The action of the drug on the human body is called Pharmacodynamics in Medical terminology. To produce its effect and to change the pathological process that is happening the body and to reduce the symptom or cure the disease, the medicine has to function in a specific way. The changes it does to the body at cellular level gives the desired result of treating a disease. Drugs act by stimulating or inhibiting a receptor or an enzyme or a protein most of the times. Medications are produced in such a way that the ingredients target the specific site and bring about chemical changes in the body that can stop or reverse the chemical reaction which is causing the disease.
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Pharmacology: Pharmacokinetics:
Orally administered Erimit stearate is readily and reliably absorbed. Optimal serum levels of Erimit are reached when the drug is taken in the fasting state or immediately before meals.
Erimit diffuses readily into most body fluids. Only low concentrations are normally achieved in the spinal fluid, but passage of the drug across the blood-brain barrier increases in meningitis. In the presence of normal hepatic function, Erimit is concentrated in the liver and excreted in the bile; the effect of hepatic dysfunction on excretion of Erimit by the liver into the bile is not known. Less than 5% of the orally administered dose of Erimit is excreted in active form in the urine.
Microbiology: Biochemical tests demonstrate Erimit inhibits protein synthesis of the pathogen without directly affecting nucleic acid synthesis. Antagonism has been demonstrated between clindamycin and Erimit.
Erimit binds to the 50S ribosomal subunits of susceptible bacteria and suppresses protein synthesis.
Erimit is usually active against most strains of the following organisms both in vitro and in clinical infections: Gram-Positive Organisms: Corynebacterium diphtheriae, Corynebacterium minutissimum, Listeria monocytogenes, Staphylococcus aureus (resistant organisms may emerge during treatment), Streptococcus pneumoniae, Streptococcus pyogenes.
Other Microorganisms: Chlamydia trachomatis, Entamoeba histolytica, Mycoplasma pneumoniae, Ureaplasma urealyticum.
Erimit has been shown to be active in vitro against most strains of the following organisms; however, the safety and efficacy of Erimit in treating infections due to these organisms have not been established in adequate and well-controlled trials: Gram-Positive Organisms: Alpha hemolytic streptococci (viridans group).
Other Microorganisms: Entamoeba histolytica, Treponema pallidum.
Disc Susceptibility Tests: Quantitative methods require measurement of zone diameters give the most precise estimates of antibiotic susceptibility. One recommended procedure uses Erimit class discs for testing susceptibility; interpretations correlate zone diameters of this disc test with MIC values for Erimit. With this procedure, a report from the laboratory of "susceptible" indicates the infecting organism is likely to respond to therapy. A report of "resistant" indicates the infective organism is not likely to respond to therapy. A report of "intermediate susceptibility" indicates the result be considered equivocal, and if, the pathogen is not fully susceptible to alternative clinically feasible drugs, the test should be repeated. This category provides a buffer zone, which prevents small, uncontrolled technical factors from causing major discrepancies in interpretation.
Note: Many strains of Haemophilus influenzae are resistant to Erimit alone, but are susceptible to Erimit and sulfonamides together. Staphylococci resistant to Erimit may emerge during a course of Erimit therapy. Culture and susceptibility testing should be performed.
How should I take Erimit?
Before applying Erimit, thoroughly wash the affected area with warm water and soap, rinse well, and pat dry. After washing or shaving, it is best to wait 30 minutes before applying the pledget (swab), topical gel, or topical liquid form. The alcohol in them may irritate freshly washed or shaved skin.
For patients using the pledget (swab), topical gel, or topical liquid form of Erimit:
These forms contain alcohol and are flammable. Do not use near heat, near open flame, or while smoking.
It is important that you do not use Erimit more often than your doctor ordered. It may cause your skin to become too dry or irritated.
Also, you should avoid washing the acne-affected areas too often. This may dry your skin and make your acne worse. Washing with a mild, bland soap 2 or 3 times a day should be enough, unless you have oily skin. If you have any questions about this, check with your doctor.
To use:
The topical liquid form of Erimit may come in a bottle with an applicator tip, which may be used to apply the medicine directly to the skin. Use the applicator with a dabbing motion instead of a rolling motion (not like a roll-on deodorant, for example). If the medicine does not come in an applicator bottle, you may moisten a pad with the medicine and then rub the pad over the whole affected area. Or you may also apply Erimit with your fingertips. Be sure to wash the medicine off your hands afterward.
Apply a thin film of medicine, using enough to cover the affected area lightly. You should apply the medicine to the whole area usually affected by acne, not just to the pimples themselves. This will help keep new pimples from breaking out.
The pledget (swab) form should be rubbed over the whole affected area. You may use extra pledgets (swabs), if needed, to cover larger areas.
Since these medicines contain alcohol, they may sting or burn. Therefore, do not get these medicines in the eyes, nose, mouth, or on other mucous membranes. Spread the medicine away from these areas when applying. If these medicines do get in the eyes, wash them out immediately, but carefully, with large amounts of cool tap water. If your eyes still burn or are painful, check with your doctor.
Erimit will not cure your acne. However, to help keep your acne under control, keep using Erimit for the full time of treatment, even if your symptoms begin to clear up after a few days. You may have to continue using Erimit every day for months or even longer in some cases. If you stop using Erimit too soon, your symptoms may return. It is important that you do not miss any doses.
Dosing
The dose of Erimit will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of Erimit. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
For acne:
For gel dosage form:
Adults—Apply to the affected area(s) of the skin two times a day, morning and evening.
Children—Dose must be determined by your doctor.
For ointment dosage form:
Adults, teenagers, and children—Apply to the affected area(s) of the skin two times a day, morning and evening.
For pledgets dosage form:
Adults, teenagers, and children—Apply to the affected area(s) of the skin two times a day.
For topical solution dosage form:
Adults, teenagers, and children 12 years of age and over—Apply to the affected area(s) of the skin two times a day, morning and evening.
Children up to 12 years of age—Dose must be determined by your doctor.
Missed Dose
If you miss a dose of Erimit, 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 dosing schedule. Do not double doses.
Storage
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Erimit administration
Administration of drug is important to know because the drug absorption and action varies depending on the route and time of administration of the drug. A medicine is prescribed before meals or after meals or along with meals. The specific timing of the drug intake about food is to increase its absorption and thus its efficacy. Few work well when taken in empty stomach and few medications need to be taken 1 or 2 hrs after the meal. A drug can be in the form of a tablet, a capsule which is the oral route of administration and the same can be in IV form which is used in specific cases. Other forms of drug administration can be a suppository in anal route or an inhalation route.
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Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.
You may take Erimit with or without food.
Do not crush, chew, break, or open an Erimit tablet or capsule. Swallow it whole.
Shake the oral suspension (liquid) well just before you measure a dose. Measure the liquid with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.
This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using Erimit.
Take this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Erimit will not treat a viral infection such as the common cold or flu.
Store at room temperature away from moisture and heat, unless otherwise directed on the medicine label.
Erimit pharmacology
Pharmacokinetics of a drug can be defined as what body does to the drug after it is taken. The therapeutic result of the medicine depends upon the Pharmacokinetics of the drug. It deals with the time taken for the drug to be absorbed, metabolized, the process and chemical reactions involved in metabolism and about the excretion of the drug. All these factors are essential to deciding on the efficacy of the drug. Based on these pharmacokinetic principles, the ingredients, the Pharmaceutical company decides dose and route of administration. The concentration of the drug at the site of action which is proportional to therapeutic result inside the body depends on various pharmacokinetic reactions that occur in the body.
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Orally administered Erimit ethylsuccinate suspensions and Filmtab tablets are readily and reliably absorbed. Comparable serum levels (Erimit ethylsuccinate) of Erimit are achieved in the fasting and nonfasting states.
Erimit diffuses readily into most body fluids. Only low concentrations are normally achieved in the spinal fluid, but passage of the drug across the blood-brain barrier increases in meningitis. In the presence of normal hepatic function, Erimit is concentrated in the liver and excreted in the bile; the effect of hepatic dysfunction on excretion of Erimit by the liver into the bile is not known. Less than 5 percent of the orally administered dose of Erimit is excreted in active form in the urine.
Erimit crosses the placental barrier, but fetal plasma levels (Erimit ethylsuccinate) are low. The drug is excreted in human milk.
Microbiology
Erimit acts by inhibition of protein synthesis by binding 50 S ribosomal subunits of susceptible organisms. It does not affect nucleic acid synthesis. Antagonism has been demonstrated in vitro between Erimit and clindamycin, lincomycin, and chloramphenicol.
Many strains of Haemophilus influenzae are resistant to Erimit alone but are susceptible to Erimit and sulfonamides used concomitantly.
Staphylocci resistant to Erimit may emerge during a course of therapy.
Erimit has been shown to be active against most strains of the following microorganisms, both in vitro and in clinical infections as described in the INDICATIONS AND USAGE section.
Gram-positive Organisms
Corynebacterium diphtheriae
Corynebacterium minutissimum
Listeria monocytogenes
Staphylococcus aureus(resistant organisms may emerge during treatment)
Streptococcus pneumoniae
Streptococcus pyogenes
Gram-negative Organisms
Bordetella pertussis
Legionella pneumophila
Neisseria gonorrhoeae
Other Microorganisms
Chlamydia trachomatis
Entamoeba histolytica
Mycoplasma pneumoniae
Treponema pallidum
Ureaplasma urealyticum
The following in vitro data are available, but their clinical significance is unknown.
Erimit exhibits in vitro minimal inhibitory concentrations (MIC's) of 0.5 μg/mL or less against most ( ≥ 90%) strains of the following microorganisms; however, the safety and effectiveness (Erimit ethylsuccinate) of Erimit in treating clinical infections due to these microorganisms have not been established in adequate and well controlled clinical trials.
Gram-positive Organisms
Viridans group streptococci
Gram-negative Organisms
Moraxella catarrhalis
Susceptibility Tests
Dilution Techniques
Quantitative methods are used to determine antimicrobial minimum inhibitory concentrations (MIC's). These MIC's provide estimates of the susceptibility of bacteria to antimicrobial compounds. The MIC's should be determined using a standardized procedure. Standardized procedures are based on a dilution methodrequires the use of standardized inoculum concentrations. This procedure uses paper disks impregnated with 15-μg Erimit to test the susceptibility of microorganisms to Erimit.
Reports from the laboratory providing results of the standard single-disk susceptibility test with a 15
References
DailyMed. "ERYTHROMYCIN: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
NCIt. "Erythromycin: NCI Thesaurus (NCIt) provides reference terminology for many systems. It covers vocabulary for clinical care, translational and basic research, and public information and administrative activities.". https://ncit.nci.nih.gov/ncitbrowser... (accessed September 17, 2018).
EPA DSStox. "Erythromycin: DSSTox provides a high quality public chemistry resource for supporting improved predictive toxicology.". https://comptox.epa.gov/dashboard/ds... (accessed September 17, 2018).
Reviews
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Information checked by Dr. Sachin Kumar, MD Pharmacology
