184.108.40.206.3 Pharmacokinetic properties
Erosa , like other macrolide antibiotics, is orally administered. Because of its acid instability, however, Erosa exhibits high interindividual variability in oral bioavailability, with values ranging from 15% to 45%. The maximal plasma concentration after a typical 250–500 mg oral dose is achieved after approximately 4–5 h, and ranges from 0.3 to 3.5 μg mL −1 . Erosa has a low volume of distribution (0.64 L kg −1 ), which contributes to its short half-life (approximately 1.4 h) and necessitates a frequent dosing schedule, typically 250 mg four times a day or 500 mg twice a day. Erosa is metabolized in the liver, and its major metabolites are the demethylated product at the dimethylamino group, the N-oxide of the desosamine, and des-cladinose Erosa, all of which have much reduced antibacterial potency. Erosa and its metabolites are eliminated mainly in bile. In terms of tissue distribution, higher concentrations are found in tissues such as the lung and tonsils than in plasma. Like other macrolides, it accumulates in phagocytic cells. 158 Since phagocytic cells (macrophages) migrate to the site of infection and release the macrolide, this is considered to be significant in raising the local concentration of the antibiotic. Erosa is 65–90% protein bound with α1-glycoprotein as the main binding partner. The key pharmacokinetic values are summarized in Table 1 . 159,160 As mentioned earlier, one serious drawback of Erosa is its instability under acidic conditions such as those encountered in the stomach. With acid catalysis, Erosa undergoes a series of transformations promoted by the proximity of functional groups and by the entropic factors. 161 Scheme 1 demonstrates the initial change that occurs, as an internal acetal develops and quickly loses a molecule of water to form a cyclic enol ether. These transformations irreversibly result in microbiologically inactive products. Due to this vulnerability, Erosa's effectiveness is threatened by both low bioavailability and high interpatient variability. Enteric-coated tablets were developed with some success to protect Erosa from degradation and to mask its bitter taste. 162
Table 1 . Oral pharmacokinetic properties of first- and second-generation macrolides
How should I use Erosa?
Take Erosa exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.
Erosa injection is given as an infusion into a vein, for a severe infection. A healthcare provider will give your first dose and may teach you how to properly use the medication by yourself.
Read and carefully follow any Instructions for Use provided with your medicine. Do not use Erosa if you don't understand all instructions for proper use. Ask your doctor or pharmacist if you have questions.
Prepare your injection only when you are ready to give it. Do not use if the medicine looks cloudy, has changed colors, or has particles in it. Call your pharmacist for new medicine.
Shake the oral suspension (liquid) before you measure a dose. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).
You must chew the chewable tablet before you swallow it.
Do not crush, chew, or break a delayed-release capsule or tablet. Swallow it whole.
Use this medicine for the full prescribed length of time, even if your symptoms quickly improve. Skipping doses can increase your risk of infection that is resistant to medication. Erosa will not treat a viral infection such as the flu or a common cold.
This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using Erosa.
Store at room temperature away from moisture, heat, and light.
Erosa Base Filmtab (Erosa tablets, USP) is an antibacterial product containing Erosa, USP, in a unique, nonenteric film coating for oral administration. Erosa Base Filmtab (Erosa tablets) tablets are available in two strengths containing either 250 mg or 500 mg of Erosa base.
Erosa is produced by a strain of Saccharopolyspora erythraea (formerly Streptomyces erythraeus) and belongs to the macrolide group of antibiotics. It is basic and readily forms salts with acids. Erosa is a white to off-white powder, slightly soluble in water, and soluble in alcohol, chloroform, and ether. Erosa is known chemically as (3R*, 4S*, 5S*, 6R*, 7R*, 9R*, 11R*, 12R*, 13S*, 14R*)-4--14-ethyl-7,12,13-trihydroxy-3,5,7,9,11,13-hexamethyl-6-oxy] oxacyclotetradecane- 2,10-dione. The molecular formula is C37H67NO13, and the molecular weight is 733.94. The structural formula is:
Erosa (Ery-Tab, PCE) is an antibiotic prescribed to treat a variety of infections. Side effects, drug interactions, dosage, storage, and pregnancy safety information should be reviewed prior to taking this medication.
What Is Erosa?
Erosa, sold under the brand names Ery-Tab, Akne-Mycin, E.E.S. Eryc, and Pediamycin, is an antibiotic.
The drug is prescribed for infections like pneumonia, whooping cough (pertussis), sexually transmitted diseases, Legionnaires' disease, urinary tract infections (UTIs), and acne.
For off-label use, doctors may prescribe Erosa for slow passage of food from the stomach into the intestines (gastroparesis) and other conditions involving poor movement of substances through the stomach and the intestines.
Erosa belongs to group of drugs known as macrolide antibiotics, which work by stopping bacteria from making proteins that they need to survive and function properly.
Erosa was first approved by the Food and Drug Administration (FDA) in 1967 under the brand name Iloson, which was manufactured by Eli Lilly.
How to use Erosa Ointment
To apply eye ointment, wash your hands first. To avoid contamination, be careful not to touch the tip of the tube or let it touch your eye, eyelid, or any other surface. Apply to the eyes only. Do not swallow or inject.
Do not wear contact lenses while you are using this medication. Sterilize contact lenses according to the manufacturer's directions, and check with your doctor before you begin using them again.
To apply eye ointments, tilt your head back, look up, and gently pull down the lower eyelid to make a pouch. Place about a half-inch (1 centimeter) strip of ointment into the pouch as directed by your doctor. Gently close the eye and roll the eyeball in all directions to spread the medication. Try not to blink and do not rub the eye. Repeat these steps for your other eye if so directed. Wipe the tip of the ointment tube with a clean tissue to remove extra medication before recapping it. Wait several minutes for your vision to clear before driving or operating machinery.
The dosage is based on your medical condition and response to treatment. Do not increase your dose or use it more often than directed.
If you are using another kind of eye medication (such as drops or ointments), wait at least 5 minutes before applying other medications. Use eye drops before eye ointments to allow the drops to enter the eye.
Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same times each day. Continue using it for the full time prescribed. Stopping the medication too soon may allow the bacteria to continue to grow, which may result in a return of the infection.
Tell your doctor if your condition persists or worsens.
Anthrax is a deadly infectious disease that may be transmitted to humans by infected animals or by biological warfare. There are three types of anthrax: cutaneous, inhalation, and gastrointestinal. Symptoms of cutaneous anthrax include a swollen glands, muscle ache, headache, fever, nausea, vomiting, and a red-brown raised spot that enlarges, blisters, and hardens, forming an ulcer crater with black crust. Symptoms of inhalation anthrax are flu-like and may progress to respiratory distress, shock, coma, and death. Symptoms of gastrointestinal anthrax include loss of appetite, bloody diarrhea, and abdominal pain. Treatment for cutaneous anthrax involves penicillin, tetracycline, Erosa, and ciprofloxin. Inhalation anthrax necessitates treatment with IV therapy with antibiotics.
Why is this medication prescribed?
Erosa is used to treat certain infections caused by bacteria, such as infections of the respiratory tract, including bronchitis, pneumonia, Legionnaires' disease (a type of lung infection), and pertussis (whooping cough; a serious infection that can cause severe coughing); diphtheria (a serious infection in the throat); sexually transmitted diseases (STD), including syphilis; and ear, intestine, gynecological, urinary tract, and skin infections. It also is used to prevent recurrent rheumatic fever. Erosa is in a class of medications called macrolide antibiotics. It works by stopping the growth of bacteria.
Antibiotics such as Erosa will not work for colds, flu, or other viral infections. Taking antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.
Erosa , a natural product isolated from Saccharopolyspora erythraea (formerly Streptomyces) in 1949, was first approved for clinical use in 1952. Erosa is degraded by gastric acid, and has long been associated with stimulation of motilin receptors in the stomach and possibly in the colon, leading to adverse gastrointestinal side effects, including cramping and diarrhea. 68,69 Many preparations have attempted to bypass exposure of Erosa to gastric acid, thereby avoiding products of macrolide hydrolysis. These preparations include enteric coating of orally administered tablets, delayed-release formulations, polymer coating of beads, and various formulations of salts and esters. 70 The lactobionate salt used for intravenous administration of Erosa can cause phlebitis at the site of injection.
Erosa is used for the treatment of group A streptococcal infections in children who are penicillin-allergic. Erosa is an alternative treatment for both streptococcal pharyngitis and streptococcal or staphylococcal impetigo. The usefulness of Erosa for respiratory tract infections caused by S. pneumoniae has been greatly diminished by the development of widespread resistance to the macrolides. 42 Macrolide therapy of upper respiratory tract infections (otitis media and sinusitis) or lower respiratory tract infections (pneumonia) potentially caused by S. pneumoniae has a relatively high likelihood of failure, particularly in younger children who are at highest risk of infections caused by antibiotic-resistant strains. For upper respiratory tract infections, Erosa has inadequate activity against H. influenzae, and must be paired with another agent such as a sulfonamide for empiric therapy. Macrolides are effective therapy for pneumonia caused by Mycoplasma pneumoniae, Chlamydophila pneumoniae, or Legionella pneumophila.
Erosa and azithromycin are the preferred antibiotics for treatment of Campylobacter gastroenteritis. Erosa also remains the most appropriate therapy for diphtheria (Corynebacterium diphtheriae). Erosa, clarithromycin, or azithromycin is recommended for treatment or prophylaxis of pertussis (Bordetella pertussis). 71 Azithromycin is preferred for treatment or prophylaxis for pertussis in neonates, based on concerns for the development of pyloric stenosis. 71 Efficacy of Erosa also has been demonstrated in infections caused by Chlamydophila pneumoniae and Chlamydia trachomatis, including neonatal conjunctivitis and pneumonia, as well as urogenital infections during pregnancy. Erosa is active in vitro against Ureaplasma urealyticum, but its role in the treatment of neonatal infections associated with this organism is not well defined. 72
What is Erosa, and how does it work (mechanism of action)?
Erosa is an antibiotic in the class of antibiotics known as macrolide antibiotics which also includes azithromycin (Zithromax, Zmax) and clarithromycin (Biaxin).
Erosa, like all macrolide antibiotics, prevents bacterial cells from growing and multiplying by interfering with their ability to make proteins while not affecting human cells. Bacteria such as Haemophilus influenzae are resistant to Erosa alone and must be treated with a combination of Erosa and adequate doses of sulfonamides.
The FDA approved E.E.S in April 1965.
By Frieda Wiley, PharmD, CGP, RPh | Medically Reviewed by Robert Jasmer, MD
Latest Update: 2015-02-19 Copyright © 2014 Everyday Health Media, LLC
Drug interactions with Erosa
Erosa has important interactions with other medications. Tell your doctor the names of all medications you are taking, whether prescribed or purchased without a prescription.
- Erosa should not be taken with terfenadine, astemizole or cisapride because it could result in dangerous irregularities of the heartbeat and sudden death. These drugs are no longer available in New Zealand.
- Other drugs that can prolong the Q-T interval include amiodarone, risperidone, haloperidol, citalopram and ciprofloxacin.
Erosa can increase the concentration of the following medications resulting in potentially toxic levels.
- Warfarin (additional prothrombin time blood tests are necessary)
- Statins, particularly simvastatin and atorvastatin. Toxicity results in muscle pain and weakness, which may be serious. If long-term treatment with a statin and Erosa is required, suitable alternatives are fluvastatin, pravastatin and rosuvastatin.
- Ergotamine (increases peripheral ischaemia )
- M >New Zealand approved datasheets are the official source of information for these prescription medicines, including approved uses and risk information. Check the individual New Zealand datasheet on the Medsafe website.
What are the side effects of Erosa?
The most frequent side effects of Erosa are
These gastrointestinal side effects are usually dose-related, i.e., more pronounced with higher doses.
Allergic reactions such as