Amoxicillin. Prescription in Latin, indications, side effects

pharmachologic effect

Amoxicillin is an antibiotic that has a wide spectrum of effects. A group of antibiotics - semisynthetic penicillins . The abstract indicates that the drug is a 4-hydroxyl analogue of ampicillin . Provides a bactericidal effect. Demonstrates activity against aerobic gram-positive bacteria, namely Streptococcus spp., Staphylococcus spp. (except for those strains that produce penicillinase). Also active against aerobic gram-negative bacteria: Shigella spp., Neisseria gonorrhoeae, Escherichia coli, Neisseria meningitidis, Klebsiella spp., Salmonella spp.

Pharmacological properties of the drug Amoxil

Pharmacodynamics . Amoxicillin is a broad-spectrum antibiotic of the aminopenicillin group. It has a bactericidal effect, inhibiting the synthesis of the cell wall of bacteria sensitive to the drug. Active against gram-positive cocci - Staphylococcus spp. (except for penicillinase-producing strains), Streptococcus spp. , anaerobic streptococci ( Peptostreptococcus , Peptococcus ), microaerophilic streptococci ( Streptococcus faecalis ), as well as gram-positive bacilli - Bacillum anthracis , most strains of Corynebacterium diphtheriae , Clostridium perfringens , Clostridium tetani , Listeria monocytogenes , Erysepelothrix rhusiopathia e and Eubacterium . Acts on gram-negative aerobic microorganisms: cocci - Neisseria gonorrhoeae , Neisseria meningitidis ; sticks - Escherichia coli , Shigella spp. , Salmonella spp. , Proteus mirabilis , most strains of Klebsiella spp. , Haemophilus influenazae , Moraxella catarrhalis ; spirochetes - Treponema pallidum , Treponema pertenue , Leptospira spp. , Borrelia burgdorferi ; chlamydia - Chlamydia trachomatis . In combination with metronidazole, it is active against Helicobacter pylori . Microorganisms that produce penicillinase are resistant to the drug. Inactive against mycobacteria, mycoplasmas, rickettsia, fungi, amoebas, plasmodia, viruses, as well as Pseudomonas aeruginosa and Proteus spp. (except for P. mirabillis ). Pharmacokinetics. After oral administration, amoxicillin is well absorbed, reaching maximum serum concentrations 2 hours after administration. The half-life is 1.5 hours. It is excreted unchanged from the body by the kidneys (60-70%).

Pharmacokinetics and pharmacodynamics

Amoxicillin trihydrate is very quickly and completely absorbed from the digestive tract, while the acidic environment of the stomach is not destroyed. The maximum level of concentration of the substance in the blood is observed 1-2 hours after taking the drug. If you double the dose of the drug, the concentration also doubles. If there is food in the stomach, the overall absorption is not reduced. If amoxicillin is administered IV or IM, similar concentrations of the active substance are observed in the blood. The substance binds to plasma proteins by approximately 20%. In the body, the active substance is distributed in fluids and tissues. The presence of large concentrations of the active substance is noted in the liver.

The plasma half-life is 1-1.5 hours. Approximately 60% of an orally administered dose is excreted from the body in the urine. Output unchanged. A certain amount of the substance is also found in feces. A longer half-life is observed in the elderly and neonates.

In small quantities it is able to penetrate the BBB during inflammatory processes of the pia mater.

Description

Capsule-shaped tablets of white or almost white color with a score.

Pharmacotherapeutic group:

antibiotic - semisynthetic penicillin

ATX code:

J01CA04

Pharmacological properties

Pharmacodynamics

Amoxicillin is an aminobenzyl penicillin, a semisynthetic broad-spectrum antibiotic that has a bactericidal effect due to inhibition of bacterial cell wall synthesis. Minimum inhibitory concentration (MIC) thresholds for different sensitive microorganisms vary. The prevalence of resistant strains varies geographically and over time, so it is advisable to rely on local resistance information, especially when treating severe infections.

Pharmacokinetics

Suction

Absorption is fast, high (93%), food intake does not affect absorption, and is not destroyed in the acidic environment of the stomach. When taken orally at a dose of 250 mg and 500 mg, the maximum concentration in blood plasma is 5 mcg/ml and 10 mcg/ml, respectively. The time to reach maximum concentration after oral administration is 1-2 hours.

Distribution

It has a large volume of distribution - high concentrations are found in blood plasma, bronchial secretions (in purulent bronchial secretions the distribution is weak), liver, lymph nodes, uterus, ovaries, paranasal sinuses, pleural and peritoneal fluid, saliva and tear fluid, urine, contents of skin blisters , lung tissue, intestinal mucosa, middle ear fluid and paranasal sinuses, bones, adipose tissue, gall bladder (the concentration in bile is 10 times higher than the concentration in blood plasma - with normal patency of the bile ducts), fetal tissues. When the dose is doubled, the concentration also doubles. In the amniotic fluid and umbilical cord vessels, the concentration of amoxicillin is about 50% of the concentration in the blood plasma of a pregnant woman. It penetrates poorly through the blood-brain barrier; with inflammation of the meninges (meningitis), the concentration in the cerebrospinal fluid increases to 20% of the concentration in the blood plasma. Bonding with blood plasma proteins is 15-25%.

Metabolism

Partially (10-20%) is metabolized to form inactive metabolites.

Removal

The half-life (T1/2) is 1-1.5 hours. It is excreted 50-70% unchanged by the kidneys through tubular excretion (80%) and glomerular filtration (20%), and 10-20% by the liver. A small amount is excreted in breast milk. If renal function is impaired (creatinine clearance [CC] ≤ 15 ml/min), T1/2 is extended to 8.5 hours.

Amoxicillin is removed by hemodialysis.

Special patient groups

Age

T1/2 of amoxicillin in children aged 3 months to 2 years is similar to T1/2 in older children and adults.

Since in elderly patients the likelihood of decreased renal function increases, dose selection is carried out with caution, and monitoring of renal function is also necessary.

Floor

When administered orally to healthy men and women, the gender of the patients does not have a significant effect on the pharmacokinetics of amoxicillin.

Kidney failure

The total serum clearance of amoxicillin increases in proportion to the decrease in renal function. If renal function is impaired (creatinine clearance < 15 ml/min), T1/2 lengthens and can reach 8.5 hours in anuria.

Liver failure

In patients with impaired liver function, dose selection should be carried out with caution, and regular monitoring of liver function is necessary.

Indications for use of Amoxicillin

The following indications for the use of this drug in combination with clavulanic acid , as well as as monotherapy, are determined:

• infectious and inflammatory diseases provoked by sensitive microorganisms ( bronchitis , tonsillitis , pyelonephritis , pneumonia , as well as cystitis , urethritis , infections of the digestive system, gynecological infectious diseases, gonorrhea , diseases of soft tissues and skin of infectious origin);
• in combination with metronidazole, it is used to treat chronic gastritis during an exacerbation, as well as duodenal and gastric ulcers during an exacerbation (provided that the ulcer is associated with Helicobacter pylori).

Also for the prescription of Amoxicillin tablets and other forms of the drug there are the following indications:

• leptospirosis , listeriosis ;
• tick-borne borreliosis ( Lyme disease );
• shigellosis;
• salmonellosis and salmonella carriage;
• meningitis;
• sepsis;
• endocarditis (for the purpose of prevention).

Contraindications

Please note that the following contraindications to the use of this medicine are noted:

• severe infectious diseases of the gastrointestinal tract, in which the patient suffers from diarrhea , vomiting ;
• Infectious mononucleosis;
• lymphocytic leukemia;
• allergic diathesis;
• viral respiratory infections;
• hay fever;
• bronchial asthma;
• high sensitivity to cephalosporins , penicillins .

Medicines containing metronidazole should not be used in the following cases:

• for diseases of the nervous system;
• for hematopoietic disorders;
• for infectious mononucleosis and lymphocytic leukemia ;
• with severe sensitivity to nitroimidazole .

Medicines containing clavulanic acid should not be used if there is a history of jaundice or impaired liver function.

Side effects

During treatment with this drug, the following side effects may occur:

• manifestations associated with an allergic reaction of the body : Quincke's edema , erythema , urticaria , conjunctivitis , rhinitis ; in rare cases, joint pain, eosinophilia, and fever may occur; in very rare cases - anaphylactic shock ;
• manifestations are a consequence of the chemotherapeutic influence : the development of superinfections, which most often occur in people suffering from chronic illnesses and those who have reduced resistance;
• symptoms are a consequence of prolonged use of the drug in large doses : ataxia , dizziness , depression , disturbances of consciousness , convulsions , peripheral neuropathies , therefore, only a doctor should determine how many days to take the drug;
• with the combination of “amoxicillin, metronidazole” : vomiting , nausea , constipation , anorexia , diarrhea , stomatitis , epigastric pain, glossitis ; in rare cases, pseudomembranous colitis, hepatitis, allergic manifestations, hematopoietic disorders, interstitial nephritis may occur;
• with the combination of “amoxicillin, clavulanic acid” : hepatitis , cholestatic jaundice ; in rare cases - erythema multiforme , exfoliative dermatitis , toxic epidermal necrolysis.

Side effects

Like all penicillins, amoxicillin can cause an allergic reaction of varying strength, including anaphylactic shock. However, most often hypersensitivity reactions manifest themselves as drug fever.

In addition to allergic reactions, nausea, vomiting, and diarrhea may occur. Penicillins are considered to be of low toxicity to the human body. They can usually be prescribed during pregnancy .

Rare side effects include insomnia and fatigue.

Instructions for use of Amoxicillin (Method and dosage)

The drug should be taken orally with water. You can take the antibiotic regardless of food intake.

Amoxicillin tablets, instructions for use

For adult patients and children over 12 years of age, 500 mg of amoxicillin is usually prescribed three times a day. However, the dosage depends on the disease and the doctor’s prescription in each specific case. For severe diseases, the dose can be increased to 750-1000 mg, the highest permissible dose per day is 6 g.

High doses of the drug are prescribed for typhoid fever (1.5-2 g three times a day), for leptospirosis (500-750 mg four times a day). Tablets or capsules should be taken for another two or three days even after the signs of the disease disappear. In most cases, treatment lasts from 5 to 12 days.

Amoxicillin suspension, instructions for use

The children's version of this antibiotic is Amoxicillin suspension, which is used to treat children under 5 years of age. The suspension must be prepared immediately before starting treatment. To do this, add cool water to the bottle with granules, after which the mixture must be shaken. The suspension can be stored for 14 days at room temperature. The medicine must be shaken each time before use. One measuring spoon contains 5 ml of suspension, respectively, it contains 250 mg of amoxicillin.

Children under 2 years of age should receive no more than 20 mg of the drug per 1 kg of weight per day. Children aged 2 to 5 years are recommended to take 125 mg of the drug. Children 5-10 years old receive a single dose of 250 mg. Children over 10 years old receive a single dose of 250-500 mg, if the disease is severe - up to 1 g.

Instructions for use Amoxicillin Sandoz

Used internally. In most cases, the dose ranges from 750 mg to 3 g of the drug, the dose is divided into several doses. More detailed information about the dosage and regimen of this drug, as well as about taking amoxicillin clavulanate, is provided by the doctor when prescribing treatment.

Veterinary Amoxicillin

In veterinary medicine, injections of amoxicillin 15% are used. For animals it is used to treat bacterial infections of the digestive system, skin diseases, respiratory diseases, diseases of the genitourinary system, etc. It is used for dogs, cats, and cattle. The drug must be administered subcutaneously or intramuscularly, the dosage is 1 ml per 10 kg of body weight. If necessary, the product is re-administered after 48 hours. A light massage of the area where the drug was injected is recommended.

Instructions for Amoxicillin DS

You need to take the drug 500 mg three times a day. If the disease is severe, the doctor may increase the dose to 750-1000 mg. Features of treatment depend on the patient's diagnosis.

The dosage of Amoxicillin for angina depends on the intensity of the pathological processes. As a rule, for angina, the usual dose of the drug is prescribed - 500 mg three times a day. How to take it for adults or how to take the medicine for children with a cold, you should definitely ask your doctor.

The dosage for sinusitis depends on the doctor's prescription. The dosage for adults is generally 500 mg of the drug 3-4 times a day, treatment lasts approximately one week. However, a specialist should tell you more precisely how many days to take the product.

Amoxicillin

Amoxicillin

(Latin
amoxycillinum
, English
amoxicillin
) is a broad-spectrum antibacterial, bactericidal, acid-resistant agent from the group of semi-synthetic penicillins.

Amoxicillin is a chemical substance

Chemical compound: [2S-[2alpha,5alpha,6beta(S*)]]-6-[[Amino-(4-hydroxyphenyl)acetyl]amino]-3,3-dimethyl-7-oxo-4-thia-1 -azabicyclo[3.2.0]heptane-2-carboxylic acid (and as trihydrate or sodium salt). Empirical formula: C16H19N3O5S.

Amoxicillin is the international nonproprietary name of the drug

Amoxicillin is the international nonproprietary name (INN) of the drug. According to the pharmacological index, amoxicillin belongs to the group “Penicillins”, according to ATC - to the group “J01C Beta-lactam antibiotics - penicillins” and has the code “J01CA04 Amoxicillin”. In addition, amoxicillin is present in a number of combination drug codes. In the group “A02BD Combinations of drugs for eradication of Helicobacter pylori
”:

• A02BD01 Omeprazole, amoxicillin and metronidazole
• A02BD03 Lansoprazole, amoxicillin and metronidazole
• A02BD04 Pantoprazole, amoxicillin and clarithromycin
• A02BD05 Omeprazole, amoxicillin and clarithromycin
• A02BD06 Esomeprazole, amoxicillin and clarithromycin
• A02BD07 Lansoprazole, amoxicillin and clarithromycin
• A02BD10 Lansoprazole, amoxicillin and levofloxacin
• A02BD11 Pantoprazole, amoxicillin, clarithromycin and metronidazole
• A02BD12 Rabeprazole, amoxicillin and clarithromycin
• A02BD13 Rabeprazole, amoxicillin and metronidazole
• A02BD14 Vonoprazan, amoxicillin and clarithromycin
• A02BD15 Vonoprazan, amoxicillin and metronidazole

In the group "J01C Beta-lactam antibiotics - penicillins":

• J01CR02 Amoxicillin in combination with beta-lactamase inhibitors

“Amoxicillin” is also a trade name for a number of drugs.

Amoxicillin is an antibiotic

Amoxicillin is active against many microbes, including:

• aerobic gram-negative bacteria: Helicobacter pylori, Neisseria gonorrhoeae, Neisseria meningitidis, Escherichia coli, Proteus mirabilis, Haemophilus influenzae
  ,
  Salmonella spp., Shigella spp., Klebsiella spp.
• aerobic gram-positive bacteria: Staphylococcus spp.
  (except penicillinase-producing strains),
  Streptococcus spp
  .

Serratia spp., Enterobacter spp., Morganella morganii, Pseudomonas spp.
are not sensitive to amoxicillin ,
Rickettsiaceae
, indole-positive
Proteus
(
Proteus vulgaris, Proteus rettgeri
), as well as mycoplasmas and viruses.

Indications for use of amoxicillin

Bacterial infections caused by sensitive microflora:

• sinusitis, tonsillitis, otitis media
• bronchitis, pneumonia
• pyelonephritis, pyelitis, cystitis, cholangitis, cholecystitis, urethritis, gonorrhea, cervicitis
• infections of the skin and soft tissues: erysipelas, impetigo, secondary infected dermatoses
• dysentery, salmonellosis, salmonella carriage, endocarditis, meningitis, sepsis

Peptic ulcer of the stomach, duodenum, atrophic gastritis, MALToma and gastric resection after gastric cancer when Helicobacter pylori
strictly as part of eradication regimens in combination with other drugs.

Method of administration of amoxicillin and dose

They are installed individually, taking into account the severity of the infection.

• Adults and children over 10 years of age are usually prescribed 500 mg 3 times a day. In severe cases of infection, the dose can be increased to 1 g 3 times a day.
• For children under 10 years of age, it is advisable to prescribe the drug in the form of a suspension.
• Children under 2 years old: 1/4 teaspoon of suspension 3 times a day (or at the rate of 20 mg/kg in 3 divided doses)
• Children from 2 to 5 years old: 1/2 teaspoon of suspension 3 times a day.
• Children 5–10 years old are usually prescribed 1 teaspoon of suspension or 1 capsule of 250 mg 3 times a day.

The course of treatment with amoxicillin is 5–14 days. The suspension is prepared by adding boiled water at room temperature to the dry substance to the 100 ml mark and then shaking. For acute uncomplicated gonorrhea, a single dose of 3 g is prescribed. Children 5–10 years old are usually prescribed 250 mg 3 times a day; from 2 to 5 years - 125 mg 3 times a day; for children under 2 years of age, the daily dose is 20 mg/kg in 3 divided doses.

Amoxicillin in Helicobacter pylori eradication regimens

Amoxicillin is classified by WHO as a drug active against Helicobacter pylori
(Podgorbunskikh E.I., Maev I.V., Isakov V.A.).
According to the “Standards for diagnosis and treatment of acid-dependent and Helicobacter pylori-associated diseases (Fourth Moscow Agreement),” amoxicillin can be included in Helicobacter pylori
.
Monotherapy of Helicobacter pylori
with amoxicillin is not allowed.
This standard recommends the following regimens with amoxicillin for first-line anti-Helicobacter therapy
, and the choice of a specific option depends on the patient’s individual intolerance to certain drugs, as well as the sensitivity of
Helicobacter pylori
to drugs:

Option 1.

One of the standard dosage proton pump inhibitors (omeprazole 20 mg, lansoprazole 30 mg, pantoprazole 40 mg, esomeprazole 20 mg, rabeprazole 20 mg twice daily) and amoxicillin (500 mg 4 times daily or 1000 mg twice daily) in combination with clarithromycin (500 mg 2 times a day), or josamycin (1000 mg 2 times a day), or nifuratel (400 mg 2 times a day) for 10-14 days.

Option 2.

Drugs used in the first option (one of the PPIs in a standard dosage, amoxicillin in combination with clarithromycin, or josamycin, or nifuratel) with the addition of a fourth component - bismuth tripotassium dicitrate 120 mg 4 times a day or 240 mg 2 times a day for 10– 14 days.

Option 3 (in the presence of atrophy of the gastric mucosa with achlorhydria, confirmed by pH-metry).

Amoxicillin (500 mg 4 times a day or 1000 mg 2 times a day) in combination with clarithromycin (500 mg 2 times a day) or josamycin (1000 mg 2 times a day), or nifuratel (400 mg 2 times a day), and bismuth tripotassium dicitrate (120 mg 4 times a day or 240 mg 2 times a day) for 10-14 days.

Option 4 (recommended only for elderly patients in situations in which full-fledged anti-Helicobacter therapy is impossible)

. One standard-dose PPI in combination with amoxicillin (500 mg 4 times daily or 1000 mg twice daily) and tripotassium bismuth dicitrate (120 mg 4 times daily or 240 mg twice daily) for 14 days.

Second line of anti-Helicobacter therapy.

It is carried out in the absence of eradication of Helicobacter pylori after treating patients with one of the first-line treatment options.

One of the standard dosage PPIs, amoxicillin (500 mg 4 times a day or 1000 mg 2 times a day) in combination with a nitrofuran drug: nifuratel (400 mg 2 times a day) or furazolidone (100 mg 4 times a day) and bismuth Tripotassium dicitrate (120 mg 4 times a day or 240 mg 2 times a day) for 10-14 days.
or
One standard-dose PPI, amoxicillin (500 mg 4 times daily or 1000 mg twice daily), rifaximin (400 mg twice daily), tripotassium bismuth dicitrate (120 mg 4 times daily) for 14 days .

“What guides us when preserving penicillins (amoxicillin) in the treatment of H. pylori

as part of 1st line eradication therapy? First of all, amoxicillin is characterized by a very low level of resistance, practically its absence. Amoxicillin is well absorbed from the gastrointestinal tract, does not irritate the gastric mucosa and rarely causes diarrhea. Has a wide spectrum of antimicrobial action. The mechanism of action of amoxicillin is to bind to transpeptidases and carboxypeptidases of the microbial cell (penicillin-binding proteins), their inactivation, causing cessation of growth and cell death.

Amoxicillin, regardless of food intake, is completely absorbed in the intestine, easily penetrating tissue barriers” (Maev I.V. et al.).

H. pylori
resistance

to the main antibacterial drugs of the first line of eradication therapy in the world (Kucheryaviy Yu.A. et al.)

The problem of preserving intestinal microflora during amoxicillin therapy

The simultaneous use of two or more antibacterial drugs cannot but affect the intestinal microflora. Antibiotic resistance also appears to be a serious problem, including among representatives of opportunistic microflora, the excessive growth of which we can expect after a course of use of antibacterial drugs. An increase in the number of opportunistic yeasts in patients with immune disorders can cause the development of an infectious process, and Clostridium difficile
can cause diarrhea or colitis.
In a study comparing the effects of various eradication regimens on the microflora, it was shown that in patients taking a 7-day triple regimen, which included omeprazole, amoxicillin and metronidazole, changes in the composition of the oropharyngeal, gastric and intestinal microflora were observed. Compared with the regimen that included clarithromycin, the gastrointestinal microflora in patients taking amoxicillin underwent fewer changes. This was the case in both groups of patients, but they were more often found in the group of patients receiving clarithromycin. Enterococcus spp
increased significantly .
and Enterobacteriaceae
in feces, resistant streptococci were cultured.
In most patients taking amoxicillin, colonization of the small intestine with opportunistic yeasts was observed, the number of opportunistic yeasts (mainly Candida albicans
) in saliva increased significantly, and the number of enterococci, enterobacteria (especially
E. coli
), and peptostreptococci increased.
Some patients have Klebsiella spp.
and
Citrobacter freundii
.

When taking a combination of omeprazole and amoxicillin, the number of Rothia mucilaginosa

, at the same time, there is an overgrowth
of Haemophillus species
.
The number of anaerobic bacteria, including gram-positive cocci and fusobacteria, is significantly reduced. Neisseria
and
Haemophillus
in the stomach increases .
In patients who had E. cloacae
and
K. pneumoniae
, colonization of the stomach by them was observed after treatment (Dobrovolsky O.V., Serebrova S.Yu.).

The most serious problem associated with antibiotic use is antibiotic-associated diarrhea, which occurs in 10–25% of patients treated with combination amoxicillin and clavulanic acid. The most severe forms of pathology are antibiotic-associated, segmental hemorrhagic and pseudomembranous colitis (Dobrovolsky O.V., Serebrova S.Yu.).

After amoxicillin therapy, it is recommended to correct the intestinal microflora with drugs containing lacto- and bifidobacteria (Volynets G.V.).

Professional medical publications regarding the use of amoxicillin

• Teplova N.V., Teplova N.N. Anti-Helicobacter therapy of peptic ulcer with azithromycin and amoxicillin // RMZh. Diseases of the digestive system. – 2004. – vol. 6. – No. 2/ – 68–70.
• Kucheryavyi Yu.A., Andreev D.N., Barkalova E.V. Clinical and molecular aspects of Helicobacter pylori resistance to antibacterial drugs // Medical Council. 2013. No. 10. pp. 11–15.
• Belousova Yu.B., Karpov O.I., Belousov D.Yu., Beketov A.S. Pharmacoeconomics of the use of bismuth tripotassium dicitrate for peptic ulcer disease // Therapeutic archive. – 2007. – T. 79. – No. 2. – P. 58–66.
• Maev I.V., Samsonov A.A., Andreev N.G., Kochetov S.A. Clarithromycin as the main element of eradication therapy for diseases associated with Helicobacter pylori infection // Gastroenterology. 2011. No. 1.
• Kornienko E.A., Parolova N.I. Antibiotic resistance of Helicobacter pylori in children and choice of therapy // Issues of modern pediatrics. – 2006. – Volume 5. – No. 5. – p. 46–50.
• Uspensky Yu.P., Baryshnikova N.V. Optimization of the treatment of diseases associated with H. pylori infection, taking into account modern recommendations // Sat. articles. Act. question health improvement for children and adolescents with pom. hospital-replacing technologies. St. Petersburg 2021. pp. 37–48.
• Maev I.V., Samsonov D.N., Andreev A.A., Grechushnikov V.B., Korovina T.I. Clinical significance of Helicobacter pylory infection // Clinical medicine. - No. 8. - 2013. P. 4-13.
• Starostin B.D. Treatment of Helicobacter pylori infection - Maastricht V/Florentine consensus report (translation with comments) // Gastroenterology of St. Petersburg. 2017; (1): 2-22.
• Maev I.V., Andreev D.N., Dicheva D.T. and others. Diagnosis and treatment of Helicobacter pilory infection: provisions of the Maastricht V consensus (2015) // Archives of Internal Medicine. Clinical recommendations. - No. 2. - 2021. P. 85-94.

On the website gastroscan.ru in the literature catalog there is a section “Antibiotics used in the treatment of gastrointestinal diseases”, containing articles on the use of antimicrobial agents in the treatment of diseases of the digestive tract.

Contraindications to the use of amoxicillin

• hypersensitivity to the drug and other beta-lactam antibiotics
• infectious mononucleosis and leukemoid reactions of the lymphatic type

Restrictions on the use of amoxicillin

Polyvalent hypersensitivity to xenobiotics, allergic diathesis, bronchial asthma, hay fever, lymphocytic leukemia, history of gastrointestinal diseases (especially colitis associated with the use of antibiotics), renal failure.

Pharmacological action of amoxicillin

Pharmacological action: broad-spectrum antibacterial, bactericidal. Inhibits transpeptidase, disrupts the synthesis of peptidoglycan (supporting protein of the cell wall) during division and growth, and causes lysis of microorganisms. Has a wide spectrum of antimicrobial action. When taken orally in the form of a suspension in doses of 125 mg/5 ml and 250 mg/5 ml, it is quickly and well absorbed (75–90%), creating Cmax (1.5–3.0 mcg/ml and 3.5–5. 0 μg/ml, respectively) after 1–2 hours. When taken orally in capsule form in doses of 250 and 500 mg, Cmax (3.5–5.0 mcg/ml and 5.5–7.5 mcg/ml, respectively) is also achieved within 1–2 hours. Stable in an acidic environment, food intake does not affect absorption. When administered parenterally, it is quickly absorbed and distributed in the tissues and fluids of the body; Cmax in the blood is detected 1 hour after intramuscular administration and remains at a therapeutic level after parenteral administration for 6–8 hours. Plasma protein binding is about 20%. Easily passes histohematic barriers, except for the unchanged blood-brain barrier, and quickly penetrates most tissues and body fluids; accumulates in therapeutic concentrations in peritoneal fluid, urine, contents of skin blisters, pleural effusion, lung tissue, intestinal mucosa, female genital organs, middle ear fluid, gallbladder and bile (with normal liver function), fetal tissue (passes through the placental barrier ). T½ is 1–1.5 hours. If renal function is impaired, T½ is extended to 4–12.6 hours, depending on creatinine clearance. Partially metabolized to form inactive metabolites. 50–70% is excreted unchanged by the kidneys by tubular secretion (80%) and glomerular filtration (20%), 10–20% by the liver. In trace quantities it is determined in the blood serum 8 hours after ingestion. A small amount is excreted in breast milk.

Use of amoxicillin during pregnancy and breastfeeding

During pregnancy, the use of amoxicillin is possible only if the benefit to the mother outweighs the potential risk to the fetus (there are no adequate and strictly controlled studies in pregnant women). FDA category of action on the fetus is B. During breastfeeding, amoxicillin is used with caution, as it passes into breast milk.

Side effects of amoxicillin

Allergic reactions:
skin flushing, rhinitis, conjunctivitis, exfoliative dermatitis, exudative erythema multiforme, Stevens-Johnson syndrome, anaphylactic shock, maculopapular rash, itching, urticaria, Quincke's edema, reactions similar to serum sickness.

From the gastrointestinal tract

: nausea, vomiting, change in taste, diarrhea, pain in the anus, stomatitis, glossitis.

From the nervous system and sensory organs:

agitation, anxiety, insomnia, confusion, behavior changes, headache, dizziness, convulsive reactions.

From the cardiovascular system and blood (hematopoiesis, hemostasis):

tachycardia, transient anemia, thrombocytopenic purpura, eosinophilia, leukopenia, neutropenia and agranulocytosis.

Other:

difficulty breathing, joint pain, interstitial nephritis, moderate increase in the level of transaminases in the blood; complications caused by the chemotherapeutic effect - dysbacteriosis, superinfection (especially in patients with chronic diseases or reduced body resistance), oral or vaginal candidiasis, pseudomembranous or hemorrhagic colitis.

There are studies showing that when using amoxicillin (either alone or with clavulonic acid), diarrhea develops in 10% of cases. The likelihood of candidiasis is even greater (Gillies M. etal. CMAJ. 2014 Nov 17).

Interaction of amoxicillin with other drugs

Probenicide, phenylbutazone, oskiphenbutazone, and to a lesser extent acetylsalicylic acid and sulfinpyrazone suppress the tubular secretion of penicillin drugs, which leads to an increase in the half-life and concentration of amoxicillin in the blood plasma. Amoxicillin acts only on multiplying microorganisms, so it should not be prescribed simultaneously with antimicrobial drugs that act bacteriostatically. If there are positive tests for the sensitivity of the pathogen, amoxicillin can be used in combination with other bactericidal antibiotics (cephalosporins, aminoglycosides).

Trade names of drugs with the active ingredient amoxicillin

The following trade names of drugs with the only active ingredient amoxicillin are (were) registered in Russia: Amoxicillin, Amoxicillin, Amoxicillin in capsules 0.25 g, Amoxicillin Watham, Amoxicillin DS, Amoxicillin sodium sterile, Amoxicillin Sandoz, Amoxicillin-ratiopharm, Amoxicillin-ratiopharm 250 TS, Amoxicillin powder for suspension 5 g, Amoxicillin tablets, Amoxicillin trihydrate, Amoxicillin trihydrate (Purimox), Amosin Gonoform, Gramox-D, Grunamox, Danemox, Ospamox, Flemoxin Solutab, Hiconcil, Ecobol.
Amoxicillin brands: Amoxil, Moxatag, Trimox, Wymox. Some combination preparations with the active ingredients amoxicillin and clavulanic acid: Amoxiclav, Augmentin, Flemoklav Solutab, Panclave, Ecoclave, Arlet, Rapiclav, Klamosar, Fibell, Medoclav, Amoxivan, Bactoclav, Amocombe, Betaclave, Taromentin, Ranclave, Verclave.

In November 2021, the US Food and Drug Administration (Food and Drug Administration, USA) gave permission for use in the eradication of Helicobacter pylori

in adult patients of the complex drug Talicia, according to the application of RedHill Biopharma Ltd., Israel, a dosage form of delayed-release capsules containing amoxicillin (250 mg in one capsule), rifabutin (12.5 mg) and omeprazole (10 mg omeprazole) as active ingredients magnesium).

Instructions from manufacturers for the use of drugs containing amoxicillin

Some official instructions for the medical use of drugs containing the only active ingredient - amoxicillin (pdf):

• for Ukraine (in Russian):
• “Instructions for medical use of the drug Amoxil”, tablets containing 0.25 and 0.5 g of amoxicillin
• “Instructions for medical use of the drug Amoxil-DT”, dispersible tablets containing 0.25 and 0.5 g of amoxicillin, dated 07/02/2012.

• "Amoxil. Prescribing Information,” amoxicillin in the form of capsules, tablets, chewable tablets, powder for oral suspension, October 2006.
• “Moxatag (amoxicillin extended-release) Tablets. Full Prescribing Information,” MiddleBrook Pharmaceuticals, Inc., January 2008.

Amoxicillin has contraindications, side effects and application features; consultation with a specialist is required. Back to section

Overdose

As a rule, in case of overdose there is no pronounced toxic effect, even if a large dose of the drug was taken. If a large dose of Amoxicillin has been taken, the patient will experience symptoms of gastrointestinal upset and water-electrolyte imbalance. In people who suffer from renal failure, overdose may show signs of nephrotoxicity and crystalluria.

Symptomatic treatment is carried out, for which drugs prescribed by the doctor are used, and activated charcoal should also be taken. Hemodialysis may be used . There is no specific antidote.

Amoxil tablets 500 mg No. 10x2

Name

Amoxil.

Description

Tablets are white with a yellowish tint, flat-cylindrical with a chamfer and a score. The risk is intended only for breaking to facilitate swallowing, and not for dividing into equal doses.

Main active ingredient

Amoxicillin.

Release form

Pills.

Dosage

500 mg.

special instructions

No studies have been conducted on the effect on the ability to drive vehicles and other machinery. However, adverse reactions may occur (for example, allergic reactions, dizziness, convulsions), which may affect the ability to drive vehicles or use other machinery (see section "Side effects").

pharmachologic effect

Amoxicillin is a semisynthetic penicillin (beta-lactam antibiotic) that inhibits one or more enzymes (often called penicillin-binding proteins, PBPs) in the biosynthetic pathway of bacterial peptidoglycan, which is an integral structural component of the bacterial cell wall. Inhibition of peptidoglycan synthesis leads to weakening of the cell wall, which is usually accompanied by lysis and cell death. Amoxicillin is inactivated by beta-lactamases produced by resistant bacteria, and therefore the spectrum of activity of amoxicillin alone does not include organisms that produce these enzymes.

Indications for use

Amoxil is indicated for the treatment of the following infections in adults and children (see sections “Dosage and Administration” and “Precautions” and “Pharmacodynamics”): • Acute bacterial sinusitis • Acute otitis media • Acute streptococcal tonsillitis and pharyngitis • Exacerbation of chronic bronchitis • Community-acquired pneumonia • Acute cystitis • Asymptomatic bacteriuria during pregnancy • Acute pyelonephritis • Typhoid and paratyphoid fever • Dental abscess with spreading cellulitis • Infections of joint prostheses • Helicobacter pylori eradication • Lyme disease Amoxil is also indicated for the prevention of endocarditis. Official guidelines for the appropriate use of antibacterial agents should be considered.

Directions for use and doses

The dose of Amoxil is determined by the doctor taking into account: • The expected pathogen and its likely susceptibility to antibacterial agents (see section “Precautions”) • the severity and location of the infectious process • the patient’s age, weight and renal function The duration of treatment should be determined by the type of infection and the patient’s response for treatment and, as a rule, should be as short as possible. Some infections require longer treatment (see Precautions section regarding long-term treatment).

Use during pregnancy and lactation

Pregnancy Animal studies do not indicate direct or indirect reproductive toxicity. Limited data on the use of amoxicillin during pregnancy in humans do not indicate an increased risk of congenital malformations. Amoxicillin may be used during pregnancy when the potential benefits outweigh the potential risks associated with treatment. Breastfeeding Amoxicillin is excreted in small quantities into breast milk with a possible risk of sensitization. Consequently, a breastfed baby may develop diarrhea and fungal infections of the mucous membranes, so breastfeeding may have to be stopped. The use of amoxicillin during breastfeeding is possible only after a benefit/risk assessment by a doctor. Fertility There are no data on the effects of amoxicillin on fertility in humans. Reproductive toxicity studies in animals have shown no effects on fertility.

Precautionary measures

Hypersensitivity reactions Before starting amoxicillin therapy, previous hypersensitivity reactions to penicillins, cephalosporins or other beta-lactam drugs should be carefully reviewed (see sections "Contraindications" and "Side Effects"). Serious and sometimes fatal hypersensitivity reactions (including anaphylactoid and severe cutaneous adverse reactions) have been reported in patients receiving penicillin therapy. These reactions are more common in people with a history of penicillin hypersensitivity and in people with atopy. If an allergic reaction occurs, treatment with amoxicillin should be discontinued and appropriate alternative therapy should be instituted. Non-susceptible organisms Amoxicillin is not suitable for the treatment of some types of infections unless the pathogen is already documented and known to be susceptible, or there is a very high likelihood that the pathogen will be suitable for treatment with amoxicillin (see Pharmacodynamics section). This is especially true when considering the treatment of patients with urinary tract infections and severe ear, nose and throat infections. Seizures Seizures may occur in patients with impaired renal function, or in patients receiving high doses of amoxicillin, or in patients with predisposing factors (for example, a history of seizures, epilepsy or meningeal disorders (see section "Side effects")). Renal failure patients with renal failure, the dose should be adjusted depending on the degree of impairment (see section "Dosage and Administration").Skin reactions The occurrence at the beginning of treatment of febrile generalized erythema, with pustules, may be a symptom of acute generalized exanthemal pustulosis (AGEP, see section "Side effect") If this reaction occurs, stop taking amoxicillin and subsequent use is contraindicated. Amoxicillin should be avoided if infectious mononucleosis is suspected, since the occurrence of a morbilliform rash has been associated with this disease after the use of amoxicillin. Jarisch-Herxheimer reaction Jarisch-Herxheimer reaction Herxheimer's disease has been described following treatment with amoxicillin for Lyme disease (see. section "Side effects"). This is directly related to the bactericidal activity of amoxicillin against the causative agent of Lyme disease, the spirochete Borrelia burgdorferi. Manifested by increased temperature, chills, decreased blood pressure, tachycardia, nausea, headache, muscle pain, aggravation of existing symptoms or the appearance of new symptoms of the underlying disease. The patient should be warned that this is a common occurrence and is usually self-limiting and is considered a normal consequence of antibiotic treatment for Lyme disease. Overgrowth of non-susceptible organisms Prolonged use may sometimes result in overgrowth of non-susceptible organisms. Antibiotic-associated colitis has been reported with almost all antibiotics and can range in severity from mild to life-threatening (see Side Effects section). Therefore, it is important to consider this diagnosis in patients with diarrhea during or after taking any antibiotics. If antibiotic-associated colitis occurs, amoxicillin should be stopped immediately, consult a physician, and initiate appropriate therapy. Medicines that slow down peristalsis are contraindicated in this situation. Long-term therapy During long-term therapy, periodic assessment of the functions of certain organs and systems is recommended: including renal, hepatic and hematopoietic function. Increased levels of liver enzymes and changes in blood counts have been reported (see section "Side effects"). Anticoagulants There are isolated reports of prolongation of prothrombin time in patients receiving amoxicillin. When used together with anticoagulants, proper monitoring is necessary. To maintain the desired level of anticoagulation, dose adjustment of oral anticoagulants may be necessary (see sections "Interaction with other drugs and other types of interactions" and "Side effects"). Crystalluria Crystalluria is observed very rarely, mainly during parenteral therapy, in patients with reduced urine output. During administration of high doses of amoxicillin, it is advisable to maintain adequate fluid intake and urination to reduce the likelihood of amoxicillin crystalluria. In patients with bladder catheterization, patency should be checked regularly (see Section "Side effects" and "Overdose"). Effect on Diagnostic Tests Elevated levels of amoxicillin in serum and urine may interfere with some laboratory tests. Due to the high concentration of amoxicillin in urine, false-positive results are possible when using chemical methods. When testing for the presence of glucose in urine during treatment with amoxicillin, it is recommended to use the enzymatic glucose oxidase method. The presence of amoxicillin may distort the results of the test for the presence of estriol in pregnant women. Excipients Amoxil contains less than 1 mmol (23 mg)/dose of sodium, that is, it is practically free of sodium.

Interaction with other drugs

Probenecid Concomitant use of probenecid is not recommended. Probenecid reduces renal tubular secretion of amoxicillin. Concomitant use of probenecid may increase and prolong the level of amoxicillin in the blood. Allopurinol Concomitant use of allopurinol during treatment with amoxicillin may increase the likelihood of allergic skin reactions. Tetracyclines Tetracyclines and other bacteriostatic drugs may reduce the bactericidal effect of amoxicillin. Oral anticoagulants Oral anticoagulants and penicillin antibiotics have been widely used in practice without reports of interaction. However, the literature has described cases of increased international normalized ratio in patients receiving acenocoumarol or warfarin concomitantly with amoxicillin. If coadministration is necessary, carefully monitor prothrombin time or international normalized ratio with amoxicillin dosage adjustments. In addition, dose adjustment of oral anticoagulants may be necessary (see sections "Precautions" and "Side Effects"). Methotrexate Penicillins may decrease the excretion rate of methotrexate, potentially causing increased toxicity.

Contraindications

Hypersensitivity to the active substance, to any of the penicillins or to any of the excipients included in the drug. History of severe immediate hypersensitivity reactions (eg, anaphylaxis) to another beta-lactam drug (eg, cephalosporin, carbapenem, or monobactam).

Compound

Symptoms: dysfunction of the gastrointestinal tract - nausea, vomiting, diarrhea, which may result in water and electrolyte imbalance. Cases of crystalluria have been reported, sometimes leading to renal failure. Patients with impaired renal function or those who have received high doses of amoxicillin may experience seizures (see Precautions and Side Effects sections). Treatment: induce vomiting or rinse the stomach, then take activated charcoal and an osmotic laxative. Water and electrolyte balance should be maintained. Amoxicillin is removed from the blood using hemodialysis. A specific antidote is unknown.

Overdose

Symptoms: dysfunction of the gastrointestinal tract - nausea, vomiting, diarrhea, which may result in water and electrolyte imbalance. Cases of crystalluria have been reported, sometimes leading to renal failure. Patients with impaired renal function or those who have received high doses of amoxicillin may experience seizures (see Precautions and Side Effects sections). Treatment: induce vomiting or rinse the stomach, then take activated charcoal and an osmotic laxative. Water and electrolyte balance should be maintained. Amoxicillin is removed from the blood using hemodialysis. A specific antidote is unknown.

Side effect

The most frequently reported adverse reactions were diarrhea, nausea and skin rash. Undesirable adverse reactions recorded during clinical trials and post-marketing surveillance of amoxicillin are presented according to systemic organ classes and frequency of occurrence. Infections and infestations: Very rare: Candidiasis of the skin and mucous membranes. Blood and lymphatic system disorders: Very rare: Reversible leukopenia (including severe neutropenia or agranulocytosis), reversible thrombocytopenia and hemolytic anemia. Prolongation of bleeding time and prothrombin time (see section "Precautions"). Immune system disorders: Very rare: Severe allergic reactions including angioedema, anaphylaxis, serum sickness and allergic vasculitis (see Precautions section). Frequency unknown: Jarisch-Herxheimer reaction (see Precautions section). Nervous system disorders: Very rare: Hyperkinesia, dizziness and convulsions (see section "Precautions"). Gastrointestinal disorders: Common: Diarrhea and nausea. Uncommon: Vomiting. Post-marketing data: Very rare: Antibiotic-associated colitis (including pseudomembranous colitis and hemorrhagic colitis, see Precautions section). Coloring the tongue black. Liver and biliary tract disorders: Very rare: Hepatitis and cholestatic jaundice. Moderate increase in AST and/or ALT. Skin and subcutaneous tissue disorders: Common: Skin rash. Uncommon: Urticaria and itching. Post-marketing data: Very rare: Skin reactions such as erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, bullous and exfoliative dermatitis, acute generalized exanthematous pustulosis (AGEP) (see Precautions section) and drug reactions with eosinophilia and systemic symptoms (DRESS). From the kidneys and urinary tract: Very rarely: Interstitial nephritis. Crystalluria (see section “Precautions” and “Overdose”). *The incidence of these adverse reactions was obtained from clinical studies of approximately 6,000 adults and children taking amoxicillin. Reporting of adverse reactions It is important to report suspected adverse reactions after registration of a medicinal product to ensure continuous monitoring of the benefit/risk profile of the medicinal product. Health care professionals are encouraged to report any suspected adverse drug reactions through national adverse reaction and drug failure reporting systems. If the patient experiences any adverse reactions, he is advised to consult a doctor. This recommendation applies to any possible adverse reactions, including those not listed in the package insert. You can also report adverse reactions to the Adverse Drug Events Information Database, including reports of drug failure. By reporting adverse reactions, you can help provide more information about the safety of the drug.

Storage conditions

To protect from light and moisture, store in original packaging at a temperature not exceeding 25°C. Keep out of the reach of children.

Buy Amoxil tab. 500 mg per bl. in pack No. 10x2 in the pharmacy

Price for Amoxil tablet. 500 mg per bl. in pack №10x2

Instructions for use for Amoxil tab. 500 mg per bl. in pack №10x2

Interaction

Wikipedia indicates that the drug may reduce the effectiveness of oral contraceptives.

If taken simultaneously with bactericidal antibiotics, the patient experiences synergy ; if taken simultaneously with bacteriostatic antibiotics, antagonism .

The drug stimulates the effect of indirect anticoagulants, reduces the prothrombin index and the synthesis of vitamin K.

Reduces the effectiveness of drugs in the process of metabolism of which PABA manifests itself.

Tubular secretion is reduced by allopurinol , diuretics, probenecid , phenylbutazone, and NSAIDs. As a result, its concentration in the blood may increase.

Under the influence of ascorbic acid, the absorption of amoxicillin increases, and when taken simultaneously with glucosamine , antacids , aminoglycosides , and laxatives , it decreases.

If the simultaneous use of amoxicillin and clavulanic acid is practiced, there is no change in the pharmacokinetics of these drugs.

Microorganisms that produce penicillinase demonstrate resistance to the main substance.

When combined with metronidazole, it is active against Helicobacter pylori.

Cross-resistance has been observed between amoxicillin and ampicillin .

Amoxicillin hemofarm Capsules, 16 pcs., 500 mg

special instructions

Before prescribing amoxicillin, like all penicillins, it is necessary to carefully collect anamnesis for allergic reactions to penicillins, cephalosporins and other beta-lactam antibiotics, taking into account possible cross-reactions.
Serious and sometimes fatal hypersensitivity reactions (including anaphylactoid and serious skin reactions) have been reported in patients receiving penicillin therapy. The development of these reactions is more likely in persons with a history of hypersensitivity to penicillin and in persons with atopy. If an allergic reaction occurs, discontinue amoxicillin therapy and institute appropriate alternative therapy.

Rare cases of hypersensitivity reaction of the allergic acute coronary syndrome type (Kounis syndrome) have been observed; if it develops, appropriate treatment is used during treatment with amoxicillin.

With long-term use, cases of superinfection and candidiasis (especially vulvovaginal candidiasis) may develop.

Convulsions may occur in patients with impaired renal function or in patients receiving high doses of the drug or having predisposing factors (for example, a history of seizures, treatment for epilepsy or meningitis).

In case of renal failure, it is necessary to adjust the dosage regimen depending on the degree of renal failure.

The occurrence of generalized erythema with fever accompanied by pustules at the beginning of treatment may be a symptom of OHEP (see section “Side effects”). This adverse reaction requires discontinuation of treatment with amoxicillin and is a contraindication for its further use in any situation.

The use of amoxicillin should be avoided if a patient is suspected of developing infectious mononucleosis, since the appearance of a morbilliform rash has been associated with the use of amoxicillin in the treatment of infectious mononucleosis.

The Jarisch-Herxheimer reaction has been observed after the use of amoxicillin in patients with Lyme disease (see section "Side effects"). Its direct cause is the bactericidal activity of amoxicillin against the bacteria that cause Lyme disease, the spirochete Borrelia burgdorferi.

Patients should be reassured that this reaction is a common and usually self-limiting consequence of antibiotic use in patients with Lyme disease.

Treatment must continue for 48-72 hours after the disappearance of clinical signs of the disease.

When taking almost all antibiotics, it is possible to develop antibiotic-associated colitis up to a life-threatening condition. This should be taken into account if diarrhea occurs during antibiotic therapy or after its completion. If antibiotic-associated colitis develops, drug therapy should be stopped immediately and consult a doctor to prescribe appropriate treatment. The use of drugs that inhibit intestinal motility is contraindicated.

During treatment, it is necessary to monitor the state of function of the hematopoietic organs, liver and kidneys. Increased activity of liver enzymes and changes in the number of blood cells were reported.

When taken simultaneously with anticoagulants, an increase in prothrombin time is observed. Appropriate monitoring and possibly adjustment (reduction) of the anticoagulant dose should be carried out.

In patients with reduced diuresis, crystalluria was very rarely observed, mainly during parenteral therapy. When using high doses of amoxicillin, it is recommended to maintain adequate fluid intake and diuresis to reduce the possibility of crystalluria associated with amoxicillin use. In patients with a catheterized bladder, catheter patency should be checked regularly.

High concentrations of amoxicillin give a false-positive reaction to urine glucose when using Benedict's reagent or Fehling's solution. The use of enzymatic glucose oxidase tests is recommended.

The use of amoxicillin may distort the results of the quantitative determination of estriol in urine in pregnant women.

The drug should be used with caution in the elderly, pregnant women, and during lactation.

When using amoxicillin to treat Helicobacter pylori infection,

You should take into account the information provided in the text of the instructions for medical use of other concomitantly used drugs.

special instructions

Amoxicillin, as well as Amoxicillin Clavulanate and other types of the drug, should be taken with caution by people who are prone to allergic reactions.

liver disease , as well as those who are under 18 years of age, should not take the drug with metronidazole

Cross-allergy may occur in people who are hypersensitive to carbapenems and cephalosporins .

You should consider what Amoxicillin helps with. Thus, the drug is ineffective in the treatment of acute respiratory viral infections.

If the patient has severe gastrointestinal infections with symptoms of diarrhea and vomiting, then tablets should not be prescribed due to poor absorption.

The drug should be used with caution by people with bronchial asthma , allergic diathesis , and hay fever .

If the patient is forced to take the drug for a long time, he is additionally prescribed Levorin , Nystatin or other drugs with antifungal action.

It is important to monitor the condition of the kidneys, liver, as well as laboratory parameters of urine and blood in people who take large doses of the drug for a long time.

Patients who ask their doctor questions about whether Amoxicillin is an antibiotic or not should note that this drug is an antibiotic, so it is advisable to always consult a doctor before starting to take it. It is the doctor who determines how many days to take the medicine, as well as its dosage. You should not independently determine what Amoxicillin tablets help with and practice self-medication.

The drug for cats, dogs and other animals should be used only after a prescription by a veterinarian.

The combination of amoxicillin, omeprazole , clarithromycin is used to treat peptic ulcers.

Amoxicillin analogues

Level 4 ATC code matches:
Hiconcil

Ampioks

Ampicillin Trihydrate

Ampicillin

Ospamox

Amoxicar

Penicillin

Flemoxin Solutab

Amosin

Amoxil

Ecoball

There are a number of analogues of this drug, which contain a similar active substance. The price of analogues depends on the manufacturer of the drug. Such medications are the following drugs: Amoxicillin trihydrate , Amoxicillin Sandoz , Flemoxin Solutab , Amoxicillin , Amosin , Amoxisar , Ecobol , etc.

Which is better: Amoxiclav or Amoxicillin?

Many patients believe that Amoxiclav and Amoxicillin are the same thing. But there is still a difference between these drugs. Amoxiclav contains clavulanic acid, so the drug has a wider spectrum of action. But this drug is more expensive.

Which is better: Flemoxin Solutab or Amoxicillin?

The drug Flemoxin contains a similar active substance. But Amoxicillin is more often used to treat adult patients. Flemoxin Solutab is absorbed faster from the gastrointestinal tract, it can be taken with meals, they have a pleasant taste. These tablets can be dissolved in water and prepared into a suspension or syrup. Flemoxin Solutab is a more expensive drug.

Buy Amoxicillin granules for suspension 250mg/5ml 100ml Hemofarm in pharmacies

Amoxicillin Buy Amoxicillin in pharmacies DOSAGE FORMS granules for the preparation of oral suspension 250mg/5ml granules for the preparation of oral suspension 250mg/5ml

MANUFACTURERS Hemofarm A.D. (Serbia) Hemofarm D.D. (Yugoslavia)

GROUP Antibiotics of the penicillin group

COMPOSITION Active substance - amoxicillin.

INTERNATIONAL NON-PROPENTED NAME Amoxicillin

SYNONYMS Amoxisan, Amoxicillin DS, Amoxicillin Sandoz, Amoxicillin trihydrate, Amoxicillin sodium salt sterile, Amosin, Clamoxil LA, Ospamox, Flemoxin Solutab, Hiconcil, Ecobol

PHARMACOLOGICAL ACTION Antibacterial (bactericidal). Stable in an acidic environment, food intake does not affect absorption. Easily passes histohematic barriers, except for the unchanged BBB, and penetrates most tissues and organs; accumulates in therapeutic concentrations in peritoneal fluid, urine, contents of skin blisters, pleural effusion, lungs, intestinal mucosa, female genital organs, middle ear fluid, gall bladder and bile, fetal tissues. Partially metabolized to form inactive metabolites, excreted unchanged by the kidneys and liver. A small amount is excreted in breast milk. The action develops 15-30 minutes after administration and lasts 8 hours. It has a wide spectrum of antimicrobial action, including Staphylococcus spp., except for penicillinase-producing strains, Streptococcus spp., Neisseria gonorrhoeae, Neisseria meningitidis, Escherichia coli, Proteus mirabilis, some Salmonella strains , Shigella, Klebsiella and Haemophilus influenzae.

INDICATIONS FOR USE Infections of the respiratory tract and ENT organs (bronchitis, pneumonia, tonsillitis, acute otitis media, pharyngitis, sinusitis), genitourinary system (urethritis, cystitis, pyelonephritis, endometritis, uncomplicated gonorrhea), skin and soft tissues, gastrointestinal tract (peritonitis, enterocolitis, cholecystitis, cholangitis, typhoid fever); leptospirosis, listeriosis, meningitis, Lyme disease (borreliosis), prevention of endocarditis and surgical infection; combination therapy of gastritis and peptic ulcer (in combination with metronidazole), sepsis (in combination with aminoglycosides).

CONTRAINDICATIONS Hypersensitivity (including to other penicillins, cephalosporins, carbapenems), allergic diathesis, bronchial asthma, hay fever, infectious mononucleosis, lymphocytic leukemia, history of gastrointestinal diseases (especially colitis associated with the use of antibiotics).

SIDE EFFECTS Nausea, vomiting, diarrhea, pain in the anus, stomatitis, glossitis; agitation, anxiety, insomnia, confusion, behavior changes, headache, dizziness, convulsive reactions; difficulty breathing, tachycardia; joint pain; interstitial nephritis; dysbiosis, superinfection, oral or vaginal candidiasis, pseudomembranous or hemorrhagic colitis; moderate increase in the level of transaminases in the blood, transient anemia, thrombocytopenic purpura, eosinophilia, leukopenia, neutropenia and agranulocytosis; allergic reactions: exfoliative dermatitis, exudative erythema multiforme, Stevens-Johnson syndrome, anaphylactic shock, maculopapular rash, itching, urticaria, Quincke's edema, reactions similar to serum sickness.

INTERACTION Reduces the effect of estrogen-containing oral contraceptives, reduces clearance and increases the toxicity of methotrexate. Enhances the absorption of digoxin. Excretion is slowed down by probenecid, sulfinpyrazone, acetylsalicylic acid, indomethacin, oxyphenbutazone, phenylbutazone and other drugs that suppress tubular secretion. Antibacterial activity is reduced by bacteriostatic chemotherapeutic agents and antacids, and increased by aminoglycosides and metronidazole. Allopurinol - increases the occurrence of skin rashes.

OVERDOSE Symptoms: nausea, vomiting, diarrhea, water and electrolyte imbalance. Treatment: gastric lavage, administration of activated carbon, saline laxatives, correction of water and electrolyte balance; hemodialysis.

SPECIAL INSTRUCTIONS Use with caution for urticaria and hay fever. Renal, liver and hematopoiesis function should be periodically monitored during long-term therapy. Treatment must be continued for 48-72 hours after the disappearance of clinical signs of the disease. During pregnancy and lactation, it is used for health reasons, taking into account the expected effect for the mother and the potential risk for the fetus or child. During the course, breastfeeding is excluded. It should be taken into account that the granules when preparing the suspension contain sugar. When determining glucose in urine, false positive results and changes in the results of determining urobilinogen are possible. For more information, see the naming instructions.

STORAGE CONDITIONS List B. At room temperature.

Amoxicillin and alcohol

The instructions for the drug do not indicate whether the drug can be combined with alcohol. However, doctors do not recommend practicing this combination. After all, alcohol significantly reduces the effectiveness of the medicine. In this case, side effects may increase significantly. There may be an unpredictable effect on the nervous system, the toxic effect on the liver is rapidly increasing, and the risk of severe allergic manifestations and breathing problems increases. It should be borne in mind that these tablets are an antibiotic, which means they should only be used during a period of abstinence from alcohol.

Amoxicillin during pregnancy and lactation

It should be borne in mind that the substance amoxicillin can penetrate the placental barrier. But still, during pregnancy, according to indications, this remedy is prescribed to women for inflammatory diseases. It is prescribed for bacterial infections. But still, the drug can provoke the development of dysbacteriosis , allergic reactions , and activation of fungal microflora. Reviews of Amoxicillin during pregnancy generally indicate its effectiveness and rare occurrence of side effects.

The drug should not be taken during lactation, as it passes into breast milk. If treatment of inflammatory processes during lactation is required, another drug is prescribed or breastfeeding is stopped.

Special instructions for the use of the drug Amoxil

Before starting therapy, it is necessary to exclude the patient's hypersensitivity to penicillin and cephalosporin drugs. Long-term or repeated use can lead to the rapid growth of resistant microflora and the development of superinfection. Patients with severe gastrointestinal disorders accompanied by diarrhea and vomiting should not use oral forms of amoxicillin, which is associated with the risk of reduced absorption. Amoxil should be prescribed with caution to patients with allergic diathesis and a history of asthma. Also, caution should be used in patients with viral infections and acute lymphatic leukemia due to the increased risk of erymatous skin rash. Patients with impaired renal function require dose adjustment (see APPLICATION). High concentrations of amoxicillin in the urine may cause sediment to form in the catheter. Therefore, catheters must be flushed regularly. In patients with reduced diuresis taking amoxicillin (mainly parenterally), there is a possibility of developing crystalluria. When taking amoxicillin in high doses, it is recommended to take enough fluids and maintain adequate diuresis to reduce the likelihood of amoxicillin crystal formation. In children, amoxicillin can change the color of tooth enamel, so strict adherence to oral hygiene by the patient is necessary. In the event of the development of anaphylactic shock and other serious allergic reactions, it is necessary to carry out appropriate emergency measures - artificial respiration, intravenous administration of epinephrine, the use of antihistamines, corticosteroids, oxygen therapy, mechanical ventilation. Patients should be under medical supervision. Use during pregnancy and lactation . A teratogenic effect of amoxicillin has not been identified. However, if it is necessary to prescribe the drug during pregnancy, the ratio of the potential risk to the fetus and the expected benefit to the woman should be assessed in advance. Amoxicillin passes into breast milk in small quantities. Use during breastfeeding is possible, however, to prevent possible sensitization of the child, it is recommended to stop breastfeeding. Children. The drug is contraindicated for use in children under 1 year of age. The ability to influence the reaction rate when driving a vehicle or working with other mechanisms. People who drive vehicles or operate other machinery should take the drug with caution due to the risk of developing possible adverse reactions from the nervous system.

Reviews about Amoxicillin

Reviews about Amoxicillin on the Internet are mostly positive. They note that after the start of treatment the effect appears very quickly, the drug is convenient to use for both adults and children, for whom there is a special suspension for children. Also mentioned as a positive is that the medicine can be taken during pregnancy .

When discussing Amoxicillin, doctors' reviews are also positive. But experts always write that self-medication with the drug is unacceptable.

Use of the drug Amoxil

Amoxil is prescribed orally (regardless of food intake). The dosage regimen of the drug is set individually, taking into account the characteristics of the disease. Standard dosage regimen for adults and children over 10 years of age with mild or moderate infections: 500-750 mg 2 times a day, for children aged 3-10 years - 375 mg 2 times a day or 250 mg 3 times per day; at the age of 1–3 years - 250 mg 2 times a day or 125 mg 3 times a day. The daily dose of the drug for children is 30–60 mg/kg body weight, divided into 2–3 doses. For chronic diseases, relapses, and severe diseases, adults are prescribed the drug at 0.75–1 g 3 times a day; children - 60 mg/kg body weight in 2 - 3 doses per day. The maximum daily dose for adults is 6 g. For acute uncomplicated gonorrhea, 3 g of the drug is prescribed per dose in combination with 1 g of probenecid. For the eradication of Helicobacter pylori in stomach or duodenal ulcers, Amoxil is prescribed as part of complex therapy according to approved international regimens: – for 7 days: amoxicillin 1 g 2 times a day + clarithromycin 500 mg 2 times a day + omeprazole 40 mg per day or 2 doses; – for 7 days: amoxicillin 0.75–1 g 2 times a day + metronidazole 400 mg 3 times a day + omeprazole 40 mg in 1 or 2 doses. The maximum daily dose for adults is 6 g.

Children with renal failure (body weight up to 40 kg):

The drug should be continued for 2-3 days after the symptoms of the disease disappear. For mild to moderate infections, the drug is taken for 5–7 days. For infections caused by beta-hemolytic streptococcus, the duration of treatment should be at least 10 days.

Amoxicillin price, where to buy

The price of Amoxicillin in tablets of 500 mg is 30-35 rubles per pack of 10 pcs. The price of Amoxicillin 1000 mg depends on the manufacturer of the drug. The price of Amoxicillin suspension for children is on average 80-90 rubles per 100 ml bottle. You can buy the antibiotic Amoxicillin Clavulanate, which contains clavulanic acid , for a price starting from 250 rubles.

How much tablets cost in Ukraine (in Odessa, Kharkov and other cities) depends on their manufacturer. The cost of the drug is from 45 hryvnia for 10 tablets. Suspension for children can be bought for an average of 130 hryvnia. Amoxicillin ampoules can be purchased for 160 rubles.

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ZdravCity

• Amoxicillin capsules 500 mg 16 pcs. Hemofarm A.D.
  Vršac, production site Dubovac RUR 101.order
• Amoxicillin Sandoz tablets p.p.o. 1g 12 pcs Sandoz GmbH

  RUB 159 order

• Amoxicillin Sandoz tablets p.p.o. 500 mg 12 pcs. Sandoz GmbH

  127 RUR order

• Amoxicillin granules for prig suspension. for internal approx. 250mg/5ml 40gHemofarm A.D. Vršac, Dubovac production site

  108 RUR order

• Amoxicillin express dispersible tablets. 125mg 20pcs JSC "LEKKO"

  103 rub. order

Pharmacy Dialogue

• Amoxicillin Sandoz tablets 1000 mg No. 12Sandoz

  167 RUR order

• Amoxicillin capsules 500 mg No. 16Barnaulsky ZMP

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• Amoxicillin tablets 500 mg No. 20Avva Rus

  104 rub. order

• Amoxicillin tablets 500 mg No. 20Biokhimik OJSC

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• Amoxicillin Sandoz tablets 500 mg No. 12Sandoz

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PaniPharmacy

• Amoxicillin 15% 100ml Ukraine, Olkar
  252 UAH. order

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