Buy Amoxiclav

Amoxiclav is a combination of amoxicillin, a semi-synthetic penicillin with a broad spectrum of antibacterial activity and clavulanic acid, an irreversible inhibitor of β-lactamases. Clavulanic acid forms a stable inactivated complex with these enzymes and provides stability of amoxicillin to the action of β-lactamases produced by microorganisms.

Clavulanic acid, similar in structure to beta-lactam antibiotics, has a weak intrinsic antibacterial activity.

Amoxiclav has a broad spectrum of antibacterial action.

It is active against amoxicillin-sensitive strains, including strains producing β-lactamases, incl. aerobic Gram-positive bacteria: Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus viridans, Streptococcus bovis, Staphylococcus aureus (except methicillin-resistant strains), Staphylococcus epidermidis (except methicillin-resistant strains), Staphylococcus saprophyticus, Listeria spp., Enterococcus spp .; aerobic gram-negative bacteria: Bordetella pertussis, Brucella spp., Campylobacter jejuni, Escherichia coli, Gardnerella vaginalis, Haemophilus influenzae, Haemophilus ducreyi, Klebsiella spp., Moraxella catarrhalis, Neisseria gonorrhoeae, Neisseria meningitidis, Pasteurella multocida, Proteus spp., Salmonella spp. Shigella spp., Vibrio cholerae, Yersinia enterocolitica, Helicobacter pylori, Eikenella corrodens; anaerobic Gram-positive bacteria: Peptococcus spp., Peptostreptococcus spp., Clostridium spp., Actinomyces israelii, Fusobacterium spp., Prevotella spp., Gram-negative anaerobes: Bacteroides spp.

The main pharmacokinetic parameters of amoxicillin and clavulanic acid are similar.

Suction

Both components are well absorbed after taking the drug inside, eating does not affect the degree of absorption. Cmax in blood plasma is achieved 1 h after administration. The Cmax values ​​for amoxicillin (depending on the dose) are 3-12 μg / ml, for clavulanic acid - about 2 μg / ml.

Distribution

Both components are characterized by a good distribution in the fluids and tissues of the body (lungs, middle ear, pleural and peritoneal fluids, uterus, ovaries, etc.). Amoxicillin also penetrates into the synovial fluid, liver, prostate, palatine tonsils, muscle tissue, gall bladder, the secret of the paranasal sinuses, saliva, bronchial secretions.

Amoxicillin and clavulanic acid do not penetrate the BBB in non-inflamed meninges.

Amoxicillin and clavulanic acid penetrate the placental barrier and in trace concentrations are excreted in breast milk. Amoxicillin and clavulanic acid are characterized by low binding to plasma proteins.

Metabolism

Amoxicillin is partially metabolized, clavulanic acid undergoes, apparently, intensive metabolism.

Excretion

Amoxicillin is excreted by the kidneys practically unchanged through tubular secretion and glomerular filtration. Clavulanic acid is excreted by glomerular filtration, partly in the form of metabolites. Small amounts can be excreted through the intestines and lungs. T1 / 2 amoxicillin and clavulanic acid is 1-1.5 h.

Pharmacokinetics in special clinical cases

In severe renal failure, T1 / 2 increases to 7.5 h for amoxicillin and up to 4.5 h for clavulanic acid. Both components are removed by hemodialysis and minor amounts of peritoneal dialysis.

Infections caused by sensitive strains of microorganisms:

- infections of the upper respiratory tract and ENT organs (including acute and chronic sinusitis, acute and chronic otitis media, zaglugal abscess, tonsillitis, pharyngitis);

- infections of the lower respiratory tract (including acute bronchitis with bacterial superinfection, chronic bronchitis, pneumonia);

- urinary tract infections;

- gynecological infections;

- skin and soft tissue infections, including animal and human bites;

- infections of bone and connective tissue;

- biliary tract infections (cholecystitis, cholangitis);

Odontogenic infections.

- Hypersensitivity to any of the components of the drug;

- heightened sensitivity in the anamnesis to penicillins, cephalosporins and other beta-lactam antibiotics;

- the presence in the anamnesis of indications of cholestatic jaundice and / or other violations of the liver caused by the use of amoxicillin / clavulanic acid;

- infectious mononucleosis and lymphocytic leukemia.

With caution should be used with pseudomembranous colitis in history, with liver failure, severe impairment of kidney function, and also during lactation.

Inside.

Daily dosage of suspensions 125 mg + 31.25 mg / 5 ml and 250 mg + 62.5 mg / 5 ml (to facilitate correct dosing in each package of suspensions 125 mg + 31.25 mg / 5 ml and 250 mg + 62.5 mg / 5 ml a dosage spoon with a capacity 5 ml or a metered graduated pipette).

Newborns and children under 3 months are prescribed 30 mg / kg (amoxicillin) / day, divided into 2 divided doses (every 12 hours); children older than 3 months - from 20 mg (amoxicillin) / kg / day for infections of mild to moderate severity up to 40 mg / kg (amoxicillin) / day for severe infection and respiratory tract infections, divided into 3 doses (every 8 h).

Recommended doses of suspensions depending on the weight of the child and the severity of the infection.

Body weight (kg) Age (approx.) Light / moderate infections Severe infections
125 mg + 31.25 mg / 5 ml 250 mg + 62.5 mg / 5 ml 125 mg + 31.25 mg / 5 ml 250 mg + 62.5 mg / 5 ml
5-10 3-12 months 3 x 2.5 ml (1/2 l.) 3 x 1.25 ml (1/4 l.) 3 x 3.75 ml (3/4 l.) 3 x 2 ml (1 / 4-1 / 2 liters.)
10-12 1-2 years 3 × 3.75 ml (3/4 l.) 3 × 2 ml (1 / 4-1 / 2 l.) 3 × 6.25 ml (11/4 l.) 3 × 3 ml (1 / 2-3 / 4 l.)
12-15 2-4 years 3 × 5 ml (1 l.) 3 × 2.5 ml (1/2 l). 3 × 7.5 ml (11/2 l.) 3 × 3.75 ml (3/4 l.)
15-20 4-6 years 3 × 6.25 ml (11/4 l.) 3 × 3 ml (1 / 2-3 / 4 l.) 3 × 9.5 ml (13 / 4-2 l.) 3 × 5 ml (1 liter)
20-30 6-10 years 3 × 8.75 ml (13/4 l.) 3 × 4.5 ml (3 / 4-1 l.) - 3 × 7 ml (11 / 4-11 / 2 l.)
30-40 10-12 years - 3 × 6.5 ml (11/4 l.) - 3 × 9.5 ml (13 / 4-2 l.)
≥ 40 ≥ 12 years Amoxiclav is given in tablets
Daily doses of the suspension of 400 mg + 57 mg / 5 ml are calculated per 1 kg of body weight depending on the severity of the infection and are 25-45 mg / kg body weight / day (in terms of amoxicillin) divided into 2 doses.

To facilitate correct dosing, a metering pipette, calibrated simultaneously for 1, 2, 3, 4, 5 ml and 4 equal parts is inserted in each packing of the suspension of 400 mg + 57 mg / 5 ml.

Recommended doses of the suspension are based on the weight of the child and the severity of the infection.

Body weight (kg) Age (approximately) Severe infections Infections of medium severity
5-10 3-12 months 2 x 2.5 ml (1/2 pipette) 2 x 1.25 ml (1/4 pipette)
10-15 1-2 years 2 × 3.75 ml (3/4 pipette) 2 × 2.5 ml (1/2 pipette)
15-20 2-4 years 2 × 5 ml (1 pipette) 2 × 3.75 ml (3/4 pipette)
20-30 4-6 years 2 × 7.5 ml (11/2 pipettes) 2 × 5 ml (1 pipette)
30-40 6-10 years 2 × 10 mL (2 pipettes) 2 × 6.5 mL (11/4 pipettes)
Exact daily doses are calculated on the basis of the child's body weight, not his age.

The maximum daily dose of amoxicillin is 6 g for adults, 45 mg / kg for children.

The maximum daily dose of clavulanic acid (in the form of potassium salt) is 600 mg for adults, 10 mg / kg for children.

In patients with severe renal insufficiency (CC less than 10 ml / min), the dose should be adequately reduced or the interval between two doses should be increased (with anuria up to 48 hours and more).

The course of treatment is 5-14 days. The duration of the course of treatment is determined by the attending physician. Treatment should not last more than 14 days without a second medical examination.

Rules for the preparation of suspension

Powder for the preparation of the suspension 125 mg + 31.25 mg / 5 ml: vigorously shake the bottle, add 86 ml of water (up to the mark) in two steps, each time shaking well until the powder is completely dissolved.

Powder for the preparation of a suspension of 250 mg + 62.5 mg / 5 ml: vigorously shake the bottle, add 85 ml of water (up to the mark) in two steps, each time shaking well until the powder is completely dissolved.

Powder for the preparation of a suspension of 400 mg + 57 mg / 5 ml: vigorously shake the vial, add water in the amount indicated on the label and listed in the table (before the label) in two steps, each time shaking well until the powder is completely dissolved.

Bottle size Required amount of water
35 ml 29.5 ml
50 ml 42 ml
70 ml of 59 ml
140 ml 118 ml
Before use, the vial should be vigorously shaken.

With the simultaneous use of the drug Amoxiclav with antacids, glucosamine, laxatives, aminoglycosides, absorption slows down, with ascorbic acid - increases.

Diuretics, allopurinol, phenylbutazone, NSAIDs and other drugs that block tubular secretion, increase the concentration of amoxicillin (clavulanic acid is excreted mainly by glomerular filtration).

With the simultaneous use of Amoxiclav increases the toxicity of methotrexate.

With the simultaneous use of Amoxiclav and allopurinol, the frequency of development of exanthema increases.

Simultaneous administration with disulfiram should be avoided.

In some cases, taking the drug may prolong prothrombin time, therefore caution should be exercised while concomitant administration of anticoagulants and Amoxiclav preparation.

The combination of amoxicillin and rifampicin is antagonistic (there is a mutual weakening of antibacterial action).

Amoxiclav should not be used concomitantly with bacteriostatic antibiotics (macrolides, tetracyclines), sulfonamides due to a possible decrease in the effectiveness of Amoxiclav.

Probenecid reduces the excretion of amoxicillin, increasing its serum concentration.

Antibiotics reduce the effectiveness of oral contraceptives.

The drug should be stored in a dry place inaccessible to children at a temperature of no higher than 25 ° C. Shelf life - 2 years.

After preparation, the suspension for oral administration should be stored at a temperature of 2 ° to 8 ° C in a tightly closed vial and used within 7 days.

Amoxiclav it is possible to appoint or nominate at pregnancy at presence of accurate indications.

Amoxicillin and clavulanic acid in small amounts are excreted in breast milk.