Antibiotic and Anti-virus
Amoxicillin

Amoxicillin

Dosage Forms:

  • ۲۵۰ mg and 500 mg capsules
  • ۲۵۰ mg chewable tablet
  • ۵۰۰ mg Faramox tablet
  • ۱۲۵ mg/5ml and 250 mg/5ml powder for oral suspensions

Drug Group

Antibiotic, Penicillins

Mechanism

Amoxicillin is a broad spectrum antibiotic that binds to PBPs (located on the inner membrane of the bacterial cell wall), resulting in the lysis of cell wall. It is active against penicillin-sensitive gram-positive bacteria as well as E. coli, P. mirabilis, non penicillinase-producing staphylococci and H. influenzae.

Indications

Amoxicillin is given by mouth in the infections of ear, nose, throat (such as acute otitis media, pharyngitis and sinusitis), genitourinary tract, skin and soft tissues, lower respiratory tract, gonorrhea, early Lyme disease and for prevention of bacterial endocarditis.

Dosage and Administration:

  • Adults: 250-500 mg every 8 hours up to a maximum of 4.5 g daily. Children up to 10 years of age: 125- 250 mg every 8 hours. Children under 20 kg of body weight: 20-40 mg per kg of body weight daily in divided doses. Infants less than 3 months of age: 30 mg per kg of body weight daily in divided doses every 12 hours.

Precautions and Warnings

Amoxicillin is not indicated in history of hypersensitivity to penicillins, cephalosporins and imipenem and, should not be used in patients with mononucleosis. Therapy should be continued for at least 10 days in group A beta-hemolytic streptococcal infections to help prevent the occurrence of acute rheumatic fever. In patients with renal function impairment, a reduction in dosage or increase in dosing interval is recommended. Renal, hepatic and hematologic systems should be evaluated during prolonged therapy.

Side Effects

The most frequent side effects of Amoxicillin are headache, oral and vaginal candidiasis. The less frequent are allergic reactions, anaphylaxis, exfoliative dermatitis, serum sickness-like reactions, skin rash, hives and itching.
Interactions: Bacteriostatic drugs interfere with bactericidal effect of penicillins. The efficacy of oral contraceptives may be reduced. Probenecid decreases renal tubular secretion of penicillins. False-positive urine glucose reactions may occur in non-enzymatic tests using cupric sulfate during penicillin therapy.

Pregnancy and Lactation

Pregnancy category B. Amoxicillin crosses the placenta and is distributed into breast milk. Use during pregnancy only if clearly needed.

Packaging:

  • ۱۰ capsules in one blister. 10 blisters in a box.
  • ۴ tablets in one Alu-Alu blister. 5 blisters in a box.
  • Powder for 100 ml oral suspensions.
Ampicillin

Ampicillin

Dosage Forms:

  • 250 mg and 500 mg capsules
  • 125 mg/5ml and 250 mg/5ml powder for oral suspensions

Drug Group

Antibiotic, Penicillins

Mechanism

Ampicillin is a broad spectrum antibiotic that inhibits the biosynthesis of bacterial cell wall.

Indications

Ampicillin is given by mouth in the treatment of bacterial exacerbation of bronchitis, bacterial pneumonia, otitis media, sinusitis, bacterial pharyngitis, soft tissue infections, gastrointestinal infections, typhoid and paratyphoid fever, uncomplicated gonorrhea, chlamydial infections in pregnant women, bacterial urinary tract infections and prophylaxis of bacterial endocarditis.

Dosage and Administration:

  • Adults and children 20 kg of body weight and over:  ۲۵۰ – ۱۰۰۰ mg every 6 hours up to a maximum of 4 g a day. Infants and children up to 20 kg of body weight: 12.5-25 mg per kg of body weight every 6 hours or 16.7-33.3 mg per kg of body weight every 8 hours.

Precautions and Warnings

Ampicillin is not indicated in history of hypersensitivity to penicillins, cephalosporins and imipenem. Streptococcal infections must be treated for at least 10 days. Ampicillin probably should not be used in patients with infectious mononucleosis. Ampicillin should be used with caution in patients with history of GI diseases especially antibiotic-associated colitis. In patients with severe renal impairment, reduction in dosage or increase in dosing interval is recommended.

Side Effects

Skin rashes are among the most common side effects and generally either urticarial or maculopapular. The erythematous maculopapular eruptions are characteristic of Ampicillin and often appear more than 7 days after commencing treatment. Diarrhea, nausea and vomiting occur quite frequently usually following administration of Ampicillin by mouth.
Interactions: Ampicillin may interact with bacteriostatic antibacterials. Ampicillin may reduce the efficacy of oral contraceptives. Probenecid decreases renal tubular secretion of Ampicillin. False-positive urine glucose reactions may occur in non-enzymatic tests using cupric sulfate during penicillin therapy.

Pregnancy and Lactation

Pregnancy category B. Ampicillin crosses the placenta. Use during pregnancy only if clearly needed. Small amounts of Ampicillin distributed into breast milk. The use of Ampicillin by nursing mothers may lead to sensitization, diarrhea, candidiasis and skin rash in the infant.

Packaging:

  • ۱۰ capsules in one blister. 10 blisters in a box.
  • Powder for 100 ml oral suspensions.
Co-Amoxiclav

Co-Amoxiclav

Dosage Forms:

  • Co-Amoxiclav 375 tablet contains 250 mg Amoxicillin and 125 mg Clavulanic acid (as potassium).
  • Co-Amoxiclav 625 tablet contains 500 mg Amoxicillin and 125 mg Clavulanic acid (as potassium).
  • Co-Amoxiclav 156 powder for oral suspension, after reconstitution each measure (5ml) contains
  • ۱۲۵ mg Amoxicillin and 31.25 mg Clavulanic acid (as potassium).
  • Co-Amoxiclav 312 powder for oral suspension, after reconstitution each measure (5ml) contains
  • ۲۵۰ mg Amoxicillin and 62.50 mg Clavulanic acid (as potassium).

Drug Group

Antibiotic, Beta-lactam + Beta-lactamase inhibitor

Drug Group

Antibiotic, Beta-lactam + Beta-lactamase inhibitor

Mechanism

Co-Amoxiclav is betalactam antibiotic that inhibits the biosynthesis of cell wall of bacteria. Clavulanic acid has a high affinity for and binds to certain betalactamases that generally inactivate amoxicillin. Co-Amoxiclav is active against H. influenzae, M. catarrhalis, S. aureus, E. coli, Klebsiella sp. and Entrobacter sp.

Indications:

  • Co-Amoxiclav is given by mouth in the treatment of bacterial infections of lower respiratory tract, otitis media, sinusitis, recurrent tonsillitis, skin and skin structure infections and urinary tract infections.

Dosage and Administration

The following doses are based on amoxicillin: Adults: 250-500mg every 8 hours. Infants older than 3 months and children less than 40 kg of body weight: – Severe infections: 40 mg per kg of body weight daily in divided doses every 8 hours. – Less severe infections: 20 mg per kg of body weight daily in divided doses every 8 hours.

Precautions and Warnings

Co-Amoxiclav is not indicated in history of hypersensitivity to penicillins, cephalosporins, imipenem and betalactamase inhibitors. Co-Amoxiclav should be used with caution in patients with evidence of hepatic dysfunction and GI disease especially antibiotic-associated colitis. In renal impairment, reduction in dosage or increase in dosing interval is recommended. The suspensions contain aspartame and should not be used by phenylketonurics. Co-Amoxiclav in patients with infectious mononucleosis should not be used.

Side Effects

Diarrhea, hepatitis, cholestatic jaundice, pseudomembranous colitis, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis and exfoliative dermatitis have been reported.
Interactions: Probenecid prolongs the half-life of amoxicillin. Amoxicillin may also interact with bacteriostatic antibacterials. Co-Amoxiclav may reduce the efficacy of oral contraceptives. Concomitant use of allopurinol and amoxicillin should be avoided. Increases in prothrombin time have been reported in patients taking Co-Amoxiclav concurrently with anticoagulants. False-positive urine glucose reactions may occur in non-enzymatic tests using cupric sulfate in penicillin therapy.

Pregnancy and Lactation

Co-Amoxiclav crosses the placenta. Use during pregnancy only if clearly Co-Amoxiclav needed. Small amounts of amoxicillin are distributed into breast milk. The use of Co-Amoxiclav may cause diarrhea, candidiasis or allergic response in the nursing infants.

Packaging:

  • ۴ tablets in one Alu-Alu blister. 5 blisters in a box.
  • Powder for 100 ml oral suspensions
Farmentin BD

Farmentin BD

Dosage Forms:

  • Farmentin BD 228 powder for oral suspension, after reconstitution each measure (5ml) contains 200 mg Amoxicillin and 28.5 mg Clavulanic acid (as potassium).
  • Farmentin BD 457 powder for oral suspension, after reconstitution each measure (5ml) contains 400 mg Amoxicillin and 57 mg Clavulanic acid (as potassium).

Drug Group

Antibiotic, Beta-lactam + Beta-lactamase inhibitor

Mechanism

Co-Amoxiclav is betalactam antibiotic that inhibits the biosynthesis of cell wall of bacteria. Clavulanic acid has a high affinity for and binds to certain betalactamases that generally inactivate amoxicillin. Co-Amoxiclav is active against H. influenzae, M. catarrhalis, S. aureus, E. coli, Klebsiella sp. and Entrobacter sp.

Indications

Co-Amoxiclav is given by mouth in the treatment of bacterial infections of lower respiratory tract, otitis media, sinusitis, recurrent tonsillitis, skin and skin structure infections and urinary tract infections.

Dosage and Administration:

  • The following doses are based on amoxicillin: Adults and children 40 kg of body weight and over: 500-875 mg twice daily.Infants older than 3 months and children less than 40 kg of body weight:– Severe infections: 45 mg per kg of body weight daily in divided doses every 12 hours.– Less severe infections: 25 mg per kg of body weight daily in divided doses every 12 hours.

Precautions and Warnings

Co-Amoxiclav is not indicated in history of hypersensitivity to penicillins, cephalosporins, imipenem and betalactamase inhibitors. Co-Amoxiclav should be used with caution in patients with evidence of hepatic dysfunction and GI disease especially antibiotic-associated colitis. In renal impairment, reduction in dosage or increase in dosing interval is recommended. The suspensions contain aspartame and should not be used by phenylketonurics. Co-Amoxiclav in patients with infectious mononucleosis should not be used.

Side Effects

Diarrhea, hepatitis, cholestatic jaundice, pseudomembranous colitis, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis and exfoliative dermatitis have been reported.
Interactions: Probenecid prolongs the half-life of amoxicillin. Amoxicillin may also interact with bacteriostatic antibacterials. Co-Amoxiclav may reduce the efficacy of oral contraceptives. Concomitant use of allopurinol and amoxicillin should be avoided. Increases in prothrombin time have been reported in patients taking Co-Amoxiclav concurrently with anticoagulants. False-positive urine glucose reactions may occur in non-enzymatic tests using cupric sulfate in penicillin therapy.

Pregnancy and Lactation

Co-Amoxiclav crosses the placenta. Use during pregnancy only if clearly needed. Small amounts of amoxicillin are distributed into breast milk. The use of Co-Amoxiclav may cause diarrhea, candidiasis or allergic response in the nursing infants.

Packaging

Powder for 100 ml oral suspensions.
Farmentin ES-643

Farmentin ES-643

Dosage Forms:

  • Farmentin ES-643 powder for oral suspension, after reconstitution each measure (5ml) contains 600 mg amoxicillin and 42.9 mg Clavulanic acid (as potassium).

Drug Group

Antibiotic, Beta-lactam + Beta-lactamase inhibitor

Mechanism

Farmentin ES-643 is an oral antibacterial combination consisting of the semisynthetic antibiotic amoxicillin and the β-lactamase inhibitor, clavulanate potassium (the potassium salt of clavulanic acid). Betalactam antibiotic that inhibits the biosynthesis of cell wall of bacteria. Clavulanic acid has a high affinity for and binds to certain betalactamases that generally inactivate amoxicillin. Farmentin ES-643 is active against H. influenzae, M. catarrhalis, S. aureus, E. coli, Klebsiella sp. and Entrobacter sp.

Indications

Farmentin ES-643 is given by mouth in the treatment of bacterial infections of lower respiratory tract, otitis media, sinusitis, skin and skin structure infections, urinary tract infections, chancroid and gonorrhea

Dosage and Administration:

  • Infants older than 3 months and children less than 40 kg of body weight:Based on the amoxicillin component (600 mg/5mL), the recommended dose of Farmentin ES-643 is 90 mg/kg/day divided every 12 hours, administered for 10 days.

Precautions and Warnings

Farmentin ES-643 is not indicated in history of hypersensitivity to penicillins, cephalosporins, imipenem and betalactamase inhibitors. Farmentin ES-643 should be used with caution in patients with evidence of hepatic dysfunction and history of GI diseases especially antibiotic-associated colitis. In renal impairment, reduction in dosage or increase in dosing interval is recommended. The suspensions contain aspartame and should not be used by phenylketonurics. Farmentin ES-643 in patients with infectious mononucleosis should not be used.

Side Effects

Diarrhea, hepatitis, cholestatic jaundice, pseudomembranous colitis, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis and exfoliative dermatitis have been reported.
Interactions: Probenecid prolongs the half-life of amoxicillin. Amoxicillin may also interact with bacteriostatic antibacterials. Co-Amoxiclav may reduce the efficacy of oral contraceptives. Concomitant use of allopurinol and amoxicillin should be avoided. Increases in prothrombin time have been reported in patients taking Co-Amoxiclav concurrently with anticoagulants. False-positive urine glucose reactions may occur in non-enzymatic tests using cupric sulfate in penicillin therapy.

Pregnancy and Lactation

Farmentin ES-643 crosses the placenta. Use during pregnancy only if clearly needed. Small amounts of amoxicillin are distributed into breast milk. The use of Farmentin ES-643 may cause diarrhea, candidiasis or allergic response in the nursing infants.

Packaging:

  • Powder for 75 ml oral suspension.
Faramox BD

Faramox BD

Dosage Forms:

  • ۲۰۰ mg/5ml and 400 mg/5ml powder for oral suspensions

Drug Group

Antibiotic, Penicillins

Mechanism

Amoxicillin is a broad spectrum antibiotic that binds to PBPs (located on the inner membrane of the bacterial cell wall), resulting in the lysis of cell wall. It is active against penicillin-sensitive gram-positive bacteria as well as E. coli, P. mirabilis, non penicillinase-producing staphylococci and H. influenzae.

Indications

Amoxicillin is given by mouth in the infections of ear, nose, throat (such as acute otitis media, pharyngitis and sinusitis), genitourinary tract, skin and soft tissues, lower respiratory tract, gonorrhea, early Lyme disease and for prevention of bacterial endocarditis.

Dosage and Administration:

  • 25-45 mg per kg of body weight daily in divided doses every 12 hours.

Precautions and Warnings

Amoxicillin is not indicated in history of hypersensitivity to penicillins, cephalosporins and imipenem and, should not be used in patients with mononucleosis. Therapy should be continued for at least 10 days in group A beta-hemolytic streptococcal infections to help prevent the occurrence of acute rheumatic fever. In patients with renal function impairment, a reduction in dosage or increase in dosing interval is recommended. Renal, hepatic and hematologic systems should be evaluated during prolonged therapy.

Side Effects

The most frequent side effects of Amoxicillin are headache, oral and vaginal candidiasis. The less frequent are allergic reactions, anaphylaxis, exfoliative dermatitis, serum sickness-like reactions, skin rash, hives and itching.
Interactions: Bacteriostatic drugs interfere with bactericidal effect of penicillins. The efficacy of oral contraceptives may be reduced. Probenecid decreases renal tubular secretion of penicillins. False-positive urine glucose reactions may occur in non-enzymatic tests using cupric sulfate during penicillin therapy.

Pregnancy and Lactation

Pregnancy category B. Amoxicillin crosses the placenta and is distributed into breast milk. Use during pregnancy only if clearly needed.

Packaging:

  • Powder for 70 ml oral suspensions.
Cloxacillin

Cloxacillin

 Dosage Forms:

  • ۲۵۰ mg and 500 mg capsules

Drug Group

Antibiotic, Penicillins

Mechanism

Cloxacillin is penicillinase-resistant penicillin that inhibits the biosynthesis of bacterial cell wall. Cloxacillin has activity against S. aureus, S. pyogenes and S. pneumoniae.

Indications

Cloxacillin is given by mouth in the treatment of mild to moderate upper respiratory tract infections, lower respiratory tract infections and localized skin and soft tissue infections.

Dosage and Administration:

  • Adults and children 20 kg of body weight and over: 250-500 mg four times daily up to maximum of 6 g a day. Infants and children up to 20 kg of body weight: 6.25-12.5 mg per kg of body weight every six hours up to maximum of 4 g a day.

Precautions and Warnings

Cloxacillin is not indicated in history of hypersensitivity to penicillins, cephalosporins and imipenem. Streptococcal infections must be treated for at least 10 days. Cloxacillin should be taken on empty stomach. Cloxacillin should be used with caution in patients with history of GI diseases especially antibiotic-associated colitis. In the renal impairment, reduction in dosage or increase in dosing interval is recommended.

Side Effects

The most frequent side effects of cloxacillin are GI reactions, headache, oral and vaginal candidiasis. The less frequent are allergic reactions specifically anaphylaxis, skin rashes, hives or itching. Pseudomembranous colitis has occurred with the use of cloxacillin.
Interactions: Cloxacillin may interact with bacteriostatic antibacterials. Cloxacillin may reduce the efficacy of oral contraceptives. Probenecid decreases renal tubular secretion of cloxacillin. Cloxacillin reduces the clearance of methotrexate. False-positive urine glucose reactions may occur in non-enzymatic tests using cupric sulfate during penicillin therapy.

Pregnancy and Lactation

Cloxacillin crosses the placenta. Use during pregnancy only if clearly needed. Cloxacillin is distributed into breast milk. The use of cloxacillin by nursing mother may lead to sensitization, diarrhea, candidiasis and skin rash in the infant.

Packaging : ۱۰ 10 capsules in one blister. 10 blisters in a box.
Penicillin V benzathine
Penicillin V benzathine

Dosage Forms:

  • 200000 UI/5 ml and 400000 UI/5 ml powder for oral suspensions

Drug Group

Antibiotic, Penicillins

Mechanism

Penicillin V is natural penicillin that acts against penicillin-sensitive organisms. Penicillin V is a broad spectrum antibiotic that inhibits the biosynthesis of cell wall of bacteria. Penicillin V Benzathine has activity against streptococci, staphylococci, fusospirochetes, anaerobes, Borrelia burgdorferi, Actinomyces sp. and Bacillus anthracis.

Indications

Drug is given by mouth in the treatment of upper respiratory tract infections, scarlet fever, erysipelas, otitis media, Vincent’s angina, prevention of rheumatic fever and chorea, Lyme disease, anthrax, prophylaxis of bacterial endocarditis, and acute gingivitis.

Dosage and Administration:

  • Adults and children 60 kg of body weight and over: 200,000-500,000 units every 6-8 hours. Infants and children up 60 kg of body weight: 100,000-250,000 units every 6-8 hours.

Precautions and Warnings

Penicillin V Benzathine is not indicated in history of hypersensitivity to penicillins, cephalosporins and imipenem. Streptococcal infections must be treated for at least 10 days. Suspension contains 15 mg/5 ml aspartame (that is metabolized to phenylalanine in the GI tract) and should not be used by phenylketonurics. Penicillin V should be used with caution in patients with history of GI diseases especially antibiotic-associated colitis. In patients with severe renal function impairment, reduction in dosage or increase in dosing interval is recommended.

Side Effects

The side effects of Penicillin V Benzathine are GI reactions, headache, oral and vaginal candidiasis. The less frequent side effects are allergic reactions, anaphylaxis, serum sickness-like reactions, hives or itching.
Interactions: Bacteriostatic antibiotics may interfere with penicillins. Penicillin V Benzathine may reduce the efficacy of oral contraceptives. Probenecid decreases renal tubular secretion of penicillins. Penicillins reduce the clearance of methotrexate. False-positive urine glucose reactions may occur in non-enzymatic tests using cupric sulfate during penicillin therapy.

Pregnancy and Lactation

Penicillin V crosses the placenta. Use during pregnancy only if clearly needed. Small amounts of Penicillin V appear in breast milk.

Packaging:

  • Powder for 100 ml oral suspension.
Penicillin V Potassium

Penicillin V Potassium

Dosage Forms:

  • ۵۰۰ mg tablet
  • ۲۵۰ mg/5 ml powder for oral solution

Drug Group

Antibiotic, Penicillins

Mechanism

Penicillin V is natural penicillin that acts against penicillin-sensitive organisms. Penicillin V is a broad spectrum antibiotic that inhibits the biosynthesis of cell wall of bacteria. Penicillin V Benzathine has activity against streptococci, staphylococci, fusospirochetes, anaerobes, Borrelia burgdorferi, Actinomyces sp. and Bacillus anthracis.

Indications

Drug is given by mouth in the treatment of upper respiratory tract infections, scarlet fever, erysipelas, otitis media, Vincent’s angina, prevention of rheumatic fever and chorea, Lyme disease, anthrax, prophylaxis of bacterial endocarditis, and acute gingivitis.

Dosage and Administration:

  • Adults and children 12 years of age and older: 125-500 mg every 6-8 hours. Infants and children up to 12 years: 2.5-8.3 mg per kg of body weight every 4 hours, 3.75 -12.5 mg per kg of body weight every 6 hours or 5-16.7 mg per kg of body weight every 8 hours.

Precautions and Warnings

Penicillin V Potassium is not indicated in history of hypersensitivity to penicillins, cephalosporins and imipenem. Streptococcal infections must be treated for at least 10 days. Penicillin V should be used with caution in patients with history of GI diseases especially antibiotic-associated colitis. In patients with severe renal impairment, reduction in dosage or increase in dosing interval is recommended.

Side Effects

Penicillin V Potassium is not indicated in history of hypersensitivity to penicillins, cephalosporins and imipenem. Streptococcal infections must be treated for at least 10 days.
Interactions: Bacteriostatic drugs may interfere with penicillins. Penicillin V Potassium may reduce the efficacy of oral contraceptives. Probenecid decreases renal tubular secretion of penicillins. Penicillins reduce the clearance of methotrexate. False-positive urine glucose reactions may occur in non-enzymatic tests using cupric sulfate with penicillin therapy.

Pregnancy and Lactation

Penicillin V crosses the placenta. Use during pregnancy only if clearly needed. Small amounts of Penicillin V appear in breast milk.

Packaging:

  • ۱۰ tablets in one blister. 10 blisters in a box.
  • Powder for 100 ml oral suspension.
Cefalexin

Cephalexin

 Dosage Forms:

  • ۲۵۰ mg and 500 mg capsules
  • ۱۲۵ mg/5ml and 250 mg/5ml powder for oral suspensions

Drug Group

Antibiotic, Penicillins

Mechanism

Cefalexin is an oral first-generation cephalosporin. Cephalosporins inhibit bacterial cell wall synthesis. Cefalexin has activity against group A beta-hemolytic streptococci, staphylococci, H. influenzae, M. catarrhalis, P. mirabilis, E. coli, Klebsiella sp. and S. pyogenes.

Indications

Cefalexin is given by mouth in the treatment of bone and joint infections, otitis media, tonsillitis, pharyngitis, skin and skin structure infections, genitourinary and urinary tract infections and prophylaxis of bacterial endocarditis.

Dosage and Administration:

  • Adults and children 40 kg of body weight and over: 250-1000 mg based on type and severity of infection every 6, 8 or 12 hours up to a maximum 4 g per day. Children 1 year of age and older, up to 40 kg of body weight: 12.5 to 50 mg per kg of body weight based on type and severity of infection every 6, 8 or 12 hours. Infants and children 1 month to 1 year of age: 6.25 to 12.5 mg per kg of body weight every 6 hours.

Precautions and Warnings

Cefalexin is not indicated in history of cephalosporins, penicillins hypersensitivity, and porphyria. Cefalexin should be used with caution in patients with history of GI diseases, especially ulcerative colitis, regional enteritis, or antibiotic-associated colitis. Cephalosporins may be nephrotoxic, use with caution in the presence of impaired renal function.

Side Effects

The most frequent side effects of cefalexin are GI disturbances and hypersensitivity reactions including skin rashes, urticaria, eosinophilia, fever, reactions resembling serum sickness and anaphylaxis. Convulsions, transient hepatitis and cholestatic jaundice have been reported.
Interactions: Probenecid delays renal excretion of cefalexin. Cefalexin may decrease the efficacy of oral contraceptives. Loop diuretics increase the risk of nephrotoxicity of cephalosporins. Cephalosporins increase the nephrotoxicity of aminoglycoside. A false-positive reaction for urine glucose may occur in non-enzymatic tests using cupric sulfate.

Pregnancy and Lactation

Safety for use of cefalexin during pregnancy is not established. Small quantities of it are found in breast milk and should be used with caution in nursing women.

Packaging:

  • ۱۰ capsules in one blister. 10 blisters in a box.
  • Powder for 100 ml oral suspensions.
Cefixime

Cefixime

Dosage Forms:

  • ۲۰۰ mg and 400 mg capsules
  • ۲۰۰ mg and 400 mg tablets
  • ۱۰۰ mg/5ml powder for oral suspension

Drug Group

Antibiotic, cephalosporins

Mechanism

Cefixime is an oral first-generation cephalosporin. Cephalosporins inhibit bacterial cell wall synthesis. Cefixime is a bactericidal antibiotic and is stable to hydrolysis by many beta–lactamases. It has a mode of action and spectrum of activity similar to that of third generation cephalosporin, cefotaxime, but some entrobacteriacea are less susceptible to cefixime. Haemophilus influenzae, Moraxella catarrhalis and Neisseria gonorrhoeae, including penicillinase-producing strains, are sensitive but most strains of staphylococci, enterococci, and Listeria spp. are not. Enterobacter spp., Pseudomonas aeruginosa, and Bacteroides spp. are resistant to cefixime.

Indications

Cefixime is given by mouth in the treatment of susceptible infections including gonorrhea, otitis media, pharyngitis, tonsillitis, lower respiratory tract infections such as bronchitis, urinary tract infections, enteric fever and shigellosis.

Dosage and Administration:

  • Adults and children 50 kg of body weight and over: 200 to 400 mg daily as a single dose or in two divided doses. For uncomplicated gonorrhea, a single oral does of 400 mg is given. Infants and children 6 months to 12 years of age and up to 50 kg of body weight: 8 mg per kg of body weight once a day, or 4 mg per kg of body weight every 12 hours.

Precautions and Warnings

Cefixime should be used with caution in patients with history of GI diseases, especially ulcerative colitis, regional enteritis, or antibiotic-associated colitis. A reduced dosage is recommended in patients with renal function impairment receiving cefixime.

Side Effects

The most frequent reported adverse effects of cefixime are gastrointestinal disturbances, especially diarrhea. Cefixime should be discontinued if diarrhea is severe. Although cefixime does not have the N-methylthiotetrazole side-chain usually associated with hypoprothrombinaemia, increases in prothrombin times have occurred in a few patients. Skin rashes, urticaria, eosinophilia, fever and transient hepatitis and cholestatic jaundice have been reported.
Interactions: Care should be exercised in patients receiving anticoagulants and cefixime concomitantly due to the possibility that cefixime may increase prothrombin times. Concomitant administration of cefixime and carbamazepine or nifedipine may result in increased plasma carbamazepine or cefixime concentrations, respectively. A false-positive reaction for urine glucose may occur in non-enzymatic tests using cupric sulfate.

Pregnancy and Lactation

Cefixime crosses the placenta. Use during pregnancy only when clearly needed. Cefixime is excreted in breast milk in small quantities. Therefore, cefixime should be used with caution in nursing women, and consideration should be given to temporarily discontinuing nursing during therapy with the drug.

Packaging:

  • Blisters or PE flacons contain 10 film coated tablets.
  • ۱۰ capsules in one blister. One blister in a box.
  • Cefixime: Powder for 100 ml oral suspension.
  • Farexime: Powder for 50 ml oral suspension.
Cefuroxime(Farinat)

Cefuroxime(Farinat)

 Dosage Forms:

  • 125 mg, 250 mg and 500 mg tablets

Drug Group

Antibiotic, Cephalosporins

Mechanism

Cefuroxime axetil is a second-generation cephalosporin antibiotic that inhibits biosynthesis of bacterial cell wall. Cefuroxime has activity against S. pyogenes, S. pneumoniae, H. influenzae, M. catarrhalis, H. parainfluenzae, S. aureus, E. coli, K. pneumoniae, N. gonorrhoeae, and Borrelia burgdorferi.

Indications

Cefuroxime axetil is given by mouth in treatment of pharyngitis, tonsillitis, acute otitis media, acute maxillary sinusitis, acute exacerbations of chronic bronchitis and secondary infections of acute bronchitis, skin and skin structure infections, urinary tract infections, uncomplicated gonorrhea and early Lyme disease.

Dosage and Administration:

  • Adults and children 12 years of age and older: 125 to 500 mg based on type and severity of infection two times a day for five to twenty days.Infants and children 3 months to 12 years of age: 10-15 mg per kg of body weight every twelve hours for ten days.

Precautions and Warnings

Cefuroxime is not indicated in patients with history of penicillins, penicillin derivatives, penicillamine and cephalosporins hypersensitivity, and porphyria. There is evidence of partial cross-allergenicity; cephalosporins cannot be assumed to the absolutely safe alternative to penicillin in the penicillin-allergic patients. Cefuroxime tablets contain phenylalanine and should not be used by phenylketonurics. Cefuroxime should be used with caution in patients with a history of GI diseases, particularly colitis. Cephalosporins may be nephrotoxic, use with caution in the presence of markedly impaired renal function.

Side Effects

Diarrhea, nausea and vomiting have occurred in some patients. Jarisch-Herxheimer reaction, rashes, pruritus and urticaria have been reported. Mild-to-moderate hearing loss reported in some pediatric patients. Hypoprothrombinemia has been reported.
Interactions: Probenecid increases cephalosporin serum concentrations, resulting prolonged elimination half-life, and increased risk of toxicity. Concurrent use of diuretics and Cefuroxime may increase the risk of adverse renal effects. The concomitantly use of Cefuroxime and an aminoglycoside may potentiate nephrotoxicity. Plasma concentration of Cefuroxime may be reduced by coadministration of H2-antagonists, decreasing the antibiotic effect. Nonsteroidal anti-inflammatory drugs [NSAIDs], salicylates, or sulfinpyrazon may increase the risk of hemorrhage. Cefuroxime axetil may produce false-positive urine glucose reactions with copper-reduction tests. Cefuroxime may cause a false-negative reaction in the ferricyanide test for blood glucose.

Pregnancy and Lactation

Cefuroxime crosses the placenta. Use only when potential benefits outweigh potential hazards to the fetus. Because Cefuroxime is distributed into milk, Cefuroxime axetil should be used with caution in nursing women.

Packaging:

  • HDPE flacons of 20’s.
Clarithromycin

Clarithromycin

 Dosage Forms:

  • 250 mg and 500 mg tablets.

Drug Group

Antibiotic, Macrolide

Mechanism

Clarithromycin is a macrolide derived from erythromycin. It reversibly binds to the P site of the 50S ribosomal subunit of susceptible organisms and may inhibit RNA-dependent protein synthesis. It may be bacteriostatic or bactericidal, depending on such factors as drug concentration.

Indications

Clarithromycin is given in the treatment of pharyngitis/tonsillitis, acute maxillary sinusitis, acute bacterial exacerbation of chronic bronchitis, pneumonia, uncomplicated skin and skin structure infections. It is also used for the prophylaxis and treatment of opportunistic mycobacterial infections and has been used in the treatment of leprosy. Clarithromycin may be given to eradicate Helicobacter pylori in treatment regimns for peptic ulcer disease.

Dosage and Administration:

  • Adults: The usual adult dose of clarithromycin is 250 mg twice daily by mouth, increased to 500 mg twice daily if necessary in severe infection. A course is usually for 7 to 14 days. For treatment and prophylaxis of disseminated infection due to Mycobacterium Avium Complex disease, Clarithromycin may be given in a dose of 500 mg twice daily by mouth; for treatment, it should be given with other antimycobacterials. For leprosy, clarithromycin 500 mg daily by mouth has been given as part of an alternative multidrug therapy regimen.  For the eradication of H. pylori associated with peptic ulcer disease, clarithromycin, usually in a dose of 500 mg twice daily, is given with another antibacterial, for 7 to 14 days. Children: children may be given 7.5 mg/kg twice daily, up to 1000 mg per day, for 5 to 10 days.

 Precautions and Warnings

Hypersensitivity to any of the macrolide antibiotics and patients receiving astemizole, cisapride, or pimozide. Do not use clarithromycin in combination with ranitidine and bismuth citrate in patients with a history of acute porphyria. Hepatic/renal function impairment may be occurred. Clarithromycin should be used with caution in patients with pseudomembranus colitis.

Side Effects

The most frequent adverse effect is gastrointestinal disturbances but is usually mild and less frequent with clarithromycin than with erythromycin. Taste disturbances, stomatitis, glossitis, and tooth discoloration have occurred. Headache and rashes from mild skin eruptions to, rarely, Stevens-Janson syndrome have occurred. There have also been reports of transient CNS effects such as anxiety, dizziness, insomnia, hallucinations, and confusion. Hearing loss has been reported occasionally and is usually reversible. Interstitial nephritis and renal failure have been reported rarely. Other adverse effects include hypoglycemia and thrombocytopenia.
Interactions: Absorption of clarithromycin may be reduced by antacids. Azithromycin increases plasma concentration of disopyramide. Avoid concomitant use with rifabutin; increased risk of side effects including neutropenia exists when clarithromycin is given with rifabutin. Clarithromycin possibly enhances the anticoagulant effects of cumarins (warfarin). Clarithromycin possibly increase the risk of colchicine toxicity, suspend or reduce dose of colchicine. (Avoid concomitant use in hepatic or renal impairment). Clarithromycin may increase pimozide plasma concentrations and cardiotoxicity may occur. Coadministration is contraindicated. Coadministration with cisapride is contraindicated as it could lead to cardiac arrhythmias.

Pregnancy and Lactation

Pregnancy category C. Clarithromycin has adverse effects on pregnancy outcome or embryo-fetal development in monkeys, rats, mice, and rabbits. There are no adequate and well-controlled studies in pregnant women. Do not use clarithromycin in pregnant women. Clarithromycin and its active metabolite are distributed into breast milk.

Packaging:

  • 10 tablets in one blister. 2 blisters in a box.
Erythromycin

Erythromycin

Dosage Forms:

  • 200 mg and 400 mg tablets
  • 200 mg/5ml powder for oral suspension

Drug Group

Antibiotic, macrolide

Mechanism

Erythromycin is a macrolide antibiotic with a wide spectrum of activity. It reversibly binds to the P site of the 50S ribosomal subunit of susceptible organisms and may inhibits RNA-dependent protein. It may be bacteriostatic or bactericidal, depending on such factors as drug concentration.

Indications

Erythromycin has been used in the treatment of a wide variety of infections caused by susceptible organisms: upper respiratory tract infections (mild to moderate severity), lower respiratory tract infections (mild to moderate severity), respiratory tract infections, skin/skin structure infections (mild to moderate severity), pertussis (whooping cough), diphtheria, erythrasma, intestinal amebiasis, Pelvic inflammatory disease (PID), conjunctivitis of newborn, pneumonia of infancy, urogenital infections during uncomplicated urethral, endocervical, or rectal infections in adults, primary syphilis, legionnaire’s disease, rheumatic fever, bacterial endocarditis, Listeria monocytogenes infections.

Dosage and Administration:

  • Adults: 400 mg every six hours; or 800 mg every twelve hours if twice a day dosing is desired. Children: 7.5 to 12.5 mg per kg of body weight every six hours; or 15 to 25 mg per kg body weight every twelve hours. For severe infections: 15 to 25 mg per kg body weight every six hours.

Precautions and Warnings

Hypersensitivity to any of the macrolide antibiotics and patients receiving astemizole, cisapride, or pimozide. Erythromycin may aggravate the weakness of patients with myasthenia gravis. Serious allergic reactions, including anaphylaxis, have occurred with Erythromycin. Renal/Hepatic function impairment may be occurred. Erythromycin should be used with caution in patients with pseudomembranus colitis.

Side Effects

Erythromycin and its salts and esters are generally well tolerated and serious adverse effects are rare. Gastrointestinal disturbances such as abdominal discomfort and cramp, nausea, vomiting, and diarrhea are common. Hypersensitivity reactions appear to be uncommon, having been reported in about 0.5% of patients, and include pruritus, urticaria and skin rash as well as occasional cases of anaphylaxis. A hypersensitivity reaction may also be responsible for the hepatotoxicity sometimes reported in patients receiving Erythromycin or its derivatives. Hearing loss more likely to occur with administration of high doses (≥ ۴ grams per day) in patients with renal or hepatic disease and /or in elderly patients. Hearing loss is usually reversible. Other adverse effects that have been reported in patients receiving erythromycin include agranulocytosis, arrhythmias, central neurotoxicity including psychotic reactions and nightmares, a myasthenia-line syndrome, and pancreatitis.
Interactions: Erythromycins may inhibit carbamazepine and valproic acid metabolism, resulting in increased anticonvulsant plasma concentrations and toxicity. Erythromycins may displace these medications from, or prevent them from binding to, 50 S subunits of bacterial ribosomes, thus antagonizing the effects of chloramphenicol and lincomycins. It may increase cyclosporine, digoxin and buspirone plasma concentrations. It may deacrease the clearance of midazolam, triazolam, warfarin and theophylline.

Pregnancy and Lactation

Pregnancy category B. Use erythromycin only when clearly needed. Erythromycin is considered compatible with breast-feeding.

Packaging:

  • ۱۰ tablets in one blister. 10 blisters in a box.
  • Powder for 100 ml oral suspension.
Azithromyicin

Azithromyicin

Dosage Forms:

  • ۲۵۰ mg and 500 mg tablets
  • ۲۵۰ mg and 500 mg capsules
  • ۱۰۰ mg/5ml and 200 mg/5ml powder for oral suspensions

Drug Group

Antibiotics, Macrolide

Mechanism

It reversibly binds to the P site of the 50S ribosomal subunit of susceptible organisms and may inhibit RNA-dependent protein. It may be bacteriostatic or bactericidal, depending on such factors as drug concentration.

Indications

Respiratory-tract infections; otitis media; skin and soft-tissue infections; uncomplicated gonorrhoea (unlicensed indication), uncomplicated genital chlamydial infections and non-gonococcal urethritis, mild or moderate typhoid due to multiple-antibacterial-resistant organisms (unlicensed indication); Lyme disease (unlicensed indication); prophylaxis of group A streptococcal infection.

Dosage and Administration:

  •  500 mg once daily for 3 days or 500 mg on first day then 250 mg once daily for 4 days. Child over 6 months 10 mg/kg once daily for 3 days; or bodyweight 15–۲۵ kg, 200 mg once daily for 3 days; bodyweight 26–۳۵ kg, 300 mg once daily for 3 days; bodyweight 36–۴۵ kg, 400 mg once daily for 3 days. Uncomplicated genital chlamydial infections and non-gonococcal urethritis, 1 g as a single dose. Lyme disease, typhoid, 500 mg once daily for 7–۱۰ days (7 days in typhoid).

Precautions and Warnings

Hypersensitivity to any of the macrolide antibiotics or ketolide antibiotics (like telithromycin). Azithromycin should be used with caution in patients with hepatic or renal impairment. Azithromycin should not be used in patients with pneumonia who are judged to be inappropriate for oral therapy because of moderate to severe illness or risk factors. Prescribing antibiotics (including azithromycin) in the absence of a proven bacterial infection is unlikely to provide benefit to the patient and increases the risk of development or drug resistant bacteria. Azithromycin may aggravate the weakness of patients with myasthenia gravis. Azithromycin suspensions contain aspartame and should not be used by phenylkrtonurics.

Side Effects

Anorexia, dyspepsia, flatulence, dizziness, headache, malaise, paraesthesia, arthralgia, disturbances in taste and vision; less commonly constipation, gastritis, chest pain, oedema, anxiety, sleep disturbances, hypoaesthesia, leucopenia, photosensitivity; rarely agitation; also reported syncope, convulsions, smell disturbances, interstitial nephritis, acute renal failure, thrombocytopenia, haemolytic anaemia, tongue discoloration
Interactions: Absorption of azithromycin may be reduced by antacids. Azithromycin increases plasma concentration of disopyramide. Avoid concomitant use with rifabutin; increased risk of side effects including neutropenia exists when azithromycin is given with rifabutin. Azithromycin possibly enhances the anticoagulant effects of cumarins (warfarin). Azithromycin possibly increase the risk of colchicine toxicity, suspend or reduce dose of colchicine. (Avoid concomitant use in hepatic or renal impairment). Azithromycin may increase pimozide plasma concentrations and cardiotoxicity may occur. Coadministration is contraindicated. Coadministration with cisapride is contraindicated as it could lead to cardiac arrhythmias.

Pregnancy and Lactation

Category B. Azithromycin crosses the placenta but fetal plasma levels generally low. Use only when clearly needed. Breast-feeding: present in milk; use only if no suitable alternatives.

Packaging:

  • 6 Capsules or tablets in a one blister. 1 blister in a box.
  • Powder for 30 ml oral suspensions.
سیپروفلوکساسین

Ciprofloxacin

 Dosage Forms:

  • 250mg and 500mg tablets

 Drug Group

Antibiotic, Flouroquinolons

Mechanism

It acts intracellulary by inhibiting topoisomerase II (DNA gyrase) and/or topoisomerase IV. Topoisomerases are essential bacterial enzymes that are critical catalysts in the duplication, transcription, and repair of bacterial DNA.

Indications

For the treatment of infections caused by susceptible strains of the designated microorganisms in the conditions listed below : Acute sinusitis, lower respiratory tract infections, nosocomial pneumonia, skin and skin structure infections, bone/joint infections, urinary tract infections, acute uncomplicated cystitis in females, chronic bacterial prostatitis, complicated intra-abdominal infections, infectious diarrhea, typhoid fever, sexually transmitted diseases and inhalational anthrax.

Dosage and Administration:

  • Adult: The usual adult oral dose of ciprofloxacin ranges from 250mg to 750mg twice daily depending on the severity and nature of the infection. Children: For inhalation anthrax, ciprofloxacin may be given to children and adolescents for 60 days in a dose of 15mg/kg twice daily by mouth up to maximum of 500mg. Ciprofloxacin is not generally recommended for other uses in children and adolescents.

Precautions and Warnings

Hypersensitivity to flouroquinolons or the quinolone. The use of ciprofloxacin may result in overgrowth of nonsusceptible organisms, including fungi. If superinfection occurs, the drug should be discontinued and appropriate therapy instituted. Ciprofloxacin should be used with caution in patients with epilepsy or a history of CNS disorders. Care is necessary in patients with impaired hepatic or renal function, G6PD deficiency, or myasthenia gravis. Ciprofloxacin should be avoided in meticillin-resistant staphylococcus aureus infections because of the high level of resistance.

Side Effects

Ciprofloxacin is generally well tolerated. It most often involves the gastrointestinal tract, CNS, or skin. Gastrointestinal disturbances include nausea, vomiting, diarrhea, abdominal pain, and dyspepsia. Pseudomembranous colitis has been reported rarely. Headache, dizziness, and restlessness are among the commonest effects on the CNS. Others include tremor, drowsiness, insomnia, nightmares, and visual and other sensory disturbances.
Interactions: Increased cyclosporine toxicity with unknown mechanism had been reported. The hepatic metabolism of caffeine is decreased by ciprofloxacin. Administration of theophylline with ciprofloxacin has decreased theophylline clearance. Antacids, Iron salts, and sucralfate decreased GI absorption of quinolones.

Pregnancy and Lactation

Pregnancy category C. Ciprofloxacin crosses the placenta. Lactations: Ciprofloxacin is known to be distributed into human breast milk. If ciprofloxacin must be administered, breast-feeding is not recommended.

Packaging:

  • 10 tablets in one blister. 2 blisters in a box.
آسیکلوویر

Acyclovir

Dosage Forms:

  • 200 mg and 400 mg tablets

Drug Group

Anti-Viral

Mechanism

Acyclovir is a synthetic purine nucleoside analogue with in vitro and in vivo inhibitory activity against Herpes Simplex Virus types 1 (HSV-1), 2 (HSV-2) and Varicella-Zoster Virus (VZV).

Indications

Acyclovir is indicated for the treatment of Herpes Zoster infections, genital herpes and chickenpox.

Dosage and Administration:

  • Herpes Zoster: 800 mg every 4 hours orally, 5 times daily for 7 to 10 days. Initial Genital Herpes: 200 mg every 4 hours, 5 times daily for 10 days. Chronic Suppressive Therapy for Recurrent Disease: 400 mg 2 times daily for up to 12 months, followed by re-evaluation. Treatment of chickenpox:  ۸۰۰ mg 4 times daily for 5 days. When therapy is indicated, it should be initiated at the earliest sign or symptom of chickenpox.

Precautions and Warnings

Acyclovir is contraindicated for patients who develop hypersensitivity to acyclovir or valacyclovir. Thrombotic Thrombocytopenic Purpura/Hemolytic Uremic Syndrome (TTP/HUS), which has resulted in death, has occurred in immunocompromised patients receiving acyclovir therapy.

Side Effects

The most frequent adverse effects are anaphylaxis, angioedema, fever, headache, pain, peripheral edema, confusion, dizziness, hallucinations, seizure, diarrhea, gastrointestinal distress, nausea and thrombocytopenia. Less frequent adverse effects are elevated liver function tests, jaundice, myalgia, erythema multiforme, photosensitive rash, pruritus, rash, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria, visual abnormalities, renal failure, elevated blood urea nitrogen and elevated creatinine.
Interactions: Co-administration of probenecid with acyclovir has been shown to increase the mean half-life and the area under the concentration-time curve. Urinary excretion and renal clearance were correspondingly reduced.

Pregnancy and Lactation

Pregnancy category B. There are no adequate and well-controlled studies in pregnant women. Acyclovir should be administered to pregnant and nursing mother with caution and only when indicated.

Packaging:

  • HDPE flacons of 50’s.
Faramox