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Pensilina

The drug is administered intramuscularly or intravenously (drip, stream).

Standard dosage regimen

The following are the total doses of ampicillin and sulbactam (in a 2:1 ratio).

Adults:

from 1500 mg to 12000 mg per day. For mild infections - 1500-3000 mg/day in 2 doses; for moderate cases - 3000-6000 mg/day in 3-4 administrations; in severe cases - 12,000 mg/day in 3-4 administrations.

For children:

150 mg/kg body weight per day (equivalent to 100 mg/kg/day ampicillin and 50 mg/kg/day sulbactam) every 6-8 hours in accordance with usual practice for the use of ampicillin.

Newborns under 1 week of age (especially premature):

75 mg/kg body weight per day with an interval of 12 hours.

Elderly patients:

usual doses for adults, not adjusted for age.

Use in patients with impaired renal function (creatinine clearance

≤
30 ml/min):
In such patients, Pensilin should be administered less frequently in accordance with the usual practice of using ampicillin, increasing the interval between drug administrations.

Duration of treatment:

The duration of the course of therapy is 5-14 days, but in more severe cases it can be increased or ampicillin may be additionally prescribed. As always with antibiotic therapy, the administration of Pensilina should be continued in patients for at least 48 hours after the temperature has normalized and other pathological symptoms have disappeared.

Dosing in special cases:

Uncomplicated gonorrhea

single intramuscular injection of 1500 mg of Pensilina. In order to increase the duration of the content of sulbactam and ampicillin in plasma, probenecid should be prescribed simultaneously at a dose of 1000 mg orally.

Prevention of postoperative infections,

depending on the degree of infectious risk, 1500-3000 mg of Pensilina is administered during induction of anesthesia. The dose may be repeated every 6 to 8 hours; For most surgical procedures, the drug is usually discontinued 24 hours after surgery, unless administration of the drug for therapeutic purposes is indicated.

Method of preparing solutions

For intramuscular administration

: the contents of the bottle are dissolved as follows:

Contents of the bottle	Solvent (lidocaine hydrochloride solution 0.5%)
375 mg	1.0 ml
750 mg	1.8 ml
1500 mg	3.5 ml

As with other intramuscular injections, Pensilin is injected into a relatively large muscle (the gluteal muscle), and a test aspiration helps avoid inadvertent injection into a blood vessel. The drug diluted with lidocaine cannot be administered intravenously.

For intravenous administration

: for initial dilution, the contents of the bottle are diluted as follows:

Contents of the bottle	Solvent (water for injection)
375 mg	1.0 ml
750 mg	1.8 ml
1500 mg	3.5 ml

Then

- for intravenous infusion

: the solution prepared during the initial dilution, containing a single dose of the drug, is dissolved in 100-200 ml of 0.9% sodium chloride solution or 5-10% glucose solution. Inject at a rate of 60-80 drops per minute.

— for jet injection

: the solution prepared during the initial dilution, containing a single dose of the drug, is dissolved in 10-20 ml of 0.9% sodium chloride solution and administered slowly over 3-5 minutes.

Shake before use.

Ampisid 250mg/5ml 40ml powder for oral solution

Directions for use and doses

Film-coated tablets Powder for the preparation of a suspension for oral administration
For adults and children weighing more than 30 kg, the daily dose is 375-750 mg/day, for children weighing less than 30 kg - 25-50 mg/kg (in depending on the severity of the infection).
Frequency of administration: 2 times/day. The course of treatment is 5-14 days. In the treatment of uncomplicated gonorrhea, sultamicillin can be prescribed as a single dose of 2.25 g (in combination with probenecid). Powder for preparing a solution for intravenous and intramuscular administration
IM, IV (drip at a speed of 60-80 drops/min, stream - slowly, for 3-5 minutes). It is administered intravenously for 5-7 days, then, if it is necessary to continue treatment, they switch to intramuscular use. The following are the total doses of ampicillin and sulbactam (in a 2:1 ratio). For mild infections - 1.5-3 g/day. in 2 injections; for moderate cases - 3-6 g/day. in 3-4 injections; for severe cases - 12 g/day. in 3-4 injections. For uncomplicated gonorrhea - 1.5 g, once. For the prevention of surgical infections - 1.5-3 g, during anesthesia; then within 24 hours after surgery - at the same dose every 6-8 hours. Children - at a daily dose of 150 mg/kg (100 mg/kg ampicillin and 50 mg/kg sulbactam); frequency - 3-4 times/day. For newborns under 1 week of age and premature babies - every 12 hours. The course of treatment is 5-14 days (can be extended if necessary). After normalization of temperature and disappearance of other pathological symptoms, treatment is continued for another 48 hours. For chronic renal failure (creatinine clearance less than 30 ml/min), it is necessary to increase the intervals between injections. A solution for parenteral use is prepared ex tempore. Add 2 or 4 ml of water for injection, 0.5% procaine solution or 0.9% sodium chloride solution to the contents of the bottle. For intramuscular administration, dilution with 0.5% lidocaine solution is acceptable. For intravenous administration, a single dose is dissolved in 0.9% sodium chloride solution or 5% dextrose solution in a volume of 10 to 200 ml.

Indications for use Ampisid 250mg/5ml 40ml powder for solution for oral administration

Bacterial infections of various localizations caused by sensitive pathogens:

- respiratory infections (including pneumonia, lung abscess, chronic bronchitis, pleural empyema); — infections of the ENT organs (including sinusitis, tonsillitis, otitis media); - infections of the urinary tract and genital organs (pyelonephritis, pyelitis, cystitis, urethritis, prostatitis, endometritis); - biliary tract infections (cholecystitis, cholangitis); - infections of the skin and soft tissues (erysipelas, impetigo, secondary infected dermatitis); — gastrointestinal infections (dysentery, salmonellosis, salmonella carriage); - infections of bones and joints; - septic endocarditis; - meningitis; - sepsis; - peritonitis; - scarlet fever; - gonococcal infection; — prevention of postoperative complications during operations on the abdominal and pelvic organs.

Contraindications

Film-coated tablets Powder for oral suspension

Hypersensitivity to penicillins.
Powder for preparing a solution for intravenous and intramuscular administration
- hypersensitivity; - Infectious mononucleosis; - lactation period. With caution: liver and/or kidney failure, pregnancy.

Application of Ampisid 250 mg/5 ml 40 ml powder for the preparation of solution for oral administration during pregnancy and lactation

Film-coated tablets Powder for oral suspension

The safety of sultamicillin during pregnancy and lactation has not been established.

Powder for the preparation of a solution for intravenous and intramuscular administration

With caution during pregnancy. Contraindicated during lactation.

Duotsid (Ampisid) tablets 375 mg No. 10 - Instructions

Dosage form

Tablets, 10 pieces per pack.

Compound

Active substance: 520.80 mg sultamicillin tosylate, equivalent to 375 mg sultamicillin (375 mg). Sultamicillin is equivalent to 147 mg sulbactam and 220 mg ampicillin.

Excipients: lactose anhydrous, dried corn starch, sodium starch, glycolate, hydroxypropyl cellulose, magnesium stearate, pure water, polyethylene glycol 6000 (macrogol), hydroxypropyl methylcellulose, titanium dioxide (E171), talc.

pharmachologic effect

Combined broad-spectrum antibacterial agent.

Ampicillin is an antibiotic from the group of semisynthetic penicillins, the bactericidal effect of which is associated with inhibition of the synthesis of proteins in the cell wall of microorganisms.

Sulbactam is an irreversible beta-lactamase inhibitor; expands the spectrum of ampicillin activity against resistant strains, the resistance of which develops under the influence of beta-lactamases; does not change the activity of ampicillin against sensitive strains; binding to certain penicillin-binding proteins of bacteria, it exhibits synergism when used simultaneously with beta-lactam antibiotics. It is stable in aqueous solution, has independent antibacterial activity against the Neisseriaceae family and Acinetobacter spp., and is resistant to the action of most plasmid beta-lactamases.

The combination of ampicillin + sulbactam is active against aerobic gram-positive bacteria - Staphylococcus aureus (strains producing and not producing beta-lactamase), Staphylococcus epidermidis (strains producing and not producing beta-lactamase), Staphylococcus saprophyticus (strains producing and not producing beta-lactamase) , Streptococcus pyogenes, Streptococcus pneumoniae (including strains resistant to penicillin), Streptococcus spp. viridans, Enterococcus faecalis, Listeria monocytogenes groups; aerobic gram-negative bacteria - Escherichia coli, Proteus mirabilis, Proteus vulgaris, Klebsiella spp., Neisseria gonorrhoeae (strains producing and not producing beta-lactamase), Moraxella catarrhalis (strains producing and not producing beta-lactamase), Morganella morganii, Haemophilus influenzae (in including strains resistant to ampicillin), Providencia rettgeri, Providencia stuartii; anaerobic microorganisms - Bacteroides spp., including Bacteroides fragilis, Clostridium spp. (except Clostridium difficile), Peptococcus spp., Peptostreptococcus spp.

Pharmacokinetics

Suction

In humans, sultamicillin is hydrolyzed during absorption following oral administration and provides a 1:1 molar ratio of sulbactam to ampicillin into the systemic circulation. The bioavailability of an oral dose is 80% of the same intravenous dose of sulbactam and ampicillin. After oral administration, it does not affect the systemic bioavailability of sultamicillin. Peak serum ampicillin levels following sultamicillin administration are approximately twice the equivalent dose of oral ampicillin.

Distribution

Sulbactam is bound to plasma proteins by 38% and ampicillin by 15-25%. Distributed in bile, vesicles and tissue fluids of the body. Ampicillin penetrates well into the cerebrospinal fluid only in the presence of inflammation in the meninges (at levels exceeding the MIC).

Removal

The half-lives of sulbactam and ampicillin in healthy volunteers are approximately 0.75 and 1 hour, respectively. 50-75% of ampicillin and sulbactam are excreted unchanged from the body.

Indications for the drug Duocid

Treatment of infectious and inflammatory diseases caused by sensitive pathogens: respiratory infections (including pneumonia, lung abscess, chronic bronchitis, pleural empyema); infections of the ENT organs (including sinusitis, tonsillitis, otitis media); infections of the urinary tract and genital organs (pyelonephritis, pyelitis, cystitis, urethritis, prostatitis, endometritis); biliary tract infections (cholecystitis, cholangitis); infections of the skin and soft tissues (erysipelas, impetigo, secondary infected dermatitis); gastrointestinal infections (dysentery, salmonellosis, salmonella carriage); bone and joint infections; septic endocarditis; meningitis; sepsis; peritonitis; scarlet fever; gonococcal infection.

Dosage regimen

Inside. For adults and children weighing more than 30 kg, the drug is prescribed at 375 - 750 mg per day. Children weighing less than 30 kg are prescribed 25 - 50 mg per kg of patient body weight per day (depending on the severity of the infection). The daily dose is given in two doses. The course of treatment ranges from 5 to 14 days. In the treatment of uncomplicated gonorrhea, sultamicillin can be prescribed as a single dose of 2250 mg (6 tablets), (preferably in combination with 1000 mg probenecid). For children, it is preferable to prescribe the drug in the form of a suspension.

Contraindications

Hypersensitivity, liver failure, history of allergic reactions to penicillins, infectious mononucleosis.

Side effect

Other: with long-term treatment - superinfection caused by drug-resistant microorganisms (candidiasis).

From the digestive system: nausea, vomiting, loss of appetite, diarrhea, increased activity of “liver” transaminases; rarely - pseudomembranous enterocolitis.

From the hematopoietic organs and hemostasis system: anemia, leukopenia, thrombocytopenia.

From the nervous system: drowsiness, malaise, headache.

Laboratory indicators: azotemia, increased urea concentration, hypercreatininemia.

Allergic reactions: urticaria, skin hyperemia, angioedema, rhinitis, conjunctivitis, fever, arthralgia, eosinophilia, and in rare cases, anaphylactic shock.

Use during pregnancy and breastfeeding

Use with caution during pregnancy. Contraindicated for use during lactation (breastfeeding).

Use for liver dysfunction

Caution: liver failure.

Use for renal impairment

Caution: renal failure.

Use in children

Application is possible according to the dosage regimen.

special instructions

In patients who are hypersensitive to penicillins, cross-allergic reactions with cephalosporin antibiotics are possible.

During a course of treatment, it is necessary to monitor the state of the function of the hematopoietic organs, liver and kidneys.

Superinfection may develop due to the growth of microflora insensitive to the drug, which requires a corresponding change in antibacterial therapy.

When treating patients with sepsis, the development of a bacteriolysis reaction (Jarisch-Herxheimer reaction) is possible.

Drug interactions

Antacids, glucosamine, laxatives, food, aminoglycosides (when taken orally) slow down and reduce absorption.

Ascorbic acid increases absorption.

Bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, vancomycin, rifampicin) - synergistic action; bacteriostatic drugs (macrolides, chloramphenicol, lincosamides, tetracyclines, sulfonamides) - antagonism of action.

Increases the effectiveness of indirect anticoagulants (suppressing intestinal microflora, reduces the synthesis of vitamin K and the prothrombin index); reduces the effectiveness of oral contraceptives, drugs whose metabolism produces PABA, and ethinyl estradiol (the risk of breakthrough bleeding).

Diuretics, allopurinol, phenylbutazone, NSAIDs and other drugs that reduce tubular secretion increase the concentration of ampicillin in plasma.

Allopurinol increases the risk of developing skin rashes.

Pharmaceutical incompatibility

With blood products or protein hydrolysates, aminoglycosides.

Best before date

2 years.

Do not use the drug after the expiration date.

Storage conditions

At a temperature not exceeding 25°C, in a dry place, protected from light.

Keep out of the reach of children.

Conditions for dispensing from pharmacies

On prescription.