Amoxiclav is a drug that experts refer to as drugs of the penicillin group. The main components in this drug are Amoxicillin and clavulanic acid. it new generation medicine differs in the presence of a powerful antimicrobial effect. When applied, it destroys most of the known pathogenic bacteria that are resistant to other drugs that are part of the pharmacological agents of the penicillin group. It is this advantage that provides a wide scope of application of this medication. A large number of diseases can be successfully treated using this antibiotic.

Amoxiclav is characterized by a wide range of antimicrobial actions... It allows you to effectively eliminate gram-positive and gram-negative bacteria from the body. The main active ingredient in this drug is amoxicillin.

It also contains clavulanic acid salts. Thanks to the combination of these substances, strong healing effect ... The presence of clavulanic acid makes it possible to maintain a high antibacterial activity of this drug during therapy with this antibiotic.

The potassium clavulanate present in the composition of this agent helps to destroy bacteria, which, against the effect of antibiotics, attempt to develop protective enzymes - B-lactamases. The activity of this enzyme is blocked by clavulanic acid. However, in addition to this, they negatively affect bacteria, destroying their walls and exerting an additional effect on microorganisms. As a result, when using this medication as part of the treatment of various ailments, a high efficiency of treatment is provided.

Basic therapeutic effect when treating with this remedy, it is achieved due to the fact that Amoxiclav has the ability accumulate in fluids and body tissues... In a short time, a high concentration of the main medicinal substance Amoxiclava. It manages to penetrate rather quickly into the parenchyma of organs, as well as blood plasma, regardless of which method was used to introduce it. After 60 minutes from the moment of taking the drug, a high concentration of the drug occurs in the lymph and blood.

The withdrawal of this agent unchanged from the body is provided by the kidneys. A small amount of metabolites of clavulanic acid is released from feces... They also leave the body along with the exhaled sick air. The drug does not penetrate the membranes of the brain, as well as into cerebrospinal fluid... This feature of the drug allows reduce the risk the appearance of negative consequences for the central nervous system during treatment with this drug. At the same time, during therapy, the active compounds of this medication can enter the placenta, and also appear in breast milk.

Forms of issue

At the moment, the manufacturer of this drug produces it in the following forms:

• in tablets placed in a film shell;
• in the form of a powder, the main purpose of which is the manufacture of suspensions;
• in the form of a lyophilized powder, which is intended for intravenous injection.

Note that before using this drug in powder form, it must be diluted in a special liquid - an infusion solution. Alternatively, you can use plain water. We will consider all types of dosage forms of this drug further.

Amoxiclav in the form of tablets contains various concentrations of active substances. They are offered in the pharmacy chain in three versions:

• Amoxiclav 375. Tablets contain 250 mg of the drug and 125 mg of acid;
• Amoxiclav 625. The content of the antibiotic in the tablets is 500 mg, and the amount of acid is 125 mg.
• Amoxiclav 1000. The preparation contains an antibiotic in the amount of 850 mg and 125 mg of acid.

In addition, Amoxiclav tablets also contain additional components that ensure the formation of the viscosity of the drug. These include magnesium stearate, silicon dioxide, as well as cellulose and citric acid. Amoxiclav medicine in the form of tablets is recommended to be dissolved in water in an amount of 100 ml before use. If it is not possible to do this, then it is necessary to chew the pill thoroughly, and then drink the medicine with a sufficient amount of water.

Amoxiclav in the form of a powder intended for the preparation of a suspension is taken orally. It comes in three types:

• Amoxiclav 125... In addition to the main active ingredient amoxicillin, which this preparation contains 125 mg, it contains salts of clavulanic acid in an amount of 31.25 mg, presented in the form of a trihydrate;
• Amoxiclav 250... The powder contains 250 mg of antibiotic and additionally acid salts in the amount of 62.5 mg;
• Amoxiclav 400... It contains 400 mg of amoxicillin and clavulanic acid in an amount of 57 mg.

As additional additives, the suspension contains gum, sodium saccharinate, silicon dioxide, and citric acid.

When preparing the suspension, follow the instructions for use. The powder is dissolved in the required amount of water. The vial for complete dissolution of the components is shaken vigorously.

Powder intended for intravenous administration of the drug. The manufacturer releases it in two forms:

• Amoxiclav 500... It contains 500 mg of the main active ingredient. It is presented in the form sodium salt... In addition, clavulanic acid salts are present in the form of a potassium salt of 100 mg.
• Amoxiclav 1000... It contains 1000 mg of amoxicillin and 200 mg of acid.

For intravenous injections, the suspension is prepared by diluting the dry powder and the liquid to be infused. The finished medicine is injected in a stream or with a dropper. When the drug is injected in a jet, they try to drive it into the vein as slowly as possible. This ensures the rapid achievement of the desired therapeutic effect, and also contributes to the improvement of the patient's condition. If there is a need for systemic exposure to the drug for a long time, then drip infusion of drugs is carried out intravenously.

This drug has certain analogues that replace the main drug if it is not available at the pharmacy:

• Augmentin;
• Lyclavus;
• Flemoklav;
• Torrentin.

Price

In pharmacies, the average price of Amoxiclav powder is 120 RUR... The cost of tablets depends largely on the concentration. active ingredients, as well as the release form. On average, the price tag for this form of medication varies from 230 to 450 p. per packing.

Indications for use

Experts prescribe Amoxiclav for the treatment of a wide range of diseases. This tool helps to effectively fight ailments that were caused by bacteria that are not resistant to this drug. The medicine is prescribed for the following diseases:

• infections respiratory tract;
• diseases of the ENT organs of an infectious nature;
• diseases of the urinary tract;
• meningitis;
• sepsis.

Medical practice shows that this remedy is effective in preventing, as well as the treatment of purulent-septic infections that have arisen after the operations, as well as diseases that are sexually transmitted.

Instructions for use

For patients suffering from diseases of an infectious nature, the doctor in each case individually selects a specific treatment regimen. When choosing the dosage and duration of the course of therapy, the specialist pays attention to the age of the patient, the severity of the ailment that has arisen, as well as the presence of concomitant diseases. The weight of the patient is also taken into account. For effective treatment diseases Amoxiclav must be taken with meals. This allows you to minimize the likelihood of side effects when taking the drug. When the patient is preparing a suspension, then the recommendations contained in the instructions should be followed.

Instructions for the use of Amoxiclav in the form of tablets

For the treatment of young patients over 12 years old with a body weight of more than 40 kg, as well as adults, Amoxiclav 250 mg is usually prescribed. The patient should take one tablet every 8 hours during the day. When therapy with Amoxiclav 500 mg, the dosage of the drug is 3 times a day, one tablet. For adults who are struggling with a severe infection, Amoxiclav 1000 mg is prescribed. The patient should take one tablet twice a day. The duration of therapy with this drug in pill form varies from 5 to 14 days. If the antibiotic is used for a long time, then side reactions may occur.

Before using the Amoxiclav tablet, you must dissolve it in half a glass of water. The resulting composition must be actively mixed. Only after that, this composition must be drunk. If there is no water nearby, then the tablet must be chewed thoroughly before swallowing, and then washed down with water in sufficient quantity.

Instructions for the use of Amoxiclav in the form of a suspension

For the treatment of diseases that have arisen in children, Amoxiclav is mainly used in the form of a suspension. When treating newborns and infants from three years of age, the dosage should be carefully selected at the time of prescribing the drug. In order to facilitate the dosing of the drug during therapy, a measuring spoon is present in the package with the drug.

For older children, the dosage is one measuring spoon... In the instructions attached to the drug, you can find a special plate with which you can make the correct calculation of the dosage for the child, depending on weight and age.

For effective therapy the drug should be taken 2 times a day every 12 hours. Alternatively, the remedy can be taken after 8 hours three times during the day. The doctor can determine exact dosage the drug, and also choose the appropriate treatment regimen. You should not prescribe this medication for yourself, since taking the drug in the wrong dosage can lead to the onset of the condition overdose... And this will entail negative health consequences.

Overdose

When the agent is taken in large doses, it can provoke the onset of a gastrointestinal disorder. The patient may experience side effects such as abdominal pain, vomiting and diarrhea. Anxiety is the main negative manifestations of the central nervous system when taking excessive doses of Amoxiclav.

In addition, nervous excitement occurs and sleep disturbances occur. Seizures can occur in rare cases with an overdose of medication. When a patient develops similar symptoms, the first thing to do is to wash the stomach. After that, the best thing to do is to take activated charcoal. In severe cases, hemodialysis is recommended.

Contraindications

It is prohibited to carry out treatment with Amoxiclav in the following cases:

• if the patient has sensitivity to the components that make up this pharmacological agent;
• in the presence of intolerance to antibiotics related to penicillin series funds and cephalosporins;
• liver dysfunctions provoked by the intake of amoxicillin and clavulanic acid;
• in the presence of lymphocytic leukemia or mononucleosis of an infectious nature.

Severe kidney disease, as well as gastrointestinal diseases are restrictions for taking this drug. Also, therapy with this agent is not recommended in the presence of liver failure or pseudomembranous colitis in history. During the period breastfeeding also do not engage in therapy with this drug. You should consult a doctor who, on an individual basis, will be able, taking into account the existing contraindications, to choose a treatment regimen that will allow the patient to quickly get rid of the disease.

It is undesirable to prescribe Amoxiclav during pregnancy for the treatment of diseases of an infectious nature. The thing is that the active substances that are present in the composition of this medication can penetrate the placenta to the fetus without any difficulty, and besides this, they can be excreted in breast milk.

This feature of the drug can provoke the fact that the use of a pregnant drug will negatively affect the health of the child.

For the treatment of pregnant women, this drug is used according to indications. When carrying out therapy, they act in accordance with the instructions. It is prescribed to women in an "interesting position" only if the effectiveness of the medication is higher than the risk that may arise for the pregnant fetus. For the reason that the active compound of this medication easily penetrates into breast milk, during lactation, if there is a need for treatment, the baby's breastfeeding is suspended and fed on artificial mixtures.

Side effect

When doctors choose a drug such as Amoxiclav for the treatment of diseases, the patient may experience the following side effects:

When Amoxiclav is taken for a long time, it is possible risk of febrile conditions.

It is worth noting that the effects listed above usually occur during therapy with this drug or immediately after the end of the course of treatment. All adverse reactions are reversible, however, manifested liver disorders can be quite difficult character... They occur mainly in patients who have liver pathologies, or can be triggered while taking hepatotoxic drugs.

Interaction with other medicines?

It is not recommended to take this drug at the same time as anticoagulants. Such complex therapy can provoke bleeding in the patient. At joint application of this drug with rifampicin, the antibacterial effect of Amoxiclav is weakened, since these drugs are antagonists.

You can not prescribe this medication at the same time as macrolides. It is not recommended to combine it with complex therapy with tetracyclines. This combination of drugs leads to a decrease in the therapeutic effect of this drug. When Amoxiclav is taken with an antibiotic, the effectiveness of the drug in the form of tablets decreases.

Conclusion

Amoxiclav is a drug that belongs to the group of drugs of the penicillin group. It can be used to treat a wide variety of diseases. The medication has a powerful antibacterial effect, which allows you to quickly relieve the patient of the ailment that has arisen. This remedy is offered in various forms in pharmacies.

It is released in the form of tablets, powder. Disease therapy can be carried out in both children and adults. Naturally, the dosage of the drug for these categories of patients is different. It is not recommended to use this medication during pregnancy. This contraindication is associated, first of all, with the fact that the components contained in this medicine easily penetrate the placenta and breast milk. Therefore, to carry out treatment infectious diseases during pregnancy it is recommended by other means.

During the period of breastfeeding, it is necessary to refuse to breastfeed the child and transfer him to feeding with artificial mixtures. It is not recommended to independently carry out treatment with Amoxiclav (tablets), since the wrong choice of the dosage of the drug can lead to health problems. In such cases, it is necessary to rinse the stomach and take activated charcoal.

Microflora restoration

Probiotics

"Amoxiclav" is in demand for many infectious diseases, because this antibiotic has a wide spectrum of activity and good tolerance. It is available in several dosage forms, among which a suspension is most often chosen for children, but sometimes tablets are also used.

Composition and form of release

The basis of the tablet form "Amoxiclav" are two compounds. The main one is amoxicillin trihydrate, since it is this component that provides the antibacterial effect of the drug. The dosage of such a substance in one tablet is 250 or 500 mg. It is supplemented by potassium clavulanate, a source of clavulanic acid. In all tablets "Amoxiclav" such acid is presented in a dosage of 125 mg.

The tablets themselves are oval, convex on both sides. They have a dense white shell made of titanium dioxide, ethylcellulose, hypromellose, macrogol 6000, and diethyl phthalate. In the core of the drug, in addition to the active compounds, there is MCC, croscarmellose sodium, silicon dioxide, talc and magnesium stearate.

The medicine with a lower dosage (375 mg of active substances) is sold in glass bottles of 15, 20 or 21 tablets. A medication containing amoxicillin in a dose of 500 mg is packed in blisters of 5 or 7 pieces, and one pack contains 10, 14 or 15 tablets. Also on sale you can find glass bottles, inside of which there are 15 tablets with a dosage of 500 mg + 125 mg.

In addition, tableted "Amoxiclav" is also produced with an increased dosage of amoxicillin - 875 mg per tablet. This preparation is also white in color, but differs in an elongated convex shape. On one side of such a medicine there is an inscription "AMC", and on the other you can see the numbers "875" and "125". The package of such "Amoxiclav" includes 10-14 tablets, placed in blisters of 5-7 pieces.

In addition to tablets, the manufacturer "Amoxiclava" also offers another solid form of the drug in a shell - dispersible tablets. Since they are able to dissolve quickly after contact with water, this medication is called "Amoxiclav Kviktab". These tablets have an octagonal shape, yellow color and a fruity smell.

Amoxicillin in dissolving tablets is contained in a dosage of 500 mg or 875 mg, and the amount of clavulanic acid, as in coated tablets, is 125 mg, regardless of the dosage of the antibiotic. Among the auxiliary ingredients of "Amoxiclava Kviktab" there is aspartame, Castor oil, yellow iron oxide, flavors and other substances (for a more precise composition, see the table in the paper annotation). The drug is packed in blisters of 2 tablets and sold in 5 or 7 blisters in one pack.

Action and indications

Due to the presence of amoxicillin in the composition, "Amoxiclav" has an antimicrobial effect on a fairly large list of microorganisms. Present in pills second active ingredient prevents the inactivation of the antibiotic by enzymes that microbes produce (they are called beta-lactamases). This allows the drug to act even on those bacteria that do not die under the influence of only amoxicillin.

The medication helps to destroy pneumococci, staphylococci, clostridia, klebsiella, meningococcus, protea, shigella and many other pathogens. It is prescribed for an infectious process of different localization - in the respiratory organs, biliary tract, paranasal sinuses, urinary tract, bones, and so on.

Is it prescribed in childhood?

"Amoxiclav" in the form of coated tablets can be given to children over 12 years old. The use of the drug "Amoxiclav Kviktab" is also allowed from the age of 12, with the proviso that the patient's body weight should be above 40 kg.

If the child weighs less or is not yet 12 years old, it is recommended to use a suspension that is prescribed from birth.

Contraindications

"Amoxiclav" in solid form is not prescribed for hypersensitivity to any ingredient of the drug, as well as for allergies to other beta-lactam antibiotics. In addition, such an antibiotic is contraindicated if the child has lymphocytic leukemia or infectious mononucleosis. Patients with liver disease and other serious pathologies require caution in using the medication.

Side effects

The digestive system of some patients reacts to "Amoxiclav" with poor appetite, diarrhea, nausea and other negative symptoms. Occasionally, tablets provoke dizziness and allergic reactions, and in some cases they note their negative effect on the kidneys, hematopoiesis or liver condition.

Any changes in the child's condition during treatment with "Amoxiclav" should be immediately reported to the doctor.

Instructions for use

So that the antibiotic does not have a harmful effect on the gastrointestinal tract, it is advised to drink the drug at the beginning of a meal. Coated tablets "Amoxiclav" are prescribed to patients over 12 years old according to the following scheme:

• if the infection is assessed by the doctor as mild, then the child should take three tablets with a dosage of 250 mg + 125 mg per day (they are given one at intervals of 8 hours) or two tablets with a dosage of 500 mg + 125 mg (at intervals of 12 hours);
• at moderate of the infectious process, single and daily dosages are the same as in the case of a mild course;
• with infection of the respiratory tract or with a severe course of infection of any localization, the patient is given three tablets per day with a dosage of 500 mg + 125 mg (at intervals of 8 hours), or two tablets with a dosage of 875 mg + 125 mg (at intervals of 12 hours).

The duration of taking "Amoxiclav" is determined by the doctor and can be up to 14 days. A child should not receive amoxicillin per day in a dose of more than 45 mg per 1 kilogram of his weight. For clavulanic acid, limitation in childhood is 10 mg / kg.

Before taking "Amoxiclav Kviktab" it is advised to dissolve in water, taking it in a volume of at least 30 ml. It is also permissible to put the pill in your mouth and wait for it to dissolve under the influence of saliva. Like tablets in a shell, the drug "Kviktab" is recommended to be taken at the beginning of meals. For the treatment of moderate to mild infection, a teenager should take one tablet with 625 mg of active ingredients twice a day, that is, every 12 hours.

If the child has a severe infectious disease or a respiratory tract injury is detected, then the frequency of administration increases up to 3 times a day with an interval of 8 hours or switches to a higher dosage - give the patient one tablet containing 1000 mg of active substances twice a day with at intervals of 12 hours. The duration of treatment with dissolving tablets is also up to 2 weeks.

Overdose

If a child accidentally drinks more Amoxiclav tablets, it will lead to abdominal pain, restlessness, insomnia, diarrhea and other negative symptoms. If they occur, a doctor's examination is required.

Terms of sale and storage

For the purchase of "Amoxiclav" in tablets, as well as for the purchase of the drug "Kviktab", you need a prescription from a doctor. The price of the medication depends on the dosage and the number of tablets in the pack. For example, for 15 coated tablets with a dosage of 250 mg + 125 mg, you need to pay about 230 rubles, and 14 Amoxiclav Kviktab tablets with a dosage of 875 mg + 125 mg cost 400-450 rubles. The shelf life of both types of antibiotic is 2 years. Until it is over, the medicine should be kept at a temperature below 25 degrees Celsius in a dry place.

Amoxiclav is a popular drug from the antibiotic category. It is often prescribed by physicians and pediatricians for the treatment of chronic infectious diseases. What are the medical features of Amoxiclav, what are its contraindications, and how to use it correctly?

Composition and pharmacological action of Amoxiclav

Amoxiclav consists of two main components. First of all, it is a semi-synthetic penicillin - amoxicillin, as well as clavulanic acid. Each component has its own function. Amoxicillin is an antibiotic, but clavulanic acid does not have a noticeable antibacterial effect. What, then, is its purpose?

As you know, these are one of the first antibiotics obtained in the middle of the last century. During their use, they showed their high efficiency... But at the same time, many bacteria managed to develop resistance to them. How does bacteria defense against antibacterial drugs work?

Amoxicillin acts on the cell wall of bacteria, binding one of the enzymes that make up its composition. As a result, the cell wall loses its strength, collapses and the bacteria dies. However, many types of bacteria began to produce special substances - beta-lactamases, which block the action of antibacterial agents. Thus, amoxicillin has become harmless to most bacteria.

Clavulanic acid is designed to fight beta-lactamases. By binding to amoxicillin, it makes its molecules immune to beta-lactamases. This effect manifests itself in relation to most types of beta-lactamases produced by bacteria.

Thus, the use of a combination of amoxicillin and clavulanic acid makes it possible to expand the spectrum of antibacterial activity in comparison with pure amoxicillin. If amoxicillin can affect only a limited number of bacteria that are not capable of producing beta-lactamases, then amoxicillin combined with clavulanic acid is active against most bacteria that cause infectious diseases. Among the bacteria that the drug can destroy, there are both gram-positive and gram-negative bacteria.

The main types of bacteria that are sensitive to Amoxiclav:

• streptococci
• staphylococci,
• shigella,
• Klebsiella,
• brucella,
• echinococcus,
• helicobacter,
• clostridia,
• Haemophilus influenzae
• salmonella,
• Proteus.

Bacteria resistant to the effects of Amoxiclav:

• enterobacter,
• pseudomonas,
• chlamydia,
• mycoplasma,
• legionella,
• Yersinia,

and some others.

Pharmacokinetics

The components of Amoxiclav are well absorbed into the blood and evenly distributed in the main tissues and body fluids, which provides a universal therapeutic effect of the drug. In this case, the components do not penetrate the blood-brain barrier. However, the substances that make up Amoxiclav can penetrate the placental barrier during pregnancy and enter breast milk in small quantities in breastfeeding women. Amoxicillin is poorly metabolized and excreted almost unchanged through the kidneys. In contrast, clavulanic acid is converted to metabolites that are excreted in the urine. The period of elimination of half of the components in healthy kidneys is 1-1.5 hours. The drug can also be removed from the body using hemodialysis.

Average pharmacokinetic parameters

Release form

Amoxiclav is produced mainly in tablet form. There are two types of this form. The main one is a film-coated tablet intended to be swallowed and dissolved in the intestine. There are also quick-dissolving tablets that dissolve in the mouth. You can also purchase the drug in the form of a suspension (powder that requires dilution), and in vials containing a powder, from which you can prepare a solution for intravenous administration.
Amoxiclav tablets can have the following dosage:

• 250 mg + 125 mg,
• 500 mg + 125 mg,
• 875 mg + 125 mg.

The first number indicates the dosage of amixicillin, and the second indicates the dosage of clavulanic acid. The Slovenian drug is produced pharmaceutical company"Lek".

The powder for the preparation of Amoxiclav solution for intravenous administration can contain 500/1000 mg of amoxicillin (100/200 mg of clavulanic acid, respectively). Powder dosage options for preparing Amoxiclav suspension are 125, 250 and 400 mg (amoxicillin). The medicine in the form of a suspension is recommended for the treatment of children under 12 years of age, although its use by adults is not excluded. Also available are instant tablets Amoxiclav Kviktab 875 mg + 125 mg.

Indications of the drug Amoxiclav

The scope of application of amoxicillin and clavulanic acid includes the treatment of various infectious diseases caused by bacteria. But most often this combination is prescribed for the treatment of acute respiratory diseases... Amoxiclav reduces the severity of the symptoms of the disease and shortens its duration.

For what infections is the drug effective:

• diseases of the upper and lower respiratory tract, lungs;
• urological, andrological and gynecological diseases;
• skin diseases caused by a bacterial infection;
• connective tissue and bone infections;
• infectious cholecystitis and cholangitis.

Bacterial diseases of the respiratory organs for which the drug can be prescribed:

• pharyngitis,
• tonsillitis,
• laryngitis,
• rhinitis,
• sinusitis,
• sinusitis,
• pneumonia,
• pleurisy,
• bronchitis,
• tracheitis.

Bacterial infections of the urinary organs and genitals, in which the drug can be used:

• pyelonephritis,
• urethritis,
• prostatitis,
• adnexitis,
• endometritis,
• salpingitis.

Contraindications

The drug has few contraindications. Amoxiclav can be treated with children, including infants. For infants, you can use a suspension and solution for intravenous administration. Pregnant women can also use the drug (under medical supervision). The main contraindication for taking Amoxiclav is intolerance to drugs of the penicillin group, as well as cephalosporins and other betalactam antibacterial agents. Also, you can not take Amoxiclav to persons suffering from severe forms of liver failure, infectious mononucleosis and lymphocytic leukemia, those who previously received amoxicillin led to the development of cholestatic jaundice.

Taking the drug also depends on the condition of the patient's kidneys. People with renal insufficiency (having a creatinine clearance below the norm) should be prescribed smaller doses of Amoxiclav than usual.

Correction of doses at renal failure

Patients on hemodialysis are prescribed a 500 + 125 mg tablet once a day or 2 tablets 250 + 125 mg once a day. In addition, it is taken as a tablet of 500 + 125 or 2 tablets of 250 + 125 mg mg during dialysis.

Children under 12 years of age are not prescribed tablet forms of Amoxiclav. For them, it is preferable to use a suspension.

The use of Amoxiclav during pregnancy and lactation

Amoxiclav is prescribed with caution during pregnancy. Its use is possible in cases where the potential benefit to the mother is higher than the harm that can be done to the developing fetus. During lactation, the drug can also be used. However, if it becomes necessary to use Amoxiclav while breastfeeding, it is recommended that you first consult with your doctor.

Side effects of Amoxiclav

The drug is well tolerated, and side effects when taking Amoxiclav appear infrequently. The most common side effects are those related to the gastrointestinal tract. Like any antibiotic, Amoxiclav destroys not only disease-causing organisms, but also normal microflora intestines. Therefore, with a long course of treatment with Amoxiclav, phenomena associated with dysbiosis are possible - dyspepsia, nausea, abdominal pain.

On the skin, mucous membranes and in the oral cavity, candidiasis can develop - a lesion by fungi of the genus Candida. Side effects associated with dysbiosis are the most common when taking Amoxiclav. Also, while taking Amoxiclav, many women may experience candidal colpitis (thrush).
Another group of side effects of Amoxiclav is allergic reactions. They can manifest themselves, for example, in the form of a skin rash, hives, dermatitis. In such a case, it is recommended to stop taking the drug and consult a doctor. It is extremely rare, due to the intake of Amoxiclav, anaphylactic shock may appear.

When using Amoxiclav, side effects associated with impaired liver function may also appear - cholestatic jaundice and hepatitis. These phenomena were most often observed in the elderly and men, especially with a long course of treatment.

There may be others as well side effects: headaches, dizziness, insomnia, changes in blood composition (leukopenia, neutropenia, thrombocytopenia, agranulocytosis), anemia, changes in urine (crystalluria, blood), pseudomembranous colitis.

Overdose with Amoxiclav

In clinical practice, no fatal overdose cases are known. When taking the drug in doses significantly higher than those prescribed by the instructions, you may experience:

• abdominal pain,
• diarrhea,
• vomit,
• excitation,
• anxiety,
• insomnia,
• dizziness.

Treatment for an overdose of Amoxiclav is symptomatic, the intake of activated charcoal is indicated, gastric lavage.

Instructions for use

The dosage of Amoxiclav may depend on many factors - the type of disease, its severity, the patient's age, the functionality of his kidneys, etc. Therefore, the exact dose should be prescribed by an infectious disease doctor or therapist. Too low a dose of Amoxiclav can lead to the fact that bacteria will be immune to it and will be able to develop resistance, and too high entails the risk of side effects.

For infections occurring with low intensity, one tablet of Amoxiclav 250 + 125 mg three times a day is usually prescribed, or a tablet of 500 + 125 twice a day. In severe diseases, 3 tablets of Amoxiclav 500 + 125 mg per day or 2 tablets of 875 + 125 mg per day can be prescribed.

In case of odontogenic infections, it is usually prescribed as a 250 + 125 mg tablet every 8 hours or a 500 + 125 mg tablet every 12 hours. The course of treatment is 5 days.

Children are prescribed a dose based on their weight. It should be remembered that it is preferable for children to use a suspension rather than tablets. For infections occurring in mild to moderate form, it is recommended to use a dose of 20 mg / kg of body weight, with severe infections it should be doubled. Amoxiclav packaging is equipped with special instructions that allow you to calculate the dose for children in various cases.

The suspension powder is available in three versions.

Doses of active substances per 5 ml of powder for suspension

Doses of suspension 125 + 31.25 mg for children

Suspension doses 250 + 62.5 mg for children

The volume of the drug indicated in the tables must be given to the child 3 times a day.

Doses of suspension 400 mg + 57 mg for children

The amount of the drug indicated in the table must be given to the child 2 times a day.

When choosing the right dose, it is necessary to proceed from the child's body weight, not age.

In case of insufficient renal function, the dose should be adjusted. With reduced creatinine clearance (10-30 ml / min) maximum dose Amoxiclav is one tablet of 500 + 125 mg twice a day after 12 hours, with a clearance of less than 10 ml - this tablet can be taken no more than once every 24 hours.

The medicine should be taken at strictly defined intervals. Thus, if three tablets are prescribed per day, they should be taken exactly 8 hours later, for example, at 8, 16 and 24 hours. If the drug is prescribed twice a day, then the tablets should be taken after 12 hours. This method allows you to maintain a constant concentration of the drug in the blood, as a result of which the effectiveness of Amoxiclav will be maximum.

The absorption of active substances into the blood occurs regardless of food intake, so Amoxiclav can be taken before, after, and during meals, this will not reduce its effectiveness. However, doctors still recommend taking the tablets at the beginning of a meal. This will reduce the likelihood of unpleasant side effects associated with the gastrointestinal tract.

Patients over 12 years old and weighing more than 40 kg take adult dose suspensions or tablets. Dose adjustment is necessary for persons with renal dysfunction associated with a decrease in creatinine clearance.

The duration of treatment is 5-14 days. Exceeding this period requires special instructions from the attending physician. In case of ineffectiveness of drug treatment, you should choose a replacement. If the drug was prescribed, and the condition improved before the course was completed, then it should still be completed in order to avoid relapses.

When using Amoxiclav Kviktab, the tablet must be dissolved in water before use, or dissolve in the mouth.

Suspension preparation

To prepare the suspension, shake the vial with the powder vigorously and then add water to the mark in two steps. Each time you add water, it is necessary to shake the bottle so that the suspension would have a uniform consistency.

Required volume of water for preparation of suspension from powder 400 / 57.5 mg

Drug analogs

The complete structural analogs of Amoxiclav include preparations containing amoxicillin and clavulanic acid, for example, Augmentin, Flemoklav Solutab. Preparations containing only amoxicillin will not be an adequate substitute due to the fact that the list of microorganisms sensitive to pure amoxicillin is much smaller than that of Amoxiclav. The same can be said about other drugs of the penicillin group - the scope of their use may not coincide with the scope of Amoxiclav.

Interaction of Amoxiclav with other substances and drugs

The effectiveness of Amoxiclav usually increases with simultaneous use with other bactericidal drugs. However, macrolides, tetracyclines, sulfonamides and other bacteriostatic agents reduce the effectiveness of the drug. Therefore, it is necessary to avoid the simultaneous administration of the drug and bacteriostatic agents. It should also be remembered that the simultaneous administration of Amoxiclav with hormonal contraceptives weakens the effect of the latter.

The simultaneous intake of alcohol and Amoxiclav is prohibited, since this may have a negative effect on the liver and a decrease in the effect of the drug.

The simultaneous administration of Amoxiclav and methotrexate is also prohibited, since Amoxiclav increases the toxicity of the latter. You can not prescribe the drug at the same time as Disulfiram, as this increases the likelihood of allergic reactions. When taken simultaneously with Allopurinol, the risk of developing exanthema increases.

Caution should be exercised when taking a suspension or tablets in combination with oral anticoagulants, as the drug can increase the prothrombin time.

Amoxiclav
Buy Amoxiclav in pharmacies

DOSAGE FORMS
coated tablets 875mg / 125mg
film-coated tablets 875mg + 125mg

MANUFACTURERS
Lek dd (Slovenia)

GROUP
Combined antimicrobial agents

COMPOSITION
Active ingredients: 875 mg of amoxicillin in the form of trihydrate and 125 mg of clavulanic acid in the form of potassium salt.

INTERNATIONAL NON-PATENTED NAME
Amoxicillin + Clavulanic Acid

SYNONYMS
Amoxiclav Kviktab, Arlet, Augmentin, Augmentin EC, Augmentin SR, Klamosar, Medoklav, Panklav, Ranklav, Rapiklav, Sinulox, Sinulox RTU, Flemoklav Solutab, Ekoklav

PHARMACHOLOGIC EFFECT
The drug is a combination of amoxicillin and clavulanic acid. Amoxicillin is a semi-synthetic penicillin (beta-lactam antibiotic) that inhibits one or more enzymes (often referred to as penicillin-binding proteins, PBPs) in the biosynthetic pathway of peptidoglycan, which is an integral structural component of the bacterial cell wall. Inhibition of peptidoglycan synthesis leads to a loss of cell wall strength, which usually leads to lysis and death of microbial cells. Amoxicillin is destroyed by the action of beta-lactamases produced by resistant bacteria, thus the spectrum of activity of amoxicillin alone does not include microorganisms that produce these enzymes. Clavulanic acid is a beta-lactam structurally related to penicillins. It inhibits some beta-lactamases, thereby preventing the inactivation of amoxicillin and expands its spectrum of activity, including bacteria that are usually resistant to amoxicillin, as well as other penicillins and cephalosporins. By itself, clavulanic acid has no clinically significant antibacterial effect. The drug has a bactericidal effect in vivo on the following microorganisms: Gram-positive aerobes. Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes. Gram-negative aerobes. Enterobacter spp, Escherichia coli, Haemophilus influenza, Species of the genus Klebsiella, Moraxella catarrhalis (Branhamella catarrhalis). The drug has an in vitro bactericidal effect on the following microorganisms (however, clinical dependence is still unknown). Gram-positive aerobes. BacilHs anthracis. Species of the genus Corynebacterium, Enterococcus faecalis, Enterococcus faecium, Listeria monocytogenes, Nocardia asteroids, Coagulase-negative staphylococci (including Staphylococcus epidermidis) Streptococcus agalaciiae. Other species of the genus Streptococcus Streptococcus viridians. Gram-positive anaerobes. Species of the genus Clostridium, Species of the genus Peptococcus, Species of the genus Peptostreptococcus. Gram-negative aerobes. Bordetella pertussis, Species of the genus Brucella, Gardnerella vaginalis, Helicobacter pylori, Species of the genus Legionella, Neisseria gonorrhoeae, Neisseria meningitides, Pasteurella multocida, Proteus mirabilis, Proteus vulgaris, Species of the genus Salmonella, Species of the genus Shigella, Vibrio cholerae, Yersinia enterocolitica. Gram-negative anaerobes. Species of the genus Bacteroides (including Bacteroides fragilis), Species of the genus Fusobacterium. Others: Borrella burgdorferi, Chlamydia spp., Leptospira icterohaemorrhagiae, Treponema pallidum. Some strains of these bacterial species produce beta-lactamases, which contribute to their insensitivity to monotherapy with amoxicillin. Pharmacokinetics. The main pharmacokinetic parameters of amoxicillin and clavulanic acid are similar. Amoxicillin and clavulanic acid dissolve well in aqueous solutions with a physiological pH value and after taking the drug inside, they are quickly and completely absorbed from gastrointestinal tract(GIT), The absorption of the active substances amoxicillin and clavulanic acid is optimal if taken at the beginning of a meal. The bioavailability of amoxicillin and clavulanic acid after oral administration is about 70%. Peak plasma concentrations are reached approximately 1 hour after ingestion. The maximum concentration values ​​for amoxicillin (depending on the dose) are 3-12 μg / ml, for clavulanic acid - about 2 μg / ml. When using the drug, the concentration of amoxicillin / clavulanic acid in plasma is similar to those for oral administration of the corresponding doses of amoxicillin or clavulanic acid separately in equivalent doses. Both components are characterized by a good volume of distribution in various organs, tissues and body fluids (including in the lungs, organs abdominal cavity; adipose, bone and muscle tissues; pleural, synovial and peritoneal fluids; in the skin, bile, urine, purulent discharge, sputum, in the interstitial fluid). Plasma protein binding is moderate: 25% for clavulanic acid and 18% for amoxicillin. The volume of distribution is approximately 0.3-0.4 l / kg for amoxicillin and approximately 0.2 l / kg for clavulanic acid. Amoxicillin and clavulanic acid do not cross the blood-brain barrier in non-inflamed meninges... Amoxicillin (like most penicillins) is excreted in breast milk. Trace amounts of clavulanic acid have also been found in breast milk. Amoxicillin and clavulanic acid cross the placental barrier. Amoxicillin is excreted primarily by the kidneys, while clavulanic acid is excreted by both renal and extrarenal mechanisms. After a single oral administration of one tablet of 250 mg / 125 mg or 500 mg / 125 mg, approximately 60-70% of amoxicillin and 40-65% of clavulanic acid are excreted unchanged in the urine during the first 6 hours. About 10-25% of the initial dose of amoxicillin is excreted in the urine as inactive penicillic acid. Clavulanic acid in the human body undergoes intensive metabolism with the formation of 2,5-dihydro-4- (2-hydroxyethyl) -5-oxo-1H-pyrrole-3-carboxylic acid and 1-amino-4-hydroxy-butan-2-one and is excreted in urine and feces. The average elimination half-life of amoxicillin / clavulanic acid is approximately one hour, and the average total clearance is approximately 25 l / h in healthy patients. In the course of various studies, it was found that the excretion of amoxicillin in the urine within 24 hours is approximately 50-85%, clavulanic acid - 27-60%. The greatest amount of clavulanic acid is excreted within the first 2 hours after ingestion. Patients with impaired liver function. In patients with severe renal insufficiency, the half-life is increased to 7.5 hours for amoxicillin and up to 4.5 hours for clavulanic acid. For patients with impaired liver function, the dose of the drug should be selected with caution, constant monitoring of the liver is necessary. Both components are removed by hemodialysis and minor amounts by peritoneal dialysis.

INDICATIONS FOR USE
Infections caused by sensitive strains of microorganisms: infections of the upper respiratory tract and ENT organs (including acute and chronic sinusitis, acute and chronic otitis media, retropharyngeal abscess, tonsillitis, pharyngitis); lower respiratory tract infections (incl. acute bronchitis with bacterial superinfection, Chronical bronchitis, pneumonia); infections urinary tract; infections in gynecology; infections of the skin and soft tissues, as well as wounds from human and animal bites; bone and connective tissue infections; biliary tract infections (cholecystitis, cholangitis); odontogenic infections.

CONTRAINDICATIONS
Hypersensitivity to the components of the drug; a history of hypersensitivity to penicillins, cephalosporins and other beta-lactam antibiotics, cholestatic jaundice and / or other liver dysfunctions caused by a history of amoxicillin / clavulanic acid; infectious mononucleosis and lymphocytic leukemia.

SIDE EFFECT
From the side digestive system: loss of appetite, nausea, vomiting, diarrhea, abdominal pain, gastritis, stomatitis, glossitis, black “hairy” tongue, darkening of tooth enamel, hemorrhagic colitis (can also develop after therapy), enterocolitis, pseudomembranous colitis, liver dysfunction, increased activity of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and / or the level of bilirubin in the blood plasma, liver failure (more often in the elderly, men, with prolonged therapy), cholestatic jaundice, hepatitis. Allergic reactions: pruritus, urticaria, erythematous rash, exudative erythema multiforme, angioedema, anaphylactic shock, allergic vasculitis, exfoliative dermatitis, Stevens-Johnson syndrome, acute generalized exanthematous pustulosis, a syndrome similar to serum epidermal disease, toxic. From the hematopoietic and lymphatic system: reversible leukopenia "(including neutropenia), platelet singing, hemolytic anemia, a reversible increase in prothrombin over time (when used together with anticoagulants), a reversible increase in bleeding time, eosinophilia, pancytopenia, thrombocytosis, agranulocytosis. From the central nervous system: dizziness, headache, convulsions (can occur in patients with impaired renal function when taking high doses of the drug), hyperactivity. Feelings of anxiety, insomnia, behavioral changes, agitation. From the urinary system: interstitial nephritis, crystalluria, hematuria. Miscellaneous: candidiasis and other types of superinfection.

INTERACTION
Antacids, glucosamine, laxatives medicines, aminoglycosides slow down absorption, ascorbic acid - increases absorption. Diuretics, allopurinol, phenylbutazone; nonsteroidal anti-inflammatory drugs and other drugs that block tubular secretion (probenecid) increase the concentration of amoxicillin (clavulanic acid is excreted mainly by glomerular filtration). The simultaneous use of the drug and methotrexate increases the toxicity of methotrexate. Prescribing in conjunction with allopurinol increases the incidence of exanthema. Simultaneous use with disulfiram should be avoided. Reduces the effectiveness of drugs, in the process of metabolism of which para-aminobenzoic acid is formed, ethinylestradiol - the risk of bleeding "breakthrough". The literature describes rare cases of an increase in the international normalized ratio (MHO) in patients with the combined use of acenocoumarol or warfarin and amoxicillin. If necessary, the simultaneous use with anti-coagulants and protobin time or MHO, it should be carefully iterated when prescribing or discontinuing the drug. The combination with rifampicin is antagonistic (mutual weakening of the antibacterial effect). The drug should not be used simultaneously in combination with bacteriostatic antibiotics (macrolides, tetracyclines), sulfonamides due to a possible decrease in the effectiveness of the drug. The drug reduces the effectiveness of oral contraceptives.

DOSAGE AND METHOD OF APPLICATION
Inside. The dosage regimen is set individually depending on the age, body weight, kidney function of the patient, as well as the severity of the infection. It is recommended to take the drug at the beginning of a meal for optimal absorption and to reduce possible side effects from the digestive system. The course of treatment is 5-14 days. The duration of the course of treatment is determined by the attending physician. The course should not continue for more than 14 days without a second medical examination. Children under 12 years old. The dose is prescribed depending on the age and body weight. Recommended dosage regimen: 40 mg / kg / day in 3 divided doses. Children weighing 40 kg or more should be given the same doses as adults. For children under 6 years of age, it is more preferable to take a suspension of the drug. Adults and children over 12 years old (or more than 40 kg of body weight). Usual dose for mild to moderate heavy course infection is 1 tablet every 12 hours, in the case of severe infections and respiratory tract infections - 1 tablet every 8 hours. Since tablets of a combination of amoxicillin and clavulanic acid of 250 mg + 125 mg and 500 mg-125 mg contain the same amount of clavulanic acid -125 mg, 2 tablets of 250 mg + 125 mg are not equivalent to 1 tablet of 500 mg + 125 mg. Dosage for odontogenic infections: 1 tablet every 12 hours for 5 days. Patients with impaired renal function. Dose adjustment is based on the maximum recommended dose of amoxicillin and is carried out taking into account the values ​​of creatinine clearance (CC). Adults and children over 12 years old (or more than 40 kg of body weight). CC> 30 ml / min: dose adjustment is not required. In case of anuria, the interval between dosing should be increased to 48 hours or more. Tablets 875 mg + 125 mg should be used only in patients with CC> 30 ml / min. Patients with impaired liver function. The drug should be taken with caution. It is necessary to carry out regular monitoring of liver function.

OVERDOSE
There are no reports of death or life-threatening side effects due to drug overdose. In most cases, overdose symptoms include gastrointestinal disorders (abdominal pain, diarrhea, vomiting). Anxiety, insomnia, dizziness, and in isolated cases - convulsive seizures are also possible. In case of an overdose, the patient should be under medical supervision, treatment is symptomatic. In the case of a recent intake (less than 4 hours), it is necessary to perform a gastric lavage and prescribe activated charcoal to reduce absorption. Amoxicillin / clavulanic acid is removed by hemodialysis.

SPECIAL INSTRUCTIONS
Carefully. History of pseudomembranous colitis, diseases of the gastrointestinal tract, liver failure, severe renal dysfunction, pregnancy, lactation, with simultaneous use with anticoagulants. Application during pregnancy and during breastfeeding. During pregnancy and lactation, the drug is used only if the intended benefit to the mother outweighs the potential risk to the fetus and child. During the course of treatment, it is necessary to monitor the state of the function of the hematopoietic organs, liver, and kidneys. In patients with severely impaired renal function, an adequate dose adjustment or an increase in the intervals between doses is required. In order to reduce the risk of side effects from the gastrointestinal tract, the drug should be taken with meals. The development of superinfection is possible due to the growth of microflora insensitive to it, which requires a corresponding change antibacterial therapy... In patients with hypersensitivity to penicillins, cross-allergic reactions with cephalosporin antibiotics are possible. In women with premature rupture of the membranes, it was found that prophylactic therapy with amoxicillin + clavulanic acid may be associated with an increased risk of necrotizing colitis in newborns. Crystalluria is very rare in patients with reduced urine output. During the use of large doses of amoxicillin, it is recommended to take a sufficient amount of fluids and maintain adequate diuresis to reduce the likelihood of amoxicillin crystals forming. Laboratory tests: high concentrations of amoxicillin give a false positive reaction to urine glucose when using Benedict's reagent or Fehling's solution. It is recommended to use enzymatic reactions with glucosidase. Special precautions for disposal of unused medicinal product... There is no need for special precautions when disposing of an unused product. Impact on the ability to manage vehicles and engaging in other activities that require concentration of attention and speed of psychomotor reactions. Due to the possibility of developing side effects from the central nervous system, such as dizziness, headache, convulsions, during treatment, care should be taken when driving and engaging in other activities that require concentration of attention and speed of psychomotor reactions.

STORAGE CONDITIONS
Store in a dry place out of the reach of children at a temperature not exceeding 25 C.

Akrikhin KhFK JSC Lek D.D. Sandoz GmbH Sandoz GmbH / Lek d.d.

Country of origin

Austria Austria / Slovenia Slovakia Slovenia

Product group

Antibacterial drugs

Broad-spectrum antibiotic of the penicillin group with a beta-lactamase inhibitor

Forms of issue

• 25 g - dark glass bottles with a volume of 100 ml (1) complete with a dosing spoon - cardboard packs 25 g - dark glass bottles with a volume of 100 ml (1) complete with a dosing spoon - cardboard packs. powder for preparation of suspension for oral administration dosage of 400 mg + 57 mg / 5 ml of 17.50 g (70 ml of finished suspension) in a dark glass bottle. powder for preparation of suspension for oral administration dosage of 400 mg + 57 mg / 5 ml 35 g each (140 ml of the finished suspension) in a dark glass bottle. pack of 14 tablets pack of 15 tablets pack of 15 tablets pack of 5 bottles Vials (5) - packs of cardboard Vials (5) - packs of cardboard.

Description of the dosage form

• Powder for preparation of solution for intravenous administration Powder for preparation of solution for intravenous administration from white to yellowish-white color. Powder for preparation of solution for intravenous administration from white to yellowish-white color. Powder for preparation of suspension for oral administration Powder: from white to yellowish-white color. suspension: almost white to yellow homogeneous suspension. Dispersible tablets Film-coated tablets Film-coated tablets

pharmachologic effect

Mechanism of action Amoxicillin is a semi-synthetic broad-spectrum antibiotic that is active against many gram-positive and gram-negative microorganisms. At the same time, amoxicillin is susceptible to destruction by beta-lactamases, and therefore the spectrum of activity of amoxicillia does not extend to microorganisms that produce this enzyme. Clavulanic acid, a beta-lactamase inhibitor, structurally related to penicillins, has the ability to inactivate a wide range of beta-lactamases found in microorganisms resistant to penicillins and cephalosporins. Clavulanic acid is sufficiently effective against plasmid beta-lactamases, which most often cause bacterial resistance, and is not effective against type I chromosomal beta-lactamases, which are not inhibited by clavulanic acid. The presence of clavulanic acid in the preparation protects amoxicillin from destruction by enzymes - beta-lactamases, which makes it possible to expand antibacterial spectrum amoxicillin. Amoxiclav® possesses a wide range antibacterial action. It is active against strains sensitive to amoxicillin, including strains producing β-lactamases, incl. aerobic gram-positive bacteria: Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus viridans, Streptococcus bovis, Staphylococcus aureus (except methicillin-resistant strains), Staphylococcus epidermidis (except methicillin-resistant. aerobic gram-negative bacteria: Bordetella pertussis, Brucella spp., Campylobacter jejuni, Escherichia coli, Gardnerella vaginalis, Haemophilus influenzae, Haemophilus ducreyi, Klebsiella spp., Moraxella catarrhalis. Shigella spp., Vibrio cholerae, Yersinia enterocolitica, Helicobacter pylori, Eikenella corrodens; anaerobic gram-positive bacteria: Peptococcus spp., Peptostreptococcus spp., Clostridium spp., Actinomyces israelii, Fusobacterium spp., Prevotella spp., gram-negative anaerobes: Bacteroides spp.

Pharmacokinetics

The main pharmacokinetic parameters of amoxicillin and clavulanic acid are similar. Absorption After taking the drug inside, both components are well absorbed from the gastrointestinal tract, food intake does not affect the degree of absorption. The bioavailability of amoxicillin and clavulanic acid is 90% and 70%, respectively. Cmax in blood plasma is reached 1 hour after taking the drug and is (depending on the dose) for amoxicillin 3-12 μg / ml, for clavulanic acid - about 2 μg / ml. Distribution Both components are characterized by a good volume of distribution in body fluids and tissues (secretion paranasal sinuses nose, synovial fluid, palatine tonsils, middle ear, pleural fluid, saliva, bronchial secretions, lungs, uterus, ovaries, liver, prostate, muscle, gall bladder, peritoneal fluid). In urine, the drug is present in high concentrations... Amoxicillin and clavulanic acid do not penetrate the BBB with non-inflamed meninges. Active substances penetrate the placental barrier and in trace concentrations are excreted in breast milk. The degree of binding to blood plasma proteins is low. Metabolism Amoxicillin is partially metabolized, clavulanic acid is extensively metabolized. Excretion Amoxicillin is excreted by the kidneys practically unchanged by tubular secretion and glomerular filtration. Clavulanic acid is excreted by glomerular filtration, partly in the form of metabolites. Small amounts can be excreted through the intestines and lungs. T1 / 2 of amoxicillin is about 1 hour. T1 / 2 of clavulanic acid is about 1 hour. Pharmacokinetics in special clinical situations In severe renal failure, T1 / 2 increases to 7.5 hours for amoxicillin and up to 4.5 hours for clavulanic acid. Both components are removed by hemodialysis and minor amounts by peritoneal dialysis.

Special conditions

When using the drug in a course, it is necessary to monitor the state of the function of the hematopoietic organs, liver, and kidneys. Patients with severely impaired renal function require an adequate dose adjustment of Amoxiclav or an increase in the intervals between drug administrations. Due to the fact that in a large number of patients with infectious mononucleosis and lymphocytic leukemia, who received ampicillin, the appearance of an erythematous rash was observed, the use of antibiotics of the ampicillin group in such patients is not recommended. The drug contains potassium. Patients on a sodium restricted diet should take into account that each 600 mg vial (500 mg + 100 mg) contains 29.7 mg sodium, each 1.2 g vial (1000 mg + 200 mg) contains 59.3 mg sodium. The amount of sodium in the maximum daily dose is greater than 200 mg. When using Amoxiclav in high doses, a false-positive reaction is possible when determining the level of glucose in the urine when using Benedict's reagent or Felling's solution (it is recommended to use enzymatic reactions with glucose oxidase). Influence on the ability to drive vehicles and use mechanisms Data on negative impact Amoxiclav in recommended doses for the ability to drive vehicles and control mechanisms are absent.

Composition

• amoxicillin (in the form of sodium salt) 1 g clavulanic acid (in the form of potassium salt) 200 mg amoxicillin (in the form of sodium salt) 500 mg clavulanic acid (in the form of potassium salt) 100 mg amoxicillin trihydrate 1004.5 mg, which corresponds to the content of amoxicillin 875 mg clavulanate potassium 148.87 mg, which corresponds to the content of clavulanic acid 125 mg Excipients: tropical mixture flavor, sweet orange flavor, aspartame, colloidal anhydrous silicon dioxide, iron (III) oxide yellow (E172), talc, hydrogenated castor oil, cellulose microcrystalline silicon-containing tri-silica mg, which corresponds to the content of amoxicillin 500 mg potassium clavulanate 148.87 mg, which corresponds to the content of clavulanic acid 125 mg Excipients: tropical mixture flavor, sweet orange flavor, aspartame, colloidal anhydrous silicon dioxide, iron (III) oxide yellow (E172), talc, oil castor hydrogenated, cellulose mi crocrystalline silicon containing Each 5 ml of suspension 400 mg + 57 mg / 5 ml contains: active substances: amoxicillin (in the form of trihydrate) in terms of active substance - 400 mg; clavulanic acid (in the form of potassium salt) in terms of the active substance - 57 mg; excipients: citric acid (anhydrous) - 2.694 mg; sodium citrate (anhydrous) - 8.335 mg; microcrystalline cellulose and sodium carmellose - 28.1 mg; xanthan gum - 10.0 mg; colloidal silicon dioxide - 16.667 mg; silicon dioxide - 0.217 g; wild cherry flavor - 4,000 mg; lemon flavor - 4,000 mg; sodium saccharinate - 5,500 mg; mannitol up to 1250 mg.

Amoxiclav indications for use

• Treatment of infectious and inflammatory diseases caused by microorganisms sensitive to the drug: - infections of the upper respiratory tract and ENT organs (including acute and chronic sinusitis, acute and chronic otitis media, retropharyngeal abscess, tonsillitis, pharyngitis); - infections of the lower respiratory tract (including acute bronchitis with bacterial superinfection, chronic bronchitis, pneumonia); - urinary tract infections; - gynecological infections; - infections of the skin and soft tissues, including human and animal bites; - infections of bones and joints; - infections of the abdominal cavity, incl. biliary tract (cholecystitis, cholangitis); - odontogenic infections; - sexually transmitted infections (gonorrhea, chancroid); - prevention of infections after surgery.

Amoxiclav contraindications

• - hypersensitivity to amoxicillin or clavulanic acid; - an indication of a history of cholestatic jaundice or liver dysfunction caused by taking amoxicillin / clavulanic acid. The drug is prescribed with caution to patients with known hypersensitivity to antibiotics of the cephalosporin series, with a history of pseudomembranous colitis, with liver failure, severe renal dysfunction. Due to the fact that in a large number of patients with infectious mononucleosis and lymphocytic leukemia, who received ampicillin, the appearance of an erythematous rash was observed, the use of antibiotics of the ampicillin group for such patients is not recommended

Amoxiclav dosage

• 1000 mg + 200 mg 1000 mg + 200 mg 125 mg + 31.25 mg / 5 ml 250 mg + 62.5 mg / 5 ml 250 mg + 125 mg 400 mg + 57 mg / 5 ml 500 mg + 100 mg 500 mg + 125 mg 500 mg + 125 mg 875 mg + 125 mg 875 mg + 125 mg

Amoxiclav side effects

• Side effects in most cases are mild and transient. From the digestive system: loss of appetite, nausea, vomiting, diarrhea; rarely - abdominal pain, liver dysfunction, increased activity of liver enzymes (ALT or AST); in isolated cases - cholestatic jaundice, hepatitis, pseudomembranous colitis. Allergic reactions: itching, urticaria, erythematous rash; rarely - exudative erythema multiforme, angioedema, anaphylactic shock, allergic vasculitis; in isolated cases - exfoliative dermatitis, Stevens-Johnson syndrome, acute generalized exanthematous pustulosis. From the hematopoietic and lymphatic system: rarely - reversible leukopenia (including neutropenia), thrombocytopenia; very rarely - hemolytic anemia, a reversible increase in prothrombin time (when used together with anticoagulants), eosinophilia, pancytopenia. From the nervous system: dizziness, headache; very rarely - convulsions (can occur in patients with impaired renal function when taking the drug in high doses), hyperactivity, anxiety, insomnia. From the urinary system: very rarely - interstitial nephritis, crystalluria. Others: rarely - the development of superinfection (including candidiasis).

Drug interactions

With the simultaneous use of the drug Amoxiclav® with antacids, glucosamine, laxatives, aminoglycosides, absorption slows down, with ascorbic acid it increases. Diuretics, allopurinol, phenylbutazone, NSAIDs and other drugs that block tubular secretion increase the concentration of amoxicillin (clavulanic acid is excreted mainly by glomerular filtration). With the simultaneous use of Amoxiclav® increases the toxicity of methotrexate. With the simultaneous use of Amoxiclav with allopurinol, the incidence of exanthema increases. Simultaneous administration with disulfiram should be avoided. In some cases, taking the drug can lengthen the prothrombin time, in this regard, caution should be exercised while prescribing anticoagulants and the drug Amoxiclav®. The combination of amoxicillin with rifampicin is antagonistic (there is a mutual weakening of the antibacterial effect). Amoxiclav® should not be used simultaneously with bacteriostatic antibiotics (macrolides, tetracyclines), sulfonamides due to a possible decrease in the effectiveness of Amoxiclav. Probenecid reduces the excretion of amoxicillin, increasing its serum concentration. Antibiotics reduce the effectiveness of oral contraceptives.

Overdose

There are no reports of death or life-threatening side effects due to drug overdose. Symptoms: in most cases - gastrointestinal disorders (abdominal pain, diarrhea, vomiting), possibly agitation, insomnia, dizziness; in isolated cases - convulsive seizures. Treatment: the patient must be under medical supervision; symptomatic therapy. In the case of a recent intake of the drug (less than 4 hours), it is necessary to wash the stomach and prescribe activated charcoal to reduce the absorption of the drug. Amoxicillin / potassium clavunate is removed by hemodialysis.

Storage conditions

• store in a dry place
• keep away from children
• store in a dark place

Information provided