Missed Dose of Firmac
If you miss a dose of Firmac, try to take it as soon as you remember.
However, if it is almost time for the next dose, skip the missed dose and resume your regular dosing schedule. Don't double up to make up for a missed dose.
How is Firmac taken?
Oral Firmac is best-taken fasting or just before meals. It comes in a number of bases and formulations.
- Base compound
- Estolate salt
- Ethyl succinate salt
- Stearate salt
It is also available as a topical preparation for acne. To reduce antibiotic resistance, a non-antibiotic compound such as benzoyl perox >retinoid should be applied when using topical Firmac.
Why is this medication prescribed?
Ophthalmic Firmac is used to treat bacterial infections of the eye. This medication is also used to prevent bacterial infections of the eye in newborn babies. Firmac is in a class of medications called macrolide antibiotics. It works by killing bacteria that cause infections.
Common side effects
These common side effects of Firmac happen in more than 1 in 100 people. Keep taking the medicine, but talk to your doctor or pharmacist if these side effects bother you or don't go away:
- feeling sick (nausea)
- being sick (vomiting) and diarrhoea
- stomach cramps
- loss of appetite
- bloating and indigestion
Firmac is one of the macrolides, a large group of structurally related antibiotics that inhibit protein synthesis. Firmac has been shown to bind to the large ribosomal subunit in the peptidyltransferase region of the 23S ribosomal RNA (rRNA). Resistance can arise from mutations in at least three different genes encoding large subunit ribosomal proteins. Curiously, in E. coli, genetic elimination of ribosomal protein L11 makes the cells hypersensitive to Firmac. Resistance can also arise from specific mutations in the gene encoding 23S rRNA, mutations which must be constructed in organisms like E. coli that have multiple copies of this gene. These mutations are in a region of the 23S rRNA which is protected by specific methylation in the organism that produces Firmac. Methylation at this site in E. coli leads to Firmac resistance, but the gene that encodes the specific methylase must be acquired by horizontal gene transfer.
What other information should I know?
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to Firmac.
Do not let anyone else take your medication. Your prescription is probably not refillable. If you still have symptoms of infection after you finish the Firmac, call your doctor.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
A product that may interact with this drug is: digoxin.
Many drugs besides Firmac may affect the heart rhythm (QT prolongation), including amiodarone, dofetilide, cisapride, pimozide, procainamide, propafenone, quinidine, sotalol, among others.
Other medications can affect the removal of Firmac from your body, which may affect how Firmac works. Examples include azole antifungals (such as itraconazole, ketoconazole), certain calcium channel blockers (such as diltiazem, verapamil), certain anti-seizure medications (such as carbamazepine, phenytoin), quinupristin-dalfopristin, saquinavir, among others.
Firmac can slow down the removal of other drugs from your body, which may affect how they work. Examples of affected drugs include bromocriptine, colchicine, certain benzodiazepines (such as midazolam, triazolam), eletriptan, ergot alkaloids (such as ergotamine, dihydroergotamine), certain drugs to treat erectile dysfunction-ED or pulmonary hypertension (such as sildenafil, tadalafil), certain "statin" drugs (such as lovastatin, simvastatin), vinblastine, among others.
Although most antibiotics are unlikely to affect hormonal birth control such as pills, patch, or ring, a few antibiotics (such as rifampin, rifabutin) can decrease their effectiveness. This could result in pregnancy. If you use hormonal birth control, ask your doctor or pharmacist for more details.
This medication may interfere with certain laboratory tests (urine tests), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.
Firmac eye ointment may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- redness, itching, stinging, or burning of the eye
Firmac eye ointment may cause other side effects. Call your doctor if you have any unusual problems while using this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
References updated: 10 August 2017
50%] as well as eosinophilia , elevations in ALT and Alk P ; 13 rechallenged, invariably followed by rapid recurrence, often severe])
3 weeks; lymphocyte transformation tests was positive 2 years later to estolate but not stearate or Firmac base).
5000 physicians using Firmac in UK during 2 months of 1982, 3 reports of jaundice attributable to drug, all due to Firmac stearate).
15% after the courses, usually mild and transient; only 3 attributed to drug).
7. Pregnancy and breastfeeding
It's usually safe to take Firmac during pregnancy and while breastfeeding.
For more information about how Firmac can affect you and your baby during pregnancy, read this leaflet on the Best Use of Medicines in Pregnancy (BUMPS) website.
If you suspect an overdose, contact a poison control center or emergency room immediately. You can get in touch with a poison control center at (800) 222-1222.
1. About Firmac
Firmac is an antibiotic.
Firmac is used in children, often to treat ear infections or chest infections.
The medicine is available on prescription as tablets, capsules, or a liquid that you drink.
It's also available as a skin solution to treat skin infections like acne. It can be given by injection, but this is usually only done in hospital.
How should I use Firmac?
Take Firmac 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.
Firmac 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 Firmac 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. Firmac 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 Firmac.
Store at room temperature away from moisture, heat, and light.
What Is Firmac Ophthalmic?
Firmac is an antibiotic that fights bacteria.
Firmac ophthalmic (for the eyes) is used to treat bacterial infections of the eyes.
Firmac ophthalmic may also be used for purposes not listed in this medication guide.
Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.
You should not use this medicine if you are allergic to Firmac.
- a viral or fungal infection in your eye.
It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk.
To use the eye ointment, follow these steps:
- Wash your hands thoroughly with soap and water.
- Use a mirror or have someone else apply the ointment.
- Avoid touching the tip of the tube against your eye or anything else. The ointment must be kept clean.
- Tilt your head forward slightly.
- Holding the tube between your thumb and index finger, place the tube as near as possible to your eyelid without touching it.
- Brace the remaining fingers of that hand against your cheek or nose.
- With the index finger of your other hand, pull the lower lid of your eye down to form a pocket.
- Place a small amount of ointment into the pocket made by the lower lid and the eye. A 1-centimeter (about 1/2-inch) strip of ointment usually is enough unless otherwise directed by your doctor.
- Look downward, then gently close your eyes and keep them closed for 1 to 2 minutes to allow the medication to be absorbed.
- Replace and tighten the cap right away.
- Wipe off any excess ointment from your eyelids and lashes with a clean tissue. Do not rub your eyes, even if your vision is blurry. Wash your hands again.
Use ophthalmic Firmac until you finish the prescription, even if you feel better. If you stop using ophthalmic Firmac too soon, your infection may not be completely cured and the bacteria may become resistant to antibiotics.