Dosage of Roxithromycin in details
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.
- FDA/SPL Indexing Data. "21KOF230FA: The UNique Ingredient Identifier (UNII) is an alphanumeric substance identifier from the joint FDA/USP Substance Registration System (SRS).". https://www.fda.gov/ForIndustry/DataStan... (accessed September 18, 2017).
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.
2 consumers reported frequency of useHow frequently do I need to take Roxithromycin?
It was reported by ndrugs.com website users that Roxithromycin should ideally be taken Once in a day as the most common frequency of the Roxithromycin. You should you adhere strictly to the instructions and guidelines provided by your doctor on how frequently this Roxithromycin should be taken. Get another patient's view on how frequent the capsule should be used by clicking here.
1 consumer reported dosesWhat doses of Roxithromycin drug you have used?
The drug can be in various doses. Most anti-diabetic, anti-hypertensive drugs, pain killers, or antibiotics are in different low and high doses and prescribed by the doctors depending on the severity and demand of the condition suffered by the patient. In our reports, ndrugs.com website users used these doses of Roxithromycin drug in following percentages. Very few drugs come in a fixed dose or a single dose. Common conditions, like fever, have almost the same doses, e.g., [acetaminophen, 500mg] of drug used by the patient, even though it is available in various doses.
Information checked by Dr. Sachin Kumar, MD Pharmacology