Amoxicillin

General characteristics. Structure:

Active ingredient: 575 mg of amoxicillin of trihydrate (in terms of amoxicillin of 500 mg).

Excipients: magnesium stearate, talc.

Antibacterial bactericidal acid resisting broad-spectrum agent from group of semi-synthetic penicillin.

Pharmacological properties:

Pharmacodynamics. Antibacterial bactericidal acid resisting broad-spectrum agent from group of semi-synthetic penicillin. Inhibits transpeptidase, breaks synthesis of a peptidoglikan (basic protein of a cell wall) during division and growth, causes a lysis of bacteria. It is active concerning gram-positive and gram-negative cocci, some gram-negative sticks (Escherichia coli, Shigella spp., Salmonella spp., Klebsiella spp.).

The microorganisms producing a penicillinase, rezistentna to effect of amoxicillin.

Pharmacokinetics. After intake amoxicillin is soaked up quickly and almost completely (93%), кислотоустойчив. Meal practically does not exert impact on drug absorption. The maximum concentration of active agent in plasma is observed in 1-2 hours.

About 17% of amoxicillin contact proteins of plasma. Amoxicillin gets into mucous membranes, a bone tissue and intraocular liquid, a phlegm in therapeutic effective concentration. Concentration of amoxicillin in bile exceeds its concentration in a blood plasma by 2-4 times. In amniotic liquid and in funic vessels concentration of amoxicillin makes 25-30% of its level in a blood plasma of the pregnant woman. Amoxicillin badly gets through GEB; however at an inflammation of a meninx (for example, at meningitis) concentration in cerebrospinal fluid makes about 20% of concentration in a blood plasma.

Amoxicillin is partially metabolized, the majority of its metabolites are inactive concerning microorganisms.

Amoxicillin eliminirutsya preferential by kidneys, about 80% by canalicular excretion, 20% - by means of glomerular filtering.

In the absence of a renal failure the elimination half-life of amoxicillin makes 1-1.5 h. At premature, 6 months - 3-4 h are younger than newborns and children. At a renal failure (the clearance of creatinine is equal or less than 15 ml/min.) the elimination half-life of amoxicillin increases and reaches at an anury of 8.5 h.

Indications to use:

The bacterial infections caused by sensitive microflora:
 - acute and persistent infections of respiratory tracts (bronchial pneumonia, abscess of lungs);
- acute and persistent infections of a GIT, biliary tract (peritonitis, cholecystitis, intestinal infections);
- acute and persistent infections of an urinary system (pyelonephritis, urethritis, gonorrhea);
- purulent infections of soft tissues;
- sepsis;
- quinsy.

Route of administration and doses:

Capsules accept inside entirely without chewing to or after food, washing down with enough water.

The adult appoint 500 mg 3 times in days. At a severe disease on 1 g 3 times in days.

To children at the age of 5-10 letnaznachat 250 mg 3 times a day.

Course of treatment — 5-12 days.

For treatment of uncomplicated gonorrhea appoint 3 g in a single dose (at the same time appoint 1 g of a probenetsid). Women are recommended to repeat the specified dose in a day.

To patients with HPN end-stage (KK <10 ml/min.) should reduce a dose of amoxicillin by 15-50% or to increase an interval between receptions to 24 h.

Features of use:

At course treatment it is necessary to carry out control of a condition of function of bodies of a hemopoiesis, a liver and kidneys. Development of superinfection due to growth of microflora, insensitive to it, is possible that demands corresponding change of antibacterial therapy.

At treatment of patients with bacteremia development of reaction of a bacteriolysis (Yarisha-Gerksgeymer's reaction) is possible. At the patients having hypersensitivity to penicillin cross allergic reactions with tsefalosporinovy antibiotics are possible. Treatment surely continues 48-72 more h after disappearance of clinical signs of a disease.

Side effects:

From a GIT: seldom - diarrhea, an itch in the field of an anus; dyspepsia is possible; in some cases - pseudomembranous and hemorrhagic colitis.

From an urinary system: seldom - development of intersticial nephrite.

From bodies of a hemopoiesis: seldom - an agranulocytosis, thrombocytopenia.

Allergic reactions: skin reactions, mainly, in the form of specific makulopapulezny rash; seldom - a multiformny erythema, Stephens-Johnson's syndrome; in some cases - an acute anaphylaxis, a Quincke's disease.

Interaction with other medicines:

Probenitsid, phenylbutazone, оскифенбутазон, to a lesser extent - acetylsalicylic acid and Sulfinpyrazonum suppress canalicular secretion of drugs of a penicillinic row that leads to increase in an elimination half-life and concentration of amoxicillin in a blood plasma.

Amoxicillin affects only the breeding microorganisms therefore it is not necessary to appoint it along with the antimicrobic drugs operating bacteriostatically.

In the presence of positive tests for sensitivity of the activator amoxicillin can be applied in a combination with other bactericidal antibiotics (cephalosporins, aminoglycosides).

Contraindications:

- hypersensitivity to drug and another beta лактамным to antibiotics;

- infectious mononucleosis and leukemoid tests of lymphatic type.

Pregnancy and lactation. Data on possible embriotoksichesky, teratogenic or mutagen effect of drug at reception at pregnancy are absent now. Amoxicillin is found in breast milk that should be considered at purpose of Amoxicillin in the period of a lactation.

Overdose:

Simptomy:toshnota, vomiting, diarrhea, disturbance of water and electrolytic balance (as a result of vomiting and diarrhea).

Treatment: a gastric lavage, absorbent carbon, salt laxatives, drugs for maintenance of water and electrolytic balance.

Storage conditions:

List B. To store in the dry, protected from light place at a temperature not above 25 °C. Period of validity 3 years.

Issue conditions:

According to the recipe

Packaging:

On 10 capsules in the blister, on 2 blisters in a cardboard pack.