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telithromycin (Ketek)

Tradename: Ketek Indications: - penicillin & macrolide-resistant pneumococcus a) community-acquired pneumonia b) chronic bronchitis exacerbation c) sinusitis Contraindications: (cautions) -> caution while operating a motor vehicle (blurred vision) Pharmacokinetics: - metabolized by cyt P450 3A4 & inhibited by cyt P450 3A4 Antimicrobial activity: - Chlamydophila pneumoniae [4] - Haemophilus influenzae - Moraxella catarrhalis - Mycoplasma pneumoniae [4] Adverse effects: 1) gastrointestinal distress 2) arrhythmias 3) prolongation of the QT interval 4) may exacerbate myasthenia gravis 5) blurred vision/difficulty focusing vision 6) liver toxicity (rare) [3] Drug interactions: 1) inhibits cyt P450 3A4, thus may increases plasma levels & toxicity of drugs metabolized by cyt P450 3A4 -> simvastatin, lovastatin, midazolam .. many others 2) metabolized by cyt P450 3A4 a) plasma levels increased by drugs that inhibit cyt P450 3A4 -> ketoconazole ... others b) plasma levels decreased by drugs that induce cyt P450 3A4 -> rifampin ... others

Interactions

drug interactions drug adverse effects of macrolide(s)

General

ketolide

Database Correlations

PUBCHEM correlations

References

  1. Norman, D, In: UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
  2. Prescriber's Letter 11(6):333 2004 Detail-Document#: 200606 (subscription needed) http://www.prescribersletter.com
  3. FDA Medwatch http://www.fda.gov/medwatch/safety/2006/safety06.htm#Ketek http://www.fda.gov/medwatch/safety/2006/safety06.htm#Ketek2 http://www.fda.gov/medwatch/safety/2007/safety07.htm#Ketek - Clay KD et al, Severe hepatotoxicity of telithromycin: Three case reports and literature review. Ann Intern Med 2006, March 1 http://www.acponline.org/journals/annals/hepatotoxicity.htm - Hunter D. First, gather the data. N Engl J Med 2006, 354:329 PMID: 16436764 - Vlahakes GJ. The value of phase 4 clinical testing N Engl J Med 2006, 354:413 PMID: 16436775 - Prescriber's Letter 13(3): 2006 Ketek (Telithromycin) and Liver Toxicity Detail-Document#: 220314 (subscription needed) http://www.prescribersletter.com - Prescriber's Letter 14(2): 2007 Safety concerns of Ketek (Telithromycin) Detail-Document#: 230212 (subscription needed) http://www.prescribersletter.com
  4. Deprecated Reference