Zithromax(Azithromycin)這個算是很強效的巨環類抗生素 如果你想要複習一下機轉,可以參考這邊:點我
這個藥物其實已經用好久了,從最古早的膠囊,到後來的錠劑,緩釋錠劑還有懸液劑,不過有時候,你卻會聽到醫師或是藥師跟你說,吃Zithromax時要空腹,甚至要空腹半小時,真的有需要這樣嗎? 根據仿單描述: I.V.: Infusate concentration and rate of infusion for azithromycin for injection should be either 1 mg/mL over 3 hours or 2 mg/mL over 1 hour. Other medications should not be infused simultaneously through the same I.V. line. Ophthalmic: Shake bottle once prior to each administration. Wash hands before and after instillation. Oral: Immediate release suspension and tablet may be taken without regard to food; extended release suspension should be taken on an empty stomach (at least 1 hour before or 2 hours following a meal), within 12 hours of reconstitution. 除非你是服用緩釋懸液劑,不過台灣沒有賣,所以並沒有必要空腹服用 甚至,廠商的病患衛教區裡面,還有說到: Take this medicine with or without food. Take with food if it causes an upset stomach. 又或者你是管灌病患,廠商也有說明: Stop tube feeding for 2 hours before giving this medicine. Restart tube feeding 1 hour after giving. 不過這段說明是針對懸液劑的,因為本身Zithromax是不建議磨粉的(所以才推出懸液劑呀) 可是為何會有要空腹服用的說明呢?因為以前是膠囊的劑型,根據實驗,膠囊劑型的zithromax會因為食物影響吸收,所以才叫病患空腹,但是一來膠囊已經停產了 二來,錠劑等新劑型並不需要空腹,所以就不需要再提醒病患空腹服用了。 如果你覺得這樣還不夠,那就繼續看下去: 我們從藥物動力學的角度來解釋: Micromedex綱要裡面就寫了: Effects of food:
minimal, no effect on AUC 接著我們看細項: Effects of Food 1) Oral suspension and tablets may be taken with or without food (Prod Info Zithromax(R), 2004; Simicevic et al, 1998). Bioavailability decreased with capsules (Drew & Gallis, 1992b; Hopkins, 1991c), which is not available in the U.S. a) The presence of food in the gastrointestinal tract may reduce the bioavailability of azithromycin CAPSULES by 50% (Drew & Gallis, 1992b; Hopkins, 1991c). Capsules should be taken at least 1 hour before or 2 hours after eating. 2) Oral, extended-release suspension should be taken on an empty stomach (at least 1 hour before or 2 hours following a meal) (Prod Info Zmax extended-release oral suspension, 2005). a) Compared with the fasting state, a high-fat meal increased the mean azithromycin Cmax by 115% and the mean AUC by 23% and a standard-meal increased the mean Cmax by 119% and the mean AUC by 12% (Prod Info Zmax extended-release oral suspension, 2005). 最後我們還有一個問題要解決:zithromax磨粉以後,要空腹嗎? 這個問題在文獻中沒有解答,所以我直接問了輝瑞的開發人員: 答案是:不用,因為從膠囊到錠劑,不是只有劑型的改變,賦型劑也變了,所以現在不管你有沒有磨粉,都不需要空腹。(至於賦型劑是什麼,就是商業機密,別逼他們了) 隨著季節的轉換,日夜溫差變大,過敏、感冒及肺炎的罹患人數也隨之增加。日前有一位二十來歲的大學生,因上呼吸道感染導致咳嗽、喉嚨痛、間歇性發燒,至一般診所治療一星期未改善,後接著高燒、畏寒三天,咳嗽加劇甚至咳到劇烈胸痛、腹痛,但無明顯濃痰或呼吸困難現象。經醫院胸腔X光檢查確診為肺炎,且經血液特殊細菌抗原檢查確定為黴漿菌感染,用了有效的抗生素後,發燒得到控制,病況也逐漸改善。
Azithromycin為新一代的紅黴素改良製劑,它和傳統紅黴素的不同為: |