Rulide: Advanced Macrolide Antibiotic for Respiratory Infections
Rulide
| Product dosage: 150mg | |||
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| 360 | $0.68
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| Product dosage: 300mg | |||
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Synonyms | |||
Rulide (roxithromycin) is a next-generation macrolide antibiotic specifically engineered to target a broad spectrum of respiratory pathogens with enhanced pharmacokinetic properties. It demonstrates superior tissue penetration and sustained antibacterial activity, making it a first-line choice for treating community-acquired infections. Its once or twice-daily dosing regimen supports improved patient adherence compared to older macrolides, while maintaining a favorable tolerability profile. Clinicians value Rulide for its reliable efficacy in both upper and lower respiratory tract infections, particularly where atypical organisms are suspected.
Features
- Active ingredient: Roxithromycin 150 mg or 300 mg tablets
- Pharmacological class: Semi-synthetic macrolide antibiotic
- Broad-spectrum activity against Gram-positive bacteria, some Gram-negative bacteria, and atypical pathogens
- High tissue concentration with penetration exceeding plasma levels
- Extended half-life (approximately 12 hours) permitting b.i.d. dosing
- Acid-stable formulation allowing administration without regard to meals
- Available in film-coated tablets for ease of swallowing
Benefits
- Effective eradication of common respiratory pathogens including Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, and Chlamydophila pneumoniae
- Reduced dosing frequency enhances compliance and minimizes peak-trough fluctuations
- Lower incidence of gastrointestinal adverse effects compared to erythromycin
- Suitable for patients with penicillin hypersensitivity (non-type I reactions)
- Demonstrated anti-inflammatory properties potentially beneficial in chronic respiratory conditions
- Well-established post-antibiotic effect maintains suppression of bacterial regrowth
Common use
Rulide is primarily indicated for the treatment of mild to moderate respiratory infections acquired in community settings. This includes acute bacterial pharyngitis, tonsillitis, acute sinusitis, acute bronchitis, and community-acquired pneumonia. It is particularly valuable when coverage against atypical pathogens is required, as it demonstrates excellent activity against Mycoplasma, Legionella, and Chlamydophila species. Off-label uses may include skin and soft tissue infections caused by susceptible organisms, though local resistance patterns should guide this application.
Dosage and direction
The standard adult dosage is 300 mg daily, administered either as a single dose or in two divided doses of 150 mg each. For severe infections, the dose may be increased to 300 mg twice daily. Administration should occur with food to optimize absorption and minimize potential gastrointestinal discomfort. The typical treatment duration ranges from 5 to 10 days, depending on infection severity and clinical response. Pediatric dosing (for children >40 kg) follows similar weight-based calculations, though local prescribing guidelines should be consulted. Renal impairment requires dosage adjustment: for creatinine clearance <30 mL/min, reduce dose by 50% and monitor carefully.
Precautions
Liver function should be monitored during prolonged therapy due to potential hepatotoxicity. Use with caution in patients with pre-existing hepatic impairment. May prolong QT interval; avoid in patients with known QT prolongation, electrolyte abnormalities, or concurrent use of other QT-prolonging drugs. Superinfection with resistant organisms including Clostridium difficile may occur. Not recommended during pregnancy (Category B3) unless potential benefits outweigh risks. Excreted in breast milk; consider temporary discontinuation of breastfeeding during treatment. May cause dizziness; caution patients about operating machinery or driving.
Contraindications
Hypersensitivity to roxithromycin, other macrolide antibiotics, or any excipient in the formulation. Concomitant administration with ergot derivatives, cisapride, pimozide, or terfenadine due to risk of serious cardiac arrhythmias. Severe hepatic impairment (Child-Pugh Class C). History of cholestatic jaundice/hepatic dysfunction with previous macrolide use. Combination with colchicine in patients with renal or hepatic impairment.
Possible side effect
Common (≥1/100): nausea, abdominal pain, diarrhea, headache, taste disturbance. Uncommon (≥1/1000): vomiting, constipation, flatulence, dizziness, skin rash, pruritus. Rare (<1/1000): pseudomembranous colitis, hepatitis, cholestatic jaundice, QT prolongation, tinnitus, hearing disturbance (usually reversible), anaphylaxis, Stevens-Johnson syndrome. Laboratory abnormalities may include transient elevations in liver transaminases, eosinophilia, and neutropenia. Most adverse effects are mild to moderate and resolve upon discontinuation.
Drug interaction
Strong CYP3A4 inhibitors: Increased roxithromycin exposure. Antacids/H2 blockers: Reduced absorption (separate administration by 2 hours). Warfarin: Potentiated anticoagulant effect (monitor INR). Theophylline: Increased theophylline levels (monitor concentration). Digoxin: Increased digoxin bioavailability. Cyclosporine: Elevated cyclosporine levels (monitor renal function). Statins: Increased risk of myopathy. Oral contraceptives: Potential reduced efficacy (recommend backup method). QT-prolonging agents: Additive effect on cardiac repolarization.
Missed dose
If a dose is missed, administer as soon as remembered unless it is nearly time for the next scheduled dose. Do not double the dose to make up for the missed administration. Maintain the regular dosing schedule thereafter. Consistent timing helps maintain therapeutic antibiotic concentrations. If multiple doses are missed, consult healthcare provider for guidance on resumption of therapy.
Overdose
Symptoms may include severe nausea, vomiting, diarrhea, and transient hearing loss. QT prolongation and torsades de pointes may occur in massive overdoses. Management is supportive: gastric lavage if recent ingestion, activated charcoal if appropriate, and ECG monitoring for at least 24 hours. Maintain hydration and electrolyte balance. Hemodialysis is not effective due to high protein binding. Specific antidote is not available. Contact poison control center for latest management recommendations.
Storage
Store below 30°C (86°F) in original packaging protected from light and moisture. Keep container tightly closed. Do not remove desiccant from bottle. Do not use if tablets show signs of discoloration or deterioration. Keep out of reach of children and pets. Do not flush medications down toilet or pour into drainage. Dispose of unused medication through take-back programs or according to local regulations.
Disclaimer
This information is for educational purposes and does not replace professional medical advice. Dosage and treatment decisions must be made by qualified healthcare providers based on individual patient characteristics, local resistance patterns, and official prescribing information. The prescriber should consult full product labeling before administration. Not all possible uses, interactions, or adverse effects are listed here.
Reviews
Clinical studies demonstrate efficacy rates of 85-92% in respiratory infections with favorable tolerability profiles. Meta-analyses confirm superior gastrointestinal tolerance compared to erythromycin. Physicians report good patient compliance due to convenient dosing. Some reports note emerging resistance in Streptococcus pneumoniae in certain regions. Post-marketing surveillance confirms the established safety profile with rare serious adverse events. Overall considered a valuable option in outpatient respiratory infection management.