Fenoksimetilpenitsillin

General characteristics. Structure:

Active agent: phenoxymethylpenicillin - 100 mg or 250 mg. Excipients: calcium stearate, lactose, talc, potato starch.

Pharmacological properties:

Pharmacodynamics. Antibacterial agent from group of penicillin, works bakteritsidno, suppresses synthesis of a cell wall. It is active concerning gram-positive (Staphylococcus spp., Streptococcus spp., Streptococcus pneumoniae) and gram-negative cocci (Neisseria meningitidis, Neisseria gonorrhoeae), Treponema spp., Haemophilus influenzae, Corynebacterium spp., Clostridium spp., Listeriamonocytogenes, Bacillus anthracis. Does not affect Staphylococcus spp strains., the producing penicillinases, Mycobacterium tuberculosis, the majority of gram-negative bacteria, viruses, Rickettsia spp., Entamoeba histolytica. Кислотоустойчив; collapses under the influence of a penicillinase.

Pharmacokinetics. It is steady in acid medium. Absorption in a small intestine – 30-60%, communication with proteins of plasma – 60-80%, are long circulates in blood, slowly gets into fabrics. High concentration are defined in kidneys, it is less – in a liver, a wall of a small bowel, skin. Therapeutic concentration in blood after intake are reached in 30 min. and 3-6 h remain. It is metabolized in a liver of 30-35%. The elimination half-life – is also extended 30-45 min. at newborn, elderly patients, at a renal failure. About 30% - with a fecal masses are removed in an invariable look (25%) and in the form of metabolites (35%).

Indications to use:

Infections of upper and lower respiratory tracts (bronchitis, pneumonia), ENT organs (tonsillitis, laryngitis, average otitis, sinusitis), an oral cavity (bacterial stomatitis, a periodontal disease, an actinomycosis), skin and soft tissues (abscess, phlegmon, an ugly face, contagious impetigo, the migrating erythematic rashes, a furunculosis, эризипелоид); gonorrhea, syphilis, tetanus, malignant anthrax, botulism, scarlet fever, hay fever, diphtheria, inflammation of lymph nodes (lymphadenitis); prevention of bacterial infections after surgeries at the weakened patients, a recurrence of rheumatism, a pseudorheumatism, a bacterial endocarditis, a glomerulonephritis, hysterical chorea.

Route of administration and doses:

Inside for 0,5-1 h to food, washing down with plentiful amount of liquid. To adults and children 12 years are more senior appoint 500-1000 mg (in 1 mg - 1610 PIECES) 3-4 times a day. At a heavy chronic renal failure the interval between receptions is increased to 12 h. A course of treatment - 5-7 days; the infections caused by a beta and hemolitic streptococcus - not less than 7-10 days and within 3 days after normalization of body temperature. To children till 1 year - in a daily dose of 20-30 mg/kg; 1-6 years - 15-30 mg/kg; 6-12 years - 10-20 mg/kg; the daily dose is divided into 4-6 receptions. To children 3 years preferably appointment in the form of solution or suspension are younger. For prevention of the rheumatic attacks or a hysterical chorea - 500 mg 2 times a day. For prevention of postoperative complications by the adult and to children with body weight more than 30 kg for 0,5-1 h before operation are appointed 2 g, then on 0,5 g by each 6 h within 2 days.

Features of use:

Long or repeated appointment can cause development of superinfections which activators are steady bacteria or mushrooms.
If during treatment or in the first weeks after its termination heavy persistent diarrhea is observed, it is necessary to exclude pseudomembranous colitis.

Side effects:

Allergic reactions: a small tortoiseshell, a dermahemia, a Quincke's edema, rhinitis, conjunctivitis, it is rare - fever, a serum disease, an arthralgia, an eosinophilia, is extremely rare - an acute anaphylaxis.
From bodies of a hemopoiesis: hemolitic anemia, leukopenia, agranulocytosis, thrombocytopenia, pancytopenia.
From the alimentary system: dispeptic disturbances (nausea, vomiting, diarrhea), the glossitis, stomatitis, a vesicular cheilitis (connected with irritant action of drug on mucous membranes), a loss of appetite, dryness in a mouth, taste disturbance, is rare - a pseudomembranous coloenteritis.
Others: intersticial nephrite, pharyngitis, vasculitis.

Interaction with other medicines:

Increases efficiency of indirect anticoagulants (suppressing intestinal microflora, reduces formation of vitamin K); reduces efficiency of oral contraceptives and medicines in the course of which para-aminobenzoic acid is formed.
Increases risk of development of bleedings of "break" against the background of ethinylestradiol reception.
Antacids, glycosamine, purgatives, food, aminoglycosides slow down and reduce absorption; ascorbic acid raises it.
Bactericidal antibiotics (including cephalosporins, Cycloserinum, Vancomycinum, rifampicin), aminoglycosides - an action synergism; bacteriostatic antibiotics (including macroleads, chloramphenicol, linkozamida, tetracyclines) - antagonism.
Diuretics, Allopyrinolum, phenylbutazone, the non-steroidal anti-inflammatory drugs and other drugs reducing canalicular secretion increase concentration of phenoxymethylpenicillin.
Allopyrinolum increases risk of development of allergic reactions (skin rash).

Contraindications:

Hypersensitivity (including to others beta лактамным to antibiotics - penicillin, cephalosporins, karbapenema), aphthous stomatitis and pharyngitis, the heavy course of infections, the digestive tract diseases which are followed by vomiting and diarrhea. 
Use at pregnancy is not specified.

Storage conditions:

List B. In dry, protected from light, the place, unavailable to children, at a temperature from 15 °C to 25 °C. 
Period of validity 4 years. To use drug before the date specified on packaging.

Issue conditions:

According to the recipe

Packaging:

Tablets on 0,1 and 0,25 g.