telithromycin (Ketek)
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Introduction
Tradename: Ketek
Indications
- penicillin & macrolide-resistant pneumococcus
- community-acquired pneumonia
- chronic bronchitis exacerbation
- sinusitis
Contraindications
(cautions)
- caution while operating a motor vehicle (blurred vision)
Pharmacokinetics
- metabolized by cyt P450 3A4 & inhibited by cyt P450 3A4
Antimicrobial activity
Adverse effects
- gastrointestinal distress
- arrhythmias
- prolongation of the QT interval
- may exacerbate myasthenia gravis
- blurred vision/difficulty focusing vision
- liver toxicity (rare)[3]
Drug interactions
- inhibits cyt P450 3A4, thus may increases plasma levels & toxicity of drugs metabolized by cyt P450 3A4
- simvastatin, lovastatin, midazolam .. many others
- metabolized by cyt P450 3A4
- plasma levels increased by drugs that inhibit cyt P450 3A4
- ketoconazole ... others
- plasma levels decreased by drugs that induce cyt P450 3A4
- rifampin ... others
- plasma levels increased by drugs that inhibit cyt P450 3A4
- drug interaction(s) anticonvulsants with anti-bacterial agents
- drug interaction(s) of digoxin in combination with macrolides
- drug interaction(s) of statins with macrolide
- drug interaction(s) of antibiotics with warfarin
- drug interaction(s) of theophylline with macrolide
- drug interaction(s) of macrolides with sulfonylureas
More general terms
References
- ↑ Norman, D, In: UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
- ↑ Prescriber's Letter 11(6):333 2004 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=200606&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 3.0 3.1 FDA Medwatch http://www.fda.gov/medwatch/safety/2006/safety06.htm#Ketek http://www.fda.gov/medwatch/safety/2006/safety06.htm#Ketek2 http://www.fda.gov/medwatch/safety/2007/safety07.htm#Ketek
Clay KD et al, Severe hepatotoxicity of telithromycin: Three case reports and literature review. Ann Intern Med 2006, March 1 http://www.acponline.org/journals/annals/hepatotoxicity.htm
Hunter D. First, gather the data. N Engl J Med 2006, 354:329 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16436764
Vlahakes GJ. The value of phase 4 clinical testing N Engl J Med 2006, 354:413 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16436775
Prescriber's Letter 13(3): 2006 Ketek (Telithromycin) and Liver Toxicity Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=220314&pb=PRL (subscription needed) http://www.prescribersletter.com
Prescriber's Letter 14(2): 2007 Safety concerns of Ketek (Telithromycin) Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=230212&pb=PRL (subscription needed) http://www.prescribersletter.com - ↑ 4.0 4.1 4.2 Deprecated Reference