Clomid for men

Clomid for men: Clomiphene Citrate (Clomid, Clostilbegit) is often prescribed to men with low testosterone levels as a replacement therapy. Low testosterone (hypogonadism) cannot be considered a normal healthy condition for a man in his 30s, 50s, or 75s.

Symptoms of this hormonal disorder usually include:

  • lack of energy;
  • depressed mood;
  • loss of vitality;
  • muscle atrophy (sarcopenia);
  • muscle pain;
  • low libido;
  • erectile dysfunction;
  • weight gain,
  • bone loss (osteopenia) and osteoporosis;
  • moderate anemia;
  • increased risk of Alzheimer’s disease, prostate cancer, and an increased risk of death.

Low testosterone levels in men can be caused by problems in the testes (or gonads). This condition is called primary hypogonadism, it is associated with mumps, testicular trauma, testicular cancer and is treated only with testosterone replacement therapy.

The most common causes of low testosterone (hypogonadism) are problems with the pituitary gland and/or hypothalamus in the male brain. The reduced T caused by such “brain” problems is collectively referred to as secondary hypogonadism, or hypogonadotropic hypogonadism. It can be the result of depression, anxiety, traumatic brain injury, excessive exercise, an overdose of anabolic steroids, diabetes, lack of sleep, or taking certain medications.

Clomiphene for men: What is assigned for?

Traditionally, if low testosterone is diagnosed, a man is prescribed testostin replacement therapy in the form of a cream, gel, tablet, patch or injection. And while these types of therapies are effective, each of them has side effects. For example, testicular shrinkage, gynecomastia (breast enlargement), low sperm count, and polycythemia (an overabundance of red blood cells) are common side effects of T replacement therapy (for most patients, these side effects are treatable and do not exceed the potential benefit of hormone treatment).

However, in particular, due to the decrease in the number of sperm, this method of increasing testosterone is not the best option for men who want to have children. Young men with hypogonadism are usually prescribed clomiphene citrate (CC tablets, or Clomid) and / or human chorionic gonadotropin (hCG). These drugs have been used by specialists for many decades to increase the natural production of testosterone, sperm, and increase the likelihood of conception in patients. This method of treatment causes the testes to produce T and thereby increases the natural level of testosterone.

When a healthy man’s pituitary gland releases luteinizing hormone (LH) into the bloodstream, the testes receive a signal to produce testosterone. After that, some of the testosterone is converted to estrogen (the female hormone), and the pituitary stops producing LH.

Clomid for men

Clomid for men works by blocking estrogen in the pituitary gland and hypothalamus. Thus, estrogen does not signal the brain to stop producing LH. Luteinizing hormone continues to be produced, and as a result, the production of testostin in the testicles increases.

When using traditional methods of testosterone replacement therapy, the brain (hypothalamus and pituitary gland) receives the message that there is a lot of T in the testes and it no longer needs to be produced. Subsequently, the pituitary gland ceases to produce LH, and the natural production of testostin (and sperm) in the testes ceases, so the traditional results of testosterone replacement therapy — TST) are a decrease in the testicles and a low sperm count.

Clomiphene for men together with hCG (or without it) does not turn off the production of test-na. Depending on the condition, its reception can be continuous or course, for 3-6 months.

Clomiphene and hCG were previously thought to work only on young men, but in the last decade, these drugs have also been successfully used by older patients.

Compared to testosterone replacement therapy, clomid for men with hypogonadism can be considered a better alternative due to the fact that:

  1. Clomiphene stimulates the body’s own production of test-na.
  2. Clomid is available in tablets and is easy to take.
  3. This drug is quite cheap and affordable.
  4. Clomid has a relatively low risk of side effects.

The main active ingredient clomifene is available under several trademarks: “Clostylbegit”, “Clomid” (Clomid), “Serpafar”. The main drug that can be found and purchased is “Clostylbegit” or generic clomid.

Clomid for men: Conclusion

Clomid for men can serve as a good alternative to dough therapy in both the short and long term. Despite this, you can only take clomiphene as prescribed and under the supervision of a doctor.

Three medicines that still remain a dream

Against the background of incredible discoveries that promise to completely transform the medicine of the future, making it preventive, there are a number of tools that have been waiting for a very long time.

Malaria vaccine

Bill Gates spends tens of millions of dollars on the search for a miracle cure. Thousands of scientists around the world are working on this problem. The first tangible success is the recent work of American researchers from the National Center for the Study of Allergies and Infections. They were able to remove mosquitoes that develop malaria parasites inside, and then make these parasites unable to infect with radiation exposure.

Super Cold Remedy

Scientists from the Massachusetts Institute of Technology are developing a drug that can mean victory over the banal cold — the most annoying disease on the planet. They claim to have created a virus that attacks an infected cell and programs it to self-destruct, but does not affect healthy cells in the neighborhood. There are years of clinical trials ahead.

A cure for infertility

Artificial insemination is becoming an increasingly popular method of conception, and many technologies have already been tested and brought to mind. Also, do not forget about the stimulation of ovulation with clomid. Nevertheless, the search for new solutions continues. Canadian scientists from the University of Vancouver are working on drugs that stimulate ovulation in women who want to get pregnant. They are able to stimulate the appearance of several eggs per month instead of one, which increases the chances of artificial insemination. But the method developed by Canadian scientists still has many side effects, including a dangerous syndrome that is associated with kidney failure and heart failure.

Coronavirus vaccine

In modern realities, humanity also dreams of one more medicine – a 100% effective coronavirus vaccine, because neither the Russian Sputnik-V, nor Pfizer, nor even the Chinese vaccine, have yet produced any results.

Women suffer from menstrual cycle disorders and infertility

The menstrual cycle is one of the most mysterious phenomena in human biology. Why did our species develop a rhythmic ovulation that is independent of coitus? What is the biological meaning of menstrual bleeding, which is absent in other mammals? There are also more practical questions: it is known that physical and psychological stress, as well as body weight, significantly affect the menstrual cycle – but how and why does this happen? In search of answers, we turn to high-level processes – the analytical system of the hypothalamus.

The extension of the genus requires an optimal external and internal environment. A woman should be safe, have a favorable social environment, and have unrestricted access to nutrients. Otherwise, the pregnancy may be terminated or the fetus will suffer from developmental defects.

How can the body assess the many external and internal factors and make a choice: to take the risk of conception now-or to sacrifice part of the fertile time, waiting for more suitable conditions? Taking into account the complexity of the task, we can say that the choice of physiological states suitable for conception cannot be carried out by the pelvic organs. This function should be performed by an organ that “knows” the whole physiological context.

Menstrual cycle: Stress and procreation

In modern biology, the concept of “stress” means an overload of the adaptive abilities of the body. As a universal response to long-term adverse conditions, the hypothalamus increases plasma cortisol (and CSF) through the pituitary-adrenal system. In response, cortisol, among other things, suppresses the secretion of GnRH. This occurs in a variety of chronic conditions, different in nature and origin, but uniformly interpreted by the hypothalamus as stress: depression and anxiety disorders, diabetes, alcoholism, violation of the “sleep – wake” mode (working night shifts). Excess cortisol is also seen in many professional athletes.

menstrual cycle

So, the species Homo sapiens is adapted to long-distance running, in which endogenous cannabinoids enter the blood. At the dawn of human history, they made it easier to run for hours during times of migration and hunting, providing an analgesic and euphoric effect. Of course, they also inhibit the release of GnRH, since such severe trials are not combined with the prolongation of the genus. This probably explains some of the cases of amenorrhea among the runners these days.

Social and psychological stress

Human society has undergone significant changes over the last millennium. However, social distress, lifestyle changes, and information overload involve the same stressful mechanisms as the threat to physical survival.

In many mammals, females fight among themselves for resources and those partners that could provide tactical and genetic advantages to future offspring. In primates, a subordinate social position causes an increase in cortisol plasma. At the same time, the peak luteinizing hormone emissions required for ovulation are reduced. As resources decrease and aggressiveness increases within the community, conception is most promising in the dominant female. Aggression, including between close relatives, seems to play an important role in the suppression of ovulation among subordinate individuals.

Menstrual cycle and microecology of nutrition

In addition to the three main nutritional classes: proteins, fats and carbohydrates – with each meal, the human body receives microscopic doses of regulatory substances that have not nutritional, but informational value. The availability of vitamins of plant and animal origin historically included Homo sapiens in specific food chains, and the microelement composition of the environment determined favorable zones for habitation. Thus, vitamins and trace elements, whose importance is often underestimated, combine the biogeocenosis with individual physiology. The female body, constantly looking for optimal conditions for the prolongation of the genus, can not ignore such data.

Today, humanity has spread across the globe everywhere, often spending most of their lives moving. Thus, medical science is faced with the task of compensating for the change of ecological subsystems, which in market conditions is available only through the development of universal adaptive complexes. The degree of their influence is individual, because each organism is unique. However, such substitution drugs occupy their own therapeutic niche along with higher-level treatment methods.

Conclusion

It is possible that both in cases of metabolic stress and in cases of chronic psychological threats, the hypothalamus acts uniformly: it seeks to protect the body by reducing energy consumption and preventing risky pregnancy. This should be taken into account in patients with functional amenorrhea. In such cases, replacement therapy alone may not be sufficient, as it does not affect adrenal hyperfunction, body weight, and psychological problems. Even with artificially induced ovulation, subsequent pregnancy is threatened by ongoing psychological and / or metabolic stress. In other words, the full restoration of sexual function requires the correction of a fundamental problem-lifestyle.

High cholesterol affects the conception of a child

It will be difficult for a couple to conceive a child if both the man and the woman have high cholesterol levels.

This conclusion was made by scientists from the National Institute of Child Health and Human Development (Rockville, Maryland).

The researchers found that couples with cholesterol levels had difficulty conceiving, as opposed to couples whose cholesterol levels were normal. In the course of the study, experts processed data from 501 married couples from Michigan and Texas. All couples tried to conceive and were not treated for infertility.

After evaluating the levels, phospholipids, triglycerides, and total lipids in each study participant, the researchers concluded that cholesterol was the greatest factor in infertility.

Blood pressure affects the ability to procreate, as it is a kind of building material for male and female hormones. Estrogen and progesterone in women, testosterone in men-these hormones play an important role in a couple’s ability to conceive a healthy child. They are also important for the processes of seminal fluid formation, ovulation, fertilization, and maintaining a healthy pregnancy process.

Do not forget, if you are all right with cholesterol, then clomid can increase the success of conception. The main thing is to consult your doctor.

How to lower bad cholesterol

Just one serving of legumes a day can lower the level of bad cholesterol, scientists have found.

The results of the latest study were published in the journal CMAJ.

It is known that cholesterol is necessary for our body – it is involved in the synthesis of sex hormones, vitamin D and other biological compounds, in contrast to bad cholesterol, or low-density lipoprotein, which is recognized as one of the most important risk factors for the development of cardiovascular diseases. Low-density lipoproteins are poorly soluble, cholesterin from them often precipitates and is deposited in the vessels in the form of atherosclerotic plaques.

high cholesterol

As part of a joint study of scientists from Canada and the United States, 26 studies were analyzed aimed at studying the effect of eating legumes on lowering cholesterol levels. The study involved 1,037 people.

“We believe this is due to the fact that men often pay less attention to their daily diet and have higher cholesterol levels,” says Dr. John Siwenpaper of St. Michael’s Hospital in Toronto, lead author of the study. “To prevent many chronic diseases, normalize body weight, blood pressure, blood glucose levels, and reduce the amount of cholesterol in the body, it is simply necessary to regularly consume crops such as Turkish peas, lentils, and beans.”

However, it should be noted that, despite the decrease, some side effects were recorded, in particular, increased flatulence, bloating, diarrhea, or even constipation.

Stress during pregnancy

Researchers have identified a link between common mental illnesses and complications during pregnancy, such as pre-eclampsia and infections that lead to stress. The results of the study were published in the journal Proceedings of the National Academy of Sciences (stress during pregnancy).

Scientists from Massachusetts General Hospital and Harvard Medical School conducted a study that lasted 40 years. The researchers wanted to find out whether prenatal stress affected a person’s response to stressful situations in adulthood.

Experts followed 40 men and 40 women from the moment of birth to their fortieth birthday. Half of the participants had a history of severe depression or psychosis that was in remission.

The researchers say that the mothers of some of the study participants had complications during pregnancy, such as fever due to an infectious disease or pre-eclampsia. One in three mothers who participated in the study had an infectious disease, and one in six had preeclampsia, which increases the level of cytokines. It turns out that the experts analyzed the data of those people who in the womb were exposed to pro-inflammatory cytokines.

stress during pregnancy

It is noted that tumor necrosis factor-alpha and interleukin-6 regulators of the immune system initiate inflammation in response to infection or injury. They can also be activated in response to stress.

The team evaluated the correlation between the participants neurological responses and their prenatal exposure to pro-inflammatory cytokines. The researchers did this by showing participants images designed to stimulate a stress response during an MRI scan of the brain.

It was found that prenatal exposure to pro-inflammatory cytokines caused by stress in mothers affected men and women after 40 years. Among all participants, lower prenatal levels of necrosis factor-alpha caused increased hypothalamus activity in adulthood. This area of the brain is responsible for regulating the level of cortisol, the so-called stress hormone.

However, only in men did lower levels of necrosis factor-alpha cause a more active connection between the hypothalamus and the anterior cingulate gyrus, which is responsible for controlling impulses and emotions. In female participants, higher levels of IL-6 in the prenatal period correlated with increased activity in the hippocampus, a region of the brain that helps control memory and arousal associated with stressful stimuli.

Absence of pregnancy

Absence of pregnancy – one of the causes of female infertility is premature ovarian failure. In 74% of cases, the only chance to get pregnant is to perform in vitro fertilization using donor oocytes. In this regard, it is relevant to search for new approaches to solving this problem.

The incidence of premature ovarian failure in the female population is 1.5%, and in the structure of secondary amenorrhea-up to 10%. There are several theories that explain the causes of ovarian insufficiency: pre-and post-pubertal destruction of oocytes, chromosomal abnormalities, autoimmune disorders, etc. A typical portrait of a patient: a young girl with the presence of menopausal symptoms, who does not become pregnant against the background of secondary amenorrhea. The diagnostic criteria for insufficiency include oligomenorrhea, amenorrhea for 4-6 months, the level of follicle-stimulating hormone (FSH) in the blood above 25 IU/l in two studies with an interval of at least four weeks, a decrease in the level of estradiol (E2) and anti-muller hormone (AMH) in the blood.

Hormone replacement therapy is recognized as a pathogenetic approach to treatment. However, at the moment, there are no effective treatment regimens that can improve the prognosis for fertility recovery. An alternative method of treatment is placental therapy with the drug Melsmon.

Clinical case absence of pregnancy

A 22-year-old patient came to the medical center with complaints about the absence of menstruation (amenorrhea) for a year and the absence of pregnancy for four years, a feeling of hot flashes up to ten times a day, hyperhidrosis, decreased libido, lethargy, increased fatigue, shortness of breath, insomnia. The patient has been married for four years, the first marriage, with a regular sexual life in the absence of any methods of contraception, pregnancy in this marriage did not occur. The patient’s husband underwent a study of the state of reproductive health. The male factor of infertility is excluded. Menstruation in a patient from 11 years old, established immediately, duration-five days, after 30 days.

absence of pregnancy

From the anamnesis, it is known about the violation of the menstrual cycle in the form of scanty bloody discharge (oligomenorrhea) and their gradual disappearance. When examined in the mirrors, a fibrous polyp of the cervical canal was found. A hysteroscopy was performed with separate diagnostic curettage and removal of the cervical canal polyp. Histological conclusion: glandular endometrial hyperplasia with elements of polyposis on the background of chronic endometritis. Fibrotic polyp of the cervix. The somatic history is not burdened. No previous tests have been performed for sexually transmitted infections. He has no professional harms or bad habits. For four months, in order to regulate the menstrual cycle, she took Regulon (she did not take the drug clomid), then stopped taking it due to a sharp increase in the body mass index (after the withdrawal of the drug Regulon, the weight returned to its previous values).

When collecting a family history, it turned out that the mother’s menstrual function stopped at the age of 34. Due to the lack of pregnancy, the family is under stress.

Difficulties with conception and clomid

Approximately 20% of married couples who have difficulties with conception, this is because, a woman’s ovaries do not produce and release an egg in each menstrual cycle (anovulation). Clomid acts by causing a gland in the brain (the anterior pituitary gland) to release hormones that stimulate ovulation.

It must be remembered that there are many causes of anovulation, so Clomid may not be effective in all cases.

When accepting Clomid, it should be 28-32 days from the beginning of one period to the next. Your ovaries should release the egg 6-12 days after a course of Clomid. You should have sexual intercourse at this time to increase your chances of conception.

If menstruation does not arrive after the 35th day there are two likely possibilities: the dose of Clomid was not enough to get ovulation, or you are pregnant.

If your menstrual period is overdue, contact your doctor who wrote you a prescription for clomid and he will advise you what steps to take.

difficulties with conception

Before taking Clomid, your doctor should perform a gynecological examination before you start taking the drug. This is necessary in order to ensure that there are no physical conditions that could prevent you from becoming pregnant or that could indicate that Clomid is not the right remedy for you.

Do not take Clomid if you are allergic to any of the ingredients of the drug. Also, do not take Clomid if you are pregnant.

To avoid accidental ingestion in the early stages of pregnancy, you should perform tests during each treatment cycle to determine if ovulation is occurring. You should have a pregnancy test before starting your next course of Clomid therapy.

Tell your doctor immediately if you notice the following side effects:

  • nausea or vomiting;
  • breast discomfort;
  • headache
  • insomnia, nervousness, depression, fatigue, dizziness, or delirium
  • rash or skin irritation;
  • increased frequency of urination;
  • hair loss;
  • fever;
  • vaginal discharge;
  • seizures;
  • vision problems;
  • increased heart rate;
  • heartbeat;

In general, the drug is absolutely safe. We wish you good health and a successful conception of the child, even if you are currently experiencing difficulties with conception!

How to stimulate ovulation?

So, how to stimulate ovulation? Problems of the reproductive system of the female body, as you know, can sometimes be solved without surgical intervention. It is enough just to go to the pharmacy for the “magic” pills prescribed by the doctor the day before. And, while your eyes are scattered when choosing medicines, we will help you understand the principle of the most popular of them, and what is the effect of each.

How to stimulate ovulation: Clomid.

Clomid was originally developed as a pilot version of a universal drug for breast cancer, but, failing to meet high expectations, began to be used as a drug to stimulate ovulation among women who want to become pregnant. So, clomid can be recommended by doctors in three cases:

  1. If the absence of ovulation is caused by a previously diagnosed polycystic ovary syndrome.
  2. If infertility does not have a certain genesis, that is, with ideal medical indicators, a woman still does not get pregnant after more than a year of intensive attempts. In this case, clomid is usually used in conjunction with another drug – metformin, which, in turn, increases the level of insulin and promotes ovulation.
  3. If in vitro fertilization (IVF, ICSI, etc. ) requires additional guarantees of the success of the procedure. Although from a medical point of view, this use of clomid is not sufficiently justified, many patients personally ask their doctor to include clomid in their treatment course, since this drug is considered effective when it comes to increasing the chances of becoming pregnant.

Studies and many years of experience show that about 80% of women who have problems with ovulation, observe the release of an egg from the ovaries after the first application of clomid. However, only 30% of patients manage to get pregnant immediately after the first cycle. However, a six-month course of clomid use is considered quite optimal, so even if you did not manage to get pregnant after your first use, you still have a good chance of seeing the long-awaited two stripes over the next few months, provided that you follow the medication course.

how to stimulate ovulation

The chronology of the process of using clomid is very simple. After your doctor has conducted a full medical examination and written out a prescription for the purchase of the drug, you can safely go to the pharmacy. Before use, it is necessary to consult a doctor about the interval of use, but, as a rule, clomid tablets are taken on the third to seventh day of the menstrual cycle. After a week from the beginning of the menstrual cycle, lead an active sexual life, preferably with a break interval of one day, so that your partner has time to accumulate sperm ready for fertilization. If by the tenth day of your menstrual cycle, your cervical mucus has the consistency of egg white, it means that you are on the right track, and that ovulation will occur soon. After another week or two, you can start using pregnancy tests and hope for the best.

The side effects of clomid are insignificant, and do not pose a direct threat to the female body. In the most frequent cases, abdominal pain, insomnia and weight gain are observed. The worst possible development is the appearance of ovarian cysts or the diagnosis of ovarian cancer. However, the chance of such consequences appearing is very, very small.

Menstrual cycles and ovulation

The duration of the female cycle varies. The most common cycle duration is between 23 and 35 days. The difference in the length of the menstrual cycles, as a rule, concerns the period before ovulation (the so-called follicular or follicular phase). In most women, from ovulation (when the egg comes out of the ovary) to the beginning of menstruation, it takes from 12 to 16 days (the so-called luteal phase).

Phases of the menstrual cycles

Menstruation: The first day of the menstrual cycles is the first day of menstruation (day 1). Menstruation then lasts from 3 to 7 days. Surely, you know that in the presence of menstrual pain, the most severe pain you experience in the first few days of menstruation. This is because your hormones actively promote the rejection of the uterine mucosa that has grown during the previous menstrual cycle.

Preparing for ovulation: At the beginning of your cycle, the pituitary gland, located at the base of the brain, produces follicle-stimulating hormone (FSH). This is the main hormone that stimulates the ovaries to produce eggs. Follicles are fluid-filled vesicles in the ovaries. Each follicle contains an immature egg. FSH promotes the maturation of a certain number of follicles and the production of the hormone estrogen. On the first day of menstruation, the estrogen content is at its lowest level. Then it begins to rise along with the maturation of the follicles.

As the follicles develop, usually one of them becomes “dominant”, and in this large follicle the egg matures. At the same time, the growing level of estrogen in the body is responsible for saturating the lining of the uterine cavity with nutrients and blood. This is so that in the event of pregnancy, the fertilized egg will have all the nutrients and support needed for growth. High levels of estrogen also contribute to the formation of mucus, a “sperm-friendly” environment (or scientifically, cervical (cervical) mucus of the fertile phase). Perhaps you have paid attention to not thick sticky discharge, which may have a cloudy whitish hue. Spermatozoa move more easily through this mucus and survive for several days.

Understanding the ovulation cycle

Ovulation: The level of estrogen in the body is steadily increasing, and at some point it leads to a sharp increase in the level of luteinizing hormone (ovulatory surge of LH). The surge of LH leads to the rupture of the dominant follicle and the release of a mature egg from it, which then enters the fallopian tube. This process is called ovulation.

Menstrual cycles and ovulation

Many women believe that ovulation occurs on day 14, but 14 days is the average, and most women usually ovulate on another day of the menstrual cycle. The day of ovulation differs from cycle to cycle. Some women claim to experience a pain spasm during ovulation, but most women do not feel anything, and ovulation passes without any signs.

After ovulation: After release, the egg moves along the fallopian tube towards the uterus. Its life cycle is up to 24 hours. The life cycle of the sperm is more variable, however, and is usually between 3 and 5 days. Thus, the days immediately preceding ovulation and the day of ovulation itself are the most fertile – it is then that you have the greatest chance of becoming pregnant. Immediately after ovulation, the follicle begins to produce another hormone – progesterone.

Progesterone contributes to the subsequent preparation of the uterine mucosa for the reception of a fertilized egg. Meanwhile, the empty follicle in the ovary begins to shrink, but it continues to produce progesterone and begins to produce estrogen. During this time, you may experience premenstrual tension syndrome (PMS), such as breast soreness, bloating, drowsiness, depression, and irritability.

Antibiotics in the elderly

Antibiotics in the elderly: Age-related changes in the liver and kidneys contribute to changes in biotransformation and the elimination of many drugs. This may be the reason for the development of side effects of drugs that are usually safe and non-toxic. Atrophic processes in the gastrointestinal mucosa lead to changes in the absorption of certain drugs, which explains the low effectiveness of therapy.

With age, as a result of weight loss and muscle atrophy, the water content in the body decreases (by 10-15%) and the relative weight of adipose tissue increases (in men from 18 to 36%, in women from 33 to 48%). Consequently, in the elderly, the volume of distribution of water-soluble drugs changes, which is accompanied by a certain increase in their concentration in the blood. The volume of distribution of fat-soluble drugs in the elderly increases.

Antibiotics in the elderly

A decrease in the penetration of drugs into the tissues as a result of a decrease in the volume of distribution and the level of tissue blood flow may be one of the reasons for the insufficient clinical and bacteriological effectiveness of antibiotics in elderly patients.

The level of drug metabolism in the liver decreases with age as a result of a decrease in liver mass (after 40 years by 1% per year), hepatic blood flow (from 25 to 65 years by 40-45%) and the activity of microsomal enzymes. This leads to a decrease in the level of presystemic metabolism and phase I metabolism of medicinal drugs in the liver. As a result, the clearance decreases and the serum concentration of those antibacterial drugs that are mainly metabolized (more than 50%) in the liver increases: cefoperazone, doxycycline, lincomycin, clindamycin, chloramphenicol, pefloxacin, macrolides, rifamgscin, etc.

The elimination of most antibiotics is carried out by the kidneys. With age, as a result of atrophy of the cortical layer of the kidneys, the level of glomerular filtration decreases (from 20 to 50 years by 0.4 ml/min per year, after 50 years — by 1 ml/min per year) and tubular secretion (on average by 7% every 10 years). This is accompanied by a slowdown in the excretion of many drugs in elderly patients, which leads to an increase in their concentration in the blood.

In this regard, it is desirable to adjust the administered doses of antibacterial drugs that have a predominantly renal elimination pathway, in accordance with the value of glomerular filtration. This is especially important for potentially toxic drugs: aminoglycosides, vancomycin, carbenicillin, ticarcillin, tetracyclines, clomiphene, polymyxins, etc.

When deciding on the choice of an antibiotic, it is necessary to consider the features of drug interaction, since many elderly patients simultaneously take several drugs from different groups (hypotensive, antianginal, nootropic, etc.).