$38.30
Manufacturer: Slovenia
Description
Ingredients
Active ingredients:
amoxicillin (as trihydrate) 875 mg;
clavulanic acid (as potassium salt) 125 mg;
Excipients:
colloidal silicon dioxide – 12 mg;
crospovidone – 61 mg;
croscarmellose sodium – 47 mg;
magnesium stearate – 17.22 mg;
MCC up to 1435 mg.
pharmachologic effect
Pharmacodynamics
Amoxiclav® is a combination of amoxicillin and clavulanic acid.
Amoxicillin is a semi-synthetic penicillin (beta-lactam antibiotic) that inhibits one or more enzymes (often referred to as penicillin-binding proteins, PBPs) in the biosynthesis pathway of peptidoglycan, which is an integral structural component of the bacterial cell wall. Inhibition of peptidoglycan synthesis leads to a loss of cell wall strength, which usually leads to lysis and death of microorganism cells.
Amoxicillin is destroyed by the action of beta-lactamases produced by resistant bacteria, so the spectrum of activity of amoxicillin does not include microorganisms that produce these enzymes.
Clavulanic acid is a beta-lactam structurally related to penicillins. It inhibits some beta-lactamases, thereby preventing the inactivation of amoxicillin and extending its spectrum of activity to include bacteria normally resistant to amoxicillin as well as to other penicillins and cephalosporins. By itself, clavulanic acid does not have a clinically significant antibacterial effect.
The drug Amoxiclav® has a bactericidal effect in vivo on the following microorganisms:
– gram-positive aerobes – Staphylococcus aureus *, Streptococcus pneumoniae, Streptococcus pyogenes;
– gram-negative aerobes – Enterobacter spp.**, Escherichia coli*, Haemophilus influenzae*, species of the genus Klebsiella*, Moraxella catarrhalis* (Branhamella catarrhalis).
The drug Amoxiclav® has a bactericidal effect in vitro on the following microorganisms (however, the clinical significance is still unknown):
– gram-positive aerobes – Bacillis anthracis*, species of the genus Corynebacterium, Enterococcus faecalis*, Enterococcus faecium*, Listeria monocytogenes, Nocardia asteroides, coagulase-negative staphylococci* (including Staphylococcus epidermidis), Streptococcus agalactiae, other species of the genus Streptococcus, Streptococcus viridans;
– Gram-positive anaerobes – species of the genus Clostridium, species of the genus Peptococcus, species of the genus Peptostreptococcus;
– Gram-negative aerobes — Bordetella pertussis, species of the genus Brucella, Gardnerella vaginalis, Helicobacter pylori, species of the genus Legionella, Neisseria gonorrhoeae*, Neisseria meningitidis*, Pasteurella multocida, Proteus mirabilis*, Proteus vulgaris*, species of the genus Salmonella*, species of the genus Shigella*, Vibrio cholerae, Yersinia enterocolitica*;
– Gram-negative anaerobes – species of the genus Bacteroides* (including Bacteroides fragilis), species of the genus Fusobacterium*;
– others – Borrelia burgdorferi, Chlamydia spp., Leptospira icterohaemorrhagiae, Treponema pallidum.
* Some strains of these bacterial species produce beta-lactamase, which contributes to their insensitivity to amoxicillin monotherapy.
** Most strains of these bacteria are resistant to the amoxicillin/clavulanic acid combination in vitro, but this combination has been shown to be clinically effective in the treatment of urinary tract infections caused by these strains.
Indications
For all dosage forms
Infections caused by susceptible strains of microorganisms:
- upper respiratory tract and ENT organs (including acute and chronic sinusitis, acute and chronic otitis media, pharyngeal abscess, tonsillitis, pharyngitis);
- lower respiratory tract (including acute bronchitis with bacterial superinfection, chronic bronchitis, pneumonia);
- urinary tract (eg cystitis, urethritis, pyelonephritis);
- in gynecology;
- skin and soft tissues, including human and animal bites;
- bone and connective tissue;
- biliary tract (cholecystitis, cholangitis);
- odontogenic.
Amoxiclav®
For powder for solution for intravenous administration additionally
- abdominal infections;
- sexually transmitted infections (gonorrhea, chancre);
- prevention of infections after surgical interventions.
Use during pregnancy and lactation
During pregnancy and lactation, Amoxiclav (amoxicillin) 875 mg/125 mg. is used only if the intended benefit to the mother outweighs the potential risk to the fetus and child.
Amoxiclav Quiktab can be prescribed during pregnancy if there are clear indications.
Amoxicillin and clavulanic acid pass into breast milk in small amounts.
Contraindications
- hypersensitivity to the components of Amoxiclav (amoxicillin) 875 mg/125 mg.;
- hypersensitivity to penicillins, cephalosporins and other beta-lactam antibiotics in history;
- cholestatic jaundice and / or other abnormal liver function caused by taking amoxicillin / clavulanic acid in history;
- infectious mononucleosis and lymphocytic leukemia;
With caution: history of pseudomembranous colitis, gastrointestinal diseases, liver failure, severe renal dysfunction, pregnancy, lactation, simultaneous use with anticoagulants.
Side effects
Amoxiclav (amoxicillin) 875 mg/125 mg. film-coated tablets and powder for solution for intravenous administration
From the digestive system: loss of appetite, nausea, vomiting, diarrhea, abdominal pain, gastritis, stomatitis, glossitis, black “hairy” tongue, darkening of tooth enamel, hemorrhagic colitis (may also develop after therapy), enterocolitis, pseudomembranous colitis, violation liver function, increased activity of ALT, AST, alkaline phosphatase and / or plasma bilirubin levels, liver failure (more often in the elderly, men, with long-term therapy), cholestatic jaundice, hepatitis.
Allergic reactions: itching, urticaria, erythematous rashes, erythema multiforme, angioedema, anaphylactic shock, allergic vasculitis, exfoliative dermatitis, Stevens-Johnson syndrome, acute generalized exanthematous pustulosis, a syndrome similar to serum sickness, toxic epidermal necrolysis.
From the hematopoietic and lymphatic systems: reversible leukopenia (including neutropenia), thrombocytopenia, hemolytic anemia, reversible increase in PT (when used together with anticoagulants), reversible increase in bleeding time, eosinophilia, pancytopenia, thrombocytosis, agranulocytosis.
From the side of the central nervous system: dizziness, headache, convulsions (may occur in patients with impaired renal function when taking high doses of the drug).
From the urinary system: interstitial nephritis, crystalluria, hematuria.
Others: candidiasis and other types of superinfection.
Amoxiclav (amoxicillin) 875 mg/125 mg.
For film-coated tablets, powder for suspension for oral administration, powder for solution for intravenous administration
From the side of the central nervous system: hyperactivity. Feelings of anxiety, insomnia, behavioral changes, agitation.
Amoxiclav®
Amoxiclav® Quiktab
Amoxiclav® Quiktab and Amoxiclav® powder for oral suspension
From the side of the hematopoietic organs and the lymphatic system: rarely – reversible leukopenia (including neutropenia), thrombocytopenia; very rarely – eosinophilia, thrombocytosis, reversible agranulocytosis, an increase in bleeding time and a reversible increase in PT, anemia, incl. reversible hemolytic anemia.
From the immune system: the frequency is unknown – angioedema, anaphylactic reactions, allergic vasculitis, a syndrome similar to serum sickness.
From the nervous system: infrequently – dizziness, headache; very rarely – insomnia, agitation, anxiety, behavior change, reversible hyperactivity, convulsions; convulsions may occur in patients with impaired renal function, as well as in those receiving high doses of the drug.
From the digestive tract: often – loss of appetite, nausea, vomiting, diarrhea. Nausea is more commonly observed when high doses are ingested. If gastrointestinal disorders are confirmed, they can be eliminated if the drug is taken at the beginning of a meal; infrequently – indigestion; very rarely – antibiotic-associated colitis induced by antibiotics (including pseudomembranous and hemorrhagic colitis), black “hairy” tongue, gastritis, stomatitis. In children, a change in the color of the surface layer of tooth enamel was very rarely noted. Oral care helps prevent discoloration of tooth enamel.
On the part of the skin: infrequently – skin rash, itching, urticaria; rarely – erythema multiforme exudative; frequency unknown – Stevens-Johnson syndrome, toxic epidermal necrolysis, bullous exfoliative dermatitis, acute generalized exanthematous pustulosis.
From the urinary system: very rarely – crystalluria, interstitial nephritis, hematuria.
From the side of the liver and biliary tract: infrequently – increased activity of ALT and / or AST (this phenomenon is observed in patients receiving therapy with beta-lactam antibiotics, but its clinical significance is unknown); Adverse events from the liver were observed mainly in men and elderly patients and may be associated with long-term therapy. These adverse events are very rare in children.
The listed signs and symptoms usually occur during or immediately after the end of therapy, but in some cases they may not appear for several weeks after the end of therapy. Adverse events are usually reversible. Adverse events from the liver can be severe, in extremely rare cases there have been reports of death. In almost all cases, these were patients with serious comorbidities or patients receiving concomitantly potentially hepatotoxic drugs. Very rarely – an increase in the activity of alkaline phosphatase, an increase in the level of bilirubin, hepatitis, cholestatic jaundice (noted with concomitant therapy with other penicillins and cephalosporins).
Other: often – candidiasis of the skin and mucous membranes; frequency unknown – growth of non-susceptible microorganisms.
Dosage and Administration
Oral intake. The dosage regimen is set individually, depending on the age, body weight, kidney function of the patient, as well as the severity of the infection.
Amoxiclav (amoxicillin) 875 mg/125 mg. is recommended to be taken at the beginning of a meal for optimal absorption and to reduce possible side effects from the digestive system.
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.
Children under 12
The dose is prescribed depending on age and body weight. The recommended dosage regimen is 40 mg / kg / day in 3 divided doses.
Children weighing 40 kg or more should be given the same doses as adults. For children aged ≥6 years, Amoxiclav® suspension is more preferable.
Adults and children over 12 years of age (or >40 kg body weight)
The usual dose in the case of mild and moderate infection is 1 table. 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
Since the tablets of the combination of amoxicillin and clavulanic acid 250 + 125 mg and 500 + 125 mg each contain the same amount of clavulanic acid – 125 mg, then 2 tables. 250 + 125 mg are not equivalent to 1 table. 500+125 mg.
Dosage for odontogenic infections
1 tab. 250+125 mg every 8 hours or 1 tab. 500+125 mg every 12 hours for 5 days.
Patients with impaired renal function
Dose adjustment is based on the maximum recommended dose of amoxicillin and is carried out taking into account the values of Cl creatinine:
– adults and children over 12 years of age (or ≥40 kg of body weight) (Table 2);
– in case of anuria, the interval between dosing should be increased to 48 hours or more;
– tablets 875 + 125 mg should be used only in patients with Cl creatinine> 30 ml / min.
table 2
Creatinine clearance | Dosing regimen of the drug Amoxiclav® |
>30 ml/min | Dose adjustment is not required |
10–30 ml/min | 1 tab. 50+125 mg 2 times a day or 1 tab. 250+125 mg (for mild and moderate infection) 2 times a day |
< 10 ml/min | 1 tab. 500+125 mg 1 time per day or 1 tab. 250+125 mg (for mild and moderate infection) 1 time per day |
Hemodialysis | 1 tab. 500 + 125 mg or 2 tablets. 250+125 mg every 24 hours + 1 tab. 500 + 125 mg or 2 tablets. 250 + 125 mg during dialysis and at the end of the dialysis session (due to a decrease in serum concentrations of amoxicillin and clavulanic acid) |
Patients with impaired liver function
Amoxiclav (amoxicillin) 875 mg/125 mg. should be taken with caution. It is necessary to conduct regular monitoring of liver function.
Overdose
There are no reports of death or life-threatening side effects due to an overdose of Amoxiclav (amoxicillin) 875 mg/125 mg. .
Symptoms: in most cases – disorders of the gastrointestinal tract (abdominal pain, diarrhea, vomiting), anxiety, insomnia, dizziness are also possible, in isolated cases – convulsive seizures.
Treatment: in case of overdose, the patient should be under the supervision of a physician, treatment is symptomatic.
In the case of a recent intake (less than 4 hours) of tAmoxiclav (amoxicillin) 875 mg/125 mg. , it is necessary to perform a gastric lavage and prescribe activated charcoal to reduce absorption. Amoxicillin/clavulanate potassium is removed by hemodialysis.
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