Buy Augmentin powder for oral suspension 125mg+31.25mg/5ml 11.5g 100ml in pharmacies
Augmentin Buy Augmentin in DOSAGE FORMS powder for the preparation of oral suspension 125mg+31 25mg/5ml powder for the preparation of suspension for oral administration 125mg+31 25mg/5ml
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 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 EC powder for preparing suspension 600 mg+42.9 mg/5 ml 100 ml
Description:
Active substance:
Amoxicillin + Clavulanic acid*
Pharmacological group
- Penicillins in combinations
pharmachologic effect
Amoxicillin is a semisynthetic broad-spectrum antibiotic that is active against many gram-positive and gram-negative microorganisms.
Clavulanic acid is a β-lactamase inhibitor. β-lactamases are produced by many gram-negative and gram-positive bacteria. The action of β-lactamases can lead to the destruction of some antibacterial drugs even before they begin to act on bacteria. Clavulanic acid blocks the action of β-lactamases, restoring the sensitivity of bacteria to amoxicillin. Clavulanic acid does not have antibacterial activity, but its combination with amoxicillin makes it possible to obtain a broad-spectrum antibiotic that is insensitive to β-lactamases.
The drug "Augmentin ® EC" has a bactericidal effect on the following microorganisms:
Sensitive gram-positive aerobic microorganisms: Staphylococcus aureus. Streptococcus pneumoniae. Streptococcus pyogenes. Sensitive gram-negative aerobic microorganisms: Haemophilus influenzae. Moraxella catarrhalis. Escherichia coli. Klebsiella spp. Proteus mirabilis. Proteus vulgaris.
Sensitive anaerobic microorganisms: Bacteroides fragilis.
Some strains of these bacterial species produce beta-lactamases, which makes them insensitive to amoxicillin monotherapy.
Cross resistance
The development of cross-resistance to unprotected amoxicillin with other beta-lactam antibiotics, a combination of a beta-lactam antibiotic and a beta-lactamase inhibitor, and cephalosporins has been shown.
Mechanisms of resistance
Clavulanic acid restores the sensitivity of beta-lactamase producing strains. Sustained release improves efficacy against strains whose resistance is due to modification of penicillin-binding proteins.
Indications
The drug "Augmentin ® EC" is used for short-term treatment of infections caused by sensitive microorganisms in children:
- Upper respiratory tract infections: recurrent or persistent acute otitis media caused by Streptococcus pneumoniae (minimal inhibitory concentration ≤2 mcg/ml), Haemophilus influenzae and Moraxella catarrhalis. Tonsillopharyngitis and sinusitis, usually caused by Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pyogenes.
- Lower respiratory tract infections: lobar pneumonia and bronchopneumonia caused by Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis.
- Infections of the skin and soft tissues, usually caused by Staphylococcus aureus and Streptococcus pyogenes.
Some strains of these bacterial species produce beta-lactamases, which makes them insensitive to amoxicillin monotherapy.
Contraindications
- Hypersensitivity to beta-lactam antibiotics (penicillins and cephalosporins).
- Jaundice or liver dysfunction that developed during the use of beta-lactam antibiotics.
- Children under 3 months of age (due to insufficient data on clinical studies for this age group).
- Chronic renal failure (creatinine clearance <30 ml/min).
Use during pregnancy and breastfeeding
Fertility: in studies of reproductive functions in animals when taking the drug Augmentin ® EC, it was shown that oral and parenteral administration of this drug did not cause teratogenic effects.
Pregnancy: A single study in women with premature rupture of membranes found that prophylactic therapy with Augmentin EC may be associated with an increased risk of necrotizing enterocolitis in newborns. Like all medicines, Augmentin EC is not recommended for use during pregnancy, except in cases where the expected benefit to the mother outweighs the potential risk of using the drug to the fetus.
Lactation: amoxicillin, like most penicillins, passes into breast milk. Trace amounts of clavulanic acid have also been found in breast milk. With the exception of the risk of sensitization, there are no known adverse effects of amoxicillin and clavulanic acid on the health of breastfed infants.
special instructions
Before starting treatment with Augmentin ® EC, it is necessary to collect a detailed medical history regarding previous hypersensitivity reactions to penicillins and cephalosporins.
Serious and sometimes fatal hypersensitivity reactions to penicillins have been described.
The risk of such reactions is highest in patients with a history of hypersensitivity reactions to penicillins. If an allergic reaction occurs, it is necessary to stop treatment with Augmentin ® EC. In case of serious hypersensitivity reactions, appropriate measures should be taken immediately. Oxygen therapy, intravenous corticosteroids, and airway management, including intubation, may also be required.
It is not recommended to prescribe Augmentin EC for suspected infectious mononucleosis, since amoxicillin can cause a skin rash in patients with this disease, which makes diagnosing the disease difficult.
Long-term treatment with Augmentin ® EC sometimes leads to excessive proliferation of insensitive microorganisms.
In general, Augmentin ® EC is well tolerated and has the low toxicity characteristic of all penicillins. During long-term therapy with Augmentin EC, it is recommended to periodically evaluate renal, liver and hematopoietic function.
It is not recommended to prescribe the drug in patients with creatinine clearance below 30 ml/min. In patients with reduced diuresis, the development of crystalluria has been reported in very rare cases, mainly with parenteral use of the drug. During administration of high doses of amoxicillin, it is recommended to take sufficient fluids and maintain adequate diuresis to reduce the likelihood of amoxicillin crystal formation.
There is no experience of use in patients weighing more than 40 kg, as well as sufficient experience of use in children under 3 months of age.
Augmentin ® EC suspension and other Augmentin ® suspensions are not interchangeable due to the different ratio of amoxicillin: clavulanic acid.
There is no data in the medical literature about the abuse of the drug Augmentin ® EC and the development of dependence on this drug.
Impact on the ability to drive vehicles and operate machinery
The drug "Augmentin ® EC" does not affect the ability to drive a car or use other machinery.
Compound
5 ml of the finished suspension contains:
Active ingredients: amoxicillin (in the form of trihydrate) - 600 mg; clavulanic acid (in the form of potassium salt) - 42.9 mg.
Excipients: xanthan gum, aspartame, silicon dioxide, colloidal silicon dioxide, carmellose sodium, strawberry flavor.
Directions for use and doses
To optimize absorption, the drug should be taken orally at the beginning of a meal. Treatment should not be continued for more than 14 days without reviewing the clinical situation.
If necessary, it is possible to carry out stepwise therapy (at the beginning, intravenous administration of the drug "Augmentin ®" (powder for preparing a solution for intravenous administration) followed by switching to oral administration).
Children
The drug "Augmentin ® EC" is recommended for children aged 3 months and older. The recommended daily dose is 90 mg/6.4 mg/kg body weight, divided into two doses every 12 hours for 10 days:
- Weight (kg) 8 - 3 ml 2 times/day (volume of Augmentin ® EC suspension (ml) at the rate of 90 mg/kg/day).
- Weight (kg) 12 - 4.5 ml 2 times/day (volume of Augmentin ® EC suspension (ml) at the rate of 90 mg/kg/day).
- Weight (kg) 16 - 6 ml 2 times/day (volume of Augmentin ® EC suspension (ml) at the rate of 90 mg/kg/day).
- Weight (kg) 20 - 7.5 ml 2 times/day (volume of Augmentin ® EC suspension (ml) at the rate of 90 mg/kg/day).
- Weight (kg) 24 - 9 ml 2 times/day (volume of Augmentin ® EC suspension (ml) at the rate of 90 mg/kg/day).
- Weight (kg) 28 - 10.5 ml 2 times/day (volume of Augmentin ® EC suspension (ml) at the rate of 90 mg/kg/day).
- Weight (kg) 32 - 12.5 ml 2 times/day (volume of Augmentin ® EC suspension (ml) at the rate of 90 mg/kg/day).
- Weight (kg) 36 - 13.5 ml 2 times/day (volume of Augmentin ® EC suspension (ml) at the rate of 90 mg/kg/day).
In patients with impaired renal function
No dosage adjustment is required if creatinine clearance is > 30 ml/min. Not recommended for creatinine clearance <30 ml/min.
In patients with impaired liver function
Use caution when monitoring liver function.
Method of preparing the suspension
- The suspension is prepared immediately before the first use.
- Approximately 2/3 of the volume of boiled water, cooled to room temperature, indicated in Table 2 should be added to the powder, then close the bottle with a lid and shake until the powder is completely diluted, let the bottle stand for 5 minutes to ensure complete dilution. Then add water up to the mark on the bottle and shake the bottle again.
- The bottle should be shaken well before each use. For accurate dosing of the drug, you should use a measuring spoon, which must be rinsed well with water after each use. After dilution, the suspension should be stored for no more than 10 days in the refrigerator, but do not freeze
Approximate volume of water to prepare the suspension:
The volume of the bottle is 50 ml - the volume of water for preparing the suspension is 45 ml.
The volume of the bottle is 100 ml - the volume of water for preparing the suspension is 90 ml.
Side effects
The adverse events presented below are listed depending on the anatomical and physiological classification and frequency of occurrence. The frequency of occurrence is determined as follows:
- Very common (≥ 1/10).
- Often (≥ 1/100 and less than 1/10).
- Uncommon (≥ 1/1000 and < 1/100).
- Rare (≥1/10,000 and <1/1000).
- Very rare (<1/10,000).
Frequency categories were based on the absolute frequency of occurrence during the drug's clinical development program.
Superinfection: often - candidiasis of the skin and mucous membranes.
From the hematopoietic and lymphatic systems: rarely - reversible leukopenia (including neutropenia) and thrombocytopenia; very rarely - reversible agranulocytosis and hemolytic anemia, prolongation of prothrombin time and bleeding time, eosinophilia, thrombocytosis, anemia.
From the immune system: not often - skin rash, itching, urticaria; rarely - erythema multiforme; very rarely - angioedema, anaphylactic reactions, a syndrome similar to serum sickness, allergic vasculitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, bullous exfoliative dermatitis, acute generalized exanthematous pustulosis.
From the nervous system: not often - dizziness, headache; very rarely - reversible hyperactivity, convulsions (may occur in patients with impaired renal function when taking high doses of the drug); insomnia, agitation, anxiety, behavior changes.
From the gastrointestinal tract: very often - diarrhea; often - nausea, vomiting, dyspeptic disorders; very rarely - colitis (including pseudomembranous colitis and hemorrhagic), gastritis, stomatitis, black “hairy” tongue, discoloration of the surface layer of tooth enamel. Oral care helps prevent tooth discoloration by simply brushing your teeth.
From the liver and biliary tract: not often - moderate increase in the activity of aspartate aminotransferase and alanine aminotransferase (AST and ALT); very rarely - hepatitis and cholestatic jaundice (noted during concomitant therapy with other penicillins and cephalosporins), increased activity of alkaline phosphatase and/or bilirubin. Liver side effects are usually reversible. Very rarely, in patients with severe pre-existing medical conditions or those who have received potentially hepatotoxic drugs, they can be quite severe and even fatal.
From the kidneys and urinary tract: very rarely - interstitial nephritis, crystalluria, hematuria. If any symptoms of hypersensitivity develop, you should stop using the drug.
Drug interactions
It is not recommended to prescribe probenecid simultaneously with Augmentin ® EC. Probenicid reduces the tubular secretion of amoxicillin, and therefore the simultaneous use of Augmentin ® EC and probenicid can lead to a stable and long-term increase in the blood concentration of amoxicillin, but not clavulanic acid.
The combined use of allopurinol and amoxicillin increases the risk of allergic reactions. Currently, there is no data in the literature on the combined use of Augmentin ® EC and allopurinol.
Like other broad-spectrum antibiotics, Augmentin ® EC may reduce the effectiveness of oral contraceptives; patients should be informed about this.
The literature describes rare cases of an increase in the international normalized ratio (INR) in patients with the combined use of acenocoumarol or warfarin and amoxicillin. If it is necessary to simultaneously prescribe Augmentin EC with indirect anticoagulants, prothrombin time or MHO should be carefully monitored during administration or o.
Overdose
Symptoms: Gastrointestinal and fluid imbalances, abdominal pain, vomiting, diarrhea, rash, hyperactivity or drowsiness may occur. Amoxicillin crystalluria has been described, in some cases leading to the development of renal failure.
Treatment: symptomatic therapy, paying special attention to the normalization of water and electrolyte balance. Amoxicillin and clavulanic acid are removed from the blood by hemodialysis.
Release form
Powder for the preparation of suspension for oral administration.
Package
Bottle 100 ml.
Storage conditions
Store at a temperature not exceeding 25°C. The prepared suspension should be stored in the refrigerator at a temperature of 2° to 8°C.
Keep out of the reach of children.
Best before date
2 years. The prepared suspension lasts for 10 days in a tightly closed bottle.
Conditions for dispensing from pharmacies
Dispensed with a doctor's prescription
