Fromilid for bacterial infections. Composition, dosage, contraindications to use

Fromilid is an antibacterial drug for systemic use. Macrolide antibiotic used to treat bacterial infections. Recommended, among others, in infections of the upper respiratory tract (pharyngitis), lower respiratory tract (bronchitis, pneumonia). Fromilid is available on prescription in the form of granules for the preparation of an oral suspension.

Fromilid, Producer: Krka

Indications for taking Fromilid

The active substance is clarithromycin, it is used to treat the following infections caused by clarithromycin-sensitive microorganisms: upper respiratory tract infections (e.g. streptococcal pharyngitis)

1. acute otitis media,
2. lower respiratory tract infections (e.g. bronchitis, pneumonia),
3. skin and soft tissue infections (e.g. contagious impetigo, folliculitis, cellulitis, abscesses),
4. disseminated or localized mycobacterial infections.

Fromilid and contraindications

A contraindication to the use of Fromilid is hypersensitivity to any of the ingredients or other macrolide antibiotics. During treatment with clarithromycin, the use of any of the following drugs is contraindicated: astemizole, cisapride, pimozide, terfenadine, ergotamine or dihydroergotamine.

Dosage

1. Children: 7,5 mg / kg body weight twice a day (children weighing less than 2 kg – 8 mg / kg body weight twice a day, body weight 7,5-2 kg – 8 mg twice a day daily, body weight 11-62,5 kg – 2 mg twice a day, body weight 12-19 kg – 125 mg twice a day, body weight 2-20 kg – 29 mg twice a day). Maximum dose 187,5 mg twice a day. Treatment usually takes 2-30 days.
2. In children with renal insufficiency (creatinine clearance less than 30 ml / min), it is necessary to adjust the dosage by the doctor (usually the doctor will reduce the dose by half). In this group of patients, the drug should not be used for more than 14 days.
3. Infections caused by mycobacteria: in children, the dose is 15-30 mg / kg body weight per day in 2 divided doses (i.e. 7,5-15 mg / kg body weight twice a day). The maximum dose is 2 mg twice daily. The doctor will determine the duration of the treatment; it should be continued as long as a favorable clinical effect is observed.

Fromilid in the form of granules for suspension preparation is intended for oral use. Mix the granules with an appropriate amount of water (up to the marked line) with the amount of boiled, cold water and shake the bottle vigorously to obtain a homogeneous suspension. If necessary, top up with water up to the marked line. The prepared suspension can be taken with or without food. Can be taken with milk. The bottle should be shaken before each use. The suspension should be measured using the applicator included in the package. The suspension contains tiny grains that should not be chewed because of the bitter taste.

Fromilid – caution

1. During treatment with Fromilid, care should be taken in people: with severe renal failure, liver dysfunction, myasthenia gravis, in old age and with renal failure, using colchicine in parallel, while using other ototoxic drugs; During treatment and after its completion, the function of the vestibular system and the hearing organs should be monitored, with coronary heart disease, severe heart failure, hypomagnesaemia, bradycardia (<50 beats per minute).
2. The drug is not recommended for use in patients with congenital or documented acquired QT prolongation or with a history of ventricular arrhythmias.
3. Fromilide may cause side effects in the form of dizziness or convulsions, which may impair the ability to drive and use machines.
4. Pregnant women should consult a doctor before taking the drug.
5. The clarithromycin contained in the drug passes into breast milk.
6. The use of Fromilid in the treatment of Helicobacter pylori infection may result in the development of microorganisms resistant to the drug.
7. Patients with hereditary problems associated with fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency should not use the preparation because it contains sucrose.

Fromilid and other drugs

Fromilid should not be used in parallel with the following drugs:

1. verapamil,
2. cisapride, pimozide, astemizole and terfenadine as this may lead to prolongation of the QT interval on the ECG and to heart rhythm disturbances including ventricular tachycardia.
3. ergotamine and dihydroergotamine as this may cause acute ergotism
4. cytochrome P-450 inducers (e.g. rifampicin, phenytoin, carbamazepine, phenobarbital, St. John’s wort, efavirenz, nevirapine, and rifapentine)
5. rifabutin, as the concentration of this medicine may increase and the concentration of clarithromycin decreases,
6. drugs metabolized mainly by cytochrome P-450 (alprazolam, astemizole, carbamazepine, cilostazol, cisapride, cyclosporin, disopyramide, ergot alkaloids, lovastatin, methylprednisolone, midazolam, omeprazole, oral anticoagulants, pimozide, quinidine, sildasthena, sildenimus tacrolimus, terfenadine, triazolam and vinblastine, phenytoin, theophylline and valproate); such a combination may increase the concentration of the co-administered drug, which may lead to an increase or prolongation of both its therapeutic and side effects,
7. antiarrhythmic drugs (e.g. quinidine, disopyramide),
8. phosphodiesterase inhibitors used to treat erectile dysfunction (e.g. sildenafil, tadalafil, vardenafil),
9. theophylline, carbamazepine, tolterodine – there may be a slight increase in their blood levels, your doctor may decide to reduce their dose,
10. intravenous midazolam, triazolam, alprazolam,
11. colchicine; colchicine poisoning may occur,
12. digoxin,
13. zidovudine; clarithromycin,

Fromilid – side effects

Fromilid can cause, among other things: insomnia, taste disturbance, headache, change in taste, diarrhea, vomiting, indigestion, nausea, abdominal pain, liver function test abnormal, rash, sweating, pseudomembranous colitis, colitis, erysipelas, erythematous dandruff, agranulocytosis, thrombocytopenia , anaphylactic reaction, hypoglycaemia, psychotic disorders, confusional state, depersonalisation, depression, hallucinations, disorientation, abnormal dreams, convulsions, lack of taste sensation, mistaken sense of smell, anosmia, deafness, torsade de pointes, ventricular tachycardia.