Telithromycin drug data and news

Telithromycin drug data, resources, and news articles (when available). Onconews.org provides news on cancer research. This section, which includes profiles on medicines that may or not be cancer-related is in beta form. If things run smoothly we will be releasing a new format late in the summer of 2006.

Generic name Telithromycin
Brand Names/Synonyms Telithromycin; Ketek (TN); Ketek
Indication For the treatment of Pneumococcal infection;Acute sinusitis;Acute bacterial tonsillitis;Acute bronchitis and bronchiolitis;Lower respiratory tract infection;Lobar (pneumococcal) pneumonia
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Description Not Available
Pharmacology Telithromycin is a macrolide antibiotic which has an antimicrobial spectrum similar or slightly wider to that of penicillin, and is often used for people who have an allergy to penicillins. For respiratory tract infections, it has better coverage of atypical organisms, including mycoplasma. It is also used to treat outbreaks of chlamydia, syphilis, and gonorrhea. Telithromycin prevents bacteria from growing, by interfering with their protein synthesis. Telithromycin binds to the subunit 50S of the bacterial ribosome, and thus inhibits the translocation of peptides.
Mechanism Of Action Telithromycin acts by binding to domains II and V of 23S rRNA of the 50S ribosomal subunit.By binding at domain II, telithromycin retains activity against gram-positive cocci (e.g., Streptococcus pneumoniae )in the presence of resistance mediated by methylases (erm genes)that alter the domain V binding site of telithromycin.Telithromycin may also inhibit the assembly of nascent ribosomal units.
Telithromycin News
(When available)

Off Label Drug Use  May 9, 2006
For instance we saw that telithromycin is effective in exacerbations of asthma. That was totally a surprise. And of course that ... - ABC 4,

Sanofi antibiotic may alleviate asthma  Apr 18, 2006
Results from a multinational study published in the New England Journal of Medicine show that Sanofi's telithromycin antibiotic, sold under the brand name Ketek ... - Pharmaceutical Business Review

Markey criticizes FDA  May 3, 2006
A February study in the Annals of Internal Medicine said three previously healthy patients who took Ketek, also known as telithromycin, developed liver damage. ... - Milford Daily News,

FDA under fire over Ketek approval  May 2, 2006
They claim that the Food and Drug Administration was wrong to approve the drug because a major safety trial of Ketek (telithromycin) had 'data integrity ... - Pharma Times (subscription),

Reps. Launch Investigation of Popular Antibiotic, Ketek  May 2, 2006
Committee, sent a letter today to the Food and Drug Administration (FDA) questioning actions surrounding its approval of the antibiotic telithromycin (Ketek). ... - PharmaLive.com (press release),

Antibiotic's results mixed for asthma  Apr 17, 2006
The study, published in last week's New England Journal of Medicine, found that 278 adults who took the antibiotic telithromycin — sold by Sanofi-Aventis ... - Los Angeles Times,

HealthWrap: China's New Fast-Food Nation  Apr 16, 2006
A study published April 13 in the New England Journal of Medicine tested the effectiveness of the antibiotic Telithromycin, which proved to be effective in ... - National Ledger,

Dosage Forms TABLET
Drug_Category Anti-bacterial Agents; Ketolides; ATC:J01FA15
Absorption Not Available
Interactions Interactions for Telithromycin: Telithromycin is a strong inhibitor of the cytochrome P450 3A4 system. Co-administration of Telithromycin tablets and a drug primarily metabolized by the cytochrome P450 3A4 enzyme system may result in increased plasma concentration of the drug co-administered with telithromycin that could increase or prolong both the therapeutic and adverse effects. Therefore, appropriate dosage adjustments may be necessary for the drug co-administered with telithromycin. The use of Telithromycin is contraindicated with cisapride. The use of Telithromycin is contraindicated with pimozide. Although there are no studies looking at the interaction between Telithromycin and pimozide, there is a potential risk of increased pimozide plasma levels by inhibition of CYP 3A4 pathways by Telithromycin as with macrolides. In a pharmacokinetic study, simvastatin levels were increased due to CYP 3A4 inhibition by telithromycin. Similarly, an interaction may occur with lovastatin or atorvastatin, but not with pravastatin or fluvastatin. High levels of HMG-CoA reductase inhibitors increase the risk of myopathy. Use of simvastatin, lovastatin, or atorvastatin concomitantly with Telithromycin should be avoided. If Telithromycin is prescribed, therapy with simvastatin, lovastatin, or atorvastatin should be suspended during the course of treatment. Monitoring of digoxin side effects or serum levels should be considered during concomitant administration of digoxin and Telithromycin. Patients should be monitored with concomitant administration of midazolam and dosage adjustment of midazolam should be considered if necessary. Precaution should be used with other benzodiazepines, which are metabolized by CYP 3A4 and undergo a high first-pass effect (e.g., triazolam). Concomitant treatment of Telithromycin with rifampin, a CYP 3A4 inducer, should be avoided. Concomitant administration of other CYP 3A4 inducers such as phenytoin, carbamazepine, or phenobarbital is likely to result in subtherapeutic levels of telithromycin and loss of effect. In patients treated with metoprolol for heart failure, the increased exposure to metoprolol, a CYP 2D6 substrate, may be of clinical importance. Therefore, co-administration of Telithromycin and metoprolol in patients with heart failure should be considered with caution. Spontaneous post-marketing reports suggest that administration of Telithromycin and oral anticoagulants concomitantly may potentiate the effects of the oral anticoagulants. Consideration should be given to monitoring prothrombin times/INR while patients are receiving Telithromycin and oral anticoagulants simultaneously. No specific drug interaction studies have been performed to evaluate the following potential drug-drug interactions with Telithromycin. However, these drug interactions have been observed with macrolide products. Drugs metabolized by the cytochrome P450 system such as carbamazepine, cyclosporine, tacrolimus, sirolimus, hexobarbital, and phenytoin: elevation of serum levels of these drugs may be observed when co-administered with telithromycin. As a result, increases or prolongation of the therapeutic and/or adverse effects of the concomitant drug may be observed. Ergot alkaloid derivatives (such as ergotamine or dihydroergotamine): acute ergot toxicity characterized by severe peripheral vasospasm and dysesthesia has been reported when macrolide antibiotics were co-administered. Without further data, the co-administration of Telithromycin and these drugs is not recommended. Laboratory test interactions There are no reported laboratory test interactions.
Toxicity LD50 PO Rat: >2000 mg/kg.
Organisms Affected Enteric bacteria and other eubacteria
Chemical IUPAC Name 7-(4-dimethylamino-3-hydroxy-6-methyl-tetrahydropyran-2-yl)oxy-13-ethyl-6-methoxy-2,4,6,8,10,14-hexamethyl-17-[4-(4-pyridin-3-yl-1H-imidazol-1-yl)butyl]-12,15-dioxa-17-azabicyclo[12.3.0]heptadecane-3,9,11,16-tetraone
Chemical Formula C43H65N5O10
Molecular Weight 812.004 g/mol
Smiles String CCC1C2(C(C(C(=O)C(CC(C(C(C(=O)C(C(=O)O1)C)C)OC3C(C(CC(O3)C)N(C)C)O)(C)OC)C)C)N(C(=O)O2)CCCCN4C=C(N=C4)C5=CN=CC=C5)C
Melting Point 176-188 °C
Water Solubility 300 mg/L
State Solid
LogP/Hphobicity 3.731
Isoelectric Point Not Available
Biotransformation Hepatic
Half Life 10 hours
Protein Binding [%] 60%-70%
RxList Link RXlist
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Drug Reference http://www.pdrhealth.com/drug_info/rxdrugprofiles/drugs/ket1695.shtml
http://www.drugs.com/cons/Telithromycin.html
http://www.rxlist.com/cgi/generic3/ketek.htm
Drug Type Approved Drug
Accession No APRD00483
CAS Registry Number 191114-48-4
KEGG Compound ID C12009
PubChem ID SID:14168
PharmGKB ID PA10202
SwissProt ID Not Available
GenBank ID Not Available
Drug ID Number [DIN] 2247520

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