Amosin tablets 500mg, No. 20

Infectious and inflammatory diseases caused by microorganisms sensitive to the drug:

-infections of the respiratory system (including bronchitis, pneumonia);

- infections of ENT organs (including sinusitis, pharyngitis, tonsillitis, acute otitis media);

- infections of the genitourinary system (including pyelonephritis, pyelitis, cystitis, urethritis, gonorrhea);

-gynecological infections (including endometritis, cervicitis);

- infections of the digestive tract (including peritonitis, enterocolitis, typhoid fever, cholangitis, cholecystitis);

-infections of the skin and soft tissues (including erysipelas, impetigo, secondarily infected dermatoses);

-leptospirosis; listeriosis;

- Lyme disease (borreliosis);

-dysentery;

-salmonellosis, salmonella carriers;

-meningitis;

-endocarditis (prevention);

-sepsis.

The drug is taken orally, before or after meals. The dosage regimen is set individually, taking into account the severity of the course of the disease, the sensitivity of the pathogen to the drug, the age of the patient.

Adults and children over 10 years of age (weighing> 40 kg) are prescribed 500 mg 3 times / day, in severe cases of the disease - 0.75-1 g 3 times / day. Children aged 5 to 10 years are prescribed 250 mg 3 times / day, at the age of 2 to 5 years - 125 mg 3 times / day, at the age of 2 years - 20 mg / kg / day in 3 divided doses. The course of treatment is 5-12 days.

For children under the age of 5 years, the drug is prescribed in the form of a suspension.

For the treatment of acute uncomplicated gonorrhea, the drug is prescribed in a dose of 3 g once; when treating women, it is recommended to take the indicated dose again.

In acute infectious diseases of the gastrointestinal tract (paratyphoid fever, typhoid fever) and biliary tract, in gynecological infectious diseases, adults are prescribed 1.5-2 g 3 times / day or 1-1.5 g 4 times / day.

With leptospirosis, adults are prescribed 500-750 mg 4 times / day for 6-12 days.

With salmonella in adults - 1.5-2 g 3 times / day for 2-4 weeks.

For the prevention of endocarditis in minor surgical interventions, adults are prescribed in a dose of 3-4 g 1 hour before the procedure.

If necessary, a second dose is prescribed after 8-9 hours.

In children, the dose is halved.

In patients with impaired renal function (CC from 15 to 40 ml / min), the interval between doses is increased to 12 hours; in the terminal stage of chronic renal failure (CC <10 ml / min), the dose of Amosin should be reduced by 15-50% or the interval should be increased between doses up to 24 hours, with anuria - the maximum dose is 2 g / day.

Tablets are white or almost white, flat-cylindrical, with beveled and scored.

Active ingredient: amoxicillin trihydrate (in terms of amoxicillin) -500mg.
Excipient: potato starch, magnesium stearate, calcium stearate, magnesium hydrosilicate (talc), povidone (Kollidon 90F).

• Allergic diathesis;

• bronchial asthma, hay fever;

• Infectious mononucleosis;

• lymphocytic leukemia;

• liver failure;

• a history of gastrointestinal diseases (especially colitis associated with the use of antibiotics);

• lactation period (breastfeeding);

• hypersensitivity to drug components;

• hypersensitivity to other penicillins, cephalosporins, carbapenems;

• children under 3 years of age (for tablets and capsules).

• The drug should be prescribed with caution during pregnancy, renal failure, and if there is a history of bleeding.

Pharmacodynamics:

Semi synthetic penicillin, has a bactericidal effect, has a wide spectrum of action. It disrupts the synthesis of peptidoglycan (a supporting polymer of the cell wall) during division and growth, and causes lysis of bacteria.
Active against aerobic gram-positive microorganisms: Staphylococcus spp. (with the exception of strains producing penicillinase), Streptococcus spp. and aerobic gram-negative microorganisms: Neisseria gonorrhoeae, Neisseria meningitidis, Escherichia coli, Shigella spp., Salmonella spp., Klebsiella spp. Penicillinase-producing strains are resistant to the action of amoxicillin.

Pharmacokinetics:

Absorption - fast, high (93%), food intake does not affect absorption, does not break down in the acidic environment of the stomach. When taken orally at a dose of 125 and 250 mg, the maximum concentration is 1.5-3 and 3.5-5 ?g / ml, respectively. The time to reach the maximum concentration after oral administration is 1-2 hours.It has a large volume of distribution: in high concentrations it is found in plasma, sputum, bronchial secretions (the distribution is weak in purulent bronchial secretions), pleural and peritoneal fluid, urine, contents of skin blisters, tissue lung, intestinal mucosa, female genital organs, prostate gland, middle ear fluid (with inflammation), bone, adipose tissue, gallbladder (with normal liver function), fetal tissues. When the dose is doubled, the concentration also doubles.The concentration in bile exceeds the concentration in plasma by 2-4 times. In the amniotic fluid and umbilical cord vessels, the concentration of amoxicillin is 25-30% of the level in the plasma of a pregnant woman. Poorly penetrates the blood-brain barrier, with inflammation of the meninges, the concentration in the cerebrospinal fluid is about 20% of the plasma level. Communication with plasma proteins -17%. Partially metabolized to form inactive metabolites. The half-life is -1-1.5 hours. It is excreted by 50-70% by the kidneys unchanged (by tubular secretion - 80% and glomerular filtration - 20%), by the liver -10-20%. A small amount is excreted in breast milk. Amoxicillin is removed by hemodialysis.In the amniotic fluid and umbilical cord vessels, the concentration of amoxicillin is 25-30% of the level in the plasma of a pregnant woman. Poorly penetrates the blood-brain barrier, with inflammation of the meninges, the concentration in the cerebrospinal fluid is about 20% of the plasma level. Communication with plasma proteins -17%. Partially metabolized to form inactive metabolites. The half-life is -1-1.5 hours. It is excreted by 50-70% by the kidneys unchanged (by tubular secretion - 80% and glomerular filtration - 20%), by the liver -10-20%. A small amount is excreted in breast milk. Amoxicillin is removed by hemodialysis.In the amniotic fluid and umbilical cord vessels, the concentration of amoxicillin is 25-30% of the level in the plasma of a pregnant woman. Poorly penetrates the blood-brain barrier, with inflammation of the meninges, the concentration in the cerebrospinal fluid is about 20% of the plasma level. Communication with plasma proteins -17%. Partially metabolized to form inactive metabolites. The half-life is -1-1.5 hours. It is excreted by 50-70% by the kidneys unchanged (by tubular secretion - 80% and glomerular filtration - 20%), by the liver -10-20%. A small amount is excreted in breast milk. Amoxicillin is removed by hemodialysis.Partially metabolized to form inactive metabolites. The half-life is -1-1.5 hours. It is excreted by 50-70% by the kidneys unchanged (by tubular secretion - 80% and glomerular filtration - 20%), by the liver -10-20%. A small amount is excreted in breast milk. Amoxicillin is removed by hemodialysis.Partially metabolized to form inactive metabolites. The half-life is -1-1.5 hours. It is excreted by 50-70% by the kidneys unchanged (by tubular secretion - 80% and glomerular filtration - 20%), by the liver -10-20%. A small amount is excreted in breast milk. Amoxicillin is removed by hemodialysis.

Pregnancy and lactation

The use of the drug during pregnancy is possible only if the intended benefit to the mother outweighs the potential risk to the fetus. If necessary, the appointment of the drug during lactation should stop breastfeeding.

Side effects

Allergic reactions: urticaria, skin flushing, erythematous rashes, angioedema, rhinitis, conjunctivitis are possible; rarely - fever, arthralgia, eosinophilia, exfoliative dermatitis, exudative erythema multiforme (including Stevens-Johnson syndrome); reactions similar to serum sickness; in isolated cases - anaphylactic shock.
From the gastrointestinal tract: dysbiosis, taste change, vomiting, nausea, diarrhea, stomatitis, glossitis, moderate increase in the activity of 'hepatic' transaminases, rarely - pseudomembranous enterocolitis.
From the nervous system: agitation, anxiety, insomnia, ataxia, confusion, behavior change, depression, peripheral neuropathy, headache, dizziness, epileptic reactions.
Laboratory indicators: leukopenia, neutropenia, thrombocytopenic purpura, anemia.
Others: shortness of breath, tachycardia, interstitial nephritis, vaginal candidiasis, superinfection (especially in patients with chronic diseases or reduced body resistance).

Overdose

Symptoms: nausea, vomiting, diarrhea, imbalance in water and electrolyte balance (as a result of vomiting and diarrhea). Treatment: gastric lavage, activated charcoal, saline laxatives, medicines to maintain water and electrolyte balance; hemodialysis.

Interaction with other medicinal products

Antacids, glucosamine, laxatives, food, aminoglycosides slow down and reduce absorption; ascorbic acid enhances absorption.
Bactericidal antibiotics (including aminoglycosides, cephalosporins, vancomycin, rifampicin) have a synergistic effect; bacteriostatic drugs (macrolides, chloramphenicol, lincosamides, tetracyclines, sulfonamides) - antagonistic.
Increases the effectiveness of indirect anticoagulants (suppressing the intestinal microflora, reduces the synthesis of vitamin K and the prothrombin index); reduces the effectiveness of estrogen-containing oral contraceptives; drugs, in the process of metabolism of which para-aminobenzoic acid is formed, ethinylestradiol - the risk of developing bleeding 'breakthrough'. Amoxicillin decreases clearance and increases the toxicity of methotrexate; enhances the absorption of digoxin.
Diuretics, allopurinol, oxyphenbutazone, phenylbutazone, nonsteroidal anti-inflammatory drugs, and other drugs that block tubular secretion increase the concentration of amoxicillin in the blood.
Allopurinol increases the risk of skin rashes.

special instructions

During the course of treatment, it is necessary to monitor the state of the function of the hematopoietic organs, liver and kidneys.
The development of superinfection is possible due to the growth of microflora insensitive to it, which requires a corresponding change in antibiotic therapy.
When prescribed to patients with sepsis, the development of a bacteriolysis reaction (Jarisch-Herxheimer reaction) is possible (rarely).
In patients with hypersensitivity to penicillins, cross-allergic reactions with other beta-lactam antibiotics are possible.
When treating mild diarrhea during a course of treatment, antidiarrheal drugs that reduce intestinal motility should be avoided; you can use kaolin- or attapulgite-containing antidiarrheals. Severe diarrhea should see a doctor.
Treatment must continue for another 48-72 hours after the disappearance of clinical signs of the disease. With the simultaneous use of estrogen-containing oral contraceptives and amoxicillin, other or additional methods of contraception should be used, if possible.