resistance to erythromycin, including microorganisms such as Escherichia coli, Salmonella spp., Proteus spp., Klebsiella spp., Shigella spp. and other representatives of the family Enterobacteriaceae, Acinetobacter spp., Pseudomonas aeruginosa, non-fermenting bacteria. In addition, anaerobic bacteria (Bacteroides spp., including Bacteroides fragilis), methicillin-resistant strains of Staphylococcus aureus, enterococci Enterococcus spp., and microbacteria are resistant to Erythromycin-LekT.

Erythromycin, being a motilin receptor agonist, has prokinetic properties. Its action helps to increase the amplitude of contraction of the pylorus and improve antral-duodenal coordination, which leads to accelerated evacuation of gastric contents.

Pharmacokinetics

After oral administration, erythromycin is well absorbed from the gastrointestinal tract. Bioavailability of the substance is 30–65%. The maximum concentration in the blood plasma is reached after 2–4 hours. Simultaneous food intake does not affect the degree of absorption.

Plasma protein binding is from 70 to 90%.

The distribution of erythromycin in the body is uneven. A large amount of it accumulates in the liver, spleen, and kidneys. The concentration level in urine and bile is tens of times higher than the content of the active substance in plasma. Penetrates well into the pleural cavity, lung tissue, lymph nodes, ascitic and synovial fluid, middle ear exudate, sperm, prostate secretions. Up to 50% of plasma concentrations are found in breast milk. It overcomes the placental barrier; in the fetal blood its content can reach up to 20% of the content in the maternal plasma. It penetrates the blood-brain barrier poorly. In the cerebrospinal fluid, the concentration of erythromycin is 10% of the plasma level. The permeability of the meninges to erythromycin increases slightly when they are inflamed.

More than 90% of the dose taken is metabolized in the liver, including partial formation of inactive metabolites. Erythromycin inhibits the liver microsomal enzymes CYP3A4, CYP3A5 and CYP3A7, which are involved in its biotransformation.

The half-life (T1/2) is 1.4–2 hours, with anuria – 4–6 hours. Excreted unchanged in bile – 20–30%, in urine – 2–5%.

Composition of Dorithricin tablets for sore throat

The product includes 3 main active ingredients:

• Tyrothricin is a unique natural antibiotic with local action. The principle of its operation is to release substances containing nitrogen and phosphorus from bacterial cells, which leads to the destruction of bacterial membranes. Mainly active against streptococci and staphylococci (gram-positive bacteria). Does not cause cross resistance.
• Benzocaine is a local anesthetic component. It has a quick anesthetic effect without the sensation of freezing.
• Benzalkonium chloride is a local antiseptic that helps destroy viruses, bacteria and fungi.

Release form and composition

The drug is available in three dosage forms - tablets, eye ointment and ointment for external use.

Film-coated tablets are sold in 10 or 20 pieces per package.

Ointment for external use is available in tubes of 10, 15, 30 g. 1 g of ointment contains 10,000 units of active ingredient.

Erythromycin in the form of ophthalmic ointment is sold in tubes of 7, 10, 15 g. 1 g of the drug contains 10,000 units of the active substance.

Customer reviews about the use of Dorithricin tablets

Veronica, 28 years old

Dorithricin is an excellent remedy for those who have a weak spot in the throat (like me). I've only been using it for the last couple of years. The tablets quickly relieve sore throat, discomfort and sore throat. They are very effective in the early stages of angina, as they do not allow it to develop further and treatment takes only a few days; there is no need to resort to the help of more “heavy” drugs. Now I experience sore throat and other infectious and inflammatory diseases of the throat with less loss and discomfort.

Dmitry, 30 years old

Recently my throat really hurt. Usually I made do with lozenges and sprays, but nothing helped here, I had to see a doctor. He diagnosed pharyngitis and prescribed Dorithricin tablets. I was surprised that there was only one remedy, but the doctor said that due to its composition it both relieves symptoms and cures. I noticed the effect after the first use. Indeed, the product perfectly relieves pain, and the effect is long-lasting. Within a few days I was completely healthy.

Evgeniya, 36 years old

I get colds quite often, 3-4 times a year. It usually starts with the throat. Previously, I had to undergo treatment for a long time, but after I discovered Dorithricin tablets, the treatment process takes only a few days, and the spread of infection can be stopped in the early stages. Very good product, I recommend it!

Anna, 40 years old

Dorithricin is the most effective remedy for a sore throat; I have never seen anything better! Usually I had to buy several medications for treatment, but now I only get by with these pills. They act quickly and allow you to heal in a few days.

Instructions for use Erythromycin (method and dosage)

The tablets are taken orally without chewing. A single dosage of the drug for patients over 14 years of age is 0.25-0.50 g, and a daily dosage is from 1 to 4 g. The interval between doses should be 6 hours.

• For children from 4 months to 14 years, depending on age, body weight and severity of the disease, the antibiotic is prescribed at 0.03-0.05 g/kg per day in 2-4 doses, and for babies under 3 months of age the daily dosage is 0.02-0.04 g/kg (doubled if necessary).
• When treating legionellosis, take 0.5-1 g of medication 4 times a day for 14 days. For gonorrhea, 0.5 g of antibiotic is first prescribed every 6 hours for 3 days, after which patients need to take 0.25 g of the drug every 6 hours for a week.
• When treating diphtheria, take 0.25 g of Erythromycin twice a day. The course dose of the drug for primary syphilis is 30-40 g. The duration of the course of treatment is 1-2 weeks.
• For amoebic dysentery, adult patients are prescribed 0.25 g of antibiotic 4 times a day, and for children the daily dosage of the drug is 0.03-0.05 g/kg. The therapeutic course lasts 10-15 days.
• For whooping cough, take 0.04-0.05 g/kg Erythromycin daily for 1-2 weeks. To prevent the development of infectious complications, the patient is given 1 g of the drug 19, 18 and 9 hours before the start of the operation.
• For pneumonia, children are prescribed 0.05 g/kg daily with a dosage frequency of 4 times per day. The duration of the course of treatment is at least 3 weeks.
• For genitourinary infections, pregnant women should take 0.5 g of antibiotic 4 times a day for 7 days.

The ointment should be applied in a thin layer to the affected area, and for eye infections, eye ointment should be placed behind the lower eyelid. The dosage, frequency and duration of use of the drug in the form of an ointment is determined individually.

Pharmacokinetics

Benzocaine is slightly soluble in water, which causes its slow absorption. Like all ether derivatives of para-aminobenzoic acid, it is cleaved by esterase in the blood plasma and liver. As a result, para-aminobenzoic acid and ethyl alcohol are formed, which is metabolized to acetyl coenzyme A.

Para-aminobenzoic acid undergoes conjugation with glycine or is excreted unchanged by the kidneys.

Benzalkonium chloride is practically not absorbed, has no resorptive effect and is excreted by the kidneys. No accumulation of the substance was detected in body tissues.

Tyrothricin - due to low systemic absorption, pharmacokinetic data are not available. Does not affect intestinal microflora.

Side effects

• from the cardiovascular system: tachycardia, prolongation of the QT interval on the ECG, in patients with a prolonged QT interval - atrial fibrillation and/or flutter;
• from the digestive system: abdominal pain, nausea, vomiting, diarrhea, dysbiosis, oral candidiasis, gastralgia, tenesmus, pseudomembranous colitis, pancreatitis, cholestatic jaundice, impaired liver function, increased activity of liver transaminases;
• from the organ of hearing: tinnitus, hearing loss;
• allergic reactions: skin rash, urticaria, eosinophilia, anaphylactic shock.

Overdose

Symptoms: hearing loss, liver dysfunction, including acute liver failure.

Treatment: immediate intake of activated carbon. It is advisable to perform gastric lavage only in cases where the overdose exceeds the average therapeutic dose by 5 times. Ensure careful monitoring of the respiratory system, acid-base status and electrolyte metabolism. An ECG is indicated and, if necessary, artificial ventilation.

The use of forced diuresis, hemodialysis or peritoneal dialysis is ineffective.

Drug interactions

When used simultaneously with Erythromycin-LekT:

• lincomycin, clindamycin, chloramphenicol: combination with each of these drugs causes antagonism;
• cephalosporins, penicillins, carbapenems: the bactericidal activity of beta-lactam antibiotics decreases;
• theophylline: erythromycin increases its concentration;
• cyclosporine: the nephrotoxicity of cyclosporine increases, especially with concomitant renal failure;
• triazolam, midazolam: their clearance is reduced, which can lead to increased pharmacological effects;
• methylprednisolone, felodipine, coumarin anticoagulants: elimination slows down and the effect of these drugs increases;
• hormonal contraceptives: the reduced effectiveness of hormonal contraceptives should be taken into account;
• digoxin: erythromycin increases its bioavailability;
• lovastatin, simvastatin and other statins: combination with these drugs increases the likelihood of increasing the risk of developing rhabdomyolysis;
• blockers of tubular secretion: help to lengthen the half-life of erythromycin;
• carbamazepine, hexobarbital, phenytoin, valproic acid, alfentanil, lovastatin, bromocriptine, disopyramide: plasma levels of these drugs may increase;
• terfenadine, astemizole: concomitant therapy with each of these drugs can cause ventricular fibrillation and flutter, ventricular tachycardia, including fatal arrhythmias;
• dihydroergotamine, non-hydrogenated ergot alkaloids: it should be taken into account that combination with ergot alkaloids causes vasoconstriction to complete spasm, dysesthesia;
• sulfonamides: Combination therapy with sulfonamides increases the sensitivity of some resistant strains of Haemophilus influenzae to erythromycin.