Flemoclav soljutab pills 500mg + 125mg №20

Tablets of oblong form from white to yellow with brown dot spots without risks, having the marking: "421" - at a dosage of 125 mg + 31.25 mg; “422” - 250 mg + 62.5 mg; "424" - 500 mg + 125 mg and the logo of the company.

Mechanism of action

Antibacterial broad spectrum.

Indications and usage

Infectious and inflammatory diseases caused by microorganisms susceptible to the drug: upper respiratory tract and ENT organs (including otitis media, sinusitis, tonsillitis, pharyngitis); lower respiratory tract (chronic bronchitis and its exacerbations, community-acquired pneumonia); skin and soft tissue; kidney and lower urinary tract.

Contraindications

Hypersensitivity to Amoxicillin, clavulanic acid or other components. Hypersensitivity to beta-lactam antibiotics such as penicillins and cephalosporins. Jaundice or liver dysfunction when taking amoxicillin / clavulanate in history. Patients with infectious mononucleosis or lymphocytic leukemia increase the risk of exanthema, therefore amoxicillin / clavulanic acid should not be administered in the presence of these diseases; This dosage form should not be used in children under 2 years.

Severe hepatic impairment, gastrointestinal disorders (including colitis in history, associated with the use of penicillins), chronic renal failure.
Use during pregnancy and breastfeeding: During the first trimester, the drug should be administered with caution. Use in the II and III trimesters of pregnancy is considered safe.

Amoxicillin is excreted in breast milk. There is no data on the secretion of clavulanic acid in breast milk. There were no adverse effects on the baby while breastfeeding while taking a combination of amoxicillin and clavulanic acid.

Adverse reactions

Allergic skin reactions: urticaria, rash; erythematous rash, rarely - exudative erythema multiforme, extremely rare - exfoliative dermatitis, exudative malignant erythema (Stevens-Johnson syndrome), erythema multiforme. Reactions depend on the dose of the drug and the patient's condition.
On the part of the digestive tract: nausea, vomiting, diarrhea, abdominal pain; abnormal liver function, increased activity of hepatic transaminases, in isolated cases - pseudomembranous colitis.
An increase in transaminase activity (AST and ALT), bilirubin and alkaline phosphatase is usually observed in males and in elderly patients, especially those over 65 years of age. To prevent adverse effects, it is recommended to take the drug at the beginning of the meal. The risk of such changes increases when taking the drug for more than 14 days.These phenomena are very rarely observed in children. The above changes usually appear during treatment or immediately after. Sometimes it may appear a few weeks after discontinuation of the drug. Most reactions from the digestive system are transient and insignificant, but sometimes are pronounced.
On the part of the blood system and lymphatic system: rarely - changes in the composition of the blood (leukopenia, thrombocytopenia, hemolytic anemia); prolongation of prothrombin time (reversible).
On the part of the hepatobiliary system: rarely - cholestatic jaundice, hepatitis.
On the part of the immune system: rarely - angioedema, vasculitis.
On the part of the urinary system: interstitial nephritis.
Others: candidiasis, development of superinfection. In rare cases - anaphylactic shock.

Drug Interactions

Antacids, Glucosamine, laxatives, drugs, aminoglycosides slow down and reduce absorption; Ascorbic acid - increases.

Bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, Vancomycin, rifampicin) have a synergistic effect; bacteriostatic antimicrobial agents (macrolides, chloramphenicol, linkosamides, tetracyclines, sulfonamides) - antagonistic.

Increases the effectiveness of indirect anticoagulants (suppresses the intestinal microflora, reduces the synthesis of vitamin K and the prothrombin index).At the same time taking anticoagulants, it is necessary to monitor blood clotting rates.

Decreases the effectiveness of oral contraceptives, drugs, in the process of metabolism which produces para-aminobenzoic acid, ethinyl estradiol - the risk of breakthrough bleeding.

Diuretics, Allopurinol, phenylbutazone, NSAIDs and other drugs that block tubular secretion, increase the concentration of amoxicillin (clavulanic acid is derived mainly by glomerular filtration). Allopurinol increases the risk of skin rash.

Amoxicillin should not be administered with disulfiram.

The simultaneous use of amoxicillin and Digoxin can lead to an increase in the concentration of digoxin in the blood plasma.

Overdosage

Symptoms: nausea, vomiting and diarrhea with possible disturbance of water and electrolyte balance.

Treatment: the appointment of Activated carbon. Maintain water and electrolyte balance. Symptomatic therapy. When convulsions prescribed diazepam. In the case of severe renal failure - hemodialysis.

Inside, at the beginning of a meal (to prevent dyspeptic symptoms), without chewing, drinking a glass of water, or dissolving the pill in half a glass of water (minimum 30 ml), thoroughly stirred before use.

The duration of treatment depends on the severity of the infection and should not, without special need, exceed 14 days.

Adults and children weighing more than 40 kg are prescribed the drug 500/125 mg 3 times a day. For severe, recurrent and chronic infections, these doses can be doubled.

For children aged 2 to 12 years (weighing about 13–37 kg), the daily dose is 20–30 mg / kg of amoxicillin and 5–7.5 mg / kg of clavulanic acid. This usually amounts to: for children 2–7 years old (body weight about 13–25 kg) - 125 / 31.25 mg 3 times a day; for children of 7–12 years old (body weight 25–37 kg) - 250 / 62.5 mg 3 times a day. In severe infections, these doses can be doubled (the maximum daily dose is 60 mg / kg of amoxicillin and 15 mg / kg of clavulanic acid).

In patients with renal insufficiency, the elimination of clavulanic acid and amoxicillin through the kidneys is delayed.

Patients with liver damage should be prescribed amoxicillin with clavulanic acid with caution. Liver function must be continuously monitored.

With the development of Anaphylactic reactions, treatment should be discontinued immediately and replaced with another appropriate therapy.

To relieve anaphylactic shock, it may be necessary to urgently administer adrenaline, corticosteroids, and eliminate respiratory failure.

There is the possibility of cross-resistance and hypersensitivity with other penicillins or cephalosporins. As with the use of other broad-spectrum penicillins, superinfections of fungal or bacterial origin (particularly candidiasis) can occur, especially in patients with chronic diseases and / or impaired immune system function.In the case of superinfection, taking the drug is canceled and / or appropriate therapy is selected.

In patients with impaired renal function, the dose should be selected based on the severity of the condition.

For patients with impaired liver function, amoxicillin / clavulanic acid combination should be administered with caution and under constant medical supervision. Flemoclav Solutab should not be used for more than 14 days without an assessment of liver function.

Amoxicillin / clavulanic acid should be administered with caution to patients receiving anticoagulant therapy.

Nonenzymatic methods for determining urine sugar, as well as the test for urobilinogen, can give false positive results.

In the course of treatment, it is necessary to monitor the state of the function of the blood-forming organs, liver and kidneys.