Roxid-150 (Rulide)

Roxithromycin is a semi-synthetic macrolide antibiotic. It is used to treat respiratory tract, urinary and soft tissue infections.

Therapeutic actions:
Roxithromycin prevents bacteria from growing, by interfering with their protein synthesis. Roxithromycin binds to the subunit 50S of the bacterial ribosome, and thus inhibits the translocation of peptides. Roxithromycin has similar antimicrobial spectrum as erythromycin, but is more effective against certain gram-negative bacteria, particularly Legionella pneumophila.

What is it used for?:
Roxithromycin is indicated for use in the treatment of mild to moderate infections of the ear, nose and throat, respiratory tract, in the skin and skin structure and genito-urinary tract caused by susceptible strains of organisms listed below:
• Pharyngitis, tonsillitis, sinusitis and otitis media, due to Group A beta-haemolytic Streptococci and Streptococcus pneumoniae.
• Pneumonia and acute bronchitis due to Streptococcus pneumoniae.
• Atypical pneumoniae, due to Mycoplasma pneumoniae.
• Pyoderma and erysipelas, due to Staphylococcus aureus and Group A beta-haemolytic Streptococci.
• Non-gonococcal urethritis in men, due to Chlamydia trachomatis and Ureaplasma urealyticum.

Contraindications and cautions:
• Known allergy to macrolides.
• Simultaneous administration of roxithromycin with vasoconstrictive ergot (alkaloid) derivatives is contra-indicated since symptoms of ergotism have been described with other macrolides.

Side effects:
• Gastrointestinal symptoms: nausea, vomiting, gastric pain, diarrhoea.
• Symptoms of pancreatitis have been observed.
• Hypersensitivity reactions: rash, urticaria, angio-oedema, purpura, bronchospasm, anaphylactic shock.
• Dizziness, headache, paraesthesia
• Increases in ASAT, ALAT and/or alkaline phosphatase. Cholestatic or acute hepatocellular hepatitis. Disturbances of taste and/or smell have been reported.

Interactions:
• Roxithromycin has less interactions than erythromycin as it has a lower affinity for cytochrome P450.
• Roxithromycin does not interact with hormonal contraceptives, prednisolone, carbamazepine, ranitidine or antacids.
• When roxithromycin is administered with theophylline, some studies have shown an increase in the plasma concentration of theophylline.
• Roxithromycin appears to interact with warfarin. This is shown by an increase in prothrombin time (international normalised ratio (INR)) in patients taking roxithromycin and warfarin concurrently. As a consequence, severe bleeding episodes have occurred.