Amoxiclav is a combination drug that belongs to the group of beta-lactam antibiotics. The therapeutic effects are provided by the active substances - amoxicillin - one of the best penicillin antibiotics and clavulanic acid - the most powerful known beta-lactamase inhibitor.
The combination of these substances leads to the appearance of special properties of Amoxiclav:
- irreversible blockade of β-lactamases of microorganisms, which allows amoxicillin to have an antibacterial effect even on resistant pathogens;
- high bioavailability;
- penetrates well into most tissues and body fluids, creating a high concentration that is necessary to destroy sensitive pathogenic bacteria.
The mechanism of action of amoxicillin in Amoxiclav is bactericidal activity - disruption of the synthesis of a component of the bacterial cell wall, which causes their dissolution. Clavulanic acid is a β-lactam inhibitor and exhibits equal activity against both gram-positive and gram-negative bacteria. Protects amoxicillin from destruction by enzymes - β-lactamases, thereby expanding the spectrum of action of amoxicillin.
Amoxiclav is manufactured by the pharmaceutical company Lek Pharmaceuticals dd in Slovenia. There are various dosage forms of the drug on the Ukrainian pharmaceutical market. This is an important point in choosing Amoxiclav when prescribing it to patients of different age categories and severity of the disease.
Advantages of using Amoxiclav:
- predictable effectiveness and non-toxicity of penicillins;
- wider spectrum of action, compared with amoxicillin and oral cephalosporins due to the presence of clavulanic acid;
- applicable in all age groups;
- food intake does not affect the absorption of the drug.
Among dosage forms, the ease of use of Amoxiclav suspension should be noted. The drug is equipped with a measuring syringe for dosing accuracy. The possibility of using the suspension three times in children minimizes the development of resistance and meets international requirements for rational antibiotic therapy.
Composition of Amoxiclav
- Amoxiclav 250 mg/125 mg tablets contain the active ingredients amoxicillin (trihydrate form) and clavulanic acid (potassium salt form). The tablets also contain auxiliary components: MCC sodium croscarmellose.
- Amoxiclav 2X 625 mg and 1000 mg tablets contain the active ingredients amoxicillin and clavulanic acid, as well as additional components: anhydrous colloidal silicon dioxide, flavorings, aspartame , yellow iron oxide, talc, hydrogenated castor oil, silicated MCC.
- Amoxiclav Quiktab 500 mg and 875 mg tablets contain the active ingredients amoxicillin and clavulanic acid, as well as additional components: anhydrous colloidal silicon dioxide, flavorings, aspartame, yellow iron oxide, talc, hydrogenated castor oil, silicated MCC.
- The powder from which the Amoxiclav suspension is prepared also contains amoxicillin and clavulanic acid, and also contains sodium citrate, MCC, sodium benzoate, mannitol, and sodium saccharin as inactive components.
- The powder for preparing Amoxiclav IV infusion contains amoxicillin and clavulanic acid.
Compound
Active ingredients: amoxicillin, clavulanic acid;
1 bottle contains 1000 mg of amoxicillin in the form of sodium salt and 200 mg of clavulanic acid in the form of potassium salt.
Amoxicillin is a semisynthetic penicillin (beta-lactam antibiotics) that inhibits one or more enzymes, often referred to as penicillin binding proteins (PBPs), in the biosynthetic metabolism of bacterial peptidoglycan, an integral structural component of the bacterial cell wall. Inhibition of peptidoglycan synthesis leads to weakening of the cell wall, resulting in cell lysis and death.
Amoxicillin is sensitive to the breakdown of beta-lactamases produced by resistant bacteria; therefore, the spectrum of activity of amoxicillin as monotherapy does not include organisms that produce these enzymes.
Clavulanic acid is a beta-lactam, structurally related to penicillins. It disables some beta-lactamase enzymes, thereby preventing the inactivation of amoxicillin. Clavulanic acid as monotherapy does not have a clinically useful antibacterial effect.
Release form
The drug is produced in the form of tablets:
- Amoxiclav 250 mg/125 mg – film-coated tablets, package contains 15 pieces.
- Amoxiclav 2X (500 mg/125 mg; 875 mg/125 mg) - coated tablets; the package may contain 10 or 14 pieces.
- Amoxiclav Quiktab (500 mg/125 mg; 875 mg/125 mg) is available in the form of dispersed tablets, 10 such tablets per package.
The product is also produced in the form of a powder from which a suspension is made; the bottle contains powder for preparing 100 ml of the product.
A powder is also produced, from which a solution is made, which is administered intravenously. The bottle contains 600 mg of the product (amoxicillin 500 mg, clavulanic acid 100 mg), 1.2 g bottles are also available (amoxicillin 1000 mg, clavulanic acid 200 mg), the package contains 5 bottles.
pharmachologic effect
The abstract provides information that the antibiotic Amoxiclav (INN Amoksiklav) is a broad-spectrum agent. Group of antibiotics: broad-spectrum penicillins. The medicine 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 produced by microorganisms.
The structure of clavulanic acid is similar to beta-lactam antibiotics, this substance also has an antibacterial effect. Amoxiclav is active against strains that demonstrate sensitivity to Amoxicillin. These are a number of gram-positive bacteria, aerobic gram-negative bacteria, gram-positive and gram-negative anaerobes.
Note!
Description of the drug Amoxiclav por. d/r-ra d/in. 1000mg/200mg vial. No. 5 on this page is a simplified author’s version of the apteka911 website, created on the basis of the instructions for use.
Before purchasing or using the drug, you should consult your doctor and read the manufacturer's original instructions (attached to each package of the drug). Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. Only a doctor can decide to prescribe the drug, as well as determine the dose and methods of its use.
Pharmacokinetics and pharmacodynamics
As the Vidal drug reference book informs, after oral administration, both substances are actively absorbed from the gastrointestinal tract; the absorption of the components is not affected by food intake, so it does not matter how you take it - before or after meals. The highest concentration in the blood is observed one hour after the drug was taken. Both active ingredients of the drug are distributed in fluids and tissues. Amoxicillin also enters the liver, synovial fluid, prostate, tonsils, gall bladder, muscle tissue, saliva, and bronchial secretions.
If the membranes of the brain are not inflamed, both active substances do not penetrate through the BBB. At the same time, the active components penetrate the placental barrier and traces of them are detected in breast milk. They bind to blood proteins to a small extent.
In the body, amoxicillin undergoes partial metabolism , clavulanic acid is intensively metabolized. It is excreted from the body through the kidneys; small particles of active substances are excreted by the intestines and lungs. The half-life of amoxicillin and clavulanic acid is 1-1.5 hours.
Amoksiklav for injection
Release form, composition and packaging
Powder for the preparation of a solution for intravenous administration is white to yellowish-white in color.
1 fl. amoxicillin (in the form of sodium salt) 500 mg clavulanic acid (in the form of potassium salt) 100 mg.
Powder for the preparation of a solution for intravenous administration is white to yellowish-white in color.
1 fl. amoxicillin (in the form of sodium salt) 1 g clavulanic acid (in the form of potassium salt) 200 mg.
Clinical and pharmacological group: Broad-spectrum penicillin antibiotic with a beta-lactamase inhibitor.
pharmachologic effect
Broad-spectrum antibiotic; contains semisynthetic penicillin amoxicillin and β-lactamase inhibitor clavulanic acid. Clavulanic acid forms a stable inactivated complex with β-lactamases and ensures the resistance of amoxicillin to their effects. Clavulanic acid, similar in structure to β-lactam antibiotics, has weak intrinsic antibacterial activity.
Thus, Amoxiclav has a bactericidal effect on a wide range of gram-positive and gram-negative bacteria (including strains that have become resistant to beta-lactam antibiotics due to the production of beta-lactamases). Amoxiclav is active against aerobic gram-positive bacteria: Streptococcus spp. (including Streptococcus pneumoniae, Streptococcus viridans, Streptococcus pyogenes, Streptococcus bovis), Enterococcus spp., Staphylococcus aureus (except methicillin-resistant strains), Staphylococcus epidermidis (except methicillin-resistant strains), Staphylococcus saprophyticus, Listeria spp.; aerobic gram-negative bacteria: Bordetella pertussis, Brucella spp., Campylobacter jejuni, Escherichia coli, Gardnerella vaginalis, Haemophilus ducreyi, Haemophilus influenzae, Helicobacter pylori, Klebsiella spp., Moraxella catarrhalis, Neisseria gonorrhoeae, Neisseria meningitidis, Pasteurella multocida, Proteus spp., Providencia spp., Salmonella spp., Shigella spp., Vibrio cholerae, Yersinia enterocolitica, Eikenella corrodens; anaerobic gram-positive bacteria: Peptococcus spp., Actinomyces israelii, Prevotella spp., Clostridium spp., Peptostreptococcus spp., Fusobacterium spp.; anaerobic gram-negative bacteria: Bacteroides spp.
Pharmacokinetics
The main pharmacokinetic parameters of amoxicillin and clavulanic acid are similar. Amoxicillin and clavulanic acid in combination do not affect each other.
Distribution
Cmax after a bolus injection of Amoxiclav 1.2 g is 105.4 mg/l for amoxicillin and 28.5 mg/l for clavulanic acid. Both components are characterized by a good volume of distribution in body fluids and tissues (lungs, middle ear, pleural and peritoneal fluids, uterus, ovaries). Amoxicillin also penetrates into the synovial fluid, liver, prostate gland, tonsils, muscle tissue, gall bladder, secretions of the paranasal sinuses, saliva, and bronchial secretions. Amoxicillin and clavulanic acid do not penetrate the BBB when the meninges are not inflamed. Cmax in body fluids is observed 1 hour after reaching Cmax in blood plasma. The active substances penetrate the placental barrier and are excreted in breast milk in trace concentrations. Amoxicillin and clavulanic acid are characterized by low binding to plasma proteins.
Metabolism
Amoxicillin is partially metabolized, clavulanic acid appears to be extensively metabolized.
Removal
Amoxicillin is excreted by the kidneys almost unchanged by tubular secretion and glomerular filtration. Clavulanic acid is excreted by glomerular filtration, partly in the form of metabolites. Small amounts may be excreted through the intestines and lungs. T1/2 of amoxicillin and clavulanic acid is 1-1.5 hours. Both components are removed by hemodialysis and, in small quantities, by peritoneal dialysis.
Pharmacokinetics in special clinical situations
In severe renal failure, T1/2 increases to 7.5 hours for amoxicillin and to 4.5 hours for clavulanic acid.
Indications
Treatment of infectious and inflammatory diseases caused by microorganisms sensitive to the drug:
- infections of the upper respiratory tract and ENT organs (including acute and chronic sinusitis, acute and chronic otitis media, retropharyngeal abscess, tonsillitis, pharyngitis);
- infections of the lower respiratory tract (including acute bronchitis with bacterial superinfection, chronic bronchitis, pneumonia);
- urinary tract infections;
- gynecological infections;
- skin and soft tissue infections, including human and animal bites;
- bone and joint infections;
- abdominal infections, incl. biliary tract (cholecystitis, cholangitis);
- odontogenic infections;
- sexually transmitted infections (gonorrhea, chancroid);
- prevention of infections after surgery.
Dosage regimen
The drug is administered intravenously. For adults and children over 12 years of age (with body weight >40 kg), the drug is prescribed at a dose of 1.2 g (1000 mg + 200 mg) with an interval of 8 hours, in case of severe infection - with an interval of 6 hours.
For children aged 3 months to 12 years, the drug is prescribed at a dose of 30 mg/kg body weight (calculated for the entire Amoxiclav) with an interval of 8 hours, in case of severe infection - with an interval of 6 hours.
Children under 3 months of age : premature and during the perinatal period - at a dose of 30 mg/kg body weight (in terms of the entire Amoxiclav) every 12 hours; in the postperinatal period - at a dose of 30 mg/kg body weight (in terms of the entire Amoxiclav) every 8 hours. Every 30 mg of Amoxiclav contains 25 mg of amoxicillin and 5 mg of clavulanic acid.
The prophylactic dose for surgical interventions is 1.2 g during induction anesthesia (for an operation lasting less than 2 hours); for longer operations - 1.2 g up to 4 times a day. For patients with renal failure, the dose and/or interval between doses of the drug should be adjusted depending on creatinine clearance (see table).
Creatinine clearance
Dosage regimen >0.5 ml/s (>30 ml/min) no dose adjustment required 0.166-0.5 ml/s (10-30 ml/min) first dose - 1.2 g (1000 mg + 200 mg), and then 600 mg (500 mg + 100 mg) IV every 12 hours <0.166 ml/s (<10 ml/min) first dose - 1.2 g (1000 mg + 200 mg), and then 600 mg (500 mg + 100 mg) i.v. /every 24 hours for anuria, the interval between administrations should be increased to 48 hours or more.
Since 85% of Amoxiclav is removed by hemodialysis, the drug is administered at the end of the hemodialysis procedure. With peritoneal dialysis, no dosage adjustment is required. The course of treatment is 5-14 days.
The duration of treatment is determined individually. When the severity of symptoms decreases, it is recommended to switch to oral forms of the drug Amoxiclav to continue therapy.
Rules for the preparation and administration of solutions for intravenous injections
The contents of the vial 600 mg (500 mg + 100 mg) should be dissolved in 10 ml of water for injection or 1.2 g (1000 mg + 200 mg) in 20 ml of water for injection. Inject intravenously slowly (over 3-4 minutes). Rules for the preparation and administration of solutions for intravenous infusions For infusion administration of Amoxiclav, further dilution is necessary: prepared solutions containing 600 mg (500 mg + 100 mg) or 1.2 g (1000 mg+200 mg) of the drug should be diluted in 50 ml or 100 ml of infusion solution, respectively. Duration of infusion is 30-40 minutes.
When using the infusion solutions listed below in the recommended volumes, they retain the required concentrations of the antibiotic. The following infusion solutions can be used as a solvent for intravenous infusions.
Amoxiclav should be administered within 20 minutes after preparing solutions for intravenous administration. Only clear solutions should be used. Do not freeze prepared solutions.
Side effect
From the digestive system: loss of appetite, nausea, vomiting, diarrhea; rarely - liver dysfunction, increased activity of ALT and AST; in isolated cases - cholestatic jaundice, hepatitis, pseudomembranous colitis.
Allergic reactions: itching, urticaria, erythematous rashes; rarely - exudative erythema multiforme, angioedema, anaphylactic shock; in isolated cases - exfoliative dermatitis, Stevens-Johnson syndrome.
Other: reversible increase in prothrombin time (when used together with anticoagulants); rarely - candidiasis and other types of superinfection.
Contraindications
- a history of cholestatic jaundice or liver dysfunction caused by taking amoxicillin/clavulanic acid;
- increased sensitivity to antibiotics of the penicillin group;
- hypersensitivity to amoxicillin or clavulanic acid or other components of the drug. The drug is prescribed with caution to patients with known hypersensitivity to cephalosporin antibiotics, a history of pseudomembranous colitis, liver failure, and severe renal impairment.
Pregnancy and lactation
Prescribing the drug during pregnancy is possible only if there are clear indications. Amoxicillin and clavulanic acid are excreted in breast milk in small quantities.
Use for liver dysfunction
The drug is prescribed with caution for liver failure.
Use for renal impairment
For patients with renal failure, the dose and/or interval between doses of the drug should be adjusted depending on the creainine clearance.
With peritoneal dialysis, no dosage adjustment is required.
Indications for use of Amoxiclav
Amoxiclav is prescribed for infectious and inflammatory diseases that develop due to the influence of microorganisms sensitive to this medicine. The following indications for the use of this drug are determined:
- infections of the ENT organs, as well as infectious diseases of the upper respiratory tract ( otitis media , retropharyngeal abscess, sinusitis , pharyngitis , tonsillitis );
- urinary tract infections ( cystitis , prostatitis , etc.);
- infectious diseases of the lower respiratory tract (pneumonia, acute and chronic bronchitis
- gynecological diseases of an infectious nature;
- connective and bone tissue infections;
- infectious diseases of soft tissues, skin (including consequences of bites);
- biliary tract infections (cholangitis, cholecystitis );
- odontogenic infections.
What else Amoxiclav helps with, you should ask a specialist during an individual consultation.
Indications
Amoxiclav is intended for the treatment of bacterial infections caused by microorganisms sensitive to the drug:
- severe infections of the throat, nose, and ear (such as mastoiditis, peritonsillar infections, epiglotitis, and sinusitis with associated severe systemic signs and symptoms)
- exacerbation of chronic bronchitis (after confirmation of diagnosis)
- community-acquired pneumonia
- cystitis;
- pyelonephritis;
- infections of the skin and soft tissues, including bacterial cellulitis, animal bites, severe dentoalveolar abscesses with widespread cellulitis;
- infections of bones and joints, including osteomyelitis;
- intra-abdominal infections;
- genital infections in women.
Prevention of bacterial infections during major surgical interventions in the following areas:
- gastrointestinal tract;
- pelvic organs;
- chairman and neck;
- biliary tract.
When prescribing antibacterial drugs, one should be guided by the rules for their proper use.
Contraindications
When determining why tablets and other forms of the drug help, you should also take into account existing contraindications:
- Infectious mononucleosis;
- previous liver disease or cholestatic jaundice when taking clavulanic acid or Amoxicillin;
- lymphocytic leukemia;
- high sensitivity to antibiotic drugs from the group of cephalosporins, penicillins, as well as other beta-lactam antibiotics;
- high sensitivity to the active components of the drug.
It is prescribed with caution to people suffering from liver failure and people with severe kidney disease.
Side effects
When taking this antibiotic, patients may experience the following side effects:
- Digestive system: loss of appetite, vomiting, nausea, diarrhea ; in rare cases, abdominal pain and liver dysfunction may occur; isolated manifestations - hepatitis, jaundice, pseudomembranous colitis.
- Hematopoietic system: in rare cases - reversible leukopenia , thrombocytopenia ; in very rare cases - eosinophilia , pancytopenia .
- Allergic manifestations: itching , erythematous rash, urticaria ; in rare cases - anaphylactic shock , exudative erythema, edema , allergic vasculitis; isolated manifestations - Stevens-Johnson syndrome, pustulosis, exfoliative dermatitis.
- Functions of the nervous system: dizziness , headache ; in rare cases - convulsions, anxiety, hyperactivity, insomnia .
- Urinary system: crystalluria , interstitial nephritis .
- In rare cases, superinfection may occur.
It is noted that such treatment, as a rule, does not provoke significant side effects.
Instructions for use of Amoxiclav (Method and dosage of Amoxiclav for adults)
Medicine in tablets is not prescribed to children under 12 years of age. When prescribing the drug, it should be taken into account that the permissible dose per day of clavulanic acid is 600 mg (adults) and 10 mg per 1 kg of weight (child). The permissible daily dose of amoxicillin is 6 g for an adult and 45 mg per 1 kg of weight for a child.
The agent for parenteral administration is 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 administered slowly over 3-4 minutes. The intravenous infusion should continue for 30-40 minutes. The solution must not be frozen.
Before anesthesia, to prevent purulent complications, 1.2 g of drugs should be administered intravenously. If there is a risk of complications, the drug is administered intravenously or taken orally in the period after surgery. The duration of the appointment is determined by the doctor.
Amoxiclav tablets, instructions for use
As a rule, adults and children (who weigh more than 40 kg) receive 1 tablet every eight hours. (375 mg), provided the infection is mild or moderate. Another acceptable treatment regimen in this case is to take 1 tablet every 12 hours. (500 mg+125 mg). For severe infectious diseases, as well as for infectious diseases of the respiratory tract, taking 1 tablet every eight hours is recommended. (500 mg+125 mg) or taken every 12 hours 1 tablet. (875 mg+125 mg). Depending on the disease, you need to take an antibiotic from five to fourteen days, but the doctor must individually prescribe a treatment regimen.
Patients with odontogenic infections should take 1 tablet every 8 hours. (250 mg + 125 mg) or once 12 hours, 1 tablet. (500 mg + 125 mg) for five days.
People suffering from moderate renal failure are advised to take 1 tablet. (500 mg + 125 mg) every twelve hours. Severe renal failure is a reason to increase the interval between doses to 24 hours.
Amoxiclav suspension, instructions for use
The patient's childhood involves calculating the dose taking into account the child's weight. Before preparing the syrup, shake the bottle well. In two doses you need to add 86 ml of water to the bottle, each time you need to shake its contents well. Please note that the measuring spoon contains 5 ml of product. Prescribed in a dose depending on the age and weight of the child.
Instructions for use Amoxiclav for children
Children from birth to three months are prescribed the drug at the rate of 30 mg per 1 kg of weight (dose per day), this dose should be divided equally and administered at equal intervals. From the age of three months, Amoxiclav is prescribed at a dose of 25 mg per 1 kg of weight, which is similarly divided equally into two administrations. For infectious diseases of moderate severity, the dose is prescribed at the rate of 20 mg per 1 kg of weight, divided into three administrations. For severe infectious diseases, the dose is prescribed at the rate of 45 mg per 1 kg of weight, divided into two doses per day.
Instructions for use Amoxiclav Quiktab
Before taking, the tablet must be dissolved in 100 ml of water (the amount of water may be more). Before taking, you need to stir the contents well. You can also chew the tablet; it is better to take the drug before meals. Adults and children after reaching 12 years of age should take 1 tablet per day. 625 mg 2-3 times a day. For severe infectious diseases, 1 tablet is prescribed. 1000 mg 2 times a day. Treatment should not last more than 2 weeks.
Sometimes a doctor may prescribe analogues of the drug, for example, Flemoclav Solutab , etc.
Amoxiclav for sore throat
The drug Amoxiclav for angina for an adult is prescribed 1 tablet. 325 mg once every 8 hours. Another treatment regimen involves taking 1 tablet once every 12 hours. A doctor may prescribe a higher dose of an antibiotic if the disease in an adult is severe. Treatment of sore throat in children involves the use of a suspension. As a rule, 1 spoon is prescribed (a dosage spoon is 5 ml). The frequency of administration is determined by the doctor, whose recommendations are important to follow. How to take Amoxiclav for children with sore throat depends on the severity of the disease.
Dosage of Amoxiclav for sinusitis
Whether Amoxiclav helps with sinusitis depends on the causes and characteristics of the course of the disease. The dosage is determined by the otolaryngologist. It is recommended to take 500 mg tablets three times a day. How many days to take the medicine depends on the severity of the disease. But after the symptoms disappear, you need to take the drug for two more days.
Amoksiklav®
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. Serious and sometimes fatal hypersensitivity reactions to penicillins (including anaphylactoid and severe skin reactions) have been described. The risk of such reactions is highest in patients with a history of hypersensitivity reactions to penicillin and in patients with atopy. If an allergic reaction occurs, treatment with Amoxiclav® should be discontinued and appropriate alternative therapy should be prescribed. In case of serious anaphylactic reactions, the patient should be given epinephrine immediately. Oxygen therapy, intravenous corticosteroids, and airway management, including intubation, may also be required.
If the infection is proven to be caused by microorganisms sensitive to amoxicillin, the advisability of switching from the combination of amoxicillin with clavulanic acid to amoxicillin should be considered in accordance with national recommendations.
This form of the drug Amoxiclav® may be ineffective if there is a high probability of resistance of pathogenic microorganisms to beta-lactam antibiotics, which is not mediated by the sensitivity of beta-lactamases to inhibition by clavulanic acid. This pharmaceutical form may not be effective in treating infections caused by penicillin-resistant S. pneumoniae.
In case of renal failure or when treated with high doses of the drug, seizures may occur. If infectious mononucleosis is suspected, Amoxiclav® should not be used, since amoxicillin can cause a measles-like rash in patients with this disease, which makes diagnosing the disease difficult.
Taking allopurinol during treatment with amoxicillin may increase the likelihood of allergic skin reactions.
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.
Amoxiclav® should be used with caution in patients with signs of liver failure.
Liver complications have been reported predominantly in men and elderly patients and may also be associated with long-term treatment. Such cases have been very rarely reported when used in children. In all patient groups, signs and symptoms usually appear during or shortly after treatment, but in some cases may not occur until several weeks after treatment has stopped. They are usually reversible. Liver complications can be severe and, in extremely rare cases, deaths have been reported. They almost always occurred in patients with severe underlying medical conditions or in the case of concomitant use of drugs that potentially affect the liver.
Cases of pseudomembranous colitis have been described when taking antibiotics, the severity of which can vary from mild to life-threatening. Thus, it is important to diagnose it in patients who develop diarrhea during or after antibiotic use. If diarrhea is prolonged or the patient experiences abdominal cramps, treatment should be stopped immediately and the patient should be examined. The use of drugs that inhibit intestinal motility is contraindicated.
In general, Amoxiclav® is well tolerated and has the low toxicity characteristic of all penicillins. During a course of treatment, it is necessary to monitor the state of the function of the hematopoietic organs, liver, and kidneys.
In patients receiving a combination of amoxicillin and clavulanic acid together with indirect (oral) anticoagulants, an increase in prothrombin time has been reported in rare cases. When co-prescribing indirect (oral) anticoagulants with a combination of amoxicillin and clavulanic acid, monitoring of relevant indicators is necessary. To maintain the desired effect of oral anticoagulants, their dose may require adjustment.
In patients with severe renal impairment, adequate dose adjustment or increased dosing intervals is required depending on creatinine clearance.
It is possible that superinfection may develop due to the growth of microflora that is insensitive to the combination of amoxicillin and clavulanic acid, which requires a corresponding change in antibacterial therapy.
In patients who are hypersensitive to penicillins, cross-allergic reactions with cephalosporin antibiotics are possible.
In women with premature rupture of membranes, it was found that prophylactic therapy with a combination of amoxicillin and clavulanic acid may be associated with an increased risk of developing necrotizing colitis in newborns.
Amoxicillin and clavulanic acid can provoke nonspecific binding of immunoglobulins and albumins to the red blood cell membrane, which can cause a false-positive Coombs test.
Crystalluria very rarely occurs in patients with reduced diuresis. During administration of large doses of amoxicillin, it is recommended to take sufficient fluids and maintain adequate diuresis to reduce the likelihood of amoxicillin crystal formation.
The drug contains potassium.
Information for patients on a low sodium diet:
Each 600 mg vial (500 mg+100 mg) contains 29.7 mg sodium. Each 1.2 g vial (1000 mg + 200 mg) contains 59.3 mg sodium. The amount of sodium in the maximum daily dose exceeds 200 mg.
Lab tests
: High concentrations of amoxicillin give a false-positive reaction to urine glucose when using Benedict's reagent or Felling's solution. It is recommended to use enzymatic reactions with glucose oxidase.
Positive test results using the Bio-Rad Laboratories Platelia Aspergillus enzyme immunoassay have been reported in patients receiving amoxicillin plus clavulanic acid who were subsequently free of Aspergillus
. Cross-reactions have been noted with non-Aspergillus polysaccharides and polyfurans with the Bio-Rad Laboratories Platelia Aspergillus Enzymatic Immunoassay. Therefore, caution should be used when interpreting positive test results in patients receiving a combination of amoxicillin and clavulanic acid, and they should also be confirmed using other diagnostic methods.
Overdose
To avoid overdose, the prescribed dosage for children and the dosage of Amoxiclav for adults must be strictly observed. It is recommended to carefully study the instructions or watch a video on how to dilute the suspension.
Wikipedia indicates that an overdose of the drug may result in a number of unpleasant symptoms, but there is no data on life-threatening conditions for the patient. , abdominal pain , vomiting , diarrhea may occur . In severe cases, seizures may occur.
If the drug has been taken recently, gastric lavage is performed, activated charcoal . The patient must be monitored by a doctor. In this case, hemodialysis .
Interaction
When taking the drug simultaneously with some drugs, undesirable manifestations may occur, which is why tablets, syrup and intravenous administration of the drug should not be used in parallel with a number of drugs.
The simultaneous use of the drug with Glucosamine , antacids, aminoglycosides, and laxatives slows down the absorption of Amoxiclav; when taken simultaneously with Ascorbic acid , the absorption accelerates.
With simultaneous treatment with Phenylbutazone , diuretics, NSAIDs, Allopurinol and other drugs that block tubular secretion, the concentration of amoxicillin increases.
If anticoagulants and Amoxiclav are taken simultaneously, the prothrombin time increases. Therefore, drugs in such a combination must be prescribed with caution.
Amoxiclav increases the toxicity of Methotrexate when taken simultaneously.
When taking Amoxiclav and Allopurinol , the likelihood of exanthema increases.
You should not take Disulfiram and Amoxiclav at the same time.
Antagonists when taken together are amoxicillin and Rifampicin . The drugs mutually weaken the antibacterial effect.
You should not take Amoxiclav and bacteriostatic antibiotics (tetracyclines, macrolides), as well as sulfonamides at the same time, as these drugs can reduce the effectiveness of Amoxiclav.
Probenecid increases the concentration of amoxicillin and slows down its elimination.
When using Amoxiclav, the effectiveness of oral contraceptives may decrease.
Interaction with other drugs and other types of interactions
Anticoagulants for oral use. Oral anticoagulants and penicillin antibiotics are widely used in practice without reports of interactions. However, cases of an increase in the international normalization coefficient have been described in patients taking acenocoumarol or warfarin and who were prescribed a course of treatment with amoxicillin. If concomitant use of drugs is necessary, the prothrombin index or international normalization ratio (INR) should be carefully monitored when amoxicillin is added or discontinued. In addition, it may be necessary to adjust the dose of anticoagulants for oral use (see Sections “Peculiarities of use” and “Adverse reactions”).
Methotrexate. Penicillins may reduce the elimination of methotrexate, causing a potential increase in toxicity.
Probenecid. Concomitant use of probenecid is not recommended. Probenecid reduces the renal tubular secretion of amoxicillin. Concomitant use of probenecid may lead to an increase in the level and duration of amoxicillin (but not clavulanic acid) presence in the blood.
Mycophenolate mofetil. In patients treated with mycophenolate mofetil, predose concentrations of the active metabolite MPA may decrease by approximately 50% after initiation of oral amoxicillin with clavulanic acid. This change in predose level may not be entirely consistent with the change in total MPA exposure. Therefore, a change in mycophenolate mofetil dosage is usually not required unless there is clinical evidence of graft dysfunction. However, close monitoring is necessary during coadministration and for some time after antibiotic therapy.
special instructions
Since most people with lymphocytic leukemia and infectious mononucleosis who received Ampicillin subsequently noted the appearance of an erythematous rash, such people are not recommended to take ampicillin antibiotics.
It is prescribed with caution to people with a tendency to allergies .
If a course of treatment with the drug is prescribed for adults or children, it is important to monitor the functions of the kidneys, liver, and the process of hematopoiesis.
People who have impaired renal function need a dose adjustment of the drug or an increase in the interval between taking the drug.
It is optimal to take the product during meals to reduce the likelihood of side effects from the digestive system.
Patients undergoing treatment with Amoxiclav may experience a false positive reaction when determining glucose levels in urine when using Felling's solution or Benedict's reagent .
There is no data on the negative impact of Amoxiclav on the ability to drive vehicles and work with precision machinery.
Patients who are interested in whether Amoxiclav is an antibiotic or not should keep in mind that the product is an antibacterial drug.
It is recommended to drink plenty of water and other liquids during the course of treatment with the drug.
If Amoxiclav is prescribed, the patient's childhood age must be taken into account when prescribing the medication form and dosage.
Features of application
Use during pregnancy or breastfeeding
Pregnancy. Reproductive studies in animals of oral and parenteral forms of Amoxiclav ® did not reveal any teratogenic effects. One study in women with premature rupture of membranes reported that prophylactic use of the drug may be associated with an increased risk of necrotizing enterocolitis in the newborn. As with the use of other medicines, the use of Amoxiclav ® should be avoided during pregnancy, especially in the first trimester, unless, in the opinion of a doctor, such use is necessary.
Breastfeeding period. Both active components of the drug are excreted into breast milk (there is no information on the effect of clavulanic acid on a breastfed infant). Accordingly, a breastfed infant may develop diarrhea and fungal infection of the mucous membranes, so breastfeeding should be stopped. The possibility of allergic reactions should be taken into account. Amoxiclav ® can be used during breastfeeding only when, in the opinion of the doctor, the benefits of use will outweigh the risks.
Children
Use for children from the first days of life.
The ability to influence the reaction rate when driving vehicles or other mechanisms
Studies on the ability of the drug to influence the reaction rate when driving vehicles or other mechanisms have not been conducted. However, undesirable effects may occur (such as allergic reactions, dizziness, convulsions), which may affect the ability to drive a car or use other machinery (see section “Adverse Reactions”).
Overdose
Symptoms. Symptoms of gastrointestinal upset and fluid and electrolyte imbalance may occur. Crystalluria associated with taking amoxicillin has been observed, which in some cases led to renal failure (see section "Peculiarities of use").
In patients with impaired renal function and in patients taking high doses of the drug, seizures may occur.
Deposition of amoxicillin in bladder catheters has been recorded, mainly after administration in high doses. The patency of catheters should be regularly checked (see Section “Peculiarities of Application”).
Treatment. Gastrointestinal disorders can be treated symptomatically with attention to fluid/electrolyte balance.
Amoxicillin/clavulanic acid can be removed from the bloodstream using hemodialysis.
Analogues of Amoxiclav
Level 4 ATX code matches:
Arlet
Ecoclave
Panclave
Oxamp-Sodium
Oxamp
Amoxicillin + Clavulanic acid
Augmentin
Ampisid
Amoxil K 625
Flemoklav Solutab
Sultasin
There are a number of analogues of this drug. The price of analogues depends, first of all, on the manufacturer of the drug. There are analogues on sale that are cheaper than Amoxiclav. For patients interested in what can replace this antibiotic, experts offer a large list of medications. These are Moxiclav , Co-Amoxiclav , Augmentin , Clavocin , Flemoclav , Medoclav , Baktoklav , Ranclave , Amoviklav , etc. However, any substitute should only be prescribed by a doctor. You can choose a cheaper analogue in tablets, for example, Augmentin. You can also choose a Russian analogue, for example, Amoxicillin .
Flemoklav Solutab and Amoxiclav - the difference between the drugs
The active components of the drugs are similar. The difference between drugs is in the dosage of the active components in the release forms of these drugs. Both drugs fall into approximately the same price category.
Which is better: Amoxiclav or Augmentin?
What is the composition of Amoxiclav and Augmentin , what is the difference between these drugs? Both of these products contain similar active ingredients, that is, in fact they are the same thing. Accordingly, the pharmacological action of the drugs is almost identical, as are the side effects. Only the manufacturers of these drugs differ.
Which is better: Sumamed or Amoxiclav?
Sumamed contains azithromycin, which is a broad-spectrum antibiotic. Before prescribing any of the drugs, it is important to check the sensitivity of the microflora to their action.
Which is better: Flemoxin Solutab or Amoxiclav?
Flemoxin contains only amoxicillin. Accordingly, its spectrum of influence is smaller than that of the drug Amoxiclav, which also contains clavulonic acid .
Reviews about Amoxiclav
In the process of discussing the drug Amoxiclav, reviews from doctors and patients are predominantly positive. It is noted that the antibiotic is effective in the treatment of respiratory tract diseases, and it is suitable for both adults and children. Reviews mention the effectiveness of the product for sinusitis, otitis media, and genital tract infections. As a rule, adult patients take 875 mg + 125 mg tablets; if the dosage is correct, relief occurs quickly. Reviews note that after a course of antibiotic treatment, it is advisable to take drugs that restore normal microflora .
Reviews of the Amoxiclav suspension are also positive. Parents write that it is convenient to give the product to children, as it has a pleasant taste and is normally perceived by children.
Amoxiclav price, where to buy
- The price of Amoxiclav tablets 250 mg + 125 mg is on average 250 rubles for 15 pieces. You can buy the antibiotic Amoxiclav 500 mg + 125 mg at a price of 350 – 400 rubles for 15 pcs. How much 875 mg + 125 mg tablets cost depends on the place of sale. On average, their cost is 400 - 500 rubles for 14 pieces.
- Price Amoxiclav Kviktab 625 mg – from 350 rubles for 14 pcs.
- The price of Amoxiclav suspension for children is 300 rubles (100 ml).
- The price of Amoxiclav 1000 mg in Ukraine (Kyiv, Kharkov, etc.) is from 300 hryvnia for 14 pieces.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Amoxiclav powder for suspension.
for internal approx. 400mg+57mg/5ml 17.5gLek dd RUB 205 order - Amoxiclav tablets p.p.o. 500mg+125mg 15 pcs. Lek dd
RUB 198 order
- Amoxiclav Quiktab dispersible tablets 250mg+62.5mg 20 pcs. Lek dd
RUB 272 order
- Amoxiclav powder for suspension. for internal approx. 400mg+57mg/5ml 35gLek dd
RUB 295 order
- Amoxiclav tablets p.p.o. 875mg+125mg 14 pcs.Lek dd
RUB 342 order
Pharmacy Dialogue
- Amoxiclav Quiktab (dispersible tablet 625 mg No. 14)Lek
RUR 326 order
- Amoxiclav Quiktab (dispersible tablet 1000 mg No. 14)Lek
402 rub. order
- Amoxiclav powder for suspension 400mg+57mg/5ml 140ml(35g)Lek
RUB 287 order
- Amoxiclav bottle 1200 mg powder No. 5Lek
RUR 771 order
- Amoxiclav (tablet p/o 625 mg No. 15 (blister sheet)) Lek
RUB 215 order
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Pharmacy24
- Amoxiclav 125 mg/31.25 mg 5 ml 100 ml powder for oral suspension Lek pharmaceutical company d.d., Slovenia
131 UAH. order - Amoxiclav 500mg/100mg No. 5 powder for the preparation of solution for injection Sandoz GmbH, Austria
379 UAH. order
- Amoxiclav Quiktab 875mg/125mg N14 tablets Lek pharmaceutical company d.d. Slovenia / Sandoz Ilac Sanay ve Tikaret A.S., Turecchina
164 UAH order
- Amoxiclav 2x 875 mg / 125 mg No. 14 tablets Lek pharmaceutical company d.d., Slovenia
189 UAH order
- Amoxiclav 2S 400 mg/57 mg 5 ml 17.5 70 ml powder for oral suspension Lek pharmaceutical company d.d., Slovenia
115 UAH order
PaniPharmacy
- Amoxiclav 2 tablets Amoxiclav 2 film-coated tablets 875/125 mg No. 14 Slovenia, Lek
217 UAH. order
- Amoxiclav Quiktab tablets Amoxiclav Quiktab dispersible tablets 500mg/125mg No. 10 Slovenia, Lek
87 UAH order
- Amoxiclav bottle Amoxiclav lyophilized powder for injection 1.2g No. 5 Slovenia, Lek
454 UAH. order
- Amoxiclav liquid Amoxiclav powder for suspension 250mg/62.5mg (312.5mg)/5ml 100ml Slovenia, Lek
167 UAH order
- Amoxiclav liquid Amoxiclav powder for suspension 125mg/31.25mg (156.25mg)/5ml 100ml Slovenia, Lek
131 UAH order
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