Amoxicillin pills 500mg №12

It is indicated for oral therapy of the following bacterial infections caused by amoxicillin-sensitive gram-positive and gram-negative pathogens:

- infections of the upper respiratory tract, including infections of the ear, nose and throat: acute otitis media, acute sinusitis and pharyngitis.

- lower respiratory tract infections: exacerbation of chronic bronchitis, community-acquired pneumonia.

- infections of the lower urinary tract: cystitis.

- infections of the gastrointestinal tract: bacterial enteritis. Combination therapy may be required for infections caused by anaerobic microorganisms.

- endocarditis: prevention of endocarditis in patients at risk for the development of endocarditis - for example, during dental procedures.

Inside

Infection Therapy:

As a rule, therapy is recommended to continue for 2-3 days after the symptoms disappear. In the case of infections caused by β-hemolytic streptococcus, complete eradication of the pathogen requires therapy for at least 10 days.

Parenteral therapy is indicated when oral inability is impossible and in the treatment of severe infections.

Adult dosages (including elderly patients):

Standard dose:

The usual dose ranges from 750 mg to 3 g of amoxicillin per day in divided doses. In some cases, it is recommended to limit the dose of 1500 mg per day in several doses.

Short course of therapy:

Uncomplicated urinary tract infections: double administration of the drug in 3 g for each injection with an interval between doses of 10 to 12 hours.

Children's dosages (up to 12 years)

The daily dose for children is 25–50 mg / kg / day in several doses (maximum 60 mg / kg / day) depending on the indication and the severity of the disease.

Children weighing more than 40 kg should receive an adult dosage.

Dosing for renal failure:

In patients with severe renal insufficiency, the dose should be reduced. With renal clearance of less than 30 ml / min, an increase in the interval between doses or a decrease in subsequent doses is recommended. In case of renal insufficiency, short courses of therapy are contraindicated. 3

Adults (including elderly patients):

In hemodialysis: 500 mg should be administered after the end of the procedure.

Impaired renal function in children weighing less than 40 kg:

Endocarditis prevention

For the prevention of endocarditis in patients who are not under general anesthesia, 3 g of amoxicillin should be administered 1 h before the operation and, if necessary, 3 g more after 6 h.

Children are recommended to administer amoxicillin 50 mg / kg.

For more detailed information and a description of the categories of patients at risk for endocarditis, refer to the local official guidelines.

Adverse reactions

Side effects are classified as follows:

Often: 10%, or less often, but more often 1%

Infrequently: 1%, or less often, but more often 0.1%

Seldom. 0.1% or less, but more often 0.01%

Very rarely, including isolated cases: 0.01% or less.

Infrequently

Prolonged and repeated use of the drug can lead to the development of superinfection and colonization of resistant microorganisms or fungi, for example, oral and vaginal candidiasis.

Seldom

Eosinophilia and hemolytic anemia.

Very rarely

Isolated cases of leukopenia, granulocytopenia, thrombocytopenia, pancytopenia, anemia, myelosuppression, agranulocytosis, lengthening of bleeding time and prothrombin time have been reported. All changes were reversible upon cessation of therapy.

Seldom

Laryngeal edema, serum sickness, allergic vasculitis, anaphylaxis and anaphylactic shock in rare cases.

Seldom

Reactions from the central nervous system are rare and include hyperkinesis, dizziness and convulsions.Seizures may occur in patients with renal insufficiency or in patients receiving high doses of the drug.

Often

Discomfort, nausea, loss of appetite, vomiting, flatulence, liquefied stools, diarrhea, enanthema (especially on the oral mucosa), dry mouth, a violation of taste perception. As a rule, the listed effects are characterized by mild severity and often disappear as the therapy continues or very quickly after its cessation. To reduce the frequency of these complications by taking amoxicillin with food.

With the development of severe persistent diarrhea, it is necessary to take into account the possibility of a very rare complication, pseudomembranous colitis. It is contraindicated in the appointment of drugs that suppress peristalsis.

Very rarely

The appearance of black coloring language.

Infrequently

Transient moderate increase in liver enzymes. Rare cases of hepatitis and cholestatic jaundice.

Often

Skin reactions in the form of exanthema, itching, urticaria; a typical core-like exanthema appears on days 5-11 from the start of therapy. The immediate development of urticaria is indicative of an allergic reaction to amoxicillin and requires discontinuation of therapy.

Rare (see also section 4.4)

Angioedema (angioedema), exudative erythema multiforme, acute generalized pustular eruptions, Stevens-Johnson syndrome, toxic epidermal necrolysis, bullous and exfoliative dermatitis.

Seldom

In rare cases, acute interstitial nephritis.

Seldom

In rare cases, the development of drug fever.

- hypersensitivity to penicillin;

- It is also necessary to take into account the possibility of cross-allergy with other beta-lactam antibiotics, such as cephalosporins, carbopenems.

Carefully:

- Ospamox should be used with caution in patients with allergic diathesis and asthma.

- in patients with renal failure, amoxicillin elimination may be delayed, which, depending on the degree of insufficiency, may require a decrease in the daily dose of the drug.

- with caution should be used in children, premature babies and newborns: it is necessary to monitor the function of the kidneys, liver and hematological parameters.

- Ospamox should be used with caution in patients with viral infections, acute lymphoblastic leukemia and infectious mononucleosis (due to an increased risk of erythematous rash on the skin).

Pregnancy and Breastfeeding

The use of the drug during pregnancy is possible only in the case when the intended benefit to the mother exceeds the potential risk to the fetus.

If necessary, the use of the drug during lactation should decide on the termination of breastfeeding.

In patients with renal insufficiency, amoxicillin elimination may be delayed, which, depending on the degree of insufficiency, may require a decrease in the daily dose of the drug.

It should be used with caution in children, premature babies and newborns: it is necessary to monitor kidney function, liver function and hematological parameters.

Before starting amoxicillin therapy, it is important to ensure that there are no history of hypersensitivity reactions to penicillins and cephalosporins that can cause a cross-allergic reaction (10-15%).

There are reports of the development of severe, sometimes fatal, hypersensitivity reactions (anaphylactoid) during therapy with penicillin. These reactions are more common in people with a history of hypersensitivity to beta-lactams.

In the presence of severe disorders of the gastrointestinal tract with diarrhea and vomiting, do not use Ospamox, since these conditions can reduce its absorption. Such patients recommended the appointment of parenteral form of amoxicillin.

With the development of severe persistent diarrhea, the likelihood of pseudomembranous colitis (in most cases caused by Clostridiumdifficile) must be considered.

Prolonged use of amoxicillin in some cases can lead to the growth of bacteria and fungi that are insensitive to it.In this regard, patients should be closely monitored for the development of superinfection.

Anaphylactic shock and other severe manifestations of allergic reactions after oral administration of amoxicillin is rare. In the event of such a reaction, it is necessary to conduct a complex of urgent measures: in / in the administration of epinephrine, then antihistamines, volume replacement and the administration of glucorticoids. Patients need careful observation and other therapeutic procedures if necessary (artificial respiration, oxygen).

The presence of amoxicillin in high concentrations in the urine can cause the drug to precipitate in the urinary catheter, so catheters should be checked periodically.

When using amoxicillin in high doses in order to minimize the risk of amoxicillin crystalluria, it is important to monitor the adequacy of fluid intake and elimination.

Forced diuresis leads to a decrease in the concentration of amoxicillin in the blood as a result of the acceleration of its elimination.

Diarrhea can contribute to the deterioration of absorbability and reduce the effectiveness of drugs.

When determining the presence of glucose in the urine during therapy with amoxicillin, it is recommended to use enzymatic glucose oxidant methods. When using chemical methods, a high concentration of amoxicillin in the urine can be the cause of frequent false positive results of the study.

Amoxicillin may reduce urine estriol concentration in pregnant women.

In high concentrations, amoxicillin may reduce blood glucose levels.

Amoxicillin may affect the results of protein studies using colorimetric analysis.

Symptoms

Amoxicillin does not usually cause acute toxic effects, even with the occasional high dose. Overdose can manifest symptoms of gastrointestinal disorders, violation of water and electrolyte balance. In patients with severe renal insufficiency, overdose with large doses of amoxicillin may be accompanied by signs of nephrotoxicity and crystalluria.

Therapy

Specific antidote amoxicillin does not exist.

Therapy includes the introduction of Activated carbon (indications for gastric lavage, as a rule, no) or symptomatic measures. Special attention should be paid to the water-electrolyte balance. Perhaps the use of hemodialysis.

Combined use is not recommended:

Allopurinol

Combined use with Allopurinol can lead to the development of allergic skin reactions.

Digoxin

It is possible to increase the absorbability of Digoxin during therapy with the drug Ospamox.

Anticoagulants

The combined use of amoxicillin and anticoagulants, such as coumarin, may increase the likelihood of bleeding due to prolonged prothrombin time. When prescribing anticoagulants along with Ospamox, monitoring of homeostatic parameters is required.

Probenecid

Probenecid inhibits the excretion of amoxicillin through the kidneys, and leads to an increase in the concentration of amoxicillin in the bile and blood.

Other antibiotics

There is a possibility of antagonism of the action of amoxicillin with the simultaneous administration of bacteriostatic drugs: macrolides, tetracyclines, sulfonamides and chloramphenicol.

Methotrexate

The combined use of Methotrexate and amoxicillin may increase the degree of methotrexate toxicity, possibly as a result of competitive inhibition of tubular renal secretion of methotrexate by amoxicillin.

Amoxicillin should be used with caution with the following drugs:

Oral hormonal contraceptives

The use of amoxicillin can lead to a transient decrease in the concentration of estrogen and Progesterone in the blood, and can reduce the effectiveness of contraceptives. In this regard, it is recommended to use other non-hormonal methods of contraception at the time of treatment with amoxicillin.

The drug should be stored at a temperature not higher than 25 ° C.

The drug should not be used after the expiration date printed on the package.

The drug is available on prescription.