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Bicofen (Roxithromycin)

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Bicofen is a semi-synthetic macrolide antibiotic. It is a white crystalline powder. Bicofen is very slightly soluble in water, freely soluble in acetone, in alcohol and in methylene chloride. It is slightly soluble in dilute hydrochloric acid.

Other names for this medication:
Acevor, Aristomycin, Asmetic, Assoral, Azuril, Bazuctril, Biaxsig, Bicofen, Biostatik, Cadithro, Claramid, Crolix, Delos, Dorolid, Elrox, Erybros, Infectoroxit, Klomicina, Ladlid, Macrolid, Macrosil, Makrodex, Monobac, Nirox, Odonticina, Overal, Pedilid, Ramivan, Redotrin, Remora, Renicin, Ritosin, Rokilide, Rokithrid, Roksimin, Roksolit, Rolexit, Rolicyn, Rolid, Romac, Romyk, Rossitrol, Rotramin, Roxacine, Roxithromycin, Roxithromycine, Roxithromycinum, Roxitromicina, Rulid

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Also known as: Roxithromycin


Bicofen is a semi-synthetic macrolide antibiotic. It is used to treat respiratory tract, urinary and soft tissue infections. Bicofen is derived from erythromycin, containing the same 14-membered lactone ring. However, an N-oxime side chain is attached to the lactone ring. It is also currently undergoing clinical trials for the treatment of male-pattern hair loss.

Bicofen is available under several brandnames. Bicofen is not available in the United States. Bicofen is available in Australia, Israel and New Zealand. Bicofen has also been tested to possess antimalarial activity.

Bicofen prevents bacteria from growing, by interfering with their protein synthesis. Bicofen binds to the subunit 50S of the bacterial ribosome, and thus inhibits the synthesis of peptides. Bicofen has similar antimicrobial spectrum as erythromycin, but is more effective against certain gram-negative bacteria, particularly Legionella pneumophila.


Bicofen is typically prescribed for a period of 7 to 14 days and patients should take the medication for as long as it has been prescribed to prevent the infection from returning even if they become asymptomatic. Patients should not however, take doses larger than has been prescribed as this can result in an overdose. Overdosing requires immediate medical intervention and may present with symptoms which include abdominal pain, nausea, diarrhea, vomiting, and a general and prolonged feeling of illness.


Symptomatic treatment should be provided as required. There is no specific antidote.


Keep the tablets in the foil until it is time to take them.

Keep the tablets/in a cool dry place where the temperature stays below 30 degrees C.

Do not store Bicofen or any other medicine in the bathroom or near a sink.

Do not leave it in the car on hot days or on window sills.

Heat and dampness can destroy some medicines.

Keep it where children cannot reach it.

A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.

Side effects

The most common side effects associated with Bicofen are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.


The safety of roxithromycin has not been demonstrated in patients with impaired hepatic or renal function. Caution should be exercised if roxithromycin is administered to patients with impaired hepatic or renal function. If administered to patients with severe impaired hepatic function (eg. hepatic cirrhosis with jaundice and/or ascites), consideration should be given to reducing the daily dosage to half the usual dosage.

Prolonged or repeated use of antibiotics including roxithromycin may result in superinfection by resistant organisms. In the event of superinfection, roxithromycin should be discontinued and appropriate therapy instituted.

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

Antibiotic associated pseudomembranous colitis has been reported with many antibiotics. A toxin produced by Clostridium difficile appears to be the primary cause. The severity of the colitis may range from mild to life threatening. It is important to consider this diagnosis in patients who develop diarrhoea or colitis in association with antibiotic use (this may occur up to several weeks after cessation of antibiotic therapy). Mild cases usually respond to drug discontinuation alone. However, in moderate to severe cases, appropriate therapy with a suitable oral antibacterial agent effective against Clostridium difficile should be considered. Fluids, electrolytes and protein replacement therapy should be provided when indicated.

Roxithromycin, like erythromycin, has been shown in vitro to elicit a concentration - dependent lengthening in cardiac action potential duration. Such an effect is manifested only at supra – therapeutic concentrations. Accordingly, the recommended doses should not be exceeded. In certain conditions macrolides, including roxithromycin, have the potential to prolong the QT interval. Therefore roxithromycin should be used with caution in patients with congenital prolongation of the QT interval, with ongoing proarrhythmic conditions (ie uncorrected hypokalemia or hypomagnesaemia, clinically significant bradycardia), and in patients receiving Class IA and III antiarrhythmic agents.

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