Flemoklav Solutab is a broad-spectrum antibiotic of the penicillin group with a beta-lactamase inhibitor.

Release form and composition

Flemoklav Solutab is available in the form of oblong dispersible tablets from white to yellow color with brown dotted spots. On the surface of the tablets, the manufacturer's logo and the marking “421”, “422”, “424” or “425” are applied. The drug is packaged in blisters (4 or 7 pcs.) And packed in cardboard boxes (2 or 5 blisters per pack).

The composition of 1 tablet includes:

• active ingredients: amoxicillin - 125/250/500/875 mg, clavulanic acid - 31.25 / 62.5 / 125/125 mg, respectively;
• excipients: crospovidone, microcrystalline cellulose, magnesium stearate, vanillin, apricot, lemon, tangerine, saccharin flavors.

Indications for use

Flemoklav Solutab is used in the treatment of infectious and inflammatory diseases that are caused by microorganisms sensitive to the action of the drug:

• infections of ENT organs and upper respiratory tract(sinusitis, otitis media, recurrent tonsillitis);
• infectious diseases of the lower respiratory tract (bronchopneumonia, lobar pneumonia, Chronical bronchitis in the stage of exacerbation);
• infections of the genitourinary tract (urethritis, pyelonephritis, cystitis, infectious diseases of the female genital organs);
• gonorrhea caused by Neisseria gonorrhoeae;
• infectious diseases of soft tissues and skin;
• odontogenic infections (maxillary sinusitis, severe dental abscesses with spreading cellulitis, periodontitis);
• joint and bone infections caused by Staphylococcus aureus and need long-term therapy (only for tablets at a dose of 875/125 mg);
• stepwise therapy of other mixed infections (postpartum and intra-abdominal sepsis, septic abortion) (only for tablets at a dose of 875/125 mg).

Contraindications

• a history of liver dysfunction (including the development of jaundice) while taking clavulanic acid and / or amoxicillin;
• age up to 2 years;
• age up to 12 years and / or body weight less than 40 kg (only for tablets at a dose of 875/125 mg);
• renal failure with QC ≤ 30 ml / min (only for tablets at a dose of 875/125 mg);
• hypersensitivity to other beta-lactam antibiotics (penicillins, cephalosporins), as well as any components of the drug.

The drug is used with caution in the following cases:

• severe liver failure;
• chronic renal failure (except for tablets at a dose of 875/125 mg);
• diseases of the gastrointestinal tract (including a history of colitis associated with the use of penicillins).

Method of administration and dosage

To achieve the maximum effect, Flemoklav Solutab is recommended to be taken at the beginning of a meal. The tablets must be swallowed whole and washed down with a glass of water. Also, the tablet can be dissolved in water (at least 30 ml), stirring well before use.

Minimum course duration antibacterial therapy- 5 days, however, treatment without revising the clinical situation should not last more than 14 days. If necessary, stepwise therapy can be carried out (at the initial stages, the drug is taken parenterally, after which the transition to the oral form is carried out).

Children aged 2 to 12 years and / or weighing less than 40 kg are prescribed tablets 125 / 31.25 mg or 250 / 62.5 mg in daily dose no more than 2400/600 mg. The dosage is selected depending on the clinical situation and is for this category of patients from 20/5 mg / kg to 60/15 mg / kg per day (divided into 3 doses). For children under 6 years of age, it is recommended to give Flemoklav Solutab in dissolved form.

When treating patients with impaired liver function, the drug is used with caution with regular monitoring of liver function.

It is not required to adjust the dose of the drug when treating the elderly. When treating elderly patients with impaired renal function, the dose should be adjusted in accordance with the information below.

Dosage for impaired renal function

In case of renal failure, the excretion of the active substances of the drug through the kidneys slows down. The recommended dose is calculated depending on the severity of the disorder.

With QC more than 30 ml / min, dose adjustment is not required.

• children from 2 to 12 years old and / or weighing less than 40 kg - 15 / 3.75 mg per 1 kg of body weight 2 times a day (no more than 500/125 mg 2 times a day);
• children over 12 years old and / or weighing more than 40 kg and adults - 500/125 mg 2 times a day.

• children from 2 to 12 years old and / or weighing less than 40 kg - 15 / 3.75 mg per 1 kg of body weight 1 time per day (no more than 500/125 mg 1 time per day);
• children over 12 years old and / or weighing more than 40 kg and adults - 500/125 mg once a day.

• children from 2 to 12 years old and / or weighing less than 40 kg - 15 / 3.75 mg per 1 kg of body weight 1 time per day, plus an additional similar dose before and after dialysis;
• children over 12 years old and / or weighing more than 40 kg and adults - 500/125 mg once a day, plus an additional similar dose before and after dialysis.

Also, when taking the drug Flemoklav Solutab, the following undesirable reactions from the digestive system are observed:

• adults: very often - diarrhea; often - vomiting, nausea;
• children: often - nausea, diarrhea, vomiting;
• common to both categories: often - the appearance of nausea and other reactions from the gastrointestinal tract when taking large doses of the drug (these effects usually disappear when using the tablets at the beginning of a meal); infrequently - digestive disorders; very rarely - antibiotic-induced colitis (including hemorrhagic and pseudomembranous), gastritis, stomatitis, black "hairy" tongue.

special instructions

In general, the drug is well tolerated and has low toxicity rates characteristic of all penicillins. With prolonged therapy, it is necessary to periodically assess the function of the liver, kidneys and hematopoiesis.

Before prescribing the drug Flemoklav Solutab, it is necessary to draw up a detailed history, including information about previous allergic reactions (to cephalosporins, penicillins or other substances).

V clinical practice described serious (up to lethal) hypersensitivity reactions to penicillins. If allergic reactions to Flemoklav Solutab occur, the drug should be stopped immediately and appropriate alternative treatment should be started. If serious hypersensitivity reactions develop, immediate administration of epinephrine is recommended. In addition to this measure, oxygen therapy, intravenous GCS administration and airway management (including intubation) may also be required.

If allergic reactions occur on the part of the skin, the drug should be discontinued.

With prolonged use of the drug, excessive reproduction of insensitive microorganisms is possible.

There is evidence of individual cases of development when taking antibiotics

pseudomembranous colitis varying degrees severity (from mild to life-threatening). This fact should be taken into account when treating patients with diarrhea during or after the use of antibiotics: with severe or prolonged diarrhea or the appearance of abdominal cramps, Flemoklav Solutab should be immediately canceled and an appropriate examination carried out.

With the use of high doses of the drug, as well as in patients with impaired renal function, seizures may develop.

In patients with reduced diuresis, in very rare cases (mainly with parenteral therapy), crystalluria may occur. To prevent the formation of amoxicillin crystals when using high doses of amoxicillin, it is necessary to maintain adequate diuresis and take a sufficient volume of fluid.

When taking the drug, the content of amoxicillin in the urine may increase, which leads to false-positive results of Fehling's, Benedict's and some other methods for determining glucose in urine, therefore, when prescribing appropriate treatment, the use of the glucose oxidase method is recommended.

Clavulanic acid can cause non-specific binding of albumin and immunoglobulin G to the membranes of erythrocytes, therefore, false-positive results of the Coombs test may develop.

The Flemoklav Solutab preparation contains the following amount of potassium:

• tablets 125 / 31.25 mg - 0.16 mmol (6.13 mg);
• tablets 250 / 62.5 mg - 0.32 mmol (12.3 mg);
• tablets 500/125 mg - 0.64 mmol (24.53 mg).

When taking potassium in an amount of> 1 mmol per day in patients with reduced renal function and patients who are on a controlled potassium diet, close medical supervision must be ensured.

Flemoklav Solutab is not addictive, drug addiction and reactions of euphoria.

In the course of studies of reproductive function in animals, parenteral and oral administration the combination of amoxicillin and clavulanic acid did not lead to the development of teratogenic effects.

During pregnancy, Flemoklav Solutab is used only in cases where possible benefit to the mother outweighs the potential risk to the baby.

It is allowed to use the drug during lactation. Penetration into breast milk trace amounts of active ingredients can cause breastfeeding children diarrhea, sensitization or candidiasis of the mucous membranes oral cavity... If these effects develop, breastfeeding should be interrupted.

Flemoklav Solutab can cause side effects in which you need to be careful when driving a moving mechanism or vehicle.

Drug interactions

• probenecid: increased concentration and persistence (long-term presence) of amoxicillin in the blood;
• allopurinol: when taken simultaneously with amoxicillin, skin allergic reactions may develop;
• methotrexate: increased toxicity of methotrexate;
• combined oral contraceptives: decrease in the effectiveness of the latter;
• acenocoumarol, warfarin: in rare cases, an increase in INR is possible;
• mycophenolate mofetil: reducing the concentration of mycophenolic acid by about 50%;
• indirect anticoagulants: increased prothrombin time (increased MHO).

Analogs

Analogs of the Flemoklav Solutab preparation are: Baktoklav, Amovikomb, Klamosar, Amoxiclav, Amoxiclav Kviktab, Betaklav, Amoxivan, Amoxicillin + Clavulanic acid, Augmentin, Verklav, Novaklav, Augmentin SR, Augmentin EC, Medoklav, Ranibell, Rilell , Ecoclave, Foraclav.

Terms and conditions of storage

Store at a temperature not exceeding 25 ° C.

Shelf life is 3 years.

Conditions of dispensing from pharmacies

Dispensed by prescription.

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There are hundreds of different antibiotics, both domestic and imported, on the Russian pharmaceutical market. They are all designed to fight bacterial infections. There are antibiotics and natural ones. The latter cause the least amount side effects... But their action is directed, as a rule, against a small group of microbes.

There are also unprotected antibiotics and protected ones, which include additional substances that prevent bacteria from defending themselves against the lethal action of the main medicinal substance. What is special? Protected antibiotics can deal with not only a wide variety of infections, but they also have more side effects than their unprotected counterparts.

In our article we will talk about a new protected semi-synthetic drug "Flemoklav Solutab" 875/125. The instruction to it explains how to use it, but not all medical terms in it can be understood by a wide range of the population. We offer a detailed overview of this medicinal product, as well as analysis of reviews of patients and physicians who are directly working with this drug.

General information

The instruction attached to each package of "Flemoklav Solutab" 875/125 informs that it is produced by a Dutch company known in the Russian pharmaceutical market and called "Astellas Pharma Europe BV".

The medicine is an antibiotic with the broadest spectrum of action. It is produced in cardboard boxes. Each pack contains only 2 blisters. Each of them contains 7 tablets in sealed cells. They are rather large in size, oblong, convex, do not have dividing risks (that is, their division into parts in the process of use is not provided). They have the company logo and numbers "424". This knowledge will help you distinguish a natural product from a fake.

The color of the Dutch tablets should be either white or yellow-cream with brown splashes. Their taste is quite specific, as reported by all respondents in their reviews. For complete clarity of the picture, we present several photos of "Flemoklav Solutab" 875/125. The instruction prescribes the tablets either swallowed with water, or dissolved in water (100-150 ml) and drunk in the form of the resulting suspension, since the drug belongs to the category of dispersible drugs.

Let us explain what this medical term means. Dispersible tablets are medications which do not have to be swallowed with water. They can dissolve in the mouth, and they can also be dissolved in water to make the medicine look like a suspension. This type of pill was invented for patients with dysphagia (having trouble swallowing), as well as for anyone who is more comfortable with this form of medication.

Therefore, the taste of such a preparation is of great importance. "Flemoklav Solutab" is produced in two types. More precisely, with lemon and orange flavors. If the flavoring of the tablets does not suit you at all and causes vomiting when used in the form of a suspension, it is allowed to add honey or sugar to the solution to taste. It is also allowed to take this medication with any product you like (for example, with fruit whipped in a blender.

You can buy the drug at any pharmacy. It is dispensed only with a doctor's prescription. When buying a drug, you should pay special attention to the numbers following the name of the drug and always indicated on the package. The fact is that the Dutch company produces Flemoklav Solutab in several forms.

So, there are tablets of this remedy with dosages of amoxicillin and helping it to destroy the bacteria clavulanic acid in the following proportions: 500/125, 250 / 62.5 and 125 / 31.25. They all have the same medicinal properties... But if a package with a lower concentration of the main medicinal components is purchased, the doctor must adjust the dosage of the drug.

A drug with a concentration of basic substances of 875/125 costs from 380 to 490 rubles, which depends on pharmacy markups caused by transport and other costs.

Chemical composition

The instructions for "Flemoklav Solutab" 875/125 indicate that there are only two main substances that act against bacteria in the preparation:

1. Amoxicillin. Each pill contains 875 mg of it.
2. Clavulanic acid: 125 mg pills.

The numbers on the packaging "875" and "125" indicate the content of these substances in the preparation. Additionally, each tablet contains:

• vanillin (1 mg);
• magnesium stearate (5 mg);
• saccharin (9 mg);
• crospovidone (100 mg)
• microporous cellulose 327 mg;
• apricot flavor.

The instruction to "Flemoklav Solutab" 875/125 does not give a description of each component. We will fill this gap so that patients have an idea of ​​what enters their body with each tablet of the drug.

Amoxicillin

This is an antibiotic from the penicillin group. It belongs to the third subgroup, called aminopenicillins, and is a complex compound that includes, in addition to synthetic penicillins, substances such as ticarcillin and carbenicillin. This explains the unusually wide range of microorganisms with which it is able to fight.

Their principle of action is to destroy the walls of bacteria by blocking the synthesis of their main component - peptidoglycan.

According to the instructions for "Flemoklav Solutab" 875/125, in the composition of tablets, the amoxicillin agent occupies a leading position. It should be borne in mind that although this substance is highly active against pathogenic microorganisms and is completely harmless for most people, in some patients it can cause allergic reactions: rash, laryngeal edema, fever up to 38 o C, abdominal pain, indigestion, even dangerous not only for health, but also for life anaphylactic shock. In rare cases, patients experience vomiting, peeling of the skin, dizziness.

It should also be noted that such a strong antibiotic as amoxicillin, with prolonged use, can destroy not only pathogenic bacteria, but also beneficial ones that inhabit the mucous membranes. This disrupts the normal balanced composition of the microflora, which ensures the tissues to perform their functions. This can provoke the onset of dysbiosis, and in women, the additional appearance of diseases such as bacvaginosis and vaginal candidiasis.

Clavulanic acid

As the instruction "Flemoklava Solutab" 875/125 informs us, in the composition of the preparation, about 1/5 part is occupied by clavulanic acid. This substance is an inhibitor of beta-lactamase enzymes. They are produced by many bacteria in order to make themselves resistant to antibiotics. By suppressing the activity of these enzymes, clavulanic acid reduces microbial resistance and enhances the antimicrobial functions of antibiotics. In addition, this component itself is capable of destroying some types of bacteria: streptococci, chlamydia, staphylococcus, genococcus, legionella. Working in pairs, clavulanic acid and amoxicillin are active against bacteria such as:

• streptococci (viridians, pyogenes, anthracis, pneumoniae);
• staphylococci (aureus, epidermidis);
• enterococci;
• corynebacteria;
• clostridiums;
• peptococci;
• peptostreptococci;
• shigella;
• bordetella;
• gardnerella;
• klebsiella;
• salmonella;
• escherichia;
• proteuses;
• Helicobacter pylori.

This information is presented in the instruction "Flemoklava Solutab" 875/125. However, it is not indicated there that acting together, amoxicillin and clavulanic acid used with it activate the intracellular bactericidal activity of leukocytes, stimulate their chemotaxis (movement to the source of damage) and leukocyte adhesion (cell adhesion). All this greatly enhances the effect of the drug. Especially these beneficial features appear during treatment respiratory infections caused by the bacterium pneumococcus.

Additional substances in the composition of the drug

Crospovidone... This substance is called povidone in Russia. It belongs to the group of enterosorbents. Its properties are complexation. That is, povidone actively binds toxins: both coming from the outside, and formed in the process of various reactions in the body itself. It does not enter the bloodstream, it works only in the digestive tract. At the same time, the mucous membranes are not disturbed, it does not accumulate in the cells, it is excreted with the feces.

Povidone is introduced into the Flemoklava Solutab tablets in order to adsorb toxins released by pathogenic bacteria, as well as to remove others from the body. harmful substances formed during metabolic reactions, thereby improving the therapeutic effect of the main medicinal components.

However, in some cases, povidone reduces drug absorption. To prevent this from happening when taking the drug in question, its quantitative content is precisely verified in it. Povidone has no contraindications, but in rare cases it can cause nausea and vomiting.

Microporous cellulose. According to the instructions for "Flemoklav Solutab" 875/125, this substance in tablets is almost three times more than crospovidone. Microporous cellulose is a polysaccharide, it is not absorbed, is not digested, does not cause allergic reactions. Once in the digestive tract, it, like a sponge, absorbs pathogenic organisms, that is, acts as a sorbent.

Magnesium stearate... It is used as a filler and shaper.

The rest of the components of the drug give the tablets their taste.

Application area

As the instruction describes, the medicine "Flemoklav Solutab" 875/125 is effective for the following diseases:

• respiratory infections (pneumonia, bronchitis, lung abscess);
• diseases of the ENT organs (otitis media, pharyngitis, sinusitis, tonsillitis);
• skin infections (erysipelas, dermatoses, impetigo, wound infections, cellulitis, abscesses);
• osteomyelitis;
• infections of the urinary and reproductive systems (cystitis, pyelitis, cervicitis, pyelonephritis, salpingitis, prostatitis, urethritis);
• some sexually transmitted diseases (gonorrhea, chancre);
• complications in obstetrics and surgery, infections after operations, septic abortion).

Pharmacokinetics

In the description of the preparation "Flemoklav Solutab" 875/125, the instruction says that, once in the stomach, clavulanic acid and the main agent of this medicine quickly penetrate the bloodstream. In this case, the maximum plasma concentration for amoxicillin is 1.5 hours (12 μg / ml). Its absorption is 90% (when taken orally). Approximately 20% of this substance binds to proteins present in the blood plasma.

It has been experimentally determined that the half-life of a substance such as amoxicillin is 1.1 hours. It is excreted by the kidneys in an almost unchanged form, moreover, approximately 80% are removed from the body within 6 (maximum 6.5) hours after the pill was drunk.

For clavulanic acid, the time to reach the maximum (3 μg / ml) plasma concentration is 1 hour. In the stomach, it is absorbed about 60%, and about 22% binds to plasma proteins. In the human body, this substance is metabolized by hydrolysis and decarboxylation reactions. That is, it is displayed in a modified form. Moreover, in the first 6-6.5 hours, about 50% of it is removed from the body.

Dosage and rules of admission

Let's consider how to take "Flemoklav Solutab" 875/125. The dosage instructions and methods of administration indicate the following:

Adults should take the drug in the same way as children over 12 years old, that is, one tablet in the morning and in the evening.

Taking the drug with meals does not affect the absorption of active ingredients. However, many patients note that the medicine is better accepted by the body if taken immediately before the start of a meal.

The duration of treatment is determined by the doctor, based on the severity of the course of the disease. In most cases, the course does not exceed 14 days, but under special circumstances it can be longer.

For people suffering renal failure any degree, the dosage of the drug "Flemoklav Solutab" 875/125 can be adjusted. The instructions for use state that if the patient's rate of so-called glomerular filtration exceeds 30 ml / min, only then he is prescribed doses and frequency of administration on a general basis. In other words, 1 tablet in the morning and evening hours.

If the filtration rate is less than 30 ml / min, the excretion of clavulanic acid and amoxicillin by the kidneys is slower. Therefore, the patient's dose of the drug is reduced (Flemoklav Solutab is prescribed with an amoxicillin content of 500 mg, or it can be used with 250 mg). Moreover, if the filtration rate is less than 30, but exceeds 10 mg per minute, the drug is taken 2 times per day, and if less than 10 mg / min - 1 time per day.

If the patient has renal impairment, the drug is prescribed only if it is possible to constantly monitor liver function.

For those patients who undergo hemodialysis, "Flemoklav Solutab" is not contraindicated. Such people are prescribed a drug with an amoxicillin content of not more than 500 mg. The tablets are taken orally either twice a day (before and after the procedure), or once a day. It depends on the condition of the patient.

Contraindications

Like others remedies, the drug "Flemoklav Solutab" 875/125 also has a number of contraindications. The instruction informs that it cannot be taken by the following categories of patients:

• with hypersensitivity to any components included in the drug;
• allergic to any drugs of the penicillin group;
• those who, after using the drug, develop liver dysfunction, the whites of the eyes and skin turn yellow;
• suffering from infectious mononucleosis;
• patients diagnosed with lymphocytic leukemia;
• with a measles rash on the body;
• with phenylketonuria.

Recall that a similar drug with a concentration of basic substances of 875/125 should not be taken by children under 12 years of age and suffering from renal failure. In this case, it is taken into account that it should not be lower than 10 mg / min.

• having gastrointestinal diseases;
• patients with colitis;
• with renal failure in chronic form;
• with hepatic failure in a severe stage;
• during pregnancy;
• during breastfeeding.

A nursing mother can use such a medicine for herself. But if the baby has diarrhea or candidiasis of the mucous membranes, the drug is canceled.

Adverse Reactions

Above, adverse reactions have already been indicated that may appear for each component included in "Flemoklav Solutab" 875/125. In the instructions for use of the drug it is reported that, in general, the substances included in this drug can cause the following undesirable reactions:

On the part of the digestive system:

• nausea;
• dysbiosis, manifested by diarrhea;
• vomiting;
• hemorrhagic colitis;
• enterocolitis;
• hepatitis;
• gastritis;
• cholestatic jaundice.

On the part of the organs responsible for hematopoiesis:

• thrombocytosis;
• leukopenia;
• hemolytic anemia;
• thrombocytopenia;
• granulocytosis;
• eosinophilia.

From the side of the central nervous system:

• headache;
• convulsions;
• dizziness;
• unexplained anxiety;
• difficulty falling asleep.

• hematuria;
• candidiasis;
• crystalluria;
• interstitial nephritis.

In some patients, such information, presented in the instructions for "Flemoklav Solutab" 875/125, raises significant concerns. In the responses of doctors to the drug, comments are also expressed about too large a list. adverse reactions for this drug. We add that its use in many adults and children can cause a number of allergic manifestations:

• skin rash;
• Stevens-Johnson syndrome;
• exudative erythema;
• acute exanthematous pustulosis;
• allergic vasculitis;
• swelling;
• anaphylactic shock.

Interaction with other medications

Not all medicines can be used, according to the instructions, "Flemoklav Solutab". In the reviews, patients note that doctors did not always warn them about this, as a result of which there were undesirable reactions of the body:

• Sulfonamides, lincosamides, macrolides, tetracyclines produce an antagonistic effect.
• Glucosamine, antacids, laxatives reduce absorption, and ascorbic acid increases it.
• Diuretics increase the amount of amoxicillin in the lymph.
• The drug reduces the effectiveness of oral contraception.

Analogs

The preparation "Flemoklav Solutab" 875/125 has many analogues that have a similar antibacterial effect. Among them are:

• "Panklav".
• Ecoclave.
• Augmentin.
• Arlet.

They are produced with different quantitative content of the main components. Therefore, the dosage and methods of administration may differ from those prescribed for "Flemoklav Solutab". For treatment with analogs to be effective, it is necessary that the possibility of their use is determined by the attending physician. He must also prescribe the dosage.

"Flemoklav Solutab" 875/125: about instructions, reviews of doctors and patients

In general, such a drug deserves attention and trust. Physicians-therapists and narrow specialists prescribe it quite often, since in most cases the effect of therapy is predictably high. With the help of such a drug, it is possible to cure patients from many severe bacterial infections and thereby avoid their complications. Also, doctors note that such a medicine has proven itself well in preventing the development of postoperative complications.

Patients have a slightly different opinion about Flemoklav Solutab 875/125. In reviews of the instructions attached to the packaging of the product, people note that it is sometimes difficult to understand when and how to give the drug to children.

But most of the negative reviews were written about multiple adverse reactions, due to which you have to interrupt treatment. In positive reviews, patients who did not experience any complications while taking the drug noted high efficiency Flemoklava Solutab and its relatively low cost, which makes this medicine affordable for people with different income levels.

Flemoklav Solutab is a drug belonging to the group of antibiotics. Has a pronounced bactericidal effect. It is available in the form of tablets with various dosages. Prescribed only by a doctor. Accepted when infectious diseases as mono- or polytherapy.

Compound

Antibiotic Flemoklav Solutab consists of two active ingredients... These include:

Flemoklav Solutab contains these two substances in different proportions. What dosage is needed is determined by the doctor according to the severity of the disease and the age of the patient. Substances are selected taking into account the existing disorders in the work of the renal and hepatic systems. The composition includes a small number of additional components. In addition to active substances, each capsule contains a small proportion of vanillin and sugar.

Mechanism and spectrum of action

The mechanism of action is bactericidal. Under its influence, the destruction of the bacterial cell and its death occurs. The action is based on a violation of the synthesis of a component of the cell wall of microbes. The production of peptidoglycan is inhibited. This leads to impaired growth and development of microorganisms.

Clavulanic acid in the structure acts in a similar way. There is a binding to the proteins of the bacterial cell. Cell death develops.

The spectrum of influence on microbes is wide. They act against various representatives of gram-positive and gram-negative aerobes.

These include streptococci and staphylococci. Activity against representatives of Neisseria is determined. Among them are causative agents of diseases such as meningitis and gonorrhea. Has a detrimental effect on pathogens intestinal infections... Such as Salmonella and Shigella and representatives from the Proteus group. Inhibits the growth and development of Haemophilus influenzae and bacteroids. Clavulanic acid has a minimal destructive effect on Pseudomonas aeruginosa. It also affects representatives of enterobacteriaceae and the genus of hemophilus influenzae. High level effects on staphylococci and streptococci.

Does not affect beta-lactomase secreting bacteria.

What is produced and how is it stored

Flemoklav for children and adults is available in the form of tablets. For children, it is available in syrup and drops or suspended solution. Color from white to light yellow. There is a strip in the middle that divides the capsule into two parts. Produced in cardboard containers. The container contains instructions for correct use. It should be stored in a place where children cannot reach the box. The implementation period is indicated on the packaging itself. It is dispensed from the pharmacy only on the prescription of the attending physician.

Available in 4 dosages. Accordingly, Amoxicillin / Clavulanova are 875 / 12.5; 250/625; 12.5 / 31.25 mg. Flemoklav Solutab 500 mg contains a high concentration of amoxicillin. The clavulanic acid level is 125 mg. In general, the substances in one capsule are at the level of 1000 mg.

List of indications for use

Due to its wide spectrum of action, this substance is used for various infectious diseases. The main indications for use are as follows:

• infectious injuries of the upper and lower respiratory tract;
• bacterial pathologies in the organ of hearing, throat and nasal passages;
• pathology of the urinary and genital tract of an infectious nature;
• lesions of the skin and visible mucous membranes;
• complications after surgery;
• preventive treatment of infection in surgical practice.

Flemoklav for angina is used in the presence of purulent overlays on the tonsils. In addition to sore throat, Flemoklav helps against diseases of an infectious nature:

1. From the respiratory tract: pneumonia, abscess of the lung tissue, empyema of the pleural sheets.
2. From the side of ENT organs: otitis media, tonsillitis, tonsillitis.
3. Urinary tract: cystitis, pyelonephritis, urethritis.
4. On the part of the reproductive system: inflammation of the appendages in women of the type of oophoritis and salpingitis, prostatitis in men, balanaposthitis, gonorrhea, complications of an infectious nature after childbirth.
5. Damage to the skin of the type of erysipelas, the presence of abscesses, complications after injury in the form of infection.

The duration of therapy is determined by the doctor. The appointment of antibiotics is always necessary in the presence of a bacterial disease.

In what cases Flemoklav Solutab should not be taken

There are a number of contraindications to the appointment of this antibiotic. These include:

The main contraindications are abnormalities in the functioning of the kidneys and liver. This is due to the fact that when active substances enter the body through the blood, they are sent to the liver. Excreted through the renal system. In the case of serious pathologies of these organs, transformation in the body can occur with negative effects on the functioning of systems.

Overdose

With excessive use, the development of a violation is possible digestive function: nausea, sometimes vomiting occurs, diarrhea may join. Overdose can cause the formation of yellowness of the skin. If these symptoms appear, you should stop taking the capsules. To eliminate the overdose, assistance is provided in the form of symptomatic therapy. The entire treatment process is monitored by a doctor.

How is it distributed in the body

When taken orally, the active substances are rapidly absorbed into the systemic circulation. Capsules can be taken by adults with or without food. The maximum level in the systemic circulation is reached after 45 minutes.

Distribution in the body depends on the number of capsules consumed. In children and adults, biotransformation occurs in the same way. In the bloodstream, two components bind with special proteins with equal strength. For amoxicillin 20%, clavulanic acid 25%.

The transformation process itself takes place in the liver. Amoxicillin in the number of 10% of the total substance. Clavulanic acid 50% of general level... It is excreted unchanged through the renal system. Accordingly, 50-60% and 70% of amoxicillin and clavulanic acid. It is displayed after 6 hours.

The transformation time in the body does not depend on other factors. Changes are possible when combined with other drugs.

How to take Flemoklav Solutab correctly

The method of administration depends on the age and nature of the infectious process. Instructions for the use of Flemoklav Solutab for children contains information on the maximum permissible dosage. All calculations are for amoxicillin.

For children under 12 years of age, drops or syrup are recommended. Dosage for children under 3 months - a single concentration is not more than 30 mg / kg / day. Older age at 25 or 20 mg. In case of serious and serious illnesses, it is allowed to double the concentration.

If the child is over 12 years old or his weight is more than 40 kg, then 500 per day is allowed. With severe infectious pathologies, you can increase the number of doses per day up to 3 times.

There is a maximum concentration per day for two active ingredients:

1. Amoxicillin for children over the age of 12 is no more than 6 g, under this age the calculation is per 1 kg of body weight. Permissible no more than 45 mg per 1 kg.
2. Clavulanic acid after 12 years, 600 mg, before this age, 10 mg per 1 kg of body weight.

For children under 12 years old, it is necessary to calculate the dosage per kg of body weight. When choosing a dose for adults - for amoxicillin no more than 1 g at a time. The maximum dosage for adults per day is no more than 6 g.

How many days to take is determined by the attending physician. On average, the duration of treatment for mild forms is 7 days, for severe pathologies - no more than 14 days.

How it interacts with other medications

Simultaneous intake of other medicinal compounds can change the biotransformation of Flemoklav Solutab. Joint intake of antacids, laxatives and representatives of the aminoglycazide group reduces the rate of absorption. They should be taken separately from antibiotics.

Other representatives of antibiotics that have a bacteriostatic effect are antagonists. Joint reception will give less therapeutic benefit. These include Chloramphenicol, macrolide groups, tetracycline compounds and sulfanilamide substances. The simultaneous appointment reduces the effectiveness of the action of the two substances.

Can simultaneously increase and accelerate the action indirect anticoagulants... Suppresses intestinal flora. This leads to a decrease in the synthesis of vitamin K. In this case, the clotting indices should be determined periodically. The effectiveness of taking oral contraceptives decreases. The risk of bleeding increases.

Taking diuretics leads to increased secretion of amoxicillin through the kidneys. Therefore, concomitant use with loop diuretics is not recommended.

Unwanted effects

Taking an antibiotic can lead to a number of side effects... But they are formed with prolonged use and depend on the individual characteristics of the organism.

• On the part of the digestive tract, dyspeptic disorders can form. These include nausea, vomiting, diarrhea, or constipation. Caution for people with chronic pathologies Gastrointestinal tract. Long-term use can cause the development of pseudomembranous colitis. This complication is associated with oppression normal microflora... In some cases, darkening of the tooth enamel is noted.
• On the part of the liver, yellowness of the skin may appear. In the analysis of blood, deviations in the content of aminotransferases are possible. Long-term use can lead to the formation of liver failure.
• From the side of the central nervous system, it is noted headache, attacks of dizziness.
• With intramuscular injection at the puncture site, vessel thrombosis is possible.
• Allergic manifestations in the form itchy skin or hives. In rare cases, anaphylactic shock is formed on the introduction. Exudative vasculitis is extremely rare. Associated with individual intolerance to the components.
• With the suppression of normal microflora, candidiasis of the vaginal mucous membranes can form in women.

Notes (edit)

Long-term use always requires monitoring general condition organism. Blood is periodically checked for clotting and aminotransferase levels. Kidney function should be monitored.

To reduce unwanted effects on the part of the digestive tract, it is recommended to take it before meals. Probiotic substances should be used to reduce dyspeptic symptoms.

Long-term therapy requires replacing antibiotics with others. There is a high risk of the formation of insensitive microbes and the development of a secondary infection.

When taking blood for glucose, notify the doctor about taking antibiotics. A false positive result is possible.

If you are allergic to penicillin group antibiotics, that is, the risk of a reaction to cephalosporins.

Flemoklav Solutab during pregnancy should be drunk with caution. Cases of colitis have been reported in newborns.

Features of use in children

Flemoklav Solutab for children is used in the form of a suspension. A certain concentration is established for children under 12 years old. Up to 3 months, it is no more than 30 mg / kg / day. If children are older than 3 months, then the maximum number is 25 or 45 mg / kg / day. Depends on the degree of the pathology.

Features of use in pathology of the kidneys and liver

Availability chronic insufficiency kidney requires additional correction. The calculation of the maximum concentration is carried out taking into account the general filtering capacity of the kidneys. Determine the QC level. If it is less than 30 ml / min, the appointment of the tablet form is contraindicated.

Liver damage in the form of jaundice requires discontinuation of antibiotic use. It is prescribed with caution for patients with chronic liver inflammation.

Photo of the drug

Latin name: Flemoсlav Solutab

ATX code: J01CR02

Active substance: Amoxicillin + Clavulanic acid

Manufacturer: Astellas Pharma Europe, B.V. (Netherlands)

Description up to date on: 13.01.18

Flemoklav Solutab 500 is a combined preparation, the action of which is based on the properties of 2 active substances - amoxicillin and clavulanic acid. The drug has a more stable and uniform absorption of the last of the ingredients, which led to its increased efficiency and fewer side reactions compared to analogues.

Other names and classification

The combination of 2 active ingredients of the drug - amoxicillin and clavulanic acid - was developed by British pharmacists in the late 1970s. However, the form "solutab" has appeared recently. And, as the analysis shows, in this form and combination, practically no drugs are produced under other trade names.

International non-proprietary name

The name of the drug is Amoxicillin + clavulanic acid.

Trade names

The combination of amoxicillin and clavulanic acid has many trade names... These are Augmentin, Baktoklav, Klavomed, Amoxiclav. Dispersible tablets are produced under some of them.

Registration number

Registration number according to the state register - P N016067 / 01.

Composition and dosage forms

The form of the preparation is dispersible tablets. They are produced in different dosages - 125, 250, 500 and 875 mg of amoxicillin and 31.25, as well as 62.5 and 125 mg of clavulanic acid salts. The excipients are practically the same as in any other effervescent tablets without a shell.

The difference between the drug is the form of its release, that is, "solutab". He is effervescent tablets... The features of their pharmacokinetics are such that the concentration active substance it grows evenly, the bioavailability of the drug increases in comparison with film-coated tablets. In addition, they have less impact on the state of the digestive system.

The maximum concentration of clavulanic acid is reached 1 hour after ingestion.

Pharmacological group

Refers to combined drugs. This is an antibiotic from the group of semi-synthetic penicillins in combination with a second substance - a beta-lactamase inhibitor.

pharmachologic effect

Flemoklav Solutab is a combined preparation. Amoxicillin in its composition is an antibiotic that has a wide range activity.

Like all other drugs from the group of semi-synthetic penicillins, it has a bactericidal effect, that is, it destroys pathogenic microorganisms due to the fact that it destroys cell walls. However, there are strains that produce some types of beta-lactamases, and amoxicillin does not work against them.

The presence of clavulanic acid in the preparation allows you to cope with this deficiency. The substance inhibits the production of beta-lactamases. Although clavulanic acid is inactive against beta-lactamases of the first type (according to the Richmond-Sykes classification), which are produced by enterobacteria and a number of other microbes.

Flemoklav is effective against a number of microorganisms, which include:

• most types of streptococci and staphylococci;
• enterococci;
• corynebacteria;
• listeria;
• clostridia;
• klebsiella;
• shigella;
• Haemophilus influenzae causing pneumonia;
• Helicobacter pylori (the main culprit for gastritis);
• gardnerella;
• proteas;
• salmonella;
• campylobacter, etc.

Indications for use of the drug Flemoklav Solutab 500

1. Diseases of the respiratory tract and ENT organs provoked by a bacterial infection. This is chronic bronchitis in the acute stage, community-acquired pneumonia. Also sinusitis, pharyngitis and tonsillitis in both acute and chronic forms. The drug is also effective against recurrent diseases, since resistance to it does not develop so quickly.
2. Infectious lesions of the skin and soft tissues.
3. Inflammatory heart disease.
4. Diseases of the kidneys and other organs of the genitourinary system, including prostatitis, provided that they are caused by a bacterial infection.

The possibility of using the drug in each case (it does not matter whether a banal sore throat or pyelonephritis) is decided by the doctor, and on the basis of an antibiogram, which makes it possible to determine the causative agent of the pathology. Although sometimes there is no time for this analysis, and the medicine is prescribed based on research data.

How to take Flemoklav Solutab 500?

The regimen for taking the drug is prescribed by the attending physician. It depends on the age of the patient and the type of disease.

Adults are prescribed the drug, 1 tablet with a dosage of 500 mg 3 times a day. In severe forms of the disease, the antibiotic can be taken in a double dose. It is recommended to take the medicine at the beginning of a meal. This sets it apart from other antibiotics that are taken 2 hours after a meal.

For adolescents who have turned 12 years old, weighing more than 40 kg, the drug is prescribed in an adult dosage.

special instructions

Most often, among the adverse reactions to Flemoklav, allergic manifestations are observed as a malfunction of the immune system. They can be severe, and if angioedema develops, you must immediately stop taking the drug, as anaphylactic reactions may develop. If they are available, appropriate therapy is carried out - adrenaline or Epinephrine is administered, respiratory failure is eliminated, etc.

When taking the medication, there is a possibility of cross-resistance with other antibiotics from the penicillin or cephalosporin group. This must be taken into account when appointing Flemoklav. Crossover are also possible. allergic reactions, therefore, it is necessary to check with the patient whether he has had a history of hypersensitivity to antibiotics.

As with the appointment of other penicillins, in this case there is a risk of developing superinfection - candidiasis of the skin and oral cavity, since fungi, unlike normal microflora, are resistant to this antibiotic. There is a high risk of such an infection in people with weakened immunity. If symptoms of candidiasis are detected, it is recommended to adjust antibiotic therapy.

While taking Flemoklav, an increase in prothrombin time may be observed. Therefore, it is undesirable to prescribe the drug simultaneously with anticoagulants, otherwise it is necessary to constantly monitor blood clotting indicators.

It should be noted that during the course of treatment, you should not do tests to detect glucose in the urine, as they will give false results.

During pregnancy and lactation

Flemoklav Solutab is a well-researched drug. During its use, no negative effects on the development of the fetus or the condition of the baby have been revealed. In the second and third trimesters, the drug is considered safe for both mother and child. But in the first, any means are taken with caution, especially antibiotics, so Flemoklav is prescribed depending on the severity of the infection, if the benefit to the mother exceeds possible risk for the fetus.

It has been established that a small amount of amoxicillin passes into breast milk. No such information is available for clavulanic acid. And although studies do not confirm the negative effects of the drug on a child with hepatitis B, the drug is also used with caution during lactation.

In childhood

The drug is not prescribed for children under the age of 2 years. For children 2-12 years old, an antibiotic is recommended in a small dosage, taking into account body weight - 20-30 mg of amoxicillin per kilogram. This is 125 mg 3 times a day for patients under 7 years of age.

For the rest, the dosage is gradually increased to 250 mg per day. The duration of treatment is 5-14 days, depending on the severity of the disease.

For violations of liver function

If the patient has impaired liver function, then during therapy bacterial infection special care must be taken with the use of this drug. Its reception is possible only under the condition of constant medical supervision.

The maximum duration of the course is no more than 14 days. Sometimes it is prolonged, but only after assessing liver function.

With impaired renal function

Taking the drug is possible only with constant medical supervision... You need to regularly take a urine test and monitor indicators.

Side effects of the drug Flemoklav Solutab 500

The drug has fewer side effects than other penicillins. These are allergic reactions, up to anaphylactic shock. Less often than when taking other drugs, but still there are dyspeptic manifestations and other reactions from the gastrointestinal tract. Dizziness and headaches are possible.

With increased concentrations of the drug, the severity of adverse reactions increases.

Contraindications

Contraindications for the use of Flemoklav are:

• hypersensitivity to its components, as well as other antibiotics from the group of penicillins and cephalosporins;
• severe liver dysfunction, a history of jaundice, especially if it occurred while taking a similar drug;
• Infectious mononucleosis.

The drug is prescribed with caution in the presence of diseases of the gastrointestinal tract, including necrotizing enterocolitis, if its development is associated with the use of antibiotics.

Overdose

Overdose symptoms are dyspeptic symptoms - nausea, vomiting, diarrhea, in severe cases, even dehydration is possible.

Treatment is prescribed the same as for any intoxication - activated carbon to remove toxins, maintaining water and electrolyte balance with the help of Regidron.

If the patient suffers from renal failure, hemodialysis is necessary. In especially severe cases, convulsions are possible, then Diazepam is prescribed.

Interoperability and compatibility

When prescribing the drug, it should be borne in mind that drugs such as antacids, aminoglycosides, laxatives and glucosamine used in the treatment of joints, while taking Flemoklav, slow down the absorption of the active ingredient. Ascorbic acid increases it.

With the simultaneous administration of other antibiotics, including cephalosporins, synergism of action is observed, that is, the agents enhance each other's action. The exception is drugs from the macrolide group and tetracyclines - they act as antagonists.

Flemoklav increases the effectiveness of indirect coagulants due to the fact that it suppresses the intestinal microflora. But this property also leads to the fact that it reduces the effectiveness of hormonal contraceptives.

When administered simultaneously with Allopurinol, a skin rash may appear.

When taken together with Digoxin, the concentration of the latter in the blood plasma increases.

With alcohol

Like all other antibiotics, regardless of their group, Flemoklav Solutab is forbidden to be taken simultaneously with alcohol.

Manufacturer

The manufacturer of the drug is the Dutch company Astellas Pharma Europe B.V.

Conditions of dispensing from pharmacies

Price

The average cost of the drug is 300-450 rubles per package.

Conditions and shelf life

The tablets are stored in a dry place out of the reach of children, at a temperature not exceeding + 25 ° C. Shelf life is 3 years.

Analogs

A direct analogue is 2 means - Amoxiclav and Augmentin. However, they are produced using a different technology, which led to lower absorption rates of clavulanic acid and a greater number of side effects.

Flemoklav Solutab | analogs