Panklav, 500 mg+125 mg 20 pcs

Panklav is a combination of amoxicillin – a semisynthetic penicillin with a broad spectrum of antibacterial activity and clavulanic acid – an irreversible inhibitor of beta-lactamases (type II, III, IV, V; inactive against type I).

Clavulanic acid forms stable inactivated complex with these enzymes and protects amoxicillin from loss of antibacterial activity caused by production of β-lactamases by both major pathogens and co-pathogens and by opportunistic microorganisms.

This combination provides high bactericidal activity.

Panklav has a broad spectrum of antibacterial activity.

Active against amoxicillin-sensitive strains as well as against strains producing β-lactamases:

Gram-positive aerobes:

Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus viridans, Streptococcus bovis, Staphylococcus aureus (except methicillin-resistant strains), Staphylococcus epidermidis (except methicillin-resistant strains), Listeria spp., Enteroccocus spp.

Gram-negative aerobes:

Bordetella pertussis, Brucella spp, Campylobacter jejuni, Escherichia coli, Gardnerella vaginalis, Haemophilus influenzae, Haemophilus ducreyi, Klebsiella spp., Moraxella catarrhalis, Neisseria gonorrhoeae, Neisseria meningitidis, Pasteurella multocida, Proteus spp, Salmonella spp., Shigella spp., Vibrio cholerae, Yersenia enterocolitica.

Anaerobes:

Peptococcus spp, Peptostreptococcus spp., Clostridium spp., Bacteroides spp., Actinomyces israelii.

Pharmacokinetics

The main pharmacokinetic parameters of amoxicillin and clavulanic acid are similar.

Both components are well absorbed after oral administration, food intake does not affect the degree of absorption.

Peak plasma concentrations are reached approximately 1 hour after ingestion.

Both components are characterized by good volume distribution in body fluids and tissues (lungs, middle ear, pleural and peritoneal fluid, uterus, ovaries, etc.).

Amoxicillin also penetrates into synovial fluid, liver, prostate, palatine tonsils, muscle tissue, gallbladder, sinus secretions, saliva and bronchial secretions.

Amoxicillin and clavulanic acid do not penetrate the blood-brain barrier in uninflamed cerebral membranes.

Amoxicillin and clavulanic acid penetrate the placental barrier and are excreted in trace concentrations with breast milk.

Amoxicillin and clavulanic acid are characterized by low binding to plasma proteins.

Amoxicillin is excreted by the kidneys almost unchanged by tubular secretion and glomerular filtration.

Clavulanic acid is excreted by glomerular filtration, partially as metabolites.

Small amounts may be excreted through the intestine and lungs.

The half-life of amoxicillin and clavulanic acid is 1 – 1.5 hours.

In patients with severe renal impairment the half-life increases to 7.5 hours for amoxicillin and to 4.5 hours for clavulanic acid.

Both components are eliminated by hemodialysis and minor amounts by peritoneal dialysis.

Indications

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

– ENT organ infections (acute and chronic sinusitis, acute and chronic otitis, tonsillitis, pharyngitis);

– Respiratory tract infections (acute and chronic bronchitis, pneumonia, pleural empyema);

– Urinary tract infections (including cystitis, urethral and perineal infections).Infections of the urinary tract (including cystitis, urethritis, pyelonephritis);

– gynecological infections (including salpingitis, salpingo-oophoritis, endometritis, septic abortion, penile peritonitis);

– infections of bones and joints (including chronic osteomyelitis).

– skin and soft tissue infections (including phlegmon, wound infection);

– biliary infections (including cholecystitis, infections of the biliary tracts);

– bone and joint infections (including chronic osteomyelitis);

– skin and soft tissue infections (including phlegmon, wound infection)

– biliary tract infections (including cholecystitis and cholangitis);

– gonorrhea;

– chancroid;

– odontogenic infections.

Active ingredient

Composition

How to take, the dosage

Interaction

Antacids, glucosamine, laxatives, aminoglycosides slow absorption of Panklava, ascorbic acid – increases.

When concomitant use of Panklava and bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, vancomycin and rifampicin.

Bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, vancomycin, rifampicin) the latter have a synergistic effect;

Bacteriostatic agents (macrolides, chloramphenicol, lincosamides, tetracyclines, sulfonamides) – antagonistic.

In concomitant administration Panklav increases the effectiveness of indirect anticoagulants (by inhibiting intestinal microflora, decreases the synthesis of vitamin K and prothrombin index).

In concomitant use of anticoagulants it is necessary to monitor blood clotting.

Concomitant use with Panklav reduces the effectiveness of oral contraceptives, drugs that metabolize PABA, ethinylestradiol – the risk of acyclic bleeding.

Diuretics, allopurinol, phenylbutazone, NSAIDs and other drugs that block tubular secretion increase the concentration of amoxicillin (clavulanic acid is eliminated mainly by glomerular filtration).

Concomitant use of Panclave with allopurinol increases the risk of skin rash.

Special Instructions

With caution is prescribed to patients with severe hepatic insufficiency, chronic renal failure, GI diseases (including colitis associated with the use of penicillins, in the anamnesis).

When administered to patients with sepsis the bacteriolysis reaction (Jarisch-Herxheimer reaction) may develop.

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

In order to decrease the risk of dyspeptic side effects the drug should be taken with food.

Superinfection may develop due to growth of microflora insensitive to it that requires respective change in antibacterial therapy.

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

Taking Panklav leads to the appearance of amoxicillin in urine. High concentrations of amoxicillin give a false positive reaction for urine glucose when using Benedict’s reagent or Felling’s solution. It is recommended to use enzymatic reactions with glucose oxidase.

Effect on driving and operating machinery

Panklav does not affect the ability to drive vehicles and operate machinery.

Contraindications

Side effects

Overdose

Symptoms: gastrointestinal dysfunction: nausea, vomiting; possible: agitation, insomnia, in rare cases – seizures, as well as disorders of water-electrolyte balance.

The treatment: symptomatic, in case of recent drug intake (less than 4 hours) – gastric lavage, absorbent intake. Hemodialysis is effective.

Similarities