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Rovamycine (Spiramycin, macrolide antibiotic)

    Rovamycine (also spelled rovamycin) is the brand name of the generic drug spiramycin. Spiramycin is a macrolide antibiotic that is used to treat certain parasitic infections, particularly toxoplasmosis. It is only available for purchase with a physician’s prescription.

    Toxoplasmosis is an infection by the parasite Toxoplasma gondii. This parasite typically does not cause symptoms unless someone is immunocompromised, such as pregnant women or HIV/AIDs patients. Ways this parasite spreads is through eating undercooked meat and shellfish, consuming contaminated water or vegetables, or handling cat feces (poop) or soil that is contaminated with the parasite. Other routes of transmission include mother-to-child and receiving infected organ transplants or blood transfusions.

    Rovamycine

    Uses

    What is Rovamycine used for?

    • Respiratory tract infections
    • Skin and soft tissue infections
    • Gonorrhea (in patients who are allergic to penicillins)
    • Toxoplasmosis in pregnancy (<18 weeks)

    How should I take Rovamycine?

    Read the directions on the packaging for complete information. Check the label and expiration date.

    For oral dosage forms, swallow it whole without chewing, crushing, or dissolving it in liquid.

    For parenteral dosage forms, only a licensed healthcare professional should administer it.

    How do I store Rovamycine?

    Store this product at controlled room temperature away from direct light and moisture. To prevent drug damage, you should not store it in the bathroom or the freezer.

    There may be different brands of this drug that may have different storage needs. So, it is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

    You should not flush this product down the toilet or pour them into a drain unless instructed to do so. Additionally, it is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

    Precautions & Warnings

    What should I know before using Rovamycine?

    Before using this drug, tell your doctor if you are/have:

    • Pregnant or breastfeeding.
    • Taking any other medicines. This includes any prescription, OTC, and herbal remedies.
    • An allergy to any of the ingredients of this product.
    • Any other illnesses, disorders, or medical conditions.

    Is it safe during pregnancy or breastfeeding?

    Pregnancy:

    Unfortunately, there isn’t enough information about the safety of using this drug during pregnancy and breastfeeding. It may be recommended if you have toxoplasmosis and are less than 18 weeks pregnant to prevent transmitting the parasite to your baby.

    Please always consult with your doctor to weigh the potential benefits and risks before taking any medication.

    Side Effects

    What side effects can occur from Rovamycine?

    Like all drugs, this product may have side effects. If they occur, side effects are generally mild and resolve once treatment is finished or the dose is lowered. Some reported side effects include:

    • Diarrhea
    • Nausea
    • Vomiting
    • Abdominal pain
    • Skin rash
    • Temporary tingling or “pins and needles”

    Seek medical attention immediately if you experience any of the following:

    • Unusual bleeding and bruising
    • Jaundice
    • Bloody urine or stools
    • Chest pain
    • Fainting or dizziness
    • Anaphylaxis *potentially fatal
    • Ventricular arrhythmias *potentially fatal
    • Pseudomembranous colitis *potentially fatal

    Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

    Interactions

    What drugs may interact with Rovamycine?

    This medication may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects.

    To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist.

    Drugs with known interactions:

    • Carbidopa, levodopa
    • Astemizole
    • Cisapride
    • Terfenadine
    • Fluphenazine
    • Lactobacillus and estriol
    • Mizolastine
    • Sodium picosulfate
    • Live vaccines (e.g. BCG, cholera, typhoid)

    If you experience an adverse drug interaction, inform your doctor immediately to reevaluate your treatment plan. Approaches include dose adjustment, drug substitution, or ending therapy.

    Does food or alcohol interact with Rovamycine?

    This drug may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

    What health conditions may interact with Rovamycine?

    This drug may interact with underlying conditions. This interaction may worsen your health condition or alter the way the drug works. Therefore, it is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

    • Hepatic impairment
    • Arrhythmia
    • Predisposition to QT interval prolongation

    Dosage

    The information provided is not a substitute for any medical advice. Therefore, you should always consult with your doctor or pharmacist before using any medication.

    What is the dose for an adult?

    Toxoplasmosis and other susceptible infections

    • Mild to moderate infections: Take 6 million to 9 million units in 2 divided doses.
    • Severe infections: Take 12 million to 15 million units in 2 divided doses.
    • Gonorrhea: Take 12 million to 13.5 million units as a single dose.

    Acute toxoplasmosis in pregnancy (<18 weeks of gestation)

    Take 3 million units every 8 hours to prevent transmission to fetus.

    What is the dose for a child?

    Prophylaxis against congenital toxoplasmosis

    Give 150,000 units per kg of body weight in 2 to 3 divided doses.

    How is Rovamycine available?

    Rovamycine is available in the following dosage forms and strengths:

    • Tablet 250mg, 500mg

    What should I do in case of an emergency or overdose?

    In case of an emergency or an overdose, call your local emergency services or go to the nearest emergency room.

    What should I do if I miss a dose?

    If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose. Avoid missing doses to prevent antibiotic resistance and treatment failure.

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    Sources

    Spiramycin https://www.mims.com/philippines/drug/info/spiramycin Accessed July 25, 2021

    Spiramycin (Oral Route, Injection Route, Rectal Route) https://www.mayoclinic.org/drugs-supplements/spiramycin-oral-route-injection-route-rectal-route/side-effects/drg-20066104?p=1 Accessed July 25, 2021

    ROVAMYCINE (Spiramycin) https://onlinelibrary.wiley.com/doi/10.1002/9781119220787.ch151 Accessed July 25, 2021

    Spiramycin https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540513/all/Spiramycin Accessed July 25, 2021

    Toxoplasmosis FAQs https://www.cdc.gov/parasites/toxoplasmosis/gen_info/faqs.html Accessed July 25, 2021

    Spiramycin. Lexi-Drugs. Lexicomp. Wolters Kluwer Health, Inc. Riverwoods, IL. Accessed July 25, 2021. http://online.lexi.com

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    Written by Stephanie Nera, RPh, PharmD Updated Jul 26, 2021