Telithromycin

A derivative of erythromycin, antibacterial spectrum of telithromycin is similar to that of macrolides and it is also active against penicillin- and erythromycin-resistant Streptococcus pneumoniae. Antibiotics require constant drug level in body for therapeutic effect. This is achieved by taking the medication at regular interval of time throughout the day and night as prescribed .It is important to take the drug for the full time period as prescribed. If you discontinue the therapy, it may result in ineffective treatment.

Brands
ENGTEL TELITHRO KETEL TELITHRO TELROM TELMARK TELROM TEL-MYCIN
Adult Dose
Dose: 800 mg
Single Dose: 800 (800)
Frequency: 24 hourly
Route: PO
Instructions: For 5 days for Beta-hemolytic streptococcal pharyngitis or tonsilitis.
Neonatal
Paedriatic
Characteristics
. It is of Semi Synthetic origin. It belongs to Antibacterial (Proetin synthesis inhibitor) pharmacological group on the basis of mechanism of action and also classified in Antibiotic, Macrolide pharmacological group.
Contraindications
Telithromycin is contraindicated in conditions like Breast feeding.
Effects
The symptomatic adverse reactions produced by Telithromycin are more or less tolerable and if they become severe, they can be treated symptomatically, these include Flatulence, Anorexia, Diarrhea, Palpitation, Constipation, Insomnia, Abdominal pain, Blurred vision, Pruritus, Hypotension, Nausea and vomiting, Muscle cramps, Facial edema, Paresthesia/hyperesthesia, Eosinophilia, Antibiotic-associated colitis, Arrhythmia.
Indications
Telithromycin is primarily indicated in conditions like Prevention of relapse in duodenal ulcer, Sedation in intensive care, Severe or recurrent duodenal and gastric ulcertion, Sinusitis, Tonsillitis.
Interactions
Telithromycin is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementCarbamazepineCarbamazepine is likely to result in subtherapeutic levels of telithromycin and loss of effect.CisaprideThe use of Teicoplanin is contraindicated with cisapride.Clorazepate (K)DigoxinMonitoring of digoxin side effects or serum levels should be considered during concomitant administration of digoxin and Teicoplanin.ErlotinibThis CYP3A4 inhibitor increases levels/toxicity of erlotinibPhenobarbitonePhenobarbitone is likely to result in subtherapeutic levels of telithromycin and loss of effect.Phenytoin (Na)Phenytoin (Na) is likely to result in subtherapeutic levels of telithromycin and loss of effect.PimozideThere is a potential risk of increased pimozide plasma levels by inhibition of CYP 3A4 pathways by Teicoplanin. Concurrent use is contraindicated.SimvastatinSimvastatin levels were increased by Teicoplanin when used concurrently.SunitinibMay increases sunitinib concentrations.VemurafenibTelithromycin inhibits P-gp, glucuronidation and CYP3A4, and increases plasma concentration of Vemurafenib.VORICONAZOLEVoriconazole may increase the serum concentration of telithromycin by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Abnormal LFTs Elevation in ALT or ASTIncreased transaminases levels
Risks
Drug should not be given to Pregnant Mothers, Cardiac / Hypertensive Patients, and patients suffering from Kidney dysfunction.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Warnings
Telithromycin should be used with caution in hepatic impairment; renal impairment (use half normal dose if creatinine clearance less than 30ml/min); pregnancy (use only if potential benefit outweighs risk); coronary heart disease, ventricular arrhythmias, brady cardia, hypokalaemia, hypomagnesaemia, risk of QT interval prolongation; cocumitant adminstration of drug that prolong QT interval. Arrhythmias: Avoid cocomitant adminstration with pimozide or terfenadine.
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