Amoxicillin suspension, capsules and tablets: instructions for use, price and reviews from doctors. Indications for use in children and pregnancy

pharmachologic effect

Amoxicillin is an antibiotic that has a wide spectrum of effects. A group of antibiotics - semisynthetic penicillins . The abstract indicates that the drug is a 4-hydroxyl analogue of ampicillin . Provides a bactericidal effect. Demonstrates activity against aerobic gram-positive bacteria, namely Streptococcus spp., Staphylococcus spp. (except for those strains that produce penicillinase). Also active against aerobic gram-negative bacteria: Shigella spp., Neisseria gonorrhoeae, Escherichia coli, Neisseria meningitidis, Klebsiella spp., Salmonella spp.

Pharmacokinetics and pharmacodynamics

Amoxicillin trihydrate is very quickly and completely absorbed from the digestive tract, while the acidic environment of the stomach is not destroyed. The maximum level of concentration of the substance in the blood is observed 1-2 hours after taking the drug. If you double the dose of the drug, the concentration also doubles. If there is food in the stomach, the overall absorption is not reduced. If amoxicillin is administered IV or IM, similar concentrations of the active substance are observed in the blood. The substance binds to plasma proteins by approximately 20%. In the body, the active substance is distributed in fluids and tissues. The presence of large concentrations of the active substance is noted in the liver.

The plasma half-life is 1-1.5 hours. Approximately 60% of an orally administered dose is excreted from the body in the urine. Output unchanged. A certain amount of the substance is also found in feces. A longer half-life is observed in the elderly and neonates.

In small quantities it is able to penetrate the BBB during inflammatory processes of the pia mater.

Indications for use of Amoxicillin

The following indications for the use of this drug in combination with clavulanic acid , as well as as monotherapy, are determined:

infectious and inflammatory diseases provoked by sensitive microorganisms ( bronchitis , tonsillitis , pyelonephritis , pneumonia , as well as cystitis , urethritis , infections of the digestive system, gynecological infectious diseases, gonorrhea , diseases of soft tissues and skin of infectious origin);
in combination with metronidazole, it is used to treat chronic gastritis during an exacerbation, as well as duodenal and gastric ulcers during an exacerbation (provided that the ulcer is associated with Helicobacter pylori).

Also for the prescription of Amoxicillin tablets and other forms of the drug there are the following indications:

leptospirosis , listeriosis ;
tick-borne borreliosis ( Lyme disease );
shigellosis;
salmonellosis and salmonella carriage;
meningitis;
sepsis;
endocarditis (for the purpose of prevention).

Contraindications

Please note that the following contraindications to the use of this medicine are noted:

severe infectious diseases of the gastrointestinal tract, in which the patient suffers from diarrhea , vomiting ;
Infectious mononucleosis;
lymphocytic leukemia;
allergic diathesis;
viral respiratory infections;
hay fever;
bronchial asthma;
high sensitivity to cephalosporins , penicillins .

Medicines containing metronidazole should not be used in the following cases:

for diseases of the nervous system;
for hematopoietic disorders;
for infectious mononucleosis and lymphocytic leukemia ;
with severe sensitivity to nitroimidazole .

Medicines containing clavulanic acid should not be used if there is a history of jaundice or impaired liver function.

Side effects

During treatment with this drug, the following side effects may occur:

manifestations associated with an allergic reaction of the body : Quincke's edema , erythema , urticaria , conjunctivitis , rhinitis ; in rare cases, joint pain, eosinophilia, and fever may occur; in very rare cases - anaphylactic shock ;
manifestations are a consequence of the chemotherapeutic influence : the development of superinfections, which most often occur in people suffering from chronic illnesses and those who have reduced resistance;
symptoms are a consequence of prolonged use of the drug in large doses : ataxia , dizziness , depression , disturbances of consciousness , convulsions , peripheral neuropathies , therefore, only a doctor should determine how many days to take the drug;
with the combination of “amoxicillin, metronidazole” : vomiting , nausea , constipation , anorexia , diarrhea , stomatitis , epigastric pain, glossitis ; in rare cases, pseudomembranous colitis, hepatitis, allergic manifestations, hematopoietic disorders, interstitial nephritis may occur;
with the combination of “amoxicillin, clavulanic acid” : hepatitis , cholestatic jaundice ; in rare cases - erythema multiforme , exfoliative dermatitis , toxic epidermal necrolysis.

Side effects

Like all penicillins, amoxicillin can cause an allergic reaction of varying strength, including anaphylactic shock. However, most often hypersensitivity reactions manifest themselves as drug fever.

In addition to allergic reactions, nausea, vomiting, and diarrhea may occur. Penicillins are considered to be of low toxicity to the human body. They can usually be prescribed during pregnancy .

Rare side effects include insomnia and fatigue.

Instructions for use of Amoxicillin (Method and dosage)

The drug should be taken orally with water. You can take the antibiotic regardless of food intake.

Amoxicillin tablets, instructions for use

For adult patients and children over 12 years of age, 500 mg of amoxicillin is usually prescribed three times a day. However, the dosage depends on the disease and the doctor’s prescription in each specific case. For severe diseases, the dose can be increased to 750-1000 mg, the highest permissible dose per day is 6 g.

High doses of the drug are prescribed for typhoid fever (1.5-2 g three times a day), for leptospirosis (500-750 mg four times a day). Tablets or capsules should be taken for another two or three days even after the signs of the disease disappear. In most cases, treatment lasts from 5 to 12 days.

Amoxicillin suspension, instructions for use

The children's version of this antibiotic is Amoxicillin suspension, which is used to treat children under 5 years of age. The suspension must be prepared immediately before starting treatment. To do this, add cool water to the bottle with granules, after which the mixture must be shaken. The suspension can be stored for 14 days at room temperature. The medicine must be shaken each time before use. One measuring spoon contains 5 ml of suspension, respectively, it contains 250 mg of amoxicillin.

Children under 2 years of age should receive no more than 20 mg of the drug per 1 kg of weight per day. Children aged 2 to 5 years are recommended to take 125 mg of the drug. Children 5-10 years old receive a single dose of 250 mg. Children over 10 years old receive a single dose of 250-500 mg, if the disease is severe - up to 1 g.

Instructions for use Amoxicillin Sandoz

Used internally. In most cases, the dose ranges from 750 mg to 3 g of the drug, the dose is divided into several doses. More detailed information about the dosage and regimen of this drug, as well as about taking amoxicillin clavulanate, is provided by the doctor when prescribing treatment.

Veterinary Amoxicillin

In veterinary medicine, injections of amoxicillin 15% are used. For animals it is used to treat bacterial infections of the digestive system, skin diseases, respiratory diseases, diseases of the genitourinary system, etc. It is used for dogs, cats, and cattle. The drug must be administered subcutaneously or intramuscularly, the dosage is 1 ml per 10 kg of body weight. If necessary, the product is re-administered after 48 hours. A light massage of the area where the drug was injected is recommended.

Instructions for Amoxicillin DS

You need to take the drug 500 mg three times a day. If the disease is severe, the doctor may increase the dose to 750-1000 mg. Features of treatment depend on the patient's diagnosis.

The dosage of Amoxicillin for angina depends on the intensity of the pathological processes. As a rule, for angina, the usual dose of the drug is prescribed - 500 mg three times a day. How to take it for adults or how to take the medicine for children with a cold, you should definitely ask your doctor.

The dosage for sinusitis depends on the doctor's prescription. The dosage for adults is generally 500 mg of the drug 3-4 times a day, treatment lasts approximately one week. However, a specialist should tell you more precisely how many days to take the product.

Amoxicillin (suspension)

Before starting treatment, it is necessary to interview the patient to identify a history of hypersensitivity reactions to penicillins, cephalosporins or other beta-lactam antibiotics. In patients who are hypersensitive to penicillins, cross-allergic reactions with cephalosporins are possible.

Anaphylactic reactions, some fatal, have been reported with the use of penicillins. In rare cases, anaphylactic shock or other severe allergic reactions may develop. Similar reactions are possible in patients with a history of hypersensitivity to beta-lactam antibiotics or atopy. In case of severe allergic reactions, amoxicillin should be discontinued and alternative treatment should be prescribed.

In patients with severe renal impairment, the elimination of amoxicillin may be slowed and, depending on the severity of renal failure, a dose reduction may be required (see section "Dosage and Administration"). Forced diuresis accelerates the elimination of amoxicillin and reduces its plasma concentration.

Crystalluria can be observed in patients with reduced urine output, mainly with parenteral administration of amoxicillin. Because amoxicillin precipitates in urinary catheters, it is necessary to regularly check the patency of catheters and monitor the adequacy of fluid intake and output to minimize the risk of amoxicillin-associated crystalluria.

Amoxicillin should not be used to treat infections whose pathogens are not sensitive to amoxicillin; this is especially important to consider when treating infections of the genitourinary system and severe infections of the ear, nose and throat. Superinfection may develop due to the growth of microflora insensitive to amoxicillin, which requires a corresponding change in antibacterial therapy.

It is not recommended to use the drug in patients with infectious mononucleosis, because amoxicillin can cause a measles-like rash.

When taking almost all antibiotics, it is possible to develop antibiotic-associated colitis up to a life-threatening condition. This should be taken into account if diarrhea occurs during antibiotic therapy or after its completion. If antibiotic-associated colitis develops, drug therapy should be stopped immediately and consult a doctor to prescribe appropriate treatment. The use of drugs that inhibit intestinal motility is contraindicated.

When using the drug for a long time and/or in high doses, you should regularly monitor your general blood count, liver and kidney function.

Treatment with high doses of beta-lactam antibiotics in patients with renal failure or a history of seizures, treated epilepsy, and meningeal lesions may rarely result in seizures. The appearance at the beginning of treatment of generalized erythema, which is accompanied by pustules, may be a symptom of acute generalized exanthematous pustulosis. This requires discontinuation of treatment; further use of the drug is contraindicated.

The Jarisch-Herxheimer reaction can be observed when amoxicillin is used to treat Lyme disease and is directly related to the bactericidal effect of amoxicillin on the causative agent of the disease, the spirochete Borrelia burgdorferi.

Clinical manifestations: fever, chills, headache, myalgia, skin reactions in the area of erythema. Patients should understand that the development of the Jarisch-Herxheimer reaction is a common consequence of treatment for Lyme disease.

Treatment must continue for 48-72 hours after the disappearance of clinical signs of the disease.

Lab tests:

high concentrations of amoxicillin give a false-positive reaction to urine glucose when using Benedict's reagent or Fehling's solution. Enzymatic glucose oxidase tests are recommended. Amoxicillin may reduce the amount of estriol in the urine in pregnant women. Patients with diabetes mellitus should take into account that 5 ml of suspension (2 g of granules) contains 1.65 g of sucrose (or 0.14 bread units, XE), respectively, the maximum daily dose of amoxicillin contains 3.3 XE.

Patients with rare hereditary fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase deficiency should not take this drug.

5 ml of the finished suspension contains 10.63 mg of sodium, which must be taken into account in patients on a sodium-restricted diet.

Overdose

As a rule, in case of overdose there is no pronounced toxic effect, even if a large dose of the drug was taken. If a large dose of Amoxicillin has been taken, the patient will experience symptoms of gastrointestinal upset and water-electrolyte imbalance. In people who suffer from renal failure, overdose may show signs of nephrotoxicity and crystalluria.

Symptomatic treatment is carried out, for which drugs prescribed by the doctor are used, and activated charcoal should also be taken. Hemodialysis may be used . There is no specific antidote.

Amoxicillin hemofarm Capsules, 16 pcs., 500 mg

special instructions

Before prescribing amoxicillin, like all penicillins, it is necessary to carefully collect anamnesis for allergic reactions to penicillins, cephalosporins and other beta-lactam antibiotics, taking into account possible cross-reactions.
Serious and sometimes fatal hypersensitivity reactions (including anaphylactoid and serious skin reactions) have been reported in patients receiving penicillin therapy. The development of these reactions is more likely in persons with a history of hypersensitivity to penicillin and in persons with atopy. If an allergic reaction occurs, discontinue amoxicillin therapy and institute appropriate alternative therapy.

Rare cases of hypersensitivity reaction of the allergic acute coronary syndrome type (Kounis syndrome) have been observed; if it develops, appropriate treatment is used during treatment with amoxicillin.

With long-term use, cases of superinfection and candidiasis (especially vulvovaginal candidiasis) may develop.

Convulsions may occur in patients with impaired renal function or in patients receiving high doses of the drug or having predisposing factors (for example, a history of seizures, treatment for epilepsy or meningitis).

In case of renal failure, it is necessary to adjust the dosage regimen depending on the degree of renal failure.

The occurrence of generalized erythema with fever accompanied by pustules at the beginning of treatment may be a symptom of OHEP (see section “Side effects”). This adverse reaction requires discontinuation of treatment with amoxicillin and is a contraindication for its further use in any situation.

The use of amoxicillin should be avoided if a patient is suspected of developing infectious mononucleosis, since the appearance of a morbilliform rash has been associated with the use of amoxicillin in the treatment of infectious mononucleosis.

The Jarisch-Herxheimer reaction has been observed after the use of amoxicillin in patients with Lyme disease (see section "Side effects"). Its direct cause is the bactericidal activity of amoxicillin against the bacteria that cause Lyme disease, the spirochete Borrelia burgdorferi.

Patients should be reassured that this reaction is a common and usually self-limiting consequence of antibiotic use in patients with Lyme disease.

Treatment must continue for 48-72 hours after the disappearance of clinical signs of the disease.

During treatment, it is necessary to monitor the state of function of the hematopoietic organs, liver and kidneys. Increased activity of liver enzymes and changes in the number of blood cells were reported.

When taken simultaneously with anticoagulants, an increase in prothrombin time is observed. Appropriate monitoring and possibly adjustment (reduction) of the anticoagulant dose should be carried out.

In patients with reduced diuresis, crystalluria was very rarely observed, mainly during parenteral therapy. When using high doses of amoxicillin, it is recommended to maintain adequate fluid intake and diuresis to reduce the possibility of crystalluria associated with amoxicillin use. In patients with a catheterized bladder, catheter patency should be checked regularly.

High concentrations of amoxicillin give a false-positive reaction to urine glucose when using Benedict's reagent or Fehling's solution. The use of enzymatic glucose oxidase tests is recommended.

The use of amoxicillin may distort the results of the quantitative determination of estriol in urine in pregnant women.

The drug should be used with caution in the elderly, pregnant women, and during lactation.

When using amoxicillin to treat Helicobacter pylori infection,

You should take into account the information provided in the text of the instructions for medical use of other concomitantly used drugs.

Interaction

Wikipedia indicates that the drug may reduce the effectiveness of oral contraceptives.

If taken simultaneously with bactericidal antibiotics, the patient experiences synergy ; if taken simultaneously with bacteriostatic antibiotics, antagonism .

The drug stimulates the effect of indirect anticoagulants, reduces the prothrombin index and the synthesis of vitamin K.

Reduces the effectiveness of drugs in the process of metabolism of which PABA manifests itself.

Tubular secretion is reduced by allopurinol , diuretics, probenecid , phenylbutazone, and NSAIDs. As a result, its concentration in the blood may increase.

Under the influence of ascorbic acid, the absorption of amoxicillin increases, and when taken simultaneously with glucosamine , antacids , aminoglycosides , and laxatives , it decreases.

If the simultaneous use of amoxicillin and clavulanic acid is practiced, there is no change in the pharmacokinetics of these drugs.

Microorganisms that produce penicillinase demonstrate resistance to the main substance.

When combined with metronidazole, it is active against Helicobacter pylori.

Cross-resistance has been observed between amoxicillin and ampicillin .

Amoxicillin (capsules)

Serious and sometimes fatal hypersensitivity reactions (including anaphylactoid and serious skin reactions) have been reported in patients receiving penicillin therapy. The development of these reactions is more likely in persons with a history of hypersensitivity to penicillin and in persons with atopy. If an allergic reaction occurs, discontinue amoxicillin therapy and institute appropriate alternative therapy.