pharmachologic effect
Amoxicillin is an antibiotic that has a wide spectrum of effects. A group of antibiotics - semisynthetic penicillins . The abstract indicates that the drug is a 4-hydroxyl analogue of ampicillin . Provides a bactericidal effect. Demonstrates activity against aerobic gram-positive bacteria, namely Streptococcus spp., Staphylococcus spp. (except for those strains that produce penicillinase). Also active against aerobic gram-negative bacteria: Shigella spp., Neisseria gonorrhoeae, Escherichia coli, Neisseria meningitidis, Klebsiella spp., Salmonella spp.
Pharmacokinetics and pharmacodynamics
Amoxicillin trihydrate is very quickly and completely absorbed from the digestive tract, while the acidic environment of the stomach is not destroyed. The maximum level of concentration of the substance in the blood is observed 1-2 hours after taking the drug. If you double the dose of the drug, the concentration also doubles. If there is food in the stomach, the overall absorption is not reduced. If amoxicillin is administered IV or IM, similar concentrations of the active substance are observed in the blood. The substance binds to plasma proteins by approximately 20%. In the body, the active substance is distributed in fluids and tissues. The presence of large concentrations of the active substance is noted in the liver.
The plasma half-life is 1-1.5 hours. Approximately 60% of an orally administered dose is excreted from the body in the urine. Output unchanged. A certain amount of the substance is also found in feces. A longer half-life is observed in the elderly and neonates.
In small quantities it is able to penetrate the BBB during inflammatory processes of the pia mater.
Description
Capsule-shaped tablets of white or almost white color with a score.
Pharmacotherapeutic group:
antibiotic - semisynthetic penicillin
ATX code:
J01CA04
Pharmacological properties
Pharmacodynamics
Amoxicillin is an aminobenzyl penicillin, a semisynthetic broad-spectrum antibiotic that has a bactericidal effect due to inhibition of bacterial cell wall synthesis. Minimum inhibitory concentration (MIC) thresholds for different sensitive microorganisms vary. The prevalence of resistant strains varies geographically and over time, so it is advisable to rely on local resistance information, especially when treating severe infections.
Pharmacokinetics
Suction
Absorption is fast, high (93%), food intake does not affect absorption, and is not destroyed in the acidic environment of the stomach. When taken orally at a dose of 250 mg and 500 mg, the maximum concentration in blood plasma is 5 mcg/ml and 10 mcg/ml, respectively. The time to reach maximum concentration after oral administration is 1-2 hours.
Distribution
It has a large volume of distribution - high concentrations are found in blood plasma, bronchial secretions (in purulent bronchial secretions the distribution is weak), liver, lymph nodes, uterus, ovaries, paranasal sinuses, pleural and peritoneal fluid, saliva and tear fluid, urine, contents of skin blisters , lung tissue, intestinal mucosa, middle ear fluid and paranasal sinuses, bones, adipose tissue, gall bladder (the concentration in bile is 10 times higher than the concentration in blood plasma - with normal patency of the bile ducts), fetal tissues. When the dose is doubled, the concentration also doubles. In the amniotic fluid and umbilical cord vessels, the concentration of amoxicillin is about 50% of the concentration in the blood plasma of a pregnant woman. It penetrates poorly through the blood-brain barrier; with inflammation of the meninges (meningitis), the concentration in the cerebrospinal fluid increases to 20% of the concentration in the blood plasma. Bonding with blood plasma proteins is 15-25%.
Metabolism
Partially (10-20%) is metabolized to form inactive metabolites.
Removal
The half-life (T1/2) is 1-1.5 hours. It is excreted 50-70% unchanged by the kidneys through tubular excretion (80%) and glomerular filtration (20%), and 10-20% by the liver. A small amount is excreted in breast milk. If renal function is impaired (creatinine clearance [CC] ≤ 15 ml/min), T1/2 is extended to 8.5 hours.
Amoxicillin is removed by hemodialysis.
Special patient groups
Age
T1/2 of amoxicillin in children aged 3 months to 2 years is similar to T1/2 in older children and adults.
Since in elderly patients the likelihood of decreased renal function increases, dose selection is carried out with caution, and monitoring of renal function is also necessary.
Floor
When administered orally to healthy men and women, the gender of the patients does not have a significant effect on the pharmacokinetics of amoxicillin.
Kidney failure
The total serum clearance of amoxicillin increases in proportion to the decrease in renal function. If renal function is impaired (creatinine clearance < 15 ml/min), T1/2 lengthens and can reach 8.5 hours in anuria.
Liver failure
In patients with impaired liver function, dose selection should be carried out with caution, and regular monitoring of liver function is necessary.
Indications for use of Amoxicillin
The following indications for the use of this drug in combination with clavulanic acid , as well as as monotherapy, are determined:
- infectious and inflammatory diseases provoked by sensitive microorganisms ( bronchitis , tonsillitis , pyelonephritis , pneumonia , as well as cystitis , urethritis , infections of the digestive system, gynecological infectious diseases, gonorrhea , diseases of soft tissues and skin of infectious origin);
- in combination with metronidazole, it is used to treat chronic gastritis during an exacerbation, as well as duodenal and gastric ulcers during an exacerbation (provided that the ulcer is associated with Helicobacter pylori).
Also for the prescription of Amoxicillin tablets and other forms of the drug there are the following indications:
- leptospirosis , listeriosis ;
- tick-borne borreliosis ( Lyme disease );
- shigellosis;
- salmonellosis and salmonella carriage;
- meningitis;
- sepsis;
- endocarditis (for the purpose of prevention).
Contraindications
Please note that the following contraindications to the use of this medicine are noted:
- severe infectious diseases of the gastrointestinal tract, in which the patient suffers from diarrhea , vomiting ;
- Infectious mononucleosis;
- lymphocytic leukemia;
- allergic diathesis;
- viral respiratory infections;
- hay fever;
- bronchial asthma;
- high sensitivity to cephalosporins , penicillins .
Medicines containing metronidazole should not be used in the following cases:
- for diseases of the nervous system;
- for hematopoietic disorders;
- for infectious mononucleosis and lymphocytic leukemia ;
- with severe sensitivity to nitroimidazole .
Medicines containing clavulanic acid should not be used if there is a history of jaundice or impaired liver function.
Side effects
During treatment with this drug, the following side effects may occur:
- manifestations associated with an allergic reaction of the body : Quincke's edema , erythema , urticaria , conjunctivitis , rhinitis ; in rare cases, joint pain, eosinophilia, and fever may occur; in very rare cases - anaphylactic shock ;
- manifestations are a consequence of the chemotherapeutic influence : the development of superinfections, which most often occur in people suffering from chronic illnesses and those who have reduced resistance;
- symptoms are a consequence of prolonged use of the drug in large doses : ataxia , dizziness , depression , disturbances of consciousness , convulsions , peripheral neuropathies , therefore, only a doctor should determine how many days to take the drug;
- with the combination of “amoxicillin, metronidazole” : vomiting , nausea , constipation , anorexia , diarrhea , stomatitis , epigastric pain, glossitis ; in rare cases, pseudomembranous colitis, hepatitis, allergic manifestations, hematopoietic disorders, interstitial nephritis may occur;
- with the combination of “amoxicillin, clavulanic acid” : hepatitis , cholestatic jaundice ; in rare cases - erythema multiforme , exfoliative dermatitis , toxic epidermal necrolysis.
Instructions for use of Amoxicillin (Method and dosage)
The drug should be taken orally with water. You can take the antibiotic regardless of food intake.
Amoxicillin tablets, instructions for use
For adult patients and children over 12 years of age, 500 mg of amoxicillin is usually prescribed three times a day. However, the dosage depends on the disease and the doctor’s prescription in each specific case. For severe diseases, the dose can be increased to 750-1000 mg, the highest permissible dose per day is 6 g.
High doses of the drug are prescribed for typhoid fever (1.5-2 g three times a day), for leptospirosis (500-750 mg four times a day). Tablets or capsules should be taken for another two or three days even after the signs of the disease disappear. In most cases, treatment lasts from 5 to 12 days.
Amoxicillin suspension, instructions for use
The children's version of this antibiotic is Amoxicillin suspension, which is used to treat children under 5 years of age. The suspension must be prepared immediately before starting treatment. To do this, add cool water to the bottle with granules, after which the mixture must be shaken. The suspension can be stored for 14 days at room temperature. The medicine must be shaken each time before use. One measuring spoon contains 5 ml of suspension, respectively, it contains 250 mg of amoxicillin.
Children under 2 years of age should receive no more than 20 mg of the drug per 1 kg of weight per day. Children aged 2 to 5 years are recommended to take 125 mg of the drug. Children 5-10 years old receive a single dose of 250 mg. Children over 10 years old receive a single dose of 250-500 mg, if the disease is severe - up to 1 g.
Instructions for use Amoxicillin Sandoz
Used internally. In most cases, the dose ranges from 750 mg to 3 g of the drug, the dose is divided into several doses. More detailed information about the dosage and regimen of this drug, as well as about taking amoxicillin clavulanate, is provided by the doctor when prescribing treatment.
Veterinary Amoxicillin
In veterinary medicine, injections of amoxicillin 15% are used. For animals it is used to treat bacterial infections of the digestive system, skin diseases, respiratory diseases, diseases of the genitourinary system, etc. It is used for dogs, cats, and cattle. The drug must be administered subcutaneously or intramuscularly, the dosage is 1 ml per 10 kg of body weight. If necessary, the product is re-administered after 48 hours. A light massage of the area where the drug was injected is recommended.
Instructions for Amoxicillin DS
You need to take the drug 500 mg three times a day. If the disease is severe, the doctor may increase the dose to 750-1000 mg. Features of treatment depend on the patient's diagnosis.
The dosage of Amoxicillin for angina depends on the intensity of the pathological processes. As a rule, for angina, the usual dose of the drug is prescribed - 500 mg three times a day. How to take it for adults or how to take the medicine for children with a cold, you should definitely ask your doctor.
The dosage for sinusitis depends on the doctor's prescription. The dosage for adults is generally 500 mg of the drug 3-4 times a day, treatment lasts approximately one week. However, a specialist should tell you more precisely how many days to take the product.
Amoxicillin (suspension)
Before starting treatment, it is necessary to interview the patient to identify a history of hypersensitivity reactions to penicillins, cephalosporins or other beta-lactam antibiotics. In patients who are hypersensitive to penicillins, cross-allergic reactions with cephalosporins are possible.
Anaphylactic reactions, some fatal, have been reported with the use of penicillins. In rare cases, anaphylactic shock or other severe allergic reactions may develop. Similar reactions are possible in patients with a history of hypersensitivity to beta-lactam antibiotics or atopy. In case of severe allergic reactions, amoxicillin should be discontinued and alternative treatment should be prescribed.
In patients with severe renal impairment, the elimination of amoxicillin may be slowed and, depending on the severity of renal failure, a dose reduction may be required (see section "Dosage and Administration"). Forced diuresis accelerates the elimination of amoxicillin and reduces its plasma concentration.
Crystalluria can be observed in patients with reduced urine output, mainly with parenteral administration of amoxicillin. Because amoxicillin precipitates in urinary catheters, it is necessary to regularly check the patency of catheters and monitor the adequacy of fluid intake and output to minimize the risk of amoxicillin-associated crystalluria.
Amoxicillin should not be used to treat infections whose pathogens are not sensitive to amoxicillin; this is especially important to consider when treating infections of the genitourinary system and severe infections of the ear, nose and throat. Superinfection may develop due to the growth of microflora insensitive to amoxicillin, which requires a corresponding change in antibacterial therapy.
It is not recommended to use the drug in patients with infectious mononucleosis, because amoxicillin can cause a measles-like rash.
When taking almost all antibiotics, it is possible to develop antibiotic-associated colitis up to a life-threatening condition. This should be taken into account if diarrhea occurs during antibiotic therapy or after its completion. If antibiotic-associated colitis develops, drug therapy should be stopped immediately and consult a doctor to prescribe appropriate treatment. The use of drugs that inhibit intestinal motility is contraindicated.
When using the drug for a long time and/or in high doses, you should regularly monitor your general blood count, liver and kidney function.
Treatment with high doses of beta-lactam antibiotics in patients with renal failure or a history of seizures, treated epilepsy, and meningeal lesions may rarely result in seizures. The appearance at the beginning of treatment of generalized erythema, which is accompanied by pustules, may be a symptom of acute generalized exanthematous pustulosis. This requires discontinuation of treatment; further use of the drug is contraindicated.
The Jarisch-Herxheimer reaction can be observed when amoxicillin is used to treat Lyme disease and is directly related to the bactericidal effect of amoxicillin on the causative agent of the disease, the spirochete Borrelia burgdorferi.
Clinical manifestations: fever, chills, headache, myalgia, skin reactions in the area of erythema. Patients should understand that the development of the Jarisch-Herxheimer reaction is a common consequence of treatment for Lyme disease.
Treatment must continue for 48-72 hours after the disappearance of clinical signs of the disease.
Lab tests:
high concentrations of amoxicillin give a false-positive reaction to urine glucose when using Benedict's reagent or Fehling's solution. Enzymatic glucose oxidase tests are recommended. Amoxicillin may reduce the amount of estriol in the urine in pregnant women. Patients with diabetes mellitus should take into account that 5 ml of suspension (2 g of granules) contains 1.65 g of sucrose (or 0.14 bread units, XE), respectively, the maximum daily dose of amoxicillin contains 3.3 XE.
Patients with rare hereditary fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase deficiency should not take this drug.
5 ml of the finished suspension contains 10.63 mg of sodium, which must be taken into account in patients on a sodium-restricted diet.
Overdose
As a rule, in case of overdose there is no pronounced toxic effect, even if a large dose of the drug was taken. If a large dose of Amoxicillin has been taken, the patient will experience symptoms of gastrointestinal upset and water-electrolyte imbalance. In people who suffer from renal failure, overdose may show signs of nephrotoxicity and crystalluria.
Symptomatic treatment is carried out, for which drugs prescribed by the doctor are used, and activated charcoal should also be taken. Hemodialysis may be used . There is no specific antidote.
Amoxicillin Express, 250 mg, dispersible tablets, 20 pcs.
Hypersensitivity reactions
Before starting treatment with amoxicillin, attention should be paid to a history of hypersensitivity reactions to penicillins, cephalosporins or other beta-lactam antibiotics.
Severe and sometimes fatal hypersensitivity reactions (including anaphylactic reactions and severe skin reactions) have been reported in patients receiving penicillin therapy. The development of these reactions is more likely in people with a history of hypersensitivity to penicillins and in people with atopy. If an allergic reaction occurs, discontinue treatment with amoxicillin and institute appropriate alternative treatment.
Acute coronary syndrome associated with hypersensitivity (Kounis syndrome)
In rare cases, hypersensitivity reactions (acute coronary syndrome associated with hypersensitivity) have been reported during treatment with amoxicillin. If this reaction occurs, amoxicillin should be discontinued and appropriate treatment should be prescribed.
Insensitive microorganisms
For some types of infections, before prescribing amoxicillin, it is necessary to first establish the pathogen and its sensitivity to the drug, or make sure that the pathogen is likely to be treatable with amoxicillin. This particularly applies to patients with urinary tract infections and severe ear, nose and throat infections.
Convulsions
Convulsions may occur in patients with renal failure, in patients receiving high doses of the drug, as well as in patients with predisposing factors - a history of seizures, treatment for epilepsy or meningitis, etc.
Kidney failure
In patients with renal impairment, the dose should be adjusted according to the degree of renal impairment.
Skin reactions
The occurrence of generalized erythema with fever, accompanied by pustules, at the initial stage of treatment may be a symptom of OHEP (see section “Side effects”). In this case, amoxicillin should be discontinued, and its subsequent use will be contraindicated in any situation.
The use of amoxicillin should be avoided in patients who are suspected of having infectious mononucleosis, since a measles-like rash (exanthema) may occur due to the use of amoxicillin for this disease.
Jarosz-Herxheimer reaction
The Jarisch-Herxheimer reaction has been observed following the use of amoxicillin in patients with Lyme disease. This reaction is associated with the bactericidal effect of amoxicillin on the causative agent of Lyme disease, the spirochete Borrelia burgdorferi. Patients should be advised that this reaction is a common side effect of antibiotic treatment for Lyme disease and usually goes away on its own.
Excessive growth of non-susceptible microorganisms
Long-term use of the drug can sometimes lead to excessive growth of microorganisms that are not sensitive to amoxicillin (superinfection).
When using almost all antibacterial drugs, the development of colitis associated with taking antibiotics is possible. Its severity can range from mild to severe (life-threatening). Therefore, it is important to consider the possibility of this diagnosis in patients who develop diarrhea during or after antibiotic use. If diarrhea develops, the patient should immediately stop taking amoxicillin, consult a doctor and begin appropriate treatment. Medicines that inhibit peristalsis are contraindicated in this situation.
Long-term treatment
During long-term therapy, it is necessary to periodically monitor the function of the hematopoietic organs, kidneys and liver. Increased activity of liver enzymes and changes in the number of blood cells were reported.
Anticoagulants
Rare cases of increased prothrombin time have been reported in patients receiving amoxicillin. When prescribing the drug simultaneously with anticoagulants, appropriate monitoring should be carried out, and the dose of oral anticoagulants may need to be adjusted to maintain the required level of blood clotting.
Crystalluria
In patients with reduced diuresis, crystalluria was very rarely observed, mainly during parenteral therapy. When using high doses of amoxicillin, it is recommended to maintain adequate fluid intake and diuresis to reduce the likelihood of developing crystalluria associated with amoxicillin use. In patients with a catheterized bladder, catheter patency should be checked regularly.
Impact on diagnostic tests
Increased levels of amoxicillin in serum and urine may interfere with some laboratory tests. Due to high concentrations of amoxicillin in urine, chemical methods often give false-positive results.
When determining glucose in urine during treatment with amoxicillin, it is recommended to use enzymatic glucose oxidase tests.
The use of amoxicillin may affect the results of the quantitative determination of estradiol in urine in pregnant women.
Impact on the ability to drive vehicles and operate machinery
Studies of the effect of amoxicillin on the ability to drive vehicles or operate other machinery have not been conducted. However, side effects may occur (for example, allergic reactions, dizziness, convulsions) that affect the ability to drive vehicles or use other machinery.
Interaction
Wikipedia indicates that the drug may reduce the effectiveness of oral contraceptives.
If taken simultaneously with bactericidal antibiotics, the patient experiences synergy ; if taken simultaneously with bacteriostatic antibiotics, antagonism .
The drug stimulates the effect of indirect anticoagulants, reduces the prothrombin index and the synthesis of vitamin K.
Reduces the effectiveness of drugs in the process of metabolism of which PABA manifests itself.
Tubular secretion is reduced by allopurinol , diuretics, probenecid , phenylbutazone, and NSAIDs. As a result, its concentration in the blood may increase.
Under the influence of ascorbic acid, the absorption of amoxicillin increases, and when taken simultaneously with glucosamine , antacids , aminoglycosides , and laxatives , it decreases.
If the simultaneous use of amoxicillin and clavulanic acid is practiced, there is no change in the pharmacokinetics of these drugs.
Microorganisms that produce penicillinase demonstrate resistance to the main substance.
When combined with metronidazole, it is active against Helicobacter pylori.
Cross-resistance has been observed between amoxicillin and ampicillin .
special instructions
Amoxicillin, as well as Amoxicillin Clavulanate and other types of the drug, should be taken with caution by people who are prone to allergic reactions.
liver disease , as well as those who are under 18 years of age, should not take the drug with metronidazole
Cross-allergy may occur in people who are hypersensitive to carbapenems and cephalosporins .
You should consider what Amoxicillin helps with. Thus, the drug is ineffective in the treatment of acute respiratory viral infections.
If the patient has severe gastrointestinal infections with symptoms of diarrhea and vomiting, then tablets should not be prescribed due to poor absorption.
The drug should be used with caution by people with bronchial asthma , allergic diathesis , and hay fever .
If the patient is forced to take the drug for a long time, he is additionally prescribed Levorin , Nystatin or other drugs with antifungal action.
It is important to monitor the condition of the kidneys, liver, as well as laboratory parameters of urine and blood in people who take large doses of the drug for a long time.
Patients who ask their doctor questions about whether Amoxicillin is an antibiotic or not should note that this drug is an antibiotic, so it is advisable to always consult a doctor before starting to take it. It is the doctor who determines how many days to take the medicine, as well as its dosage. You should not independently determine what Amoxicillin tablets help with and practice self-medication.
The drug for cats, dogs and other animals should be used only after a prescription by a veterinarian.
The combination of amoxicillin, omeprazole , clarithromycin is used to treat peptic ulcers.
Amoxicillin 250 mg No. 20 Tablets
Release form
Capsules.
Pills.
Granules for the preparation of suspension for oral administration.
Compound
1 capsule contains amoxicillin trihydrate 250 or 500 mg. 1 tablet contains amoxicillin trihydrate 250 or 500 mg. Suspension: 2 g of granules (5 ml of suspension) contain the active substance amoxicillin - 250 mg (in trihydrate form). Excipients: sodium saccharinate, simethicone S 184, guar gum, sodium benzoate, sodium citrate, sucrose, passionflower flavor, raspberry flavor, strawberry flavor.
pharmachologic effect
Amoxicillin is a broad-spectrum antibiotic from the group of semisynthetic penicillins with a broad spectrum of action. The effect of amoxicillin occurs very quickly. Like other penicillin antibiotics, it inhibits cell wall synthesis. Amoxicillin is bactericidal and active against gram-positive cocci (Staphylococcus spp., Streptococcus pneumoniae, group A, B, C, G, H, I, M streptococci); gram-negative cocci (Neisseria meningitidis, N. gonorrhoeae); gram-negative rods (Escherichia coli, Shigella spp., Klebsiella spp., Proteus mirabilis, Salmonella, Campilobacter, Haemophilus influenzae, Bordetella pertussis, Chlamydia). Amoxicillin is active against all microorganisms sensitive to penicillin G: Erysipelothrix rhysiopathiae, Corynebacterium, Bacillus anthracis, Actinomycetes, Streptobacilli, Spirillium minus, Pastereulla multocida, Listeria, Spirochaeta (Leptospira, Treponema, Borrelia), etc., as well as various anaerobic microorganisms ( including peptococci, peptostreptococci, clostridia and fusobacteria). Strains of microorganisms that produce beta-lactamases are resistant to Amoxicillin. Amoxicillin is acid-resistant and therefore effective when administered orally.
Amoxicillin, indications for use
Bacterial infections caused by pathogens sensitive to Amoxicillin: – acute and chronic respiratory tract infections (angina, acute otitis media, pharyngitis, sinusitis; acute and chronic bronchitis, bronchopneumonia, lung abscess); – acute and chronic infections of the gastrointestinal tract, biliary tract (peritonitis, cholecystitis, intestinal infections); – acute and chronic infections of the urinary system (pyelonephritis, urethritis, gonorrhea); – purulent infections of soft tissues; – sepsis.
Contraindications
– hypersensitivity to penicillins; - Infectious mononucleosis.
Directions for use and doses
Adults are prescribed 500 mg 3 times a day. In severe cases of the disease - 1 g 3 times a day. Children aged 5-10 years are prescribed 250 mg 3 times/day, children 2-5 years old - 125 mg 3 times/day, children under 2 years old - at the rate of 20 mg/kg body weight (divided into 3 doses). The course of treatment is 5-12 days. The interval between doses is 8 hours. For the treatment of acute uncomplicated gonorrhea, a single dose of 3 g is prescribed (in combination with 1 g of probenecid). For women, it is recommended to repeat this dose every other day.
Use during pregnancy and breastfeeding
There is currently no data on the possible embryotoxic, teratogenic or mutagenic effects of the drug when taken during pregnancy. Amoxicillin is found in breast milk, which should be taken into account when prescribing Amoxicillin during lactation.
Side effects
Allergic reactions: urticaria, skin rash, erythema, exanthema, Quincke's edema, rhinitis, conjunctivitis, photosensitivity; rarely – fever, joint pain, eosinophilia; in isolated cases - anaphylactic shock. Other: superinfection may develop with the appearance of loose stools and nausea.
special instructions
In patients with hypersensitivity to cephalosporins and carbapenems, the possibility of cross-allergy should be taken into account. For severe gastrointestinal infections accompanied by persistent diarrhea or vomiting, amoxicillin should not be administered orally due to the possibility of poor absorption. The use of antibiotics is ineffective in the treatment of acute respiratory viral infections. Particular caution should be observed in patients with allergic diathesis or bronchial asthma and hay fever (hay fever), a history of gastrointestinal diseases (especially colitis associated with the use of antibiotics). When taking Amoxicillin for a long time, nystatin, levorin or other antifungal drugs should be prescribed simultaneously. With long-term use of high doses of the drug in patients, liver and kidney function indicators should be monitored and general urine tests should be performed. It is advisable to monitor the peripheral blood picture.
Release from pharmacies
On prescription.
Drug interactions
Pharmaceutically incompatible with aminoglycosides (to avoid mutual inactivation, do not mix). Antacids, glucosamine, laxatives, food, aminoglycosides - slow down and reduce absorption; ascorbic acid increases absorption. Bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, vancomycin, rifampicin) - synergistic effect; bacteriostatic drugs (macrolides, chloramphenicol, lincosamides, tetracyclines, sulfonamides) antagonistic. Increases the effectiveness of indirect anticoagulants (suppressing intestinal microflora, reduces the synthesis of vitamin K and the prothrombin index); reduces the effectiveness of estrogen-containing oral contraceptives, drugs whose metabolism produces paraaminobenzoic acid, ethinyl estradiol - the risk of breakthrough bleeding. Diuretics, allopurinol, oxyphenbutazone, phenylbutazone, non-steroidal anti-inflammatory drugs; drugs that block tubular secretion - by reducing tubular secretion, they increase concentration. Allopurinol increases the risk of developing skin rashes. Reduces clearance and increases toxicity of methotrexate. Enhances the absorption of digoxin.
Storage conditions
Store in a dry place, protected from light, at room temperature.
Best before date
2 years.
Amoxicillin analogues
Level 4 ATC code matches:
Hiconcil
Ampioks
Ampicillin Trihydrate
Ampicillin
Ospamox
Amoxicar
Penicillin
Flemoxin Solutab
Amosin
Amoxil
Ecoball
There are a number of analogues of this drug, which contain a similar active substance. The price of analogues depends on the manufacturer of the drug. Such medications are the following drugs: Amoxicillin trihydrate , Amoxicillin Sandoz , Flemoxin Solutab , Amoxicillin , Amosin , Amoxisar , Ecobol , etc.
Which is better: Amoxiclav or Amoxicillin?
Many patients believe that Amoxiclav and Amoxicillin are the same thing. But there is still a difference between these drugs. Amoxiclav contains clavulanic acid, so the drug has a wider spectrum of action. But this drug is more expensive.
Which is better: Flemoxin Solutab or Amoxicillin?
The drug Flemoxin contains a similar active substance. But Amoxicillin is more often used to treat adult patients. Flemoxin Solutab is absorbed faster from the gastrointestinal tract, it can be taken with meals, they have a pleasant taste. These tablets can be dissolved in water and prepared into a suspension or syrup. Flemoxin Solutab is a more expensive drug.
Buy Amoxicillin granules for suspension 250mg/5ml 100ml Hemofarm in pharmacies
Amoxicillin Buy Amoxicillin in pharmacies DOSAGE FORMS granules for the preparation of oral suspension 250mg/5ml granules for the preparation of oral suspension 250mg/5ml
MANUFACTURERS Hemofarm A.D. (Serbia) Hemofarm D.D. (Yugoslavia)
GROUP Antibiotics of the penicillin group
COMPOSITION Active substance - amoxicillin.
INTERNATIONAL NON-PROPENTED NAME Amoxicillin
SYNONYMS Amoxisan, Amoxicillin DS, Amoxicillin Sandoz, Amoxicillin trihydrate, Amoxicillin sodium salt sterile, Amosin, Clamoxil LA, Ospamox, Flemoxin Solutab, Hiconcil, Ecobol
PHARMACOLOGICAL ACTION Antibacterial (bactericidal). Stable in an acidic environment, food intake does not affect absorption. Easily passes histohematic barriers, except for the unchanged BBB, and penetrates most tissues and organs; accumulates in therapeutic concentrations in peritoneal fluid, urine, contents of skin blisters, pleural effusion, lungs, intestinal mucosa, female genital organs, middle ear fluid, gall bladder and bile, fetal tissues. Partially metabolized to form inactive metabolites, excreted unchanged by the kidneys and liver. A small amount is excreted in breast milk. The action develops 15-30 minutes after administration and lasts 8 hours. It has a wide spectrum of antimicrobial action, including Staphylococcus spp., except for penicillinase-producing strains, Streptococcus spp., Neisseria gonorrhoeae, Neisseria meningitidis, Escherichia coli, Proteus mirabilis, some Salmonella strains , Shigella, Klebsiella and Haemophilus influenzae.
INDICATIONS FOR USE Infections of the respiratory tract and ENT organs (bronchitis, pneumonia, tonsillitis, acute otitis media, pharyngitis, sinusitis), genitourinary system (urethritis, cystitis, pyelonephritis, endometritis, uncomplicated gonorrhea), skin and soft tissues, gastrointestinal tract (peritonitis, enterocolitis, cholecystitis, cholangitis, typhoid fever); leptospirosis, listeriosis, meningitis, Lyme disease (borreliosis), prevention of endocarditis and surgical infection; combination therapy of gastritis and peptic ulcer (in combination with metronidazole), sepsis (in combination with aminoglycosides).
CONTRAINDICATIONS Hypersensitivity (including to other penicillins, cephalosporins, carbapenems), allergic diathesis, bronchial asthma, hay fever, infectious mononucleosis, lymphocytic leukemia, history of gastrointestinal diseases (especially colitis associated with the use of antibiotics).
SIDE EFFECTS Nausea, vomiting, diarrhea, pain in the anus, stomatitis, glossitis; agitation, anxiety, insomnia, confusion, behavior changes, headache, dizziness, convulsive reactions; difficulty breathing, tachycardia; joint pain; interstitial nephritis; dysbiosis, superinfection, oral or vaginal candidiasis, pseudomembranous or hemorrhagic colitis; moderate increase in the level of transaminases in the blood, transient anemia, thrombocytopenic purpura, eosinophilia, leukopenia, neutropenia and agranulocytosis; allergic reactions: exfoliative dermatitis, exudative erythema multiforme, Stevens-Johnson syndrome, anaphylactic shock, maculopapular rash, itching, urticaria, Quincke's edema, reactions similar to serum sickness.
INTERACTION Reduces the effect of estrogen-containing oral contraceptives, reduces clearance and increases the toxicity of methotrexate. Enhances the absorption of digoxin. Excretion is slowed down by probenecid, sulfinpyrazone, acetylsalicylic acid, indomethacin, oxyphenbutazone, phenylbutazone and other drugs that suppress tubular secretion. Antibacterial activity is reduced by bacteriostatic chemotherapeutic agents and antacids, and increased by aminoglycosides and metronidazole. Allopurinol - increases the occurrence of skin rashes.
OVERDOSE Symptoms: nausea, vomiting, diarrhea, water and electrolyte imbalance. Treatment: gastric lavage, administration of activated carbon, saline laxatives, correction of water and electrolyte balance; hemodialysis.
SPECIAL INSTRUCTIONS Use with caution for urticaria and hay fever. Renal, liver and hematopoiesis function should be periodically monitored during long-term therapy. Treatment must be continued for 48-72 hours after the disappearance of clinical signs of the disease. During pregnancy and lactation, it is used for health reasons, taking into account the expected effect for the mother and the potential risk for the fetus or child. During the course, breastfeeding is excluded. It should be taken into account that the granules when preparing the suspension contain sugar. When determining glucose in urine, false positive results and changes in the results of determining urobilinogen are possible. For more information, see the naming instructions.
STORAGE CONDITIONS List B. At room temperature.
Amoxicillin and alcohol
The instructions for the drug do not indicate whether the drug can be combined with alcohol. However, doctors do not recommend practicing this combination. After all, alcohol significantly reduces the effectiveness of the medicine. In this case, side effects may increase significantly. There may be an unpredictable effect on the nervous system, the toxic effect on the liver is rapidly increasing, and the risk of severe allergic manifestations and breathing problems increases. It should be borne in mind that these tablets are an antibiotic, which means they should only be used during a period of abstinence from alcohol.
Amoxicillin during pregnancy and lactation
It should be borne in mind that the substance amoxicillin can penetrate the placental barrier. But still, during pregnancy, according to indications, this remedy is prescribed to women for inflammatory diseases. It is prescribed for bacterial infections. But still, the drug can provoke the development of dysbacteriosis , allergic reactions , and activation of fungal microflora. Reviews of Amoxicillin during pregnancy generally indicate its effectiveness and rare occurrence of side effects.
The drug should not be taken during lactation, as it passes into breast milk. If treatment of inflammatory processes during lactation is required, another drug is prescribed or breastfeeding is stopped.
Use during pregnancy and breastfeeding
Results from animal studies do not indicate direct or indirect effects on reproductive toxicity. Limited data on the use of amoxicillin during human pregnancy do not indicate an increased risk of congenital malformations. Amoxicillin can be used during pregnancy only in cases where the expected benefit to the mother outweighs the potential risk to the fetus.
Amoxicillin is excreted into breast milk in small quantities; if necessary, the drug can be used during breastfeeding. A breastfed baby may develop diarrhea, sensitization and fungal infection of the mucous membranes, so it may be necessary to stop breastfeeding. Amoxicillin should be used during breastfeeding only after the attending physician has assessed the benefit/risk ratio.
Reviews about Amoxicillin
Reviews about Amoxicillin on the Internet are mostly positive. They note that after the start of treatment the effect appears very quickly, the drug is convenient to use for both adults and children, for whom there is a special suspension for children. Also mentioned as a positive is that the medicine can be taken during pregnancy .
When discussing Amoxicillin, doctors' reviews are also positive. But experts always write that self-medication with the drug is unacceptable.
Amoxicillin price, where to buy
The price of Amoxicillin in tablets of 500 mg is 30-35 rubles per pack of 10 pcs. The price of Amoxicillin 1000 mg depends on the manufacturer of the drug. The price of Amoxicillin suspension for children is on average 80-90 rubles per 100 ml bottle. You can buy the antibiotic Amoxicillin Clavulanate, which contains clavulanic acid , for a price starting from 250 rubles.
How much tablets cost in Ukraine (in Odessa, Kharkov and other cities) depends on their manufacturer. The cost of the drug is from 45 hryvnia for 10 tablets. Suspension for children can be bought for an average of 130 hryvnia. Amoxicillin ampoules can be purchased for 160 rubles.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Amoxicillin + clavulanic acid express dispersant tablets.
250mg+62.5mg 14 pcs. JSC "LECCO" 217 rub. order - Amoxicillin Dispertab tab. dispersant 0.5g 20pcs JSC AVVA RUS
RUB 291 order
- Amoxicillin capsules 500 mg 16 pcs. Hemofarm A.D. Vršac, Dubovac production site
102 RUR order
- Amoxicillin+clavulanic acid tablets p.p.o 500mg+125mg 14 pcs JSC "LEKKO"
RUB 273 order
- Amoxicillin tablets 500 mg 10 pcs. JSC "AVVA RUS"
56 RUR order
Pharmacy Dialogue
- Amoxicillin capsules 250 mg No. 16Hemofarm
58 RUR order
- Amoxicillin granules for suspension 250mg/5ml 100mlHemofarm
97 RUR order
- Amoxicillin tablets 500 mg No. 20Avva Rus
115 rub. order
- Amoxicillin capsules 500 mg No. 16Barnaulsky ZMP
68 RUR order
- Amoxicillin tablets 500 mg No. 20Biokhimik OJSC
65 rub. order
show more
PaniPharmacy
- Amoxicillin 15% 100ml Ukraine, Olkar
252 UAH. order
show more
Release form and composition
Amoxicillin is produced in the following forms:
- Capsules 250 and 500 mg. Gelatin capsules with a yellow body and a red cap. Inside contains white or light yellow powder. The drug does not have a specific smell or taste. Active ingredient: amoxicillin trihydrate. Excipients: magnesium stearate, microcrystalline cellulose.
- Tablets 250 and 500 mg. Round or oblong white tablets. They do not have a specific smell. Active ingredient: amoxicillin trihydrate.
- Granules for preparing a suspension. Granular powder of white or yellowish color. After adding water, a suspension is formed that has a yellowish tint and a fruity odor. Active ingredient: amoxicillin trihydrate. Excipients: simethicone, sucrose, sodium citrate dihydrate, sodium saccharinate dihydrate, guar gum, sodium benzoate, flavoring.
