Buy Augmentin powder for oral suspension 200mg+28.5mg/5ml 7.7g 70ml in pharmacies
Augmentin Buy Augmentin in pharmacies DOSAGE FORMS powder for the preparation of oral suspension 200mg+28 5mg/5ml powder for the preparation of suspension for oral administration 200mg+28 5mg/5ml
MANUFACTURERS Smithkline Beacham (Great Britain) Smithkline Beacham PLC (Great Britain)
GROUP Combined antimicrobial agents
COMPOSITION Active substance: amoxicillin + clavulanic acid.
INTERNATIONAL NON-PROPENTED NAME Amoxicillin + Clavulanic acid
SYNONYMS Amoxiclav, Amoxiclav Quiktab, Arlet, Augmentin EU, Augmentin SR, Clamosar, Medoclav, Panclave, Ranclave, Rapiclav, Sinulox, Sinulox RTU, Flemoclav Solutab, Ecoclave
PHARMACOLOGICAL ACTION Broad spectrum antibacterial. Blocks the synthesis of peptidoglycan of the membrane of microbial cells (amoxicillin), inhibits beta-lactamases (clavulanic acid). Clavulanic acid forms a stable inactivated complex with these enzymes and protects amoxicillin from the loss of antibacterial activity caused by the production of beta-lactamases by the main pathogens and opportunistic microorganisms. Active against gram-positive aerobes: Streptococcus pneumoniae, S.pyogenes, S.viridans, S.bovis, Staphylococcus aureus (except methicillin-resistant strains), S.epidermidis (except methicillin-resistant strains), Listeria spp., Enterococcus spp. Gram-negative aerobes: Bordetella pertussis , Brucella spp., Campylobacter jejuni, E.coli, Gardnerella vaginalis, H.influenzae, H.ducreyi, Klebsiella spp., Moraxella catarrhalis, N.gonorrhoeae, N.meningitidis, Pasteurella multocida, Proteus spp., Salmonella spp., Shigella spp., Vibrio cholerae, Yersinia enterocolitica. Anaerobes: Peptococcus spp., Peptostreptococcus spp., Clostridium spp., Bacteroides spp., Actinomyces israelii. Rapidly absorbed after oral administration (food intake does not affect absorption). The maximum concentration is reached 1 hour after administration. The maximum plasma concentration after a bolus injection of 1.2 g is 105.4 mg/l (for amoxicillin) and 28.5 mg/l (for clavulanic acid). It has a large volume of distribution - high concentrations are found in body fluids and tissues (lungs, pleural, peritoneal, synovial fluid, tonsils, bronchial secretions, prostate gland, peritoneal abscess, muscle tissue, adipose tissue, paranasal sinus secretions, middle ear, etc. .). Peak concentrations in body fluids are observed 1 hour after peak plasma concentrations are reached. Does not pass through the BBB when the meninges are not inflamed, passes through the placental barrier and penetrates into breast milk in trace concentrations. Weakly binds to plasma proteins. Amoxicillin is partially metabolized, clavulanic acid undergoes intensive metabolism. Amoxicillin is excreted by the kidneys almost unchanged by tubular secretion and glomerular filtration; clavulanic acid - by glomerular filtration, partly in the form of metabolites. Small amounts are excreted by the intestines and lungs. The half-life is 1-1.5 hours, with severe renal failure it increases to 7.5 (for amoxicillin) and 4.5 hours (for clavulanic acid). It is removed during hemodialysis, and slightly - during peritoneal dialysis.
INDICATIONS FOR USE Infectious diseases of the upper (acute and chronic sinusitis, acute and chronic otitis media, retropharyngeal abscess, tonsilopharyngitis) and lower respiratory tract (acute and chronic bronchitis, pneumonia, pleural empyema); urinary tract infections (including cystitis, urethritis, pyelonephritis), gynecological infections (including salpingitis, salpingoophoritis, endometritis, septic abortion, pelvioperitonitis); biliary tract (cholecystitis, cholangitis), bone and connective tissue (including chronic osteomyelitis), skin and soft tissue (phlegmon, wound infection), odontogenic infections (periodontitis); sexually transmitted infections (gonorrhea, chancroid).
CONTRAINDICATIONS Hypersensitivity; history of allergic reactions to antibiotics of the penicillin and cephalosporin group; cholestatic jaundice, hepatitis caused by taking penicillin antibiotics (in history); liver failure; infectious mononucleosis, lymphocytic leukemia. Use during pregnancy and breastfeeding: possible if the expected effect of therapy exceeds the potential risk to the fetus. Breastfeeding should be stopped during treatment.
SIDE EFFECTS In most cases, side effects are weak and transient, most often affecting the gastrointestinal tract: loss of appetite, nausea, vomiting, diarrhea. Possible development of superinfection, stomatitis, vaginitis; in rare cases - pseudomembranous colitis with severe diarrhea. Allergic reactions may occur: itching, skin rashes; in sensitive patients, immediate hypersensitivity reactions may develop (angioedema, bronchospasm, rarely - anaphylactic shock). It is extremely rare that a transient increase in the level of transaminases in the blood plasma can be observed. There are isolated reports of cholestatic jaundice, hepatitis, and liver dysfunction.
INTERACTION When used simultaneously with methotrexate, the toxicity of methotrexate increases, with allopurinol - the incidence of exanthema, and with anticoagulants - the prothrombin time is prolonged. Reduces the effectiveness of oral contraceptives. Concomitant use with disulfiram should be avoided. The effectiveness of Amoxiclav is weakened by combination with bacteriostatic antibiotics (macrolides, tetracyclines), combination with rifampicin is antagonistic. Probenecid reduces the excretion of amoxicillin, increasing its serum concentration. Pharmaceutically incompatible with solutions containing blood, proteins, lipids, glucose, dextran, bicarbonate. Do not mix in a syringe or infusion bottle with other drugs. Incompatible with aminoglycosides.
DOSAGE AND ADMINISTRATION The dose of the drug depends on age, body weight and kidney function.
OVERDOSE Symptoms: in most cases nausea, diarrhea, vomiting, possible agitation, insomnia, dizziness, and in some cases seizures. There are no reports of deaths or life-threatening side effects. Treatment: symptomatic, in case of recent use (less than 4 hours), remove the drug from the gastrointestinal tract (gastric lavage, taking activated charcoal to reduce absorption), hemodialysis is effective.
SPECIAL INSTRUCTIONS Prescribe with caution to patients prone to allergic reactions to cephalosporins and other beta-lactam antibiotics (risk of cross-sensitivity), with severe impairment of liver and kidney function (dosage regimen adjustment is necessary). High concentrations give a false positive reaction for glucose in urine when using Benedict's reagent or Felling's solution (it is recommended to use enzymatic reactions with glucose oxidase).
STORAGE CONDITIONS List B. At room temperature.
AUGMENTIN por. d/prig. susp. 200+28.5 mg/5 ml vial. 70 ml
Directions for use and doses
The dosage regimen is set individually depending on the age, body weight, kidney function of the patient, as well as the severity of the infection.
For optimal absorption and to reduce possible side effects from the digestive system, Augmentin is recommended to be taken at the beginning of a meal.
The minimum course of antibacterial therapy is 5 days.
Treatment should not continue for more than 14 days without reviewing the clinical situation.
If necessary, it is possible to carry out stepwise therapy (at the beginning of therapy, parenteral administration of the drug followed by switching to oral administration).
Adults and children over 12 years of age or weighing 40 kg or more
1 tablet 250 mg/125 mg 3 times a day (for mild to moderate infections), or 1 tablet 500 mg/125 mg 3 times a day, or 1 tablet 875 mg/125 mg 2 times a day, or 11 ml of suspension 400 mg/57 mg/5 ml 2 times a day (equivalent to 1 tablet of 875 mg/125 mg).
2 tablets of 250 mg/125 mg are not equivalent to 1 tablet of 500 mg/125 mg.
Children from 3 months to 12 years weighing less than 40 kg
The drug is prescribed in the form of a suspension for oral administration.
The dose is calculated depending on age and body weight, indicated in mg/kg body weight/day (calculation based on amoxicillin) or in ml of suspension.
The frequency of administration of the suspension is 125 mg/31.25 mg in 5 ml - 3 times a day every 8 hours.
The frequency of administration of the suspension is 200 mg/28.5 mg in 5 ml or 400 mg/57 mg in 5 ml - 2 times a day every 12 hours.
The recommended dosage regimen and frequency of administration are presented below:
Frequency of administration: 3 times/day, suspension 4:1 (125 mg/31.25 mg in 5 ml):
- Low doses - 20 mg/kg/day.
- High doses - 40 mg/kg/day.
Frequency of administration: 2 times/day, suspension 7:1 (200 mg/28.5 mg in 5 ml or 400 mg/57 mg in 5 ml):
- Low doses - 25 mg/kg/day.
- High doses - 45 mg/kg/day.
Low doses of Augmentin are used to treat skin and soft tissue infections, as well as recurrent tonsillitis.
High doses of Augmentin are used to treat diseases such as otitis media, sinusitis, lower respiratory tract and urinary tract infections, bone and joint infections.
There is insufficient clinical data to recommend the use of Augmentin at a dose of more than 40 mg/kg/day in 3 divided doses (4:1 suspension) in children under 2 years of age.
Children from birth to 3 months
Due to the immaturity of the excretory function of the kidneys, the recommended dose of Augmentin (calculated according to amoxicillin) is 30 mg/kg/day in 2 doses in the form of a 4:1 suspension.
The use of a 7:1 suspension (200 mg/28.5 mg in 5 ml or 400 mg/57 mg in 5 ml) is not recommended in this population.
Children born prematurely
There are no recommendations regarding dosage regimen.
Elderly patients
No dose adjustment is required. In elderly patients with impaired renal function, the dose should be adjusted as indicated below for adults with impaired renal function.
Patients with impaired renal function
Dose adjustments are based on the maximum recommended dose of amoxicillin and are carried out taking into account QC values.
Adults
Tablets 250 mg+125 mg or 500 mg+125 mg:
- CC > 30 ml/min - no dosage adjustment required.
- CC 10-30 ml/min - 1 tablet. 250 mg+125 mg 2 times a day or 1 tablet. 500 mg+125 mg (for mild to moderate infection) 2 times a day.
- QC
Suspension 4:1 (125 mg/31.25 mg in 5 ml):
- CC > 30 ml/min - no dosage adjustment required.
- CC 10-30 ml/min - 15 mg/3.75 mg/kg 2 times/day, maximum dose - 500 mg/125 mg 2 times/day.
- QC
Tablets 875 mg + 125 mg and suspension 7:1 (200 mg/28.5 mg in 5 ml or 400 mg/57 mg in 5 ml) should only be used in patients with CC > 30 ml/min, and no dose adjustment is required required.
In most cases, whenever possible, parenteral therapy should be preferred.
Patients on hemodialysis
Dose adjustments are based on the maximum recommended dose of amoxicillin: 2 tablets. 250 mg/125 mg in one dose every 24 hours, or 1 tablet. 500 mg/125 mg in one dose every 24 hours, or suspension at a dose of 15 mg/3.75 mg/kg 1 time/day.
Tablets: during a hemodialysis session, an additional 1 dose (one tablet) and another 1 dose (one tablet) at the end of the dialysis session (to compensate for the decrease in serum concentrations of amoxicillin and clavulanic acid).
Suspension: Before a hemodialysis session, one additional dose of 15 mg/3.75 mg/kg should be administered. To restore the concentrations of the active components of the drug Augmentin in the blood, a second additional dose of 15 mg/3.75 mg/kg should be administered after a hemodialysis session.
Patients with liver dysfunction
Treatment is carried out with caution, and liver function is regularly monitored. There is insufficient data to adjust the dosage regimen in this category of patients.
Rules for preparing the suspension
The suspension is prepared immediately before the first use.
Suspension (125 mg / 31.25 mg in 5 ml): add approximately 60 ml of boiled water, cooled to room temperature, to the bottle with the powder, then close the bottle with a lid and shake until the powder is completely diluted, let the bottle stand for 5 minutes to ensuring complete dilution. Then add water up to the mark on the bottle and shake the bottle again. In total, about 92 ml of water is required to prepare the suspension. The bottle should be shaken well before each use. For accurate dosing of the drug, you should use a measuring cap, which must be rinsed well with water after each use. After dilution, the suspension should be stored for no more than 7 days in the refrigerator, but not frozen.
For children under 2 years of age, a measured single dose of Augmentin suspension can be diluted by half with water.
Suspension (200 mg/28.5 mg in 5 ml or 400 mg/57 mg in 5 ml): add approximately 40 ml of boiled water, cooled to room temperature, to the bottle with the powder, then close the bottle with a lid and shake until the powder is completely diluted , allow the vial to stand for 5 minutes to ensure complete dilution. Then add water up to the mark on the bottle and shake the bottle again. In total, about 64 ml of water is required to prepare the suspension. The bottle should be shaken well before each use. For precise dosing of the drug, use a measuring cap or dosing syringe, which must be rinsed well with water after each use. After dilution, the suspension should be stored for no more than 7 days in the refrigerator, but not frozen.
For children under 2 years of age, a measured single dose of Augmentin suspension can be diluted with water in a 1:1 ratio.
