Amoxiclav 825 instructions for use of the tablet. Instructions for use of amoxiclav, from which it helps

Amoxiclav is an antibiotic that can effectively fight pathogenic microorganisms. And what helps Amoxiclav?

Amoxiclav is used to treat various diseases- tonsillitis, bronchitis and many other pathologies of ENT organs and respiratory system, as well as the urinary system, infectious processes skin and soft tissues, joints and other diseases of infectious and inflammatory origin.

Components and dosage form

Amoxiclav consists of two main components - amoxicillin and clavulanic acid, which differ in composition and, therefore, in their action on pathogenic microorganisms. This is precisely the effect of the drug. There are also additional components, namely:

• talc;
• stearic acid;
• various flavoring substances;
• sodium salt of citric acid;
• citric acid, etc.

Today, a medicine such as Amoxiclav can be found on pharmacy shelves in such dosage forms Oh:

• tablets containing amoxicillin 250, 500 and 875 mg and clavulanic acid 125 mg in each of the three tablet forms, respectively;
• powdered substance for suspension preparation;
• powdered substance for solutions for parenteral administration.

Features of the therapeutic action

Amoxiclav is a substance that has a wide range of applications and is a representative of the penicillin group. Due to the fact that clavulanic acid is present in the composition, it ensures the resistance of the remaining components to the beta-lactamase enzyme, which is produced pathogenic bacteria. The structure of clavulanate is similar to beta-lactam antibiotics, which allows you to fight bacteria.

The presence of amoxicillin enables Amoxiclav to fight anaerobes and various types bacteria.

What pathological conditions will Amoxiclav help to cope with?

In any form, Amoxiclav is prescribed for the treatment of such diseases, pathological processes:

• pathologies respiratory tract, as well as bronchitis;
• inflammation of the gallbladder;
• erysipelas;
• meningitis;
• sepsis;
• abscesses;
• skin infections and many others.

Amoxiclav is also taken to prevent postoperative complications.

Contraindications

The use of the drug Amoxiclav is contraindicated in such pathologies:

• when diagnosing a patient with hepatitis or Gospel disease, which progresses against the background of use medicines penicillin group;
• with mononucleosis of infectious origin;
• with hypersensitivity of the patient to drugs of the penicillin group and other components that are part of Amoxiclav;
• if the patient has lymphocytic leukemia.

Also, with special care and under the close supervision of a doctor, Amoxiclav should be taken by people who have been diagnosed with pseudomembranous colitis, as well as kidney dysfunction or liver failure.

Amoxiclav is taken for the treatment of diseases during pregnancy and lactation only after the appointment of a treating specialist and exclusively on an individual basis.

How to treat with Amoxiclav?

According to the instructions for the drug, Amoxiclav in the form of tablets is prescribed for adults and children over the age of 12 years.

To prepare a solution for intravenous administration for a dosage of 600 mg of the active substance, 10 ml of water for injection is added to it, for a dosage of 1200 mg, respectively, 20 ml. The liquid is administered intravenously slowly, over 3-4 minutes. To prepare an infusion solution for a dropper, the drug, after dissolving in 10 ml (20 ml), is added to 50 ml (100 ml) and administered intravenously by drip for 30-40 minutes.

With mild illness and middle degree gravity Amoxiclav take 250 + 125 mg active substances 3 times a day, with an interval of 8 hours or 500 + 125 mg twice a day, with an interval of 12 hours.

In severe form of the disease, the drug is taken at 500 + 125 mg three times a day or 875 + 125 mg twice a day, with an interval of 8 and 12 hours, respectively.

Depending on the complications and course of the disease, Amoxiclav is taken for 7-14 days.

Considering that Amoxiclav is also effective in inflammation of the maxillary sinuses, it is taken 500 + 125 mg 3 times a day, and the duration of therapy is regulated by the doctor. Please note that with sinusitis, Amoxiclav does not stop taking even after recovery for about 48 hours, even if the patient has no signs of the disease.

Amoxiclav in the form of a suspension is an excellent option for treatment if a child is sick, the dosage is calculated by the weight of the patient. To prepare a suspension, add 86 ml of water to the powder in two steps and shake the mixture well until the powder dissolves. Before giving the drug to a child, the vial must also be shaken thoroughly.

For babies up to 3 months old, Amoxiclav is prescribed in the amount of 30 mg per 1 kg of weight. The resulting volume is divided into 2 doses, the time interval between which is 12 hours.

Children over 3 months of age increase the amount of the drug: give twice 25 mg. If the disease moderate, the drug can be prescribed in the amount of 20 mg per 1 kg of body weight, 3 times a day. In more complex cases, the dosage may be 45 mg per 1 kg of body weight, 2 times a day.

Amoxiclav, like any other antibacterial drug, has side effects.

Description

375 mg tablets: white or off-white, octagonal, biconvex, film-coated tablets debossed with 250/125 on one side and AMC on the other side.
Tablets 625 mg: white or almost white oval biconvex tablets, film-coated.

Composition

Each tablet (375 mg) contains 250 mg amoxicillin trihydrate and 125 mg clavulanic acid potassium salt in a 2:1 ratio.
Excipients: colloidal silicon dioxide, crospovidone, croscarmellose sodium, magnesium stearate, talc, microcrystalline cellulose.

Each tablet (625 mg) contains 500 mg amoxicillin trihydrate and 125 mg clavulanic acid potassium salt in a 4:1 ratio.
Excipients: colloidal silicon dioxide, crospovidone, croscarmellose sodium, magnesium stearate, microcrystalline cellulose.
Tablet shell: hydroxypropyl cellulose, ethyl cellulose, polysorbate, triethyl citrate, titanium dioxide, talc.

Pharmacotherapeutic group

Antibacterial agents for systemic use; combinations of penicillins, including beta-lactamase inhibitors.
ATX code: J01CR02.

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Pharmacological properties

Pharmacodynamics
Amoxicillin is a semi-synthetic penicillin, a beta-lactam antibiotic that inhibits one or more enzymes (often referred to as the penicillin-binding protein) in the biosynthesis of peptidoglycan, an integral component of the bacterial cell wall. Inhibition of peptidoglycan synthesis results in a loss of cell wall strength, which usually results in cell lysis and death.
Amoxicillin is destroyed by the action of beta-lactamases produced by resistant bacteria, so it is inactive against microorganisms that produce these enzymes.
Clavulanic acid is a beta-lactam structurally similar to penicillins. It inhibits some beta-lactamases and thus prevents the inactivation of amoxicillin. By itself, clavulanic acid does not have a clinically useful antibacterial effect.
The time to maintain concentrations above the minimum inhibitory (T> MIC) is recognized as the main determinant of the effectiveness of amoxicillin.
Mechanisms of resistance
There are two main mechanisms of bacterial resistance to amoxicillin/clavulanic acid:
inactivation by bacterial beta-lactamases insensitive to the inhibitory action of clavulanic acid, including beta-lactamases of classes B, C and D;
a change in penicillin-binding proteins, as a result of which the affinity of antibacterial drugs for target structures decreases.
Bacterial impermeability or mechanisms for active drug transport out of the bacterial cell can directly cause or contribute to resistance, especially in Gram-negative bacteria.

Sensitivity limits
Minimum inhibitory concentrations for amoxicillin/clavulanic acid comply with the detection limits set by the European Committee for the Evaluation of Antibiotic Susceptibility (EUCAST)

Microorganism	Limits of sensitivity (µg/ml)
	Sensitivity	Intermediate sensitivity	resistance
Haemophilus influenzae 1	≤ 1	-	> 1
Moraxella catarrhalis 1	≤ 1	-	> 1
Staphylococcus aureus 2	≤ 2	-	> 2
Coagulase-negative staphylococcus 2	≤ 0,25		> 0,25
Enterococcus 2	≤ 4	8	> 8
Streptococcus A, B, C, G 5	≤ 0,25	-	> 0,25
Streptococcus pneumoniae 3	≤ 0,5	1-2	> 2
Enterobacteria 1.4	-	-	> 8
Gram-negative anaerobes 1	≤ 4	8	> 8
Gram-positive anaerobes 1	≤ 4	8	> 8
Non-species-specific limits 1	≤ 2	4-8	> 8
1 The values ​​obtained correspond to the concentrations of amoxicillin. For the purpose of sensitivity assessment, a fixed concentration of clavulanic acid is used - 2 mg / l. 2 The values ​​obtained correspond to the concentrations of oxacillin. 3 Limit values ​​in the table are based on ampicillin susceptibility limits. 4 The resistance limit R > 8 mg/l guarantees the antibiotic resistance of all isolated strains with resistance mechanisms. 5 Limit values ​​in the table are based on sensitivity limits for benzylpenicillin.

Prevalence of resistance certain types characterized by geographical and temporal dependence, therefore, before starting therapy, it is desirable to obtain local information on antibiotic resistance, especially in the case of severe infections. In cases where local indicators of antibiotic resistance cast doubt on the appropriateness of the drug for at least some types of infections, you should seek the help of appropriate specialists.
Usually sensitive species
Gram-positive aerobes: Enterococcus faecalis, Gardnerella vaginalis, Staphylococcus aureus Coagulase-negative Staphylococci(methicillin-susceptible strains) £, Streptococcus agalactiae, Streptococcus pneumoniae 1 , Streptococcus pyogenes and other beta-hemolytic streptococci, group Streptococcus viridans
Gram-negative aerobes: Capnocytophaga spp., Eikenella corrodens, Haemophilus influenzae 2 , Moraxella catarrhalis, Pasteurella multocida
Anaerobes: Bacteroides fragilis, Fusobacterium nucleatum, Prevotella spp.
Views from possible development acquired resistance
Gram-positive aerobes: Enterococcus faecium $
Gram-negative aerobes: Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae, Proteus mirabilis, Proteus vulgaris
Species with natural resistance
Gram-negative aerobes: Acinetobacter sp., Citrobacter freundii, Enterobacter sp., Legionella pneumophila, Morganella morganii, Providencia spp, Pseudomonas sp., Serratia sp., Stenotrophomonas maltophilia
Other microorganisms: Chlamydophyla pneumoniae, Chlamydophyla psittaci, Coxiella burnetti, Mycoplasma pneumoniae
$ Natural intermediate susceptibility in the absence of an acquired resistance mechanism.
£ All methicillin-resistant staphylococci are resistant to amoxicillin/clavulanic acid.
1 Infections caused by penicillin-resistant strains of Streptococcus pneumoniae should not be treated with this dosage form of the drug, if there is a high risk that the alleged pathogens are resistant, due not to the production of beta-lactamase sensitive to clavulanic acid inhibition, but to a change in penicillin-binding proteins (see "Method of application and dosage" and "Precautions").
2 In some EU countries, strains with reduced sensitivity have been identified, occurring at a frequency above 10%.

Pharmacokinetics
Amoxicillin and clavulanic acid are completely soluble in water at physiological pH. Both components are quickly and well absorbed after oral administration. Their absorption improves if the drug is taken immediately before meals. When administered orally, the bioavailability of amoxicillin and clavulanic acid reaches approximately 70%. The plasma concentration profiles of both components are similar, the time to peak concentration (T max) for each substance is approximately one hour.
When groups of healthy volunteers took the 875 mg/125 mg combination tablet twice daily on an empty stomach, peak serum concentrations (Cmax) were 11.64 ± 2.78 μg/mL for amoxicillin and 2.18 ± 0.99 µg/ml for clavulanic acid. The time to reach maximum serum concentration (T max) was 1.5 hours (range 1.0-2.5) for amoxicillin and 1.25 hours (range 1.0-2.0) for clavulanic acid. Mean T 1/2 values ​​were 1.19 ± 0.21 h for amoxicillin and 0.96 ± 0.12 h for clavulanic acid.
Serum concentrations of amoxicillin and clavulanic acid achieved by oral administration combination drug, similar to the concentrations obtained by ingestion of equivalent doses of amoxicillin or clavulanic acid alone.
About 25% of the total plasma clavulanic acid and 18% of the total plasma amoxicillin is in a protein-bound state. The apparent volume of distribution is about 0.3-0.4 l/kg for amoxicillin and about 0.2 l/kg for clavulanic acid.
After intravenous administration, amoxicillin and clavulanic acid are found in gallbladder, tissues of the abdominal wall, skin, adipose tissue, muscle tissue, synovial and peritoneal fluids, bile and pus. Amoxicillin only slightly penetrates into the cerebrospinal fluid.
Amoxicillin, like most penicillins, passes into breast milk.
Trace amounts of clavulanic acid are also determined in breast milk(See "Pregnancy and breastfeeding").
Both amoxicillin and clavulanic acid cross the placental barrier.
Amoxicillin is partially excreted in the urine in the form of inactive penicillic acid in volumes equivalent to no more than 10-25% of the initial dose. Clavulanic acid is extensively metabolized in the human body, excreted in urine and feces, as well as in the form of carbon dioxide with exhaled air.
The main route of excretion of amoxicillin is the kidneys, while clavulanic acid is excreted from the body using renal and extrarenal mechanisms.
The amoxicillin/clavulanic acid combination has a mean half-life of about one hour and a mean total clearance of about 25 L/h in healthy subjects. Approximately 60-70% of amoxicillin and approximately 40-65% of clavulanic acid are excreted unchanged in the urine in the first 6 hours after a single dose of amoxicillin/clavulanic acid 250 mg/125 mg or 500 mg/125 mg tablets. The level of excretion in the urine within a 24-hour period is 50-85% for amoxicillin and 27-60% for clavulanic acid. The maximum amount of clavulanic acid is excreted in the first two hours after taking the drug.
Age
The half-life of amoxicillin in children aged three months to two years, older children and adults is similar. In the elderly, the dose is selected with caution due to the possible decrease in kidney function and, if necessary, regularly check the work of the kidneys.
Floor
The pharmacokinetics of amoxicillin or clavulanic acid does not depend on the gender of the patient.
Impaired kidney function
The total plasma clearance of amoxicillin and clavulanic acid decreases in proportion to the decrease in renal function. The decrease in clearance is more pronounced for amoxicillin than for clavulanic acid, since the proportion of amoxicillin excreted by the kidneys is higher. In renal insufficiency, doses are selected so as to avoid excessive accumulation of amoxicillin while maintaining adequate levels of clavulanic acid (see "Method of application and dosage").
Liver failure
In patients with hepatic insufficiency, the drug is prescribed with caution and regularly monitor liver function.

Indications for use

Amoxiclav is indicated for the treatment of the following infections caused by strains sensitive to the combination of amoxicillin/clavulanic acid:
Acute bacterial sinusitis (adequately diagnosed);
Spicy otitis media;
Aggravation chronic bronchitis(adequately diagnosed);
community-acquired pneumonia;
Cystitis;
Pyelonephritis;
Infections of the skin and soft tissues, in particular inflammation of the subcutaneous tissue, animal bites, severe dental abscesses with widespread phlegmon;
Infections of bones and joints, in particular osteomyelitis.
Consideration should be given to official guidelines on the appropriate use of antibacterial drugs.

Contraindications

Hypersensitivity to the active or excipients of the drug, as well as to any penicillins.
History of severe immediate hypersensitivity reactions (eg, anaphylaxis) to other beta-lactam drugs (eg, cephalosporins, carbapenems, or monobactams).
History of jaundice or other liver damage associated with the use of amoxicillin / clavulanic acid.

Method of application and dosage

Doses reflect the content of amoxicillin and clavulanic acid.
When choosing a dose for the treatment of specific infections, consider the following factors:
suspected pathogens and their possible susceptibility to antibacterial drugs;
the severity and location of the infection;
age, weight, and kidney function, as listed below.
The use of other dosage forms of the drug (for example, with higher doses of amoxicillin and / or with a different dose ratio of amoxicillin / clavulanic acid) is considered as necessary.
When taking Amoxiclav 375 mg tablets at the doses recommended below, adults and children weighing ≥ 40 kg will receive a total daily dose of 750 mg amoxicillin/375 mg clavulanic acid.
When taking Amoxiclav 625 mg tablets at the doses recommended below, adults and children weighing ≥ 40 kg will receive a total daily dose of 1500 mg amoxicillin/375 mg clavulanic acid.
Children with body weight< 40 кг будут получать дозу от 20 мг/5 мг/кг/сутки до 60 мг/15 мг/кг/сутки, при этом максимальная суточная доза составит 2400 мг амоксициллина/600 мг клавулановой кислоты.
If necessary, a higher daily dose amoxicillin, it is recommended to choose another dosage form of the drug in order to avoid taking excessively high daily doses of clavulanic acid.
The duration of treatment should not exceed 14 days without revision (see information on long-term therapy in the Precautions section).
Adults and children weighing ≥ 40 kg
One 375 mg tablet or one 625 mg tablet three times a day.
Children with body weight< 40 кг
Amoxiclav 375 mg film-coated tablets are not recommended for use in overweight children< 40 кг.
Dose from 20 mg / 5 mg / kg / day to 60 mg / 15 mg / kg / day, divided into three doses.
The table below shows doses (mg/kg body weight) in children weighing 25 to 40 kg after taking one 625 mg tablet.

Body weight (kg)	40	35	30	25	Recommended single dose (mg/kg body weight)
Amoxicillin (mg/kg body weight) after a single dose of one tablet 625 mg	12.5	14.3	16.7	20.0	6.67 – 20
Clavulanic acid (mg/kg body weight) after a single dose of one 625 mg tablet)	3.1	3.6	4.2	5.0	1.67 – 5

For the treatment of children under the age of six years or weighing less than 25 kg, it is preferable to use a suspension.
For the treatment of children from 6 to 12 years old, the optimal dosage form is 625 mg tablets taken 2 times a day.
Clinical data on the use of dosage forms of the drug with a ratio of active ingredients 4:1 at doses above 40 mg / 10 mg / kg / day for the treatment of children under the age of two years are not available.
Elderly patients
Dose adjustment is not required.
Patients with impaired renal function
The dose is adjusted based on the maximum recommended dose of amoxicillin.
Patients with a creatinine clearance of more than 30 ml / min dose adjustment is not required.
Adults and children with body weight ≥40 kg
Children with body weight<40 кг
In children with body weight< 40 кг с клиренсом креатинина менее 30 мл/мин применение Амоксиклава с соотношением амоксициллина и клавулановой кислоты 2:1 не рекомендуется из-за отсутствия возможности корректировки дозы. У таких пациентов рекомендуется применение форм Амоксиклава с соотношением амоксициллина и клавулановой кислоты 4:1.
Patients with impaired liver function
Apply with caution. Regularly monitor liver function (see "Contraindications" and "Precautions").

Mode of application
For oral administration. Take immediately before meals to minimize possible gastrointestinal side effects.
Treatment can be started with the parenteral form of the drug, following the instructions attached to it, and continue with the oral dosage form.

Precautionary measures

Before prescribing the drug, a detailed history should be taken regarding previous hypersensitivity reactions to penicillins, cephalosporins or other β-lactam antibiotics.
There have been reports of the development of serious hypersensitivity reactions, sometimes fatal, (including anaphylactoid and severe skin adverse reactions) in patients receiving penicillin therapy. The risk of such reactions is highest in patients with a history of hypersensitivity reactions to penicillins. In the event of an allergic reaction, it is necessary to stop treatment with Amoxiclav and start alternative therapy.
In cases of proven susceptibility of infectious agents to amoxicillin, consider switching from Amoxiclav to amoxicillin in accordance with official guidelines.
This dosage form of the drug is not suitable for use if there is a high risk that the alleged pathogens are resistant, due not to the production of beta-lactamase sensitive to clavulanic acid inhibition, but to a change in penicillin-binding proteins (including resistant S. pneumoniae).
In patients with impaired renal function or receiving high-dose therapy, seizures may develop (see "Side Effects").
Therapy with Amoxiclav should be avoided if infectious mononucleosis is suspected, because in patients with this disease, amoxicillin can cause a skin rash, which makes it difficult to diagnose the disease.
The simultaneous use of allopurinol during treatment with amoxicillin may increase the likelihood of allergic skin reactions.
Long-term treatment with Amoxiclav sometimes leads to an overgrowth of insensitive microflora.
The appearance at the beginning of treatment of febrile generalized erythema with fever and the formation of pustules at the beginning of therapy is a potential symptom of acute generalized exanthemic pustulosis (AGEP). This reaction requires discontinuation of treatment with Amoxiclav and is a contraindication for any subsequent administration of amoxicillin.
Amoxiclav is prescribed with caution to patients with impaired liver function.
Hepatic insufficiency caused by the use of the drug has been observed mainly in men and elderly patients and may be associated with long-term therapy. These phenomena have been very rarely observed in children. In all populations, signs and symptoms usually occur during or shortly after treatment, but in some cases become apparent only a few weeks after treatment is stopped. They are usually reversible. Liver failure can be severe and, in extremely rare cases, be fatal. It is almost always seen in patients with a serious underlying disease or who are concomitantly taking drugs with a known potential for liver damage.
Antibiotic-induced colitis occurs with almost all antibiotics and can range in severity from mild to life-threatening. In this regard, it is important to recognize this diagnosis in patients with diarrhea, during or after taking any antibiotic. In case of colitis caused by an antibiotic, Amoxiclav should be stopped immediately, a doctor's consultation should be carried out, and appropriate therapy should be started. In this situation, the use of drugs that depress peristalsis is contraindicated.
During long-term therapy, periodic evaluation of the functions of various organ systems, including the kidneys, liver, and hematopoietic organs, is recommended.
In rare cases, while taking the drug, prolongation of prothrombin time was noted. With the simultaneous use of Amoxiclav and anticoagulants, it is necessary to regularly monitor the relevant indicators. Dose adjustment of oral anticoagulants may be required to achieve the desired level of anticoagulation.
In patients with kidney failure, the dose should be adjusted according to the degree of insufficiency.
In patients with reduced diuresis, crystalluria very rarely occurs, mainly with parenteral therapy. During the administration of high doses of amoxicillin, it is recommended to take a sufficient amount of fluid and maintain adequate diuresis to reduce the likelihood of amoxicillin-associated crystalluria. In patients with a catheter installed in the bladder, it is imperative to regularly monitor its patency.
If it is necessary to assess the level of glucose in the urine during treatment with amoxicillin, enzymatic methods with glucose oxidase should be used, since non-enzymatic methods sometimes give false positive results.
The presence of clavulanic acid in Amoxiclav can cause non-specific binding of IgG and albumin to erythrocyte membranes, which can lead to false positive Coombs test results.
There have been cases of positive enzyme immunoassay (ELISA) results for Aspergillus in patients treated with the drug, in whom the absence of induced Aspergillus infections. Cross-reactions with non-Aspergillus polysaccharides and polyfuranoses have been noted in the ELISA test for Aspergillus. Positive test results in patients taking Amoxiclav should be interpreted with caution and confirmed by other diagnostic methods.

Use during pregnancy and lactation

Limited data on the use of the drug during pregnancy do not indicate an increased risk of congenital anomalies. In women with preterm preterm rupture of membranes, prophylactic treatment with amoxicillin/clavulanic acid has been potentially associated with an increased risk of neonatal necrotizing enterocolitis. The use of the drug during pregnancy should be avoided unless the doctor considers treatment necessary.
Both active ingredients are excreted in breast milk (data on the effect of clavulanic acid on breastfed children are not available).
Breastfed babies may develop diarrhea and fungal infections
mucous membranes, which may require cessation of breastfeeding. The possibility of sensitization should be considered. Therapy with the drug during breastfeeding is possible only after assessing the benefit-risk ratio by the attending physician.
Influence on the ability to drive vehicles and work with mechanisms
It is possible to develop undesirable effects (for example, allergic reactions, dizziness, convulsions), potentially affecting the performance of these functions.

Drug interactions and other types of interactions:

Oral anticoagulants
Cases of an increase in the international normalized ratio (INR) have been described in patients receiving maintenance therapy with acenocoumarol or warfarin against the background of the prescribed course of amoxicillin. If necessary, the simultaneous administration of drugs carefully monitor the prothrombin time or INR at the beginning and after stopping treatment with amoxicillin. Dose adjustment of oral anticoagulants may be required.
Methotrexate
Penicillins can reduce the excretion of methotrexate, which can lead to increased toxicity.
probenecid
It is not recommended to use simultaneously probenecid, which reduces the secretion of amoxicillin by the renal tubules. The simultaneous use of probenecid with Amoxiclav may lead to an increase and to a longer maintenance of the level of amoxicillin (but not clavulanic acid) in the blood.
Mycophenolate mofetil
In patients taking mycophenolate mofetil, after starting oral amoxicillin and clavulanic acid, an approximately 50% decrease in the concentration of the active metabolite, mycophenolic acid (MPA), was observed before taking the next dose of mycophenolate mofetil. Such a change in the concentration of MFC before taking the next dose may not indicate a change in the overall exposure of the MFC. Therefore, in the absence of clinical signs of graft dysfunction, there is usually no need to change the dose of mycophenolate mofetil. However, during such combination therapy and for some time after the end of antibiotic therapy, close medical supervision is necessary.

Overdose

Perhaps the development of gastrointestinal symptoms, as well as a violation of water and electrolyte balance. There have been cases of amoxicillin-associated crystalluria, sometimes leading to renal failure.
Convulsions may develop in patients with impaired renal function or in those receiving high dose therapy.
Amoxicillin precipitates in urinary catheters, predominantly after intravenous administration of large doses. It is necessary to regularly monitor the patency of catheters.
For gastrointestinal symptoms, symptomatic treatment can be carried out, along with the restoration of fluid and electrolyte balance.
Amoxicillin and potassium clavulanate can be excreted from the body by hemodialysis.

Side effect

Storage conditions

Store in a dry place at a temperature not exceeding 25 °C. Keep out of the reach of children.
The red desiccant contained in the bottle is inedible.

Best before date

2 years.
Do not use after the expiry date stated on the package.

Holiday conditions

Released only by prescription.

Manufacturer
Lek d.d.,
Verovshkova 57, Ljubljana, Slovenia

Amoxiclav - a new instruction for the use of the drug, you can see contraindications, side effects, prices in pharmacies for Amoxiclav. Reviews about Amoxiclav -

A broad-spectrum penicillin antibiotic with a beta-lactamase inhibitor.
Preparation: AMOXIKLAV®
The active substance of the drug: amoxicillin, clavulanic acid
ATX encoding: J01CR02
CFG: Broad-spectrum penicillin antibiotic with beta-lactamase inhibitor
Registration number: P No. 012124/02
Date of registration: 01.09.06
The owner of the reg. credit: LEK d.d. (Slovenia)

Amoxiclav release form, drug packaging and composition.

Powder for solution for intravenous administration from white to yellowish-white. Powder for solution for intravenous administration 1 vial. amoxicillin (as sodium salt) 500 mg clavulanic acid (as potassium salt) 100 mg
Powder for solution for intravenous administration from white to yellowish-white. Powder for solution for intravenous administration 1 vial. amoxicillin (as sodium salt) 1 g clavulanic acid (as potassium salt) 200 mg
Vials (5) - packs of cardboard.

The description of the drug is based on the officially approved instructions for use.

Pharmacological action Amoxiclav

Broad spectrum antibiotic; contains semi-synthetic penicillin amoxicillin and β-lactamase inhibitor clavulanic acid. Clavulanic acid forms a stable inactivated complex with β-lactamases and provides amoxicillin resistance to their effects.
Clavulanic acid, similar in structure to β-lactam antibiotics, has a weak intrinsic antibacterial activity.
Thus, Amoxiclav acts bactericidal on a wide range of gram-positive and gram-negative bacteria (including strains that have acquired resistance to beta-lactam antibiotics due to the production of β-lactamases).
Amoxiclav is active against aerobic gram-positive bacteria: Streptococcus spp. (including Streptococcus pneumoniae, Streptococcus viridans, Streptococcus pyogenes, Streptococcus bovis), Enterococcus spp., Staphylococcus aureus (except methicillin-resistant strains), Staphylococcus epidermidis (except methicillin-resistant strains), Staphylococcus saprophyticus, Listeria spp.; aerobic Gram-negative bacteria: Bordetella pertussis, Brucella spp., Campylobacter jejuni, Escherichia coli, Gardnerella vaginalis, Haemophilus ducreyi, Haemophilus influenzae, Helicobacter pylori, Klebsiella spp., Moraxella catarrhalis, Neisseria gonorrhoeae, Neisseria meningitidis, Pasteurella multocida, Proteus spp., Salmonella spp., Shigella spp., Vibrio cholerae, Yersinia enterocolitica, Eikenella corrodens; anaerobic gram-positive bacteria: Peptococcus spp., Actinomyces israelii, Prevotella spp., Clostridium spp., Peptostreptococcus spp., Fusobacterium spp.; anaerobic Gram-negative bacteria: Bacteroides spp.

Pharmacokinetics of the drug.

The main pharmacokinetic parameters of amoxicillin and clavulanic acid are similar. Amoxicillin and clavulanic acid in combination do not affect each other.
Distribution
Cmax after a 1.2 g bolus injection of Amoxiclav is 105.4 mg/l for amoxicillin and 28.5 mg/l for clavulanic acid. Both components are characterized by a good volume of distribution in body fluids and tissues (lungs, middle ear, pleural and peritoneal fluids, uterus, ovaries). Amoxicillin also penetrates into the synovial fluid, liver, prostate gland, palatine tonsils, muscle tissue, gallbladder, sinus secretions, saliva, bronchial secretions.
Amoxicillin and clavulanic acid do not penetrate the BBB in non-inflamed meninges.
Cmax in body fluids is observed 1 hour after reaching Cmax in blood plasma.
Active substances penetrate the placental barrier and are excreted in breast milk in trace concentrations. Amoxicillin and clavulanic acid are characterized by low binding to plasma proteins.
Metabolism
Amoxicillin is partially metabolized, clavulanic acid appears to be extensively metabolized.
breeding
Amoxicillin is excreted by the kidneys almost unchanged by tubular secretion and glomerular filtration. Clavulanic acid is excreted by glomerular filtration, partly as metabolites. Small amounts can be excreted through the intestines and lungs. T1 / 2 of amoxicillin and clavulanic acid is 1-1.5 hours.
Both components are removed by hemodialysis and, in small amounts, by peritoneal dialysis.

Pharmacokinetics of the drug.

in special clinical situations
In severe renal failure, T1 / 2 increases to 7.5 hours for amoxicillin and up to 4.5 hours for clavulanic acid.

Indications for use:

Treatment of infectious and inflammatory diseases caused by microorganisms sensitive to the drug:
- infections of the upper respiratory tract and ENT organs (including acute and chronic sinusitis, acute and chronic otitis media, pharyngeal abscess, tonsillitis, pharyngitis);
- infections of the lower respiratory tract (including acute bronchitis with bacterial superinfection, chronic bronchitis, pneumonia);
- urinary tract infections;
- gynecological infections;
- skin and soft tissue infections, including human and animal bites;
- infections of bones and joints;
- infections of the abdominal cavity, incl. biliary tract (cholecystitis, cholangitis);
- odontogenic infections;
- sexually transmitted infections (gonorrhea, chancroid);
- prevention of infections after surgical interventions.

The drug is administered in/in.
For adults and children over 12 years of age (weighing >40 kg), the drug is prescribed at a dose of 1.2 g (1000 mg + 200 mg) with an interval of 8 hours, in case of severe infection - with an interval of 6 hours.
For children aged 3 months to 12 years, the drug is prescribed at a dose of 30 mg / kg of body weight (in terms of the entire Amoxiclav) with an interval of 8 hours, in case of severe infection - with an interval of 6 hours.
Children under the age of 3 months: premature and in the perinatal period - at a dose of 30 mg / kg of body weight (in terms of the entire Amoxiclav) every 12 hours; in the postperinatal period - at a dose of 30 mg / kg of body weight (in terms of the entire Amoxiclav) every 8 hours.
Each 30 mg of Amoxiclav contains 25 mg of amoxicillin and 5 mg of clavulanic acid.
The prophylactic dose for surgical interventions is 1.2 g during induction anesthesia (with an operation duration of less than 2 hours); with longer operations - 1.2 g up to 4 times / day.
For patients with renal insufficiency, the dose and / or interval between injections of the drug should be adjusted depending on creatinine clearance (see table). Creatinine clearance

Dosage and method of application of the drug.

> 0.5 ml / s (> 30 ml / min) dose adjustment is not required mg + 100 mg) IV every 12 hours<0.166 мл/с (<10 мл/мин) первая доза — 1.2 г (1000 мг+200 мг), а затем по 600 мг (500 мг+100 мг) в/в каждые 24 ч анурия интервал между введениями следует увеличить до 48 ч или больше
Since 85% of Amoxiclav is removed by hemodialysis, the drug is administered at the end of the hemodialysis procedure. With peritoneal dialysis, no dosage adjustment is required.
The course of treatment is 5-14 days. The duration of the course of treatment is determined individually. With a decrease in the severity of symptoms, a transition to oral forms of the drug Amoxiclav is recommended to continue therapy.
Rules for the preparation and administration of solutions for intravenous injection
The contents of the 600 mg (500 mg + 100 mg) vial should be dissolved in 10 ml of water for injection or 1.2 g (1000 mg + 200 mg) in 20 ml of water for injection.
In / in enter slowly (within 3-4 minutes)
Rules for the preparation and administration of solutions for intravenous infusion
For infusion administration of Amoxiclav, further dilution is necessary: ​​prepared solutions containing 600 mg (500 mg + 100 mg) or 1.2 g (1000 mg + 200 mg) of the drug should be diluted in 50 ml or 100 ml of infusion solution, respectively. The duration of the infusion is 30-40 minutes.
When using the following infusion solutions in the recommended volumes, they retain the necessary concentrations of the antibiotic.
The following infusion solutions can be used as a solvent for IV infusion. Infusion solution Stability at 25°C Stability at 5°C Water for injection 4 h 8 h Sodium chloride infusion solution (0.9%) 4 h 8 h Ringer's lactate infusion solution 3 h - Potassium chloride or sodium chloride infusion solution 3 h -
Amoxiclav is less stable in infusion solutions containing dextrose (glucose), dextran or bicarbonate.
Amoxiclav should be administered within 20 minutes after preparation of intravenous solutions. Only clear solutions should be used. Do not freeze prepared solutions.

Side effects of Amoxiclav:

From the digestive system: loss of appetite, nausea, vomiting, diarrhea; rarely - abnormal liver function, increased activity of ALT and AST; in isolated cases - cholestatic jaundice, hepatitis, pseudomembranous colitis.
Allergic reactions: itching, urticaria, erythematous rashes; rarely - erythema multiforme exudative, angioedema, anaphylactic shock; in isolated cases - exfoliative dermatitis, Stevens-Johnson syndrome.
Others: a reversible increase in prothrombin time (when used together with anticoagulants); rarely - candidiasis and other types of superinfection.

Contraindications to the drug:

A history of cholestatic jaundice or abnormal liver function caused by taking amoxicillin / clavulanic acid;
- hypersensitivity to antibiotics of the penicillin group;
- hypersensitivity to amoxicillin or clavulanic acid or other components of the drug.
With caution, the drug is prescribed to patients with known hypersensitivity to cephalosporin antibiotics, a history of pseudomembranous colitis, liver failure, and severe renal dysfunction.

Use during pregnancy and lactation.

The appointment of the drug during pregnancy is possible only if there are clear indications. Amoxicillin and clavulanic acid are excreted in breast milk in small amounts.

Special instructions for the use of Amoxiclav.

With the course use of the drug, it is necessary to monitor the state of the function of the hematopoietic organs, liver, kidneys.
Patients with severely impaired renal function require an adequate dose adjustment of Amoxiclav or an increase in the intervals between the use of the drug.
Due to the fact that a large number of patients with infectious mononucleosis and lymphocytic leukemia treated with ampicillin, the appearance of an erythematous rash was observed, the use of antibiotics of the ampicillin group in such patients is not recommended.
The drug contains potassium.
Patients on a sodium restricted diet should be aware that each 600 mg vial (500 mg + 100 mg) contains 29.7 mg sodium, each 1.2 g vial (1000 mg + 200 mg) contains 59.3 mg sodium. The amount of sodium in the maximum daily dose exceeds 200 mg.
When using Amoxiclav in high doses, a false positive reaction is possible when determining the level of glucose in the urine using Benedict's reagent or Felling's solution (it is recommended to use enzymatic reactions with glucose oxidase).
Influence on the ability to drive vehicles and control mechanisms
There are no data on the negative effect of Amoxiclav in recommended doses on the ability to drive vehicles and control mechanisms.

Drug overdose:

There are no reports of death or life-threatening side effects due to an overdose of the drug.
Symptoms: abdominal pain, diarrhea, vomiting; anxiety, insomnia, dizziness are also possible; in some cases - convulsions.
Treatment: carry out symptomatic therapy, medical supervision is necessary. effective hemodialysis.

Interaction of Amoxiclav with other drugs.

With the simultaneous use of Amoxiclav and anticoagulants, an increase in prothrombin time is noted. Therefore, this combination is prescribed with caution.
With the simultaneous use of Amoxiclav with allopurinol, the risk of developing side effects such as exanthema increases.
With the simultaneous use of Amoxiclav enhances the toxicity of methotrexate.
When used simultaneously with Amoxiclav, diuretics, allopurinol, phenylbutazone, NSAIDs and other drugs that block tubular secretion increase the concentration of amoxicillin (clavulanic acid is excreted mainly by glomerular filtration).
Antibiotics reduce the effectiveness of oral contraceptives.
Avoid concomitant use with disulfiram.
Amoxiclav should not be mixed in a syringe or infusion bottle with other drugs.
Avoid mixing Amoxiclav with solutions of glucose, dextran, bicarbonate and solutions containing blood, proteins, lipids.
Pharmaceutical interaction
Amoxiclav and aminoglycoside antibiotics are physically and chemically incompatible.
Avoid mixing Amoxiclav with solutions of dextrose (glucose), dextran, bicarbonate (because the drug is less stable in them), as well as with solutions containing blood, proteins and lipids.
Amoxiclav is not mixed in the same syringe or infusion bottle with other drugs.

Conditions of sale in pharmacies.

The drug is dispensed by prescription.

Terms of the storage conditions of the drug Amoxiclav.

The drug should be stored out of the reach of children, protected from light at a temperature not exceeding 25°C. Shelf life - 2 years.

Amoxiclav is an antibiotic of the penicillin group, it includes amoxicillin and clavulanic acid. This is a complex drug of a new generation, which has a powerful antimicrobial activity against most pathogenic bacteria that are resistant to other drugs of the penicillin series. Due to this, Amoxiclav has an extensive scope and is successfully used to treat a number of diseases. In this article, we will dwell in more detail on the forms of release of the drug, its main properties, instructions for use and tell you what Amoxiclav helps from.

Amoxiclav tablets and suspension - pharmacological action and composition

Amoxiclav is a penicillin antibiotic with a wide spectrum of antimicrobial activity, effective against gram-positive and gram-negative microorganisms. Consists of amoxicillin (semi-synthetic penicillin) and salts of clavulanic acid. The combination of these substances provides a pronounced therapeutic effect of Amoxiclav. It is clavulanic acid that is an important link that supports the powerful antibacterial activity of the drug.

The unique substance potassium clavulate destroys bacteria that, in response to antibiotic exposure, try to produce protective enzymes - B-lactamases. Salts of clavulanic acid not only block the activity of B-lactamases, but also destroy the walls of bacteria, providing an additional antimicrobial effect and thereby increasing the therapeutic effect of the drug.

The main advantage of the drug is its unique ability to accumulate in almost all tissues of the body and its liquid media. Amoxiclav in a short time and in maximum quantities penetrates into the parenchyma of organs and blood plasma, regardless of the method of its administration. Already one hour after application, a high concentration of both active substances in the blood and lymph is noted.

The antibiotic is excreted from the body by the kidneys almost unchanged. A small amount of metabolites of clavulanic acid is excreted with feces and exhaled air. The drug does not penetrate into the cerebrospinal fluid and through the membranes of the brain, this feature significantly reduces the risk of unwanted adverse reactions from the central nervous system. At the same time, the antibiotic is able to cross the placenta and be excreted in breast milk.

Forms of release of the drug

Photo: Forms of release of the drug Amoxiclav

The drug is available in the form:

• film-coated tablets
• Powder intended for the manufacture of suspension
• Lyophilized powder for intravenous injection

Before using the drug in the form of a powder, it is diluted in an infusion solution or water. Let us consider in more detail all types of dosage forms.

Amoxiclav tablets contain different concentrations of active substances and are available in three versions:

1. Amoxiclav 375 (contain 250 mg antibiotic + 125 mg acid)
2. Amoxiclav 625 (500mg antibiotic + 125mg acid)
3. Amoxiclav 1000 ( 850mg antibiotic + 125mg acid)

In addition, the composition of the tablet forms includes auxiliary components responsible for the formation of the viscosity of the drug: magnesium stearate, silicon dioxide, cellulose, talc, etc. Amoxiclav tablets with any composition of active ingredients are recommended to be dissolved in 100 ml of water before use. If it is not possible to dissolve the tablet, it must be thoroughly chewed and washed down with a sufficient amount of liquid.

Powder for the preparation of a suspension intended for oral administration is produced in three varieties:

1. Amoxiclav 125 in addition to amoxicillin (125 mg) in the form of trihydrate contains 31.25 mg of clavulanic acid salt.
2. Amoxiclav 250 contains an antibiotic (250 mg) and 62.5 mg of acid.
3. Amoxiclav 400 consists of amoxicillin (400 mg) and 57 mg of clavulonic acid.

Of the auxiliary substances, the suspension includes: silicon dioxide, sodium citrate, gum, sodium saccharinate, flavors, citric acid, etc.

The suspension is prepared according to the instructions for use of Amoxiclav, dissolving the powder in a certain amount of water and shaking the vial vigorously until the ingredients are completely dissolved.

Photo: Amoxiclav suspension powder

Powder for intravenous administration is available in two forms:

1. Amoxiclav 500 contains 500 mg of amoxicillin in the form of sodium salt and 100 mg of clavulanic acid in the form of potassium salt.
2. Amoxiclav 1000 – 1000 mg amoxicillin + 200 mg acid.

Suspension for intravenous injection is obtained by diluting the dry powder in liquid for infusion, it is administered by stream or drip. With jet administration, they try to inject the drug into the vein as slowly as possible, this helps to achieve a rapid therapeutic effect and significantly alleviate the patient's condition. If there is a need for a longer systemic exposure, intravenous drip infusions are used.

Amoxiclav has a number of analogues, these are drugs such as

• Liklav
• Medoklav
• Klamosar
• panclave
• ranclave
• Ecoclave
• Flemoklav
• toromentin

In the pharmacy chain, the average price of Amoxiclav powder is from 120 rubles. The price of tablets depends on the form of release and the concentration of active ingredients and ranges from 230 to 450 rubles per package of the drug.

Indications for use

Amoxiclav is used to treat an extensive list of inflammatory processes and infectious diseases provoked by antibiotic-resistant bacteria. The drug is prescribed for the following pathologies:

In addition, therapeutic practice indicates that Amoxiclav is effective in the prevention and treatment of postoperative purulent-septic infections and sexually transmitted diseases (gonorrhea, chancre).

Instructions for use

The Amoxiclav treatment regimen is selected by the doctor individually for each patient and depends on the severity of the infection, the presence of concomitant diseases, the age and weight of the patient. The drug should be taken with meals, this will significantly reduce the risk of side effects. When preparing a suspension and taking tablet forms, it is necessary to strictly follow the instructions for the use of Amoxiclav.

Adults and children over 12 years of age (weighing over 40 kg), Amoxiclav 250 mg. appoint one tablet every 8 hours, Amoxiclav 500 mg. – one tablet 2-3 times a day. Adults with severe infections are shown to use Amoxiclav 1000 mg, 1 tablet twice a day. The duration of treatment with the drug is from 5 to 14 days, prolonged use of the antibiotic can lead to unwanted side reactions.

Before use, the tablet should be dissolved in 1/2 cup of water, the resulting suspension should be thoroughly mixed and drunk. Or, the drug in tablets is thoroughly chewed before swallowing and washed down with a sufficient amount of water.

Powder for suspensions is used to treat children. In newborns and infants up to 3 months, the dosage should be carefully observed (no more than half a teaspoon at a time). To facilitate dosing, a special measuring spoon is inserted into the package with the drug.

In older children, for the treatment of infections, a single dosage is one scoop. In the instructions for use attached to the drug, there is a special plate that allows you to calculate the required dose depending on the age and weight of the child.

The drug is taken twice a day every 12 hours or 3 times - after 8 hours. The doctor will help you choose the optimal dosage and treatment regimen, it is dangerous to engage in self-medication, this can lead to an overdose of the drug and the occurrence of unwanted complications.

Overdose

When taken in high doses, disorders of the gastrointestinal tract (nausea, abdominal pain, vomiting, diarrhea) may occur. From the side of the central nervous system, a state of anxiety, nervous excitement, sleep disturbance, and in rare cases, convulsive seizures are noted.

When such symptoms appear, the patient is prescribed gastric lavage and activated charcoal. In severe cases, hemodialysis is required.

The use of the drug is contraindicated in the following cases:

• With hypersensitivity to any component of the drug.
• With intolerance to penicillin antibiotics and cephalosporins.
• With violations of the liver caused by taking amoxicillin and clavulonic acid.
• With infectious lymphocytic leukemia and mononucleosis.

Restrictions on taking an antibiotic are severe kidney pathologies, gastrointestinal diseases, liver failure, a history of pseudomembranous colitis, and the period of breastfeeding. The drug should be prescribed by a doctor on an individual basis, he will take into account possible contraindications and select the optimal treatment regimen.

Photo: Amoxiclav during pregnancy

It is advisable not to prescribe Amoxiclav during pregnancy. The active substances of the drug easily cross the placenta to the fetus and are excreted in breast milk. This can negatively affect the health of the unborn child. There have been cases of necrotizing colitis in those newborns whose mothers received antibiotic therapy during pregnancy.

For the treatment of pregnant women, the antibiotic is used strictly according to the indications and according to the instructions, and only in cases where the positive result from taking the drug will be higher than the possible risk to the development of the fetus. Since the active substance penetrates into breast milk, if treatment is necessary during lactation, breastfeeding is stopped and the baby is transferred to artificial mixtures.

Side effect

When treated with Amoxiclav, side reactions may occur:

With prolonged use of Amoxiclav, manifestations of febrile conditions, oral candidiasis or candidal vaginitis are not excluded.

These phenomena usually occur during treatment or immediately after the end of therapy. Adverse reactions are usually reversible, but liver dysfunction can be quite severe. They occur mainly in patients with concomitant liver pathologies or are associated with the simultaneous use of hepatotoxic drugs.

It is undesirable to use Amoxiclav simultaneously with anticoagulants, this can lead to the development of bleeding. The combined use of an antibiotic with rifampicin weakens the antibacterial effect of the drug, since these drugs are antagonists.

Amoxiclav can not be administered simultaneously with macrolides and tetracyclines, this will lead to a decrease in the therapeutic effect of the drug. When taken together with an antibiotic, the effectiveness of contraceptives in tablet form is significantly reduced.

Additional Information

During antibiotic therapy, it is necessary to monitor the functions of the kidneys, liver and hematopoietic organs. In patients suffering from severe kidney damage, individual dosage adjustments and an increase in the time interval between doses of the drug are required.

To avoid unwanted side reactions from the gastrointestinal tract, it is necessary to take the drug with meals. During the course of treatment, it is recommended to drink plenty of fluids. It is strictly forbidden to drink alcohol during Amoxiclav therapy, this can lead to serious liver damage.

With extreme caution, Amoxiclav should be prescribed to patients with a history of allergic reactions. If side effects from the nervous system occur, it is recommended to refuse to drive vehicles and stop work that requires quick reaction and increased attention.

Antibiotic Amoxiclav 1000 is a drug effective against microbes with a large spectrum of action against a mass of types of bacteria. It contains a derivative of ampicillin (or amoxicillin) + clavulanic acid. The functions of the latter are to stop the enzymatic inactivation of penicillin through association with bacterial beta-lactamases.

Active:

• Amoxicillin (as trihydrate) - 875 mg;
• Clavulanic acid (as clavunalate potassium) 125 mg

Auxiliary:

• Crospovidone;
• silicon dioxide;
• magnesium stearate;
• Talc;
• Cellulose in microcrystals;
• Croscamellose sodium.

The film coat consists of the following: titanium dioxide, macrogol 6000, diethyl phthalate, hypromellose, ethylcellulose.

Amoxiclav 1000 is well absorbed into the blood, regardless of the time of the meal. The highest concentration in the blood is created after an hour after the use of this medicine. Traditionally, the course of treatment lasts from 5 to 10 days. For more than two weeks, this drug should not be taken without a prescription from the attending physician.

What does the number 1000 in the name of this drug mean? This means that one tablet contains 875 mg of the antibiotic (amoxicillin) and 125 mg of clavulanic acid. The total will be a thousand mg or 1 g.

Indications for use

• Sinusitis;
• Otitis;
• Pharyngitis;
• Tonsillitis;
• Chronical bronchitis;
• Acute bronchitis;
• Pneumonia;
• Abscesses;
• Inflammation on the skin;
• Inflammation of the skin caused by animal bites;
• Pyelonephritis;
• Diseases of the urinary tract;
• Gynecological inflammation;
• postpartum sepsis;
• infected abortion;
• Pelvioperitonitis;
• endometritis;
• STDs (sexually transmitted diseases);
• To prevent infections during operations.

The effectiveness of Amoxiclav 1000 mg against microbes

From which aerobes (microbes) is Amoxiclav 1000 mg effective:

• Gram-positive (enterococci, staphylococci, streptococci);
• Gram-negative (escherichia, klebsiella, moraxella, Haemophilus influenzae, gonococcus, shigella, meningococcus).

Amoxiclav 1000 mg tablets are not effective against the following microbes:

• Pseudomonas aeruginosa;
• Intracellular pathogens (chlamydia, mycoplasma, legionella);
• Methicillin-resistant staphylococci;
• Bacteria: Enterobacter, Acitobacter, Serrations.

Contraindications

There are body conditions in which Amoxiclav 1000 tablets cannot be taken:

• Mononucleosis;
• Allergy to clavulanic acid;
• Pathology of the liver;
• cholestatic jaundice;
• lymphocytic leukemia;
• Diarrhea;
• Pathologies in the intestines;
• Colitis.

This medicine is not prescribed to those who have been diagnosed with a creatinine clearance of less than 30 ml per minute, children under 12 years of age, patients with phenylketonuria. Carefully, under the permanent supervision of a doctor, such a medicine should be used by pregnant women, and even more so by mothers with impaired kidney function, during breastfeeding. With caution, it is prescribed to those who have been diagnosed with liver failure.

Side effect

Judging by clinical studies and reviews of Amoxiclav 1000 mg, its use can lead to such negative consequences:

• Diarrhea;
• Oral thrush;
• Vaginal thrush;
• Violation of the intestinal microflora;
• Skin rashes;
• allergic vasculitis;
• pseudomembranous colitis;
• drug-induced hepatitis;
• Cholestatic jaundice (mainly in elderly patients).

All of the above is extremely rare, this is not a pattern, but an exception. An increase in the level of a biochemical blood test returns to normal after discontinuation of the drug, within seven days.

Many side effects, especially those associated with the gastrointestinal tract, can be avoided by taking Linex (live bacteria) or other probiotics along with the antibiotic we are describing.

Analogues of tablets Amoxiclav 1000 mg

Analogues of Amoxiclav 1000 mg:

• Abiclav;
• Augmentin;
• Bactoclav;
• Betaclav;
• Clavam;
• Clavamitin;
• Clamox;
• Panklav;
• Novaklav;
• Repiclav;
• Theraclav;
• Flemoklav;
• Sumamed.

The cost of Amoxiclav 1000 and its analogues

The price of Amoxiclav 1000mg is approximately 440-480 rubles per package, consisting of two blisters, each of which contains 7 tablets. This cost is due to Swiss production and associated shipping costs. German-made amoxiclav will cost about 650 rubles. Domestic analogues are cheaper, but not by much, the same Augmentin 1000 mg will cost about 300 rubles. Such is the cost of this antibiotic.

Interaction with other drugs

Drugs that block tubular secretion increase the concentration of amoxicillin. With the simultaneous use of Amoxiclav with glucosamine and antacids, laxatives, absorption slows down. If you drink Amoxiclav and ascorbic acid at the same time, absorption, on the contrary, will accelerate.

Reviews

Irina F. 39 years old. Therapist “A good antibiotic, effective for a lot of simple infections of the upper respiratory tract. Low level of toxicity. When taken simultaneously with Linex or other probiotics, it does not cause disorders of the gastrointestinal tract. The clinical effect comes very quickly.

Karina S. 23 years old. Accountant “I took this drug for kidney problems. When the urine became dark, with sediment, I realized without a doctor that there was an infection. I took it according to the instructions for use. Everything passed quickly, urine is normal - it can be seen even without analysis.

Larisa M. 44 years old. Seller “It is important not to take this antibiotic if it has been less than three months since your last treatment with it. I learned this from a doctor when I was self-medicating sinusitis, but there was no effect. Because before that she had treated her kidneys with Amoxiclav. If 3 months have not passed since the last treatment, change the antibiotic.

What is the drug "Amoxiclav"? What does this remedy help with? You will learn the answers to these and other questions from the materials of this article. We will tell you about how much this medicine costs, in what form it is produced and whether it can be combined with alcohol.

Composition, form and packaging

The drug "Amoxiclav" (1000 mg) contains such active substances as the potassium salt of clavulanic acid and amoxicillin trihydrate. It is currently available in the following forms:

• film-coated tablets;
• powder for preparation of suspensions;
• lyophilized powder for injection.

Tablets "Amoxiclav" (1000 mg) are packed in aluminum blisters and cardboard boxes, respectively.

Powder for suspension can be purchased in dark glass bottles. Also included is a measuring spoon.

As for the injection form, it is available in 1.2 and 0.6 g vials, which are placed in cardboard boxes.

Pharmacological features

How does the drug "Amoxiclav" work? Instructions, reviews report that the combination of clavulanic acid and amoxicillin is unique in its kind.

Amoxicillin kills bacteria by binding to their surface receptors. However, most microorganisms have learned to destroy this antibiotic substance through the enzyme beta-lactamase. The activity of this enzyme is able to reduce clavulanic acid. Due to this effect, the suspension, injection solution and tablets "Amoxiclav" (1000 mg) are used to treat many infectious diseases.

Properties of the drug

What properties do antibiotics have? "Amoxiclav" (1000 mg) kills even those strains of bacteria that have already shown resistance to amoxicillin.

The drug under consideration has a pronounced bactericidal and bacteriostatic effect on all types of echinococci, streptococci and listeria (except for methicillin-resistant strains). Gram-negative bacteria such as Brucella, Bordetella, Gardnerella, Salmonella, Klebsiella, Proteus, Moraxella, Clostridium, Shigella and others are also sensitive to this drug.

Pharmacokinetics

Can Amoxiclav (1000 mg) be taken with food? Regardless of food, this medication is well absorbed from the intestines. Its highest concentration is reached after 60 minutes. It has a high rate and volume of distribution in the body (in the tonsils, lungs, synovial and pleural fluids, adipose and muscle tissues, prostate, middle ear and sinuses).

In breast milk, this drug enters in small quantities.

Amoxicillin is partially destroyed in the body, and clavulanic acid is extensively metabolized.

The drug is excreted through the kidneys, as well as the lungs and intestines. Its half-life is 90 minutes.

The drug "Amoxiclav": what helps?

The antibiotic in question is prescribed for the treatment of various infectious diseases:

• respiratory tract (for example, chronic or acute sinusitis), inflammation of the middle ear, pharyngeal abscess, tonsillopharyngitis, bronchitis, pneumonia, and others;
• gynecological infections (septic abortion, endometritis, salpingitis, etc.);
• urinary tract (pyelonephritis, cystitis, urethritis, etc.);
• bone infections;
• odontogenic infections, in which the pathogen enters the human body through cavities in the teeth;
• genital infections (gonorrhea, chancroid);
• connective tissue infections;
• inflammation of the biliary tract (for example, cholecystitis, cholangitis);
• infections of the skin, as well as soft tissues (phlegmon, bites, wound infection).

Contraindications for use

Does the antibiotic "Amoxiclav" have contraindications? Treatment with this remedy is not carried out with impaired liver function and jaundice (cholestatic), as well as with hypersensitivity to the substances of the drug or to all penicillins.

This drug is prescribed with extreme caution in the presence of allergy to cephalosporins, insufficiency of liver function, pseudomembranous colitis and severe renal dysfunction.

Patients with lymphocytic leukemia or mononucleosis who have been prescribed ampicillin may develop an erythematous rash. With such a reaction, the antibiotic should be discontinued.

The drug "Amoxiclav": doses and methods of application

The drug "Amoxiclav" can be administered to patients in different ways. The method of its use depends on the weight and age of the patient, the condition of the liver and kidneys, as well as the severity of the infection.

The most optimal time to use this medicine is when you start eating. The duration of therapy with this drug is 6-14 days. It is forbidden to use the medication for longer than the specified period.

For children under 12 years of age, an antibiotic is prescribed at the rate of 40 mg per kg of body weight per day. Adolescents weighing more than 40 kg are given the drug in the same dosage as adults.

For adults, 375 mg tablets are prescribed every eight hours, and a 625 mg drug every 12 hours. In severe infections, the patient is recommended to take the medication at a dose of 625 mg (every eight hours) or 1000 mg (every 12 hours).

Doctors emphasize that Amoxiclav tablets may differ in the number of active ingredients. Therefore, it should be borne in mind that it is forbidden to replace a dose of 625 mg with two doses of 375 mg.

For the treatment of odontogenic infections, the following scheme is used: the drug at a dosage of 375 mg is prescribed every eight hours, and at a dose of 625 mg every 12.

If you need to take medicine for patients with kidney disease, then be sure to take into account the content of creatinine in the urine. In people with liver pathologies, constant monitoring of its work should be carried out.

How should Amoxiclav be given to young children? Suspension, the price of which is not very high, is prescribed for babies up to 3 months. The dose of this medicine is determined using a measuring spoon or pipette. For every kg of a child's weight, 30 mg of amoxicillin should be given. The medication should be taken twice a day.

For children older than 3 months with moderate and mild disease, the drug is prescribed at the rate of 20 mg per kg of weight.

How is Amoxiclav used for severe infections? Suspension (the price of the drug will be indicated below) is prescribed for children in the amount of 40 mg per kg of weight. The same dose is used to treat deep infections (for example, inflammation of the middle ear, bronchitis, sinusitis, pneumonia, etc.).

The maximum daily dose of amoxicillin for children is 45 mg / kg, and for adults - 6 grams. As for clavulanic acid, it can be taken per day no more than 10 mg / kg for children and 600 mg for adults.

Side effects

As a rule, the drug "Amoxiclav" is well tolerated. Although in some cases, side effects occur in the elderly and those patients who take the medication for a long time.

Most often, adverse reactions occur during or after completion of therapy. Although sometimes their development is observed after a few weeks after treatment:

• diarrhea, flatulence, nausea, glossitis, vomiting, pseudomembranous colitis, dyspepsia, stomatitis, discoloration of the tongue, gastritis, enterocolitis;
• anemia (hemolytic), agranulocytosis, eosinophilia, a decrease in the number of platelets and leukocytes;
• dizziness, headaches, inappropriate behavior, agitation, insomnia, hyperactivity, convulsions;
• an increase in liver function tests, an asymptomatic increase in the activity of AST, alkaline phosphatase and ALT, as well as the level of bilirubin in the blood;
• rash, erythema multiforme, urticaria, exfoliative dermatitis, angioedema, Stevens-Johnson syndrome, toxic epidermal necrolysis;
• blood in urine, interstitial nephritis;
• oral candidiasis, fever, candidal vaginitis (with prolonged use of the drug).

Compatibility with other drugs

It is undesirable to combine "Amoxiclav" and means of indirect anticoagulants, as this may contribute to an increase in prothrombin time.

The medication in question enhances the toxicity of Metatrexate.

The interaction of allopurinol and Amoxiclav causes the risk of exanthema.

It is forbidden to prescribe the drug together with macrolides or tetracyclines, as well as with sulfonamides due to a decrease in its effectiveness.

Do not combine rifampicin and amoxicillin, as these are antagonist drugs. Their joint reception weakens the antibacterial effect of both.

Taking the medication in question reduces the effectiveness of oral contraceptives.

It should also be noted that the drug "Amoxiclav" (1000) and alcohol are prohibited from combining due to the possible increase in adverse reactions.

Price, synonyms and analogues

Synonyms of this drug are: Clavocin, Augmentin and Moxiclav. As for analogues, they include:

• "Amocomb",
• "Ecoclave",
• "Arlet",
• "Flemoklav",
• "Bactoclav",
• "Toromentin"
• "Klamosar",
• "Rapiclav",
• "Verklav",
• "ranclave"
• "Medoklav",
• "Panklav",
• "Liklav".

How much does the antibiotic "Amoxiclav" cost? Its price depends on the form of release. Tablets (1000 mg) can be purchased for 480 rubles, suspension - for 280, and lyophilized powder for injection - for 180.

Reviews about the drug

According to patient reviews, this medication is an effective drug that is used to treat many infectious diseases. When taking a medicine for the treatment of respiratory ailments, relief comes on the third day.

Also, the drug is actively prescribed for the treatment of genitourinary infections.

In addition to positive feedback about this antibiotic, patients also leave negative messages. According to them, the drug "Amoxiclav" causes many side effects, which manifest themselves in the form of nausea, diarrhea and vomiting.

The composition of the drug

Amoxiclav are included

amoxicillin antibiotic

trihydrate and potassium salt of clavulanic acid, which is an enzyme inhibitor. Belongs to the pharmacological group

penicillins

Release form Available in the form:

• film-coated tablets;
• powder for suspensions;
• lyophilized powder for injection.

One 375 mg tablet contains 250 mg of amoxicillin and 125 mg of clavulanic acid.

The 625 mg tablet contains 500 mg of amoxicillin, 125 mg of clavulonic acid.

Auxiliary substances are:

• silicon dioxide (colloidal);
• croscarmellose (sodium salt);
• magnesium stearate;
• talc;
• hypromellose;
• ethylcellulose;
• polysorbate;
• titanium dioxide;
• triethyl citrate.

Tablets are packed into bottles, 15 pieces in everyone. One box contains one bottle of medicine.

Powder for suspension is available in dark glass bottles, one per box. There is also a measuring spoon. The composition of the usual finished suspension includes 125 and 31.25 mg of active ingredients, respectively. When preparing the suspension "Amoxiclav Forte", 5 ml of it contains twice as much active ingredients - 250 and 62.5 mg, respectively. Auxiliary substances are:

• lemon acid;
• sodium citrate;
• sodium benzoate;
• carmellose sodium;
• silica colloid;
• sodium saccharin;
• mannitol;
• strawberry and wild cherry flavors.

For injection, a lyophilized powder is produced in vials of 0.6 and 1.2 g. The content of amoxicillin sodium salt in the solution is 500 or 1000 mg, and the potassium salt of clavulanic acid is 100 and 200 mg, respectively. One box contains 5 vials.
pharmachologic effect

The combination of amoxicillin with clavulanic acid is unique in its kind. Amoxicillin and other antibiotics of the penicillin group cause the death of bacterial cells by binding to their surface receptors. However, most

bacteria

during the use of the drug, they learned to destroy this antibiotic with the help of the beta-lactamase enzyme. Clavulanic acid reduces the activity of this enzyme, so this drug has a very wide spectrum of action. It even kills strains of bacteria that are resistant to amoxicillin. The drug has a pronounced bacteriostatic and bactericidal effect on all types of

streptococci

(with the exception of methicillin-resistant strains),

echinococcus

Listeria. Sensitive to amoxiclav and gram-negative bacteria:

• bordetella;
• brucella;
• gardnerella;
• klebsiella;
• moraxella;
• salmonella;
• Proteus;
• shigella;
• clostridium and others.

Regardless of the combination with food intake, the drug is well absorbed into the body, the maximum concentration of the drug is reached already in the first hour after ingestion. It has a high rate and volume of distribution in the body - in the lungs, pleural, synovial fluids, tonsils, prostate gland, muscle and adipose tissue, sinuses, middle ear. In tissues, the highest concentrations of amoxiclav are observed one hour after the maximum in blood plasma. It passes into breast milk in insignificant amounts. Amoxicillin undergoes partial destruction in the body, and clavulanic acid is metabolized very intensively. Excreted by the kidneys. Insignificant excretion is carried out by the lungs and intestines. The half-life in healthy kidneys is 1-1.5 hours. Slightly excreted from the blood during dialysis.
Indications

The use of this antibiotic is prescribed for the treatment of various infectious diseases:

• Respiratory tract diseases - sinusitis (acute or chronic), inflammation of the middle ear, pharyngeal abscess, bronchitis, tonsillopharyngitis, pneumonia and others.
• Diseases of the urinary tract - cystitis, pyelonephritis, urethritis and others.
• Gynecological infections, endometritis, septic abortion, salpingitis, and others.
• Inflammation of the biliary tract (cholangitis, cholecystitis).
• Connective and bone tissue infections.
• Infections of soft tissues and skin (bites, phlegmon, wound infection).
• Sexual infections (chancroid, gonorrhea).
• Odontogenic infections, in which the pathogen enters the body through cavities in the teeth.

Amoxiclav tablets and powder - instructions for use

Amoxiclav is prescribed in different ways. The method of administration depends on the age and weight of the patient, the severity

infections

kidney conditions and

The optimal time for the use of the drug is the beginning of a meal. The course of taking this medication lasts from 5 to 14 days, it can not be used longer.

For children under 12- 40 mg per kilogram of body weight per day.

For children whose weight exceeds 40 kg, the drug is prescribed as adults.

Adults are prescribed: 375 mg tablets are taken every 8 hours around the clock, 625 mg tablets every 12 hours. When prescribing a drug for the treatment of severe infections, doses of 625 mg every 8 hours, or 1000 mg every 12 hours, are used.

It should be noted that tablets may differ in the proportions of active ingredients. Therefore, you cannot replace a 625 mg tablet (500 g amoxicillin and 125 g clavulanic acid) with two 375 mg tablets (250 g amoxicillin and 125 g clavulanic acid).

For the treatment of odontogenic infections, the following scheme is used. The 375 mg tablets are taken every 8 hours, around the clock. Tablets 625 mg every 12 hours.

If it is necessary to use a drug for the treatment of patients with kidney diseases, the content of creatinine in the urine must be taken into account. In patients with liver disease, constant monitoring of its function is necessary.

Powder for the preparation of suspensions is used for newborns and children up to 3 months. Dosing is carried out using a special measuring pipette or spoon. Dosage - 30 mg of amoxicillin per kilogram of body weight, twice a day.

For children over three months old for mild and moderate infections - 20 mg / kg of body weight, and for severe infections - 40 mg / kg. The second dose is also used in the treatment of deep infections - inflammation of the middle ear, sinusitis, bronchitis, pneumonia. Instructions are attached to this medicine, in which there are special tables that allow you to calculate the doses of the drug necessary for children as accurately as possible.

The maximum allowable daily dose of amoxicillin for children is 45 mg / kg of body weight, for adults - 6 grams. Clavulanic acid can be taken per day no more than 600 mg for adults and 10 mg/kg for children.

Description of release formsSuspension

Powder for oral suspension is used for children. Five milliliters of the finished suspension contains amoxicillin trihydrate 250 mg and potassium salt of clavulanic acid - 62.5 mg. Or 5 ml may contain 125 mg of amoxicillin and 31.5 mg of clavulanic acid. To give the suspension a pleasant taste, it contains sweet substances and fruit flavors. The powder for the preparation of the suspension is packaged in dark glass bottles. The volume of bottles is 35, 50, 70 or 140 ml. A dosing spoon is included in the box with the bottle.

Tablets

This medicine is available in the form of film-coated tablets that are white or beige-white in color. Tablets have an oval biconvex shape.

One 625 mg tablet contains 500 mg of amoxicillin trihydrate with 125 mg of clavulanic acid (potassium salt).

Tablets can be produced in plastic jars (15 tablets each) or in aluminum blisters of 5 or 7 pieces.

Tablets of 1000 mg are also coated, have an oblong shape with beveled edges. They are imprinted with “AMS” on one side and “875/125” on the other. They contain 875 mg of the antibiotic and 125 mg of clavulanic acid.

Amoxiclav 125

This is the name of the powder for the preparation of a suspension containing 5 ml of 125 mg of amoxicillin and 31.5 mg of clavulanic acid. Produced in bottles of 100 ml, in a cardboard box with a dosing spoon. The dosage is indicated in the section "Amoxiclav - instructions for use".

Amoxiclav 250 ("Amoxiclav Forte")

This is also a suspension powder, but it contains a double dose of amoxicillin - 250 mg in 5 ml and 62.5 mg of clavulanic acid. This suspension is called "Amoxiclav Forte" because of the increased dose of the antibiotic in its composition. The dosage is indicated in the section "Amoxiclav - instructions for use".

Amoxiclav 500

These are Amoxiclav tablets - 625 mg, containing 500 mg of the antibiotic itself. Application and doses are indicated in the section "Amoxiclav instructions for use", and the composition and properties - in the section "Amoxiclav tablets".

Amoxiclav 875

These are Amoxiclav tablets - 1000 mg, containing 875 mg of the antibiotic itself, and 125 mg of clavulanic acid. Application and doses are indicated in the section on the method of application of the drug, and the composition and properties - in the section "Amoxiclav tablets".

Amoxiclav 625

Amoxiclav 1000

Amoxiclav Quiktab

Fruit flavored fast-dissolving tablets containing either 500 mg amoxicillin and 125 mg clavulanic acid or 875 mg amoxicillin and 125 mg clavulanic acid.

Contraindications

When taking the medicine, there may be a violation of the functions of the liver and

(cholestatic), if this drug has already been used before and the patient has hypersensitivity to the components of the drug, or to all penicillins.

In patients who are allergic to cephalosporins, or in the presence of pseudomembranous colitis, insufficiency of liver function or severe renal dysfunction, the drug is administered with caution.

Patients with mononucleosis or lymphocytic leukemia who have previously been prescribed ampicillin may develop an erythematous rash. In this case, the antibiotic should be discontinued.

Side effects

Usually they pass easily and are easily tolerated by patients. Side effects are more common in elderly patients, as well as in those patients who use Amoxiclav for a long time. Most often, side effects appear either during or after the completion of treatment, but sometimes their development occurs several weeks after the end of the drug.

Digestive system. As a rule, it is diarrhea, nausea, vomiting, and dyspepsia. Less common are flatulence, stomatitis or gastritis, discoloration of the tongue or glossitis, enterocolitis. During or after treatment with this medicine, pseudomembranous colitis, a disease caused by one of the bacteria of the Clostridium genus, may occur.

The blood system. Anemia (including hemolytic), eosinophilia, a decrease in the number of platelets and / or leukocytes, and agranulocytosis may also occur.

Nervous system may respond to the drug with headaches, dizziness, agitation, insomnia, convulsions, inappropriate behavior or hyperactivity.

Liver. Increases in liver function tests, including asymptomatic increases in the activity of AST and / or ALT, alkaline phosphatase and serum bilirubin levels.

Leather. The skin can react to taking amoxiclav with a rash, urticaria, angioedema, rarely develops erythema multiforme, toxic epidermal necrolysis, exfoliative dermatitis, Stevens-Johnson syndrome.

urinary system- there is the appearance of blood in the urine and interstitial nephritis.

With prolonged use of the drug, fever may occur,

candidiasis

oral cavity, as well as candidiasis

vaginitis

Amoxiclav during pregnancy

Amoxiclav during

pregnancy

it is advisable not to use. The exception is those cases where the benefit of taking the drug is higher than the harm it causes. Taking this medicine during pregnancy increases the risk of necrotizing colitis in

newborns

Amoxiclav for children

For children, powder for suspensions, regular and Amoxiclav Forte, is used. The method of application is described in the section Amoxiclav - method of application.

Amoxiclav with angina

Antibiotics for angina are prescribed only in cases of moderate and high severity. Amoxiclav, as an antibiotic of the penicillin series, is often prescribed for tonsillitis. Its use is indicated only when the bacterial form of the infection is confirmed, and the pathogenic microflora is tested for sensitivity to this drug. In the treatment of angina in children, suspensions are used, in adults - tablets. In severe cases, injections of the drug are used.

It must be remembered that antibiotics should not be used for a long time, as this increases the resistance of pathogenic microflora to them.

More about angina

Compatibility with other medicines

• It is undesirable to simultaneously use Amoxiclav and preparations of indirect anticoagulants. This may cause an increase in prothrombin time.
• The interaction of Amoxiclav and allopurinol causes the risk of exanthema.
• Amoxiclav enhances the toxicity of methotrexate.
• You can not use amoxicillin and rifampicin at the same time - these are antagonist drugs, the combined use weakens the antibacterial effect of both.
• You can not prescribe amoxiclav together with tetracyclines or macrolides (these are bacteriostatic antibiotics), as well as with sulfonamides due to a decrease in the effectiveness of this medication.
• Taking Amoxiclav reduces the effectiveness of contraceptive pills.

Comparison with other drugs It makes no sense to use a drug that does not kill bacteria - that is, it does not heal. Therefore, the antibiotic to which the pathogenic microflora of the patient is sensitive will be better.
Amoxiclav or amoxicillin?

Amoxiclav is a more effective drug than amoxicillin, since many pathogenic microorganisms have developed immunity to this antibiotic and have learned to destroy it, preventing it from showing its bactericidal effect. The addition of clavulanic acid to amoxicillin made this antibiotic much more active, expanding its range of action.

Amoxiclav or Augmentin?

Augmentin is an analogue of Amoxiclav, contains the same active ingredients.

Learn more about Augmentin

Amoxiclav or Flemoxin? Flemoxin is a drug containing only amoxicillin. Without the use of clavulonic acid, it has a smaller spectrum of action, therefore, it is used only if the bacterial microflora is sensitive to this antibiotic.

More about Flemoxin

Amoxiclav or Sumamed? Sumamed contains the antibiotic azithromycin, which has a wide spectrum of action. The choice should be made on the basis of testing the sensitivity of pathogenic microflora to these two antibiotics. Side effects are similar.

More about Sumamed

Compatibility with alcohol During treatment with Amoxiclav, it is forbidden to take alcohol. The intake of alcoholic beverages significantly reduces the antibacterial effect of the drug.

Synonyms and analogues Synonyms:

• Augmentin;
• Clavocin;
• Moksiklav.

Analogues of Amoxiclav:

• Amovicomb;
• Arlet;
• Bactoclav;
• Klamosar;
• Verclave;
• Medoklav;
• Liklav;
• Panklav;
• ranclave;
• Rapiclav;
• Toromentin;
• Flemoklav;
• Ecoclave;
• Amoxicillin + clavulanic acid (Fizer) and others.