Azithromycin Tablets(阿奇霉素片) USP40

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希舒美说明书

希舒美说明书
希舒美产品培训资料,仅供内部使用
SFDA approved on May 11,2007
19
注射用阿奇霉素说明书
适应症: – 本品适用于敏感病原菌所致的下列感染,阿奇霉 素治疗各种感染时推荐的剂量、疗程及适用患者 人群不同,具体的用药方案请参阅(用法用量)。
希舒美产品培训资料,仅供内部使用
18
SFDA approved on Apr.27,2007
注射用阿奇霉素说明书
药品名称 通用名称:注射用阿奇霉素 商品名称:希舒美(Zithromax) 英文名称:Azithromycin for Injection 成份:主要成份为阿奇霉素。 本品所含辅料为:无水柠檬酸,氢氧化钠 性状:本品为白色结晶粉末。 规格:每瓶含阿奇霉素0.5g. 贮藏:密闭,在干燥处保存。 如按说明书稀释成浓度1.0mg/ml-2.0mg/ml时,希舒美 (注射用阿奇霉素)在室温(30°C或86°F)下或低 于室温可保存24小时,冰箱中(5°C或41°F)可保存 7天。 包装:模制抗生素瓶。1支/盒,10支/盒 有效期:36个月 生产企业:企业名称:Ben Venue Laboratories Inc. 分装企业:辉瑞制药有限公司
希舒美产品说明书
希舒美产品培训资料,仅供内部使用
阿奇霉素片说明书
药品名称
通用名称:阿奇霉素片 商品名称:希舒美(Zithromax) 英文名称:Azithromycin Tablets
成份:主要成份为阿奇霉素。 性状:本品为白色或类白色胶囊型薄膜衣片。
本品含阿奇霉素二水合物,相当于250mg或500mg阿奇霉素。
希舒美产品培训资料,仅供内部使用源自5阿奇霉素片说明书
不良反应: – 患者对本品的耐受性良好,不良反应发生率较低。 禁忌: – 对阿奇霉素、红霉素、其他大环内酯类或酮内酯 类抗生素,或任何赋形剂过敏的患者,禁忌使用 本品

阿奇霉素片说明书20160803(希舒美)

阿奇霉素片说明书20160803(希舒美)

儿童患者:
单剂量和多剂量方案:与成人相比,虽然儿童患者出现的不良反应类型相似,但采用建议
第 3 页,共 13 页 Version No: 20160803
的剂量方案时,儿童患者的不良反应发生率有所不同。
急性中耳炎:采用建议的 30 mg/kg 总剂量方案时,治疗引起的最常见不良反应(1%)有腹 泻、腹痛、呕吐、恶心及皮疹。
发生率如下表所示:
剂量方案 5天
腹泻/稀便,% 5.8%
腹痛,% 1.9%
呕吐,% 1.9%
ห้องสมุดไป่ตู้恶心,% 1.9%
皮疹,% 1.6%
咽炎/扁桃腺炎:采用在第 1~5 天服用 12mg/kg 的建议剂量方案时,治疗引起的最常见不 良反应有腹泻、呕吐、腹痛、恶心及头痛。
发生率如下表所示:
剂量方案 5天
腹泻, % 5.4%
第 6 页,共 13 页 Version No: 20160803
在新生儿中使用阿奇霉素之后 (出生后 42 天内的治疗) , 有发生婴儿肥厚性幽门狭窄 (IHPS) 的报告。应告知家长和看护者,如果婴儿有伴随哺乳的呕吐和应激反应发生,需要联系医生。 肺炎的治疗 在肺炎治疗中,阿奇霉素在适宜口服治疗的患者中,仅对肺炎衣原体、流感嗜血杆菌、肺 炎支原体或肺炎链球菌引起的社区获得性肺炎安全和有效。阿奇霉素不得用于因中度至重度疾 病或高危因素而被认为不适宜口服治疗的肺炎患者,例如囊肿性纤维化患者、医院获得性感染 患者、确诊或疑似菌血症患者、需要住院的患者、老年或体弱患者,或者患重大基础疾病以致 机体对疾病的反应能力受损(包括免疫缺陷或功能性无脾)的患者。 难辨梭菌相关性腹泻 几乎所有抗菌药物的应用都有难辨梭菌相关性腹泻(CDAD)的报告,其中包括本品,其 严重程度可表现为轻度腹泻至致死性结肠炎。抗菌药物治疗可引起结肠内正常菌群的改变,导 致难辨梭菌的过度繁殖。 难辨梭菌产生的毒素 A 和毒素 B 与 CDAD 的发病有关。高产毒的难辨梭菌导致发病率和 死亡率升高,这些感染可能难以用抗菌药物治疗,可能需要结肠切除术。对于所有使用抗生素 后出现腹泻的患者,必须考虑到 CDAD 的可能。由于曾经有给予抗菌药物治疗超过 2 个月后发 生 CDAD 的报道,因此需仔细询问病史。 如果怀疑或确诊 CDAD,可能需要停用正在使用的并非针对难辨梭菌的抗生素。必须根据 临床需要适当补充水、电解质和蛋白质,并给予对难辨梭菌有效的抗生素,必要时进行手术评 估。 QT 间期延长 有报道,应用其他大环内酯类抗生素包括阿奇霉素可引起心室复极化和 QT 间期延长,从 而有发生心律失常和尖端扭转型室性心动过速的风险。 在对使用阿奇霉素患者的上市后监测中, 有尖端扭转型室性心动过速案例的自发性报告。 在权衡高危人群使用阿奇霉素的风险和获益时, 医疗卫生保健人员应考虑可能致命的 QT 间期延长的风险,高危人群包括: 已知有 QT 间期延长、尖端扭转型室性心动过速病史、先天性 QT 间期延长综合征、缓

阿奇霉素片分析

阿奇霉素片分析

阿奇霉素片一致性评价信息1.品种基本信息1.1. 通用名:阿奇霉素片1.2. 英文名:Azithromycin Tablets1.3. 主成分化学名称:(2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-13-[(2,6-二脱氧-3-C-甲基-3-O-甲基-α-L-核-己吡喃糖基)氧]-2-乙基-3,4,10-三羟基-3,5,6,8,10,12,14-七甲基-11-[3,4,6-三脱氧-3-(二甲氨基)-β-D-木-己吡喃糖基]氧]-1-氧杂-6-氮杂环十五烷-15-酮1.4. 主成分分子式:C38H72N2O12·2H2O(二水合物)、C38H72N2O12(无水物)1.5. 主成分分子量:785.03 (二水合物)、749.00 (无水物)1.6. 《国家基本药物目录》收载:片剂、胶囊、肠溶(片剂、胶囊):0.25g(25 万单位);颗粒剂:0.1g(10 万单位)1.2 临床信息1.2.1 临床应用与适应症本品适用于敏感细菌所引起的下列感染:支气管炎、肺炎等下呼吸道感染;皮肤和软组织感染;急性中耳炎;鼻窦炎、咽炎、扁桃体炎等上呼吸道感染(青霉素是治疗化脓性链球菌咽炎的常用药,也是预防风湿热的常用药物。

阿奇霉素可有效清除口咽部链球菌,但目前尚无阿奇霉素治疗和预防风湿热疗效的资料)。

阿奇霉素可用于男女性传播疾病中由沙眼衣原体所致的单纯性生殖器感染。

阿奇霉素亦可用于由非多重耐药淋球菌所致的单纯性生殖器感染及由杜克嗜血杆菌引起的软下疳(需排除梅毒螺旋体的合并感染)。

1.2.2 不良反应虽然不能确定所有事件均是由阿奇霉素引起的,但我们仍在此报告了在临床试验期间及产品上市后的报告中所收集到的所有不良事件。

患者对本品的耐受性良好,不良反应发生率较低。

在临床试验中观察到下列不良事件:血液和淋巴系统异常:临床试验中偶见一过性的中性粒细胞减少症,但无资料表明与阿奇霉素有关。

耳和迷路异常:部分患者服用阿奇霉素后曾出现听力损害包括听力丧失、耳鸣和/或耳聋。

阿奇霉素 (Azithromycin)使用说明书

 阿奇霉素 (Azithromycin)使用说明书

阿奇霉素 (Azithromycin)使用说明书阿奇霉素 (Azithromycin)使用说明书一、药品名称阿奇霉素(Azithromycin)二、药品成分和含量主要成分:阿奇霉素每片含量:500mg三、适应症阿奇霉素属于广谱抗生素,主要用于治疗以下感染症状:1. 呼吸道感染:如细菌性支气管炎、肺炎等;2. 皮肤和软组织感染:如红斑狼疮、疥疮、蜂窝繁殖等;3. 生殖系统感染:如尿路感染、淋病等;4. 胃肠道感染:如胃炎、胃溃疡等。

四、用法用量1. 通常用量为每天一次,空腹服用或餐后一小时内服用。

2. 成人用量为一次500mg,疗程为3-5天。

3. 儿童患者的用量需根据年龄、体重和病情而定,请咨询医生进行准确剂量确定。

4. 请遵守医生的指导,避免自行调整剂量。

五、使用注意事项1. 对阿奇霉素过敏者禁用,对其它大环内酯类抗生素过敏者慎用。

2. 在使用阿奇霉素期间,如出现过敏反应(如皮疹、荨麻疹、呼吸困难等),应立即停药并就医。

3. 长期使用阿奇霉素会增加细菌耐药性,请按医生规定的疗程和剂量使用,不要滥用或过量使用。

4. 在使用阿奇霉素期间,如出现严重的胃肠道反应(如腹泻、恶心、呕吐等),应减少剂量或停药并就医。

5. 孕妇、哺乳期妇女和儿童患者应在医生指导下使用阿奇霉素。

6. 同时使用抗生素和洗胃药可能会影响药效,请避免同时使用。

7. 阿奇霉素可能会与某些药物发生相互作用,包括但不限于华法林和西咪替丁,请在使用前告知医生当前使用的所有药物。

8. 药物过期后请不要使用,注意储存温度和湿度。

六、不良反应阿奇霉素可能会引起以下不良反应,请在使用期间留意:1. 胃肠道反应:如腹泻、恶心、呕吐等;2. 皮肤反应:如皮疹、荨麻疹等;3. 注意力不集中、头晕、疲劳等。

如出现以上不良反应或其他不适症状,请咨询医生。

七、贮藏1. 请将阿奇霉素储存在原包装中,避免阳光直射。

2. 请放置于儿童无法触及的地方。

八、包装规格阿奇霉素主要以药片的形式销售,每片含500mg阿奇霉素。

希舒美说明书

希舒美说明书

• 对沙眼衣原体、杜克嗜血杆菌或敏感淋球菌所 致的性传播疾病,仅需单次口服本品1000mg。
• 对其他感染的治疗:总剂量1500mg,每日一次 服用本品500mg共三天。或总剂量相同,首日 服用500mg,第二至第五日每日一次口服本品 250mg。
4
阿奇霉素片说明 书
用法用量:
– 肾功能不全患者
• 轻、中度肾功能不全者(肾小球滤过率为1080ml/min)不需要调整剂量。严重肾功能不全 者慎用(肾小球滤过率〈10ml/min)
– 肝功能不全患者
• 轻中度肝功能不全患者,本品的用法与用量同 肝功能正常者。
5
阿奇霉素片说明 书
不良反应:
– 患者对本品的耐受性良好,不良反应发生 率较低。
禁忌:
等上呼吸道感染
• 阿奇霉素可有效清除口咽部链球菌,但目前 尚无阿奇霉素治疗和预防风湿热疗效的资料 。
– 男女性传播疾病中由沙眼衣原体所致的 单纯性生殖器感染。
– 由非多重耐药淋球菌所致的单纯性生殖 3
阿奇霉素片说明 书
用法用量:
– 每日口服给药一次,整片吞服 – 可与食物同时服用。 – 各种感染性疾病,其疗程及使用方法如下
弯曲菌属 等
与HIV感染相关的条件致病菌: 鸟胞内分枝杆菌 卡氏肺囊虫 鼠弓形体
9
耐药机理:
阿奇霉素片说明 书
在肺炎链球菌和化脓性链球菌临床分离株中有两种主要耐药性决 定簇:mef和erm。 – Mef编码的排出泵仅导致细菌对14和15元环的大环内酯类抗 生素耐药。在其他多种菌属中也曾检测到mef。 – erm基因编码23S-rRNA甲基转移酶,将甲基基团加至23SrRNA(大肠杆菌rRNA的编号系统)的腺嘌呤2058上。甲 基化后的核苷酸在V区域,除与大环内酯类抗生素、还可与 林表型可。酰胺类抗生素和链阳霉素B相互作用,形成MLSB耐药

阿奇霉素片的功能主治价格

阿奇霉素片的功能主治价格

阿奇霉素片的功能主治及价格功能主治阿奇霉素片是一种广谱抗生素,其主要成分为阿奇霉素。

它在医学领域被广泛应用,具有以下功能和主治:1.抗菌作用: 阿奇霉素片可以有效抑制多种细菌的生长和繁殖,包括革兰阳性菌、革兰阴性菌及一些厌氧菌。

它的广谱抗菌特性使其适用于治疗多种细菌感染。

2.呼吸道感染: 阿奇霉素片常用于治疗呼吸道感染,如肺炎、支气管炎、鼻窦炎等。

它可以通过抑制细菌的蛋白质合成来杀灭细菌并缓解感染症状。

3.皮肤软组织感染: 阿奇霉素片也可用于治疗皮肤软组织感染,如蜂窝组织炎、脓肿等。

它可以渗透到感染部位,抑制细菌的增殖,促进组织修复和愈合。

4.性病: 阿奇霉素片对一些常见的性病病原体具有抗菌作用,包括衣原体、淋菌、非淋菌等。

它可用于治疗淋病、尖锐湿疣等疾病。

5.消化道感染: 阿奇霉素片可用于治疗消化道感染,如胃肠炎、胃溃疡等。

它可以通过抑制细菌的生长来减轻消化道感染引起的症状。

价格阿奇霉素片的价格因品牌和剂型的不同而有所差异。

以下是几个常见品牌的价格范围供参考:1.阿奇霉素片(普通剂型):约20元/盒 - 50元/盒。

这是市场上最常见的阿奇霉素片剂型,价格相对较低。

2.阿奇霉素片(控释剂型):约50元/盒 - 100元/盒。

这种剂型采用控释技术,使药物可以缓慢释放,从而延长药效。

3.阿奇霉素片(注射剂型):约100元/支 - 300元/支。

注射剂型适用于严重感染病例,药效更迅速、强效。

请注意,以上价格仅供参考,并可能因地区、药店、促销活动等因素而有所变动。

购买药物时请咨询医生或药师,并注意选择正规渠道购买。

注意事项在使用阿奇霉素片时,也需要注意以下事项:1.遵医嘱使用: 请严格按照医生的指导和处方使用阿奇霉素片。

不要自行增减剂量或停药,以免影响疗效或产生不良反应。

2.过敏反应: 对阿奇霉素或其他大环内酯类抗生素过敏者禁用。

使用阿奇霉素片时如果出现过敏反应(如皮疹、荨麻疹、呼吸困难等),应立即停药并就医。

阿奇霉素片.doc

阿奇霉素片.doc
【含量测定】 取本品10片,精密称定,研细,混合均匀,精密称取适量(约相当于阿奇霉素0.1g),加乙腈定量稀释制成每1ml中含阿奇霉素1mg的溶液,滤过,取续滤液照阿奇霉素项下的方法测定。
[增订]
【鉴别】 (2)在含量测定项下记录的色谱图中,供试品溶液主峰的保留时间应与对照品溶液主峰的保留时间一致。

有关物质 取本品细粉适量,精密称定,加乙腈使阿奇霉素溶解并定量稀释制成每1ml中含阿奇霉素10mg的溶液,滤过,取续滤液作为供试品溶液;照阿奇霉素项下的方法试验,供试品溶液的色谱图中如有杂质峰,杂质B不得过2.0%,其他单个杂质不得过1.0%,杂质总量不得过4.0%(主峰相对保留时间0.12之前出现的色谱峰为辅料峰,计算时予以扣除,必要时应取辅料进行对照)。
溶出度 取本品,照溶出度测定法(附录Ⅹ C第二法),以磷酸盐缓冲液(pH6.0)(0.1mol/L磷酸氢二钠溶液6000ml,加盐酸约40ml,调节pH值至6.0±0.05)900ml(0.25g)或500ml(0.125g)为溶出介质,转速为每分钟100转,依法操作,经45分钟时,取溶液适量,滤过,取续滤液加溶出介质定量稀释制成每1ml中约含阿奇霉素0.25mg的溶液,作为供试品溶液;另取阿奇霉素对照品适量,精密称定,加适量乙醇(每2mg约加乙醇1ml)使溶解,加溶出介质定量稀释制成每1ml中约含0.25mg的溶液,作为对照品溶液。照含量测定项下的色谱条件,精密量取上述两种溶液各50μl,分别注入液相色谱仪,记录色谱图,按外标法以峰面积计算每片的溶出量。限度为标示量的75%,应符合规定。
阿奇霉素片
Aqimeisu Pian
Azithromycin Tablets
ቤተ መጻሕፍቲ ባይዱ
书页号:中国药典2005年版二部附录p292

阿奇霉素 原理-概述说明以及解释

阿奇霉素 原理-概述说明以及解释

阿奇霉素原理-概述说明以及解释1.引言1.1 概述阿奇霉素(Azithromycin)是一种广谱抗生素,属于大环内酯类药物。

它是目前临床上使用较广泛的抗生素之一,具有广谱抗菌活性,能有效治疗多种感染疾病。

阿奇霉素主要通过抑制细菌蛋白合成来发挥其抗菌作用。

它能与细菌的核糖体亚基结合,阻止蛋白质的合成,从而阻碍细菌的生长和繁殖。

与其他抗生素相比,阿奇霉素具有较强的抗菌活性,并且可在体内维持较长时间,使其具有方便的用药方案。

阿奇霉素具有广泛的药理特点。

它对多种革兰氏阳性菌和阴性菌都有良好的抗菌活性,尤其对肺部感染的病原菌有较高的杀菌效果。

除了对细菌的抗菌作用外,阿奇霉素还具有一定的抗炎和免疫调节作用,在一些炎症相关性疾病的治疗中也显示出一定的疗效。

临床上,阿奇霉素被广泛用于多种感染疾病的治疗。

它可以有效地治疗上呼吸道感染、皮肤软组织感染、性传播疾病及泌尿生殖感染等病症。

此外,阿奇霉素还可用于预防某些感染疾病,如麻疹、结核病等。

其方便的用药方案(每日一次)和较少的不良反应也使其得到了广泛应用。

尽管阿奇霉素具有许多优势,但它仍然存在一些局限性。

抗生素的滥用和耐药菌株的出现是目前抗菌治疗所面临的严峻挑战,阿奇霉素也不例外。

此外,个别患者可能对阿奇霉素过敏,使用时需慎重。

针对这些局限性,我们需要进一步深入研究和探索新的抗菌策略,以提高阿奇霉素的临床疗效。

综上所述,阿奇霉素是一种广谱抗生素,通过抑制细菌蛋白合成来发挥其抗菌作用。

它具有广泛的药理特点,临床应用广泛。

然而,我们也应该认识到其局限性,并努力寻求更好的抗菌治疗策略,以应对当前面临的挑战。

对阿奇霉素的进一步研究和展望将有助于发展更有效的抗菌治疗方案。

1.2文章结构文章结构部分的内容如下:1.2 文章结构本文将按照以下结构来进行阐述阿奇霉素的原理和相关内容:1. 引言:首先对阿奇霉素进行概述,介绍它的背景和意义。

2. 正文:2.1 阿奇霉素的作用原理:详细阐述阿奇霉素的作用机制,包括其对细菌的抑制和杀灭作用,涉及到药物与目标细菌之间的相互作用。

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C S= concentration of USP Azithromycin RS in the Sample solution: Nominally 1mg/mL of azithromycinStandard solution (mg/mL)in Mobile phase from NLT 20 Tablets, finely powdered.C U= nominal concentration of azithromycin in Sonicate and shake as needed to dissolve.Sample solution 1 (mg/mL)Chromatographic systemP= potency of azithromycin in USP Azithromycin(See Chromatography 〈621〉, System Suitability.) RS (µg/mg)Mode: LCF= conversion factor, 0.001mg/µg Detector: UV 210 nmWhere packaged in a multiple-unit container Column: 4.6-mm × 25-cm; 5-µm packing L1Calculate the percentage of the labeled amount of Column temperature: 50°azithromycin (C38H72N2O12) in the portion of Flow rate: 2mL/minAzithromycin for Oral Suspension taken:Injection volume: 100µLSystem suitabilityResult = (r U/r S) × (C S/C U) ×P×F× 100Sample:Standard solutionSuitability requirementsr U= peak response from Sample solution 2Tailing factor: NMT 2.0, Standard solutionr S= peak response from the Standard solution Relative standard deviation: NMT 2.0%, StandardC S= concentration of USP Azithromycin RS in the solutionStandard solution (mg/mL)AnalysisC U= nominal concentration of azithromycin in Samples:Standard solution and Sample solutionSample solution 2 (mg/mL)Calculate the percentage of the labeled amount of P= potency of azithromycin in USP Azithromycin azithromycin (C38H72N2O12) in the portion of Tablets RS (µg/mg)taken:F= conversion factor, 0.001mg/µgAcceptance criteria: 90.0%–110.0%Result = (r U/r S) × (C S/C U) ×P×F× 100PERFORMANCE TESTS rU= peak response of azithromycin from the•D ELIVERABLE V OLUME〈698〉: Meets the requirements Sample solution•U NIFORMITY OF D OSAGE U NITS〈905〉rS= peak response of azithromycin from the For single-unit containers Standard solutionAcceptance criteria: Meets the requirements CS= concentration of USP Azithromycin RS in theStandard solution (mg/mL)SPECIFIC TESTS CU= nominal concentration of azithromycin in the •P H 〈791〉Sample solution (mg/mL) For a solid packaged in single-unit containers:P= potency of USP Azithromycin RS (µg/mg)9.0–11.0, in the suspension constituted as directed in F= conversion factor, 0.001mg/µgthe labeling Acceptance criteria: 90.0%–110.0%For a solid packaged in multiple-unit containers:8.5–11.0, in the suspension constituted as directed in PERFORMANCE TESTSthe labeling•D ISSOLUTION〈711〉Medium: pH 6.0phosphate buffer; 900mL ADDITIONAL REQUIREMENTS Apparatus 2: 75 rpm•P ACKAGING AND S TORAGE: Preserve in tight containers.Time: 30 min•USP R EFERENCE S TANDARDS〈11〉Solution A: 4.4mg/mL of dibasic potassium phosphate USP Azaerythromycin A RS and 0.5mg/mL of sodium 1-octanesulfonate, adjusted 9-Deoxo-9a-aza-9a-homoerythromycin A;with phosphoric acid to a pH of 8.20 ± 0.056-Demethylazithromycin.Mobile phase: Acetonitrile, methanol, and Solution A C37H70N2O12734.96(9:3:8)USP Azithromycin RS Diluent: 17.5mg/mL of dibasic potassium phosphate.Adjust with phosphoric acid to a pH of 8.00 ± 0.05.Prepare a mixture of this solution and acetonitrile(80:20).Standard stock solution: Dissolve USP Azithromycin RS Azithromycin Tablets in Medium to obtain a solution having a known concen-tration of about (L/1000) mg/mL, where L is the Tablet DEFINITION label claim in mg.Azithromycin Tablets contain NLT 90.0% and NMT 110.0%Standard solution: Dilute the Standard stock solutionof the labeled amount of azithromycin (C38H72N2O12).with Diluent to obtain a solution having a known con-centration of about (L/2000) mg/mL, where L is the IDENTIFICATION Tablet label claim in mg.•A. The retention time of the major peak of the Sample Sample solution: Pass a portion of the solution under solution corresponds to that of the Standard solution, as test through a suitable filter of 0.45-µm pore size. Di-obtained in the Assay.lute a portion of the filtrate with Diluent to obtain asolution having a theoretical concentration of about ASSAY(L/2000) mg/mL, where L is the Tablet label claim in•P ROCEDURE mg, assuming complete dissolution.Buffer: Dissolve 4.6g of monobasic potassium phos-Chromatographic systemphate anhydrous in 900mL of water. Adjust with 1N(See Chromatography 〈621〉, System Suitability.)sodium hydroxide to a pH of 7.5, and dilute with waterto 1L.Mobile phase: Acetonitrile and Buffer (65:35)Standard solution: 1mg/mL of USP Azithromycin RS inMobile phase. Sonicate and shake as needed to dissolve.Mode: LC Standard stock solution: 0.4mg/mL of USP Azithro-Detector: UV 210 nm mycin RS in acetonitrile. Sonicate and shake as needed Column: 4.6-mm × 15-cm; 5-µm packing L1to dissolve.Column temperature: 50°Standard solution: 0.02mg/mL of azithromycin from Flow rate: 1.5mL/min Standard stock solution in Diluent AInjection volume: 50µL Sensitivity solution: 0.004mg/mL of azithromycin System suitability from Standard solution in Diluent ASample:Standard solution Sample stock solution: Nominally 14.3mg/mL of Suitability requirements azithromycin prepared as follows. Weigh and finely Tailing factor: NMT 2.0powder NLT 20 Tablets. Transfer nominally 1430mg of Relative standard deviation: NMT 2.0%azithromycin to a 100-mL volumetric flask. Add 75mL Analysis of acetonitrile, and sonicate for NLT 15 min. Shake by Samples:Standard solution and Sample solution mechanical means for NLT 15 min. Allow the solution Calculate the percentage of the labeled amount of to equilibrate to room temperature, dilute with acetoni-azithromycin (C38H72N2O12) dissolved:trile to volume, and mix.Sample solution: Nominally 4mg/mL of azithromycin Result = (r U/r S) × (C S/L) ×V× 100prepared as follows. Centrifuge an aliquot of the Samplestock solution for NLT 15 min. Transfer 7.0mL of the r U= peak response of azithromycin from the supernatant to a 25-mL volumetric flask, and dilute Sample solution with Diluent B to volume.r S= peak response of azithromycin from the Blank:Diluent AStandard solution Chromatographic systemC S= concentration of the Standard solution(See Chromatography 〈621〉, System Suitability.)(mg/mL)Mode: LCL= label claim (mg/Tablet)Detector: UV 210 nmV= volume of Medium, 900mL Column: 4.6-mm × 15-cm; 3.5-µm packing L1 Tolerances: NLT 80% (Q) of the labeled amount of Column temperature: 50°azithromycin (C38H72N2O12) is dissolved.Flow rate: 1.2mL/min•U NIFORMITY OF D OSAGE U NITS〈905〉: Meet the Autosampler temperature: 4°requirements Injection volume: 100µLSystem suitabilityIMPURITIES Samples:System suitability solution, Standard solution,•O RGANIC I MPURITIES and Sensitivity solutionProtect all solutions containing azithromycin from light.Suitability requirementsRefrigerate the Standard solution and the Sample solution Signal-to-noise ratio: NLT 10, Sensitivity solution after preparation and during analysis, using a refriger-Resolution: NLT 1.0 between desosaminylazithromy-ated autosampler set at 4°. The solutions must be ana-cin and azithromycin related compound F, System lyzed within 24 h of preparation.suitability solutionSolution A: Water and ammonium hydroxide Relative standard deviation: NMT 2.0%, Standard (2000:1.2). The pH of this solution is about 10.5.solutionSolution B: Acetonitrile, methanol, and ammonium hy-Analysisdroxide (1800:200:1.2)Samples:Sample solution and BlankMobile phase: See Table 1.Calculate the percentage of each impurity in the por-tion of Tablets taken:Table 1Result = (r U/r S) × (C S/C U) ×P×F1× (1/F2) × 100 Time Solution A Solution B(min)(%)(%)rU= peak response of each impurity from the 05446Sample solution205446r S= peak response of azithromycin from theStandard solution351090C S= concentration of USP Azithromycin RS in the35.15446Standard solution (mg/mL) 405446CU= nominal concentration of azithromycin in theSample solution (mg/mL) Buffer: 1.7g/L of monobasic ammonium phosphate inP= potency of USP Azithromycin RS (µg/mg) water. Adjust with ammonium hydroxide to a pH of 10.F1= conversion factor, 0.001mg/µg Diluent A: Methanol, acetonitrile, and BufferF2= relative response factor (see Table 2) (350:300:350)Acceptance criteria: See Table 2. The reporting level Diluent B: Methanol and Buffer (1:1)for impurities is 0.1%. Disregard any peaks in the Sam-System suitability stock solution: 0.1mg/mL each ofple solution that correspond to peaks in the Blank.USP Desosaminylazithromycin RS and USP AzithromycinRelated Compound F RS in acetonitrileSystem suitability solution: 0.028mg/mL each of USPDesosaminylazithromycin RS and USP Azithromycin Re-lated Compound F RS from System suitability stock solu-tion in Diluent ATable 2Table 2 (Continued)Relative Relative Acceptance Relative Relative AcceptanceRetention Response Criteria,Retention Response Criteria, Name Time Factor NMT (%)Name Time Factor NMT (%) Azithromycin N-ox-3-Deoxyazithro-ide a0.200.42 1.0mycin (azithro-——mycin B)h,l 1.143′-(N,N-Didemeth-yl)-3′-N-for-Any individual un-—mylazithromycin b0.29 1.7 1.0specified impurity h 1.00.23′-(N,N-Didemeth-Total impurities h—— 5.0yl)azithro-a(2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-13-[(2,6-Dideoxy-3-C-methyl-3-O-methyl-α-L-ribo-hexopyranosyl)oxy]-2-ethyl-3,4,10-trihydroxy-3,5,6,8,10, mycin(ami-12,14-heptamethyl-11-[[3,4,6-trideoxy-3-(dimethylazinoyl)-β-D-xylo-hex-noazithromycin)c0.340.490.5opyranosyl]oxy]-1-oxa-6-azacyclopentadecan-15-one.Azithromycin related b(2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-13-[(2,6-Dideoxy-3-C-methyl-3-O-compound F d0.42 4.3 1.0methyl-α-L-ribo-hexopyranosyl)oxy]-2-ethyl-3,4,10-trihydroxy-3,5,6,8,10,12,14-heptamethyl-11-[[3-formamido-3,4,6-trideoxy-β-D-xylo-hexopyra-Desosaminylazithro-nosyl]oxy]-1-oxa-6-azacyclopentadecan-15-one.mycin e0.46 1.10.5c(2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-13-[(2,6-Dideoxy-3-C-methyl-3-O-N-Demethylazithro-methyl-α-L-ribo-hexopyranosyl)oxy]-2-ethyl-3,4,10-trihydroxy-3,5,6,8,10,12,14-heptamethyl-11-[[3-amino-3,4,6-trideoxy-β-D-xylo-hexopyra-mycin f0.500.540.7nosyl]oxy]-1-oxa-6-azacyclopentadecan-15-one.3′-De(dimethylami-d3′-(N-Demethyl)-3′-N-formylazithromycin; (2R,3S,4R,5R,8R,10R,11R,12S, no)-3′-oxoazithro-13S,14R)-13-[(2,6-Dideoxy-3-C-methyl-3-O-methyl-α-L-ribo-hexopyra-mycin g0.87 1.4 1.0nosyl)oxy]-2-ethyl-3,4,10-trihydroxy-3,5,6,8,10,12,14-heptamethyl-11-[[3-(N-methyl)formamido-3,4,6-trideoxy-β-D-xylo-hexopyranosyl]oxy]-1-oxa-6-Azaerythromycin A h,i0.94——azacyclopentadecan-15-one.Azithromycin 1.0——e(2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-2-Ethyl-3,4,10,13-tetrahydroxy-3,5,6,8,10,12,14-heptamethyl-11-[[3,4,6-trideoxy-3-dimethylamino-β-D-xylo-2-Desethyl-2-prop-——hexopyranosyl]oxy]-1-oxa-6-azacyclopentadecan-15-one. ylazithromycin h,j 1.10f(2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-13-[(2,6-Dideoxy-3-C-methyl-3-O-3′-N-Demethyl-3′-N-methyl-α-L-ribo-hexopyranosyl)oxy]-2-ethyl-3,4,10-trihydroxy-3,5,6,8,10,[(4-methylphen-12,14-heptamethyl-11-[[3,4,6-trideoxy-3-methylamino-β-D-xylo-hexopyra-——nosyl]oxy]-1-oxa-6-azacyclopentadecan-15-one.yl)sulfonyl]azithro-g(2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-13-[(2,6-Dideoxy-3,3-dimethyl-α-mycin h,k 1.11L-ribo-hexopyranosyl)oxy]-2-ethyl-3,4,10-trihydroxy-3,5,6,8,10,12,14-a(2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-13-[(2,6-Dideoxy-3-C-methyl-3-O-heptamethyl-11-[[3,4,6-trideoxy-3-oxo-β-D-xylo-hexopyranosyl]oxy]-1-oxa-methyl-α-L-ribo-hexopyranosyl)oxy]-2-ethyl-3,4,10-trihydroxy-3,5,6,8,10,6-azacyclopentadecan-15-one.12,14-heptamethyl-11-[[3,4,6-trideoxy-3-(dimethylazinoyl)-β-D-xylo-hex-h Process impurities that are controlled in the drug substance are not to be opyranosyl]oxy]-1-oxa-6-azacyclopentadecan-15-one.reported. They are listed here for information only. The unspecified impu-b(2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-13-[(2,6-Dideoxy-3-C-methyl-3-O-rities and total impurities limits do not include these impurities.methyl-α-L-ribo-hexopyranosyl)oxy]-2-ethyl-3,4,10-trihydroxy-3,5,6,8,10,i9-Deoxo-9a-aza-9a-homoerythromycin A.12,14-heptamethyl-11-[[3-formamido-3,4,6-trideoxy-β-D-xylo-hexopyra-j(2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-13-[(2,6-Dideoxy-3-C-methyl-3-O-nosyl]oxy]-1-oxa-6-azacyclopentadecan-15-one.methyl-α-L-ribo-hexopyranosyl)oxy]-2-propyl-3,4,10-trihydroxy-3,5,6,8,10, c(2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-13-[(2,6-Dideoxy-3-C-methyl-3-O-12,14-heptamethyl-11-[[3,4,6-trideoxy-3-(dimethylamino)-β-D-xylo-hex-methyl-α-L-ribo-hexopyranosyl)oxy]-2-ethyl-3,4,10-trihydroxy-3,5,6,8,10,opyranosyl]oxy]-1-oxa-6-azacyclopentadecan-15-one dihydrate.12,14-heptamethyl-11-[[3-amino-3,4,6-trideoxy-β-D-xylo-hexopyra-k(2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-13-[(2,6-Dideoxy-3-C-methyl-3-O-nosyl]oxy]-1-oxa-6-azacyclopentadecan-15-one.methyl-α-L-ribo-hexopyranosyl)oxy]-2-ethyl-3,4,10-trihydroxy-3,5,6,8,10, d3′-(N-Demethyl)-3′-N-formylazithromycin; (2R,3S,4R,5R,8R,10R,11R,12S,12,14-heptamethyl-11-[[3-[N-(4-methylphenylsulfonyl)-N-methylamino]-3, 13S,14R)-13-[(2,6-Dideoxy-3-C-methyl-3-O-methyl-α-L-ribo-hexopyra-4,6-trideoxy-β-D-xylo-hexopyranosyl]oxy]-1-oxa-6-azacyclopentadecan-15-nosyl)oxy]-2-ethyl-3,4,10-trihydroxy-3,5,6,8,10,12,14-heptamethyl-11-[[3-one.(N-methyl)formamido-3,4,6-trideoxy-β-D-xylo-hexopyranosyl]oxy]-1-oxa-6-l(2R,3R,4S,5R,8R,10R,11R,12S,13S,14R)-13-[(2,6-Dideoxy-3-C-methyl-3-O-azacyclopentadecan-15-one.methyl-α-L-ribo-hexopyranosyl)oxy]-2-ethyl-4,10-dihydroxy-3,5,6,8,10,12, e(2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-2-Ethyl-3,4,10,13-tetrahydroxy-3,14-heptamethyl-11-[[3,4,6-trideoxy-3-(dimethylamino)-β-D-xylo-hexopyra-5,6,8,10,12,14-heptamethyl-11-[[3,4,6-trideoxy-3-dimethylamino-β-D-xylo-nosyl]oxy]-1-oxa-6-azacyclopentadecan-15-one.hexopyranosyl]oxy]-1-oxa-6-azacyclopentadecan-15-one.f(2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-13-[(2,6-Dideoxy-3-C-methyl-3-O-ADDITIONAL REQUIREMENTSmethyl-α-L-ribo-hexopyranosyl)oxy]-2-ethyl-3,4,10-trihydroxy-3,5,6,8,10,•PACKAGING AND S TORAGE: Preserve in tight containers. 12,14-heptamethyl-11-[[3,4,6-trideoxy-3-methylamino-β-D-xylo-hexopyra-nosyl]oxy]-1-oxa-6-azacyclopentadecan-15-one.Store at controlled room temperature.g(2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-13-[(2,6-Dideoxy-3,3-dimethyl-α-•USP R EFERENCE S TANDARDS〈11〉L-ribo-hexopyranosyl)oxy]-2-ethyl-3,4,10-trihydroxy-3,5,6,8,10,12,14-USP Azithromycin RSheptamethyl-11-[[3,4,6-trideoxy-3-oxo-β-D-xylo-hexopyranosyl]oxy]-1-oxa-USP Azithromycin Related Compound F RS6-azacyclopentadecan-15-one.3′-(N-Demethyl)-3′-N-formylazithromycin;h Process impurities that are controlled in the drug substance are not to be(2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-13-[(2,6-Dide-reported. They are listed here for information only. The unspecified impu-rities and total impurities limits do not include these impurities.oxy-3-C-methyl-3-O-methyl-α-L-ribo-hexopyra-i9-Deoxo-9a-aza-9a-homoerythromycin A.nosyl)oxy]-2-ethyl-3,4,10-trihydroxy-3,5,6,8,10,12,j(2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-13-[(2,6-Dideoxy-3-C-methyl-3-O-14-heptamethyl-11-[[3-(N-methyl)formamido-3,4, methyl-α-L-ribo-hexopyranosyl)oxy]-2-propyl-3,4,10-trihydroxy-3,5,6,8,10,6-trideoxy-β-D-xylo-hexopyranosyl]oxy]-1-oxa-6-aza-12,14-heptamethyl-11-[[3,4,6-trideoxy-3-(dimethylamino)-β-D-xylo-hex-cyclopentadecan-15-one.opyranosyl]oxy]-1-oxa-6-azacyclopentadecan-15-one dihydrate.C38H70N2O13762.97k(2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-13-[(2,6-Dideoxy-3-C-methyl-3-O-methyl-α-L-ribo-hexopyranosyl)oxy]-2-ethyl-3,4,10-trihydroxy-3,5,6,8,10, USP Desosaminylazithromycin RS12,14-heptamethyl-11-[[3-[N-(4-methylphenylsulfonyl)-N-methylamino]-3,(2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-2-Ethyl-3,4,4,6-trideoxy-β-D-xylo-hexopyranosyl]oxy]-1-oxa-6-azacyclopentadecan-15-10,13-tetrahydroxy-3,5,6,8,10,12,14-heptamethyl-11 one.-[[3,4,6-trideoxy-3-dimethylamino-β-D-xylo-hexopyra-l(2R,3R,4S,5R,8R,10R,11R,12S,13S,14R)-13-[(2,6-Dideoxy-3-C-methyl-3-O-nosyl]oxy]-1-oxa-6-azacyclopentadecan-15-one. methyl-α-L-ribo-hexopyranosyl)oxy]-2-ethyl-4,10-dihydroxy-3,5,6,8,10,12,14-heptamethyl-11-[[3,4,6-trideoxy-3-(dimethylamino)-β-D-xylo-hexopyra-C30H58N2O9590.79nosyl]oxy]-1-oxa-6-azacyclopentadecan-15-one.Suitability requirementsResolution: NLT 2.0 between aztreonam and aztre-Aztreonamonam E -isomer, System suitability solutionTailing factor: NMT 2 for aztreonam, System suitabil-ity solutionRelative standard deviation: NMT 2.0%, Standard solution AnalysisSamples: Standard solution and Sample solutionCalculate the percentage of aztreonam (C 13H 17N 5O 8S 2)in the portion of Aztreonam taken:Result = (r U /r S ) × (C S /C U ) × P × F × 100C 13H 17N 5O 8S 2435.43r U = peak response from the Sample solution Propanoic acid, 2-[[[1-(2-amino-4-thiazolyl)-2-[(2-methyl-r S = peak response from the Standard solution 4-oxo-1-sulfo-3-azetidinyl)amino]-2-oxoethylidene]ami-C S= concentration of USP Aztreonam RS in theno]oxy]-2-methyl-, [2S -[2α,3β(Z )]]-;Standard solution (mg/mL)(Z )-2-[[[(2-Amino-4-thiazolyl)[[(2S ,3S )-2-methyl-4-oxo-C U = concentration of Aztreonam in the Sample1-sulfo-3-azetidinyl]carbamoyl]methylene]amino]oxy]-solution (mg/mL)2-methylpropionic acid [78110-38-0].P = potency of USP Aztreonam RS (µg/mg)F = unit conversion factor, 0.001mg/µgDEFINITIONAcceptance criteria: 92.0%–105.0% on the anhydrous Aztreonam, which may be anhydrous or hydrated, contains and solvent-free basisNLT 92.0% and NMT 105.0% of C 13H 17N 5O 8S 2, calculated on the anhydrous and solvent-free basis.IMPURITIESInorganic ImpuritiesIDENTIFICATION•R ESIDUE ON I GNITION 〈281〉: NMT 0.1%, the charred resi-•I NFRARED A BSORPTION 〈197K 〉: If a difference appears in due being moistened with 2mL of nitric acid and the IR spectra of the analyte and the standard, dissolve 5drops of sulfuric acidequal portions of the test specimen and the reference standard in equal volumes of methanol. [N OTE —To achieve a complete dissolution, it is suggested to use Delete the following:about 25mL of methanol for each 50mg of material,and stir the mixture for 40 min at room temperature.]••H EAVY M ETALS , Method II 〈231〉: NMT 30ppm •(Official 1-Evaporate the solutions to dryness under vacuum, and Jan-2018)dry at 40° for 4 h under vacuum. Perform the test on Organic Impurities the residues.•P ROCEDURE[N OTE —Store the System suitability solution , Standard so-ASSAYlution , and Sample solution at 5°, and protect from light •P ROCEDUREto prevent isomerization of aztreonam Z -isomer to az-[N OTE —Store the System suitability solution , Standard so-treonam E -isomer.]lution , and Sample solution at 5°, and protect from light Mobile phase, System suitability solution, Standard to prevent isomerization of aztreonam Z -isomer to az-solution, Sample solution, Chromatographic system,treonam E -isomer.]and System suitability: Proceed as directed in the Buffer: 6.8mg/mL of monobasic potassium phosphate Assay .in water. Adjust with 1M phosphoric acid to a pH of Analysis3.0.Samples: Standard solution and Sample solutionMobile phase: Methanol and Buffer (1:4)Calculate the percentage of each impurity in the por-System suitability solution: 1mg/mL of USP Aztre-tion of Aztreonam taken:onam RS and 1mg/mL of USP Aztreonam E -Isomer RS in Mobile phaseResult = (r U /r S ) × (C S /C U ) × P × F × 100Standard solution: 1mg/mL of USP Aztreonam RS in Mobile phaser U= peak response of each impurity from theSample solution: 1mg/mL of Aztreonam in Mobile Sample solutionphaser S = peak response of aztreonam from the StandardChromatographic systemsolution(See Chromatography 〈621〉, System Suitability .)C S = concentration of USP Aztreonam RS in theMode: LCStandard solution (mg/mL)Detector: UV 254 nmC U = concentration of Aztreonam in the SampleColumn: 3.9-mm × 30-cm; 10-µm packing L1solution (mg/mL)Flow rate: 1.5mL/min P = potency of USP Aztreonam RS (µg/mg)Injection size: 10µL F = unit conversion factor, 0.001mg/µg System suitabilityAcceptance criteriaSamples: System suitability solution and Standard Individual impurities: See Table 1.solution[N OTE —The relative retention times for aztreonam and aztreonam E -isomer are 1.0 and 1.8, respectively.]。

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