Troleandomycin

Oral
Susceptible infections

Should be taken on an empty stomach.

Hypersensitivity. Patients who previously developed liver disorders while receiving the drug.

Hepatic or renal impairment; predisposition to prolongation of QT interval; history of arrhythmias. Monitor LFT if used for >14 days or repeated courses used.

GI disturbances; hypersensitivity reactions.
Potentially Fatal: Stevens-Johnson syndrome; toxic epidermal necrolysis; hepatotoxicity; arrhythmias.

Increased plasma concentrations of calcium channel blockers, bromocriptine, aprepitant, opioids, carbamazepine, etoposide, warfarin, aminophylline, theophylline, carbamazepine, ciclosporin, methylprednisolone, toremifene, benzodiazepines and tacrolimus. Increased risk of hepatotoxicity with rifampicin. Increased risk of ergotism with ergot alkaloids.
Potentially Fatal: Increased risk of ventricular arrhythmias with astemizole, terfenadine, disopyramide, diltiazem, verapamil, mizolastine and cisapride. Increased plasma concentration of cabergoline. Increased risk of severe pruritus and cholestatic jaundice with oral contraceptives and hormonal replacement therapy. Increased risk of cardiotoxicity with pimozide. Increased concentrations with sirolimus. Increased risk of respiratory depression with alfentanil.

May interfere with measurements of urinary catecholamines and 17-hydroxycorticosteroids. False elevation of serum aspartate aminotransferase (AST) values when measured colorimetrically.

Description: Troleandomycin, a prodrug of oleandomycin, reversibly binds to 50S subunit of bacterial ribosome blocking the transpeptidation and inhibiting protein synthesis of susceptible bacteria thus inhibiting cell growth. It has general properties similar to erythromycin but is less effective in activity than erythromycin. 1.18g of troleandomycin is approximately equivalent to 1g of oleandomycin.
Pharmacokinetics:
Absorption: Rapid and complete absorption. Peak plasma concentration of oleandomycin: 2 hr.
Excretion: Excreted in faeces and bile.

Macrolid