Amosin

General characteristics. Structure:

Active agent: amoxicillin trihydrate (in terms of amoxicillin) - 0,250 g. Excipient: potato starch. Structure of a gelatin capsule: titanium dioxide, methylparahydroxybenzoate, пропилпарагидроксибензоат, acetic acid, gelatin.

Pharmacological properties:

Pharmacodynamics. Semi-synthetic penicillin, possesses bactericidal action, has a broad spectrum of activity. Breaks synthesis of a peptidoglikan (basic polymer of a cell wall) during division and growth, causes a lysis of bacteria. It is active concerning aerobic gram-positive microorganisms: Staphylococcus spp. (except for the strains producing a penicillinase), Streptococcus spp. and aerobic gram-negative microorganisms: Neisseria gonorrhoeae, Neisseria meningitidis, Escherichia coli, Shigella spp., Salmonella spp., Klebsiella spp. The strains producing a penicillinase, rezistentna to effect of amoxicillin.

Pharmacokinetics. Absorption - bystry, high (93%), meal does not exert impact on absorption, does not collapse in acid medium of a stomach. At intake in a dose of 125 and 250 mg the maximum concentration - 1.5-3 and 3.5-5 mkg/ml respectively. Time of achievement of the maximum concentration after oral administration - 1-2 h. Has the large volume of distribution: in high concentration it is found in plasma, a phlegm, a bronchial secret (in a purulent bronchial secret distribution weak), pleural and peritoneal liquid, urine, contents of skin blisters, lung tissue, a mucous membrane of intestines, female generative organs, a prostate, liquid of a middle ear (at its inflammation), bones, fatty tissue, a gall bladder (at normal function of a liver), fruit fabrics. At increase in a dose twice concentration also increases twice. Concentration in bile exceeds concentration in plasma by 2-4 times. In amniotic liquid and vessels of an umbilical cord concentration of amoxicillin - 25-30% of level in plasma of the pregnant woman. Badly gets through a blood-brain barrier, at an inflammation of a meninx concentration in cerebrospinal fluid - about 20% of level in plasma. Communication with proteins of plasma - 17%. It is partially metabolized with formation of inactive metabolites. An elimination half-life - 1-1.5 h. It is brought to 50-70% by kidneys in not changed look (by canalicular secretion - 80% and glomerular filtering - 20%), to cookies - 10-20%. In a small amount it is allocated with breast milk. Amoxicillin is removed at a hemodialysis.

Indications to use:

The bacterial infections caused by sensitive activators: lower respiratory tract infections (bronchitis, pneumonia) and ENT organs (sinusitis, pharyngitis, tonsillitis, acute average otitis), urinogenital system (pyelonephritis, a pyelitis, cystitis, an urethritis, gonorrhea, an endometritis, a cervicitis), digestive tract (a cholangitis, cholecystitis, dysentery, salmonellosis, a salmonellezny carriage), infections of skin and soft tissues (the ugly face, impetigo for the second time infected a dermatosis), leptospirosis, listeriosis, a disease Laima (borreliosis), an endocarditis (prevention).

Route of administration and doses:

Inside, to or after meal.
To adults and children 10 years are more senior (with body weight more than 40 kg) appoint 0.5 g 3 times a day; at the heavy course of an infection - 0.75-1 g 3 times a day. To children at the age of 5-10 years appoint 0:25 g 3 times a day; 5 years are younger - appoint in the form of suspension. A course of treatment of 5-12 days depending on a form and disease severity.
At acute uncomplicated gonorrhea appoint 3 g once; at treatment of women repeated reception of the specified dose is recommended.
At digestive tract acute infectious diseases (paratyphus, a typhoid) and bilious ways, at gynecologic infectious diseases adult - 1.5-2 g 3 times a day or on 1-1.5 g 4 times a day.
At a hay fever adult - 0.5-0.75 g 4 times a day within 6-12 days.
At a salmonellonositelstvo adult - 1.5-2 g 3 times a day during 2-4 weeks.
For prevention of an endocarditis at small surgical interventions adult - 3-4 g for 1 h before holding a procedure. If necessary appoint a repeated dose in 8-9 h. At children the dose is reduced twice.
At patients with a renal failure at the clearance of creatinine (CC) of 15-40 ml/min. the interval between receptions is increased to 12 h; at KK lower than 10 ml/min. reduce a dose by 15-50%; at an anury - the maximum dose of 2 g/days.

Side effects:

Allergic reactions: the small tortoiseshell, a dermahemia, erythematic rashes, a Quincke's disease, rhinitis, conjunctivitis are possible; seldom - fever, an arthralgia, an eosinophilia, exfoliative dermatitis, a multiformny exudative erythema (including Stephens-Johnson's syndrome); reactions similar to a serum disease; in isolated cases - an acute anaphylaxis.
From digestive tract: dysbacteriosis, taste change, vomiting, nausea, diarrhea, stomatitis, a glossitis, moderate increase in activity of "hepatic" transaminases, it is rare - a pseudomembranous coloenteritis.
From a nervous system: excitement, uneasiness, sleeplessness, ataxy, confusion of consciousness, change of behavior, depression, peripheral neuropathy, headache, dizziness, epileptic reactions.
Laboratory indicators: leukopenia, neutropenia, Werlhof's disease, anemia.
Others: the complicated breath, tachycardia, intersticial nephrite, a vagina candidiasis, superinfection (especially at patients with chronic diseases or the lowered resistance of an organism).

Interaction with other medicines:

Antacids, glycosamine, laxative medicines, food, aminoglycosides slow down and reduce absorption; ascorbic acid increases absorption. Bactericidal antibiotics (including aminoglycosides, cephalosporins, Vancomycinum, rifampicin) have sinergidny effect; bacteriostatic medicines (macroleads, chloramphenicol, linkozamida, tetracyclines, streptocides) - antagonistic. Increases efficiency of indirect anticoagulants (suppressing intestinal microflora, reduces synthesis of vitamin K and a prothrombin ratio); reduces efficiency of estrogensoderzhashchy oral contraceptives; medicines in the course of which metabolism para-aminobenzoic acid is formed, ethinylestradiol - risk of development of bleedings of "break". Amoxicillin reduces clearance and increases toxicity of a methotrexate; strengthens digoxin absorption. Diuretics, Allopyrinolum, оксифенбутазон, phenylbutazone, non-steroidal anti-inflammatory drugs, and other medicines blocking canalicular secretion increase concentration of amoxicillin in blood. Allopyrinolum increases risk of development of skin rash.

Contraindications:

Hypersensitivity (including to other penicillin, cephalosporins, karbapenema), children's age up to 3 years (for this dosage form). With care - allergic diseases (including in the anamnesis), digestive tract diseases in the anamnesis (especially the colitis connected using antibiotics), a renal failure, heavy abnormal liver functions, pregnancy, the lactation period, an infectious mononucleosis, a lymphoid leukosis. 
Use at pregnancy is not specified.

Overdose:

Symptoms: nausea, vomiting, diarrhea, disturbance of water and electrolytic balance (as a result of vomiting and diarrhea). Treatment: a gastric lavage, absorbent carbon, salt laxatives, medicines for maintenance of water and electrolytic balance; hemodialysis.

Storage conditions:

List B. In the dry, protected from light place at a temperature not above 25 °C. To store in the places unavailable to children. Period of validity 2 years. Not to apply after expiry date.

Issue conditions:

According to the recipe

Packaging:

Capsules of 250 mg: 20 pieces.