Flemoxin SoluTab pills 1000mg №20

Mechanism of action

A bactericidal, acid-resistant broad-spectrum antibiotic from the group of semi-synthetic penicillins.

Active against Gram-positive and Gram-negative microorganisms:Streptococcus pyogenes, Streptococcus pneumoniae, Clostridium tetani, Clostridium welchii, Neisseria gonorrhoeae, Neisseria meningitidis, Staphylococcus aureus (which do not produce β-lactamases), Bacillus anthracis, Listeria monocytochenturize, ancestrophysis, which is not only producing β-lactamases, Bacillus anthracis, Listeria monocytois, anheroephrope, which is not β-lactamase, non-β-lactamase, Bacillus anthracis, Bacillus anthracis aureus, Staphylococcus aureus

Less active against Enterococcus faecalis, Escherichia coli, Proteus mirabilis, Salmonella typhi, Shigella sonnei, Vibrio cholerae.

Inactive against microorganisms that produce β-lactamase, Pseudomonas spp., Proteus spp. (indole-positive strains), Serratia spp., Enterobacter spp.

Suction

After ingestion, Amoxicillin is absorbed quickly and almost completely (93%), acid resistant. Eating almost no effect on the absorption of the drug. After oral administration of 500 mg of Amoxicillin C_max the active substance, which is 5 mcg / ml, is noted in the blood plasma after 2 h. With an increase or decrease in the dose of the drug in 2 times C_max in blood plasma also changes 2 times.

Distribution

About 20% of amoxicillin binds to plasma proteins. Amoxicillin penetrates mucous membranes, bone tissue, intraocular fluid and sputum in therapeutically effective concentrations. The concentration of amoxicillin in bile exceeds its concentration in the blood plasma by 2-4 times. In amniotic fluid and umbilical cord vessels, amoxicillin concentration is 25-30% of its level in the blood plasma of a pregnant woman.Amoxicillin poorly penetrates the BBB; however, during inflammation of the meninges, the concentration in the cerebrospinal fluid is about 20% of the concentration in the blood plasma.

Metabolism

Amoxicillin is partially metabolized in the liver, most of its metabolites are not microbiologically active.

Removal

Amoxicillin is eliminated predominantly by the kidneys, about 80% by tubular excretion, 20% by glomerular filtration.

In the absence of renal dysfunction T_1/2 Amoxicillin is 1-1.5 hours. In premature babies, newborns and children younger than 6 months - 3-4 hours.

Pharmacokinetics in special clinical situations

T_1/2 Amoxicillin does not change in violation of liver function.

In case of impaired renal function (CC ≤ 15 ml / min) T_1/2 Amoxicillin increases and reaches 8.5 hours during anuria.

Indications and usage

Infectious and inflammatory diseases caused by microorganisms sensitive to the drug:

- respiratory infections;

- infections of the genitourinary system;

- infections of the digestive tract;

- infections of the skin and soft tissues.

The drug is taken orally. The drug is prescribed regardless of the meal. The pill can be swallowed whole, divided into parts or chewed, washed down with a glass of water, and can also be diluted in water to form a syrup (in 20 ml) or a suspension (in 100 ml), which have a pleasant fruity taste.

Instructions for use / dosage set individuallytaking into account the severity of the disease, the sensitivity of the pathogen to the drug, the patient's age.

Wheninfectious and inflammatory diseases of mild to moderate severityIt is recommended to use the drug according to the following scheme:for adults and children over 10 years old appoint 500-750 mg 2 times / day or 375-500 mg 3 times / day;children aged 3 to 10 years appoint 375 mg 2 times / day or 250 mg 3 times / day;children aged 1 to 3 years appoint 250 mg 2 times / day or 125 mg 3 times / day.

Daily dose of the drug for children (including children up to 1 year) is 30-60 mg / kg / day, divided into 2-3 doses.

Athard-to-reach foci of infection (for example, acute otitis media) is recommended three times.

Atchronic diseases, recurrent infections, severe infections for adults appoint 0.75-1 g 3 times / day;for children - 60 mg / kg / day, divided into 3 doses.

Atacute uncomplicated gonorrhea prescribe 3 g of the drug in 1 reception in combination with 1 g of probenecid.

atQC≤10 ml / min the dose of the drug is reduced by 15-50%.

Whenmild to moderate infections the drug is taken within 5-7 days. However, for infections caused by Streptococcus pyogenes, the duration of treatment should be at least 10 days.

In the treatment ofchronic diseases, severe infectionsthe duration of the drug should be determined by the clinical picture of the disease.

The drug should be continued for 48 hours after the disappearance of the symptoms of the disease.

Adverse reactions

Gastrointestinal: rarely - a change in taste, nausea, vomiting, diarrhea; in some cases - a moderate increase in the activity of hepatic transaminases; very rarely, pseudomembranous and hemorrhagic colitis.

Urogenital: very rarely - the development of interstitial nephritis.

Hemic and lymphatic: very rarely - agranulocytosis, neutropenia, thrombocytopenia, hemolytic anemia.

Allergic reactions: skin reactions, mainly in the form of a specific maculopapular rash; rarely, erythema multiforme exudative (Stevens-Johnson syndrome); in some cases - anaphylactic shock, angioedema.

Side effects from the nervous system when using amoxicillin in the form of dispersible pills are not registered.

Contraindications

- Hypersensitivity to the drug or other beta-lactam antibiotics.

with caution the drug should be used in case of polyvalent hypersensitivity to xenobiotics, infectious mononucleosis, lymphocytic leukemia, gastrointestinal tract history (especially for colitis associated with the use of antibiotics), renal failure, during pregnancy and lactation.

Pregnancy and Breastfeeding

Drug useFlemoxin Solutab during pregnancy and lactation is possible if the expected positive result from the use of the drug exceeds the risk of side effects.

In small quantities, amoxicillin is excreted in breast milk, which can lead to the development of sensitization phenomena in a child.

atQC≤10 ml / min the dose of the drug is reduced by 15-50%.

It is necessary to administer the drug to patients with infectious mononucleosis and lymphocytic leukemia with caution, since there is a high probability of the appearance of exanthema of non-allergic genesis.

The presence of erythroderma in history is not a contraindication for the appointment of Flemoxin Solutab.

Cross-resistance and cross-hypersensitivity with penicillin preparations, cephalosporins are possible.

As with the use of other penicillin preparations, the development of superinfection is possible.

The appearance of severe diarrhea, characteristic of pseudomembranous colitis, is an indication for discontinuation of the drug.

Overdosage

Symptoms: dysfunction of the digestive tract - nausea, vomiting, diarrhea; vomiting and diarrhea can be a violation of water and electrolyte balance.

Treatment: designate gastric lavage, Activated carbon, saline laxatives; apply measures to maintain water and electrolyte balance.

Drug Interactions

Probenecid, phenylbutazone, oxyphenbutazone, to a lesser extent - Acetylsalicylic acid and sulfinpyrazone inhibit the tubular secretion of penicillin preparations, which leads to an increase in T_1/2 and increasing the concentration of amoxicillin in the blood plasma.

Bactericidal antibiotics (including aminoglycosides, cephalosporins, Vancomycin, rifampicin) while receiving concurrently show synergism.

Antagonism is possible when taken with certain bacteriostatic drugs (for example, chloramphenicol, sulfonamides).

Simultaneous administration of amoxicillin with estrogen-containing oral contraceptives may decrease the effectiveness of the latter and increase the risk of acyclic bleeding.

The simultaneous use of amoxicillin with Allopurinol does not increase the frequency of skin reactions in contrast to the combination of allopurinol with ampicillin