Flemoxin Solutab dispersible tablets 250mg, No. 20

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

• respiratory infections;

• organs of the genitourinary system;

• organs of the digestive tract;

• skin and soft tissues.

The drug is taken orally. The drug is prescribed before, during or after a meal. The tablet can be swallowed whole, divided into parts or chewed with a glass of water, and can also be diluted in water to form a syrup (20 ml) or suspension (100 ml) with a pleasant fruity taste.

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.

In the case of infectious and inflammatory diseases of mild and moderate severity, it is recommended to use the drug according to the following scheme: adults and children over 10 years of age are prescribed 500-750 mg 2 times / day or 375-500 mg 3 times / day; children aged 3 to 10 years are prescribed 375 mg 2 times / day or 250 mg 3 times / day; children aged 1 to 3 years are prescribed 250 mg 2 times / day or 125 mg 3 times / day.

The daily dose of the drug for children (including children under 1 year old) is 30-60 mg / kg / day, divided into 2-3 doses.

In the treatment of severe infections, as well as in hard-to-reach foci of infection (for example, acute otitis media), a three-time dose is recommended.

For chronic diseases, recurrent infections, severe infections, adults are prescribed 0.75-1 g 3 times / day; children - 60 mg / kg / day, divided into 3 doses.

In acute uncomplicated gonorrhea, 3 g of the drug is prescribed in 1 dose in combination with 1 g of probenecid.

For patients with impaired renal function with a CC of 10 ml / min, the dose of the drug is reduced by 15-50%. In the case of infections of mild and moderate severity, the drug is taken within 5-7 days.

However, for infections caused by Streptococcus pyogenes, the duration of treatment should be at least 10 days. The drug must be continued for 48 hours after the disappearance of the symptoms of the disease.

Dispersible tablets from white to light yellow, oval in shape with the company logo and the numeral '232' on one side and a line dividing the tablet in half on the other side.

1 tab.

amoxicillin trihydrate 291.4 mg,?

which corresponds to the content of amoxicillin 250 mg

Excipients: lemon flavoring - 2.8 mg, tangerine flavoring - 2.3 mg, vanillin - 0.26 mg, crospovidone - 12.6 mg, magnesium stearate - 1.5 mg, saccharin - 3.3 mg, dispersible cellulose - 8.7 mg, microcrystalline cellulose - 12.6 mg.

Hypersensitivity to the drug and other beta-lactam antibiotics.

Carefully:

• polyvalent hypersensitivity to xenobiotics;

• Infectious mononucleosis;

• lymphocytic leukemia;

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

• renal failure;

• pregnancy;

• lactation period.

pharmachologic effect

Antibiotic of the group of semisynthetic penicillins with a broad spectrum of action. It is a 4-hydroxyl analogue of ampicillin. Has a bactericidal effect. Active against aerobic gram-positive bacteria: Staphylococcus spp. (with the exception of strains producing penicillinase), Streptococcus spp .; aerobic gram-negative bacteria: Neisseria gonorrhoeae, Neisseria meningitidis, Escherichia coli, Shigella spp., Salmonella spp., Klebsiella spp.

Microorganisms that produce penicillinase are resistant to amoxicillin.

In combination with metronidazole, it is active against Helicobacter pylori. It is believed that amoxicillin inhibits the development of resistance of Helicobacter pylori to metronidazole.

Cross-resistance exists between amoxicillin and ampicillin.

The spectrum of antibacterial action expands with the simultaneous use of amoxicillin and a beta-lactamase inhibitor clavulanic acid. This combination increases the activity of amoxicillin against Bacteroides spp., Legionella spp., Nocardia spp., Pseudomonas (Burkholderia) pseudomallei. However, Pseudomonas aeruginosa, Serratia marcescens, and many other gram-negative bacteria remain resistant.

Pharmacokinetics

When taken orally, amoxicillin is rapidly and completely absorbed from the gastrointestinal tract, it is not destroyed in the acidic environment of the stomach. Cmax of amoxicillin in blood plasma is achieved after 1-2 hours. When the dose is doubled, the concentration also doubles. In the presence of food in the stomach, it does not decrease total absorption. With intravenous, intramuscular and intramuscular administration, similar concentrations of amoxicillin are achieved in the blood.

Plasma protein binding of amoxicillin is about 20%.

It is widely distributed in tissues and body fluids. Reported high concentrations of amoxicillin in the liver.

T1 / 2 from plasma is 1-1.5 hours. About 60% of the dose taken orally is excreted unchanged in the urine by glomerular filtration and tubular secretion; at a dose of 250 mg, the concentration of amoxicillin in the urine is more than 300 ?g / ml. A certain amount of amoxicillin is determined in the feces.

In newborns and the elderly, T1 / 2 may be longer.

In renal failure, T1 / 2 may be 7-20 hours.

In small amounts, amoxicillin penetrates the BBB during inflammation of the pia mater.

Amoxicillin is removed by hemodialysis.

Side effect

Allergic reactions: urticaria, erythema, Quincke's edema, rhinitis, conjunctivitis; rarely - fever, joint pain, eosinophilia; in isolated cases - anaphylactic shock.

Effects associated with chemotherapeutic action: the development of superinfections is possible (especially in patients with chronic diseases or reduced body resistance).

With prolonged use in high doses: dizziness, ataxia, confusion, depression, peripheral neuropathy, convulsions.

Mainly when used in combination with metronidazole: nausea, vomiting, anorexia, diarrhea, constipation, epigastric pain, glossitis, stomatitis; rarely - hepatitis, pseudomembranous colitis, allergic reactions (urticaria, angioedema), interstitial nephritis, hematopoietic disorders.

Mainly when used in combination with clavulanic acid: cholestatic jaundice, hepatitis; rarely - erythema multiforme, toxic epidermal necrolysis, exfoliative dermatitis.

Application during pregnancy and lactation

Amoxicillin crosses the placental barrier, in small amounts excreted in breast milk.

If it is necessary to use amoxicillin during pregnancy, the expected benefits of therapy for the mother and the potential risk to the fetus should be carefully weighed.

Use amoxicillin with caution during lactation (breastfeeding).

Application for violations of liver function

Amoxicillin in combination with metronidazole should not be used for liver disease.

Application for impaired renal function

Patients with impaired renal function, the dose and the interval between injections should be adjusted in accordance with the CC values.

Application in children

Application in children is possible according to the dosage regimen.

Amoxicillin in combination with metronidazole is not recommended for use in patients under 18 years of age.

special instructions

Use with caution in patients prone to allergic reactions.

Amoxicillin in combination with metronidazole is not recommended for use in patients under 18 years of age; should not be used for liver disease.

Alcohol consumption is not recommended against the background of combination therapy with metronidazole.

Drug interactions

Amoxicillin may decrease the effectiveness of oral contraceptives.

With the simultaneous use of amoxicillin with bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, vancomycin, rifampicin), synergism is manifested; with bacteriostatic antibiotics (including macrolides, chloramphenicol, lincosamides, tetracyclines, sulfonamides) - antagonism.

Amoxicillin enhances the effect of indirect anticoagulants by suppressing the intestinal microflora, reduces the synthesis of vitamin K and the prothrombin index.

Amoxicillin reduces the effect of drugs, in the process of metabolism of which PABA is formed.

Probenecid, diuretics, allopurinol, phenylbutazone, NSAIDs reduce the tubular secretion of amoxicillin, which may be accompanied by an increase in its concentration in the blood plasma.

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

With the combined use of amoxicillin and clavulanic acid, the pharmacokinetics of both components does not change.