Amoxiclav maximum daily dose. Symptoms and treatment of an overdose of amoxiclav

This page contains detailed instructions for use. Amoxiclav. The available dosage forms of the drug are listed (tablets 125 mg, 250 mg, 500 mg, 875 mg, 1000 mg, suspension), as well as its analogues. Information is provided on the side effects that the antibiotic Amoxiclav can cause, on interactions with other drugs. In addition to information about the diseases for the treatment and prevention of which the drug is prescribed (tonsillitis, otitis media, sinusitis and other infectious diseases), the algorithms for admission, possible dosages for adults and children are described in detail, the possibility of using during pregnancy and lactation is specified. The annotation to Amoxiclav is supplemented by reviews of patients and doctors.

Instructions for use and dosage

Adults and children over 12 years of age (or more than 40 kg of body weight): the usual dose for mild to moderate infections is 1 tab. 250 + 125 mg every 8 hours or 1 tab. 500 + 125 mg every 12 hours, in case of severe infection and respiratory tract infections - 1 table. 500 + 125 mg every 8 hours or 1 tab. 875 + 125 mg every 12 hours. Tablets are not prescribed for children under 12 years of age (less than 40 kg of body weight).

The maximum daily dose of clavulanic acid (in the form of potassium salt) is 600 mg for adults and 10 mg/kg of body weight for children. The maximum daily dose of amoxicillin is 6 g for adults and 45 mg/kg of body weight for children.

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.

Dosage for odontogenic infections: 1 tab. 250 +125 mg every 8 hours or 1 tab. 500 + 125 mg every 12 hours for 5 days.

Release forms

Powder for the preparation of an injection solution for intravenous administration (4) 500 mg, 1000 mg.

Powder for suspension for oral administration 125 mg, 250 mg, 400 mg (a convenient children's form of the drug).

Film-coated tablets 250 mg, 500 mg, 875 mg.

Amoxiclav- is a combination of amoxicillin - a semi-synthetic penicillin with a wide spectrum of antibacterial activity and clavulanic acid - an irreversible beta-lactamase inhibitor. Clavulanic acid forms a stable inactivated complex with these enzymes and provides amoxicillin resistance to the effects of beta-lactamases produced by microorganisms.

Clavulanic acid, similar in structure to beta-lactam antibiotics, has a weak intrinsic antibacterial activity.

Amoxiclav has a wide spectrum of antibacterial action.

Active against amoxicillin-sensitive strains, including strains producing beta-lactamase, incl. aerobic gram-positive bacteria, aerobic gram-negative bacteria, anaerobic gram-positive bacteria, gram-negative anaerobes.

Pharmacokinetics

The main pharmacokinetic parameters of amoxicillin and clavulanic acid are similar. Both components are well absorbed after oral administration, food intake does not affect the degree of absorption. Both components are characterized by a good volume of distribution in body fluids and tissues (lungs, middle ear, pleural and peritoneal fluids, uterus, ovaries, etc.). Amoxicillin also penetrates into the synovial fluid, liver, prostate gland, palatine tonsils, muscle tissue, gallbladder, sinus secretions, saliva, bronchial secretions. Amoxicillin and clavulanic acid do not penetrate the BBB in non-inflamed meninges. Amoxicillin and clavulanic acid cross the placental barrier and are excreted in breast milk in trace concentrations. Amoxicillin and clavulanic acid are characterized by low plasma protein binding. Amoxicillin is partially metabolized, clavulanic acid appears to be extensively metabolized. Amoxicillin is excreted by the kidneys almost unchanged by tubular secretion and glomerular filtration. Clavulanic acid is excreted by glomerular filtration, partly as metabolites.

Indications

Infections caused by susceptible strains of microorganisms:

• 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.

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.

special instructions

During the course of treatment, the functions of the hematopoietic organs, 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.

Laboratory tests: High concentrations of amoxicillin give a false positive reaction to urine glucose when using Benedict's reagent or Felling's solution. Enzymatic reactions with glucosidase are recommended.

It is forbidden to use Amoxiclav with the simultaneous use of alcohol in any form, since the risk of hepatic disorders is seriously increased when they are taken simultaneously.

Influence on the ability to drive vehicles and control mechanisms

There are no data on the negative effect of Amoxiclav in recommended doses on the ability to drive a car or work with mechanisms.

Side effect

Side effects in most cases are mild and transient.

• loss of appetite;
• nausea, vomiting;
• diarrhea;
• stomach ache;
• itching, urticaria, erythematous rash;
• angioedema;
• anaphylactic shock;
• allergic vasculitis;
• exfoliative dermatitis;
• Stevens-Johnson syndrome;
• reversible leukopenia (including neutropenia);
• thrombocytopenia;
• hemolytic anemia;
• eosinophilia;
• dizziness, headache;
• convulsions (may occur in patients with impaired renal function when taking the drug in high doses);
• sense of anxiety;
• insomnia;
• interstitial nephritis;
• crystalluria;
• development of superinfection (including candidiasis).

drug interaction

With the simultaneous use of the drug Amoxiclav with antacids, glucosamine, laxatives, aminoglycosides, absorption slows down, with ascorbic acid it increases.

Diuretics, allopurinol, phenylbutazone, NSAIDs and other drugs that block tubular secretion increase the concentration of amoxicillin (clavulanic acid is excreted mainly by glomerular filtration).

With the simultaneous use of Amoxiclav increases the toxicity of methotrexate.

With the simultaneous use of Amoxiclav with allopurinol, the incidence of exanthema increases.

Co-administration with disulfiram should be avoided.

In some cases, taking the drug may lengthen the prothrombin time, in this regard, care should be taken when prescribing anticoagulants and the drug Amoxiclav.

The combination of amoxicillin with rifampicin is antagonistic (there is a mutual weakening of the antibacterial action).

Amoxiclav should not be used simultaneously with bacteriostatic antibiotics (macrolides, tetracyclines), sulfonamides due to a possible decrease in the effectiveness of Amoxiclav.

Probenecid reduces the excretion of amoxicillin by increasing its serum concentration.

Antibiotics reduce the effectiveness of oral contraceptives.

Antibiotic analogs Amoksiklav

Structural analogues for the active substance:

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

Use during pregnancy and lactation

Amoxiclav can be prescribed during pregnancy if there are clear indications.

Amoxicillin and clavulanic acid are excreted in breast milk in small amounts.

AMOXIKLAV

Compound

main physical and chemical properties: tablets (250 mg / 125 mg): white or almost white, oval, biconvex film-coated tablets;

tablets (500 mg/125 mg): white or off-white, oval, film-coated tablets;

1 tablet (250 mg / 125 mg) contains 250 mg of amoxicillin in the form of RK trihydrate and 125 mg of clavulanic acid in the form of potassium salt, ratio 2: 1;

Excipients: colloidal silicon dioxide, crospovidone, croscarmellose sodium, magnesium stearate, talc, microcrystalline cellulose, hypromellose 606, ethylcellulose No. 7, diethyl phthalate, macrogol 6000, titanium;

1 tablet (500 mg / 125 mg) contains 500 mg of amoxicillin in hydrate form and 125 mg of clavulanic acid in the form of potassium salt, ratio 4: 1;

Excipients: anhydrous colloidal silicon, crospovidone, croscarmellose sodium, magnesium stearate, methylhydroxypropyl cellulose, ethylcellulose, diethyl phthalate, polyethylene glycol 6000, titanium dioxide E 171.

Release form

Film-coated tablets.

Tablets Amoxiclav- 250 mg amoxicillin / 125 mg clavulanic acid; film-coated, 15 pieces per pack.

Tablets Amoxiclav 2X- 500 mg / 125 mg; 875 mg / 125 mg, film-coated, (pack of 10 or 14 pieces).

Amoxiclav Quiktab tablets- 500 mg / 125 mg; 875 mg/125 mg, dispersed tablets, pack of 10.

Powder for suspension for oral administration Amoxiclav- 312.5 mg / 5 ml (250 mg of amoxicillin per 5 ml of suspension / 62.5 mg of clavulanic acid per 5 ml of suspension); 156.25 mg / 5 ml (125 mg of amoxicillin per 5 ml of suspension / 31.25 mg of clavulanic acid per 5 ml of suspension) - a bottle for the preparation of 100 ml of a suspension, in a package - 1 bottle.

Amoxiclav for parenteral administration- powder for solution for injection into a vein, 600 mg in a vial (500 mg of amoxicillin and 100 mg of clavulanic acid) or 1.2 g in a vial (1000 mg of amoxicillin and 200 mg of clavulanic acid), in a package of 5 vials.

Pharmacotherapeutic group

Antibacterial agents for systemic use. Amoxicillin and an enzyme inhibitor. PBX J01C R02.

Pharmacodynamics

Amoxiclav is a combination of amoxicillin, a semi-synthetic penicillin antibiotic with a wide spectrum of antibacterial action, and clavulanic acid, an irreversible inhibitor of ß-lactamase, forms stable inactive complex compounds with enzymes and protects amoxicillin from decay.

Amoxiclav has a wide spectrum of antibacterial activity. It is active against microorganisms sensitive to amoxicillin, as well as visible bacteria that form ß-lactamase, including such species:

gram-positive aerobes (Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus viridans, Staphylococcus aureus (staphylococci resistant to dimethicillin / oxacillin are also considered resistant to the action of the combination of amoxicillin / clavulanic acid), Staphylococcus epidermidis, Staphylococcussaprophyticus, Listeria spp., Enteroccocus faecalis)

gram-negative aerobes (Haemophillus influenzae, Haemophillus ducreyi, Moraxella (Branchamella) catarrhalis, Escherichia coli, Klebsiella spp. , Proteus mirabilis, Proteus vulgaris, Neisseria gonorrhoeae, Pasteurella multocida, Salmonella species, Shigella species, Vibrio cholerae, Helicobacter pylori, Eikenella corrodens)

anaerobes (Peptococcus spp., Peptostreptococcus spp., Bacteroides spp., Fusobacterium spp., Prevotella spp., Clostridium perfringens, Actinomycesisraelli).

In general, the pharmacokinetic parameters of clavulanic acid and amoxicillin are similar when used in combination, therefore they do not have a mutual effect on the pharmacokinetic properties of each individual substance. After oral administration, both ingredients are well absorbed. Their maximum plasma concentrations are reached after about 60 minutes. The use of Amoxiclav during meals does not affect the absorption of clavulanic acid and amoxicillin. The half-life for clavulanic acid is 60-70 minutes, for amoxicillin - 78 minutes. Both substances penetrate into the tissues and fluids of the body easily, especially accumulate in the secret of the maxillary sinuses, lungs, middle ear cavity, peritoneal and pleural fluids, ovaries and uterus. With meningitis, the components of Amoxiclav penetrate the blood-brain barrier. They also penetrate the placental barrier and are determined in trace amounts in breast milk.

With the bolus administration of Amoxiclav at a dosage of 1.2 g, the maximum plasma concentration of clavulanic acid is 28.5 mg / l, amoxicillin - 105.4 mg / ml. After 60 minutes, the peak concentration of these substances in body fluids is determined. Clavulanic acid and amoxicillin bind to plasma proteins, respectively, by 22-30% and 17-20%.

Clavulanic acid is extensively metabolized in the liver tissue. Partially excreted with exhaled air and feces, mainly by the kidneys. Amoxicillin is predominantly excreted unchanged in the urine.

Indications

acute and chronic sinusitis;

pharyngeal abscess;

otitis media;

· pneumonia;

· Chronical bronchitis;

· urinary tract infections;

· odontogenic infections, including periodontitis;

gynecological infections;

gonorrhea (including those caused by gonococci that produce beta-lactamase;

skin and soft tissue infections (including wound infections);

· chancroid;

infections of the bones and joints;

prevention of purulent-septic complications during surgical interventions on the pelvic organs, abdominal cavity, kidneys, heart, bile ducts;

Therapy of mixed infections caused by gram-positive and gram-negative microorganisms, as well as anaerobic pathogens (biliary tract infections, ENT infections and postoperative abdominal infections, aspiration pneumonia, breast abscess);

· Maxillofacial Surgery;

orthopedic practice.

Dosage and administration

Amoxiclav tablets. Before use, the tablets are dissolved in half a glass of water (at least 100 ml). After that, the resulting suspension is thoroughly stirred or the tablets are chewed before swallowing. They are prescribed orally for children weighing 40 kg or more, as well as for adults. The average daily dosage is 375 mg (1 tablet) every 8 hours (3 r / day); or 625 mg (1 tablet) 2-3 r / day (depending on the severity of the infectious process).

Tablets Amoxiclav 2X. Appointed only for adult patients with severe respiratory diseases or severe infections, 1000 mg (1 tablet) twice a day.

The maximum daily dosage for adults is 6000 mg of amoxicillin.

The maximum daily dose of clavulanic acid in the form of potassium salt is 600 mg.

In pediatrics. Children from the first days of life up to the age of 3 months are prescribed at a dose of 30 mg / kg / day (in terms of amoxicillin), daily. The daily dose is divided equally, taken at regular intervals.
Amoxiclav is prescribed from the age of 3 months or more or with a body weight of less than 40 kg at a dose of 25 mg / kg / day (divided into 2 injections every 12 hours); or 20 mg / kg / day (divided into 3 injections every 8 hours) - for moderate infectious diseases. In severe infections, Amoxiclav is used at 45 mg / kg / day (dose divided into 2 doses every 12 hours); or 40 mg/kg/day (divided into 3 doses every 8 hours).

The maximum daily dosage for children is 45 mg per 1 kg of body weight.

The maximum daily dose of clavulanic acid in the form of potassium salt is 10 mg per 1 kg of body weight.

In the case of infections of moderate severity, the daily dose is 25 mg / kg every 12 hours (based on amoxicillin).

For infections of the lower respiratory tract, sinusitis, otitis media and other severe infections, Amoxiclav is prescribed to children at the rate of 45 mg / kg / day of amoxicillin every 12 hours.

Patients with renal insufficiency. In case of insufficiency of kidney function with a creatinine clearance level of 10 ml / min or less, the dosage of Amoxiclav is adjusted or the interval between taking the drug is increased. With anuria, the interval between doses can be 48 hours.

With a creatinine clearance of 80 ml / min or more, the interval between taking Amoxiclav is 8 hours, with a clearance of 80-50 ml / min - 8 hours, with a clearance of 50-10 ml / min - 12 hours, with a clearance of 10 ml / min and less than 0 24 hours.

Amoxiclav - suspension. The exact dose of Amoxiclav suspension for pediatric patients is calculated only taking into account body weight.
Before preparing the suspension of the drug, the vial is shaken well until the powder particles are separated from the bottom and walls of the vessel. 86 ml of water is added to the vial in 2 doses, after each addition of water, the vial is thoroughly shaken. 1 measuring spoon for taking Amoxiclav suspension contains 5 ml of the drug; half - 2.5 ml; ¾ - 3.75 ml.

Amoxiclav for parenteral use. 30 mg Amoxiclav for intravenous administration contains 5 mg of clavulanic acid and 25 mg of amoxicillin. Preparation of Amoxiclav solution for intravenous administration: the contents of the vial are dissolved in water for injection (for Amoxiclav 600 mg - 10 ml of water; for Amoxiclav 1.2 g - 20 ml of water). The resulting solution should be administered intravenously slowly over 3-4 minutes. If the drug is administered as an intravenous infusion, then 600 mg of Amoxiclav is dissolved in 10 ml of water for injection, and then added to the infusion solution (50 ml). Amoxiclav - 1.2 g is dissolved in 20 ml of water for injection and added to 100 ml of infusion solution. Infusion is carried out intravenously for 30-40 minutes. Intravenous administration of Amoxiclav should begin no more than 20 minutes after the preparation of the solution. Freezing of Amoxiclav solution is not allowed.

Assign to children over 12 years old (or weighing 40 kg or more) and adults (intravenously) 1.2 g every 8 hours. In pediatrics - children from 3 months to 12 years old - 30 mg / kg every 8 hours. In severe cases of the disease, the drug is administered every 6 hours (for children under 3 months - 30 mg / kg every 8 hours). For children of the first days of life, including premature babies, Amoxiclav is prescribed 30 mg / kg every 12 hours. After achieving a therapeutic effect with the bolus administration of Amoxiclav, you can switch to oral administration. Amoxiclav treatment of children and adults continues for 14 days.

Application for the prevention of purulent-septic complications before surgical operations

Assign before anesthesia 1.2 g intravenously: in the case of short interventions - once, with prolonged (more than 60 minutes) an additional administration of the solution is necessary - 1.2 g (maximum - up to 4 times a day). With a high risk of developing infectious complications, Amoxiclav continues to be administered intravenously or orally in the postoperative period, especially if there were clear signs of an infectious process during the operation (in this case, intravenous use is continued after surgery).

In case of renal insufficiency, the dose for intravenous administration of the drug is calculated based on creatinine clearance: with a clearance of 30 ml / min or more, the dosage is not adjusted; with a clearance of 10-30 ml / min, therapy begins with intravenous administration of 1.2 g, then 600 mg is prescribed every 12 hours; with a clearance of 10 ml / min or less, treatment begins with intravenous administration of 1.2 g, then 600 mg intravenously is prescribed with an interval of 24 hours. In case of renal failure in children, dose adjustment is also carried out. If the patient undergoes hemodialysis, then approximately 85% of the drug is excreted from the body. After hemodialysis, Amoxiclav is prescribed at a dosage of 600 mg intravenously. Peritoneal dialysis does not remove the drug, so dose adjustment is not needed.

Amoxiclav Quiktab. Before use, the tablets are dissolved in half a glass of water (at least 100 ml). After that, the resulting suspension is thoroughly stirred or the tablet is chewed before swallowing. Amoxiclav Quiktab is best taken at the beginning of a meal.

For children weighing 40 kg or more, as well as for adults, the daily dose of Amoxiclav Quiktab is 500 mg of amoxicillin and 125 mg of clavulanic acid (1 tablet) 2-3 r / day every 8-12 hours; or 875 mg / 125 mg (1 tablet) 2 r / day every 12 hours. The usual dosage regimen for mild to moderate infections is 500 mg / 125 mg (1 tablet) 2 r / day every 12 hours. In severe cases of the disease - 875 mg / 125 mg 2 r / day every 12 hours. The duration of the course of treatment depends on the indications, which is individually determined by the doctor, but should not exceed 2 weeks.

With renal failure. The excretion of clavulanic acid and amoxicillin in renal failure is delayed, so the dosage of the drug is reduced depending on the severity of functional disorders. You can increase the interval between taking the drug. In mild renal failure with a creatinine clearance of 0.166-0.5 ml / s, Amoxiclav Quiktab is prescribed 500 mg / 125 mg (1 tablet) 2 r / day every 12 hours. With a clearance of less than 0.166 ml / s, a dose of 500 mg / 125 mg (1 tablet) is used 1 r / day (every 24 hours).

Adverse reactions

Side effects are usually temporary and mild in severity.

From the digestive system: nausea (3%), diarrhea (4.1%), dyspepsia (1.6%) and vomiting (1.8%); rarely - flatulence, anorexia, gastritis, glossitis, enterocolitis, stomatitis or discoloration of the tongue. During or after discontinuation of Amoxiclav therapy, pseudomembranous colitis may develop, caused by the formation of Clostridium difficile toxins.

From the side of the skin: angioedema, rash, urticaria, rarely - erythema multiforme, exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis.

From the nervous system: rarely - agitation, anxiety, headache, dizziness, inappropriate behavior, insomnia, convulsions, confusion, hyperactivity.

From the blood system: thrombocytopenia, anemia (including cases of hemolytic anemia), leukopenia, eosinophilia, agranulocytosis.

Hepatobiliary disorders: it is possible to increase the parameters of 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. Signs and symptoms usually occur during treatment or immediately after the end of the course, but sometimes they may not appear for several weeks after the end of therapy.

From the urinary system: hematuria and interstitial nephritis (rare).

Others: vulvovaginal candidiasis (1%) and fever; taking for a long time can provoke oral candidiasis.

Contraindications

Hepatitis or cholestatic jaundice, provoked by the use of antibacterial agents of the penicillin group in history;

Individual hypersensitivity to clavulanic acid and amoxicillin, as well as other components of Amoxiclav or penicillin preparations.

Use during pregnancy or lactation

There is no information about the teratogenic effect of the active components of Amoxiclav, therefore, according to strict indications, the drug can be prescribed during pregnancy and lactation.

Interaction with other drugs

Amoxiclav for intravenous use is compatible with water for injection, Ringer's lactate solution, isotonic sodium chloride solution, potassium chloride solution. Amoxiclav is less stable in media that contain glucose or dextran. The drug must not be mixed with other means for parenteral administration in the same volume.

Overdose

Exceeding the dose is unlikely, however, taking Amoxiclav in a large dose can cause the following symptoms: insomnia, agitation, dizziness, and rarely, convulsions. In case of an overdose, hemodialysis is possible, treatment is symptomatic.

Trade names of the drug Amoxiclav:

The active substance of the drug Amoxiclav:

Dosage forms of the drug Amoxiclav:

The therapeutic effect of the drug Amoxiclav:

Indications for use of the drug Amoxiclav:

Contraindications of the drug Amoxiclav:

Methods of application and doses of the drug Amoxiclav:

Pregnancy and lactation:

Pharmacological group of the drug Amoxiclav:

Interaction of the drug Amoxiclav with alcohol:

Side effects of the drug Amoxiclav:

Special instructions for use:

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 single-celled 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 spectrum of action 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 were simultaneously undergoing 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 undergo regular 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.

From this medical article you can get acquainted with the drug Amoxiclav. Instructions for use will explain in which cases you can take an antibiotic, what it helps with, what are the indications for use, contraindications and side effects. The annotation presents the form of release of the drug and its composition.

In the article, doctors and consumers can only leave real reviews about Amoxiclav, from which you can find out if the medicine helped in the treatment of sinusitis, otitis media, tonsillitis, pharyngitis, bronchitis, pneumonia, cholecystitis, cholangitis in adults and children. The instructions list analogues of Amoxiclav, drug prices in pharmacies, as well as its use during pregnancy and breastfeeding.

Amoxiclav is a combined antibiotic.

Composition and form of release

The drug is produced in the form of tablets:

• Amoxiclav 250 mg / 125 mg.
• Amoxiclav 2X (500 mg/125 mg; 875 mg/125 mg).
• Amoxiclav Quiktab (500 mg/125 mg; 875 mg/125 mg) is available as dispersed tablets.

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.

Produced powder for solution for intravenous injection. The bottle contains 600 mg of the product (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.

Pharmacological properties

Amoxiclav is a combination of amoxicillin, a semi-synthetic penicillin with a wide spectrum of antibacterial activity, and clavulanic acid, an irreversible beta-lactamase inhibitor. Clavulanic acid forms a stable inactivated complex with these enzymes and provides amoxicillin resistance to the effects of beta-lactamases produced by microorganisms.

Clavulanic acid, similar in structure to beta-lactam antibiotics, has a weak intrinsic antibacterial activity. Amoxiclav, instructions for use confirms this, has a wide spectrum of antibacterial action.

The drug is active against strains sensitive to amoxicillin, including strains producing beta-lactamase, incl. aerobic gram-positive bacteria, aerobic gram-negative bacteria, anaerobic gram-positive bacteria, gram-negative anaerobes.

What helps Amoxiclav

Indications for use include diseases of an infectious and inflammatory nature, which develop as a result of the influence of microorganisms sensitive to this drug. The following indications for the use of Amoxiclav are determined:

• biliary tract infections (cholangitis, cholecystitis);
• odontogenic infections;
• infections of connective and bone tissues;
• infectious diseases of soft tissues, skin (including the consequences of bites);
• infectious diseases of the lower respiratory tract (pneumonia, acute and chronic bronchitis);
• gynecological diseases of an infectious nature;
• urinary tract infections (with cystitis, with prostatitis, etc.);
• infections of ENT organs, as well as infectious diseases of the upper respiratory tract (otitis media, pharyngeal abscess, sinusitis, pharyngitis, tonsillitis).

Instructions for use and dosage

Amoxiclav for adults and children over 12 years of age (or more than 40 kg of body weight):

• the usual dose in case of mild to moderate infection is 1 tablet 250 + 125 mg every 8 hours or 1 tablet 500 + 125 mg every 12 hours;
• in case of severe infection and respiratory tract infections - 1 tablet 500 + 125 mg every 8 hours or 1 table. 875 + 125 mg every 12 hours

Tablets are not prescribed for children under 12 years of age (less than 40 kg of body weight).

The maximum daily dose of clavulanic acid (in the form of potassium salt) is 600 mg for adults and 10 mg/kg for children. The maximum daily dose of amoxicillin is 6 g for adults and 45 mg/kg for children.

The course of therapy 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.

Dosage for renal insufficiency: for patients with moderate renal insufficiency (Cl creatinine - 10-30 ml / min), the dose is 1 table. 500 + 125 mg every 12 hours;

for patients with severe renal insufficiency (Cl creatinine less than 10 ml / min), the dose is 1 table. 500 + 125 mg every 24 hours

Dosage for odontogenic infections: 1 tab. 250 +125 mg every 8 hours or 1 tab. 500 + 125 mg every 12 hours for 5 days.

Contraindications

According to the instructions, Amoxiclav is contraindicated in the following cases:

• the presence of infectious lymphocytic leukemia or mononucleosis;
• high sensitivity of the patient to the main or additional components of the drug;
• high sensitivity to beta-lactam antibiotics, cephalosporins, penicillins;
• a history of liver dysfunction caused by the use of the drug (amoxicillin, clavulanic acid).

In addition, the use of Amoxiclav should be limited in severe renal impairment, liver failure, gastrointestinal diseases, history of pseudomembranous colitis. When taking anticoagulants, the drug must be used in the maximum permissible doses.

Side effect

• exfoliative dermatitis;
• dizziness, headache;
• convulsions (may occur in patients with impaired renal function when taking the drug in high doses);
• eosinophilia;
• thrombocytopenia;
• diarrhea;
• insomnia;
• loss of appetite;
• interstitial nephritis;
• anaphylactic shock;
• allergic vasculitis;
• nausea, vomiting;
• Stevens-Johnson syndrome;
• hemolytic anemia;
• crystalluria;
• itching, urticaria, erythematous rash;
• development of superinfection (including candidiasis);
• stomach ache;
• angioedema;
• reversible leukopenia (including neutropenia);
• sense of anxiety.

For kids

Children antibiotic Amoxiclav should be taken only after a doctor's prescription. It is important to adhere to the indicated dosage. Children under 12 years of age are usually prescribed a suspension. The dosage of Amoxiclav suspension for children depends on the severity of the disease and the diagnosis. As a rule, children under 2 years of age are prescribed a dose of 62.5 mg, at the age of 2 to 7 years - 125 mg, at the age of 7 to 12 years - 250 mg.

During pregnancy and lactation

Amoxiclav during pregnancy can be used if the expected effect outweighs the possible harm to the fetus. It is undesirable to use the drug in early pregnancy.

The 2nd trimester and 3rd trimester are more preferable, but even during this period, the dosage of Amoxiclav during pregnancy should be observed very accurately. When breastfeeding is not prescribed, since the active components of the drug penetrate into breast milk.

Interaction

Diuretics, phenylbutazone, allopurinol and non-steroidal anti-inflammatory drugs that block tubular secretion increase the concentration of the drug in the patient's body.

When Amoxiclav interacts with laxatives, antacids, aminoglycosides, glucosamine, the absorption of the drug slows down. When interacting with ascorbic acid, on the contrary, absorption increases.

Amoxiclav increases the toxicity of methotrexate. Simultaneous administration of the drug with allopurinol can lead to an increase in the incidence of exanthema. It is not recommended to take together with disulfiram.

The combined use of anticoagulants and Amoxiclav may increase the interval of prothrombosis. Interaction with rifampicin leads to a weakening of the antibacterial properties of drugs.

The effect of the drug is reduced when used together with bacteriostatic antibiotics (tetracyclines, macrolides) and sulfonamides. Probenecid reduces the excretion of the drug by increasing its serum concentration. Amoxiclav reduces the effectiveness of oral contraceptives.

special instructions

Taking Amoxiclav with meals reduces the likelihood of side effects from the gastrointestinal tract. During course therapy, it is necessary to control the functions of the liver, hematopoiesis and kidneys. Against the background of severe renal impairment, the doctor should adjust the dosing regimen or increase the interval between taking the medication.

Analogues of the drug Amoxiclav

Full analogues containing the same active substances are:

1. Arlet.
2. Amocomb.
3. Amoxiclav Quiktab.
4. Bactoclav.
5. Verclave.
6. Klamosar.
7. Liklav.
8. Medoklav.
9. Panklav.
10. Rapiclav.
11. ranclave.
12. Taromentin.
13. Flemoklav Solutab.
14. Ecoclave.

Price

In pharmacies, the price of Amoxiclav (Moscow) 250 mg + 125 mg tablets is 235 rubles. Powder for the preparation of an intravenous solution 1 g + 200 mg costs 845 rubles for 5 vials.