Drug reference

spiramycin

16-membered macrolide antibiotic · Antiprotozoal

START

Toxoplasmosis in pregnancy: 1 g PO three times daily

TYPICAL MAX

3 g (9 MIU)/day

STOP IF

Severe hypersensitivity, significant QT prolongation, or haemolysis

WATCH

GI tolerance; consider G6PD status; fetal infection follow-up

CDSCO approvedATC J01FA02

Dose laddermg/d

Renal dose adjustmenteGFR mL/min/1.73m²

KDIGO 2024 + manufacturer label

Pharmacokineticsplasma · t hours

ONSET: 1h · absorption
PEAK: 2h · Tmax
t½: 6h · t½
DURATION: 8h · per dose

EXCRETION

Mainly biliary; minor renal

route + CYP

INTERACTIONS

1 major

SEVERE in our sources

PREGNANCY

Used in pregnancy for toxoplasmosis (preferred); generally considered safe.

FDA category + note

Top interactionssee all 5 →

Levodopa + CarbidopaSevereDatabaseKimi deep-research + Cla

Mechanism

Binds bacterial 50S ribosomal subunit, inhibiting protein synthesis; bacteriostatic against susceptible Gram-positive organisms and Toxoplasma gondii (placental concentration → fetal prophylaxis).

Indications

Acute toxoplasmosis in pregnancy (preventing transmission to fetus)Susceptible respiratory tract / ENT / skin infections (selected, where licensed)

Dosing

Adult: Toxoplasmosis in pregnancy: 1 g (3 MIU) PO three times daily, continued until delivery or until diagnostic clarification.
Pediatric: 50,000–100,000 IU/kg/day in 2–3 divided doses.
Renal adjustment: No specific adjustment for usual oral dosing.
Hepatic adjustment: Caution in significant hepatic impairment.
Geriatric: No specific adjustment.
Max dose: 3 g (9 MIU)/day

Pharmacokinetics

Onset

Antibacterial effect over hours

Peak effect

~1.5–3 h (Tmax)

Duration

~8 h

Half-life

~5–8 h

Bioavailability

~30–40%

Protein binding

~10–25%

Metabolism

Hepatic (limited)

Excretion

Mainly biliary; minor renal

Contraindications

Hypersensitivity to macrolides
Caution: prolonged QT/risk factors

Side effects

Common

Nausea/vomitingDiarrhoeaAbdominal painRash

Serious

QT prolongation (less than other macrolides)
Severe hypersensitivity reactions
Acute haemolysis (G6PD deficiency)

Pregnancy & lactation

Pregnancy

Used in pregnancy for toxoplasmosis (preferred); generally considered safe.

Lactation

Excreted in milk; usually compatible (monitor infant).

Drug interactions

Levodopa + Carbidopa

Severe

Database

Spiramycin reduces carbidopa absorption

Avoid combination