Amoxiclav instructions for use contraindications. Symptoms of an overdose of amoxiclav. In severe cases of pathology,

Amoxiclav is an antibacterial drug of the penicillin group. This is a complex tool of a new generation, which has a powerful antimicrobial activity against most pathogenic bacteria. Due to this, the medicine has an extensive scope of use, and is successfully used to treat many diseases. Read on about Amoxiclav, the forms of its release, what helps, side effects and contraindications.

Composition and action

The main active ingredients are amoxicillin and clavulanic acid. The combination of these active substances provides a pronounced therapeutic effect of the antibiotic. Thanks to clavulanic acid, Amoxiclav can also be prescribed for infections resistant to the action of amoxicillin.

The antibacterial drug has a pronounced bactericidal and bacteriostatic effect on almost all types of streptococci (with the exception of methicillin-resistant strains), listeria, echinococci. Gram-negative bacteria are also sensitive to the drug: Klebsiella, Brucella, Moraxella, Salmonella, Gardnerella, Proteus, Clostridium and others.

The maximum concentration of the antibiotic is reached within 1 hour after taking the drug. The active substances, regardless of the method of administration, are rapidly distributed in the tissues and body fluids (middle ear, lungs, uterus, ovaries, peritoneal and pleural fluids, adipose and muscle tissues, sinuses, tonsils, and so on).

The drug is excreted from the body through the kidneys (half-life in healthy kidneys is 1-1.5 hours). A small amount of clavulanic acid metabolites is excreted in exhaled air and feces.

The drug does not penetrate the membrane of the brain and cerebrospinal fluid, this feature significantly reduces the risk of unpleasant adverse reactions from the central nervous system.

Release form

• Amoxiclav tablets - 250 milligrams of amoxicillin / 125 milligrams of clavulanic acid, 500 milligrams / 125 milligrams and 875 milligrams / 125 milligrams, respectively;
• tablets Amoxiclav Quiktab - 500 milligrams / 125 milligrams, 875 milligrams / 125 milligrams, dispersed tablets;
• Amoxiclav for parenteral administration - powder for the preparation of a solution for injection into a vein of 600 milligrams (500 milligrams of amoxicillin and 100 milligrams of clavulanic acid) or 1.2 grams in a vial (1000 milligrams of amoxicillin and 200 milligrams of clavulanic acid);
• suspension powder - 125 milligrams of amoxicillin and 31.25 milligrams of clavulanic acid per 5 milliliters and 250 milligrams of amoxicillin and 62.5 milligrams of clavulanic acid per 5 milliliters.

Indications for use

• ENT infections and infectious diseases of the upper respiratory tract (pharyngeal abscess, pharyngitis, scarlet fever, otitis media, tonsillitis, sinusitis, chronic and acute sinusitis, laryngitis, tracheitis, tonsillitis).
• Infections of the lower respiratory tract (chronic and acute bronchitis, pneumonia).
• Infections of the biliary tract (cholangitis, cholecystitis).
• Urinary tract infections (cystitis, prostatitis, pyelonephritis, urethritis and others).
• Gynecological diseases of infectious origin (adnexitis, inflammation of the appendages, endometritis and others).
• Odontogenic infections, including periodontitis.
• Venereological infections (syphilis, ureaplasma, gonorrhea, including those provoked by gonococci).
• Chancroid.
• Infections of soft tissues and skin, including wound infections (furunculosis and so on).
• Joint and bone infections.
• Orthopedic practice.
• Infections of the lymphatic system (lymphadenitis and others).
• Mixed infections that are caused by gram-negative and gram-positive microorganisms, anaerobic pathogens (breast abscess, mastitis, postoperative abdominal infections, aspiration pneumonia).

Amoxiclav is also used in dentistry (with flux, stomatitis, and so on) and for the prevention of purulent-septic complications during surgical interventions on the abdominal organs, small pelvis, kidneys, bile ducts, and heart muscle.

How to use

The exact dosage regimen is set by the doctor on an individual basis, depending on the severity of the disease and the therapeutic effect. The duration of antibiotic treatment is from 5 to 14 days.

Tablets

It is taken orally immediately before meals, swallowed whole, without chewing and washed down with water.

According to the instructions, adults and children weighing over 40 kilograms with mild to moderate pathologies are prescribed 1 tablet (250 milligrams / 125 milligrams) every 8 hours (3 times a day) or 1 tablet (500/125 milligrams) every 12 hours (2 times a day); in a severe form of the disease, it is prescribed - 1 tablet of 500 milligrams / 125 milligrams every 8 hours (three times a day) or 1 tablet of 875 milligrams / 125 milligrams every 12 hours (twice a day).

Amoxiclav Quiktab tablets

Before use, the tablet must be dissolved in 100-150 milliliters of water and mixed well. Adults and children from 12 years of age are prescribed 1 tablet (500 milligrams / 125 milligrams) 2-3 times a day; in severe conditions - 1 tablet (875 milligrams / 125 milligrams) twice a day.

Powder for parenteral use

To prepare a solution for intravenous administration, dissolve the contents of the vial in water for injection (for Amoxiclav 600 milligrams - 10 milliliters; for Amoxiclav 1.2 grams - 20 milliliters). Further, the resulting solution is injected intravenously slowly over 4-5 minutes.

If the drug is to be administered as an intravenous infusion, then 600 milligrams of the drug is dissolved in 10 milliliters of water for injection and added to the infusion solution (50 milliliters). Antibiotic 1.2 grams is dissolved in 20 milliliters of water for injection and added to 100 milliliters of infusion solution. Drip drug is administered for 30-40 minutes. Freezing of the product is prohibited.

Suspension

Shake the powder bottle well, add warm boiled water (up to the mark) in 2 passes, shaking each time until the powder is completely dissolved.

In pediatrics, newborns and infants up to 3 months old are prescribed a medicine at the rate of 30 milligrams per 1 kilogram of weight (daily dose), this amount must be divided and given in 2 doses at regular intervals.

From 3 months, the antibiotic is prescribed at a dose of 25 milligrams per 1 kilogram of body weight, it is also divided equally into 2 doses. In infectious diseases of moderate severity, 20 milligrams per 1 kilogram of body weight are prescribed and divided into 3 injections. In severe conditions, the dose is increased - 45 milligrams per 1 kilogram of weight and divided into 2 injections per day.

Contraindications

• lymphocytic leukemia;
• Infectious mononucleosis;
• cholestatic jaundice or hepatitis resulting from the use of antibacterial drugs of the penicillin group;
• hypersensitivity to antibiotics of the cephalosporin group, penicillins and other beta-lactam drugs;
• hypersensitivity to clavulanic acid or amoxicillin.

With caution, the drug is prescribed for severe renal impairment, renal failure and patients with a history of pseudomembranous colitis.

Side effects

• allergic reactions: urticaria, itching, erythematous rash; in rare cases - angioedema, allergic vasculitis, anaphylactic shock, Stevens-Johnson syndrome, exfoliative dermatitis.
• From the digestive tract: possible nausea, loss of appetite, diarrhea, vomiting; rarely - pain in the abdomen, impaired liver function; in isolated cases, hepatitis, cholestatic jaundice, pseudomembranous colitis may develop.
• From the side of the nervous system: headache, dizziness; rarely - hyperactivity, insomnia, anxiety, convulsions (may occur in patients with impaired renal function when using the drug in high doses).
• From the hematopoietic system: rare cases of reversible leukopenia (including neutropenia), thrombocytopenia; in isolated cases, hemolytic anemia, pancytopenia, eosinophilia, a reversible increase in prothrombin time develops (when used simultaneously with anticoagulants).
• From the urinary system: rarely - crystalluria, interstitial nephritis.
• Other: candidiasis.

During pregnancy

Antibacterial drug is not recommended during pregnancy. Exceptions are cases where the benefit of treatment outweighs the potential harm to the fetus. Taking Amoxiclav during pregnancy increases the risk of developing necrotizing colitis in newborns.

It is undesirable to take the drug during lactation, since clavulanic acid and amoxicillin are excreted in breast milk in small quantities. If mothers nevertheless prescribed medication, it is worthwhile to stop breastfeeding for a while. Otherwise, the child may develop diarrhea, allergic reactions, and so on.

For kids

Children under 12 years of age and weighing less than 40 kilograms are prescribed an antibiotic in the form of a suspension. Recommended dosages are listed above.

With alcohol

During drug therapy, it is forbidden to drink alcoholic beverages. Alcohol intake significantly reduces the antibacterial effect of the drug and makes it difficult to excrete it through the kidneys.

Analogues

Substitutes for the active substance: Amovikomb, Arlet, Augmentin, Amoxicillin + Clavulanic acid, Baktoclave, Verklav, Klamosar, Liklav, Medoklav, Panklav, Ranklav, Rapiclav, Taromentin, Flemoclav Solutab, Ecoclave.

Analogues according to the mechanism of action:

Amoxicillin (Amoxicillin Sandoz, Amosin, Ecobol, Ranoxyl)

Release form - tablets, capsules, powder for injection, suspension; the active substance is amoxicillin.

Bactericidal antibacterial drug from the group of semi-synthetic penicillins. It has a wide spectrum of action and is used to treat bacterial infections: pneumonia, bronchitis, tonsillitis, urethritis, pyelonephritis, gonorrhea and other caused by drug-sensitive microorganisms.

The dosage is selected individually. For oral administration, adults and children from 12 years of age (or weighing more than 40 kilograms) are prescribed 250-500 milligrams, with a severe course of the disease - up to 1 gram; children 5-10 years old - 250 milligrams; 2-5 years - 125 milligrams; up to 2 years, the daily dose is 20 milligrams per kilogram of body weight. Between doses of the drug should be at least 8 hours. For children under 12 years of age, it is recommended to use Amoxicillin in the form of a suspension.

For parenteral use, adults are injected intramuscularly at 1 gram twice a day; children - 50 milligrams / kilogram / day, single - 500 milligrams, frequency of administration - 2 times a day.

Side effects: erythema, angioedema, conjunctivitis, anaphylactic shock, joint pain, fever.

Contraindications: hypersensitivity to penicillins, infectious mononucleosis. With caution, the antibiotic is prescribed to pregnant women and patients prone to allergic reactions.

Ampiox (Oxampicin, Oxamp)

Release form - capsules, powder for solution preparation; active ingredients - ampicillin sodium, oxacillin sodium.

The antibacterial drug belongs to semi-synthetic penicillins and is active against gram-negative (meningococcus, E. coli, gonococcus, salmonella, and so on) and gram-positive (streptococcus, pneumococcus, staphylococcus) microorganisms. Indications for use are: tonsillitis, pyelonephritis, sinusitis, tonsillitis, pneumonia, otitis media, meningitis, cystitis, cervicitis and so on.

Capsules are taken orally before meals, swallowed whole and washed down with water. Adults and adolescents from the age of 14 are prescribed 0.5-1.0 grams (2-4 capsules); 7-14 years - 50 milligrams / kilogram / day; 3-7 years - 100 milligrams / kilogram / day; The daily dose is divided into 4-6 doses. The duration of treatment is 7-14 days.

Intravenous and intramuscular (drip, jet) daily dose for adults and adolescents from 14 years of age is 3-6 grams; children 7-14 years old - 100 milligrams / kilogram / day; 1-6 years - 100 milligrams / kilogram / day; newborns, premature babies and babies under 1 year old - 100-200 milligrams / kilogram / day. The daily dose must be administered in 3-4 doses, with an interval of 6-8 hours. According to the indications, the dose can be increased by 1.5-2 times.

Side effects: rhinitis, hyperemia of the skin, arthralgia, conjunctivitis, vomiting, diarrhea, nausea, leukopenia, enterocolitis, anemia, angioedema.

Contraindications: lymphocytic leukemia, infectious mononucleosis, hypersensitivity. Use with caution in chronic insufficiency, in children born to a mother with intolerance to penicillins.

Ampisid (Sultasin, Sulacillin, Libaccyl, Ampicillin + Sulbactam, Sulbacin)

Release form - powder, tablets; active ingredients - ampicillin, sulbactam.

The combined antibiotic of the penicillin group is prescribed to patients of all age groups for infectious diseases caused by microorganisms sensitive to ampicillin and sulbactam. Among them are infections: respiratory organs (pleurisy, bronchitis, bacterial pneumonia), ENT organs (otitis media, sinusitis, tonsillitis), urinary and reproductive system organs (cystitis, pyelonephritis, adnexitis, and so on), gastrointestinal organs (cholangitis, pancreatitis, cholecystitis ), musculoskeletal system (myositis, arthritis, osteomyelitis), skin and subcutaneous tissue (burn wounds, erysipelas, infected dermatoses), prevention of postoperative infections.

Tablets are prescribed orally before meals, 1-2 hours in a daily dose of 375-750 milligrams for adults and 25-50 milligrams per kilogram of body weight for children whose weight does not exceed 30 kilograms. The daily dose of the drug must be divided into 2 doses.

Intramuscularly and intravenously (drip at a rate of 60-80 drops per minute, jet - slowly, for 3-4 minutes). Intravenously injected for 5-7 days, if you need to continue treatment, then switch to intramuscular use. With a mild infection for adults - 1.5-3 grams per day in 2 injections; with an average course - 3-6 grams per day in 3-4 injections; severe course - 12 grams per day in 3-4 injections. For children, the daily dose is taken at the rate of 150 milligrams per 1 kilogram of weight, the frequency of administration is 3-4 times; newborns and premature babies - every 12 hours. The duration of therapy is 5-14 days.

Side effects: loss of appetite, nausea, vomiting, diarrhea, anemia, leukopenia, drowsiness, headache, flushing of the skin, urticaria, rhinitis, eosinophilia, candidiasis (with prolonged use).

Contraindications: lactation period, infectious mononucleosis, hypersensitivity. With caution in hepatic and / or renal failure, pregnancy.

Clonacom-X

Release form - capsules; active ingredients - amoxicillin trihydrate, cloxacillin sodium.

The drug is active against most gram-positive and gram-negative bacteria. It is prescribed for infections of the upper respiratory tract, pneumonia, bronchitis, infections of the gastrointestinal tract, urinary tract, skin and soft tissues, gonorrhea, and so on.

Capsules are taken before meals, washed down with water, swallowed whole, without chewing. Adults are prescribed 1 capsule every 6-8 hours, depending on the severity of the disease. In case of impaired renal function, the dose is reduced.

Side effects: nausea, diarrhea, skin rashes, in rare cases, pseudomembranous colitis (intestinal colic) may develop.

Contraindications: childhood, pregnancy, lactation, infectious mononucleosis, hypersensitivity to active substances. Use with caution in patients with allergic reactions.

Tazocin (Tazrobida, Piperacillin + Tazobactam Teva)

Release form - lyophilisate for solution; active ingredients - piperacillin, tazobactam.

A bactericidal semi-synthetic broad-spectrum antibacterial drug is effective for moderate and severe infections: bacterial infections of the lower and upper respiratory tract, abdominal organs, complicated and uncomplicated pathologies of the skin and soft tissues, abscess, pelvic organs, bacterial septicemia (blood infection by bacteria), joint and bone infections.

The drug is administered intravenously drip (slowly over 30 minutes) or intramuscularly. The daily dose in adults and adolescents from 12 years of age with normal kidney function is 2.25 grams every 6 hours or 4.5 grams every 8 hours; children 2-12 years old - 90 milligrams per 1 kilogram of body weight every 6 hours. For patients undergoing hemodialysis (blood purification method), the maximum dose is 2.25 grams every 8 hours. The duration of therapy is 7-10 days.

Side effects: vomiting, nausea, development of intestinal colic, itching, urticaria, rashes, erythema, headache, convulsions, hypoglycemia, phlebitis, hypotension, flushing of the skin of the face, fever, rarely - arthralgia and others.

Contraindications: hypersensitivity, age up to 2 years. With caution in severe bleeding (history), pregnancy, lactation, cystic fibrosis, hypokalemia, pseudomembranous enterocolitis.

Timentin

Release form - lyophilisate for solution preparation; active ingredients - ticarcillin, clavulanic acid.

The antibiotic has a wide spectrum of action and is indicated for the treatment of infections of the connective and bone tissue, in gynecology, skin and subcutaneous tissue, urinary tract, and so on.

The drug is administered intravenously drip or jet. The intervals between infusions should be at least 4 hours. Therapy should be continued for 48-72 hours after the symptoms disappear.

For adults and adolescents weighing over 40 kilograms, the average dose is 3 grams every 6 hours or 5 grams every 8 hours. The maximum dose is 3 grams every 4 hours. Children weighing less than 40 kilograms are prescribed 75 milligrams/kg every 8 hours (maximum 75 milligrams every 6 hours); premature babies weighing less than 2 kilograms - 75 milligrams every 12 hours, those weighing more than 2 kilograms - 75 milligrams every 8 hours. In case of impaired renal function, the dose is adjusted.

Side effects: diarrhea, nausea, vomiting, hepatitis, cholestatic jaundice, convulsions, leukopenia, decreased hemoglobin levels, eosinophilia, urticaria, rashes, itching, anaphylactic reactions, skin redness, burning sensation, and so on.

Contraindications: premature babies with impaired renal function, hypersensitivity to active substances, pregnancy, lactation.

The use of antibiotics in childhood is controversial. The truth is that all children at least once took antibacterial drugs. With a competent pediatrician approach, the use of an antibiotic has a minimal effect on the children's body, and also eliminates the consequences of serious diseases.

A common remedy for the treatment of children and adults is Amoxiclav. It is necessary to understand its composition, pharmacological action, the main indications for use. How is the drug used in pediatrics? Can it be given to infants and children and what side effects are possible? How long should the drug be taken?

The composition of the medicinal product

Amoxiclav is a broad spectrum antibiotic. It has a detrimental effect on many bacteria. The active substance is amoxicillin (semi-synthetic penicillin). A feature of the drug is the presence of clavulanic acid, structurally connected with amoxicillin.

Additional components depend on the form of release of the drug. The composition of Amoxiclav in addition to active compounds includes: silicon dioxide, citric acid, talc, titanium dioxide, sodium citrate and others. The powder for children contains sweeteners (not sugar) and flavorings.

pharmachologic effect

This article talks about typical ways to solve your questions, but each case is unique! If you want to know from me how to solve exactly your problem - ask your question. It's fast and free!

Amoxiclav has a broad spectrum antibacterial effect. Amoxicillin is a beta-lactam antibiotic (we recommend reading:).

In the literature, the action of an antibiotic is explained in a complex scientific form, incomprehensible to people without a medical education. Simply put, amoxicillin acts at the cellular level. It violates the integrity of the walls of bacterial cells and leads to their complete destruction. As a result, pathogenic microorganisms die.

Some pathogens independently produce beta-lactamase, which destroys the active substance of the drug. This means that the antibiotic is not able to kill such bacteria, as it loses its medicinal properties.

Clavulanic acid itself does not affect bacteria and does not have bactericidal properties. It is a beta-lactam associated with penicillins. Clavulanic acid prevents the destruction of amoxicillin in a pathogenic environment. With its help, the drug is able to act on a larger number of microorganisms, which makes it almost universal. This is the key role of matter.

Amoxiclav has a detrimental effect on the following groups of microorganisms:

• staphylococci;
• streptococci;
• echinococcus;
• bordetella;
• brucella;
• salmonella;
• Proteus;
• clostridium etc.

According to medical practice, Amoxiclav is active even against some bacteria that are resistant to it. Doctors have established that drug treatment gives positive results, but there is no single scientific justification for this.

Forms of release of the drug with a concentration of active substances

The universal qualities of the medicine allow it to be used to treat many ailments. Doctors often prescribe it to patients of childhood and adulthood.

That is why it is available in two forms - tablets and powder for suspension. In addition, each of them has several types of concentration of active substances. Due to this, the drug is easy to pick up for people of different ages, weight, physical condition, and also depending on the severity of the infection.

Coated tablets

Amoxiclav is available in the form of white or light beige film-coated tablets. They have an oval or oblong shape with convex sides. Tablets are sold in plastic jars of 15 pieces or standard aluminum blisters of 5 or 7 pieces.

Tablet classification:

• 375 mg - 250 mg of amoxicillin and 125 mg of potassium salt (clavulanic acid);
• 500 mg - 375 mg of amoxicillin and 125 mg of clavulanic acid;
• 625 mg - 500 mg of antibiotic and 125 mg of clavulanic acid;
• 875 mg or 1000 mg - 875 mg of active antibiotic and 125 mg of clavulanic acid;
• Quiktab - tablets dissolve quickly, have a fruity flavor, are available in dosages of 625 mg and 1000 mg.

It is important to follow the prescribed dosage of the substance. So, for example, you cannot replace 1000 mg with two 625 tablets, since the concentration of the potassium salt will be doubled.

Powder for suspension preparation

Amoxiclav for children is available in the form of a powder for self-preparation of a suspension. It additionally includes artificial sweeteners (not sugar) and flavors. This makes the drug pleasant to the taste, but the characteristic medicinal aftertaste is still preserved. The medication is sold in dark glass bottles of various sizes. The box includes a special measuring spoon, pipette dispenser and instructions for use.

Powder types:

• 125 mg - 5 ml of the finished suspension contains 125 mg of the antibiotic and 31.5 mg of clavulanic acid;
• 250 mg (Forte) - 5 ml of syrup contains 250 mg of active ingredient and 62.5 mg of clavulanic acid.

Indications for use

The drug is prescribed in the presence of bacterial microorganisms in the body, which are affected by amoxicillin. The long list includes diseases of the respiratory tract (sinusitis, bronchitis), ears (otitis media), throat (tonsillitis, pharyngitis, pharyngeal abscess), urinary and biliary systems.

Amoxiclav is used for lesions of bones, joints, soft tissues and skin (infection of wounds, physical injuries, after surgical interventions for preventive purposes). For adults, the medicine has found application in some venereal diseases (gonorrhea) and in gynecology.

In pediatrics, the drug is usually used specifically for respiratory diseases that are of bacterial origin. Many mothers are accustomed to using it for bronchitis, otitis or sinusitis.

The drug for angina is prescribed for moderate and severe disease. It is taken when tests have confirmed angina of bacterial origin. An antibiotic from the penicillin group effectively fights diseases of the ENT organs.

Dosage of tablets

Children over 12 years of age, and if their weight exceeds 40 kg, should adhere to the dosage for adults:

• tablets 500 mg (375/125) - every 8 hours;
• tablets 625 mg (500/125) - 12 hours (for severe infections 8 hours);
• tablets 1000 mg (875/125) - 12 hours.

When prescribing Amoxiclav, the pediatrician takes into account not only the age and weight of the child, but also the condition of his kidneys and liver, as well as his general health. In individual cases, the maximum permitted amount of a substance may vary.

Dosage of the suspension for children

• For newborns and children under 3 months, the drug is dosed with a pipette and prescribed 30 mg / kg per day. The daily dose is divided into 2 doses - every 12 hours.
• For children older than 3 months, the drug is dosed at 20 mg / kg for mild to moderate infectious diseases and 40 mg / kg for severe illness. The daily dose is divided into 3 doses (at regular intervals).

How to calculate the required amount of suspension?

First, the daily dose of the substance is calculated. Recall that in case of severe infections, children older than 3 months are prescribed 40 mg. This figure is multiplied by the number of kilograms. For a child weighing 10 kg, you will need 400 mg of amoxicillin, 15 kg - 600 mg, 18 kg - 720 mg, etc.

Then the number of milliliters of the suspension is calculated. A simple proportion, for example, for 10 kg and a dosage of 250 mg per 5 ml is 250/5 = 400/?.? = 5*400/250. It turns out 8 ml of suspension. The drug is usually taken twice a day, that is, 4 ml in the morning and evening. The same for 10 kg and 125 mg per 5 ml - 5 * 400/125. It comes out 16 ml (8 ml twice a day). If the doctor prescribes 3 times a day, the total number is divided by three.

Practicing pediatricians know the required amount of medicine for any weight. In the destination sheet, they indicate the prescribed amount of syrup. The instructions often indicate the amount of the drug in the form of a convenient table (depending on the manufacturer of the drug), where:

• 125* = 125 mg + 31.25 mg/5 ml;
• 250** = 250 mg + 62.5 mg/5 ml

Dosage table up to 3 months

The drug is indicated 2 times a day. The table shows single dosages for 1 dose.

Dosage table older than 3 months

The drug is taken 3 times a day. The table shows single dosages for 1 dose. In the case of mild and moderate infections, appoint:

In case of severe infections appoint:

If there is no measuring pipette included with the medicine, the drug is dosed with a teaspoon according to the scheme:

How to dilute the powder?

It is not difficult to dilute the powder and prepare the syrup. In order not to spoil the medicine, you should be careful and attentive, follow the rules exactly.

Water must be clean drinking and boiled. It must be cooled to cool room temperature. There is a raised line mark on the bottle. Ready liquid should reach exactly to it. This means that the drug is prepared correctly.

Before you begin to dilute the drug, shake the bottle vigorously to fluff the powder. Then carefully pour the water in two steps. After each, shake the bottle well until completely dissolved and check the amount of liquid so as not to pour too much.

For 125 g, 86 ml of water will be required, for 250 mg - 85 ml of water. It is better to keep track of the mark yourself. The figures are approximate, since the drug is produced in several volumes of the finished substance (35, 50, 70, 140 milliliters).

The finished suspension is stored in the refrigerator for 7 days (but no more). Shake the bottle vigorously before each use. It is recommended to take it at the same time at regular intervals - 2-3 times a day at the beginning of a meal (before meals).

How many days do you need to take the drug?

According to the official instructions, the course of taking an antibiotic is 5-14 days. Reception for more than two weeks is prohibited. If necessary, after the maximum course, you need to take a break. According to well-known practice, antibiotics are taken on average 5-7 days.

The course of treatment is prescribed only by a doctor. You must follow his instructions and recommendations. Do not exceed the prescribed number of days or the amount of the drug. Constant medical monitoring is required when treating a child under 1 year old with Amoxiclav.

Amoxiclav is a broad-spectrum bactericidal antibacterial drug. Belongs to the penicillin group. Tablets for children and adults contain an antibiotic (amoxicillin trihydrate) and an enzyme inhibitor, which is the potassium salt of clavuanic acid. It enhances the antimicrobial effect by reducing the activity of beta-lactamase.

Instructions for use Amoxiclav indicates the ability of the drug to bactericidal and bacteriostatic effect on most gram-negative and gram-positive microorganisms.

In this article, we will consider when doctors prescribe Amoxiclav, including instructions for use, analogues and prices for this drug in pharmacies. If you have already used Amoxiclav, leave your feedback in the comments.

Composition and form of release

Clinico-pharmacological group: a broad-spectrum penicillin antibiotic with a beta-lactamase inhibitor. Release form:

• Tablets 250+125 mg: white or almost white, oblong, octagonal, biconvex film-coated tablets, imprinted "250/125" on one side and "AMC" on the other side. Each 250mg+125mg tablet contains 250mg amoxicillin trihydrate and 125mg clavulanic acid potassium salt.
• Tablets 500+125 mg: white or almost white, oval, biconvex film-coated tablets. Each 500mg+125mg tablet contains 500mg amoxicillin trihydrate and 125mg clavulanic acid potassium salt.
• Tablets 875+125 mg: white or almost white, oblong, biconvex film-coated tablets, scored and imprinted "875" and "125" on one side and "AMC" on the other side. Each 875mg+125mg tablet contains 875mg amoxicillin trihydrate and 125mg clavulanic acid potassium salt.

Also, the product is produced in the form of a powder, from which a suspension is made, the bottle contains a powder for preparing 100 ml of the product.

A powder is also produced, from which a solution is made, which is administered intravenously. The bottle contains 600 mg of the product (amoxicillin 500 mg, clavulanic acid 100 mg), 1.2 g bottles are also available (amoxicillin 1000 mg, clavulanic acid 200 mg), the package contains 5 vials.

pharmachologic effect

Amoxiclav is a broad-spectrum antibiotic; contains semi-synthetic penicillin amoxicillin and b-lactamase inhibitor clavulanic acid. Clavulanic acid inhibits most clinically significant b-lactamases (types 2, 3, 4 and 5 - according to the Richmond Sykes classification) produced by Staphylococcus spp., Escherichia coli, Proteus mirabilis, Haemophilus influenzae, Moraxella catarrhalis, Bacteroides spp. Inactive against type 1 b-lactamases produced by Enterobacter spp., Morganella morganii, Pseudomonas aeruginosa, Serratia spp., Acinetobacter spp.

Indications for use

Amoxiclav is prescribed for diseases of an infectious and inflammatory nature, which develop as a result of the influence of microorganisms sensitive to this drug.

Such indications for the use of this drug are determined:

• infections of the upper respiratory tract and ENT organs (including acute and chronic sinusitis, acute and chronic otitis media, pharyngeal abscess, tonsillitis, pharyngitis);
• infections of the lower respiratory tract (including acute bronchitis with bacterial superinfection, chronic bronchitis, pneumonia);
• urinary tract infections;
• gynecological infections;
• skin and soft tissue infections, including animal and human bites;
• bone and connective tissue infections;
• biliary tract infections (cholecystitis, cholangitis);
• odontogenic infections.

From what Amoxiclav helps yet, you should ask a specialist during an individual consultation.

Instructions for use

Amoxiclav tablets are taken orally, preferably after meals. According to the instructions for use, the dosage depends on the severity of the infectious process and the age of the patient.

• Adults and children over 12 years of age (or weighing >40 kg) with mild or moderate infection are prescribed 1 tab. (250 mg + 125 mg) every 8 hours or 1 tab. (500 mg + 125 mg) every 12 hours, in case of severe infection and respiratory tract infections - 1 tab. (500 mg + 125 mg) every 8 hours or 1 tab. (875 mg + 125 mg) every 12 hours.
• The drug in the form of tablets is not prescribed for children under 12 years of age (with body weight<40 кг). В этом случае лучше использовать лекарственную форму в виде суспензии. Максимальная суточная доза клавулановой кислоты (в форме калиевой соли) составляет для взрослых – 600 мг, для детей – 10 мг/кг массы тела. Максимальная суточная доза амоксициллина составляет для взрослых – 6 г, для детей – 45 мг/кг массы тела.

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. The course of treatment is 5-14 days. The duration of the course of treatment is determined by the attending physician. Treatment should not continue for more than 14 days without a second medical examination.

Contraindications

• hypersensitivity to any of the components of the drug;
• a history of hypersensitivity to penicillins, cephalosporins and other beta-lactam antibiotics;
• a history of indications of cholestatic jaundice and / or other abnormal liver function caused by taking amoxicillin / clavulanic acid;
• infectious mononucleosis and lymphocytic leukemia.

With caution, the drug should be prescribed for allergic reactions to cephalosporins and pseudomembranous colitis in history, liver failure, severe renal dysfunction.

Side effects

Side effects are usually temporary and mild in severity.

1. From the digestive system: loss of appetite, nausea, vomiting, diarrhea are possible; rarely - a transient increase in the activity of liver enzymes (ALT, AST), impaired liver function; in isolated cases - cholestatic jaundice, hepatitis, pseudomembranous colitis.
2. From the nervous system: rarely - agitation, anxiety, headache, dizziness, inappropriate behavior, insomnia, convulsions, confusion, hyperactivity.
3. From the blood system: thrombocytopenia, anemia (including cases of hemolytic anemia), leukopenia, eosinophilia, agranulocytosis.
4. Allergic reactions: erythematous rash, itching, urticaria; rarely - erythema multiforme exudative, angioedema, anaphylactic shock; in isolated cases - exfoliative dermatitis, Stevens-Johnson syndrome.
5. Hepatobiliary disorders: possible increase in liver function tests, including an increase in the activity (asymptomatic) of ALT and / or AST, alkaline phosphatase and serum bilirubin. Liver dysfunction usually develops in elderly patients or in patients who are prescribed long-term drug therapy. Hepatitis and cholestatic jaundice develop quite rarely.
6. From the urinary system: hematuria and interstitial nephritis (rarely).

Others: rarely - the development of superinfection (including candidiasis); reversible increase in prothrombin time (when used together with anticoagulants).

Overdose

There are no reports of death or life-threatening side effects due to an overdose of the drug.
In most cases, overdose symptoms include gastrointestinal disorders (abdominal pain, diarrhea, vomiting). Anxiety, insomnia, dizziness are also possible, in isolated cases - convulsive seizures.

In case of an overdose, the patient should be under the supervision of a physician, treatment is symptomatic. In case of recent intake (less than 4 hours), it is necessary to perform gastric lavage and prescribe activated charcoal to reduce absorption.

special instructions

Due to the fact that in a large number of patients with infectious mononucleosis and lymphocytic leukemia treated with ampicillin, the appearance of an erythematous rash was observed, the use of antibiotics of the ampicillin group for such patients is not recommended.

Since the 250mg + 125mg and 500mg + 125mg tablets of the combination of amoxicillin and clavulanic acid contain the same amount of clavulanic acid - 125mg, then 2 tablets of 250mg + 125mg are not equivalent to 1 tablet of 500mg + 125mg.

During the course of treatment, the functions of hematopoiesis, liver and kidneys should be monitored. In patients with severely impaired renal function, an adequate correction of the dosing regimen or an increase in the intervals between dosing is required. In order to reduce the risk of developing adverse reactions from the gastrointestinal tract, the drug should be taken with food.

Prices

The average price of AMOKSIKLAV, 250 mg tablets in pharmacies (Moscow) is 250 rubles. Price for 500 mg 400 rubles

Analogues

Structural analogues for the active substance:

• Amovicomb;
• Amoxiclav Quiktab;
• Arlet;
• Bactoclav;
• Verclave;
• Klamosar;
• Liklav;
• Medoklav;
• Panklav;
• ranclave;
• Rapiclav;
• Taromentin;
• Ecoclave.

Attention: the use of analogues must be agreed with the attending physician.

Storage conditions

In a dry place at a temperature not exceeding 25°C. Keep out of the reach of children.

ALO (Included in the Free Outpatient Drug Supply List)

Manufacturer: Lek Pharmaceuticals d.d.

Anatomical-therapeutic-chemical classification: Amoxicillin in combination with beta-lactamase inhibitors

Registration number: No. RK-LS-5 No. 016456

Date of registration: 14.10.2015 - 14.10.2020

Instruction

• Russian

Tradename

Amoxiclav 2X

International non-proprietary name

Dosage form

Film-coated tablets 500 mg/125 mg, 875 mg/125 mg

Compound

One film-coated tablet contains

active substances: amoxicillin (as amoxicillin trihydrate) 500 mg and clavulanic acid (as clavulanate potassium) 125 mg (for a 500 mg/125 mg dosage) or amoxicillin (as amoxicillin trihydrate) 875 mg and clavulanic acid (as clavulanate potassium) 125 mg (for a dosage of 875mg/125mg).

Excipients: colloidal silicon dioxide, anhydrous crospovidone, sodium carboxymethylcellulose, magnesium stearate, dried microcrystalline cellulose.

film composition: hydroxypropyl cellulose, ethyl cellulose, polysorbate, triethyl citrate, titanium dioxide (E 171), talc.

Description

Film-coated tablets, white or almost white, oblong, chamfered, debossed "875/125" and notched on one side, and debossed "AMC" on the other side (for a dosage of 875 mg / 125 mg).

Farmacotherapeutic group

Antibacterial drugs for systemic use. Beta-lactam antibiotics - Penicillins. Penicillins in combination with beta-lactamase inhibitors. Clavulanic acid + amoxicillin.

ATX code J01CR02

Pharmacological properties

Pharmacokinetics

Amoxicillin and clavulanic acid are completely soluble in aqueous solution at physiological pH values ​​of the body. Both components are well absorbed after oral administration. It is optimal to take amoxicillin/clavulanic acid during or at the beginning of a meal. After oral administration, the bioavailability of amoxicillin and clavulanic acid is approximately 70%. The dynamics of the concentration of the drug in the plasma of both components is similar. Peak serum concentrations are reached 1 hour after ingestion.

Serum concentrations of amoxicillin and clavulanic acid when taking a combination of amoxicillin/clavulanic acid preparations are similar to those observed when an equivalent dose of amoxicillin and clavulanic acid is taken orally separately.

About 25% of the total amount of clavulanic acid and 18% of amoxicillin bind to proteins in the blood plasma. The volume of distribution for oral administration of the drug is approximately 0.3-0.4 l / kg of amoxicillin and 0.2 l / kg of clavulanic acid.

After intravenous administration, both amoxicillin and clavulanic acid have been found in the gallbladder, abdominal tissue, skin, fat, muscle tissue, synovial and peritoneal fluids, bile, and pus. Amoxicillin does not penetrate well into the cerebrospinal fluid.

Amoxicillin and clavulanic acid cross the placental barrier. Both components also pass into breast milk.

Amoxicillin is partially excreted in the urine as inactive penicillic acid in amounts equivalent to 10-25% of the initial dose. Clavulanic acid is metabolized in the body and excreted in the urine and feces, as well as in the form of carbon dioxide with exhaled air.

The mean half-life of amoxicillin/clavulanic acid is approximately 1 hour and the mean total clearance is about 25 l/h. Approximately 60-70% of amoxicillin and 40-65% of clavulanic acid are excreted unchanged in the urine during the first 6 hours after taking a single dose of amoxicillin/clavulanic acid tablets. During various studies, it was found that 50-85% of amoxicillin and 27-60% of clavulanic acid are excreted in the urine within 24 hours. The greatest amount of clavulanic acid is excreted during the first 2 hours after application.

The simultaneous use of probenecid slows down the release of amoxicillin, but this drug does not affect the excretion of clavulanic acid through the kidneys.

The half-life of amoxicillin is similar in children aged 3 months to 2 years, as well as in older children and adults. When prescribing the drug to very young children (including premature newborns) in the first weeks of life, the drug should not be administered more than twice a day, which is associated with the immaturity of the renal excretion pathway in children. Due to the fact that elderly patients are more likely to suffer from renal dysfunction, Amoxiclav 2X should be used with caution in this group of patients, but if necessary, renal function should be monitored.

The total clearance of amoxicillin / clavulanic acid in plasma decreases in direct proportion to the decrease in kidney function. The decrease in the clearance of amoxicillin is more pronounced compared with clavulanic acid, since more amoxicillin is excreted through the kidneys. Therefore, when prescribing the drug to patients with renal insufficiency, dose adjustment is necessary to prevent excessive accumulation of amoxicillin and maintain the desired level of clavulanic acid.

When prescribing the drug to patients with hepatic insufficiency, care should be taken when choosing a dose and regularly monitor liver function.

Pharmacodynamics

Amoxicillin is a semi-synthetic antibiotic from the penicillin group (beta-lactam antibiotic) that inhibits one or more enzymes (often referred to as penicillin-binding proteins) involved in the biosynthesis of peptidoglycan, which is an important structural component of the bacterial cell wall. Inhibition of peptidoglycan synthesis leads to weakening of the cell wall, which is usually followed by cell lysis and death.

Amoxicillin is degraded by beta-lactamases produced by resistant bacteria, and therefore 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-lactamase, thereby preventing the inactivation of amoxicillin, and expands its spectrum of activity. By itself, clavulanic acid does not have a clinically significant antibacterial effect.

The time to exceed the minimum inhibitory concentration (T > MIC) is considered the main determinant of the effectiveness of amoxicillin.

The two main mechanisms of resistance to amoxicillin and clavulanic acid are:

inactivation by bacterial beta-lactamases that are not inhibited by clavulanic acid, including classes B, C and D.

change in penicillin-binding proteins, which reduces the affinity of the antibacterial agent to the target pathogen.

Bacterial impermeability or efflux pump mechanisms (transport systems) can cause or maintain bacterial resistance, especially Gram-negative bacteria.

The MIC breakpoints for amoxicillin/clavulanic acid are those defined by the European Committee for Antimicrobial Susceptibility Testing (EUCAST).

sensitivity, the concentration of clavulanic acid is fixed at 2 mg/L.

3 Breakpoint values ​​in the table are based on breakpoints

ampicillin.

4 The resistance breakpoint R > 8 mg/l ensures that all strains with

resistance mechanisms are reported as resistant.

5 Breakpoint values ​​in the table are based on breakpoints

benzylpenicillin.

The prevalence of resistance may vary geographically and over time for selected species, and local information on resistance is desirable, especially when treating severe infections.

Sensitive strains

: Enterococcus faecalis, Gardnerella vaginalis, Staphylococcus aureus (methicillin sensitive), Streptococcus agalacticae, Streptococcus pneumoniae, Streptococcus pyogenes and other beta-hemolytic streptococci, Streptococcus viridans group

Aerobic gram negative microorganisms: Capnocyptophaga spp., Eikenella corrodens, Haemophilus influenzae, Moraxella catarrhalis, Pasteurella multocida

Anaerobic microorganisms: Bacteroides fragilis, Fusobacterium nucleatum, Prevotella spp.

Strains whose acquired resistance may cause problems

Aerobic gram-positive microorganisms: Enterococcus faecium

: Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae, Proteus mirabilis, Proteus vulgaris

Resistant strains

Aerobic gram-negative microorganisms: Acinetobacter sp., Citrobacter freundii, Enterobacter sp., Legionella pneumophila, Morganella morganii, Providencia spp., Pseudomonas sp., Serratia sp., Stenotrophomonas maltophilia

Other strains

Chlamydophila pneumoniae, Chlamydophila psitacci, Coxiella burnetti, Mycoplasma pneumoniae

Indications for use

acute bacterial sinusitis

acute otitis media

exacerbation of chronic bronchitis

community-acquired pneumonia

• pyelonephritis

  infections of the skin and soft tissues (including phlegmon, animal bites, severe periodontal abscess, phlegmon of the maxillofacial region)

  bone and joint infections (particularly osteomyelitis)

Dosage and administration

Doses are calculated taking into account the content of amoxicillin / clavulanic acid. When choosing a dose of Amoxiclav 2X for the treatment of individual infections, the following should be considered:

susceptibility of pathogen to antibiotic

the severity and location of the infection

age, weight and kidney function of the patient as shown below.

It is also necessary to consider other ways of using the drug Amoxiclav 2X, for example, using higher doses of amoxicillin and / or prescribing amoxicillin and clavulanic acid in different ratios.

Tablets should be taken orally before meals to reduce possible gastrointestinal disturbances and increase the absorption of amoxicillin/clavulanic acid.

Adults and children over 12 years oldor with body weight over 40 kg

Assign 1 tablet 500 mg / 125 mg 3 times a day or 1 tablet 875 mg / 125 mg twice a day.

In severe cases, with infections of the lower respiratory tract, urinary tract, otitis media and sinusitis, 1 tablet of 875 mg / 125 mg is prescribed 2 times a day.

The duration of treatment depends on the response of the patient. Some infections (such as osteomyelitis) require a longer period of treatment. The maximum therapy time should not exceed 14 days.

The maximum daily dose for a dosage of 500 mg / 125 mg is 1500 mg of amoxicillin / 375 mg of clavulanic acid, for a dosage of 875 mg / 125 mg it is 1750 mg of amoxicillin / 250 mg of clavulanic acid.

Children under 12 years of age or weighing less than 40 kg

This dosage form is not intended for children under 12 years of age or children weighing less than 40 kg. Such children are prescribed the drug Amoxiclav 2X in the form of a suspension for oral administration.

Elderly patients dose adjustment is not required.

With kidney failure Dose adjustments are made based on the maximum recommended level of amoxicillin. Dose adjustment is not required when prescribing the drug to patients with a creatinine clearance (CrCl) of more than 30 ml / min.

In patients whose creatinine level is less than 30 ml / min, the use of amoxicillin and clavulanic acid at a dose of 875/125 mg is not recommended, since there are no recommendations for dosage adjustment.

Adults and children weighing over 40 kg

With liver failure apply with caution. Necessary

check liver function regularly.

Side effects

Classification of side effects by frequency of occurrence:

"very often" -  1/10, "often" - from  1/100 to  1/10, "infrequently" - from  1/1000 to  1/100, "rarely" - from  1/10000 to  1/1000, "very rarely" -  1/10000, the frequency is unknown (there is not enough data to make an estimate).

Often:

Often:

candidiasis (skin and mucous membranes)

Infrequently:

dizziness, headache

indigestion

increased AST and/or ALT5 levels

skin rash7, itching7, urticaria7

Rarely:

transient leukopenia (including neutropenia), thrombocytopenia

erythema multiforme7

Frequency unknown:

growth of non-susceptible organisms

transient agranulocytosis, hemolytic anemia, increased bleeding time and prothrombin time1

angioedema10, anaphylaxis10, serum-like syndrome10, allergic vasculitis10

transient hyperactivity, convulsions2

antibiotic-associated colitis4, black hairy tongue, discoloration of teeth11

hepatitis6, cholestatic jaundice6

Stevens-Johnson syndrome7, toxic epidermal necrolysis7, bullous exfoliative dermatitis7, acute generalized exanthematous pustulosis (AGEP)9

interstitial nephritis, crystalluria8

1 see section Special instructions.

2 see section Special instructions.

3 Nausea more frequent with higher oral doses. Can be reduced

gastrointestinal reactions while taking amoxicillin/clavulanic acid in

the beginning of a meal.

4 Including pseudomembranous colitis and hemorrhagic colitis (see Special

instructions).

5 Moderate increases in AST and/or ALT levels have been noted in patients

treated with beta-lactam antibiotics, but the significance of these results is unknown.

6 These complications have been noted when the drug is used in combination with other

penicillins and cephalosporins (see section Special Instructions).

7 If any skin hypersensitivity reaction occurs, treatment should be

stop (see section Special Instructions).

8 see section Special instructions.

9 see section Contraindications.

10 see section Special instructions.

Contraindications

hypersensitivity to the active substance or any auxiliary component of the drug

history of severe hypersensitivity reaction to other beta-

lactam drugs (eg, cephalosporins, carbapenems, or

monobactam)

cholestatic jaundice or other history of liver failure (due to the use of amoxicillin/clavulanic acid)

children under 12 years of age (weighing less than 40 kg)

Drug Interactions

Oral anticoagulants

Oral anticoagulants and antibiotics of the penicillin group are widely used in practice without interaction reports. However, in the literature, an increase in the international normalized ratio was noted in patients taking acenocoumarol or warfarin together with amoxicillin. If the simultaneous use of drugs is necessary, the prothrombin time or international normalized ratio should be carefully monitored when prescribing and canceling amoxicillin. Moreover, a change in the dosage of oral anticoagulants may be required.

Methotrexate

Drugs of the penicillin group can reduce the excretion of methotrexate, which causes a potential increase in toxicity.

probenecid

Co-administration of probenecid is not recommended. Probenecid reduces the renal tubular secretion of amoxicillin. Co-administration with Amoxiclav 2X may result in increased blood levels of amoxicillin but not clavulanic acid.

The simultaneous use of allopurinol and the drug Amoxiclav 2X may increase the risk of allergic reactions. Data on the simultaneous use of allopurinol and the drug Amoxiclav 2X are currently not available.

In patients taking mycophenolate mofetil, when combined with the drug Amoxiclav 2X, the concentration of the active metabolite of mycophenolic acid at the initial dose is reduced by approximately 50%. The change in the initial dose level may not correspond to the change in the total concentration of mycophenolic acid.

special instructions

Before starting therapy with amoxicillin/clavulanic acid, it is necessary to carefully study the presence of hypersensitivity reactions in the patient to penicillins, cephalosporins or other beta-lactam substances.

Serious and sometimes fatal (anaphylactic) hypersensitivity reactions have been reported in patients treated with penicillin. These reactions are more common in people with a penicillin hypersensitivity reaction and a history of atopy. With the development of an allergic reaction to amoxicillin / clavulanic acid, therapy with this drug should be discontinued and switched to another alternative treatment.

If the infection is resistant to amoxicillin, consideration should be given to using amoxicillin/clavulanic acid instead of amoxicillin.

At a high risk of pathogen resistance to beta-lactam antibiotics, Amoxiclav 2X should not be used. It is not recommended to use the drug for the treatment of penicillin-resistant S. pneumoniae.

Patients with impaired renal function and taking a high dose of the drug may develop convulsions.

Amoxicillin/clavulanic acid should not be prescribed for infectious mononucleosis, as a measles-like rash (for amoxicillin) may occur.

The simultaneous use of allopurinol during treatment with amoxicillin may increase the likelihood of skin allergic reactions. Data on the simultaneous use of allopurinol and the drug Amoxiclav 2X are currently not available.

Prolonged use of the drug may cause overgrowth of non-susceptible microorganisms.

The appearance at the beginning of treatment of generalized erythema with pustular rashes and fever may be a symptom of the development of acute generalized exanthematous pustulosis. With the development of this reaction, it is required to stop using the drug Amoxiclav 2X and no longer use amoxicillin in the future.

The drug should be used with caution in patients with hepatic impairment.

Cases of hepatic dysfunction have been reported mainly in men and elderly patients, and are quite rare in children who have taken the drug for a long period of time. Signs and symptoms usually develop during or immediately after the start of treatment, but in some cases may not appear until a few weeks after stopping therapy. These symptoms are usually reversible. Complications from the liver can be severe and in extremely rare cases be fatal. They almost always develop in patients with serious comorbidities or in patients taking other drugs that affect the liver.

The development of antibiotic-associated colitis is characteristic of any antibacterial drugs, including amoxicillin, and can vary in severity from moderate to life-threatening. Therefore, it is important to consider this diagnosis when prescribing the drug to patients suffering from diarrhea during or after the use of any antibiotics. If antibiotic-associated colitis occurs, use of Amoxiclav 2X should be discontinued immediately. After consulting a doctor, appropriate therapy should be prescribed. Drugs that reduce peristalsis are contraindicated in this situation. During long-term therapy, it is recommended to regularly evaluate the function of organ systems, including kidney, liver and hematopoietic function. It is necessary to adjust the dose of oral anticoagulants to maintain the desired level of blood clotting.

In patients with impaired renal function, dose adjustment is required depending on the severity of the impairment.

In patients with reduced diuresis, crystalluria was observed very rarely, mainly during parenteral therapy. During treatment, the patient is advised to drink plenty of fluids to avoid the possible development of crystalluria. According to the data obtained, amoxicillin settles in the catheters of the bladder (mainly with intravenous administration of large doses), in this case, it is necessary to regularly monitor the patency of the catheter.

During treatment with amoxicillin, glucose oxidase enzymatic methods should be used when testing for the presence of glucose in the urine, since false positive results are possible when using non-enzymatic methods.

The presence of clavulanic acid in Amoxiclav 2X can lead to non-specific binding of immunoglobulin G and albumin to erythrocyte membranes and false positive Coombs test results. were not infected with Aspergillus infection, but there are no data on cross-reactions with non-Aspergillus polysaccharides and polyfuranoses. Thus, positive test results in patients treated with amoxicillin/clavulanic acid should be interpreted with caution and confirmed by other diagnostic methods. Pregnancy

Animal studies do not indicate direct or indirect harmful effects in relation to pregnancy, embryonic/fetal development, parturition or postnatal development.

Currently, there is a limited amount of data on the use of the drug Amoxiclav 2X during pregnancy in humans, which did not reveal an increased risk of congenital malformations. In a clinical study in women with premature rupture of the membranes, a causal relationship was documented between prophylactic treatment with amoxicillin/clavulanic acid and an increased risk of necrotizing enterocolitis in the newborn. It is not recommended to use the drug Amoxiclav 2X during pregnancy, the use is possible only in case of emergency, as directed by a doctor.

Lactation

Both active substances are excreted in breast milk (there is no data on the effect of clavulanic acid on breastfeeding). Therefore, symptoms such as diarrhea and fungal infections of the mucous membranes may occur during breastfeeding, in which case breastfeeding should be discontinued. The drug Amoxiclav 2X is allowed to be used during breastfeeding only after a benefit / risk assessment by the attending physician.

Features of the influence of the drug on the ability to drive a vehicle or potentially dangerous mechanisms

Studies to identify effects that affect the ability to drive a car and machinery have not been conducted. However, the drug Amoxiclav 2X can cause side effects such as allergic reactions, convulsions, which can affect the ability to drive a car and move machinery.

Overdose

Symptoms: Gastrointestinal symptoms and fluid and electrolyte disturbances are possible. Crystalluria of amoxicillin in some cases leads to renal failure. Convulsions may occur in patients with impaired renal function or in patients taking high doses of the drug.

Treatment: symptomatic treatment, taking into account the water and electrolyte balance. Amoxicillin/clavulanic acid can be removed from the body by hemodialysis.

Release form and packaging

7 tablets in a blister pack of aluminum foil.

2 blister packs, together with instructions for medical use in the state and Russian languages, are placed in a cardboard pack.

Storage conditions

Store in a dry place at a temperature not exceeding 25 °C.

Keep out of the reach of children!

Shelf life

Do not use after the expiry date stated on the package.

Terms of dispensing from pharmacies

On prescription

Manufacturer/Packer

Perzonali 47, SI - 2391 Prevalje, Slovenia

Registration certificate holder

Lek Pharmaceuticals d.d., Slovenia

Verovskova, 57, 1526 Ljubljana, Slovenia

Address of the organization accepting claims from consumers on the quality of products (goods) on the territory of the Republic of Kazakhstan

Representative office of Sandoz Pharmaceuticals d.d. JSC in the Republic of Kazakhstan, Almaty, st. Luganskogo 96,

Phone number: +7 727 258 10 48, fax: +7 727 258 10 47

e-mail: [email protected]

8 800 080 0066 - free dial-up number within Kazakhstan

Attached files

Amoxiclav is an antibiotic that contains amoxicillin, which has antibacterial properties, and clavulanic acid. Thanks to the enzymes that make up amoxicillin, the bacterial cell wall loses its integrity, as a result of which the latter is destroyed and dies.

However, most types of bacteria have learned to produce special substances to block the action of antibiotics. These components are called beta-lactomases (a group of enzymes aimed at fighting antibiotics). Because of this type of substance, amoxicillin has become harmless to many types of bacteria.

That is why clavulanic acid, designed to combat beta-lactamases, was included in the preparation. In conjunction with amoxicillin, antibiotic molecules become less susceptible to beta-lactamases. Thus, the combination of amoxicillin and clavulanic acid has a wider spectrum of bacterial activity than amoxicillin alone. Bacteria that can be affected by the antibiotic Amoxiclav include:

• gram positive bacteria. This type of bacteria has an easily permeable membrane for antibiotics, forms spores (a unicellular formation that serves for asexual reproduction), exotoxins (poisons that are formed by living pathogenic bacteria), has a blue color;
• gram-negative bacteria. They have a thicker shell of the cell wall, which makes the effect of antibiotics on this flora much more complicated. This type of bacteria does not form spores and is red in color.

Pharmacological properties

The pharmacokinetic properties of Amoxicillin and clavulanic acid are similar. Both components are well accepted by the body. It should be noted that food intake does not affect absorption. The highest degree of plasma concentration occurs one hour after taking the drug.. Amoxicillin and clavulanic acid are well distributed in body fluids and tissues, such as:

• peritoneal fluid;
• pleural fluid;
• lungs;
• middle ear;
• ovaries;
• uterus;
• liver;
• muscle tissue;
• the secret of the paranasal sinuses;
• bronchial secret;
• prostate;
• palatine tonsils;
• gallbladder.

Clavulanic acid is well absorbed by the body, and Amoxicillin has only partial absorption. The drug is excreted from the body almost unchanged within 1-2 hours. If the patient suffers from severe renal insufficiency, the drug withdrawal period may increase up to 7 hours.

How to take Amoxiclav for adults

The antibiotic Amoxiclav is prescribed for adults to treat many infectious diseases, including:

• sinusitis (can be acute or chronic) - a disease associated with inflammation of the airways;
• pharyngeal abscess - purulent inflammation in the pharyngeal space of the fiber;
• tonsillopharyngitis - an acute infection of the pharynx and palatine tonsils;
• bronchitis;
• inflammation of the middle ear;
• pneumonia;
• gynecological infections;
• endometritis;
• inflammation of the gallbladder;
• infection of the skin or soft tissues;
• various sexual infections;
• odontogenic infections (inflammatory diseases of the oral cavity).

Amoxiclav can be used in surgery for the prevention of postoperative infections.

Contraindications and side effects

The list of contraindications of Amoxiclav is small, it includes:

• Infectious mononucleosis;
• violations of the liver and kidneys;
• lymphocytic leukemia - a malignant lesion in the lymphatic tissue;
• Allergy to penicillin is one of the main contraindications. In such cases, Amoxiclav should be replaced by antibiotics of other groups. The drug can cause a pronounced allergic reaction, which manifests itself in the form of various rashes, severe itching, urticaria, skin edema, anaphylactic shock.

In the presence of any allergic reactions to antibiotics, the use of Amoxiclav is contraindicated.

Before using the drug, a specialist consultation is necessary.

Side effects

When using Amoxiclav, the following side effects may occur:

• problems with the digestive system: loss of appetite, vomiting, inflammation of the tongue, flatulence, inflammation of the mucous membranes, a change in the color of the tongue is possible;
• fever;
• allergic reactions: rash, skin edema, erythema (severe reddening of the skin), dermatitis;
• changes in the circulatory system: a decrease in the number of eosinophils and agranulocytes (a group of leukocytes);
• kidney inflammation. In some cases, the presence of blood in the urine;
• infectious diseases with damage to the skin and mucous membranes;
• feeling of anxiety, lack of sleep, clouding of consciousness, pain in the head, hyperkinesis (appearance of tics, uncontrolled movements).

There is sporadic evidence of hepatitis and liver dysfunction.

Amoxiclav release form

Amoxiclav can be produced in the form of:

• film-coated tablets. Amoxiclav tablets should be swallowed whole, washed down with a glass of water or dissolved in water. The duration of the course of treatment Amoxiclav Solutab is determined by the severity of the disease, on average it lasts from 13 to 14 days;
• powder for suspension. The exact dose of suspension for adults must be calculated taking into account body weight. During the preparation of the suspension, the bottle must be shaken well in order to detach the powder particles from the walls of the vessel. The composition should be taken several times a day, the duration of the course of treatment should be determined by the attending physician. It is necessary to strictly follow the instructions for using the medicine;
• lyophilized powder for injection. The drug for intravenous use contains about 5 mg of clavulanic acid and 35 mg of amoxicillin. To prepare a solution of Amoxiclav for the purpose of intravenous administration, it is necessary to dissolve the contents of the vial in saline. The introduction of the drug intravenously should be slow - about 3-4 minutes. The use of the drug, as a rule, should occur at intervals of 8 hours with an average severity of the disease and after 6 hours in severe cases of the disease. The introduction of the drug should be carried out no later than 15 minutes after the preparation of the solution. It is forbidden to freeze Amoxiclav solution and mix it with other drugs.

Annotation when used during pregnancy and lactation

Animal studies have not confirmed the possibility of harm from the drug during pregnancy. However, in cases with premature rupture of the membranes, the use of Amoxiclav can cause the development of necrotizing enterocolitis (an inflammatory disease caused by infectious agents against the background of damage to the intestinal mucosa) in newborns.

When taking the drug, you should think about stopping breastfeeding.

It is not recommended to use the drug during lactation and pregnancy.. It is recommended to take Amoxiclav only in cases where the benefit of taking the drug for the mother outweighs the potential risk to the fetus. Amoxicillin and clavulanic acid are able to pass into breast milk in small amounts - the baby may develop sensitization (acquisition of increased sensitivity to foreign substances by the body), diarrhea, and damage to the mucous membranes of the oral cavity.

For diseases of the respiratory tract and ENT organs

Amoxiclav is a fairly effective remedy for combating ENT diseases of varying severity. In case of a severe course of the disease, the drug is primarily prescribed intravenously, and later, after the patient's condition has stabilized, they are transferred to the tablet form of the drug.

Amoxiclav is also able to provide significant assistance in the fight against complications of lower respiratory tract infections. The drug promotes coughing and relieves inflammation in the bronchi. In the inflammatory process in the lungs, the dosage of the drug is determined in each case individually. The appointment of this drug should be done only by an infectious disease specialist or therapist.

If symptoms of pneumonia occur, the patient must be hospitalized and rescue measures should be taken using the drug intramuscularly or intravenously. The dosage for adults and children depends on the severity of the disease, as well as the general condition of the patient - his kidneys and liver - since the drug is withdrawn through them.

In the severe stage of pneumonia, the drug must be administered intravenously. At earlier stages, you can get by with a tablet option. With a small dosage, the drug may be ineffective, because even in a short period of time, bacteria are able to develop immunity. Exceeding the dosage of the drug can cause side effects. Therefore, the dosage recommended by the doctor must be strictly observed. In case of kidney disease, the dosage should be reduced.

Amoxiclav must be taken at the strictly allotted time.

Treatment of angina with Amoxiclav

Amoxil is effective in the fight against streptococci. These microbes are the main causative agents of angina. This drug also has a significant effect on Haemophilus influenzae and Escherichia coli, Proteus, Klebsiella, Enterocci. With angina, Amoxiclav penetrates into the tissues of the tonsils and nearby organs, where it acts bactericidal, destroying microbial cells.

Treatment of sinusitis with Amoxiclav

Amoxiclav is distinguished by its ability to accumulate well in all biological fluids, including inflamed sinuses. Due to its wide range of antibacterial components, Amoxiclav is very effective for sinusitis of various forms of leakage. During the studies, it was found that after using this drug for 5-6 days, the contents of the punctate of the maxillary sinuses became sterile (did not contain active microflora).

In severe forms of the course of the disease, the drug must be taken in the interval from 7 to 14 days. When prescribing a medicine, consider:

• age;
• body weight;
• the state of the excretory system;
• the presence of chronic diseases.

The daily intake of tablets is usually divided into 3 doses.

The effectiveness of the remedy is not related to food intake. You can drink tablets before and after meals.

Chronic sinusitis during an exacerbation should be treated with the same doses as in a severe form of the disease. When foreign bodies get into the maxillary sinus, treatment is carried out comprehensively in the departments of the hospital. This drug has good tolerability, high efficiency, a relatively small number of contraindications, which is why it is characterized by a significant number of advantages in the treatment of this disease, in comparison with other drugs.

Treatment of otitis with Amoxiclav

For otitis in adults, antibiotics are the main course of treatment. Preparations are selected based on the type of pathogen and the characteristics of the course of the inflammatory process. Amoxiclav, as a rule, is prescribed for the moderate severity of the patient's condition. The dosage is determined by the degree of development of the pathological process. Therapy lasts about 2 weeks on average.

In more severe cases of ear inflammation, dosages may be adjusted. For the treatment of particularly severe cases of otitis, intravenous injections are possible. In this case, the introduction of the drug should be carried out slowly (within 3-4 minutes). The evaluation of the patient's treatment takes place on the 3-4th day in the presence of visible improvements, the method of application of the drug may change.

Since dangerous complications can develop with otitis media, which are most often provoked by untimely and incorrect therapy, consultation with an ENT doctor is necessary before use.

special instructions

Most allergic reactions occur in patients with hypersensitivity to penicillins. In this regard, before starting the course of therapy, it is necessary to exclude the presence of hypersensitivity to penicillins or other allergens.

If allergic reactions to Amoxiclav are detected, it is necessary to replace the course of treatment with therapy using an alternative drug.

If the infection is caused by microorganisms sensitive to amoxicillin, it is necessary to consider the possibility of switching from the combination of amoxicillin + clavulanic acid to simple amoxicillin. If severe anaphylactic reactions occur, immediate treatment with epinephrine should be sought.

With prolonged use of the drug, excessive growth of microflora that is insensitive to Amoxiclav may occur.

In patients with impaired renal or hepatic function, convulsions may occur at high doses of the drug. Amaksiklav should be taken with caution in patients with liver and kidney dysfunction. Negative reactions from the liver and kidneys most often occur in men and elderly patients.

Symptoms of the disease may appear during therapy or immediately after treatment, however, there have been cases of later manifestations about 1-2 weeks after the end of treatment. As a rule, these phenomena are reversible, in very rare cases, deaths are possible. This was observed in patients with severe underlying diseases or in those who underwent concurrent therapy with drugs that adversely affect the kidneys and liver.

The use of Amoxiclav can cause the development of pseudomembranous colitis (acute inflammation of the large intestine) of varying degrees. In the presence of severe persistent diarrhea after taking an antibiotic, it is necessary to make sure that it is not associated with the above pathology.

With long-term treatment, it is necessary to regularly undergo examination of the kidneys and liver. For patients with any impairment in the functioning of the kidneys and liver, it is necessary to adjust the dosage of the drug in accordance with the degree of impairment. In rare cases, patients with reduced urine output may experience crystallurgy (excessive salts in the body that, for whatever reason, are not excreted naturally from the body). Most often, this can happen with the parenteral (bypassing the intestinal tract) route of drug administration. For this reason, when using the drug in large doses, it is necessary to constantly ensure that the body receives a sufficient amount of fluid for the appropriate excretion of urine.

During treatment with Amoxiclav, many methods for determining the level of glucose in the blood can give false results. It is recommended to use enzymatic reactions with glucose oxidase (a reagent for the determination of glucose in the blood).

Amoxiclav compatibility

In cases of simultaneous use of Amoxiclav with antacids, aminoglycosides, various laxatives, it is possible to slow down the absorption of the substance into the body. When taking ascorbic acid, the acceleration of assimilation is not ruled out.

Since clavulanic acid is excreted through the urine, the simultaneous use of drugs that block tubular secretion (transportation of substances from the blood into the urine) is not recommended. Among these drugs: Allopurinol, Diuretic, Phenylbutazone, NSAIDs (drugs aimed at symptomatic treatment, inflammation and pain relief, temperature reduction) and other drugs with similar properties.

When undergoing treatment with Methotrexate, the simultaneous use of Amoxiclav may increase the toxicity of the drugs. The combination of Amoxiclav with Allopurinol increases the incidence of exanthema (skin inflammation of a viral nature).

In cases of taking the drug together with anticoagulants (drugs that prevent the formation of blood clots), prolongation of the prothrombized time (a temporary indicator of blood clotting) may occur. When taking Amoxiclav with Rimfapicin, there may be a mutual weakening of the antibacterial action.

Amoxiclav, like all antibiotics, reduces the effectiveness of oral contraceptives.