Classifications: antibiotic; ketolide; Therapeutic: antibiotic; ketolide
Pregnancy Category: C
400 mg tablets
Telithromycin binds to bacterial ribosomal RNa site of the 50S subunit; this action results in inhibition of RNA-dependent
protein synthesis of bacteria, thus resulting in cell death. Telithromycin concentrates in phagocytes where it works against
intracellular respiratory pathogens.
Its broad spectrum of activity is effective against respiratory pathogens, including erythromycin- and penicillin-resistant
Treatment of mild to moderate community-acquired pneumonia.
Macrolide antibiotic hypersensitivity; QT prolongation; ongoing proarrhythmic conditions such as hypokalemia, hypomagnesemia,
significant bradycardia, concurrent administration of Class IA or Class III antiarrhythmic drugs; myasthenia gravis, unless
no other therapeutic option is available; severe renal impairment or renal failure; concurrent administration with terfenadine
or pimozide; viral infections; pregnancy (category C). Safety and efficacy in children <18 y are not established.
History of GI disease; hepatic disease; history of hepatitis or jaundice; lactation.
Route & Dosage
Adult: PO 800 mg once daily for 710 d
- Do not administer concurrently with simvastatin, lovastatin, atorvastatin, Class 1A (e.g., quinidine, procainamide) or Class
III (e.g., dofetilide) antiarrhythmic agents. See drug interactions for other prohibited drug combinations.
- Store at 15°30° C (59°86° F). Keep container tightly closed. Protect from light.
Adverse Effects (≥1%)CNS:
Headache, dizziness. CV:
Potential to cause QTc
prolongation. GI: Diarrhea,
nausea, vomiting, loose stools, dysgeusia. Metabolic:
Elevated LFTs, liver failure. Musculoskeletal:
May exacerbate myasthenia gravis. Special Senses:
Blurred vision, diplopia, difficulty focusing.
or class ia
or class iii antiarrhythmics
may cause life-threatening arrhythmias; may increase concentrations of atorvastatin, lovastatin, simvastatin, benzodiazepines
decreases telithromycin levels; ergot derivatives (ergotamine, dihydroergotamine)
may cause severe peripheral vasospasm; theophylline
may exacerbate adverse GI effects. Food: Grapefruit juice
(>1 qt/d) may increase plasma
concentrations and adverse effects.
57% bioavailable. Peak:
1 h. Metabolism:
50% in liver (CYP3A4), 50% by CYP-independent mechanisms. Elimination:
In urine and feces. Half-Life:
Assessment & Drug Effects
- Monitor ECG in patients at risk for QTc interval prolongation (i.e., bradycardia).
- Withhold drug and notify physician for S&S of QTc interval prolongation such as dizziness or fainting; liver dysfunction.
- Lab tests: baseline LFTs, BUN and creatinine, serum potassium.
Patient & Family Education
- Stop taking drug and notify physician for episodes of dizziness or fainting; jaundice (yellow color of the skin and/or eyes).
- Exercise caution when engaging in potentially hazardous activities; visual disturbances (e.g., blurred vision, difficulty
focusing, double vision) are potential side effects of this drug. If visual problems occur, avoid quick changes in viewing
between close and distant objects.