Amoxiclav pills 625mg №15

Active ingredient and dosage form

Coated Tablets white or almost white, oval, biconvex.
1 pill of 625 mg contains Amoxicillin (as trihydrate) 500 mg and clavulanic acid (as potassium salt) 125 mg;
15 pieces packaged.

Mechanism of action

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 b-lactamase type 1, produced by Enterobacter spp., Morganella morganii, Pseudomonas aeruginosa, Serratia spp., Acinetobacter spp.
This combination provides a high bactericidal activity of Amoxiclav (including in relation to amoxicillin-resistant microorganism strains). Clavulanic acid, having a higher affinity for b-lactamase than amoxicillin, forms a stable deactivated complex with the enzyme, preventing the enzymatic degradation of amoxicillin under the action of b-lactamase.
Thus, Amoxiclav acts bactericidal on a wide range of gram-positive and gram-negative bacteria (including strains that have become resistant to beta-lactam antibiotics due to the production of b-lactamase).
Amoxiclav active against aerobic gram-positive bacteria: Streptococcus spp.(including Streptococcus pneumoniae, Streptococcus viridans, Streptococcus milleri, ryptows rye, Streptococcus pyogenes, Streptococcus bovis), Enterococcus faecium, Staphylococcus aureus (except for methicillin-resistant strains), Staphylococcus epitheypoury, aureus, Staphylococcus aureus (except methicillin-resistant strains), Staphylococcus epitheypoury, aureus, Staphylococcus aureus (except methicillin-resistant strains), Staphylococcus epitheypush, p'eurectus, aureus (except methicillin-resistant strains), Staphylococcus epiderheypush, apycarty, aureus, Staphylococcus aureus (except methicillin-resistant strains) monocytogenes, Nocardia asteroides; aerobic gram-negative bacteria: Aeromonas spp., Bordetella pertussis, Brucella spp., Campylobacter jejuni, Campylobacter coli, Citrobacter spp. (moderately sensitive), Escherichia coli, Gardnerella vaginalis, Haemophilus ducreyi, Haemophilus influenzae, Helicobacter pylori, Klebsiella spp., Legionella pneumophila, Moraxella catarrhalis, Morganella spp. (moderately sensitive), Neisseria gonorrhoeae, Neisseria meningitidis, Pasteurella multocida, Proteus mirabilis, Proteus vulgaris, Providencia spp., Salmonella spp., Shigella spp., Vibrio cholerae, Yersinia enterocolitica (Shigella spp., Vibrio cholerae, Yersinia enterocolitica (Shigella spp., Vibrio cholerae, Yersinia enterocolitica (Shigella spp., Vibrio cholerae, Yersinia enterocolitica (Shigella spp., Vibrio cholerae, Yersinia enterocolitica (Shigella spp., Vibrio cholerae, Yersinia enterocolitica (Shigella spp., Vibrio cholerae, Yersinia enterocolitica (Shigella spp., Vibrio cholerae, Yersinia enterocolitica) anaerobic bacteria: Actinomyces israelii, Bacteroides spp. (including Bacteroides fragilis), Prevotella melaninogenica, Clostridium spp. (except Clostridium difficile), Peptostreptococcus spp., Eikenella corrodens, Fusobacterium spp., Propionibacterium spp., Treponema pallidum.
To drug moderately sensitive Mycobacterium tuberculosis, Mycobacterium fortuitum, Mycobacterium bovis, Mycobacterium kansasii.
To drug steady Mycobacterium chelonae.

Indications and usage

Treatment of infectious and inflammatory diseases caused by microorganisms sensitive to the drug:
- infections of the upper respiratory tract and upper respiratory tract (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;
- infections of the skin and soft tissues;
- infections of bones and joints;
- infections of the biliary tract (cholecystitis, cholangitis);
- odontogenic infections.

Dosage and administration

Adults and children over 12 years old (or with a body weight of more than 40 kg) with mild or moderate infection appoint 1 tab. 375 mg every 8 hours or 1 tab. 625 mg every 12 hours, in the case of severe infection and respiratory infections - 1 tab.625 mg every 8 hours or 1 tab. 1000 mg every 12 hours
The drug in the form of pills is not prescribed. children under 12 years old (weighing less than 40 kg).

The maximum daily dose of clavulanic acid is for adults - 600 mg for kids - 10 mg / kg body weight.
The maximum daily dose of amoxicillin is for adults - 6 g for kids - 45 mg / kg body weight.
The course of treatment is 5-14 days. The duration of treatment is determined by the attending physician. Treatment should not last more than 14 days without re-medical examination.

With odontogenic infections appoint 1 tab. 375 mg every 8 hours or 1 tab. 625 mg every 12 hours for 5 days.
In moderate renal failure (CC 10-30 ml / min) appoint 1 tab. 625 mg every 12 hours
with severe renal failure (CC less than 10 ml / min) - 1 tab. 625 mg every 24 hours
With anuria, the interval between doses should be increased to 48 hours or more.

Adverse reactions

Gastrointestinal: possible loss of appetite, nausea, vomiting, diarrhea; rarely, a transient increase in liver enzymes (ALT, AST), abnormal liver function; in rare cases - cholestatic jaundice, hepatitis, pseudomembranous colitis.
Allergic reactions: erythematous rash, pruritus, urticaria; rarely, exudative erythema multiforme, angioedema, and anaphylactic shock; in rare cases - exfoliative dermatitis, Stevens-Johnson syndrome.
Other: rarely - the development of superinfection, candidiasis.

Contraindications

- cholestatic jaundice or abnormal liver function caused by taking amoxicillin / clavulanic acid in history;
- hypersensitivity to amoxicillin, clavulanic acid or penicillins.
Carefully It should appoint a drug for allergic reactions to cephalosporins and pseudomembranous colitis in history, liver failure, severe renal impairment.
Due to the fact that a large number of patients with infectious mononucleosis and lymphocytic leukemia who received ampicillin, the appearance of an erythematous rash was observed, the use of ampicillin antibiotics in these patients is not recommended.

Pregnancy and breastfeeding

Amoxicillin and clavulanic acid pass in small quantities into breast milk.
Amoxiclav can be used during pregnancy in cases where the expected benefit to the mother outweighs the potential risk to the fetus.

In the course of treatment should be monitored the function of blood, liver and kidneys.
Patients with severe impaired renal function require an adequate correction of the dosing regimen or an increase in the intervals between dosing.
In order to reduce the risk of adverse reactions from the gastrointestinal tract should take the drug during meals.
When using Amoxiclav, a false positive reaction is possible when determining the level of glucose in the urine using Benedict's reagent or Felling's solution (it is recommended to use enzymatic reactions with glucose oxidase).
Since pills 375 mg (250/125) and 625 mg (500/125) contain the same amount of clavulanic acid - 125 mg, then 2 tab. 375 mg are not equivalent to 1 tab. 625 mg.
Concurrent administration with disulfiram should be avoided.

Overdosage

There are no reports of death or life-threatening side effects due to overdose of the drug.
Symptoms: abdominal pain, diarrhea, vomiting; it is also possible anxiety, insomnia, dizziness; in some cases - seizures.
Treatment: in the case of recent administration of the drug (less than 4 hours), it is necessary to carry out a gastric lavage and to appoint activated charcoal to reduce the absorption of the drug; if necessary, conduct symptomatic therapy. Effective hemodialysis.

With simultaneous use of Amoxiclav and indirect anticoagulants, an increase in prothrombin time has been observed. Therefore, this combination is appointed with caution.
With the simultaneous use of Amoxiclav with Allopurinol increases the risk of side effects such as rash.
With simultaneous use Amoxiclav enhances the toxicity of Methotrexate .
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 because of the possible reduction in the effectiveness of Amoxiclav.
With simultaneous use of Amoxiclav reduces the effectiveness of oral contraceptives.

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