Amoxicillin, clarithromycin, lansoprazole | Lantsid Whale tablets and capsules, 56 pcs.

packaging 56 pcs

Pharmacological action

Lantsid - antiulcer.

Inhibits H + - K + ATPase (proton pump) of parietal cells, blocks the final stage of hydrochloric acid formation, suppresses basal and stimulated secretion.

Contraindications

hypersensitivity to any component of the preparations (main substance and / or auxiliary components), to macrolides, to penicillins, cephalosporins,

carbapenems while taking clarithromycin with the following drugs: astemizole, cisapride, pimozide, terfenadine with ergot alkaloids, for example, ergotamine, dihydroergotamine with midazolam for oral administration of

, concomitant use of clarithromycin with HMG-CoA reductase inhibitors (statins), which are significantly associated with an increased risk of myopathy, including rhabdomyolysis of

, concomitant use of clarithromycin with colchicine in patients with impaired liver and kidney function

in patients with a history of elongation ntervala QT,

ventricular fibrillation or ventricular tachycardia type "pirouette»

patients with hypokalemia (risk of lengthening the interval QT)

patients with severe liver failure, occurring simultaneously with renal failure of

in patients with a history of cholestatic jaundice / hepatitis, who developed with the use of clarithromycin

with porphyria

during breastfeeding and pregnancy,

in patients with atopic dermatitis, bronchial asthma, lymphocytic leukemia, pollinosis history (especially colitis associated with the use of antibiotics),

children under 18 years of age

in the presence of a sucrose / isomaltase deficiency, neper endurance of fructose, glucose-galactose malabsorption.

Special instructions

Before starting therapy, it is necessary to exclude the presence of a malignant process (especially with gastric ulcer), since treatment, masking the symptoms, can delay the correct diagnosis.

Clarithromycin

Prolonged use of antibiotics can lead to the formation of colonies with an increased number of insensitive bacteria and fungi. With superinfection, appropriate therapy should be prescribed.

When using clarithromycin, hepatic dysfunction has been reported (increased concentration of hepatic enzymes in blood plasma, hepatocellular and / or cholestatic hepatitis with or without jaundice). Hepatic dysfunction can be severe, but is usually reversible. There are cases of fatal liver failure, mainly associated with the presence of serious concomitant diseases and / or the simultaneous use of other drugs. When signs and symptoms of hepatitis appear, such as anorexia. jaundice, dark urine, abdominal tenderness on palpation, it is necessary to immediately stop clarithromycin therapy.

In the presence of chronic liver diseases, regular monitoring of plasma enzymes is necessary.

In the treatment of almost all antibacterial agents, including clarithromycin, cases of pseudomembranous colitis have been described, the severity of which can vary from mild to life-threatening.

Antibacterial drugs can alter the normal intestinal microflora, which can lead to the growth of Clostridium difficile. Pseudomembranous colitis caused by Clostridium difficile should be suspected in all patients experiencing the appearance of diarrhea after using antibacterial agents. After a course of antibiotic therapy, careful medical monitoring of the patient is necessary. Cases of development of pseudomembranous colitis 2 months after taking antibiotics were described.

Clarithromycin should be used with caution in patients with coronary heart disease (CHD), severe heart failure, hypomagnesemia, severe bradycardia (less than 50 beats / min), and also when used with antiarrhythmic drugs of class IA (quinidine, procainamide) and class III (dofetilide, amiodarone, sotalol). In these conditions and while taking clarithromycin with these drugs, an electrocardiogram should be monitored regularly to increase the QT interval.

Perhaps the development of cross-resistance to clarithromycin and other antibiotics of the macrolide group, as well as lincomycin and clindamycin.

In case of acute hypersensitivity reactions, such as anaphylactic reaction, Stevens-Johnson syndrome, toxic epidermal necrolysis, drug rash with eosinophilia and systemic symptoms (DRESS-syndrome), Shenlein-Genoch purpura, it is necessary to immediately stop taking clarithromycin and start appropriate therapy .

In patients taking clarithromycin, worsening symptoms of myasthenia gravis have been reported.

When used together with warfarin or other indirect anticoagulants, it is necessary to control the MHO and prothrombin time.

Amoxicillin

Before taking amoxicillin, a detailed history should be collected regarding previous hypersensitivity reactions to penicillins, cephalosporins, or other allergens. Serious and sometimes fatal hypersensitivity reactions (anaphylactic reactions) to penicillins are described. The risk of such reactions is highest in patients with a history of hypersensitivity reactions to penicillins. In case of allergic reactions, it is necessary to stop taking amoxicillin and start antibiotic therapy in another group. In case of serious hypersensitivity reactions, appropriate measures should be taken immediately. Epinephrine, oxygen therapy, intravenous administration of glucocorticosteroids, and airway management, including intubation, may also be required.

It is necessary to refrain from using amoxicillin in cases of suspected infectious mononucleosis, since in patients with this disease, amoxicillin can cause a measles-like skin rash that makes diagnosis difficult.

Long-term treatment with amoxicillin sometimes leads to excessive reproduction of insensitive microorganisms.

During the use of amoxicillin, it is recommended to periodically evaluate the function of the kidneys, liver and hematopoiesis. Amoxicillin should be used with caution in patients with impaired liver function. Monitoring liver function should be done on a regular basis. In patients with impaired renal function, the dose of amoxicillin should be reduced accordingly to the degree of impairment.

Amoxicillin can provoke nonspecific binding of immunoglobulins and albumin to the erythrocyte membrane, which can be the cause of a false positive reaction with the Coombs test.

Crystalluria is very rare in patients with reduced diuresis. When conducting amoxicillin therapy, adequate fluid intake and maintaining adequate diuresis are extremely important.

Patients with cholangitis or cholecystitis can be prescribed antibiotics only with a mild course of the disease and in the absence of cholestasis. During therapy with amoxicillin, it is necessary to remember the possible development of superinfection (usually caused by bacteria of the genus Pseudomonas spp. Or fungi of the genus Candida). In this case, amoxicillin therapy should be discontinued and / or appropriate treatment prescribed.

With persistent severe diarrhea, pseudomembranous colitis caused by antibiotics should be suspected, which may pose a threat to the patient’s life (watery feces mixed with blood and mucus are dull, common or colicky abdominal pain fever, sometimes tenesmus). In such cases, amoxicillin should be immediately discontinued and a treatment specific to the pathogen should be prescribed, for example, vancomycin. At the same time, drugs that reduce peristatics of the gastrointestinal tract are contraindicated. Excretion of amoxicillin leads to its high content in the urine, which can lead to false-positive results in the determination of glucose in the urine (for example, a Benedict test, a Feling test). In this case, it is recommended to use the glucose oxidase method for determining the concentration of glucose in the urine.

If it is necessary to use amoxicillin with anticoagulants simultaneously, prothrombin time or INR should be carefully monitored when prescribing or canceling amoxicillin.

With the simultaneous use of estrogen-containing oral contraceptives and amoxicillin, other or additional contraceptive methods should be used if possible.

Special care is recommended for patients with an allergic diathesis or bronchial asthma, a history of gastrointestinal diseases (in particular, colitis caused by antibiotic treatment).

With long-term use of amoxicillin, nystatin, levorin, or other antifungal drugs should be prescribed at the same time.

Alcohol is not recommended during treatment.

Lansoprazole

It is recommended to avoid the combined use of proton pump inhibitors and clopidogrel. When used together, the risk of repeated myocardial infarction, hospitalization for a heart attack or unstable angina, stroke, repeated revascularization increases. If there is an absolute need for co-administration, patients should be closely monitored.

It is recommended to avoid the combined use of proton pump inhibitors and antiretroviral drugs in HIV-infected patients. If you need to use it together with atazanavir / ritonavir, it is recommended to observe the 12-hour interval between taking lansoprazole and these drugs, and also not to exceed the dose of lansoprazole 30 mg.

When used together with antiretroviral drugs (indinavir, nelfinavir, atazanavir), as well as ketoconazole, itraconazole, posaconazole, cefpodoxime, cefuroxime and ampicillin, monitoring of their effectiveness and the appearance of resistance is necessary.

Co-administration with imatinib may increase the risk of adverse reactions (potential interaction via CYP3A4), especially in individuals with a history of severe allergic reactions.

Due to the increased risk of myotoxicity, patients taking atorvastatin, lovastatin or simvastatin should be carefully observed during the concomitant use of lansoprazole.

In patients taking warfarin at the same time, prothrombin time and MHO should be monitored.

Prolonged use of proton pump inhibitors increases the risk of infection (including Salmonella, Campylobacter, Clostridium difficile). The benefits of preventing bleeding from the upper gastrointestinal tract should be correlated with the potential risk of developing ventilator-associated pneumonia.

Long-term use of inhibitorsproton pump increases the risk of fractures in women during menopause.

During treatment, alcohol should be avoided.

Pharmacogenetic factor. The effectiveness of the drug depends on the genetic polymorphism of CYP2C19. In patients belonging to the “slow metabolizers” (PM type), the efficacy is higher, Helicobacte rpylori eradication is significantly more often achieved in comparison with the “fast metabolizers” (homEM type), even against the background of resistance to clarithromycin.

"Cancellation syndrome" or "acid ricochet" when observing the recommendations for the duration of use for lansoprazole is not typical.

Influence on the ability to drive machinery and vehicles

During the treatment period, care must be taken when driving vehicles and engaging in other potentially dangerous activities, requiring increased concentration of attention and speed of psychomotor reactions, since the drug can cause weakness, drowsiness and dizziness.

Composition of

Tablets

Active ingredient: clarithromycin 500 mg

Excipients: microcrystalline cellulose 31 mg mg, sorbitol 9 mg, karbum acid, 8 mg krambit, 8 mg karbum acid 30 mg, colloidal silicon dioxide 8 mg, magnesium stearate 11 mg, talc 24 mg, croscarmellose sodium 55 mg, stearic acid 20 mg

Film composition: hypromellose 20.65 mg, titanium dioxide 4.75 mg, propylene glycol 3.2 mg, dye quinoline yellow 0.195 mg, vanilla flavor 1.2 mg

Capsules

Active ingredient: amoxicillin 500 mg

Excipients: magnesium stearate 5 mg, talc 8 mg 3 la, sodium.

Composition of capsule lid: propyl parahydroxybenzoate 0.2 mg, methyl parahydroxybenzoate 0.8 mg, water 14-15 mg, gelatin qs, titanium dioxide 0.8132 mg, dye brilliant blue 0.0062 mg, dye sunny sunset yellow 0.0495 mg

Composition of capsule body: propyl parahydroxybenzohydroxybenzene 0.2 mg, water 14-15 mg, gelatin qs, titanium dioxide 1.6266 mg, dye iron oxide yellow 0.9999 mg

Black ink composition: ethanol 29-33%, isopropanol 9-12%, butanol 4-7%, shellac 24-28% , iron oxide black oxide 24-28%, ammonia water 1-3%, propylene glycol 0.5-2%

Enteric-soluble capsules

Active ingredient: lansoprazole 30 mg

Excipients: mannitol 41.11 mg, sucrose 123.22 mg, povidone 1.09 mg, sucrose microspheres 38.19 mg, sodium hydrogen phosphate 2.08 mg, carmellose calcium 10.41 mg, magnesium hydroxycarbonate 5.3 mg, polysorbate 80 0.99 mg, hypromellose 25.58 mg, titanium dioxide 2.19 mg, methacrylic acid polymer 65.78 mg, talc 8.77 mg, diethyl phthalate 8.11 mg, sodium hydroxide 0.44 mg srdlp The composition of the capsule body: gelatin 38.9575 mg, sodium lauryl Ulfat 0.0376 mg, 0.376 mg of propyl parahydroxybenzoate, methyl parahydroxybenzoate 0.094 mg Titanium dioxide 0.712 mg carmine dye (Ponceau 4R) 0.0078 mg, 6,815 mg water

Composition cap capsules: Gelatin 24.0376 mg, sodium lauryl sulfate 0. 0232 mg, propyl parahydroxybenzoate 0.058 mg, methyl parahydroxybenzoate 0.232 mg, titanium dioxide 0.4393 mg, crimson dye (Ponso 4R) 0.0048 mg, water 4.205 mg

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Clarithromycin

Infectious and parasitic diseases: infrequently - candidiasis, gastroenteritis, the development of superinfection (with prolonged or repeated use of clarithromycin), vaginal infections, the frequency is unknown - pseudomembranous colitis, erysipelas, erythrasma.

Disorders from the blood and lymphatic system: infrequently - leukopenia, neutropenia, thrombocythemia, eosinophilia, frequency unknown - agranulocytosis, thrombocytopenia.

Disorders of the immune system: infrequently hypersensitivity frequency unknown - anaphylactic reactions.

Disorders from metabolism and nutrition: infrequently - anorexia, decreased appetite, frequency is unknown - hypoglycemia (including while taking hypoglycemic drugs).

Mental disorders: often - insomnia infrequently - anxiety, nervousness frequency is unknown - psychosis, confusion, depersonalization, depression, disorientation, hallucinations, "nightmare" dreams, mania.

Violations of the nervous system: often - a change in taste (dysgeusia), headache infrequently - dizziness, loss of consciousness, drowsiness, tremor frequency is unknown - convulsions, loss of taste, sense of smell, loss of smell, paresthesia.

Hearing impairment and labyrinth disorders: infrequently -vertigo, hearing impairment, noise, tinnitus frequency unknown - hearing loss (occurring after drug withdrawal).

Heart abnormalities: infrequently - lengthening of the QT interval on the electrocardiogram, heart rate sensation is unknown - ventricular tachycardia of the “pirouette” type, ventricular tachycardia, flutter and ventricular fibrillation.

Vascular disorders: frequency unknown - unusual bleeding, hemorrhage.

Disorders of the respiratory system, chest and mediastinal organs: infrequently - nosebleeds.

Disorders of the gastrointestinal tract: often - diarrhea, vomiting, dyspepsia, nausea, abdominal pain infrequently - gastroesophageal reflux disease, gastritis, proctalgia, stomatitis, glossitis, bloating, constipation, dry mouth, belching, flatulence - acute pancreatitis, discoloration of the tongue and teeth.

Disorders from the liver and biliary tract: often - an atypical functional liver test is rare - cholestasis, hepatitis, increased ALT activity, increased AST activity, increased GGT activity, frequency is unknown - liver failure, hepatocellular jaundice.

Disorders of the skin and subcutaneous tissues: often - rash, increased sweating infrequently - itching, urticaria, maculopapular rash, frequency unknown - malignant exudative erythema (Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome), drug rash with eosinophilia and systemic manifestations, acne, Shenlein-Genoch purpura.

Violations of the musculoskeletal and connective tissue: infrequently - muscle spasm, myalgia, frequency unknown - rhabdomyolysis, myopathy, increased symptoms of myasthenia gravis.

Disorders of the kidneys and urinary tract: very rarely renal failure, interstitial nephritis.

General disorders and disorders at the injection site: infrequently - malaise, fever, asthenia, chest pain, chills, weakness.

Laboratory indicators: infrequently - increased activity of alkaline phosphatase, increased activity of LDH blood is very rare - hypercreatininemia frequency is unknown - increased international normalized ratio (MHO), increased prothrombin time, discoloration of urine, increased bilirubin concentration.

Amoxicillin

Infectious and parasitic diseases: infrequently - development of superinfection, candidiasis of the oral mucosa, vaginal candidiasis.

Disorders from the blood and lymphatic system: rarely eosinophilia, hemolytic anemia very rarely - leukopenia, neutropenia, graiulocytopenia, thrombocytopenia, pancytopenia, anemia, myelosuppression, agranulocytosis, a reversible increase in prothrombin time and bleeding time.

Immune system disorders: rarely - laryngeal edema, serum sickness, allergic purpura, anaphylactic reaction.

Disorders of the nervous system: infrequently - headache rarely - agitation, anxiety, insomnia, ataxia, confusion, hyperkinesia, behavior change, depression, peripheral neuropathy, dizziness, convulsions (in patients with impaired renal function, epilepsy or meningitis).

Disorders of the gastrointestinal tract: often - nausea, loss of appetite, vomiting, flatulence, soft stools, diarrhea, rash on the oral mucosa, dry mouth, distortion of taste perception rarely - darkening of enamel is very rare - pseudomembranous colitis, black hairy tongue.

Disorders from the liver and biliary tract: infrequently - a reversible increase in the activity of “liver” transaminases is rare - hepatitis, cholestatic jaundice.

Disorders of the skin and subcutaneous tissue: often - skin rashes, itching, urticaria, rarely - angioedema (Quincke's edema), polymorphic exudative erythema, acute generalized exanthematous pustulosis, toxic epidermal necrolysis (Lyell's syndrome), malignant exudative erythema (Stevens-Johnson dermatitis syndrome and b).

Disorders from the kidneys: rarely - acute interstitial nephritis, crystalluria.

General disorders and disorders at the injection site: rarely - drug fever.

Lansoprazole

Disorders from the blood and lymphatic system: infrequently - thrombocytopenia, eosinophilia, leukopenia rarely - anemia very rarely - agranulocytosis, pancytopenia.

Disorders of the immune system: very rarely - anaphylactic shock.

Metabolism and nutritional disorders: rarely - anorexia frequency unknown - hypomagnesemia.

Mental disorders: infrequently - depression rarely - insomnia, hallucinations, confusion.

Disorders of the nervous system: often - headache, dizziness rarely - restlessness, vertigo and paresthesia, drowsiness, tremor.

Disorders of the organ of vision: rarely - visual impairment.

Disorders of the gastrointestinal tract: often - nausea, diarrhea, abdominal pain, constipation, vomiting, flatulence, dry mouth or throat rarely - glossitis, candidiasis of the esophagus, pancreatitis, taste perception disorder very rarely - colitis, stomatitis.

Disorders from the liver and biliary tract: often - increased activity of "liver" transaminases rarely - hepatitis, jaundice very rarely - hyperbilirubinemia.

From the respiratory system: rarely - cough, pharyngitis, rhinitis, upper respiratory tract infection, flu-like syndrome.

Disorders of the skin and subcutaneous tissues: often - urticaria, itching, rash rarely - petechiae, purpura, alopecia, angioedema (Quincke's edema), polymorphic erythema, photosensitivity very rarely - malignant exudative erythema (Stevens-Johnson syndrome, necrolysis (Lyell's syndrome).

Disorders of the musculoskeletal and connective tissue: infrequently - arthralgia, myalgia, fracture of the hip, wrist or spine.

Disorders of the kidneys and urinary tract: rarely - interstitial nephritis.

Violations of the genitals and mammary gland: rarely - gynecomastia, impotence.

General disorders and disorders at the injection site: often - weakness infrequently - edema rarely - fever, increased sweating.

Laboratory indicators: very rarely - increased cholesterol and triglycerides, hyponatremia.

Drug Interactions

Clarithromycin

When taking clarithromycin and drugs that are primarily metabolized by CYP3A isoenzymes, they may increase their concentrations mutually, which may enhance or prolong both therapeutic and side effects. Co-administration with astemizole, cisapride, pimozide, terfenadine, ergotamine and other ergot alkaloids, alprazolam, midazolam, triazolam is contraindicated.

is prescribed with caution with carbamazepine, cilostazole, cyclosporine, disopyramide, lovastatin, methylprednisolone, omeprazole, indirect anticoagulants (including warfarin), quinidine, rifabutin, sildenafil, simvastatin, tinomerolithrominomeroliminomeroliminomeroliminomerolithrominomerolithrominomeroliminomerolithrominomerolithrominomeroliminoinolinominojinominolinominojinominolinominojinominolinominojinominolinominojinominolinominojinominolinominojinomerolinomene isoenzymes of cytochrome P450). It is necessary to adjust the dose of drugs and control the concentration in the blood plasma.

When used together with cisapride, pimozide, terfenadine and astemizole, an increase in the plasma concentration of the latter, prolonged QT interval, and the development of cardiac arrhythmias, including ventricular paroxysmal tachycardia, fibrillation, ventricular flutter or fibrillation, polymorphic ventricular tachycardia. section "Contraindications"). A similar mechanism of interaction is noted with the use of drugs metabolized by another isoenzyme of the cytochrome P450 system - phenytoin, theophylline, and valproic acid. With the simultaneous administration of the above drugs, monitoring of their concentration in blood plasma and ECG is required.

Clarithromycin can reduce the clearance of triazolam and, thus, increase its pharmacological effects with the development of drowsiness and confusion.

For benzodiazepines, excretion of which is independent of CYP3A4 isoenzymes (temazepam, nitrazepam, lorazepam), a clinically significant interaction with clarithromycin is unlikely.

There are reports of an increase in the concentration of digoxin in the blood plasma of patients receiving both digoxin and clarithromycin. You should constantly monitor the content of digoxin in blood plasma, to avoid digitalis intoxication and the development of potentially lethal arrhythmias.

Combined use with ergotamine and dihydroergotamine (ergot derivatives) can lead to acute ergotamine intoxication, manifested by severe peripheral vasospasm, ischemia of limbs and other tissues, including the central nervous system, and perverse sensitivity.

With the simultaneous administration of clarithromycin with HMG-CoA reductase inhibitors - lovastatin and simvastatin - rare cases of rhabdomyolysis have been described.

Efavirenz, nevirapine, rifampicin, rifabutin and rifapentin (cytochrome P450 inducers) reduce the concentration of clarithromycin in the blood plasma and weaken its therapeutic effect, and at the same time increase the concentration of 14 (R) -hydroxyclarithromycin.

With the combined use of fluconazole at a dose of 200 mg and clarithromycin at a dose of 1 g / day, it is possible to increase the equilibrium concentration and AUC of clarithromycin by 33% and 18%, respectively. Clarithromycin dose adjustment is not required.

It is necessary to pay attention to the possibility of cross-resistance between clarithromycin and other macrolide antibiotics, as well as lincomycin and clindamycin.

Concomitant use of clarithromycin and zidovudine in adult HIV-infected patients can lead to a decrease in the equilibrium level of zidovudine concentration. A selection of doses of clarithromycin and zidovudine is necessary.

With the simultaneous administration of clarithromycin and ritonavir, atazanavir or other protease inhibitors, the values ​​of the plasma concentration increase as clarithromycin, which in this case should not be prescribed in a dose of more than 1 g / day, or of a protease inhibitor.

With the combined use of clarithromycin and itraconazole, a mutual increase in the concentration of drugs in the blood plasma is possible. Patients taking itraconazole and clarithromycin at the same time should be closely monitored because of the possible enhancement or prolongation of the pharmacological effects of these drugs.

With the simultaneous administration of clarithromycin (1 g / day) and saquinavir (in soft gelatin capsules, 1200 mg 3 times a day), AUC and equilibrium concentrations of saquinavir may increase by 177% and 187%, respectively, and clarithromycin by 40%. When these two drugs are co-administered for a limited time in the doses / dosage forms indicated above, dose adjustment is not required. Since when co-administered with colchicine, which is a substrate for CYP3A and P-glycoprotein, and clarithromycin, as well as other macrolides, inhibitors of CYP3A and P-glycoprotein, inhibition can increase the effect of colchicine, patients should be carefully monitored to identify symptoms of the toxic effect of colchicine . When using clarithromycin with tolterodine in patients with low activity of the CYP2D6 isoenzyme, a dose reduction of tolterodine in the presence of clarithromycin (an inhibitor of CYP3A isoenzymes) may be required.

With the combined use of clarithromycin with verapamil, a decrease in blood pressure, bradyarrhythmia and lactic acidosis is possible.

When using etravirine, the concentration of clarithromycin decreases, but the concentration of the active metabolite of 14 (R) -hydroxyclarithromycin increases.

With the combined use of clarithromycin and oral hypoglycemic agents and / or insulin, severe hypoglycemia may be observed. With the simultaneous administration of clarithromycin and certain glucose-lowering drugs, such as nateglinide, pioglitazone, repaglinide and rosiglitazone, inhibition of the CYP3A isoenzyme by clarithromycin may occur, which may result in hypoglycemia. Careful monitoring of glucose concentration is recommended.

Amoxicillin

Antacids, glucosamine, laxatives, aminoglycosides, food slow down and reduce the absorption of amoxicillin ascorbic acid increases absorption.

Probenecid reduces the excretion of amoxicillin by the kidneys and increases the concentration of amoxicillin in bile and blood plasma. Bactericidal antibiotics (including aminoglycosides, cephalosporins, vancomycin, rifampicin) - a synergistic effect of bacteriostatic drugs (macrolides, chloramphinecol, lincosamides, tetracyclines, sulfonamides) - antagonistic.

When taking amoxicillin in combination with metronidazole, nausea, vomiting, anorexia, diarrhea, constipation, epigastric pain, digestive upset, in rare cases jaundice, interstitial nephritis, hematopoiesis disorders are observed.

Amoxicillin increases the effectiveness of indirect anticoagulants (suppressing the intestinal microflora, reduces the synthesis of vitamin K and the prothrombin index), which leads to an increase in blood clotting time. If necessary, adjust the dose of indirect anticoagulants. The simultaneous use of amoxicillin and allopurinol increases the risk of developing a skin rash.

Amoxicillin reduces clearance and increases the toxicity of methotrexate, probably due to competitive inhibition of tubular renal secretion of methotrexate by amoxicillin. In patients receiving both amoxicillin and methotrexate, plasma concentrations of the latter should be carefully monitored. It is possible to increase the absorption time of digoxin during amoxicillin therapy. If necessary, adjust the dose of digoxin.

Diuretics, allopurinol, oxyphenbutazone, phenylbutazone, non-steroidal anti-inflammatory drugs and other drugs that block tubular secretion increase the concentration of amoxicillin in blood plasma.

Amoxicillin reduces the concentration of estrogen and progesterone in blood plasma, which can lead to the loss of the contraceptive effect of oral contraceptives. During treatment with amoxicillin, additional non-hormonal methods of contraception should be used.

Lansoprazole

Lansoprazole slows down the elimination of drugs metabolized in the liver by microsomal oxidation (including diazepam, phenytoin, indirect anticoagulants).

Reduces clearance of theophylline by 10%.

Slows down the pH-dependent absorption of drugs related to the groups of weak acids, and accelerates the absorption of drugs related to the groups of bases.

Prevents the absorption of ketoconazole, itraconazole, ampicillin, iron salts, digoxin.

Lansoprazole slows the absorption of cyanocobalamin.

Compatible with ibuprofen, indomethacin, diazepam, propranolol, warfarin, oral contraceptives, phenytoin, prednisolone. Sucralfate reduces the bioavailability of lansoprazole by 30%, therefore, it is necessary to observe the interval between taking these medicines for 30-40 minutes.

Antacids should be prescribed 1 hour before or 1-2 hours after taking lansoprazole, as they slow down and reduce its absorption.

Volunteers who simultaneously received 60 mg of lansoprazole and 400 mg of atazanavir per day showed a 90% decrease in AUC and Cmax of the latter. Lansoprazole should not be given concurrently with atazanavir.

Ritonavir (substrate and CYP2C19 inhibitor) can variablely affect the AUC of lansoprazole (increase or decrease). If necessary, concomitant therapy is recommended to monitor therapeutic and possible side effects, as well as dose adjustment of lansoprazole.

The simultaneous administration of lansoprazole and tacrolimus (a substrate of the isoenzyme CYP3A4 and P-glycoprotein) leads to an increase in the plasma concentration of the latter (up to 81%). The concentration of tacrolimus in the blood plasma should be monitored while it is prescribed with lansoprazole.

The simultaneous administration of fluvoxamine (an inhibitor of the isoenzyme CYP2C19) and lansoprazole leads to a four-fold increase in the concentration of the latter in blood plasma.

Rifampicin and Hypericum perforatum (induce isoenzymes CYP2C19 and CYP3A4) can significantly reduce plasma concentrations of lansoprazole.

Overdose

Clarithromycin

Symptoms: abdominal pain, nausea, vomiting, diarrhea, possible headache, confusion.

Treatment: gastric lavage, maintenance therapy. It is not removed during hemo- or peritoneal dialysis.

Amoxicillin

Symptoms: nausea, vomiting, diarrhea, impaired water-electrolyte balance (as a result of vomiting and diarrhea), crystalluria.

Treatment: gastric lavage, activated charcoal, salt laxatives, preparations for maintaining water-electrolyte balance hemodialysis.

Storage Conditions

In a dry, dark place, at a temperature not exceeding 25 РC.

shelf life

3 years

Active ingredient

Amoxicillin, Lansoprazole

Terms and conditions

prescription

dosage form

capsule

Possible product names

LANCID KIT N7 KIT

LANCID KIT COMBINED KIT No. 56

LANCID KIT COMBINED KIT No. 56 TAB AND CAPS

Lancid Kit set table. and caps. N56 India

Lantsid Whale tablets and capsules, 56 pcs.