Flemoklava solyutab - instructions for the use of antibiotics, reviews, analogs and forms of release (tablets dispersible 125 mg, 250 mg, 500 mg, 875 mg and 1000 mg) of the drug for the treatment of angina and sinusitis in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Flemoclav solute. Comments from visitors to the site - consumers of this medication, as well as opinions of physicians specialists on the use of antibiotic Flemoclav soluteab in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues Flemoklava solutab in the presence of existing structural analogs.Use for the treatment of sore throats, herpes and other infectious diseases of adults, children, as well as during pregnancy and lactation. Composition and interaction of the drug with alcohol.

Flemoclav solute - broad-spectrum antibiotic; a combined preparation of Amoxicillin and clavulanic acid, a beta-lactamase inhibitor. It is active against Gram-positive and Gram-negative microorganisms (including strains producing beta-lactamases).

Amoxicillin acts bactericidal, inhibits the synthesis of peptidoglycan of the bacterial cell wall. Clavulanic acid inhibits beta-lactamase 2, 3, 4 and 5 types. Not active against beta-lactamase type 1 produced by Enterobacter spp., Pseudomonas aeruginosa, Serratia spp., Acinetobacter spp. Clavulanic acid has high affinity for penicillinases, thereby forming a stable complex with the enzyme, thus preventing the enzymatic degradation of amoxicillin influenced by the beta-lactamase and extends the range of action.

Flemoklav Soljutab active against aerobic and anaerobic gram-positive bacteria, aerobic and anaerobic gram-negative bacteria.

Composition

Amoxicillin trihydrate (Amoxicillin) + Potassium clavulanate (Clavulanic acid) + auxiliary substances.

Pharmacokinetics

Amoxicillin

After oral administration, it is rapidly absorbed from the digestive tract. Absorption of amoxicillin for oral administration is 90-94%. Simultaneous food intake does not affect absorption. Amoxicillin penetrates the placental barrier and in small amounts is excreted in breast milk. Approximately 60-80% of amoxicillin is excreted through the kidneys during the first 6 hours after taking the drug.

Clavulanic acid

After oral administration, it is rapidly absorbed from the digestive tract. Absolute bioavailability is approximately 60%. Simultaneous food intake does not affect absorption. Binding to blood serum proteins is 22%. Clavulanic acid penetrates the placental barrier. There is no reliable data on excretion with breast milk. Clavulanic acid undergoes intensive metabolism by hydrolysis and subsequent decarboxylation. Approximately 30-50% of clavulanic acid is excreted through the kidneys within the first 6 hours after taking the drug.

Indications

• bacterial infections,caused by susceptible pathogens: infections of the lower respiratory tract (bronchitis (acute and exacerbation of chronic), pneumonia, empyema of the pleura, lung abscess);
• infection of ENT organs (sinusitis, tonsillitis, tonsillitis, otitis media);
• infections of the genitourinary system and pelvic organs (pyelonephritis, pyelitis, cystitis, urethritis, prostatitis, cervicitis, salpingitis, salpingo-oophoritis, tubo-ovarian abscess, endometritis, bacterial vaginitis, septic abortion, postpartum sepsis, pelvioperitonitis, chancroid, gonorrhea);
• infections of the skin and soft tissues (erysipelas, impetigo, secondarily infected dermatoses, abscess, phlegmon, wound infection);
• osteomyelitis;
• postoperative infections;
• prevention of infections in surgery.

Forms of release

Tablets are dispersible 125 mg, 250 mg, 500 mg, 625 mg, 875 mg and 1000 mg.

Other forms of release, whether it be syrup, injections in ampoules or capsules does not exist.

Instructions for use and dosage

Adults and children over 12 years and children under 12 years with a body weight of more than 40 kg Flemoklava Solutab in a dose of 875 mg / 125 mg is prescribed 2 times a day (every 12 hours).

Children under the age of 12 years with a body weight of less than 40 kg are prescribed Flemoclav Solutab in smaller dosages.

Adults and children with a body weight of more than 40 kg of the drug prescribed 500 mg / 125 mg 3 times a day. In severe, chronic, recurrent infections, this dose can be doubled.

The daily dose for children is usually 20-30 mg of amoxicillin and 5-7.5 mg of clavulanic acid per kg of body weight. Possible dosage regimen for children, depending on the age and body weight of the child:

• age from 3 months to 2 years - body weight from 5 to 12 kg - daily dose of the pill 125 mg / 31.25 mg 2 times a day;
• age from 2 to 7 years - body weight from 13 to 25 kg - daily dose of the pill 125 mg / 31.25 mg 3 times a day;
• age from 7 to 12 years - body weight from 25 to 37 kg - daily dose of the pill 250 mg / 62.5 mg 3 times a day.

In severe infections, these doses can be doubled (the maximum daily dose is 60 mg of amoxicillin and 15 mg of clavulanic acid per kg of body weight).

The duration of treatment depends on the severity of the infection and, if necessary, should not exceed 14 days.

To prevent the appearance of side effects from the digestive system, the drug should be taken at the beginning of the meal. The tablet is swallowed whole, with a glass of water, or dissolve it in half a glass of water (at least 30 ml), stirring thoroughly before use (a suspension is obtained, convenient for children).

Side effect

• thrombocytosis, hemolytic anemia, leukopenia, granulocytopenia, thrombocytopenia, pancytopenia, anemia;
• increased prothrombin time and bleeding time;
• dizziness;
• headache;
• convulsions;
• anxiety;
• anxiety;
• insomnia;
• impaired consciousness;
• aggressive behavior;
• vasculitis;
• abdominal pain;
• nausea, vomiting;
• flatulence;
• diarrhea;
• pseudomembranous colitis (in case of severe and persistent diarrhea against the background of taking the drug or within 5 weeks after completion of therapy);
• candidiasis of the intestine;
• hemorrhagic colitis;
• cholestatic jaundice;
• itching, burning and discharge from the vagina;
• interstitial nephritis;
• skin rash and itching;
• koreal-like exanthema;
• hives;
• bullous or exfoliative dermatitis (multiforme exudative erythema, Stevens-Johnson syndrome, toxic epidermal necrolysis);
• anaphylactic shock;
• drug fever;
• eosinophilia;
• angioedema (edema of Quincke);
• laryngeal edema;
• serum sickness;
• hemolytic anemia;
• allergic vasculitis;
• bacterial or fungal superinfections (with prolonged therapy or repeated courses of therapy).

Contraindications

• violations of the liver (incl.jaundice) with amoxicillin / clavulanic acid in history;
• Infectious mononucleosis;
• lymphocytic leukemia;
• renal failure (glomerular filtration ≤ 30 ml / min) - for tablets dispersible 875 mg / 125 mg;
• children under 12 years of age with a body weight of less than 40 kg (for tablets dispersible 875 mg / 125 mg);
• increased sensitivity to amoxicillin, clavulanic acid and other components of the drug;
• increased sensitivity to other beta-lactam antibiotics (penicillins and cephalosporins).

Application in pregnancy and lactation

With the use of Flemoklava Solutab during pregnancy, there was no adverse effect on the fetus or newborn. The use of the drug in the 2nd and 3rd trimester of pregnancy is possible after a medical evaluation of the risk / benefit. In the first trimester of the use of Flemoclave, Solutab should be avoided (only for tablets dispersible with 875 mg / 125 mg). Dispersible tablets 125 mg / 31.25 mg, 250 mg / 62.5 mg, 500 mg / 125 mg in the 1 trimester of pregnancy should be administered with caution.

Amoxicillin and clavulanic acid penetrate the hemato-placental barrier and are excreted in breast milk.Possible use of the drug during breastfeeding.

If the child develops sensitization, diarrhea, or mucosal candidiasis, breast-feeding should be discontinued.

special instructions

When taking Flemoklava Solutab there is the possibility of cross resistance and hypersensitivity with other penicillins or cephalosporins.

In case of development of anaphylactic reactions, the drug should be stopped immediately and appropriate therapy should be carried out: for the treatment of anaphylactic shock, epinephrine (adrenaline), glucocorticosteroids (SCS) and elimination of respiratory failure may be required.

It is possible to develop superinfection (eg, candidiasis), especially in patients with chronic diseases and / or impaired immune system function. In case of superinfection, taking the drug is canceled and / or the antibacterial therapy is changed accordingly.

Patients with severe gastrointestinal disorders accompanied by vomiting and / or diarrhea, the use of Flemoklava Solutab is not advisable until the above symptoms are eliminated, since the symptoms are not eliminated. possibly a violation of absorption of the drug from the digestive tract.

The appearance of severe and persistent diarrhea can be associated with the development of pseudomembranous colitis, in this case the drug is canceled and prescribed treatment is prescribed. In the case of hemorrhagic colitis, immediate withdrawal of the drug and corrective therapy are also necessary. The use of drugs that impair intestinal peristalsis in these cases is contraindicated.

If the liver function is impaired, the drug should be administered with caution and under constant medical supervision. Do not use the drug for more than 14 days without assessing liver function.

In a single study, the prophylactic administration of amoxicillin / clavulanate in women with premature rupture of membranes increased the risk of necrotizing enterocolitis in newborns.

Against the background of taking the drug, there may be an increase in prothrombin time. Therefore Flemoclav Solutab should be administered with caution to patients receiving anticoagulant therapy (it is necessary to monitor blood clotting indices).

Due to the high concentration of amoxicillin in the urine, it can be deposited on the walls of the urinary catheter, so such patients need a periodic change of catheters.Forced diuresis accelerates the excretion of amoxicillin and reduces its concentration in the plasma.

During the use of Flemoklava Solutab, non-enzyme methods for determining glucose in the urine, as well as a test for urobilinogen, can give false positive results.

At course treatment it is necessary to control the functions of the organs of hematopoiesis, liver and kidneys.

In the case of the appearance of seizures on the background of therapy, the drug is canceled.

It should be taken into account that 1 tablet of dispersible 875 mg / 125 mg contains 25 mg of potassium.

Drug Interactions

With simultaneous use with certain bacteriostatic drugs (eg, chloramphenicol, sulfonamides) antagonism with amoxicillin / clavulanic acid was noted.

Flemoclave soluteba should not be administered simultaneously with disulfiram.

The simultaneous use of drugs that inhibit renal excretion of amoxicillin (probenecid, phenylbutazone, oxyphenbutazone and, to a lesser extent, acetylsalicylic acid, Indomethacin and sulfinpyrazone), promotes an increase in concentration and a longer exposure to amoxicillin in blood plasma and bile.The excretion of clavulanic acid is not disturbed.

When combined with Flemoklav Solutab antacids, glucosamine, laxatives, aminoglycosides slow down and reduce the absorption of amoxicillin, Ascorbic acid increases the absorption of amoxicillin.

Simultaneous application of Flemoklava Solutab with Allopurinol may increase the risk of skin rash.

Ethanol (alcohol) reduces the absorption rate of Amoxicillin in the digestive tract.

Aminopenicillins can reduce the concentration of Sulfasalazine in the blood serum.

Amoxicillin reduces the renal clearance of methotrexate, which can lead to an increased risk of its toxic effects. With simultaneous admission with amoxicillin, monitoring of the concentration of Methotrexate in serum is required.

The simultaneous use of amoxicillin / clavulanic acid and Digoxin can lead to an increase in the absorption of digoxin.

With the simultaneous use of Flemoklava Solutab and indirect anticoagulants, an increased risk of bleeding may occur.

In rare cases, amoxicillin therapy was associated with a decrease in the effectiveness of oral contraceptives, so the patient should be recommended to use non-hormonal methods of contraception.

Analogues of the drug Flemoclav solute

Structural analogs for the active substance:

• Amovicomb;
• Amoxiclav;
• Amoksiklav Quiktab;
• Amoxicillin + Clavulanic acid Pfizer;
• Arlette;
• Augmentin;
• Bactocklave;
• Verklav;
• Clamosar;
• Liklave;
• Médoclase;
• Panklav;
• Ranklav;
• Rapiklav;
• Taromentine;
• Fibell;
• Ecoclave.

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