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Order Roxithromycin (Rulide) No Prescription 150mg

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Buy Roxithromycin Online

Roxithromycin is authorised in the world under the following brand names: ROX, Rulid, Rulide, Surlid.

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Roxithromycin [Rulide 150mg]

Drug Nomenclature

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Synonyms: RU-28965; RU-965; Roksitromicinas; Roksitromysiini; Roxithromycin; Roxithromycinum; Roxitromicin; Roxitromicina; Roxitromycin

USAN: Roxithromycin
INN: Roxithromycin [rINN (en)]
INN: Roxitromicina [rINN (es)]
INN: Roxithromycine [rINN (fr)]
INN: Roxithromycinum [rINN (la)]
INN: Рокситромицин [rINN (ru)]
Chemical name: Erythromycin 9-{O-[(2-methoxyethoxy)methyl]oxime}
Molecular formula: C41H76N2O15 =837.0
CAS: 80214-83-1
ATC code: J01FA06

Pharmacopoeias. In China, Europe, and Japan.

European Pharmacopoeia, 6th ed., 2008 and Supplements 6.1 and 6.2 (Roxithromycin). A white or almost white, crystalline powder. It exhibits polymorphism. Very slightly soluble in water; freely soluble in alcohol, in acetone, and in dichloromethane; slightly soluble in dilute hydrochloric acid. Store in airtight containers.

Roxithromycin (Rulide)

Adverse Effects and Precautions

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As for Erythromycin.

Gastrointestinal disturbances are the most frequent adverse effect, but are less frequent than with erythromycin.

The dose of roxithromycin may need to be reduced in patients with hepatic or renal impairment.

Effects on the kidneys

Acute interstitial nephritis has been reported in a patient given roxithromycin; renal function improved over several days after the drug was stopped.

Effects on the lungs

Acute eosinophilic pneumonia was attributed in a patient to the use of roxithromycin. The condition resolved after treatment with methylprednisolone.

Effects on the pancreas

Acute pancreatitis, with duodenal inflammation, pain, pancreatic enlargement, and raised serumamylase developed in a patient within 24 hours of substituting roxithromycin for erythromycin ethyl succinate. Symptoms resolved rapidly once roxithromycin was stopped.

Eosinophilia

For a report of an eosinophilic syndrome in a patient after treatment with azithromycin or roxithromycin, see Azithromycin. See also under Effects on the Lungs, above.

Interactions

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For a discussion of drug interactions of macrolide anti-bacterials, see Erythromycin.

Roxithromycin has a much lower affinity for cytochrome P450 isoenzymes than erythromycin and therefore has fewer interactions. It does not appear to interact with antacids, carbamazepine, oral contraceptives, prednisolone, or ranitidine.

Antimicrobial Action

As for Erythromycin. It is reported to be as active or slightly less active than erythromycin.

Pharmacokinetics

Roxithromycin is absorbed after oral doses with a bio-availability of about 50%. Peak plasma concentrations of about 6 to 8 micrograms/mL occur around 2 hours after a single dose of 150 mg. The mean peak plasma concentration at steady state after a dose of 150 mg twice daily is 9.3 micrograms/mL. Absorption is reduced when taken after a meal. It is widely distributed into tissues and body fluids; high concentrations are taken up into white blood cells. Small amounts of roxithromycin are distributed into breast milk. It is about 96% bound to plasma proteins (mainly aracid glycoprotein) at trough concentrations, but binding is saturable, and only about 87% is bound at usual peak concentrations. Small amounts of roxithromycin are metabolised in the liver, and the majority of a dose is excreted in the faeces as unchanged drug and metabolites; about 7 to 10% is excreted in urine, and up to 15% via the lungs. The elimination half-life is reported to range from about 8 to 13 hours, but may be more prolonged in patients with hepatic or renal impairment and in children. It has been reported that roxithromycin is not substantially removed by peritoneal dialysis.

Uses and Administration

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Roxithromycin is a macrolide antibacterial with actions and uses similar to those of erythromycin. It is given orally to adults in a usual dose of 150 mg twice daily or sometimes 300 mg once daily, at least 15 minutes before meals, for 5 to 10 days in the treatment of susceptible infections.

Dosage may need to be modified in patients with hepatic or renal impairment (see below). For doses in infants and children, see below.

Administration in children

In children weighing from 6 up to 40 kg a dose of 5 to 8 mg/kg daily of roxithromycin may be used.

Administration in hepatic impairment

The licensed product information for roxithromycin notes that safety in hepatic impairment has not been established and advises halving the usual daily dose (see above) if used.

Administration in renal impairment

The licensed product information for roxithromycin notes that safety in renal impairment has not been established and dosage adjustment details are not specified.

A pharmacokinetic study in 20 subjects (10 with normal renal function and 10 with severely impaired function) suggested that doubling the dosage interval of roxithromycin would be suitable in those with a creatinine clearance of less than 15 mL/minute.

Hyperplasia

Gingival hyperplasia is a well recognised adverse effect of ciclosporin treatment; a small study indicated that roxithromycin could reduce overgrowth, possibly by an effect on transforming growth factor-β. For the use of another macrolide, azithromycin, for this indication see Hyperplasia.

Ischaemic heart disease

For mention of studies investigating roxithromycin in the prevention of ischaemic heart disease, see under Azithromycin.

Respiratory disorders

For reference to the use of roxithromycin in the management of respiratory disorders, see under Erythromycin.

Preparations

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Proprietary Preparations

  • Argentina: Anuar; Delos; Klomicina; Rulid; Sinurit;
  • Australia: Biaxsig; Roxar; Roximycin; Rulide;
  • Austria: Roxithrostad; Rulide;
  • Belgium: Claramid; Docroxithro; Rulid;
  • Brazil: Floxid; Rotram; Roxid; Roxina; Roxitran; Roxitricina; Roxitrom; Roxitromin; Rulid;
  • Chile: Ramivan;
  • Czech Republic: Rovenal; Rulid;
  • Denmark: Forilirr; Forimycin; Roximstad; Surlid;
  • Finland: Roxibion; Surlicl;
  • France: Claramid; Rulid; Subroxine;
  • Germany; Infectoroxit; Romyk Roxi; Roxipaed; Roxi-Puren; Roxi-Q; Roxisaar; Roxibeta; Roxidura; Roxigamma; Roxigrun; RoxiHefa; RoxiHexal; Roxiklinge; Roxithro-Lich; Rulid;
  • Greece: Acevor; Anti-Bio; Aristom/cin; Asmetic; Azuril; Bazuctril; Bicofen; Delitroxin; Erybros; Macrolid-S; Neo-Suxigal; Nirox; Oxetine; Redotrin; Roxibron; Roxicillin; Roximin; Roxitazon; Roxivinol; Roxy-Due; Roxyspes; Rulid; Seide; Siguon; Thriostaxil; Tirabicin; Toscam/cin-R; Uramilon; Vaselpin; Vomitoran;
  • Hong Kong; Roxicin; Rudin; Rulid; Uonin;
  • Hungary: Renicin; Rulid;
  • India: Biorox; Roxee; Roxem; Roxeptin; Roxibid; Roxid; Roxivista; Roxyrol; Unorox;
  • Indonesia: Anbiolid; Biostatik Ixor; Rolexit; Rulid; Ruxcine; Simacron; Sitro; Uplores; Xorin;
  • Israel: Roxo; Rulid;
  • Italy: Assoral; Overal; Rossitrol; Rulid
  • Malaysia: Roxcin; Roxinox; Rulid; Uonin;
  • Mexico: Crolix; Kensodic; Rulid Sertrom;
  • The Netherlands: Rulide;
  • New Zealand: Romicin;
  • Philippines: Macrol; Marulide; Rulid Ruthison; Thromyn;
  • Poland: Renicin; Rolicyn; Roxiratio; Roxitron; Rulid; Xitrocin;
  • Portugal: Inferoxin; Odonticina; Roxitron; Rulide;
  • South Africa: Roxulide; Roxxibid; Rulide; Throsyn;
  • Singapore; Roxid; Rulid;
  • Spain: Macrosil; Rotramin; Rulide;
  • Sweden: Surlid;
  • Switzerland: Rulid;
  • Thailand: Ammirox; Eroxade; Poliroxin; Rothricin; Roxcin; Roxicin; Roxilan; Roximin; Roxithro; Roxithroxyl; Roxitin; Roxitop; Roxlecon; Roxomycin; Roxthomed; Roxthrin; Roxto; Roxtrocin; Roxy; Roxydin; Rucin; Rulid; Uonin; Utolid; Vesthromycin;
  • Turkey: Remora; Ritosin; Roksimin; Roksolit; Rulid;
  • Venezuela: Rancolid; Roxicure; Roxitrol; Rulid.

Multi-ingredient

  • India: Roxeptin-ME
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