indication

For the treatment of bacterial infections.

pharmacology

Josamycin is a macrolide antibiotic from Streptomyces narbonensis. The drug has antimicrobial activity against a wide spectrum of pathogens.

mechanism of action

The mechanism of action of macrolides such as Josamycin is via inhibition of bacterial protein biosynthesis by binding reversibly to the subunit 50S of the bacterial ribosome, thereby inhibiting translocation of peptidyl tRNA. This action is mainly bacteriostatic, but can also be bactericidal in high concentrations. Macrolides tend to accumulate within leukocytes, and are therefore actually transported into the site of infection.

drug interactions

Alprazolam: The macrolide, josamycin, may increase the effect of the benzodiazepine, alprazolam.

Aminophylline: The macrolide, josamycin, may increase the effect and toxicity of the theophylline derivative, aminophylline.

Astemizole: Increased risk of cardiotoxicity and arrhythmias

Atorvastatin: The macrolide, josamycin, may increase the toxicity of the statin, atorvastatin.

Bromocriptine: Erythromycin increases serum levels of bromocriptine

Buspirone: The macrolide, josamycin, may increase the effect and toxicity of buspirone.

Carbamazepine: The macrolide, josamycin, may increase the effect of carbamazepine.

Cerivastatin: The macrolide, josamycin, may increase the toxicity of the statin, cerivastatin.

Cilostazol: Erythromycin increases the effect of cilostazol

Cisapride: Increased risk of cardiotoxicity and arrhythmias

Citalopram: Possible serotoninergic sydrome with this combination

Clozapine: Erythromycin increases the effect of clozapine

Cyclosporine: The macrolide, josamycin, may increase the effect of cyclosporine.

Diazepam: The macrolide, josamycin, may increase the effect of the benzodiazepine, diazepam.

Digoxin: The macrolide, josamycin, may increase the effect of digoxin in 10% of patients.

Dihydroergotamine: Possible ergotism and severe ischemia with this combination

Docetaxel: Josamycin may increase the serum levels and toxicity of docetaxel.

Ergotamine: Possible ergotism and severe ischemia with this combination

Felodipine: Erythromycin increases the effect of felodipine

Fluoxetine: Possible serotoninergic syndrome with this combination

Grepafloxacin: Increased risk of cardiotoxicity and arrhythmias

Imatinib: The macrolide, josamycin, may increase the serum concentration of imatinib.

Itraconazole: The macrolide, josamycin, may increase the effect and toxicity of itraconazole.

Levofloxacin: Increased risk of cardiotoxicity and arrhythmias

Lovastatin: The macrolide, josamycin, may increase the toxicity of the statin, lovastatin.

Mesoridazine: Increased risk of cardiotoxicity and arrhythmias

Methysergide: Possible ergotism and severe ischemia with this combination

Midazolam: The macrolide, josamycin, may increase the effect of the benzodiazepine, midazolam.

Moxifloxacin: Increased risk of cardiotoxicity and arrhythmias

Oxtriphylline: The macrolide, josamycin, may increase the effect and toxicity of the theophylline derivative, oxtriphylline.

Pimozide: Increased risk of cardiotoxicity and arrhythmias

Repaglinide: The macrolide, josamycin, may increase the effect of repaglinide.

Rifabutin: The rifamycin, rifabutin, may decrease the effect of the macrolide, josamycin.

Rifampin: The rifamycin, rifampin, may decrease the effect of the macrolide, josamycin.

Terfenadine: Increased risk of cardiotoxicity and arrhythmias

Theophylline: The macrolide, josamycin, may increase the effect and toxicity of theophylline.

Thioridazine: Increased risk of cardiotoxicity and arrhythmias

Triazolam: The macrolide, josamycin, may increase the effect of the benzodiazepine, triazolam.