Amosin, tablets 500 mg 10 pcs

Pharmacotherapeutic group

Antibiotic, semisynthetic penicillin

ATX code

J01CA04

Pharmacodynamics:

A broad spectrum bactericidal antibiotic from the group of semisynthetic penicillins. It disrupts synthesis of peptidoglycan (support polymer of cell wall) during division and growth causing lysis of bacteria.

Active against aerobic gram-positive microorganisms: Staphylococcus spp. (except strains producing penicillinase) Streptococcus spp. and aerobic gram-negative microorganisms: Neisseria gonorrhoeae Neisseria meningitidis Escherichia coli Shigella spp. Salmonella spp. Klebsiella spp. Penicillinase-producing strains are resistant to the action of amoxicillin.

Pharmacokinetics:

Absorption – fast high (93%) food intake has no effect on absorption is not destroyed in the acidic environment of the stomach. When administered orally in doses of 125 and 250 mg, the maximum concentration is 1.5-3 and 3.5-5 mcg/ml, respectively. Time to reach maximum concentration after oral administration -1-2 hours.

It has a large volume of distribution: in high concentrations it is found in plasma sputum bronchial secretion (in purulent bronchial secretion the distribution is poor) pleural and peritoneal fluid urine contents of skin blister tissue lung tissue intestinal mucosa female genital organs prostate gland middle ear fluid (in inflammation) bone fat tissue gallbladder (with normal liver function) fetal tissue. When the dose is increased by a factor of 2, the concentration also increases by a factor of 2.

The concentration in bile exceeds the concentration in plasma by 2-4 times. In amniotic fluid and umbilical cord vessels, the concentration of amoxicillin is 25-30% of the level in plasma of a pregnant woman. It penetrates poorly through the blood-brain barrier, but with inflammation of the cerebral membranes, the concentration in cerebrospinal fluid is about 20% of the level in plasma. Binding with plasma proteins is 17%. Partially metabolized with formation of inactive metabolites.

Half-life is 1-1.5 hours. It is eliminated 50-70% by kidneys in unchanged form (by tubular secretion – 80% and glomerular filtration – 20%) and by liver – 10-20%. A small amount is excreted with breast milk. In patients with impaired renal function (creatinine clearance (CK) is less than or equal to 15 ml/min) the half-life is increased up to 8.5 hours. Amoxicillin is excreted with hemodialysis.

Indications

Active ingredient

Composition

Active ingredient:

Amoxicillin trihydrate (in terms of amoxicillin) – 0.500 g;

Auxiliary substances:

Polyvinylpyrrolidone (povidone), glucose (dextrose), salts of diatrium ethylenediamine N,N,N’,N’tetraacetic acid 2-water (trilon B) (dietary edetate), displaced sodium phosphate (sodium hydrophosphate), sodium αglutamic acid 1-water, food flavoring, vanillin, sugar (sucrose).

How to take, the dosage

To be taken by mouth, regardless of meals. The tablet can be swallowed whole, divided into parts or chewed with a glass of water.

Adults and children over 10 years of age (with body weight over 40 kg) are prescribed 0.5 g 3 times a day; in case of severe course of infection – 0.75-1 g 3 times a day.

Interaction

Antacids glucosamine laxative drugs food aminoglycosides slow down and reduce absorption; ascorbic acid increases absorption.

The bactericidal antibiotics (including the aminoglycosides cephalosporins vancomycin rifampicin) have a synergistic effect; bacteriostatic drugs (macrolides chloramphenicol lincosamides tetracyclines sulfonamides) have an antagonistic effect.

Increases the effectiveness of indirect anticoagulants (by suppressing intestinal microflora it reduces the synthesis of vitamin K and prothrombin index); reduces the effectiveness of estrogen-containing oral contraceptives; drugs in the metabolism of which para-aminobenzoic acid ethinyl estradiol is formed – risk of bleeding “breakthrough”.

Amoxicillin reduces clearance and increases toxicity of methotrexate; increases digoxin absorption.

Diuretics allopurinol oxyphenbutazone phenylbutazone nonsteroidal anti-inflammatory drugs and other drugs that block tubular secretion increase the blood concentration of amoxicillin.

Allopurinol increases the risk of skin rash.

Special Instructions

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

The development of superinfection due to growth of microflora insensitive to it is possible, which requires appropriate changes in antibiotic therapy.

When administered to patients with sepsis a bacteriolysis reaction (Jarisch-Herxheimer reaction) may occur (rare).

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

In the treatment of mild diarrhea, anti-diarrheal medications that decrease intestinal peristalsis should be avoided; kaolin- or attapulgit-containing anti-diarrheal medications may be used. If the diarrhea is severe, a physician should be consulted.

The treatment must be continued for an additional 48-72 hours after clinical signs of illness have disappeared.

In case of concomitant use of estrogen-containing oral contraceptives and amoxicillin, other or additional contraceptive methods should be used if possible.

Contraindications

Hypersensitivity (including to other penicillins cephalosporins carbapenems) children under 3 years of age (for this dosage form).

Allergic diseases (including anamnesis) gastrointestinal diseases in anamnesis (especially colitis associated with antibiotic use) renal failure severe liver function disorders pregnancy lactation period infectious mononucleosis lympholeukosis.

Side effects

Allergic reactions: possible urticaria hyperemic skin erythematous rash angioneurotic edema rhinitis conjunctivitis; rarely – fever arthralgia eosinophilia exfoliative dermatitis erythema multiforme exudative (including Stevens-Johnson syndrome); serum disease-like reactions; in rare cases – anaphylactic shock.

Digestive system disorders: dysbacteriosis change of taste vomiting diarrhea stomatitis glossitis moderate increase in “hepatic” transaminase activity rarely – pseudomembranous enterocolitis.

Nervous system disorders: agitation anxiety insomnia ataxia confusion altered behavior depression peripheral neuropathy headache dizziness epileptic reactions.

Laboratory findings: leukopenia neutropenia thrombocytopenic purpura anemia.

Others: difficulty breathing tachycardia interstitial nephritis candidiasis vaginal superinfection (especially in patients with chronic disease or reduced body resistance).

Overdose

Symptoms: nausea vomiting diarrhea water-electrolyte imbalance (as a consequence of vomiting and diarrhea).

Treatment: gastric lavage activated charcoal saline laxatives drugs to maintain water-electrolyte balance; hemodialysis.

Similarities