Buy Augmentin film-coated tablets 875mg+125mg No. 14 in pharmacies
Augmentin Buy Augmentin in DOSAGE FORMS film- coated tablets 875mg/125mg film-coated tablets 875mg+125mg
MANUFACTURERS Smithkline Beacham (Great Britain) Smithkline Beacham PLC (Great Britain)
GROUP Combined antimicrobial agents
COMPOSITION Active substance: amoxicillin + clavulanic acid.
INTERNATIONAL NON-PROPENTED NAME Amoxicillin + Clavulanic acid
SYNONYMS Amoxiclav, Amoxiclav Quiktab, Arlet, Augmentin EU, Augmentin SR, Clamosar, Medoclav, Panclave, Ranclave, Rapiclav, Sinulox, Sinulox RTU, Flemoclav Solutab, Ecoclave
PHARMACOLOGICAL ACTION Broad spectrum antibacterial. Blocks the synthesis of peptidoglycan of the membrane of microbial cells (amoxicillin), inhibits beta-lactamases (clavulanic acid). Clavulanic acid forms a stable inactivated complex with these enzymes and protects amoxicillin from the loss of antibacterial activity caused by the production of beta-lactamases by the main pathogens and opportunistic microorganisms. Active against gram-positive aerobes: Streptococcus pneumoniae, S.pyogenes, S.viridans, S.bovis, Staphylococcus aureus (except methicillin-resistant strains), S.epidermidis (except methicillin-resistant strains), Listeria spp., Enterococcus spp. Gram-negative aerobes: Bordetella pertussis, Brucella spp., Campylobacter jejuni, E.coli, Gardnerella vaginalis, H.influenzae, H.ducreyi, Klebsiella spp., Moraxella catarrhalis, N.gonorrhoeae, N.meningitidis, Pasteurella multocida, Proteus spp., Salmonella spp., Shigella spp., Vibrio cholerae, Yersinia enterocolitica. Anaerobes: Peptococcus spp., Peptostreptococcus spp., Clostridium spp., Bacteroides spp., Actinomyces israelii. Rapidly absorbed after oral administration (food intake does not affect absorption). The maximum concentration is reached 1 hour after administration. The maximum plasma concentration after a bolus injection of 1.2 g is 105.4 mg/l (for amoxicillin) and 28.5 mg/l (for clavulanic acid). It has a large volume of distribution - high concentrations are found in body fluids and tissues (lungs, pleural, peritoneal, synovial fluid, tonsils, bronchial secretions, prostate gland, peritoneal abscess, muscle tissue, adipose tissue, paranasal sinus secretions, middle ear, etc. .). Peak concentrations in body fluids are observed 1 hour after peak plasma concentrations are reached. Does not pass through the BBB when the meninges are not inflamed, passes through the placental barrier and penetrates into breast milk in trace concentrations. Weakly binds to plasma proteins. Amoxicillin is partially metabolized, clavulanic acid undergoes intensive metabolism. Amoxicillin is excreted by the kidneys almost unchanged by tubular secretion and glomerular filtration; clavulanic acid - by glomerular filtration, partly in the form of metabolites. Small amounts are excreted by the intestines and lungs. The half-life is 1-1.5 hours, with severe renal failure it increases to 7.5 (for amoxicillin) and 4.5 hours (for clavulanic acid). It is removed during hemodialysis, and slightly - during peritoneal dialysis.
INDICATIONS FOR USE Infectious diseases of the upper (acute and chronic sinusitis, acute and chronic otitis media, retropharyngeal abscess, tonsilopharyngitis) and lower respiratory tract (acute and chronic bronchitis, pneumonia, pleural empyema); urinary tract infections (including cystitis, urethritis, pyelonephritis), gynecological infections (including salpingitis, salpingoophoritis, endometritis, septic abortion, pelvioperitonitis); biliary tract (cholecystitis, cholangitis), bone and connective tissue (including chronic osteomyelitis), skin and soft tissue (phlegmon, wound infection), odontogenic infections (periodontitis); sexually transmitted infections (gonorrhea, chancroid).
CONTRAINDICATIONS Hypersensitivity; history of allergic reactions to antibiotics of the penicillin and cephalosporin group; cholestatic jaundice, hepatitis caused by taking penicillin antibiotics (in history); liver failure; infectious mononucleosis, lymphocytic leukemia. Use during pregnancy and breastfeeding: possible if the expected effect of therapy exceeds the potential risk to the fetus. Breastfeeding should be stopped during treatment.
SIDE EFFECTS In most cases, side effects are weak and transient, most often affecting the gastrointestinal tract: loss of appetite, nausea, vomiting, diarrhea. Possible development of superinfection, stomatitis, vaginitis; in rare cases - pseudomembranous colitis with severe diarrhea. Allergic reactions may occur: itching, skin rashes; in sensitive patients, immediate hypersensitivity reactions may develop (angioedema, bronchospasm, rarely - anaphylactic shock). It is extremely rare that a transient increase in the level of transaminases in the blood plasma can be observed. There are isolated reports of the occurrence of cholestatic jaundice, hepatitis, and liver dysfunction.
INTERACTION When used simultaneously with methotrexate, the toxicity of methotrexate increases, with allopurinol - the incidence of exanthema, and with anticoagulants - the prothrombin time is prolonged. Reduces the effectiveness of oral contraceptives. Concomitant use with disulfiram should be avoided. The effectiveness of Amoxiclav is weakened by combination with bacteriostatic antibiotics (macrolides, tetracyclines), combination with rifampicin is antagonistic. Probenecid reduces the excretion of amoxicillin, increasing its serum concentration. Pharmaceutically incompatible with solutions containing blood, proteins, lipids, glucose, dextran, bicarbonate. Do not mix in a syringe or infusion bottle with other drugs. Incompatible with aminoglycosides.
DOSAGE AND ADMINISTRATION The dose of the drug depends on age, body weight and kidney function.
OVERDOSE Symptoms: in most cases nausea, diarrhea, vomiting, possible agitation, insomnia, dizziness, and in some cases seizures. There are no reports of deaths or life-threatening side effects. Treatment: symptomatic, in case of recent use (less than 4 hours), remove the drug from the gastrointestinal tract (gastric lavage, taking activated charcoal to reduce absorption), hemodialysis is effective.
SPECIAL INSTRUCTIONS Prescribe with caution to patients prone to allergic reactions to cephalosporins and other beta-lactam antibiotics (risk of cross-sensitivity), with severe impairment of liver and kidney function (dosage regimen adjustment is necessary). High concentrations give a false positive reaction for glucose in urine when using Benedict's reagent or Felling's solution (it is recommended to use enzymatic reactions with glucose oxidase).
STORAGE CONDITIONS List B. At room temperature.
Augmentin®
Before starting treatment with Augmentin®, it is necessary to collect a detailed history regarding previous hypersensitivity reactions to penicillins, cephalosporins, other beta-lactam drugs or other substances that cause an allergic reaction in the patient.
Serious and in some cases fatal hypersensitivity reactions (including anaphylactoid and severe skin adverse reactions) to penicillins have been reported. The risk of such reactions is highest in patients with a history of hypersensitivity reactions to penicillins and in individuals with atopy. If an allergic reaction occurs, treatment with Augmentin® should be discontinued and appropriate alternative therapy should be initiated.
If the infection is proven to be caused by microorganisms sensitive to amoxicillin, the possibility of replacing the combination of amoxicillin with clavulanic acid with amoxicillin should be considered in accordance with official recommendations. The combination of amoxicillin and clavulanic acid is not suitable for use in cases where there is a high risk that the suspected pathogens have beta-lactam resistance that is not due to beta-lactamases susceptible to inhibition by clavulanic acid. The combination of amoxicillin and clavulanic acid should not be used to treat infections caused by penicillin-resistant Streptococcus pneumoniae.
If infectious mononucleosis is suspected, Augmentin® should not be used, since amoxicillin can cause a measles-like skin rash in patients with this disease, which makes diagnosing the disease difficult.
The occurrence of generalized erythema with fever accompanied by pustules at the beginning of treatment may be a symptom of acute generalized exanthematous pustulosis. This reaction requires discontinuation of treatment with Augmentin® and is a contraindication for its further use in any situation.
Concomitant use of allopurinol during amoxicillin therapy may increase the likelihood of allergic skin reactions.
Long-term treatment with Augmentin® may lead to excessive proliferation of insensitive microorganisms.
Cases of pseudomembranous colitis have been described when taking antibiotics, the severity of which can vary from mild to life-threatening. Therefore, it is important to consider the possibility of developing pseudomembranous colitis in patients with diarrhea during or after antibiotic use. If diarrhea is prolonged or severe, or the patient experiences abdominal cramps, treatment should be stopped immediately and the patient should be examined. If pseudomembranous colitis develops, appropriate treatment must be started. The use of drugs that inhibit intestinal motility is contraindicated.
During long-term therapy with Augmentin®, it is recommended to periodically evaluate renal, liver and hematopoietic function.
Convulsions may occur in patients with impaired renal function or in patients receiving high doses of the drug (see section "Side effects").
The combination of amoxicillin with clavulanic acid should be used with caution in patients with signs of liver dysfunction (see section "Side effects").
In patients receiving a combination of amoxicillin and clavulanic acid together with indirect (oral) anticoagulants, an increase in prothrombin time (increase in INR) 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. Dosage adjustments may be required to maintain the desired effect of oral anticoagulants.
In patients with impaired renal function, the dose of amoxicillin with clavulanic acid should be reduced according to the degree of impairment.
In patients with reduced diuresis, crystalluria very rarely occurs, mainly during parenteral therapy. When using high doses of amoxicillin, it is recommended to take sufficient fluids and maintain adequate diuresis to reduce the likelihood of amoxicillin crystal formation (see section "Overdose"). In patients with a catheterized bladder, it is necessary to regularly check the patency of the catheter, since according to the data obtained, amoxicillin deposits in bladder catheters mainly when administered intravenously in high doses.
Taking Augmentin® orally leads to a high level of amoxicillin in the urine, which can lead to false-positive results when determining glucose in the urine (for example, Benedict's test, Fehling's test). In this case, it is recommended to use the glucose oxidant method for determining the concentration of glucose in urine.
Clavulanic acid may cause nonspecific binding of immunoglobulins G and albumin to red blood cell membranes, leading to false-positive Coombs test results.
Positive results from a study using the Platelia Aspergillus ELISA diagnostic kit (Bio-Rad Laboratories) have been reported in patients receiving a combination of amoxicillin and clavulanic acid who were subsequently free of Aspergillus infection. Cross-reactions with non-Aspergillus polysaccharides and polyfurans have been reported when tested using the Platelia Aspergillus ELISA diagnostic kit (Bio-Rad Laboratories). Therefore, positive test results in patients receiving a combination of amoxicillin and clavulanic acid should be interpreted with caution and confirmed by other diagnostic methods.
The laminated aluminum foil package contains a desiccant pouch that is not intended for ingestion. Augmentin® must be used within 30 days of opening the laminated aluminum foil package.
Drug abuse and dependence
There was no drug dependence, addiction, or euphoric reactions associated with the use of Augmentin®.
