Flemoklav Solutab: instructions for use, price, reviews. Dosage for children

Compound

Flemoklav Solutab tablets can be produced in four different dosages, including 31.25 mg + 125 mg / 62.5 mg + 250 mg / 125 mg + 500 mg / 125 mg + 875 mg of active ingredients clavulanic acid ( potassium clavulanate ) and amoxicillin ( amoxicillin trihydrate ).
Excipients are: dispersed cellulose, MCC, vanillin, crospovidone, tangerine flavor, lemon flavor, saccharin, magnesium stearate.

Reviews about Amoxiclav

In the process of discussing the drug Amoxiclav, reviews from doctors and patients are predominantly positive. It is noted that the antibiotic is effective in the treatment of respiratory tract diseases, and it is suitable for both adults and children. Reviews mention the effectiveness of the product for sinusitis, otitis media, and genital tract infections. As a rule, adult patients take 875 mg + 125 mg tablets; if the dosage is correct, relief occurs quickly. Reviews note that after a course of antibiotic treatment, it is advisable to take drugs that restore normal microflora .

Reviews of the Amoxiclav suspension are also positive. Parents write that it is convenient to give the product to children, as it has a pleasant taste and is normally perceived by children.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Flemoklav Solutab is an antibiotic with a fairly wide spectrum of action, contains clavulanic acid and amoxicillin .

The drug is active against gram-negative and gram-positive bacteria (including species that synthesize beta-lactamases), inhibits the synthesis of peptidoglycan (an element of the cell wall of microorganisms).

Clavulanic acid inhibits types 5, 4, 3 and 2 beta-lactamases and is inactive against type 1 beta-lactamases synthesized by Enterobacter spp., Pseudomonas aeruginosa, Acinetobacter spp. Forms a complex with proteins and prevents enzymatic denaturation of amoxicillin under the influence of beta-lactamases, thus expanding the spectrum of action of Flemoclav Solutab.

Microorganisms sensitive to amoxicillin in vitro:

gram-positive aerobic bacteria: Enterococcus faecalis, Nocardia asteroids, Bacillus anthracis, Gardnerella vaginalis, Streptococcus pneumoniae, Listeria monocytogenes, Streptococcus pyogenes and some other beta-hemolytic strains of Streptococcus, methylene-sensitive strains of Staphylococcus saprophyticus, Staphylococcus aureus, coagulase-negative bacteria phylococci;
gram-negative aerobic bacteria: Haemophilus influenza, Bordetella pertussis, Helicobacter pylori, Haemophilus parainfluenzae, Asteurella multocida, Moraxella catarrhalis, PVibrio cholera;
gram-positive anaerobic bacteria - some species of Clostridium, Peptostreptococcus micros, Peptostreptococcus magnus, Peptococcus niger, some species of Peptostreptococcus;
gram-negative anaerobic bacteria: some species of Bacteroides, Capnocytophaga, Eikenella corrodens, Fusobacterium, Porphyromonas, Prevotella;
others: Leptospirosa ictterohaemorrhagiae, Treponema pallidum.

Strains in which resistance may develop:

gram-negative aerobic bacteria: Klesiella pneumonia, Escherichia coli, Klebsiella spp., Proteus vulgaris, Proteus mirabilis, Proteus spp., Salmonella spp., Shigella spp.;
gram-positive aerobic bacteria: Enterococcus faecium, Corynebacterium species.

Resistant microorganisms:

gram-negative aerobic bacteria: Citrobacter freundii, Acinetobacter spp., Enterobacter spp., Providencia spp., Serratia spp., Pseudomonas spp., Hafnia alvei, Morganella morganii, Legionella pneumophila, Stenotrophomas maltophilia;
others: Chlamydia species, Coxiella burnetti, Mycoplasma species.

Pharmacokinetics

After penetration of the drug at a dosage of 875/125 mg (amoxicillin/clavulanic acid) into the intestine, the concentration of amoxicillin in the blood reaches its maximum value after 90 minutes, clavulanic acid - after 60 minutes.

The bioavailability of amoxicillin when taken orally is about 90%, the absorption of clavulanic acid reaches 60%.

Approximately 20% of amoxicillin and 21% of clavulanic acid form bonds with blood proteins. The half-life of amoxicillin is 1 hour, clavulanic acid is 50 minutes. Approximately 70% of amoxicillin and 40% of clavulanic acid are excreted by the kidneys in the first 5.5 hours.

Therapeutic concentrations of both substances can be achieved in the gall bladder, abdominal cavity, muscle tissue, skin, bile, peritoneal and synovial fluids, and pus.

Pharmacokinetics

Tablets 125 mg + 31.25 mg; 250 mg + 62.5 mg; 500 mg + 125 mg

Amoxicillin. The absolute bioavailability of amoxicillin reaches 94%. Absorption is independent of food intake. Cmax in plasma is observed 1–2 hours after taking amoxicillin. After taking a single dose of 500 mg + 125 mg (amoxicillin + clavulanic acid), the average concentration of amoxicillin (after 8 hours) is 0.3 mg/l. Serum protein binding is approximately 17–20%. Amoxicillin penetrates the placental barrier and, in small quantities, into breast milk.

Amoxicillin is metabolized in the liver (10% of the administered dose). Mostly excreted through the kidneys (52±15)% of the dose (unchanged within 7 hours) and in small quantities with bile. T1/2 from blood serum in patients with normal renal function is approximately 1 hour (0.9–1.2 hours), in patients with creatinine Cl in the range of 10–30 ml/min it is 6 hours, and in the case of anuria it fluctuates in between 10 and 15 hours. It is excreted during hemodialysis.

Clavulanic acid. The absolute bioavailability of clavulanic acid is approximately 60%. Absorption is independent of food intake. Cmax of clavulanic acid in the blood is observed 1–2 hours after administration. After taking amoxicillin with clavulanic acid in a single dose of 500 mg + 125 mg, the average Cmax of clavulanic acid (0.08 mg/l) is achieved after 8 hours. Plasma protein binding is 22%. Clavulanic acid penetrates the placental barrier. There is no reliable data on penetration into breast milk.

Clavulanate is metabolized in the liver (50–70%) and about 40% is excreted through the kidneys (18–38% unchanged). Total Cl is approximately 260 ml/min. T1/2 in patients with normal renal function is approximately 1 hour, in patients with creatinine Cl 20-70 ml/min - 2.6 hours, and with anuria - within 3-4 hours. It is eliminated by hemodialysis.

Tablets 875 mg + 125 mg

After a single dose of Flemoklav Solutab® at a dose of 875 mg + 125 mg (amoxicillin + clavulanic acid), the Cmax of amoxicillin in the blood plasma is created after 1.5 hours and is 12 μg/ml, clavulanic acid - after 1 hour, amounting to 3 μg/ml. The AUC of amoxicillin and clavulanic acid is 33 mcg h/l and 6 mcg h/l, respectively. Absorption of amoxicillin when administered orally reaches 90%, the absolute bioavailability of clavulanic acid averages 60%.

Approximately 17–20% of amoxicillin and 22% of clavulanic acid are bound to plasma proteins. The total Cl for the two active substances is 25 l/h, T1/2 amoxicillin - 1.1 hours, clavulanic acid - 0.9 hours. Approximately 60-80% of amoxicillin and 30-50% of clavulanic acid are excreted through the kidneys during the first 6 hours after taking the drug. Amoxicillin is excreted predominantly unchanged, a small part is metabolized by hydrolysis of the beta-lactam ring to inactive metabolites (the main ones are penicillic and penamaldic acids). Clavulanic acid undergoes extensive metabolism through hydrolysis and subsequent decarboxylation.

Indications for use

Inflammatory infectious diseases caused by microorganisms sensitive to Flemoclav:

infections of the ENT organs and respiratory tract ( COPD , exacerbation of chronic bronchitis , otitis media , tonsillitis , pharyngitis , sinusitis , community-acquired pneumonia );
gynecological infections;
infections of joints and bones, including osteomyelitis ;
soft tissue and skin infections;
infections of the genitourinary system ( cystitis , pyelonephritis ).

Nosological classification (ICD-10)

H66.9 Otitis media, unspecified
J01 Acute sinusitis
J02.9 Acute pharyngitis, unspecified
J03.9 Acute tonsillitis, unspecified (angina agranulocytic)
J04 Acute laryngitis and tracheitis
J06 Acute upper respiratory tract infections of multiple and unspecified localization
J15.9 Bacterial pneumonia, unspecified
J31.2 Chronic pharyngitis
J32.9 Chronic sinusitis, unspecified
J35.0 Chronic tonsillitis
J42 Chronic bronchitis, unspecified
L00-L08 Infections of the skin and subcutaneous tissue
N15.9 Tubulointerstitial kidney disease, unspecified

Contraindications

severe liver damage after taking the drug in the past;
lymphocytic leukemia;
Infectious mononucleosis;
renal failure (filtration below 30 ml per minute) - for tablets 875/125 mg;
age less than 12 years and weight up to 40 kg - for tablets 875/125 mg;
hypersensitivity to the components of the drug and any beta-lactam antibiotics ( cephalosporins and penicillins ).

Use the drug with caution in severe forms of liver and kidney failure, and diseases of the digestive system.

How it affects the body

"Flemoclav Solutab" kills pathogenic bacteria and prevents the synthesis of their cell wall. The medicine helps to successfully fight bacterial infections thanks to its main components. Clavulanic acid inhibits the activity of beta-lactamase types II, III, IV and V (an enzyme that causes bacterial resistance to antibiotics), but is powerless against type I. In addition, clavulanic acid destroys germs and stimulates the body's immune system to protect against harmful bacteria. It effectively fights chlamydia, legionella, streptococci, staphylococci, and gonococci. It is slightly less active against various enterobacteria, as well as Pseudomonas aeruginosa and Haemophilus influenzae. Clavulanic acid is capable of breaking down the walls of gram-positive and gram-negative bacteria.

Amoxicillin is an antibiotic that can destroy various bacteria. It belongs to the group of penicillins, which are beta-lactam antibiotics, and treats all kinds of bacterial diseases.

The medicine affects many bacteria only during experiments, outside a living organism, in vitro.

The drug is quickly absorbed into the gastrointestinal tract. It can be taken every 8 or 12 hours. Its effectiveness is not reduced even if the tablet is taken with food.

Side effects

From the nervous system: in less than 0.001% - headache, convulsions (in case of drug overdose); less than 0.0001% have restlessness, hyperactivity, impaired consciousness, insomnia, anxiety, aggressive behavior.
From the hematopoietic system: hemolytic anemia , thrombocytosis ; in less than 0.0001% - granulocytopenia , leukopenia , thrombocytopenia , pancytopenia , increased clotting time.
From the digestive system: less than 0.1% - nausea, abdominal pain, diarrhea , vomiting , pseudomembranous colitis ; less than 0.001% have hemorrhagic colitis , intestinal candidiasis , discoloration of tooth enamel.
From the side of blood vessels: less than 0.001% have vasculitis .
From the liver: in less than 0.1% - increased transaminase activity; less than 0.001% have jaundice and hepatitis .
From the genitourinary tract: less than 0.01% - burning, itching and vaginal discharge; less than 0.001% have nephritis .
Allergic reactions: less than 0.1% - urticaria , itching; less than 0.001% - dermatitis , anaphylactic shock , Quincke's edema , serum sickness .
Other: less than 0.01% have superinfection of bacterial or fungal origin (with frequent and long-term treatment with the drug).

Instructions for Flemoclav Solutab

Instructions for use Flemoklav Solutab recommends that adults, children under 12 years of age and children under twelve years of age weighing more than 40 kilograms take this antibiotic at a dose of 875+125 mg (total dose of active ingredients - 1000 mg) twice a day (for chronic, severe, for recurrent infectious diseases, double the dose).

Children under 12 years of age and weighing less than 40 kilograms are prescribed the drug in weaker dosages (Flemoklav 250 mg + 62.5 mg and Flemoklav 500 mg + 125 mg).

For adults and children weighing over 40 kilograms, Flemoclav Solutab 500 mg + 125 mg three times a day is recommended.

The daily dose for children under 12 years of age and weighing up to 40 kilograms is 5 mg of clavulanic acid and 25 mg of amoxicillin per kilogram of weight.

In severe infectious and inflammatory diseases, these doses can be doubled, but it is prohibited to exceed the dose of 60 mg of amoxicillin and 15 mg of clavulanic acid per kilogram of body weight per day.

The duration of treatment with the drug should not exceed two weeks.

In patients with concomitant renal failure, Flemoclav Solutab 875 mg/125 mg can be used if the renal filtration rate is more than 30 ml per minute.

To reduce the risk of side effects from the digestive system, it is recommended to take the drug immediately before meals. The tablet must be swallowed whole with water, or dissolved in 50 ml of water, stirring completely before use.

Flemoclav solutab 125mg+31.25mg 20 pcs. dispersible tablets

pharmachologic effect

Broad spectrum antibacterial.

Composition and release form Flemoklav solutab 125 mg + 31.25 mg 20 pcs. dispersible tablets

Tablets - 1 tablet:

Active ingredients: amoxicillin (in the form of amoxicillin trihydrate) - 125 mg; clavulanic acid (in the form of potassium clavulanate) - 31.25 mg;
Excipients: MCC, crospovidone, vanillin, apricot flavor, saccharin, magnesium stearate.

There are 4 pcs in a blister; There are 5 blisters in a cardboard pack.

Description of the dosage form

Tablets of oblong shape from white to yellow with brown dotted spots, without marks, marked “421” and a graphic part of the company logo.

Characteristic

A combination drug containing semisynthetic penicillin and a beta-lactamase inhibitor.

Directions for use and doses

Orally, at the beginning of a meal (to prevent dyspeptic symptoms), without chewing, with a glass of water or dissolving the tablet in half a glass of water (at least 30 ml), stirring thoroughly before use.

The duration of treatment depends on the severity of the infection and should not exceed 14 days unless absolutely necessary.

For adults and children over 12 years of age, as well as children under 12 years of age weighing more than 40 kg, the drug is prescribed at 500 mg + 125 mg 3 times a day or 875 mg + 125 mg 2 times a day. A single dose is taken at regular intervals. For severe, recurrent and chronic infections, these doses can be doubled.

Children under 12 years of age weighing up to 40 kg are prescribed Flemoclav Solutab® with lower dosages: 125 mg + 31.25 mg; 250 mg + 62.5 mg; 500 mg + 125 mg.

For children aged 2 to 12 years (body weight approximately 13–37 kg), the daily dose is 20–30 mg/kg amoxicillin and 5–7.5 mg/kg clavulanic acid. This usually amounts to: for children 2–7 years old (body weight about 13–25 kg) - 125 mg + 31.25 mg 3 times a day; for children 7–12 years old (body weight 25–37 kg) - 250 mg + 62.5 mg 3 times a day. For severe infections, these doses can be doubled (maximum daily dose - 60 mg/kg amoxicillin and 15 mg/kg clavulanic acid).

In patients with renal failure, the excretion of clavulanic acid and amoxicillin through the kidneys is slow. Flemoclav Solutab® at a dose of 875 mg + 125 mg can only be used if the glomerular filtration rate is >30 ml/min. In this case, no dose adjustment is required.

Depending on the severity of renal failure, the total dose of Flemoclav Solutab® (in doses of 125 mg + 31.25 mg, 250 mg + 62.5 mg, 500 mg + 125 mg), expressed as a dose of amoxicillin, should not exceed the dosages presented in the table:

Glomerular filtration rate, ml/min	Adults	Children
10–30	500 mg 2 times a day	15 mg/kg 2 times a day
500 mg per day	15 mg/kg per day
Hemodialysis	500 mg daily and 500 mg during and after dialysis	15 mg/kg per day and 15 mg/kg during and after dialysis

Amoxicillin with clavulanic acid should be administered with caution to patients with liver damage. Liver function should be constantly monitored.

Pharmacodynamics

It has a bactericidal effect and inhibits the synthesis of the bacterial wall. Active against gram-positive and gram-negative microorganisms (including strains producing beta-lactamases). Clavulanic acid, which is part of the drug, suppresses types II, III, IV and V beta-lactamases, and is inactive against type I beta-lactamases produced by Enterobacter spp., Pseudomonas aeruginosa, Serratia spp., Acinetobacter spp. Clavulanic acid has a high tropism for penicillinases, due to which it forms a stable complex with the enzyme, which prevents the enzymatic degradation of amoxicillin under the influence of beta-lactamases and expands its spectrum of action.

Flemoklav is active in relation to:

aerobic gram-positive bacteria Streptococcus pyogenes, Streptococcus viridans, Streptococcus pneumoniae, Staphylococcus aureus (including strains producing beta-lactamases), Staphylococcus epidermidis (including strains producing beta-lactamases) Enterococcus faecalis, Corynebacterium spp., Bacillus anthracis, Listeria monocytogenes;
anaerobic gram-positive bacteria Clostridium spp., Peptococcus spp., Peptostreptococcus spp.
aerobic gram-negative bacteria Escherichia coli, Klebsiella spp., Proteus mirabilis, Proteus vulgaris, Yersinia enterocolitica, Salmonella spp., Shigella spp., Haemophilus influenzae, Haemophilus duсreyi, Neisseria gonorrhoeae (including strains of the above bacteria that produce beta-lactamases), Neisseria meningitidis, Bordetella pertussis, Gardnerella vaginalis, Brucella spp., Branhamella catarrhalis, Pasteurella multocida, Campylobacter jejuni, Vibrio cholerae, Moraxella catarrhalis, Helicobacter pylori;
anaerobic gram-negative bacteria Bacteroides spp., including Bacteroides fragilis (including strains that produce beta-lactamases).

Pharmacokinetics

Indications for use Flemoklav solutab 125 mg + 31.25 mg 20 pcs. dispersible tablets

Infectious and inflammatory diseases caused by microorganisms sensitive to the drug:

diseases of the upper respiratory tract and ENT organs (including otitis media, sinusitis, tonsillitis, pharyngitis);
lower respiratory tract (including exacerbation of chronic bronchitis, COPD, community-acquired pneumonia);
skin and soft tissue infections;
urinary system (including cystitis, pyelonephritis).

Contraindications

hypersensitivity to amoxicillin, clavulanic acid and other components of the drug;
hypersensitivity to other beta-lactam antibiotics (penicillins and cephalosporins);
a history of jaundice or liver dysfunction when taking amoxicillin + clavulanic acid;
Infectious mononucleosis;
lymphocytic leukemia

Carefully:

severe liver failure;
gastrointestinal diseases (including a history of colitis associated with the use of penicillins);
chronic renal failure.

Application Flemoklav solutab 125 mg + 31.25 mg 20 pcs. dispersible tablets during pregnancy and breastfeeding

There were no adverse effects of amoxicillin/clavulanate on the fetus or newborns when used by pregnant women. Use in the second and third trimesters of pregnancy is possible after a medical assessment of the risks/benefits of treatment. In the first trimester, the use of the drug should be avoided.

Both components of the drug penetrate the hematoplacental barrier and are excreted into breast milk. It is possible to use the drug during breastfeeding.

If a child develops sensitization, diarrhea or candidiasis of the mucous membranes, breastfeeding should be stopped.

special instructions

If anaphylactic reactions occur, treatment should be stopped immediately and replaced with another appropriate therapy.

To recover from a state of anaphylactic shock, urgent administration of adrenaline, corticosteroids and elimination of respiratory failure may be required.

There is a possibility of cross-resistance and hypersensitivity to other penicillins or cephalosporins. As with the use of other broad-spectrum penicillins, superinfections of fungal or bacterial origin (in particular candidiasis) may occur, especially in patients with chronic diseases and/or impaired immune system function. If superinfection occurs, the drug is discontinued and/or appropriate therapy is selected.

For patients with severe gastrointestinal disorders accompanied by vomiting and/or diarrhea, the administration of Flemoclav Solutab® is not advisable until the above symptoms are eliminated, because Possible disruption of drug absorption from the gastrointestinal tract.

The appearance of severe and persistent diarrhea may be associated with the development of pseudomembranous colitis, in which case the drug is discontinued and the necessary treatment is prescribed. In case of development of hemorrhagic colitis, immediate discontinuation of the drug and corrective therapy are also necessary. The use of drugs that weaken intestinal motility is contraindicated in these cases.

In a single study, prophylactic amoxicillin/clavulanate in women with premature rupture of membranes increased the risk of neonatal necrotizing enterocolitis.

Flemoclav Solutab® at a dose of 875 mg + 125 mg can be prescribed only if the glomerular filtration rate is >30 ml/min.

Due to the high concentration of amoxicillin in the urine, it can be deposited on the walls of the urinary catheter, so such patients require periodic catheter changes. Forced diuresis accelerates the elimination of amoxicillin and reduces its plasma concentration.

If seizures occur during therapy, the drug is discontinued. One dispersible tablet Flemoclav Solutab® 875 mg + 125 mg contains 25 mg of potassium.

In patients with impaired renal function, the dose must be adjusted based on the severity of the condition.

In patients with impaired liver function, the amoxicillin/clavulanic acid combination should be administered with caution and under constant medical supervision. Flemoklav Solutab® should not be used for more than 14 days without assessing liver function.

Amoxicillin/clavulanic acid should be administered with caution to patients receiving anticoagulant therapy.

Non-enzymatic methods for determining urine sugar, as well as the urobilinogen test, can give false positive results.

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

Overdose

Symptoms: nausea, vomiting and diarrhea with possible disturbance of water and electrolyte balance.

Treatment: administration of activated carbon. Maintaining water and electrolyte balance. Symptomatic therapy. For convulsions, diazepam is prescribed. In case of severe renal failure - hemodialysis.

Side effects Flemoklav solutab 125 mg + 31.25 mg 20 pcs. dispersible tablets

Allergic skin reactions: urticaria, exanthema; erythematous rashes, rarely - exudative erythema multiforme, extremely rarely - exfoliative dermatitis, malignant exudative erythema (Stevens-Johnson syndrome), erythema multiforme. Reactions depend on the dose of the drug and the patient's condition.

From the gastrointestinal tract: nausea, vomiting, diarrhea, abdominal pain; impaired liver function, increased activity of liver transaminases, in isolated cases - pseudomembranous colitis.

An increase in the activity of transaminases (AST and ALT), bilirubin and alkaline phosphatase is usually observed in males and elderly patients, especially over 65 years of age. These phenomena are very rarely observed in children. The above changes usually appear during treatment or immediately after. Sometimes they may appear several weeks after stopping the drug. Basically, reactions from the digestive system are transient and minor, but sometimes they are pronounced. To prevent side effects, it is recommended to take the drug at the beginning of a meal. The risk of such changes increases when taking the drug for more than 14 days.

From the blood and lymphatic system: rarely - changes in the composition of the blood (leukopenia, thrombocytopenia, hemolytic anemia); prolongation of prothrombin time (reversible).

From the hepatobiliary system: rarely - cholestatic jaundice, hepatitis.

From the immune system: rarely - angioedema, vasculitis.

From the urinary system: interstitial nephritis.

Other: candidiasis, development of superinfection. In isolated cases - anaphylactic shock.

Drug interactions

Antacids, glucosamine, laxatives, aminoglycosides slow down and reduce absorption; ascorbic acid - increases.

Bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, vancomycin, rifampicin) have a synergistic effect; bacteriostatic antimicrobial agents (macrolides, chloramphenicol, lincosamides, tetracyclines, sulfonamides) - antagonistic.

Increases the effectiveness of indirect anticoagulants (suppresses intestinal microflora, reduces the synthesis of vitamin K and the prothrombin index). When taking anticoagulants simultaneously, it is necessary to monitor blood clotting indicators.

Reduces the effectiveness of oral contraceptives, drugs, during the metabolism of which para-aminobenzoic acid, ethinyl estradiol are formed (risk of breakthrough bleeding).

Diuretics, allopurinol, phenylbutazone, NSAIDs and other drugs that block tubular secretion increase the concentration of amoxicillin (clavulanic acid is excreted mainly by glomerular filtration). Allopurinol increases the risk of developing skin rashes.

Amoxicillin should not be given with disulfiram.

The simultaneous use of amoxicillin and digoxin may lead to an increase in the concentration of digoxin in the blood plasma.

Tablets 875 mg + 125 mg

Other antimicrobial drugs. When used together with some bacteriostatic drugs (for example, chloramphenicol, sulfonamides, etc.), antagonism with amoxicillin/clavulanic acid was observed in vitro.

Disulfiram. Amoxicillin/clavulanic acid should not be used concomitantly with disulfiram.

Medicines that inhibit the renal excretion of amoxicillin. Simultaneous administration of probenecid, phenylbutazone, oxyphenbutazone and, to a lesser extent, acetylsalicylic acid, indomethacin and sulfinpyrazone helps to increase the concentration and longer presence of amoxicillin in the blood plasma and bile. The excretion of clavulanic acid is not impaired.

Antacids, glucosamine, laxatives, aminoglycosides slow down and reduce absorption; ascorbic acid increases the absorption of amoxicillin.

Allopurinol. Prescription of allopurinol and amoxicillin may increase the risk of developing skin rash.

Sulfasalazine. Aminopenicillins may decrease serum concentrations of sulfasalazine.

Methotrexate. Amoxicillin reduces the renal clearance of methotrexate, which may lead to an increased risk of toxicity. When taken concomitantly with amoxicillin, monitoring of the concentration of methotrexate in the blood serum is necessary.

Digoxin. While taking amoxicillin/clavulanic acid, digoxin absorption may be increased.

Anticoagulants. When taken simultaneously with indirect anticoagulants, the risk of bleeding may increase.

Hormonal contraceptives. In rare cases, while taking amoxicillin, a decrease in the effectiveness of oral contraceptives has been observed, so patients should be advised to use non-hormonal methods of contraception.

Overdose

The effects of overdose are usually limited to intestinal symptoms such as nausea and diarrhea .

Less commonly, when using large doses of the drug, convulsions , coma , hemolysis , and renal failure .

Treatment of overdose

Taking activated carbon and osmodiuretics. Maintaining water and mineral balance. Treat seizures with Diazepam . In case of severe renal impairment, hemodialysis is necessary. Otherwise, treatment is symptomatic.

Interaction

Other antibiotics

Flemoklav Solutab should not be used together with bacteriostatic drugs, chemotherapy, Disulfiram , antibiotics ( chloramphenicol , macrolides, Tetracycline , sulfonamides).

Drugs that inhibit the excretion of amoxicillin by the kidneys

Concomitant use with Phenylbutazone , probenecid , oxyphenbutazone , Indomethacin , Acetylsalicylic acid and sulfinpyrazone may cause an increase in the concentration of amoxicillin in the blood and bile. The excretion of clavulanic acid in such cases does not change.

Allopurinol

Use with amoxicillin increases the risk of skin rash.

Methotrexate

Taking amoxicillin reduces the excretion of Methotrexate , so toxic effects may occur. It is necessary to monitor the level of the latter in the blood.

Digoxin

Flemoklav Solutab increases the absorption of Digoxin in the intestine.

Anticoagulants

Combining the drug with indirect anticoagulants may increase the risk of bleeding.

Hormonal contraceptives

Amoxicillin in rare cases may inhibit the effects of oral contraceptives.

special instructions

Before starting treatment with Flemoklav Solutab, it is necessary to exclude the presence in the past of allergic reactions to cephalosporins , penicillins or components of the drug.

infectious mononucleosis is suspected , as cases of morbilliform rashes have been reported with the use of amoxicillin in this situation.

Persons with severe forms of allergies and a history of bronchial asthma

There is a possibility of cross-resistance and allergic reactions with other cephalosporins or penicillins.

Long-term use of the drug causes the appearance and growth of microflora resistant to Flemoclav Solutab, as well as fungal or bacterial superinfections.

Use with caution in persons with liver disease, there is a risk of jaundice.

Due to the high content of amoxicillin in the urine, it may settle on the walls of the urethral catheter, so it is necessary to regularly change the catheter.

The occurrence at the beginning of therapy of generalized erythema , accompanied by fever and pustular rash, may be a sign of acute exanthematous pustulosis . In this case, you must stop taking the drug.

If seizures , treatment with the drug is discontinued.

It should be remembered that one tablet of Flemoklav Solutab 875/125 mg contains 0.025 g of potassium.

Use during pregnancy and breastfeeding

Both components of the drug penetrate the hematoplacental barrier and are excreted into breast milk. It is possible to use the drug during breastfeeding.

If a child develops sensitization, diarrhea or candidiasis of the mucous membranes, breastfeeding should be stopped.

Analogues of Flemoklav Solutab

Level 4 ATX code matches:
Arlet

Ecoclave

Panclave

Amoxiclav

Oxamp-Sodium

Oxamp

Amoxicillin + Clavulanic acid

Augmentin

Ampisid

Amoxil K 625

Sultasin

The price of the analogues listed below is often more attractive to patients:

Amoxiclav
Augmentin
Ecoclave
Klamosar
Amoxivan
Arlet
Rapiklav
Bactoclav
Klavam
Honeyclave
Panclave
Rekut
Trifamox IBL

What is the difference between Flemoxin Solutab and Flemoklav Solutab?

Patients often ask questions: what is the difference Flemoxin and Flemoklav? It is not difficult to understand the difference: Flemoklav, unlike Flemoxin, contains clavulonic acid, which prevents the destruction of antibiotic molecules by bacterial enzymes, which has a better effect on many indicators characterizing the effectiveness of the drug.

Which is better: Amoxiclav or Flemoklav Solutab?

The difference between Amoxiclav and Flemoklav is only in the variety of dosages produced; the latter has more, which allows better control over the dose used and reduces the number of side effects. The price category of both drugs is comparable.

Price Flemoklav Solutab

In Russia, the price of Flemoklav 1000 mg (875/125 mg) is close to 500 rubles. The price of 250 mg (250 mg + 62.5 mg) of the drug is about 300 rubles.

Online pharmacies in RussiaRussia
Online pharmacies in UkraineUkraine
Online pharmacies in KazakhstanKazakhstan

Pharmacy Dialogue

Flemoclav Solutab tablets 250 mg + 62.5 No. 20Astellas Pharma
RUB 285 order

Pharmacy24

Flemoclav Solutab 125 mg/31.25 mg No. 20 tablets Astellas Pharma Europe B.V., Netherlands
85 UAH.order
Flemoklav Solutab 250 mg/62.5 mg N20 tablets Astellas Pharma Europe B.V., Netherlands
101 UAH order
Flemoklav Solutab 500 mg/125 mg N20 tablets Astellas Pharma Europe B.V., Netherlands
129 UAH order

PaniPharmacy

Flemoclav solutab tablet 500/125 mg No. 20 Australia, Astellas Pharma Europe B.V. Leiderdorp
189 UAH order
Flemoklav tablets Flemoklav solutab, tablet. dispers. 500mg/125mg No. 20 Netherlands, Astellas Pharma Europe
136 UAH order
Flemoklav tablets Flemoklav solutab, tablet. 125 mg/31.25 mg. No. 20 Netherlands, Astellas Pharma Europe
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Flemoklav tablets Flemoklav solutab tablets. dispers. 250 mg/62.5 mg No. 20 Netherlands, Astellas Pharma Europe
108 UAH order