Roxithromycin is indicated for the treatment of the following types of mild to
moderately severe infections caused by or likely to be caused by susceptible
micro-organisms: • upper respiratory tract infection - acute pharyngitis, tonsillitis and
• dental infections
• lower respiratory tract infection - acute bronchitis; acute exacerbations
of chronic bronchitis and community acquired pneumonia
• skin and skin structure infections
• non-gonococcal urethritis.
Uses of Roxithromycin in details
Roxithromycin is used to treat ear, nose and throat infections, pneumonia (lung infection), skin infections and infections of the genitalia.
Roxithromycin is a semi-synthetic macrolide antibiotic. It is very similar in composition, chemical structure and mechanism of action to erythromycin, azithromycin, or clarithromycin. Roxithromycin prevents bacteria from growing, by interfering with their protein synthesis. Roxithromycin binds to the subunit 50S of the bacterial ribosome, and thus inhibits the translocation of peptides. Roxithromycin has similar antimicrobial spectrum as erythromycin, but is more effective against certain gram-negative bacteria, particularly Legionella pneumophila. It can treat respiratory tract, urinary and soft tissue infections. It is in the United States, but is available in Australia.
Adult: 150 mg bid or 300 mg once daily for 5-10 days in susceptible infections.
Child: 6-40 kg: 5-8 mg/kg daily.
Renal impairment: Dosage adjustment may be required.
Hepatic impairment: Usual daily doses should be halved in hepatic impairment.
Roxithromycin has a much lower affinity for cytochrome P450 than
erythromycin, and consequently has fewer interactions. Interactions may be
observed, however, with drugs that bind to alpha-1-acid glycoprotein, e.g.
Roxithromycin does not appear to interact with oral contraceptives,
prednisolone, carbamazepine, ranitidine or antacids.
Theophylline. A study in normal subjects concurrently administered
roxithromycin and theophylline has shown some increase in the plasma
concentration of the latter. While a change in dosage is usually not required,
patients with high levels of theophylline at commencement of treatment
should have levels monitored.
Ergot alkaloids. Reactions of ergotism with possible peripheral necrosis have
been reported after concomitant therapy of macrolides with vasoconstrictive ergot alkaloids, particularly ergotamine and dihydroergotamine. Because a
clinical interaction with roxithromycin cannot be excluded, administration of
roxithromycin to patients taking ergot alkaloids is contraindicated.
Disopyramide. An in vitro study has shown that roxithromycin can displace
protein bound disopyramide; such an effect in vivo could result in increased
serum levels of disopyramide. Consequently, ECG and, if possible,
disopyramide serum levels should be monitored.
Terfenadine. Some macrolide antibiotics (e.g. erythromycin) may increase
serum levels of terfenadine. This can result in severe cardiovascular adverse
events, including QT prolongation, torsades de pointes and other ventricular
arrhythmias. Such a reaction has not been documented with roxithromycin,
which has a much lower affinity for cytochrome P450 than erythromycin.
However, in the absence of a systematic interaction study, concomitant
administration of roxithromycin and terfenadine is not recommended.
Astemizole, cisapride, pimozide. Other drugs, such as astemizole, cisapride
or pimozide, which are metabolised by the hepatic isozyme CYP3A4, have
been associated with QT interval prolongation and/or cardiac arrhythmias
(typically torsades de pointes) as a result of an increase in their serum level
subsequent to interaction with significant inhibitors of this isozyme, including
some macrolide antibacterials. Although roxithromycin has no or limited ability
to complex CYP3A4 and hence to inhibit the metabolism of other drugs
processed by this isozyme, a potential for clinical interaction of roxithromycin
with the above mentioned drugs cannot be either ascertained or ruled out in
confidence. Thus, concomitant administration of roxithromycin and such drugs
is not recommended.
Warfarin. While no interaction was observed in volunteer studies,
roxithromycin appears to interact with warfarin. Increases in prothrombin time
(international normalised ratio (INR)) have been reported in patients treated
concomitantly with roxithromycin and warfarin or the related vitamin K
antagonist phenprocoumon, and severe bleeding episodes have occurred as
Digoxin and other cardiac glycosides. A study in healthy volunteers has
shown that roxithromycin may increase the absorption of digoxin. This effect,
common to other macrolides, may very rarely result in cardiac glycoside
toxicity. This may be manifested by symptoms such as nausea, vomiting,
diarrhoea, headache or dizziness. Cardiac glycoside toxicity may also elicit
heart conduction and/or rhythm disorders. Consequently, in patients treated
with roxithromycin and digoxin or another cardiac glycoside, ECG and, if
possible, the serum level of the cardiac glycoside should be monitored. This is
mandatory if symptoms suggesting cardiac glycoside overdosage have
Midazolam. Roxithromycin, like other macrolides, may increase the area
under the midazolam concentration-time curve and the midazolam half-life.
Thus, the effects of midazolam may be enhanced and prolonged in patients treated with roxithromycin. There is no conclusive evidence for an interaction
between roxithromycin and triazolam.
Cyclosporin. A slight increase in plasma concentrations of cyclosporin A has
been observed. This does not generally necessitate altering the usual dosage.
Roxithromycin side effects
Applies to benzoyl peroxide topical: topical bar, topical cream, topical foam, topical gel/jelly, topical liquid, topical lotion, topical pad, topical soap, topical solution
In addition to its needed effects, some unwanted effects may be caused by benzoyl peroxide topical (the active ingredient contained in Roxithromycin). In the event that any of these side effects do occur, they may require medical attention.
Major Side Effects
You should check with your doctor immediately if any of these side effects occur when taking benzoyl peroxide topical:
Less common or rare:
- Painful irritation of skin, including burning, blistering, crusting, itching, severe redness, or swelling
- skin rash
- Difficult breathing
- swelling of the eyes, face, lips, or tongue
- tightness in the throat
If any of the following symptoms of overdose occur while taking benzoyl peroxide topical, get emergency help immediately:
Symptoms of overdose:
- Burning, itching, scaling, redness, or swelling of skin (severe)
Minor Side Effects
Some of the side effects that can occur with benzoyl peroxide topical may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:
- Dryness or peeling of the skin (may occur after a few days)
- feeling of warmth, mild stinging, and redness of the skin
Known allergy to macrolides.
Concomitant administration of roxithromycin with vasoconstrictive ergot (alkaloid) derivatives is contra-indicated since symptoms of ergotism have been described with other macrolides.
Active ingredient matches for Roxithromycin:
- PubChem. "roxithromycin". https://pubchem.ncbi.nlm.nih.gov/compoun... (accessed September 17, 2018).
- DrugBank. "roxithromycin". http://www.drugbank.ca/drugs/DB00778 (accessed September 17, 2018).
- Wikipedia. "roxithromycin: Link to the compound information in Wikipedia.". https://en.wikipedia.org/wiki/Roxithromy... (accessed September 17, 2018).
- MeSH. "Anti-Bacterial Agents". https://www.ncbi.nlm.nih.gov/mesh/680009... (accessed September 17, 2018).
- KEGG. "Cytochrome P450 interactions". http://www.genome.jp/kegg-bin/get_htext?... (accessed September 17, 2018).
- DTP/NCI. "roxithromycin: The NCI Development Therapeutics Program (DTP) provides services and resources to the academic and private-sector research communities worldwide to facilitate the discovery and development of new cancer therapeutic agents.". https://dtp.cancer.gov/dtpstandard/servl... (accessed September 17, 2018).
- European Chemicals Agency - ECHA. "(3R,4S,5S,6R,7R,9R,10E,11S,12R,13S,14R)-6-[4-(dimethylamino)-3-hydroxy-6-methyloxan-2-yl]oxy-14-ethyl-7,12,13-trihydroxy-4-(5-hydroxy-4-methoxy-4,6-dimethyloxan-2-yl)oxy-10-(2-methoxyethoxymethoxyimino)-3,5,7,9,11,13-hexamethyl-oxacyclotetradecan-2-one: The information provided here is aggregated from the "Notified classification and labelling" from ECHA's C&L Inventory. ". https://echa.europa.eu/information-on-ch... (accessed September 17, 2018).
ReviewsThe results of a survey conducted on ndrugs.com for Roxithromycin are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Roxithromycin. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.
1 consumer reported usefulWas the Roxithromycin drug useful in terms of decreasing the symptom or the disease?
According to the reports released by ndrugs.com website users, the below mentioned percentages of users say the drug is useful / not useful to them in decreasing their symptoms/disease. The usefulness of the drug depends on many factors, like severity of the disease, perception of symptom, or disease by the patient, brand name used [matters only to a certain extent], other associated conditions of the patient. If the drug is not effective or useful in your case, you need to meet the doctor to get re-evaluated about your symptoms/disease, and he will prescribe an alternative drug.
2 consumers reported age
Information checked by Dr. Sachin Kumar, MD Pharmacology