Erythrocin Injection USP
 Erythrocin Injection

drug-information.ru

|Erythrocin Injection USP Erythrocin Injection

Drugs search, click the first letter of a drug name:


| A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | 1 | 2 | 3 | 4 | 5 | 6 | 8 | 9  Home

Erythrocin


Generic Name: Erythrocin lactobionate
Dosage Form: Injection usp

For I.V. use only

Vials

Rx only

To reduce the development of drug-resistant bacteria and maintain the effectiveness of erythromycin and other antibacterial drugs, erythromycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria.

Erythrocin Description

Erythromycin is produced by a strain of Streptomyces erythraeus and belongs to the macrolide group of antibiotics. It is basic and readily forms salts with acids.

Erythrocin Lactobionate (Sterile Erythromycin Lactobionate, USP), is a soluble salt of erythromycin suitable for intravenous administration. It is available as a sterile, lyophilized powder in vials containing the equivalent of 500 mg or 1 g of erythromycin activity. It is prepared as a solution and lyophilized in its final container.

Erythromycin lactobionate is chemically known as erythromycin mono (4-0-β-D-galactopyranosyl-D-gluconate) (salt). The structural formula is:

Erythrocin - Clinical Pharmacology

Erythromycin diffuses readily into most body fluids. In the absence of meningeal inflammation, low concentrations are normally achieved in the spinal fluid but the passage of the drug across the blood-brain barrier increases in meningitis. Erythromycin crosses the placental barrier and is excreted in breast milk. Erythromycin is not removed by peritoneal dialysis or hemodialysis.

In the presence of normal hepatic function, erythromycin is concentrated in the liver and is excreted in the bile; the effect of hepatic dysfunction on biliary excretion of erythromycin is not known. From 12 to 15 percent of intravenously administered erythromycin is excreted in active form in the urine.

Intravenous infusion of 500 mg of erythromycin lactobionate at a constant rate over 1 hour in fasting adults produced a mean serum erythromycin level of approximately 7 mcg/mL at 20 minutes, 10 mcg/mL at 1 hour, 2.6 mcg/mL at 2.5 hours, and 1 mcg/mL at 6 hours.

Microbiology:

Erythromycin acts by inhibition of protein synthesis by binding 50 S ribosomal subunits of susceptible organisms. It does not affect nucleic acid synthesis. Antagonism has been demonstrated in vitro between erythromycin and clindamycin, lincomycin and chloramphenicol.

Many strains of Haemophilus influenzae are resistant to erythromycin alone, but are susceptible to erythromycin and sulfonamides together.

Staphylococci resistant to erythromycin may emerge during a course of therapy. Culture and susceptibility testing should be performed.

Erythromycin is usually active against the following organisms in vitro (prior to use, refer to INDICATIONS AND USAGE section):

Gram-positive Bacteria: Staphylococcus aureus (resistant organisms may emerge during treatment), Streptococcus pyogenes (Group A beta-hemolytic streptococcus), Alpha-hemolytic streptococcus (viridans group), Streptococcus (diplococcus) pneumoniae, Corynebacterium diphtheriae, Corynebacterium minutissimum.

Gram-negative Bacteria: Neisseria gonorrhoeae, Legionella pneumophila, Bordetella pertussis.

Mycoplasma: Mycoplasma pneumoniae, Ureaplasma urealyticum.

Other Microorganisms: Chlamydia trachomatis, Entamoeba histolytica, Treponema pallidum, Listeria monocytogenes.

Susceptibility Testing:

Quantitative methods that require measurement of zone diameters give the most precise estimates of antibiotic susceptibility. One such standardized single-disc procedure has been recommended for use with discs to test susceptibility to erythromycin.1 Interpretation involves correlation of the zone diameters obtained in the disc test with minimal inhibitory concentration (MIC) values for erythromycin.

Reports from the laboratory giving results of the standardized single-disc susceptibility test using a 15 mcg erythromycin disc should be interpreted according to the following criteria:

Susceptible organisms produce zones of 18 mm or greater, indicating that the tested organism is likely to respond to therapy.

Resistant organisms produce zones of 13 mm or less, indicating that other therapy should be selected.

Organisms of intermediate susceptibility produce zones of 14 to 17 mm. The “intermediate” category provides a “buffer zone” which should prevent small, uncontrolled technical factors from causing major discrepancies in interpretations; thus, when a zone diameter falls within the “intermediate” range, the results may be considered equivocal. If alternative drugs are not available, confirmation by dilution tests may be indicated.

Standardized procedures require the use of control organisms. The 15 mcg erythromycin disc should give zone diameters between 22 and 30 mm for the S. aureus ATCC 25923 control strain.

A bacterial isolate may be considered susceptible if the MIC value2 for erythromycin is not more than 2 mcg/mL. Organisms are considered resistant if the MIC is 8 mcg/mL or higher. The MIC of erythromycin for S. aureus ATCC 29213 control strain should be between 0.12 and 0.5 mcg/mL.

Indications and Usage for Erythrocin

Erythrocin Lactobionate-I.V. (Sterile Erythromycin Lactobionate, USP) is indicated in the treatment of infections caused by susceptible strains of the designated organisms in the diseases listed below when oral administration is not possible or when the severity of the infection requires immediate high serum levels of erythromycin. Intravenous therapy should be replaced by oral administration at the appropriate time.

Upper respiratory tract infections of mild to moderate degree caused by Streptococcus pyogenes (Group A beta-hemolytic streptococci); Streptococcus pneumoniae(Diplococcus pneumoniae);Haemophilus influenzae (when used concomitantly with adequate doses of sulfonamides, since many strains of H. influenzae are not susceptible to the erythromycin concentrations ordinarily achieved). (See appropriate sulfonamide labeling for prescribing information.)

Lower respiratory tract infections of mild to moderate severity caused by Streptococcus pyogenes (Group A beta-hemolytic streptococci); Streptococcus pneumoniae(Diplococcuspneumoniae).

Respiratory tract infections due to Mycoplasma pneumoniae.

Skin and skin structure infections of mild to moderate severity caused by Streptococcus pyogenes and Staphylococcus aureus (resistant staphylococci may emerge during treatment).

Diphtheria: As an adjunct to antitoxin infections due to Corynebacterium diphtheriae to prevent establishment of carriers and to eradicate the organism in carriers.

Erythrasma: In the treatment of infections due to Corynebacterium minutissimum .

Acute pelvic inflammatory disease caused by Neisseria gonorrhoeae: Erythrocin

Lactobionate-I.V. (Sterile Erythromycin Lactobionate, USP) followed by erythromycin stearate of base orally, as an alternative drug in treatment of acute pelvic inflammatory disease caused by N. gonorrhoeae in female patients with a history of sensitivity to penicillin.

Before treatment of gonorrhea, patients who are suspected of also having syphilis should have a microscopic examination for T. pallidum (by immunofluorescence or darkfield) before receiving erythromycin and monthly serologic tests for a minimum of 4 months thereafter.

Legionnaires’ Disease caused by Legionella pneumophila. Although no controlled clinical efficacy studies have been conducted, in vitro and limited preliminary clinical data suggest that erythromycin may be effective in treating Legionnaires’ Disease.

Prevention of Initial Attacks of Rheumatic Fever: Penicillin is considered by the American Heart Association to be the drug of choice in the prevention of initial attacks of rheumatic fever (treatment of Group A beta-hemolytic streptococcal infections of the upper respiratory tract e.g., tonsillitis, or pharyngitis).3 Erythromycin is indicated for the treatment of penicillin-allergic patients. The therapeutic dose should be administered for ten days.

Prevention of Recurrent Attacks of Rheumatic Fever: Penicillin or sulfonamides are considered by the American Heart Association to be the drugs of choice in the prevention of recurrent attacks of rheumatic fever. In patients who are allergic to penicillin and sulfonamides, oral erythromycin is recommended by the American Heart Association in the long-term prophylaxis of streptococcal pharyngitis (for the prevention of recurrent attacks of rheumatic fever).3

Prevention of Bacterial Endocarditis: Although no controlled clinical efficacy trials have been conducted, oral erythromycin has been recommended by the American Heart Association for prevention of bacterial endocarditis in penicillin-allergic patients with prosthetic cardiac valves, most congenital cardiac malformations, surgically constructed systemic pulmonary shunts, rheumatic or other acquired valvular dysfunction, idiopathic hypertrophic subaortic stenosis (IHSS), previous history of bacterial endocarditis and mitral valve prolapse with insufficiency when they undergo dental procedures and surgical procedures of the upper respiratory tract.4

To reduce the development of drug-resistant bacteria and maintain the effectiveness of erythromycin and other antibacterial drugs, erythromycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

Contraindications

Erythromycin is contraindicated in patients with known hypersensitivity to this antibiotic.

Erythromycin is contraindicated in patients taking terfenadine or astemizole. (See PRECAUTIONS— Drug Interactions.)

Warnings

There have been reports of hepatic dysfunction, with or without jaundice occurring in patients receiving oral erythromycin products.

Precautions

General:

Since erythromycin is principally excreted by the liver, caution should be exercised when erythromycin is administered to patients with impaired hepatic function. (See CLINICALPHARMACOLOGY and WARNINGS sections.)

There have been reports that erythromycin may aggravate the weakness of patients with myasthenia gravis.

Prolonged or repeated use of erythromycin may result in an overgrowth of non-susceptible bacteria or fungi. If superinfection occurs, erythromycin should be discontinued and appropriate therapy instituted.

When indicated, incision and drainage or other surgical procedures should be performed in conjunction with antibiotic therapy.

Prescribing erythromycin in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.

Laboratory Tests:

Erythromycin interferes with the fluorometric determination of urinary catecholamines.

Drug Interactions:

Erythromycin use in patients who are receiving high doses of theophylline may be associated with an increase of serum theophylline levels and potential theophylline toxicity. In case of theophylline toxicity and/or elevated serum theophylline levels, the dose of theophylline should be reduced while the patient is receiving concomitant erythromycin therapy.

There have been published reports suggesting that when oral erythromycin is given concurrently with theophylline there is a significant decrease in erythromycin serum concentrations. This decrease could result in subtherapeutic concentrations of erythromycin.

Erythromycin administration in patients receiving carbamazepine has been reported to cause increased serum levels of carbamazepine with subsequent development of signs of carbamazepine toxicity.

Concomitant administration of erythromycin and digoxin has been reported to result in elevated serum digoxin levels.

There have been reports of increased anticoagulant effects when erythromycin and oral anticoagulants were used concomitantly.

Erythromycin has been reported to significantly alter the metabolism of the nonsedating antihistamines, terfenadine and astemizole, when taken concomitantly. Rare cases of serious cardiovascular adverse events, including electrocardiographic QT/QTc interval prolongation, cardiac arrest, torsades de pointes, and other ventricular arrhythmias, have been observed. (See CONTRAINDICATIONS.) In addition, deaths have been reported rarely with concomitant administration of terfenadine and erythromycin.

The use of erythromycin in patients concurrently taking drugs metabolized by the cytochrome P450 system may be associated with elevations in serum levels of these other drugs. There have been reports of interactions of erythromycin with carbamazepine, cyclosporine, hexobarbital, phenytoin, alfentanil, disopyramide, lovastatin, bromocriptine, valproate, terfenadine, and astemizole. Serum concentrations of drugs metabolized by the cytochrome P450 system should be monitored closely in patients concurrently receiving erythromycin.

Carcinogenesis, Mutagenesis, Impairment of Fertility:

Long-term animal data with erythromycin lactobionate for use in determination of possible carcinogenic effects are not available. However, long-term oral studies in rats with erythromycin ethylsuccinate and erythromycin base did not provide evidence of tumorigenicity. Mutagenicity studies have not been conducted. There was no apparent effect on male or female fertility in rats fed erythromycin (base) at levels up to 0.25% of diet.

Pregnancy:

Pregnancy Category B: There was no evidence of teratogenicity or any other adverse effect on reproduction in female rats fed erythromycin base (up to 0.25% of diet) prior to and during mating, during gestation, and through weaning of two successive litters. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Erythromycin has been reported to cross the placental barrier in humans, but fetal plasma levels are generally low.

Labor and Delivery:

The effect of erythromycin on labor and delivery is unknown.

Nursing Mothers:

Erythromycin is excreted in breast milk. Caution should be exercised when erythromycin is administered to a nursing woman.

Pediatric Use:

See INDICATIONS AND USAGE and DOSAGE AND ADMINISTRATION sections.

Geriatric Use:

Elderly patients, particularly those with reduced renal or hepatic function, may be at increased risk for developing erythromycin-induced hearing loss, when Erythrocin® doses of 4 grams/day or higher are given. (See ADVERSE REACTIONS and DOSAGE AND ADMINISTRATION).

Elderly patients may be more susceptible to the development of torsades de pointes arrhythmias than younger patients. (See ADVERSE REACTIONS).

Elderly patients may experience increased effects of oral anticoagulant therapy while undergoing treatment with Erythrocin®. (See PRECAUTIONS , Drug Interactions).

Erythromycin Lactobionate does not contain sodium.

Information for Patients:

Patients should be counseled that antibacterial drugs including erythromycin should only be used to treat bacterial infections. They do not treat viral infections (e.g., the common cold). When erythromycin is prescribed to treat a bacterial infection, patients should be told that although it is common to feel better early in the course of therapy, the medication should be taken exactly as directed. Skipping doses or not completing the full course of therapy may (1) decrease the effectiveness of the immediate treatment and (2) increase the likelihood that bacteria will develop resistance and will not be treatable by erythromycin or other antibacterial drugs in the future.

Adverse Reactions

Side effects following the use of intravenous erythromycin are rare. Occasional venous irritation has been encountered, but if the infusion is given slowly, in dilute solution, preferably by continuous intravenous infusion or intermittent infusion in no less than 20 to 60 minutes, pain and vessel trauma are minimized.

Life-threatening episodes of ventricular tachycardia associated with prolonged QT interval (torsades de pointes) have been reported in some patients after intravenous administration of erythromycin lactobionate.

Susceptibility to the development of torsades de pointes arrhythmias, a rare but serious cardiac condition, is related to electrolyte imbalance, hepatic dysfunction, myocardial ischemia, left ventricular dysfunction, idiopathic Q-T prolongation, and concurrent antiarrhythmic therapy.5 Elderly patients exhibit a greater frequency of decreased hepatic function, cardiac function, and of concomitant disease and other drug therapy, and therefore should be monitored carefully during Erythrocin® therapy.

Allergic reactions ranging from urticaria to anaphylaxis have occurred. Skin reactions ranging from mild eruptions to erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis have been reported rarely.

There have been isolated reports of reversible hearing loss occurring chiefly in patients with renal insufficiency and in patients receiving high doses of erythromycin.

Elderly patients, particularly those with reduced renal or hepatic function, may also be at increased risk for developing this effect when Erythrocin® doses of 4 grams/day or higher are given. (See DOSAGE AND ADMINISTRATION ).

Overdosage

In the case of overdosage, erythromycin infusion should be discontinued and all other appropriate measures should be instituted.

Erythromycin is not removed by peritoneal dialysis or hemodialysis.

Erythrocin Dosage and Administration

For the treatment of severe infections in adults and pediatric patients, the recommended intravenous dose of erythromycin lactobionate is 15 to 20 mg/kg/day. Higher doses, up to 4 g/day, may be given for severe infections.

Administration of doses of ≥ 4 g/day may increase the risk for the development of erythromycin-induced hearing loss in elderly patients, particularly those with reduced renal or hepatic function. Erythrocin Lactobionate-I.V. (Sterile Erythromycin Lactobionate, USP) must be administered by continuous or intermittent intravenous infusion only. Due to the irritative properties of erythromycin, I.V. push is an unacceptable route of administration.

Continuous infusion of erythromycin lactobionate is preferable due to the slower infusion rate and lower concentration of erythromycin; however, intermittent infusion at six hour intervals is also effective. Intravenous erythromycin should be replaced by oral erythromycin as soon as possible.

For slow continuous infusion: The final diluted solution of erythromycin lactobionate is prepared to give a concentration of 1 g per liter (1 mg/mL).

For intermittent infusion: Administer one-fourth the total daily dose of erythromycin lactobionate by intravenous infusion in 20 to 60 minutes at intervals not greater than every six hours. The final diluted solution of erythromycin lactobionate is prepared to give a concentration of 1 to 5 mg/mL. No less than 100 mL of I.V. diluent should be used. Infusion should be sufficiently slow to minimize pain along the vein.

For treatment of acute pelvic inflammatory disease caused by N. Gonorrhoeae, in female patients hypersensitive to penicillins, administer 500 mg erythromycin lactobionate every six hours for three days, followed by oral administration of 250 mg erythromycin stearate or base every six hours for seven days.

For treatment of Legionnaires’ Disease: Although optimal doses have not been established, doses utilized in reported clinical data were 1 to 4 grams daily in divided doses.

Administration of doses of ≥ 4 g/day may increase the risk for the development of erythromycin-induced hearing loss in elderly patients, particularly those with reduced renal or hepatic function.

In the treatment of Group A beta-hemolytic streptococcal infections of the upper respiratory tract (e.g., tonsillitis or pharyngitis), the therapeutic dosage of erythromycin should be administered for ten days. The American Heart Association suggests a dosage of 250 mg of erythromycin orally, twice a day in long-term prophylaxis of streptococcal upper respiratory tract infections for the prevention of recurring attacks of rheumatic fever in patients allergic to penicillin and sulfonamides.3

In prophylaxis against bacterial endocarditis (See INDICATIONS AND USAGE section) the oral regimen for penicillin allergic patients is erythromycin 1 gram, 1 hour before the procedure followed by 500 mg six hours later.4

Preparation of Solution:

  1. PREPARE THE INITIAL SOLUTION OF Erythrocin® LACTOBIONATE-I.V. BY ADDING 10 ML OF STERILE WATER FOR INJECTION, USP, TO THE 500 MG VIAL OR 20 ML OF STERILE WATER FOR INJECTION, USP, TO THE 1 G VIAL. Use only Sterile Water for Injection, USP, as other diluents may cause precipitation during reconstitution. Do not use diluents containing preservatives or inorganic salts.

      After reconstitution, each mL contains 50 mg of erythromycin activity. The initial solution is stable at refrigerator temperature for two weeks, or for 24 hours at room temperature.

  2. ADD THE INITIAL DILUTION TO ONE OF THE FOLLOWING DILUENTS BEFORE ADMINISTRATION to give a concentration of 1 g of erythromycin activity per liter (1 mg/mL) for continuous infusion or 1 to 5 mg/mL for intermittent infusion:

      0.9% SODIUM CHLORIDE INJECTION, USP; LACTATED RINGER’S INJECTION, USP; NORMOSOL®-R.

  3. THE FOLLOWING SOLUTIONS MAY ALSO BE USED PROVIDING THEY ARE FIRST BUFFERED WITH NEUT ® (4% SODIUM BICARBONATE, HOSPIRA) by adding 1 mL of Neut per 100 mL of solution:

      5% DEXTROSE INJECTION, USP

      5% DEXTROSE AND LACTATED RINGER’S INJECTION

      5% DEXTROSE AND 0.9% SODIUM CHLORIDE INJECTION, USP

Neut® (4% sodium bicarbonate, Hospira) must be added to these solutions so that their pH is in the optimum range for erythromycin lactobionate stability. Acidic solutions of erythromycin lactobionate are unstable and lose their potency rapidly. A pH of at least 5.5 is desirable for the final diluted solution of erythromycin lactobionate.

No drug or chemical agent should be added to an erythromycin lactobionate-I.V. fluid admixture unless its effect on the chemical and physical stability of the solution has first been determined.

Stability:

The final diluted solution of erythromycin lactobionate should be completely administered within 8 hours, since it is not suitable for storage.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.

How is Erythrocin Supplied

Erythrocin Lactobionate-I.V. (Sterile Erythromycin Lactobionate, USP) is supplied as a sterile, lyophilized powder in packages of ten vials (NDC 0409-6481-01), each vial containing the equivalent of 1 g of erythromycin: and in packages of ten vials (NDC 0409-6482-01), each vial containing the equivalent of 500 mg of erythromycin.

Store at 20 to 25°C (68 to 77°F). [See USP Controlled Room Temperature.]

REFERENCES

  1. National Committee for Clinical Laboratory Standards, Approved Standard: Performance Standards for Antimicrobial Disk Susceptibility Tests, 3rd Edition, Vol. 4(16):M2-A3, Villanova, PA, December 1984.

  2. Ericson, H.M., Sherris, J.C., Antibiotic Sensitivity Testing Report of an International Collaborative Study, Acta Pathologica etMicrobiologica Scandinavica Section B Suppl. 217:1-90, 1971.

  3. Committee on Rheumatic Fever and Infective Endocarditis of the Council on Cardiovascular Disease of the Young: Prevention of Rheumatic Fever, Circulation 70(6):1118A-1122A, December 1984.

  4. Committee on Rheumatic Fever and Infective Endocarditis of the Council on Cardiovascular Disease of the Young: Prevention of Bacterial Endocarditis, Circulation 70(6):1123A-1127A, December 1984.

  5. Gilter, B., et al, Torsades de Pointes Induced by Erythromycin, Chest, Volume 105: 368-72, February 1994.

November, 2004

©Hospira 2004 EN-0611 Printed in USA

HOSPIRA, INC., LAKE FOREST, IL 60045 USA


Erythrocin Lactobionate (Erythromycin Lactobionate)
PRODUCT INFO
Product Code 0409-6481 Dosage Form INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION
Route Of Administration INTRAVENOUS DEA Schedule
INGREDIENTS
Name (Active Moiety) Type Strength
Erythromycin Lactobionate (Erythromycin) Active 1 GRAM  In 20 MILLILITER
IMPRINT INFORMATION
Characteristic Appearance Characteristic Appearance
Color Score
Shape Symbol
Imprint Code Coating
Size
PACKAGING
# NDC Package Description Multilevel Packaging
1 0409-6481-01 5 PACKAGE In 1 CASE contains a PACKAGE
1 10 VIAL In 1 PACKAGE This package is contained within the CASE (0409-6481-01) and contains a VIAL ()
1 20 MILLILITER In 1 VIAL This package is contained within a PACKAGE and a CASE (0409-6481-01)

Erythrocin Lactobionate (Erythromycin Lactobionate)
PRODUCT INFO
Product Code 0409-6482 Dosage Form INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION
Route Of Administration INTRAVENOUS DEA Schedule
INGREDIENTS
Name (Active Moiety) Type Strength
Erythromycin Lactobionate (Erythromycin) Active 500 MILLIGRAM  In 10 MILLILITER
IMPRINT INFORMATION
Characteristic Appearance Characteristic Appearance
Color Score
Shape Symbol
Imprint Code Coating
Size
PACKAGING
# NDC Package Description Multilevel Packaging
1 0409-6482-01 10 PACKAGE In 1 CASE contains a PACKAGE
1 10 VIAL In 1 PACKAGE This package is contained within the CASE (0409-6482-01) and contains a VIAL ()
1 10 MILLILITER In 1 VIAL This package is contained within a PACKAGE and a CASE (0409-6482-01)

Revised: 11/2006





Where can I get more information about Erythrocin Injection USP Erythrocin Injection ? We recommend to use www.Drugs.com

Typical mistypes for Erythrocin Injection USP Erythrocin Injection
wrythrocin injection usp erythrocin injection, srythrocin injection usp erythrocin injection, drythrocin injection usp erythrocin injection, rrythrocin injection usp erythrocin injection, 4rythrocin injection usp erythrocin injection, 3rythrocin injection usp erythrocin injection, eeythrocin injection usp erythrocin injection, edythrocin injection usp erythrocin injection, efythrocin injection usp erythrocin injection, etythrocin injection usp erythrocin injection, e5ythrocin injection usp erythrocin injection, e4ythrocin injection usp erythrocin injection, ertthrocin injection usp erythrocin injection, ergthrocin injection usp erythrocin injection, erhthrocin injection usp erythrocin injection, eruthrocin injection usp erythrocin injection, er7throcin injection usp erythrocin injection, er6throcin injection usp erythrocin injection, eryrhrocin injection usp erythrocin injection, eryfhrocin injection usp erythrocin injection, eryghrocin injection usp erythrocin injection, eryyhrocin injection usp erythrocin injection, ery6hrocin injection usp erythrocin injection, ery5hrocin injection usp erythrocin injection, erytgrocin injection usp erythrocin injection, erytbrocin injection usp erythrocin injection, erytnrocin injection usp erythrocin injection, erytjrocin injection usp erythrocin injection, eryturocin injection usp erythrocin injection, erytyrocin injection usp erythrocin injection, erytheocin injection usp erythrocin injection, erythdocin injection usp erythrocin injection, erythfocin injection usp erythrocin injection, erythtocin injection usp erythrocin injection, eryth5ocin injection usp erythrocin injection, eryth4ocin injection usp erythrocin injection, erythricin injection usp erythrocin injection, erythrkcin injection usp erythrocin injection, erythrlcin injection usp erythrocin injection, erythrpcin injection usp erythrocin injection, erythr0cin injection usp erythrocin injection, erythr9cin injection usp erythrocin injection, erythroxin injection usp erythrocin injection, erythrovin injection usp erythrocin injection, erythrofin injection usp erythrocin injection, erythrodin injection usp erythrocin injection, erythrocun injection usp erythrocin injection, erythrocjn injection usp erythrocin injection, erythrockn injection usp erythrocin injection, erythrocon injection usp erythrocin injection, erythroc9n injection usp erythrocin injection, erythroc8n injection usp erythrocin injection, erythrocib injection usp erythrocin injection, erythrocim injection usp erythrocin injection, erythrocij injection usp erythrocin injection, erythrocih injection usp erythrocin injection, erythrocin unjection usp erythrocin injection, erythrocin jnjection usp erythrocin injection, erythrocin knjection usp erythrocin injection, erythrocin onjection usp erythrocin injection, erythrocin 9njection usp erythrocin injection, erythrocin 8njection usp erythrocin injection, erythrocin ibjection usp erythrocin injection, erythrocin imjection usp erythrocin injection, erythrocin ijjection usp erythrocin injection, erythrocin ihjection usp erythrocin injection, erythrocin inhection usp erythrocin injection, erythrocin innection usp erythrocin injection, erythrocin inmection usp erythrocin injection, erythrocin inkection usp erythrocin injection, erythrocin iniection usp erythrocin injection, erythrocin inuection usp erythrocin injection, erythrocin injwction usp erythrocin injection, erythrocin injsction usp erythrocin injection, erythrocin injdction usp erythrocin injection, erythrocin injrction usp erythrocin injection, erythrocin inj4ction usp erythrocin injection, erythrocin inj3ction usp erythrocin injection, erythrocin injextion usp erythrocin injection, erythrocin injevtion usp erythrocin injection, erythrocin injeftion usp erythrocin injection, erythrocin injedtion usp erythrocin injection, erythrocin injecrion usp erythrocin injection, erythrocin injecfion usp erythrocin injection, erythrocin injecgion usp erythrocin injection, erythrocin injecyion usp erythrocin injection, erythrocin injec6ion usp erythrocin injection, erythrocin injec5ion usp erythrocin injection, erythrocin injectuon usp erythrocin injection, erythrocin injectjon usp erythrocin injection, erythrocin injectkon usp erythrocin injection, erythrocin injectoon usp erythrocin injection, erythrocin inject9on usp erythrocin injection, erythrocin inject8on usp erythrocin injection, erythrocin injectiin usp erythrocin injection, erythrocin injectikn usp erythrocin injection, erythrocin injectiln usp erythrocin injection, erythrocin injectipn usp erythrocin injection, erythrocin injecti0n usp erythrocin injection, erythrocin injecti9n usp erythrocin injection, erythrocin injectiob usp erythrocin injection, erythrocin injectiom usp erythrocin injection, erythrocin injectioj usp erythrocin injection, erythrocin injectioh usp erythrocin injection, erythrocin injection ysp erythrocin injection, erythrocin injection hsp erythrocin injection, erythrocin injection jsp erythrocin injection, erythrocin injection isp erythrocin injection, erythrocin injection 8sp erythrocin injection, erythrocin injection 7sp erythrocin injection, erythrocin injection uap erythrocin injection, erythrocin injection uzp erythrocin injection, erythrocin injection uxp erythrocin injection, erythrocin injection udp erythrocin injection, erythrocin injection uep erythrocin injection, erythrocin injection uwp erythrocin injection, erythrocin injection uso erythrocin injection, erythrocin injection usl erythrocin injection, erythrocin injection us- erythrocin injection, erythrocin injection us0 erythrocin injection, erythrocin injection usp wrythrocin injection, erythrocin injection usp srythrocin injection, erythrocin injection usp drythrocin injection, erythrocin injection usp rrythrocin injection, erythrocin injection usp 4rythrocin injection, erythrocin injection usp 3rythrocin injection, erythrocin injection usp eeythrocin injection, erythrocin injection usp edythrocin injection, erythrocin injection usp efythrocin injection, erythrocin injection usp etythrocin injection, erythrocin injection usp e5ythrocin injection, erythrocin injection usp e4ythrocin injection, erythrocin injection usp ertthrocin injection, erythrocin injection usp ergthrocin injection, erythrocin injection usp erhthrocin injection, erythrocin injection usp eruthrocin injection, erythrocin injection usp er7throcin injection, erythrocin injection usp er6throcin injection, erythrocin injection usp eryrhrocin injection, erythrocin injection usp eryfhrocin injection, erythrocin injection usp eryghrocin injection, erythrocin injection usp eryyhrocin injection, erythrocin injection usp ery6hrocin injection, erythrocin injection usp ery5hrocin injection, erythrocin injection usp erytgrocin injection, erythrocin injection usp erytbrocin injection, erythrocin injection usp erytnrocin injection, erythrocin injection usp erytjrocin injection, erythrocin injection usp eryturocin injection, erythrocin injection usp erytyrocin injection, erythrocin injection usp erytheocin injection, erythrocin injection usp erythdocin injection, erythrocin injection usp erythfocin injection, erythrocin injection usp erythtocin injection, erythrocin injection usp eryth5ocin injection, erythrocin injection usp eryth4ocin injection, erythrocin injection usp erythricin injection, erythrocin injection usp erythrkcin injection, erythrocin injection usp erythrlcin injection, erythrocin injection usp erythrpcin injection, erythrocin injection usp erythr0cin injection, erythrocin injection usp erythr9cin injection, erythrocin injection usp erythroxin injection, erythrocin injection usp erythrovin injection, erythrocin injection usp erythrofin injection, erythrocin injection usp erythrodin injection, erythrocin injection usp erythrocun injection, erythrocin injection usp erythrocjn injection, erythrocin injection usp erythrockn injection, erythrocin injection usp erythrocon injection, erythrocin injection usp erythroc9n injection, erythrocin injection usp erythroc8n injection, erythrocin injection usp erythrocib injection, erythrocin injection usp erythrocim injection, erythrocin injection usp erythrocij injection, erythrocin injection usp erythrocih injection, erythrocin injection usp erythrocin unjection, erythrocin injection usp erythrocin jnjection, erythrocin injection usp erythrocin knjection, erythrocin injection usp erythrocin onjection, erythrocin injection usp erythrocin 9njection, erythrocin injection usp erythrocin 8njection, erythrocin injection usp erythrocin ibjection, erythrocin injection usp erythrocin imjection, erythrocin injection usp erythrocin ijjection, erythrocin injection usp erythrocin ihjection, erythrocin injection usp erythrocin inhection, erythrocin injection usp erythrocin innection, erythrocin injection usp erythrocin inmection, erythrocin injection usp erythrocin inkection, erythrocin injection usp erythrocin iniection, erythrocin injection usp erythrocin inuection, erythrocin injection usp erythrocin injwction, erythrocin injection usp erythrocin injsction, erythrocin injection usp erythrocin injdction, erythrocin injection usp erythrocin injrction, erythrocin injection usp erythrocin inj4ction, erythrocin injection usp erythrocin inj3ction, erythrocin injection usp erythrocin injextion, erythrocin injection usp erythrocin injevtion, erythrocin injection usp erythrocin injeftion, erythrocin injection usp erythrocin injedtion, erythrocin injection usp erythrocin injecrion, erythrocin injection usp erythrocin injecfion, erythrocin injection usp erythrocin injecgion, erythrocin injection usp erythrocin injecyion, erythrocin injection usp erythrocin injec6ion, erythrocin injection usp erythrocin injec5ion, erythrocin injection usp erythrocin injectuon, erythrocin injection usp erythrocin injectjon, erythrocin injection usp erythrocin injectkon, erythrocin injection usp erythrocin injectoon, erythrocin injection usp erythrocin inject9on, erythrocin injection usp erythrocin inject8on, erythrocin injection usp erythrocin injectiin, erythrocin injection usp erythrocin injectikn, erythrocin injection usp erythrocin injectiln, erythrocin injection usp erythrocin injectipn, erythrocin injection usp erythrocin injecti0n, erythrocin injection usp erythrocin injecti9n, erythrocin injection usp erythrocin injectiob, erythrocin injection usp erythrocin injectiom, erythrocin injection usp erythrocin injectioj, erythrocin injection usp erythrocin injectioh, rythrocin injection usp erythrocin injection, eythrocin injection usp erythrocin injection, erthrocin injection usp erythrocin injection, eryhrocin injection usp erythrocin injection, erytrocin injection usp erythrocin injection, erythocin injection usp erythrocin injection, erythrcin injection usp erythrocin injection, erythroin injection usp erythrocin injection, erythrocn injection usp erythrocin injection, erythroci injection usp erythrocin injection, erythrocininjection usp erythrocin injection, erythrocin njection usp erythrocin injection, erythrocin ijection usp erythrocin injection, erythrocin inection usp erythrocin injection, erythrocin injction usp erythrocin injection, erythrocin injetion usp erythrocin injection, erythrocin injecion usp erythrocin injection, erythrocin injecton usp erythrocin injection, erythrocin injectin usp erythrocin injection, erythrocin injectio usp erythrocin injection, erythrocin injectionusp erythrocin injection, erythrocin injection sp erythrocin injection, erythrocin injection up erythrocin injection, erythrocin injection us erythrocin injection, erythrocin injection usp erythrocin injection, erythrocin injection usp erythrocin injection, erythrocin injection usp rythrocin injection, erythrocin injection usp eythrocin injection, erythrocin injection usp erthrocin injection, erythrocin injection usp eryhrocin injection, erythrocin injection usp erytrocin injection, erythrocin injection usp erythocin injection, erythrocin injection usp erythrcin injection, erythrocin injection usp erythroin injection, erythrocin injection usp erythrocn injection, erythrocin injection usp erythroci injection, erythrocin injection usp erythrocininjection, erythrocin injection usp erythrocin njection, erythrocin injection usp erythrocin ijection, erythrocin injection usp erythrocin inection, erythrocin injection usp erythrocin injction, erythrocin injection usp erythrocin injetion, erythrocin injection usp erythrocin injecion, erythrocin injection usp erythrocin injecton, erythrocin injection usp erythrocin injectin, erythrocin injection usp erythrocin injectio, reythrocin injection usp erythrocin injection, eyrthrocin injection usp erythrocin injection, ertyhrocin injection usp erythrocin injection, eryhtrocin injection usp erythrocin injection, erytrhocin injection usp erythrocin injection, erythorcin injection usp erythrocin injection, erythrcoin injection usp erythrocin injection, erythroicn injection usp erythrocin injection, erythrocni injection usp erythrocin injection, erythroci ninjection usp erythrocin injection, erythrocini njection usp erythrocin injection, erythrocin nijection usp erythrocin injection, erythrocin ijnection usp erythrocin injection, erythrocin inejction usp erythrocin injection, erythrocin injcetion usp erythrocin injection, erythrocin injetcion usp erythrocin injection, erythrocin injeciton usp erythrocin injection, erythrocin injectoin usp erythrocin injection, erythrocin injectino usp erythrocin injection, erythrocin injectio nusp erythrocin injection, erythrocin injectionu sp erythrocin injection, erythrocin injection sup erythrocin injection, erythrocin injection ups erythrocin injection, erythrocin injection us p erythrocin injection, erythrocin injection usp erythrocin injection, erythrocin injection usp e rythrocin injection, erythrocin injection usp reythrocin injection, erythrocin injection usp eyrthrocin injection, erythrocin injection usp ertyhrocin injection, erythrocin injection usp eryhtrocin injection, erythrocin injection usp erytrhocin injection, erythrocin injection usp erythorcin injection, erythrocin injection usp erythrcoin injection, erythrocin injection usp erythroicn injection, erythrocin injection usp erythrocni injection, erythrocin injection usp erythroci ninjection, erythrocin injection usp erythrocini njection, erythrocin injection usp erythrocin nijection, erythrocin injection usp erythrocin ijnection, erythrocin injection usp erythrocin inejction, erythrocin injection usp erythrocin injcetion, erythrocin injection usp erythrocin injetcion, erythrocin injection usp erythrocin injeciton, erythrocin injection usp erythrocin injectoin, erythrocin injection usp erythrocin injectino, eerythrocin injection usp erythrocin injection, errythrocin injection usp erythrocin injection, eryythrocin injection usp erythrocin injection, erytthrocin injection usp erythrocin injection, erythhrocin injection usp erythrocin injection, erythrrocin injection usp erythrocin injection, erythroocin injection usp erythrocin injection, erythroccin injection usp erythrocin injection, erythrociin injection usp erythrocin injection, erythrocinn injection usp erythrocin injection, erythrocin injection usp erythrocin injection, erythrocin iinjection usp erythrocin injection, erythrocin innjection usp erythrocin injection, erythrocin injjection usp erythrocin injection, erythrocin injeection usp erythrocin injection, erythrocin injecction usp erythrocin injection, erythrocin injecttion usp erythrocin injection, erythrocin injectiion usp erythrocin injection, erythrocin injectioon usp erythrocin injection, erythrocin injectionn usp erythrocin injection, erythrocin injection usp erythrocin injection, erythrocin injection uusp erythrocin injection, erythrocin injection ussp erythrocin injection, erythrocin injection uspp erythrocin injection, erythrocin injection usp erythrocin injection, erythrocin injection usp erythrocin injection, erythrocin injection usp eerythrocin injection, erythrocin injection usp errythrocin injection, erythrocin injection usp eryythrocin injection, erythrocin injection usp erytthrocin injection, erythrocin injection usp erythhrocin injection, erythrocin injection usp erythrrocin injection, erythrocin injection usp erythroocin injection, erythrocin injection usp erythroccin injection, erythrocin injection usp erythrociin injection, erythrocin injection usp erythrocinn injection, erythrocin injection usp erythrocin injection, erythrocin injection usp erythrocin iinjection, erythrocin injection usp erythrocin innjection, erythrocin injection usp erythrocin injjection, erythrocin injection usp erythrocin injeection, erythrocin injection usp erythrocin injecction, erythrocin injection usp erythrocin injecttion, erythrocin injection usp erythrocin injectiion, erythrocin injection usp erythrocin injectioon, erythrocin injection usp erythrocin injectionn, etc.



© Copyright by drug-information.ru 2001-2019. All rights reserved