Penalox 500mg

Penalox is an antibiotic used to treat various types of bacterial infections of the respiratory tract, ear, nose, throat, lungs, skin, and eye in adults and children. It is also effective in typhoid fever and some sexually transmitted diseases like gonorrhea. Penalox is a broad-spectrum type of antibiotic effective in killing many types of gram-positive bacteria, some types of gram-negative bacteria and other microorganisms. This medicine is taken orally, preferably either one hour before or 2 hours after a meal. It should be used regularly at evenly spaced time intervals as prescribed by your doctor. Do not skip any doses and finish the full course of treatment even if you feel better. Stopping the medicine too early may lead to the return or worsening of the infection. Commonly seen side effects seen with this medicine include vomiting, nausea, stomach pain, and diarrhea. These are usually temporary and subside with the completion of treatment. Consult your doctor if you find these side effects worry you or persist for a longer duration. Inform your doctor if you have any previous history of allergy or heart problems before taking this medicine. Pregnant or breastfeeding women should consult their doctor before using this medicine.

Uses of Penalox

• Bacterial infections

Side effects of Penalox

Common

• Vomiting
• Nausea
• Abdominal pain
• Diarrhea

How to use Penalox

Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Penalox may be taken with or without food, but it is better to take it at a fixed time.

How Penalox works

Penalox is an antibiotic. It works by preventing synthesis of essential proteins required by bacteria to carry out vital functions. Thus, it stops the bacteria from growing, and prevents the infection from spreading.

What if you forget to take Penalox?

If you miss a dose of Penalox, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.

Quick Tips

• Do not skip any doses and finish the full course of treatment even if you feel better. Stopping it early may make the infection to come back and harder to treat.
• Take it 1 hour before or two hours after food.
• Do not take antacids 2 hours before or after taking Penalox.
• Diarrhea may occur as a side effect but should stop when your course is complete. Inform your doctor if it doesn't stop or if you find blood in your stools.
• Stop taking Penalox and inform your doctor immediately if you develop an itchy rash, swelling of the face, throat or tongue or breathing difficulties while taking it.

Brief Description

Indication

Bacterial infections, bacterial endocarditis, typhoid fever, community-acquired pneumonia, uncomplicated gonorrhea, streptococcal pharyngitis/tonsillitis, COPD, acute bacterial sinusitis, acute otitis media, uncomplicated UTI, Uncomplicated gonorrhea, PID, non-gonococcal urethritis, chancroid, acute salmonellosis, cervicitis, babesiosis, chlamydial infections, pelvic inflammatory disease, PID, traveler's diarrhea,

Administration

Oral Administration Tablet: Take tablets without regard to food; however, food may enhance tolerability Oral suspension Conventional oral suspension (100 mg/5 mL, 200 mg/5 mL) may be stored for 10 days after reconstitution and taken without regard to food Conventional 1 g package must be taken immediately after reconstitution Extended-release oral suspension must be taken on empty stomach within 12 hours of reconstitution; given only in single dose; not interchangeable with immediate release formulation IV Preparation Dilute 500-mg vial in 4.8 mL of SWI (100 mg/mL) Dilute further in NS to 1 mg/mL (500 mL) or 2 mg/mL (250 mL) IV Administration 1 mg/mL solution: Infuse over 3 hours 2 mg/mL solution: Infuse over 1 hour

Adult Dose

Adult: PO Resp tract infections; Skin and soft tissue infections 500 mg once daily for 3 days. Chancroid; Non-gonococcal cervicitis/urethritis due to Chlamydia trachomatis; Uncomplicated genital infections due to Chlamydia trachomatis 1 g as a single dose. Prophylaxis of disseminated MAC infections 1.2 g once wkly. Treatment or secondary propjhylaxis: 500 mg once daily w/ other antimycobacterials. Uncomplicated gonorrhoea 2 g as a single dose. Granuloma inguinale Initial: 1 g, then 500 mg/day until all lesions have healed completely. Active immunisation against typhoid fever caused by Salmonella typhi 1 g once daily for 5 days. IV Community-acquired pneumonia 500 mg as a single IV daily dose for 2 days, then 500 mg single oral dose daily to complete 7-10 days of therapy. Pelvic inflammatory disease 500 mg as a single IV daily dose for 1-2 days, then 250 mg single oral dose daily to complete a 7-day therapy. Elderly: No dosage adjustment needed. Hepatic impairment: No dosage adjustment needed.

Child Dose

Child: PO: q24h Otitis: 10 mg/kg/day for 1 day, then 5 mg/kg for 4 days; or 10 mg/kg/day for 3 days; or 30 mg/kg once. Pharyngitis: 12 mg/kg/day for 5 days. Sinusitis: 10 mg/kg/day for 3 days. CABP: 10 mg/kg for 1 day, then 5 mg/kg/day for 4 days or 60 mg/kg once of ER susp MAC/PCP prophylaxis: 5 mg/kg/day IV: 10 mg/kg q24h >6 mth 10 mg/kg; 15-25 kg: 200 mg; 26-35 kg: 300 mg; 36-45 kg: 400 mg. All doses to be taken once daily for 3 days.

Renal Dose

Renal impairment: No dosage adjustment needed.

Contraindication

Known hypersensitivity to azithromycin, erythromycin, any macrolide or ketolide antibiotic. Coadministration w/ pimozide. History of cholestatic jaundice/hepatic dysfunction associated w/ prior use of azithromycin.

Mode of Action

Azithromycin is a semisynthetic azalide antibiotic. It blocks transpeptidation by binding to 50s ribosomal subunit of susceptible organisms and disrupting RNA-dependent protein synthesis at the chain elongation step.

Precaution

May increase the risk of Torsades de pointes and fatal heart arrhythmias in patients w/ prolonged QT interval, low K or Mg blood levels, slow heart rate and medication treating abnormal heart rhythms. Impaired hepatic and renal function. Pregnancy and lactation. Monitoring Parameters Liver function tests, CBC w/ differential. Lactation: Unknown whether drug is excreted into breast milk; use with caution

Side Effect

>10% High single dose therapy Diarrhea (52.8%),Nausea (32.6%),Abdominal pain (27%),Loose stool (19.1%) 1-10% Cramping (2-10%),Vaginitis (2-10%),Dyspepsia (9% with single high dose therapy),Flatulence (9% with single high dose therapy),Vomiting (6.7% with single high dose therapy),Malaise (1.1%) <1% Agitation,Allergic reaction,Anemia,Anorexia,Candidiasis,Chest pain,Conjunctivitis,Constipation,Dermatitis (fungal),Dizziness,Eczema,Edema,Enteritis,Facial edema,Fatigue,Gastritis,Headache,Hyperkinesia,Hypotension,Increased cough,Insomnia,Leukopenia,Malaise,Melena,Mucositis,Nervousness,Oral candidiasis,Pain,Palpitations,Pharyngitis,Pleural effusion,Pruritus,Pseudomembranous colitis,Rash,Rhinitis,Seizures,Somnolence,Urticaria,Vertigo Potentially Fatal: Angioedema and cholestatic jaundice.

Pregnancy Category Note

Pregnancy Available data from published literature and postmarketing experience over several decades with azithromycin use in pregnant women have not identified drug-associated risks for major birth defects, miscarriage, or adverse maternal or fetal outcomes (see Data); data do not suggest embryofetal risk (Developmental and Reproductive Toxicology Database [DART]; https://toxnet.nlm.nih.gov/newtoxnet/dart.htm) Animal data Developmental toxicity studies with azithromycin in rats, mice, and rabbits showed no drug-induced fetal malformations at doses up to 4, 2, and 2 times, respectively, an adult human daily dose of 500 mg based on body surface area; decreased viability and delayed development were observed in offspring of pregnant rats administered azithromycin from day 6 of pregnancy through weaning at a dose equivalent to 4 times an adult human daily dose of 500 mg based on body surface area Lactation Drug is present in human milk; non-serious adverse reactions reported in breastfed infants after maternal administration of therapy; there are no available data on effects on milk production; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and potential adverse effects on breastfed infant from drug or underlying maternal condition; advise women to monitor breastfed infant for diarrhea, vomiting, or rash.

Interaction

Increases serum concentrations of digoxin, ciclosporin, terfenadine, hexobarbital and phenytoin. Decreased rate of absorption w/ antacids containing aluminium and magnesium. Increased risk of ergot toxicity. Potentially Fatal: Increased risk of cardiotoxicity w/ pimozide.