Roxithromycin; Uses, Dosage, Side Effects, Drug Interactions

Last updated: February 7, 2026Reviewed date: February 7, 2026Reading time: 6 min read

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বাংলা রোগী নোট এখনো যোগ করা হয়নি। পোস্ট এডিটরে “RX Bangla Patient Mode” বক্স থেকে সহজ বাংলা সারাংশ যোগ করুন।

এই তথ্য শিক্ষা ও সচেতনতার জন্য। এটি ডাক্তারি পরীক্ষা, রোগ নির্ণয় বা প্রেসক্রিপশনের বিকল্প নয়।

Article Summary

Roxithromycin is a semi-synthetic derivative of the macrolide antibiotic erythromycin that includes an N-oxime side chain on the lactone ring, with antibacterial and anti-malarial activities. Roxithromycin binds to the subunit 50S of the bacterial ribosome, which inhibits bacterial protein synthesis and leads to inhibition of bacterial cell growth and replication. Semisynthetic derivative of erythromycin. Roxithromycin is concentrated by human phagocytes and is bioactive intracellularly. While the drug is active against...

Key Takeaways

This article explains Mechanism of Action of Roxithromycin in simple medical language.
This article explains Indications of Roxithromycin in simple medical language.
This article explains Contra-Indications of Roxithromycin in simple medical language.
This article explains Dosages of Roxithromycin in simple medical language.

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Emergency safety firstUrgent warning signs are highlighted below.

Seek urgent medical care if you notice

These warning signs are general safety guidance. Local emergency numbers and clinical judgment should always come first.

Severe symptoms, breathing difficulty, fainting, confusion, or rapidly worsening illness.
New weakness, severe pain, high fever, or symptoms after a serious injury.
Any symptom that feels urgent, unusual, or unsafe for the patient.

Emergency now

Use emergency care for severe, sudden, rapidly worsening, or life-threatening symptoms.

See a doctor

Book a professional medical evaluation if symptoms persist, worsen, recur often, affect daily activities, or occur in a high-risk patient.

Learn safely

Use this article to understand possible causes, tests, treatment options, prevention, and questions to ask your clinician.

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Definition

Roxithromycin is a semi-synthetic derivative of the macrolide bacterial infections. সহজ বাংলা: ব্যাকটেরিয়ার সংক্রমণের ওষুধ।" data-rx-term="antibiotic" data-rx-definition="An antibiotic is a medicine used to treat bacterial infections. সহজ বাংলা: ব্যাকটেরিয়ার সংক্রমণের ওষুধ।">antibiotic erythromycin that includes an N-oxime side chain on the lactone ring, with antibacterial and anti-malarial activities. Roxithromycin binds to the subunit 50S of the bacterial ribosome, which inhibits bacterial protein synthesis and leads to inhibition of bacterial cell growth and replication.

Semisynthetic derivative of erythromycin. Roxithromycin is concentrated by human phagocytes and is bioactive intracellularly. While the drug is active against a wide spectrum of pathogens, it is particularly effective in the treatment of respiratory and genital tract infections.

Roxithromycin is a semi-synthetic macrolide bacterial infections. সহজ বাংলা: ব্যাকটেরিয়ার সংক্রমণের ওষুধ।" data-rx-term="antibiotic" data-rx-definition="An antibiotic is a medicine used to treat bacterial infections. সহজ বাংলা: ব্যাকটেরিয়ার সংক্রমণের ওষুধ।">antibiotic. It is very similar in composition, chemical structure and mechanism of action to erythromycin, azithromycin, or clarithromycin. Roxithromycin prevents bacteria from growing, by interfering with their protein synthesis. Roxithromycin binds to the subunit 50S of the bacterial ribosome, and thus inhibits the translocation of peptides. Roxithromycin has similar antimicrobial spectrum as erythromycin, but is more effective against certain gram-negative bacteria, particularly Legionella pneumophila. It can treat respiratory tract, urinary and soft tissue infections.

Mechanism of Action of Roxithromycin

Roxithromycin prevents bacteria from growing, by interfering with their protein synthesis. Roxithromycin binds to the subunit 50S of the bacterial ribosome, and thus inhibits the synthesis of peptides. Roxithromycin has similar antimicrobial spectrum as erythromycin, but is more effective against certain gram-negative bacteria, particularly Legionella pneumophila.Roxithromycin has the following antibacterial spectrum in vitro: Streptococcus agalactiae, Streptococcus pneumoniae (Pneumococcus), Neisseria meningitides (Meningococcus), Listeria monocytogenes, Mycoplasma pneumoniae, Chlamydia trachomatis, Ureaplasma urealyticum, Legionella pneumophila, Helicobacter (Campylobacter), Gardnerella vaginalis, Bordetella pertussis, Moraxella catarrhalis (Branhamella Catarrhalis), and Haemophilus ducreyi. Roxithromycin is highly concentrated in polymorphonuclear leukocytes and macrophages, achieving intracellular concentrations greater than those outside the cell. Roxithromycin enhances the adhesive and chemotactic functions of these cells which in the presence of infection produce phagocytosis and bacterial lysis. Roxithromycin also possesses intracellular bactericidal activity.

Roxithromycin is a semi-synthetic derivative of the macrolide bacterial infections. সহজ বাংলা: ব্যাকটেরিয়ার সংক্রমণের ওষুধ।" data-rx-term="antibiotic" data-rx-definition="An antibiotic is a medicine used to treat bacterial infections. সহজ বাংলা: ব্যাকটেরিয়ার সংক্রমণের ওষুধ।">antibiotic erythromycin that includes an N-oxime side chain on the lactone ring, with antibacterial and anti-malarial activities. Roxithromycin binds to the subunit 50S of the bacterial ribosome, which inhibits bacterial protein synthesis and leads to inhibition of bacterial cell growth and replication.

Indications of Roxithromycin

Mycoplasma Pneumonia
Sinusitis
Bronchitis
acute bronchitis (infection of the bronchi causing coughing)
pneumonia (lung infection characterised by fever, malaise, headache)
skin and soft tissue infections
non gonococcal urethritis
impetigo (bacterial infection causing sores on the skin).
Nongonococcal Urethritis
Pharyngitis
Pneumonia
Skin and Structure Infection
Skin or Soft Tissue Infection
Strep Throat
Tonsillitis/Pharyngitis
Toxoplasmosis
Upper Respiratory Tract Infection
Used to treat respiratory tract, urinary and soft tissue infections.

Contra-Indications of Roxithromycin

Allergic to roxithromycin or to any of the other ingredients in roxithromycin tablets or to drugs like erythromycin, azithromycin, or clarithromycin
Diarrhea with blood in stools
Porphyria
It should not be used with colchicine in people with kidney or liver impairment.

Dosages of Roxithromycin

The recommended dosage for adults is 300 mg per day.

You may take this according to one of the following dosage regimens:

one 300 mg tablet once a day, or
one 150 mg tablet twice a day, or
two 150 mg tablets once a day.

The dose for a child will depend on this child’s weight.

The recommended dose for children weighing 40 kg and more is 150 mg twice a day.

Roxithromycin AN should not be used for children less than 40 kg in weight.

Side Effects of Roxithromycin

The most common

Common

Serious

Porphyria
Gastrointestinal: abdominal cramps, nausea, diarrhea, anorexia, pancreatitis
Genitourinary: vulvovaginal candidiasis, renal failure
Cardiovascular System: prolongation of QT interval
Hepatic: hepatotoxicity, jaundice
Hematologic: allergy, parasites, and some inflammation. সহজ বাংলা: অ্যালার্জি/পরজীবী সংক্রমণে জড়িত রক্তকণিকা।" data-rx-term="eosinophil" data-rx-definition="Eosinophil is a white blood cell involved in allergy, parasites, and some inflammation. সহজ বাংলা: অ্যালার্জি/পরজীবী সংক্রমণে জড়িত রক্তকণিকা।">eosinophil count, often linked with allergy, parasites, inflammation, or blood disease. সহজ বাংলা: ইওসিনোফিল বেশি হওয়া।" data-rx-term="eosinophilia" data-rx-definition="Eosinophilia means high eosinophil count, often linked with allergy, parasites, inflammation, or blood disease. সহজ বাংলা: ইওসিনোফিল বেশি হওয়া।">eosinophilia, thrombocytosis, lymphopenia
Central Nervous System a headache, fatigue
Endocrine/Metabolic, hyperglycemia
Dermatologic: itching, nail discoloratiom

Drug Interactions of Roxithromycin

Roxithromycin has fewer interactions than erythromycin as it has a lower affinity for cytochrome P450. Roxithromycin does not interact with hormonal contraceptives, prednisolone, carbamazepine, ranitidine or antacids. When roxithromycin is administered with theophylline, some studies have shown an increase in the plasma concentration of theophylline. A change in dosage is usually not required but patients with high levels of theophylline at the start of the treatment should have their plasma levels monitored.

terfenadine and astemizole, medicines used to treat allergies
digoxin, a medicine used to treat heart failure
midazolam, a medicine used to induce sleep before operations
cyclosporin, a medicine used to prevent organ transplant rejection or to treat certain problems with the immune system
cisapride, a medicine used to treat gastrointestinal problems
pimozide, an antipsychotic medicine.

Roxithromycin appears to interact with warfarin. This is shown by an increase in prothrombin time and/or international normalised ratio (INR) in patients taking roxithromycin and warfarin concurrently. As a consequence, severe bleeding episodes have occurred.

Pregnancy & Lactation of Roxithromycin

Pregnancy Category B1

B1 catagory drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed.

Pregnancy

Erythromycin is still the drug of choice among the macrolides during pregnancy. Erythromycin estolate and troleandomycin should not be given in the second and third trimesters. Newer macrolides such as azithromycin, clarithromycin, josamycin, and roxithromycin are second-choice macrolides.

Lactation

Breastfeeding or treatment of the mother should be discontinued as necessary. Use in the Elderly. No dosage adjustment is required in elderly patients. Carcinogenesis and Mutagenesis. Long-term studies in animals have not been performed to evaluate the carcinogenic potential of roxithromycin.

References

Roxithromycin; Uses, Dosage, Side Effects, Drug Interactions

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

What to tell the doctor

Write when the problem started and how it changed.
Bring old prescriptions, investigation reports, and current medicines.
Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

What is the most likely cause of my symptoms?
Which danger signs mean I should go to hospital quickly?
Which tests are necessary now, and which can wait?
How should I take medicines safely and what side effects should I watch for?
When should I come for follow-up?

Tests to discuss

Vital signs: temperature, pulse, blood pressure, oxygen saturation
Basic physical examination by a clinician
CBC, urine test, blood sugar, or imaging only when clinically needed

Avoid these mistakes

Do not use antibiotics, steroid tablets/injections, or strong painkillers without proper medical advice.
Do not hide pregnancy, kidney disease, ulcer, allergy, or blood thinner use.
Do not delay emergency care when danger signs are present.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

Avoid heavy lifting, sudden bending, and prolonged bed rest.
Use comfortable posture and gentle movement as tolerated.
Discuss physiotherapy, X-ray, or MRI only when clinically needed.

OTC medicine safety

For mild back pain, pain-relief medicine may be discussed with a doctor or pharmacist.
Avoid repeated painkiller use if you have kidney disease, stomach ulcer, uncontrolled blood pressure, or are taking blood thinners.

Avoid these mistakes

Do not start antibiotics without a proper medical decision.
Do not use steroid tablets or injections casually for quick relief.
Do not delay emergency care because of home remedies.

Get urgent help if

Back pain with leg weakness, numbness around private area, loss of urine/stool control, fever, cancer history, or major injury needs urgent care.

Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Medicine doctor / pediatrician for children / qualified clinician

Tests to discuss with doctor

Temperature chart and hydration assessment
CBC with platelet count if fever persists or dengue/other infection is possible
Urine test, malaria/dengue tests, chest evaluation, or blood culture only when clinically indicated

Questions to ask

What is the most likely cause of my symptoms?
Which warning signs mean I should go to emergency care?
Which tests are really needed now?
Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?
Do I need antibiotics, or is this more likely viral?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Go to emergency care if you notice:

Severe or rapidly worsening symptoms
Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration

Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.

Step 1
Check danger signs first

If danger signs are present, seek emergency care and do not wait for online information.
Step 2
Record the symptom story

Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.
Step 3
Visit a qualified clinician

A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.
Step 4
Do only useful tests

Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.
Step 5
Follow up and return early if worse

If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips

Take a written symptom diary and all previous prescriptions/test reports.
Do not hide medicines already taken, even herbal or over-the-counter medicines.
Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

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Frequently Asked Questions

Is this article a replacement for a doctor?

No. It is educational content only. Patients should consult a qualified clinician for diagnosis and treatment.

When should I seek urgent care?

Seek urgent care for severe symptoms, rapidly worsening condition, breathing difficulty, severe pain, neurological changes, or any emergency warning sign.

References

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