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

pharmachologic effect

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

Pharmacokinetics and pharmacodynamics

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

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

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

Description

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

Pharmacotherapeutic group:

antibiotic - semisynthetic penicillin

ATX code:

J01CA04

Pharmacological properties

Pharmacodynamics

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

Pharmacokinetics

Suction

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

Distribution

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

Metabolism

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

Removal

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

Amoxicillin is removed by hemodialysis.

Special patient groups

Age

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

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

Floor

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

Kidney failure

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

Liver failure

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

Indications for use of Amoxicillin

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

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

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

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

Directions for use and doses

Inside, before or after meals.

The dose of Amoxicillin depends on the sensitivity of the infectious agent, the severity of the disease and the localization of the infectious process.

Adults and children over 13 years of age and/or weighing more than 40 kg

Usually prescribed 250 mg - 500 mg 3 times a day or 500 mg - 1000 mg 2 times a day. For sinusitis, community-acquired pneumonia and other severe infections, it is recommended to prescribe 500 mg - 1000 mg 3 times a day. The maximum daily dose is 6 g.

Children from 3 to 5 years old and/or weighing from 15 kg to 19 kg

Usually prescribed 250 mg 2 times a day. In cases where there is a high likelihood of infection caused by resistant Streptococcus
pneumoniae
, higher doses of 500 mg 2-3 times daily are recommended.

Children from 5 to 13 years old and/or weighing from 19 kg to 40 kg

Usually recommended is 250 mg 3 times a day. In cases where there is a high likelihood of infection caused by resistant Streptococcus
pneumoniae
, higher doses are recommended - 500-1000 mg 3 times a day.

The maximum daily dose for children is 100 mg/kg/day.

Lyme disease (borreliosis)

—
early stage
Adults and children over 13 years of age and/or weighing more than 40 kg

500 mg - 1000 mg 3 times a day up to a maximum daily dose of 4 g, divided into several doses, for 14 days (10-21 days).

Children from 3 to 5 years old and/or weighing from 15 kg to 19 kg

250 mg 3 times a day.

Children from 5 to 13 years old and/or weighing from 19 kg to 40 kg

500 mg 2-3 times a day (at the rate of 50 mg/kg/day, divided into 3 doses).

Eradication of
Helicobacter pylori in patients with duodenal or gastric ulcers
(always in combination with other drugs)

Adults: 1000 mg twice daily in combination with a proton pump inhibitor (eg, omeprazole, lansoprazole) and another antibiotic (eg, clarithrominin, metronidazole) for 7 days.

Children over 13 years old and/or weighing more than 40 kg -

1000 mg 2 times as part of combination therapy.

Children from 3 to 5 years old and/or weighing from 15 kg to 19 kg

250-500 mg 2 times a day.

Children from 5 to 13 years old and/or weighing from 19 kg to 40 kg

500-1000 mg 2 times a day (at the rate of 50 mg/kg/day, divided into 2 doses).

Prevention of bacterial endocarditis

Adults and children over 13 years of age and/or weighing more than 40 kg

It is recommended 2 g (or at the rate of 50 mg/kg/day) 0.5-1 hour before surgery.

Children from 3 to 5 years old
u /or body weight from 15 kg to 19 kg
750-1000 mg (at the rate of 50 mg/kg/day) before the procedure.

Children from 5 to 13 years old and/or with a body weight of 19 kg and up to 40 kg

1000-2000 mg (at the rate of 50 mg/kg/day) before the procedure.

For renal failure

In patients with CC > 30 ml/min, there is no need for dose adjustment. When CC < 30 ml/min, it is recommended to increase the interval between doses or reduce subsequent doses.

Contraindications

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

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

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

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

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

Side effects

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

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

Instructions for use of Amoxicillin (Method and dosage)

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

Amoxicillin tablets, instructions for use

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

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

Amoxicillin suspension, instructions for use

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

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

Instructions for use Amoxicillin Sandoz

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

Veterinary Amoxicillin

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

Instructions for Amoxicillin DS

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

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

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

Amoxicillin

Amoxicillin

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

Amoxicillin is a chemical substance

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

Amoxicillin is the international nonproprietary name of the drug

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

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

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

• J01CR02 Amoxicillin in combination with beta-lactamase inhibitors

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

Amoxicillin is an antibiotic

Amoxicillin is active against many microbes, including:

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

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

Indications for use of amoxicillin

Bacterial infections caused by sensitive microflora:

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

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

Method of administration of amoxicillin and dose

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

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

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

Amoxicillin in Helicobacter pylori eradication regimens

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

Option 1.

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

Option 2.

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

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

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

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

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

Second line of anti-Helicobacter therapy.

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

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

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

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

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

H. pylori
resistance

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

The problem of preserving intestinal microflora during amoxicillin therapy

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

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

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

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

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

Professional medical publications regarding the use of amoxicillin

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

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

Contraindications to the use of amoxicillin

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

Restrictions on the use of amoxicillin

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

Pharmacological action of amoxicillin

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

Use of amoxicillin during pregnancy and breastfeeding

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

Side effects of amoxicillin

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

From the gastrointestinal tract

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

From the nervous system and sensory organs:

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

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

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

Other:

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

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

Interaction of amoxicillin with other drugs

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

Trade names of drugs with the active ingredient amoxicillin

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

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

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

Instructions from manufacturers for the use of drugs containing amoxicillin

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

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

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

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

Overdose

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

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

Amoxicillin Express, 250 mg, dispersible tablets, 20 pcs.

Hypersensitivity reactions

Before starting treatment with amoxicillin, attention should be paid to a history of hypersensitivity reactions to penicillins, cephalosporins or other beta-lactam antibiotics.

Severe and sometimes fatal hypersensitivity reactions (including anaphylactic reactions and severe skin reactions) have been reported in patients receiving penicillin therapy. The development of these reactions is more likely in people with a history of hypersensitivity to penicillins and in people with atopy. If an allergic reaction occurs, discontinue treatment with amoxicillin and institute appropriate alternative treatment.

Acute coronary syndrome associated with hypersensitivity (Kounis syndrome)

In rare cases, hypersensitivity reactions (acute coronary syndrome associated with hypersensitivity) have been reported during treatment with amoxicillin. If this reaction occurs, amoxicillin should be discontinued and appropriate treatment should be prescribed.

Insensitive microorganisms

For some types of infections, before prescribing amoxicillin, it is necessary to first establish the pathogen and its sensitivity to the drug, or make sure that the pathogen is likely to be treatable with amoxicillin. This particularly applies to patients with urinary tract infections and severe ear, nose and throat infections.

Convulsions

Convulsions may occur in patients with renal failure, in patients receiving high doses of the drug, as well as in patients with predisposing factors - a history of seizures, treatment for epilepsy or meningitis, etc.

Kidney failure

In patients with renal impairment, the dose should be adjusted according to the degree of renal impairment.

Skin reactions

The occurrence of generalized erythema with fever, accompanied by pustules, at the initial stage of treatment may be a symptom of OHEP (see section “Side effects”). In this case, amoxicillin should be discontinued, and its subsequent use will be contraindicated in any situation.

The use of amoxicillin should be avoided in patients who are suspected of having infectious mononucleosis, since a measles-like rash (exanthema) may occur due to the use of amoxicillin for this disease.

Jarosz-Herxheimer reaction

The Jarisch-Herxheimer reaction has been observed following the use of amoxicillin in patients with Lyme disease. This reaction is associated with the bactericidal effect of amoxicillin on the causative agent of Lyme disease, the spirochete Borrelia burgdorferi. Patients should be advised that this reaction is a common side effect of antibiotic treatment for Lyme disease and usually goes away on its own.

Excessive growth of non-susceptible microorganisms

Long-term use of the drug can sometimes lead to excessive growth of microorganisms that are not sensitive to amoxicillin (superinfection).

When using almost all antibacterial drugs, the development of colitis associated with taking antibiotics is possible. Its severity can range from mild to severe (life-threatening). Therefore, it is important to consider the possibility of this diagnosis in patients who develop diarrhea during or after antibiotic use. If diarrhea develops, the patient should immediately stop taking amoxicillin, consult a doctor and begin appropriate treatment. Medicines that inhibit peristalsis are contraindicated in this situation.

Long-term treatment

During long-term therapy, it is necessary to periodically monitor the function of the hematopoietic organs, kidneys and liver. Increased activity of liver enzymes and changes in the number of blood cells were reported.

Anticoagulants

Rare cases of increased prothrombin time have been reported in patients receiving amoxicillin. When prescribing the drug simultaneously with anticoagulants, appropriate monitoring should be carried out, and the dose of oral anticoagulants may need to be adjusted to maintain the required level of blood clotting.

Crystalluria

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

Impact on diagnostic tests

Increased levels of amoxicillin in serum and urine may interfere with some laboratory tests. Due to high concentrations of amoxicillin in urine, chemical methods often give false-positive results.

When determining glucose in urine during treatment with amoxicillin, it is recommended to use enzymatic glucose oxidase tests.

The use of amoxicillin may affect the results of the quantitative determination of estradiol in urine in pregnant women.

Impact on the ability to drive vehicles and operate machinery

Studies of the effect of amoxicillin on the ability to drive vehicles or operate other machinery have not been conducted. However, side effects may occur (for example, allergic reactions, dizziness, convulsions) that affect the ability to drive vehicles or use other machinery.

Interaction

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

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

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

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

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

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

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

Microorganisms that produce penicillinase demonstrate resistance to the main substance.

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

Cross-resistance has been observed between amoxicillin and ampicillin .

special instructions

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

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

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

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

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

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

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

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

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

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

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

AMOXICILLIN SANDOZ

special instructions

Before prescribing Amoxicillin Sandoz®, you must make sure that the strains of microorganisms that cause the infectious disease are sensitive to the drug.
In case of severe infectious and inflammatory processes of the gastrointestinal tract, accompanied by prolonged diarrhea or nausea, it is not recommended to take Amoxicillin Sandoz® orally due to possible low absorption of the drug.

When treating mild diarrhea during a course of treatment, antidiarrheal drugs that reduce intestinal motility should be avoided; You can use kaolin- or attapulgite-containing antidiarrheal drugs. If diarrhea is severe, consult a doctor.

If severe persistent diarrhea develops, the development of pseudomembranous colitis (caused by Clostridium
difficile ) should be excluded.
In this case, Amoxicillin Sandoz® should be discontinued and appropriate treatment prescribed. In this case, drugs that slow down gastrointestinal motility are contraindicated.

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

It is possible that superinfection may develop due to the growth of microflora that is insensitive to it, which requires a corresponding change in antibacterial therapy.

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

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

When using estrogen-containing oral contraceptives and amoxicillin simultaneously, other or additional methods of contraception should be used if possible.

Amoxicillin Sandoz® is not recommended for the treatment of acute respiratory viral infectious diseases due to low effectiveness.

Particular caution is recommended for patients with allergic diathesis or bronchial asthma, or a history of gastrointestinal diseases (in particular, colitis caused by antibiotic treatment). When taking Amoxicillin Sandoz® for a long time, nystatin, levorin or other antifungal drugs should be prescribed simultaneously.

It is not recommended to consume ethanol during treatment.

The use of Amoxicillin Sandoz® does not affect the results of the enzymatic test for glycosuria, however, false-positive results of a urine test for glucose are possible.

While taking Amoxicillin Sandoz®, it is recommended to drink plenty of fluids to prevent the formation of amoxicillin crystals in the urine.

Special precautions when disposing of unused drug

There is no need for special precautions when disposing of unused drug.

Amoxicillin analogues

Level 4 ATC code matches:
Hiconcil

Ampioks

Ampicillin Trihydrate

Ampicillin

Ospamox

Amoxicar

Penicillin

Flemoxin Solutab

Amosin

Amoxil

Ecoball

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

Which is better: Amoxiclav or Amoxicillin?

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

Which is better: Flemoxin Solutab or Amoxicillin?

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

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

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

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

GROUP Antibiotics of the penicillin group

COMPOSITION Active substance - amoxicillin.

INTERNATIONAL NON-PROPENTED NAME Amoxicillin

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

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

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

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

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

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

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

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

STORAGE CONDITIONS List B. At room temperature.

Amoxicillin and alcohol

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

Amoxicillin during pregnancy and lactation

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

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

Use during pregnancy and breastfeeding

Results from animal studies do not indicate direct or indirect effects on reproductive toxicity. Limited data on the use of amoxicillin during human pregnancy do not indicate an increased risk of congenital malformations. Amoxicillin can be used during pregnancy only in cases where the expected benefit to the mother outweighs the potential risk to the fetus.

Amoxicillin is excreted into breast milk in small quantities; if necessary, the drug can be used during breastfeeding. A breastfed baby may develop diarrhea, sensitization and fungal infection of the mucous membranes, so it may be necessary to stop breastfeeding. Amoxicillin should be used during breastfeeding only after the attending physician has assessed the benefit/risk ratio.

Reviews about Amoxicillin

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

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

Amoxicillin price, where to buy

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

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

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

ZdravCity

• Amoxicillin tablets 500 mg 20 pcs. Biokhimik OJSC
  77 rub. order
• Amoxicillin capsules 500 mg 16 pcs. Hemofarm A.D. Vršac, Dubovac production site

  105 rub. order

• Amoxicillin Sandoz tablets p.p.o. 1g 12 pcs Sandoz GmbH

  RUB 159 order

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

  127 RUR order

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

  108 RUR order

Pharmacy Dialogue

• Amoxicillin capsules 500 mg No. 16Hemofarm

  98 RUR order

• Amoxicillin Sandoz tablets 500 mg No. 12Sandoz

  125 rub. order

• Amoxicillin tablets 500 mg No. 20Avva Rus

  107 RUR order

• Amoxicillin granules for suspension 250mg/5ml 100mlHemofarm

  91 rub. order

• Amoxicillin capsules 500 mg No. 16Barnaulsky ZMP

  59 RUR order

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PaniPharmacy

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

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