Amoxiclav is a popular drug from the antibiotic category. It is often prescribed by physicians and pediatricians for the treatment of chronic infectious diseases. What are the medical features of Amoxiclav, what are its contraindications, and how to use it correctly?
Composition and pharmacological action of Amoxiclav
Amoxiclav consists of two main components. First of all, it is a semi-synthetic penicillin - amoxicillin, as well as clavulanic acid. Each component has its own function. Amoxicillin is an antibiotic, but clavulanic acid does not have a noticeable antibacterial effect. What, then, is its purpose?
As you know, these are one of the first antibiotics obtained in the middle of the last century. During their use, they have shown their high efficiency. But at the same time, many bacteria managed to develop resistance to them. How does bacteria defense against antibacterial drugs work?
Amoxicillin acts on the cell wall of bacteria, binding one of the enzymes that make up its composition. As a result, the cell wall loses its strength, collapses and the bacteria dies. However, many types of bacteria began to produce special substances - beta-lactamases, which block the action of antibacterial agents. Thus, amoxicillin has become harmless to most bacteria.
Clavulanic acid is designed to fight beta-lactamases. By binding to amoxicillin, it makes its molecules immune to beta-lactamases. This effect manifests itself in relation to most types of beta-lactamases produced by bacteria.
Thus, the use of a combination of amoxicillin and clavulanic acid makes it possible to expand the spectrum of antibacterial activity in comparison with pure amoxicillin. If amoxicillin can affect only a limited number of bacteria that are not able to produce beta-lactamases, then amoxicillin combined with clavulanic acid is active against most bacteria that cause infectious diseases. Among the bacteria that the drug can destroy, there are both gram-positive and gram-negative bacteria.
The main types of bacteria that are sensitive to Amoxiclav:
- streptococci,
- staphylococci,
- shigella,
- klebsiella,
- brucella,
- echinococcus,
- helicobacter,
- clostridia,
- haemophilus influenzae
- salmonella,
- proteus.
Bacteria resistant to the effects of Amoxiclav:
- enterobacter,
- pseudomonads,
- chlamydia,
- mycoplasma,
- legionella,
- yersinia,
and some others.
Pharmacokinetics
The components of Amoxiclav are well absorbed into the blood and are evenly distributed in the main tissues and body fluids, which provides a universal therapeutic effect of the drug. In this case, the components do not penetrate the blood-brain barrier. However, the substances that make up Amoxiclav can penetrate the placental barrier during pregnancy and enter breast milk in small quantities in breastfeeding women. Amoxicillin is poorly metabolized and excreted almost unchanged through the kidneys. In contrast, clavulanic acid is converted into metabolites that are excreted in the urine. The period of elimination of half of the components in healthy kidneys is 1-1.5 hours. The drug can also be removed from the body using hemodialysis.
Average pharmacokinetic parameters
Release form
Amoxiclav is produced mainly in tablet form. There are two types of this form. The main one is a film-coated tablet intended to be swallowed and dissolved in the intestine. There are also quick-dissolving tablets that dissolve in the mouth. You can also purchase the drug in the form of a suspension (powder that requires dilution), and in vials containing a powder, from which you can prepare a solution for intravenous administration.
Amoxiclav tablets can have the following dosage:
- 250 mg + 125 mg,
- 500 mg + 125 mg,
- 875 mg + 125 mg.
The first number indicates the dosage of amixicillin, and the second indicates the dosage of clavulanic acid. The drug is produced by the Slovenian pharmaceutical company Lek.
The powder for the preparation of Amoxiclav solution for intravenous administration can contain 500/1000 mg of amoxicillin (100/200 mg of clavulanic acid, respectively). Powder dosage options for preparing Amoxiclav suspension are 125, 250 and 400 mg (amoxicillin). The medicine in the form of a suspension is recommended for the treatment of children under 12 years of age, although its use by adults is not excluded. Also available are instant tablets Amoxiclav Kviktab 875 mg + 125 mg.
Indications of the drug Amoxiclav
The scope of application of amoxicillin and clavulanic acid includes the treatment of various infectious diseases caused by bacteria. But most often this combination is prescribed for the treatment of acute respiratory diseases. Amoxiclav reduces the severity of the symptoms of the disease and shortens its duration.
For what infections is the drug effective:
- diseases of the upper and lower respiratory tract, lungs;
- urological, andrological and gynecological diseases;
- skin diseases caused by a bacterial infection;
- connective and bone tissue infections;
- infectious cholecystitis and cholangitis.
Bacterial diseases of the respiratory organs for which the drug can be prescribed:
- pharyngitis,
- tonsillitis,
- laryngitis,
- rhinitis,
- sinusitis,
- sinusitis,
- pneumonia,
- pleurisy,
- bronchitis,
- tracheitis.
Bacterial infections of the urinary organs and genitals, in which the drug can be used:
- pyelonephritis,
- urethritis,
- prostatitis,
- adnexitis,
- endometritis,
- salpingitis.
Contraindications
The drug has few contraindications. Amoxiclav can be treated with children, including infants. For infants, you can use a suspension and solution for intravenous administration. Pregnant women can also use the drug (under medical supervision). The main contraindication for taking Amoxiclav is intolerance to drugs of the penicillin group, as well as cephalosporins and other betalactam antibacterial agents. Also, you can not take Amoxiclav to persons suffering from severe hepatic insufficiency, infectious mononucleosis and lymphocytic leukemia, those who previously received amoxicillin led to the development of cholestatic jaundice.
Taking the drug also depends on the condition of the patient's kidneys. People with renal insufficiency (having a creatinine clearance below the norm) should be prescribed smaller doses of Amoxiclav than usual.
Dose adjustment for renal failure
Patients on hemodialysis are prescribed a 500 + 125 mg tablet once a day or 2 tablets 250 + 125 mg once a day. In addition, it is taken as a 500 + 125 tablet or 2 tablets of 250 + 125 mg mg during dialysis.
Children under 12 years of age are not prescribed tablet forms of Amoxiclav. For them, it is preferable to use a suspension.
The use of Amoxiclav during pregnancy and lactation
Amoxiclav is prescribed with caution during pregnancy. Its use is possible in cases where the potential benefit to the mother is higher than the harm that can be done to the developing fetus. During lactation, the drug can also be used. However, if there is a need to use Amoxiclav while breastfeeding, it is recommended that you first consult with your doctor.
Side effects of Amoxiclav
The drug is well tolerated, and side effects when taking Amoxiclav appear infrequently. The most common side effects associated with the gastrointestinal tract. Like any antibiotic, Amoxiclav destroys not only disease-causing organisms, but also the normal intestinal microflora. Therefore, with a long course of treatment with Amoxiclav, phenomena associated with dysbiosis are possible - dyspepsia, nausea, abdominal pain.
On the skin, mucous membranes and in the oral cavity, candidiasis can develop - a lesion by fungi of the genus Candida. Side effects associated with dysbiosis are the most common when taking Amoxiclav. Also, while taking Amoxiclav, many women may experience candidal colpitis (thrush).
Another group of side effects of Amoxiclav is allergic reactions. They can manifest, for example, in the form of a skin rash, urticaria, dermatitis. In this case, it is recommended to stop taking the drug and consult a doctor. It is extremely rare, due to the intake of Amoxiclav, anaphylactic shock may appear.
When using Amoxiclav, side effects associated with impaired liver function may occur - cholestatic jaundice and hepatitis. These phenomena were most often observed in the elderly and men, especially with a long course of treatment.
There may also be other side effects: headaches, dizziness, insomnia, changes in the composition of the blood (leukopenia, neutropenia, thrombocytopenia, agranulocytosis), anemia, changes in urine (crystalluria, the appearance of blood), pseudomembranous colitis.
Overdose with Amoxiclav
In clinical practice, there are no known fatal overdose cases. When taking the drug in doses significantly exceeding the prescribed instructions, you may experience:
- abdominal pain,
- diarrhea,
- vomiting
- excitation,
- anxiety,
- insomnia,
- dizziness.
Treatment for an overdose of Amoxiclav is symptomatic, the intake of activated carbon, gastric lavage is indicated.
Instructions for use
The dosage of Amoxiclav may depend on many factors - the type of disease, its severity, the patient's age, the functionality of his kidneys, etc. Therefore, the exact dose should be prescribed by an infectious disease doctor or therapist. Too low a dose of Amoxiclav can lead to the fact that bacteria will be immune to it and will be able to develop resistance, and too high entails the risk of side effects.
For infections occurring with low intensity, one tablet of Amoxiclav 250 + 125 mg three times a day is usually prescribed, or a tablet of 500 + 125 twice a day. In case of severe diseases, 3 tablets of Amoxiclav 500 + 125 mg per day or 2 tablets of 875 + 125 mg per day can be prescribed.
In case of odontogenic infections, it is usually prescribed as a 250 + 125 mg tablet every 8 hours or a 500 + 125 mg tablet every 12 hours. The course of treatment is 5 days.
Children are prescribed a dose based on their weight. It should be remembered that it is preferable for children to use a suspension rather than tablets. For infections occurring in mild to moderate form, it is recommended to use a dose of 20 mg / kg body weight; in severe infections, it should be doubled. Amoxiclav packaging is provided with special instructions that allow you to calculate the dose for children in various cases.
The suspension powder is available in three versions.
Doses of active substances per 5 ml of powder for suspension
Doses of suspension 125 + 31.25 mg for children
Suspension doses 250 + 62.5 mg for children
The volume of the drug indicated in the tables must be given to the child 3 times a day
Doses of suspension 400 mg + 57 mg for children
The amount of the drug indicated in the table must be given to the child 2 times a day
When choosing the right dose, it is necessary to proceed from the child's body weight, not age.
In case of insufficient renal function, the dose should be adjusted. With a reduced creatinine clearance (10-30 ml / min), the maximum dose of Amoxiclav is one tablet of 500 + 125 mg twice a day after 12 hours, with a clearance of less than 10 ml - this tablet can be taken no more than once every 24 hours.
The medicine should be taken at strictly defined intervals. Thus, if three tablets are prescribed per day, they should be taken exactly 8 hours later, for example, at 8, 16 and 24 hours. If the drug is prescribed twice a day, then the tablets should be taken after 12 hours. This method allows maintaining a constant concentration of the drug in the blood, as a result of which the effectiveness of Amoxiclav will be maximum.
The absorption of active substances into the blood occurs regardless of food intake, so Amoxiclav can be taken before, after, and during meals, this will not reduce its effectiveness. However, doctors still recommend taking the tablets at the beginning of a meal. This will reduce the likelihood of unpleasant side effects associated with the gastrointestinal tract.
Patients over 12 years old and weighing more than 40 kg take an adult dose of suspension or tablets. Dose adjustment is necessary for persons with renal dysfunction associated with a decrease in creatinine clearance.
The duration of treatment is 5-14 days. Exceeding this period requires special instructions from the attending physician. In case of ineffectiveness of drug treatment, you should choose a replacement. If the drug was prescribed, and the condition improved before the course was completed, then it should still be completed in order to avoid relapses.
When using Amoxiclav Kviktab, the tablet must be dissolved in water before use, or dissolve in the mouth.
Suspension preparation
To prepare the suspension, you must vigorously shake the bottle with the powder and then add water to it to the mark in two steps. Each time you add water, it is necessary to shake the bottle so that the suspension would have a uniform consistency.
Required volume of water for preparation of suspension from powder 400 / 57.5 mg
Drug analogues
The complete structural analogs of Amoxiclav include preparations containing amoxicillin and clavulanic acid, for example, Augmentin, Flemoklav Solutab. Preparations containing only amoxicillin will not be an adequate substitute due to the fact that the list of microorganisms sensitive to pure amoxicillin is much smaller than that of Amoxiclav. The same can be said about other drugs of the penicillin group - the scope of their use may not coincide with the scope of Amoxiclav.
Interaction of Amoxiclav with other substances and drugs
The effectiveness of Amoxiclav usually increases with simultaneous use with other bactericidal drugs. However, macrolides, tetracyclines, sulfonamides and other bacteriostatic agents reduce the effectiveness of the drug. Therefore, it is necessary to avoid the simultaneous administration of the drug and bacteriostatic agents. It should also be remembered that the simultaneous administration of Amoxiclav with hormonal contraceptives weakens the effect of the latter.
The simultaneous intake of alcohol and Amoxiclav is prohibited, since this may have a negative effect on the liver and a decrease in the effect of the drug.
Also, the simultaneous administration of Amoxiclav and methotrexate is prohibited, since Amoxiclav increases the toxicity of the latter. You can not prescribe the drug simultaneously with Disulfiram, as this increases the likelihood of allergic reactions. When taken simultaneously with Allopurinol, the risk of developing exanthema increases.
When taking a suspension or tablets in combination with oral anticoagulants, caution should be exercised, since the drug can increase the prothrombin time.
Combined antimicrobial agents.
Composition of Amoxiclav
The active substance is amoxicillin + clavulanic acid.
Manufacturers
Lek dd (Slovenia)
pharmachologic effect
Broad spectrum antibacterial.
Blocks the synthesis of peptidoglycan membrane of microbial cells (amoxicillin), inhibits beta-lactamase (clavulanic acid).
Clavulanic acid forms a stable inactivated complex with the indicated enzymes and protects amoxicillin from the loss of antibacterial activity caused by the production of beta-lactamases by the main pathogens and opportunistic pathogens.
Active against gram-positive aerobes:
- Streptococcus pneumonia,
- S.pyogene,
- S.viridan,
- S.bovi,
- Staphylococcus aureus (except methicillin-resistant strains,
- S.epidermidis (except for methicillin-resistant strains,
- Listeria spp,
- Enterococcus spp.
Gram-negative aerobes:
- Bordetella pertussi,
- Brucella spp,
- Campylobacter jejun,
- E.col,
- Gardnerella vaginali,
- H.influenza,
- H.ducrey,
- Klebsiella spp,
- Moraxella catarrhali,
- N.gonorrhoea,
- N.meningitidi,
- Pasteurella multocid,
- Proteus spp,
- Salmonella spp,
- Shigella spp,
- Vibrio cholera,
- Yersinia enterocolitica.
Anaerobes:
- Peptococcus spp,
- Peptostreptococcus spp,
- Clostridium spp,
- Bacteroides spp,
- Actinomyces israelii.
It is rapidly absorbed after oral administration (food intake does not affect absorption).
The maximum concentration is reached 1 hour after administration.
The maximum plasma concentration after a bolus injection of 1.2 g is 105.4 mg / l (for amoxicillin) and 28.5 mg / l (for clavulanic acid).
Has a large volume of distribution - high concentrations are found in body fluids and tissues (lungs, pleural, peritoneal, synovial fluid, palatine tonsils, bronchial secretions, prostate gland, peritoneal abscess, muscle tissue, adipose tissue, secretion of the paranasal sinuses, middle ear, etc. .).
The peak concentration in body fluids is observed 1 hour after reaching the peak of plasma concentrations.
Does not pass through the BBB with non-inflamed meninges, passes through the placental barrier and enters breast milk in trace concentrations.
Weakly binds to plasma proteins.
Amoxicillin is partially metabolized, clavulanic acid is extensively metabolized.
Amoxicillin is excreted by the kidneys practically unchanged by tubular secretion and glomerular filtration; clavulanic acid - by glomerular filtration, partly in the form of metabolites.
Small amounts are excreted by the intestines and lungs.
The half-life is 1-1.5 hours, with severe renal failure it increases to 7.5 (for amoxicillin) and 4.5 hours (for clavulanic acid).
It is removed with hemodialysis, slightly - with peritoneal dialysis.
Side effect of Amoxiclav
In most cases, side effects are mild and transient, more common from the digestive tract:
- loss of appetite
- nausea
- vomiting
- diarrhea.
Development of superinfection, stomatitis, vaginitis is possible; in rare cases, pseudomembranous colitis with severe diarrhea.
Allergic reactions may occur:
- itching, skin rash;
- in sensitive patients, immediate hypersensitivity reactions (angioedema, bronchospasm, rarely anaphylactic shock) may develop.
It is extremely rare that a transient increase in the level of transaminases in the blood plasma can be observed.
There are isolated reports of the occurrence of cholestatic jaundice, hepatitis, liver dysfunctions.
Indications for use
Infectious diseases of the upper (acute and chronic sinusitis, acute and chronic otitis media, retropharyngeal abscess, tonsilopharyngitis) and lower respiratory tract (acute and chronic bronchitis, pneumonia, pleural empyema); urinary tract infections (including cystitis, urethritis, pyelonephritis), gynecological infections (including salpingitis, salpingo-oophoritis, endometritis, septic abortion, pelvioperitonitis); biliary tract (cholecystitis, cholangitis), bone and connective tissues (including chronic osteomyelitis), skin and soft tissues (phlegmon, wound infection), odontogenic infections (periodontitis); sexually transmitted infections (gonorrhea, chancroid).
Contraindications Amoxiclav
Hypersensitivity; a history of allergic reactions to antibiotics of the penicillin and cephalosporin group; cholestatic jaundice, hepatitis caused by taking antibiotics of the penicillin group (in history); liver failure; infectious mononucleosis, lymphocytic leukemia.
Application during pregnancy and lactation:
- Possibly
- if the expected effect of therapy outweighs the potential risk to the fetus.
During treatment, breastfeeding should be discontinued.
Overdose
Symptoms:
- in most cases, nausea,
- diarrhea,
- vomiting
- possible - excitement,
- insomnia,
- dizziness
- in some cases, seizures.
There are no reports of death or life-threatening side effects.
Treatment:
- symptomatic,
- in case of recent administration (less than 4 hours), remove the drug from the gastrointestinal tract (gastric lavage,
- taking activated carbon to reduce absorption,
- effective hemodialysis.
Interaction
With simultaneous use with methotrexate, the toxicity of methotrexate increases, with allopurinol - the incidence of exanthema, anticoagulants - the prothrombin time is lengthened.
Reduces the effectiveness of oral contraceptives.
Simultaneous use with disulfiram should be avoided.
The effectiveness of Amoxiclav is weakened by the combination with bacteriostatic antibiotics (macrolides, tetracyclines), the combination with rifampicin is antagonistic.
Probenecid reduces the excretion of amoxicillin, increasing its serum concentration.
Pharmaceutically incompatible with solutions containing blood, proteins, lipids, glucose, dextran, bicarbonate.
Do not mix in a syringe or infusion bottle with other drugs.
Incompatible with aminoglycosides.
special instructions
It is prescribed with caution to patients prone to allergic reactions to cephalosporins and other beta-lactam antibiotics (risk of cross-sensitivity), with severe impairment of liver and kidney function (dosage adjustment is necessary).
High concentrations give a false positive reaction to glucose in urine when using Benedict's reagent or Felling's solution (it is recommended to use enzymatic reactions with glucose oxidase).
Amoxiclav 500 is a modern antibacterial drug that is a combination of two active ingredients. Amoxicillin, as a broad-spectrum bactericidal antibiotic, carries out the main action against pathogens. Clavulanic acid blocks the defense mechanisms of pathogens and expands the range of action on bacteria that are otherwise resistant to penicillins.
Other names and classification
International non-proprietary name
According to the WHO classification, the INN of Amoxicillin is Amoxicillin + Clavulanic acid (in Latin: amoxicillin, clavulanic acid).
Trade names
The combination of the same active ingredients is present on the pharmaceutical market under the following names: Amoxiclav Kviktab (soluble form), Augmentin, Ekoklav, Panklav, Panklav 2x (with increased dosage), Medoklav, Novoklav and others.
When buying an analogue, you should study the instructions to comply with the prescribed dosage.
Registration number
Composition and dosage forms
The combined drug is produced in several forms for a different route of administration:
- soluble film coated tablets;
- dispersible form (Kviktab) in the form of dissolving tablets;
- suspensions for oral administration;
- lyophilisate for preparation of solution for injection.
1 tablet 500 + 125 contains 0.5 g of amoxicillin and 0.125 g of potassium salt of clavulanic acid.
In tablets of other dosages, the antibiotic is present in the amount of 250 and 875 mg; the concentration of clavulanate remains unchanged - 125 mg.
Pharmacological group of Amoxiclav 500
Clinical and pharmacological group: a broad-spectrum antibiotic from a number of semi-synthetic penicillins in combination with a β-lactamase inhibitor.
pharmachologic effect
The combination of amoxicillin with clavulanic acid in the indicated ratio has a bactericidal and bacteriostatic effect on pathogens that are sensitive to penicillin drugs, as well as to microorganisms that have developed resistance to therapy. Most of the bacteria have learned to destroy the antibiotic, producing protective enzymes - β-lactamase.
Clavulanate binds beta-lactamases, blocks their activity and removes them from the body in the form of inactive metabolites. This makes it possible for the antibiotic to show its activity, destroying the cell wall of pathogens, which causes their death.
Sensitive to the combined drug:
- streptococci;
- echinococcus;
- listeria.
Of the bacteria that do not show sensitivity to antibiotic penicillins, Amoxiclav therapy can be used:
- gram-positive aerobes (including Staphylococcus aureus);
- gram-negative aerobic pathogens (moraxella, klebsiella, bacillus, escherichia).
Regardless of the fullness of the stomach, the drug is rapidly absorbed in the gastrointestinal tract, reaching therapeutic concentrations within an hour after ingestion, penetrates into all tissues and fluids of the body, mucous membranes, secretions and sputum.
The drug is excreted mainly by the kidneys; clavulanate is preliminarily metabolized in the liver.
Indications for use of Amoxiclav 500
The purpose of the drug is due to bacterial damage to various organs and systems:
- diseases of the upper and lower parts of the bronchopulmonary system;
- ENT organs: middle ear, sinuses, tonsils;
- an infection in the urinary tract or pelvic organs;
- abscesses of various localization, sepsis, purulent wounds;
- osteomyelitis, inflammation of the joints and bones.
An antibiotic is used to treat combined infectious processes, and if the pathogen has not been reliably established. For the prevention of postoperative complications, the drug is used in short courses before or after surgery.
How to take amoxiclav 500
The bioavailability of the drug does not depend on the degree of stomach fullness. To prevent reactions with the mucous membranes of the gastrointestinal tract, it is recommended to drink an antibiotic at the beginning of a meal. To restore beneficial microflora, a parallel intake of probiotics is prescribed.
The tablets should be taken whole, without crushing, with water. To prevent violations of water-salt metabolism during the course of treatment, a drinking regimen is observed - at least 2 liters of fluid per day.
How many days to take
The duration of the course of treatment is set individually on the basis of clinical manifestations and the severity of the disease. Therapy is prescribed for a period of 7 to 14 days. According to indications, it is possible to prescribe an antibiotic in a short course, but not less than for 5 days.
After two weeks of treatment, laboratory tests are carried out; based on their results, the effectiveness of therapy is determined. If necessary, the treatment period can be extended.
Unauthorized interruption of treatment threatens with incomplete destruction of the pathogen, which leads to relapses and the development of resistant strains.
Dosage
It should be borne in mind that 2 tablets containing 250 mg of amoxicillin are not equivalent to 1 tablet of 500 mg due to different concentrations of clavulanic acid. When prescribing Amoxiclav 500/125, it is unacceptable to replace it by taking several tablets with a lower dosage. This increases the likelihood of adverse reactions.
With a mild course of infection, forms of the drug are used, equivalent to 500 mg of the antibiotic, 1 tablet every 12 hours.
Prescribe a drug in a concentration of 500/125 mg for infections of moderate severity or acute condition with respiratory tract damage (tonsillitis, sinusitis, sinusitis). We recommend taking 1 tablet every 8 hours.
The maximum dose of the drug for adults is 6 g (in terms of antibiotic).
With prostatitis
The duration of therapy for bacterial prostatitis varies from 10 days to 2 weeks or more. Treatment is carried out inpatiently or on an outpatient basis with the condition of constant medical supervision.
In a hospital setting, treatment is possible with constant laboratory monitoring of the results. The attending physician adjusts the dosage based on objective indicators of the patient's condition, and has the ability to replace the drug if it is ineffective or intolerant.
For prostatitis, 1 tablet (500 mg) is prescribed twice a day at regular intervals. The total amount of amoxicillin taken per day should not exceed 1.125 g; if necessary, this amount is divided into 3-4 doses.
Amoxiclav
special instructions
During pregnancy and lactation
Do not appoint Amoxiclav in the first trimester. There was no clinical evidence of a negative effect on fetal development. However, the decision to prescribe a drug at any stage of pregnancy is made on the basis of an analysis of the harm and benefits to the health of the mother and child.
During lactation, the medicine can be prescribed according to strict indications. The active ingredients are found in low concentrations in milk. When allergic reactions or digestive disorders appear in a child, feeding is temporarily stopped.
In childhood
For patients under the age of 12, tablets with a dosage of 500/125 are not used. The daily dose for children under 12 years of age or with a body weight of less than 40 kg should not exceed 45 mg per 1 kg of the child's weight. For such patients, a suspension form has been created.
A correctly calculated dose of medication can be prescribed to newborns according to strict indications. The drug is administered by intravenous infusion.
In old age
For patients over 60 years of age, subject to normal renal function, dose adjustment is not performed.
For violations of liver function
In patients with hepatic pathologies, the agent is used with caution with constant laboratory monitoring of organ function.
Both active ingredients can be removed by hemodialysis and, in small amounts, by peritoneal dialysis.
With impaired renal function
The total clearance of the complex drug decreases in proportion to the decrease in renal function. When CC values \u200b\u200bare more than 30 ml / minute, dose adjustment is not required.
In severe renal failure, the half-life of amoxicillin slows down to 7 hours. In such cases, it is necessary to adjust the dose and increase the intervals between doses.
Side effects of Amoxiclav 500
Adverse reactions most often manifest from the gastrointestinal tract: nausea, change in taste, vomiting, diarrhea, and sometimes constipation. Symptoms may disappear during treatment or after the end of the course. With prolonged therapy, isolated cases of renal and hepatic abnormalities, the occurrence of colitis, jaundice are noted.
From the side of the central nervous system: headache, hyperactivity, anxiety, dizziness, convulsions.
Allergic reactions of varying severity (from urticaria to anaphylactic shock) indicate intolerance to the components and require immediate discontinuation of the drug. If you experience any skin reactions or edema during treatment, you should immediately consult your doctor.
Among other side effects from prolonged therapy with Amoxiclav, they note: the development of superinfection, crystalluria, hematuria, candidiasis.
Taking the drug in high doses can give a false positive reaction to sugar in the urine. To obtain reliable results in laboratory studies, enzymatic reactions with glucosidase are used.
Influence on the ability to drive vehicles and other mechanisms
The negative effect of Amoxiclav on the ability to drive a car has not been established. If the prescribed doses are observed, there is no danger of loss of concentration; work with mechanisms of any complexity is allowed.
Contraindications
The reception of Amoxiclav is contraindicated in such conditions:
- sensitivity to penicillins, cephalosporins, any beta-lactam antibiotics;
- infectious mononucleosis;
- liver dysfunction associated with taking antibiotics;
- violation of phenylalanine metabolism;
- episodes of jaundice.
With caution and only under medical supervision, the drug is treated during pregnancy, chronic hepatic and renal failure, antibiotic-associated colitis.
Overdose
The first symptoms of overdose duplicate side effects (nausea, dizziness, vomiting, diarrhea, rash) and can often be ignored. Alarming signs are disturbances in the central nervous system and heart rhythm disturbances:
- insomnia;
- overexcitation;
- tachycardia;
- convulsive seizures.
From the moment the symptoms are detected, the victim's stomach should be flushed, enterosorbents should be applied and a doctor should be expected, observing an increased drinking regime.
Interoperability and compatibility
Amoxiclav interacts with many drugs, but the parallel use of several drugs is possible only with the permission of the attending physician.
INSTRUCTIONS for the use of the drug Amoxiclav (tablets for adults 1000, suspension for children) for medical use. An antibiotic of the broad-spectrum penicillin group with a beta-lactamase inhibitor. Many patients who are prescribed the drug for diseases of an infectious and inflammatory nature are praised.
Release form and composition
Amoxiclav is produced in the form:
- Coated tablets containing 250 mg, 500 mg or 875 mg of amoxicillin, 125 mg of clavulanic acid and excipients: colloidal silicon dioxide, crospovidone, croscarmellose sodium, magnesium stearate, talc, MCC. In blisters and dark glass bottles;
- Powder for the preparation of a suspension for oral administration containing 5 ml of a ready-made suspension of amoxicillin and clavulanic acid in a ratio of 125 mg / 31.25 mg, 250 mg / 62.5 mg, 400 mg / 57 mg;
- Powder for the preparation of a solution for injection containing amoxicillin and clavulanic acid in 1 bottle in a ratio of 500 mg / 100 mg, 1000 mg / 200 mg.
pharmachologic effect
The abstract provides information that the antibiotic Amoxiclav is a means of a wide range of effects. Group of antibiotics: penicillins with a wide range of effects. The drug contains amoxicillin (semi-synthetic penicillin) and clavulanic acid (β-lactamase inhibitor). The presence of clavulanic acid in the composition of the drug ensures the resistance of amoxicillin to the action of β-lactamases, which are produced by microorganisms.
The structure of clavulanic acid is similar to that of beta-lactam antibiotics, this substance also has an antibacterial effect. Amoxiclav is active against strains that show sensitivity to amoxicillin. These are a number of gram-positive bacteria, aerobic gram-negative bacteria, gram-positive and gram-negative anaerobes.
Indications for use
What does an antibiotic help with? Amoxiclav is prescribed for diseases of an infectious and inflammatory nature that develop as a result of the influence of microorganisms that are sensitive to this drug. The following indications for the use of this drug are determined:
- Lower respiratory tract infections (including acute bronchitis with bacterial superinfection, chronic bronchitis, pneumonia);
- Bone and connective tissue infections;
- Gynecological infections;
- Infections of the upper respiratory tract and ENT organs (including acute and chronic sinusitis, acute and chronic otitis media, pharyngeal abscess, tonsillitis, pharyngitis);
- Biliary tract infections (cholecystitis, cholangitis);
- Skin and soft tissue infections, including animal and human bites;
- Urinary tract infections;
- Odontogenic infections.
What else helps Amoxiclav, you should ask a specialist with an individual consultation.
Side effect
When taking this antibiotic, patients may experience the following side effects:
- Hematopoietic system: in rare cases - reversible leukopenia, thrombocytopenia; in very rare cases - eosinophilia, pancytopenia;
- Nervous system functions: dizziness, headache; in rare cases - convulsions, anxiety, hyperactivity, insomnia;
- Digestive system: loss of appetite, vomiting, nausea, diarrhea; in rare cases, there may be abdominal pain, liver dysfunction; isolated manifestations - hepatitis, jaundice, pseudomembranous colitis;
- Urinary system: crystalluria, interstitial nephritis. In rare cases, the manifestation of superinfection may be noted;
- Allergic manifestations: itching, erythematous rash, urticaria; in rare cases - anaphylactic shock, exudative erythema, edema, allergic vasculitis; isolated manifestations - Stevens-Johnson syndrome, pustulosis, exfoliative dermatitis.
Contraindications
Does the antibiotic Amoxiclav have contraindications to the use? Treatment with this remedy is not carried out with impaired liver function and jaundice (cholestatic), as well as with increased sensitivity to drug substances or to all penicillins.
This drug is prescribed with extreme caution if you are allergic to cephalosporins, liver failure, pseudomembranous colitis and severe renal dysfunction.
Patients with lymphocytic leukemia or mononucleosis who have been prescribed ampicillin may develop an erythematous rash. With such a reaction, the antibiotic should be canceled.
Amoxiclav tablets - instructions for use, drug dosage
Inside. 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.
The dose is prescribed depending on age and body weight. The recommended dosing regimen is 40 mg / kg / day in 3 divided doses. Children weighing 40 kg. and more should be given the same dose as for adults. For children under 6 years of age, it is more preferable to take a suspension of the drug Amoxiclav ®.
A 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. The course and dosage of Amoxiclav is established by the attending physician based on many factors - improvement of the condition, the severity of the infectious process, and its localization.
Adults and children 12 years and older or weighing 40 kg. and more:
- For the treatment of infections of mild to moderate severity - 1 tablet 250 mg + 125 mg every 8 hours (3 times a day);
- For the treatment of severe infections and respiratory tract infections - 1 tablet 500 mg + 125 mg every 8 hours (3 times a day) or 1 tablet 875 mg + 125 mg every 12 hours (2 times a day).
- In odontogenic infections, 1 tablet (250 mg + 125 mg) is prescribed every 8 hours or 1 tablet (500 mg + 125 mg) every 12 hours for 5 days;
- With renal failure of moderate severity (CC 10-30 ml / min), 1 tablet (500 mg + 125 mg) is prescribed every 12 hours, with renal failure of severe degree (CC less than 10 ml / min) - 1 tablet (500 mg + 125 mg) every 24 hours. With anuria, the interval between doses should be increased to 48 hours or more;
The medicine in tablets is not prescribed for children under 12 years of age. When prescribing the drug, it should be borne in mind that the permissible daily dose of clavulanic acid is 600 mg (for adults) and 10 mg per 1 kg of weight (for a child). The permissible daily dose of amoxicillin is 6 g for an adult and 45 mg per 1 kg of weight for a child.
Before anesthesia, for the prevention of purulent complications, 1.2 g of drugs must be administered intravenously. If there is a risk of complications, the drug is administered intravenously or administered orally after surgery. The duration of the appointment is determined by the doctor.
Means for parenteral administration are prepared by dissolving the contents of the vial in water for injection. To dissolve 600 mg of the product, you need 10 mol of water, to dissolve 1.2 g of the product - 20 ml of water. The solution should be injected slowly over 3-4 minutes. Intravenous infusion should be continued for 30-40 minutes. You cannot freeze the solution.
Price
- Bottle (portions for preparation of oral suspension) 125 mg + 31.25 mg / 5ml 25 g. Elite product / Russia. RUB 101.70;
- Powder for suspension preparation 400 mg + 57 mg / 5 ml, 17.5 g. Elite product / Russia. RUB 165.60;
- Tablets 250 mg + 125 mg, 15 pcs. Elite product / Russia. RUB 204.30;
- Powder for suspension preparation 400 mg + 57 mg / 5 ml, 35 g. Elite product / Russia. RUB 226.62;
- Bottle (portions for preparation of oral suspension) 250 mg + 62.5 mg / 5ml 25g, 100 ml. Elite product / Russia. RUB 256.50;
- Quiktab tablets 500 mg + 125 mg, 14 pcs. Elite product / Russia. RUB 321.30;
- Bottles for solution preparation 500 mg + 100 mg, 5 pcs. 360 rubles;
- Tablets 875 mg + 125 mg, 14 pcs. Elite product / Russia. RUB 372.60;
- Quiktab tablets 875 mg + 125 mg, 14 pcs. Elite product / Russia. RUB 381.60;
- Powder for solution preparation 500 mg + 100 mg, 5 pcs. Lek / Slovenia. 434 rubles;
- Servings for solution preparation 1 g + 200 mg, 5 pcs. RUB 701.10
Tablets 2X 875 + 125 mg.
Many patients are interested in the question: how many days to take Amoxiclav 875 + 125 and what is the dosage of the drug, depending on age indicators? In most cases, the course of treatment with an antibacterial drug is 5-7 days.
If the disease is protracted, the doctor may extend the treatment period by another week. Amoxiclav Kviktab 875 mg + 125 mg can be bought at almost any pharmacy. On average, the price of a medicine is about 400-500 rubles per package.
- For adults and children who have reached 12 years of age, doctors prescribe a drug with a dosage of 500 mg. The medicine should be drunk 30 minutes after a meal, every 12 hours. In severe pathologies, the dose may be increased;
- For small children, the dosage of Amoxiclav is calculated based on body weight indicators. In case of a disease of mild and moderate severity, the dosage per day is not more than 20 mg / kg of body weight, with a severe degree - not more than 40 mg / kg;
- Amoxiclav 875 + 125 with angina is very effective. When treating catarrhal sore throat, your doctor may prescribe 250 mg tablets of amoxicillin. But to fight a purulent infection, an increased dosage (875 mg of the active substance) will be required. Take the medicine 2 times a day;
It is important to remember that only the attending physician can prescribe such a serious antibiotic as Amoxiclav.
Tablets 500 + 125 mg.
- Adults and children over 12 years old (or weighing more than 40 kg) with a mild or moderate course are prescribed 1 tablet 375 mg every 8 hours, in case of a severe course of respiratory tract disease - 1 piece 625 mg every 8 hours or 1 piece 1000 mg after 12 hours;
- The drug in the form of coated tablets is not prescribed for children under 12 years of age (weighing less than 40 kg);
- The maximum daily dose of clavulanic acid is 600 mg for adults, 10 mg / kg for children;
- The maximum daily dose of amoxicillin is 6 g for adults, 45 mg / kg for children;
- 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;
- For odontogenic infections, 1 tablet of 375 mg is prescribed every 8 hours for 5 days.
14 analogues are cheaper than Russian and foreign ones
The active active ingredients of Amoxiclav are amoxicillin (the main active ingredient) and clavulanic acid (necessary to protect amoxicillin from toxic substances produced by bacteria).
It follows from this that the best substitute for the original drug would be a drug that copies its structure, in other words, containing both of these substances. Most of the antibiotics in the pharmacy are sold by prescription, so a specialist should appoint an analogue of Amoxiclav.
List of cheap analogues:
- Amoxicillin - from 27 rubles;
- Amosin - from 30 rubles;
- Azithromycin - from 32 rubles;
- Amoxiclav - from 100 rubles;
- Augmentin - from 127 rubles;
- Ecoclave - from 155 rubles;
- Sumamed - from 160 rubles;
- Flemoxin Solutab - from 195 rubles;
- Arlet - from 219 rubles;
- Rapiklav - from 255 rubles;
- Flemoklav Solutab - from 276 rubles;
- Panklav - from 280 rubles;
- Medoklav - from 280 rubles;
- Klamosar - from 290 rubles.
Of these, Russian counterparts are:
- Ekoklav - analogue of Amoxiclav in tablets, as well as in the form of a powder for preparing a suspension from the company Avva Rus;
- Arlet is a production of Sintez ACOMP.
Suspension for children
Inside. Daily dosages of suspensions 125 mg + 31.25 mg / 5 ml and 250 mg + 62.5 mg / 5 ml (to facilitate correct dosing, a dosage spoon with a capacity of 125 mg + 31.25 mg / 5 ml and 250 mg + 62.5 mg / 5 ml is inserted into each package of suspensions 5 ml or graduated dosing pipette).
Newborns and children up to 3 months are prescribed 30 mg / kg (for amoxicillin) / day, divided into 2 doses (every 12 hours); children older than 3 months - from 20 mg (for amoxicillin) / kg / day for mild and moderate infections up to 40 mg / kg (for amoxicillin) / day for severe respiratory tract disease, divided into 3 doses (every 8 hours) ...
Daily doses of a suspension of 400 mg + 57 mg / 5 ml are calculated per 1 kg of body weight, depending on the severity of the course of the infection and are 25-45 mg / kg of body weight / day (in terms of amoxicillin), divided into 2 doses.
To facilitate correct dosing, a dosage pipette is included in each package of the 400 mg + 57 mg / 5 ml suspension, graduated simultaneously in 1, 2, 3, 4, 5 ml and in 4 equal parts.
Exact daily doses are calculated based on the child's body weight, not age. The maximum daily dose of amoxicillin is 6 g for adults and 45 mg / kg of body weight for children. The maximum daily dose of clavulanic acid (in the form of potassium salt) is 600 mg for adults, and 10 mg / kg for children.
In patients with severe renal failure (CC less than 10 ml / min), the dose should be adequately reduced or the interval between two doses should be increased (with anuria up to 48 hours or more).
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.
Suspension preparation rules:
- Powder for suspension preparation 125 mg + 31.25 mg / 5 ml: shake the bottle vigorously, add 86 ml of water (up to the mark) in two steps, shaking well each time until the powder is completely dissolved;
- Powder for suspension preparation 250 mg + 62.5 mg / 5 ml: shake the bottle vigorously, add 85 ml of water (up to the mark) in two steps, shaking well each time until the powder is completely dissolved;
- Powder for suspension preparation 400 mg + 57 mg / 5 ml: shake the bottle vigorously, add water in the amount indicated on the label and given in the table (up to the mark) in two steps, shaking well each time until the powder is completely dissolved.
- Bottle size: 35 ml, required amount of water: 29.5 ml;
- Bottle size: 50 ml, required amount of water: 42 ml;
- Bottle size: 70 ml, required amount of water: 59 ml;
- Bottle size: 140 ml, required amount of water: 118 ml.
Shake the bottle vigorously before use.
Amoxiclav 1000 mg. - price, instructions for use
The drug is selected individually for admission. Tablets in 1 g are prescribed in acute conditions and only for adults (children from 12 years old, with weights of more than 45 kg).
In severe cases of the disease, they drink 1 tablet of Amoxiclav (which contains 875 mg + 125 mg of basic substances) once a day for a period of 5 days. In case of pathologies of mild and moderate severity, it is recommended to purchase doses smaller in volume.
Most often, the medicine is prescribed in tablets. When a solution composition is prescribed for individual indications, it is injected intravenously (slowly) or intravenously by drip. The solution is shown for adults and children from 12 years old - 1 g every 8 hours (in acute stages - every 6 hours). The maximum daily rate of Amoxiclav: adults - 6 g, children - 45 mg per 1 kg of weight. Prices in pharmacies are 440-480 rubles per package, consisting of two blisters, each of which contains 7 tablets.
With prostatitis.
An antibiotic is an essential ingredient in the treatment of prostatitis. Often, the drug is resorted to when, for some reason, the patient is not able to do a laboratory analysis to identify the pathogen.
For prostatitis, tablet forms or powder are prescribed for the preparation of an oral suspension. It is recommended to take tablets with 1 g of active substances in one dose according to the scheme - 1 pc. course of 5 days. The effectiveness can be felt after just 2 days of use. Expected Symptoms:
- Reducing pressure on the urethra;
- Facilitate urination;
- Removal of puffiness and size of inflammation;
- Reducing the frequency of urge to use the toilet.
But if after 3-4 days there is no improvement, then the course of therapy must be adjusted with the help of a doctor. The use of the drug for prostatitis leads to a reduction in the frequency of urge to use the toilet.
Before or after meals.
Tablets or suspension are taken orally during meals. At the same time, it is important to drink plenty of water (this promotes better absorption of components by the intestines). The tablet does not need to be chewed. If it is impossible to swallow the whole dose, it must be crushed and dissolved in liquid.
How many days to take.
Traditional antibiotic therapy lasts 5-10 days. But the exact dosage and dosage regimen is prescribed by the doctor. Here play a role:
- The patient's age and weight;
- The severity of the condition;
- Concomitant pathologies.
Do not use the drug for more than 15 days.
During pregnancy and breastfeeding.
Amoxiclav is prescribed to pregnant women if the expected benefit outweighs the existing danger to the unborn child. This is done under the supervision of a specialist, since amoxicillin and clavulanic acid, although in small volumes, are included in the composition of breast milk.
In childhood.
Children are not prescribed a volume dose of 1 g. The tool can be used in suspensions and in lower dosages:
- Up to 3 months - 30 mg per 1 kg of body weight (orientation by amoxicillin) every 12 hours (i.e., 2 times a day);
- From 3 months in conditions of mild and moderate severity (orientation to amoxicillin) - from 20 to 45 mg per 1 kg of body weight (2 doses), in severe forms - for 3 doses;
- The maximum permissible pediatric dosage of amoxicillin is 45 mg / kg body weight per day. The maximum permitted dosage of clavulanic acid is 10 mg / kg.
For violations of liver function.
With liver pathologies, the antibiotic is prescribed with caution. Corrective measures are required for such manifestations:
- Medicinal hepatitis;
- Cholestatic jaundice (in the elderly);
- Transient increase in the activity of liver enzymes (AST and ALT).
With impaired renal function.
Patients with kidney problems need to monitor the dosage downward or increase the time range. In this case, Amoxiclav with a dosage of 1 g is replaced with smaller doses (125 or 500 mg). Patients with kidney problems need to monitor the dosage downward or increase the time range:
- The disease is in a moderate stage - up to 500 mg 2 times a day;
- In severe form - up to 500 mg 1 time;
- In the presence of anuria, the range between doses increases to 2 days or more (based on the results of a consultation with a specialist).
The course of therapy is no more than 2 weeks. The indications for prolongation are determined by the doctor.
