Co-Amoxiclav

Amoxicillin Sodium:

• Pharmacological action
• Pharmacokinetics
• Why is Co-Amoxiclav prescribed?
• Dosage and administration
• Co-Amoxiclav (Amoxicillin Sodium) side effects, adverse reactions
• Contraindications
• Using during pregnancy and breastfeeding
• Special instructions
• Precautionary measures
• Co-Amoxiclav drug interactions
• Co-Amoxiclav in case of emergency / overdose
• Co-Amoxiclav (Amoxicillin Sodium) reviews

Pharmacological action

Co-Amoxiclav is an antibiotic of group semisynthetic penicillins a wide spectrum of action. It is a 4-hydroxyl analog of ampicillin. It has bactericidal action. Co-Amoxiclav (Amoxicillin Sodium) is active against aerobic gram-positive bacteria: Staphylococcus spp. (except strains producing penicillinase), Streptococcus spp; aerobic gram-negative bacteria: Neisseria Gonorrhoeae, Neisseria Meningitidis, Escherichia Coli, Shigella spp., Salmonella spp., Klebsiella spp.

Microorganisms producing penicillinase is resistant to Co-Amoxiclav (Amoxicillin Sodium).

In combination with metronidazole Co-Amoxiclav (Amoxicillin Sodium) is active against Helicobacter Pylori. It is believed that inhibits the development of Co-Amoxiclav (Amoxicillin Sodium) resistance of Helicobacter pylori to metronidazole.

There is a cross-resistance between amoxycillin and ampicillin.

The spectrum of antibacterial action while expanding the application of Co-Amoxiclav (Amoxicillin Sodium) and beta-lactamase inhibitor clavulanic acid. This combination increased the activity of Co-Amoxiclav (Amoxicillin Sodium) against Bacteroides spp., Legionella spp., Nocardia spp., Pseudomonas (Burkholderia) Pseudomallei. However, Pseudomonas Aeruginosa, Serratia Marcescens, and many other gram-bacteria are resistant.

Pharmacokinetics

When Co-Amoxiclav (Amoxicillin Sodium) administered orally Co-Amoxiclav (Amoxicillin Sodium) rapidly and completely absorbed from the gastrointestinal tract and is not destroyed in the acidic environment of the stomach. C_max of Co-Amoxiclav (Amoxicillin Sodium) in the blood plasma is reached after 1-2 h. When increasing doses of 2 times the concentration also increased by 2 times. In the presence of food in the stomach does not reduce the overall removals. Similar concentrations of Co-Amoxiclav (Amoxicillin Sodium) reached in the blood when administered orally, IV and IM.

The binding of Co-Amoxiclav (Amoxicillin Sodium) to plasma proteins is about 20%.

Widely distributed in tissues and body fluids. Reported high concentrations of Co-Amoxiclav (Amoxicillin Sodium) in the liver.

T1/2 from the plasma is 1-1.5 h. About 60% of the dose adopted by mouth, is excreted unchanged in the urine by glomerular filtration and tubular secretion, with a dose of 250 mg of Co-Amoxiclav (Amoxicillin Sodium) concentration in urine exceeds 300 micrograms / ml. A number of Co-Amoxiclav (Amoxicillin Sodium) is determined in feces.

T1/2 for Newborns and the elderly can be longer.

In renal insufficiency T1/2 may be 7-20 hours.

In small quantities Co-Amoxiclav (Amoxicillin Sodium) penetrates through BBB in inflammation of the pia mater.

Co-Amoxiclav (Amoxicillin Sodium) is removed by hemodialysis.

Why is Co-Amoxiclav prescribed?

For use Co-Amoxiclav (Amoxicillin Sodium) as monotherapy and in combination with clavulanic acid: an infectious-inflammatory diseases caused by susceptible microorganisms, including bronchitis, pneumonia, tonsillitis, pyelonephritis, urethritis, infections of the gastrointestinal tract, gynecological infections, infections of the skin and soft tissue, listeria, leptospirosis, gonorrhea.

For use Co-Amoxiclav (Amoxicillin Sodium) in combination with metronidazole: chronic gastritis in acute, peptic ulcer and duodenal ulcer in acute, associated with Helicobacter Pylori.

Dosage and administration

Individual. For oral single dose for adults and children over 10 years is 250-500 mg, in case of serious illness - up to 1 g. For children aged 5-10 years, a single dose of 250 mg in age from 2 to 5 years - 125 mg for children aged under 2 years of daily dose is 20 mg / kg. For adults and children interval is 8 h. In the treatment of acute uncomplicated gonorrhea - 3 g once (in combination with probenecid). Patients with impaired renal function in creatinine clearance 10-40 ml / min interval between doses should be increased to 12 h and if creatinine clearance is less than 10 ml / min interval between doses should be 24 hours.

When parenteral use in adults IM - 1 g 2 times / day, IV (with normal renal function) - 2.12 g / day. Children IM 50 mg / kg / day, single dose - 500 mg, the frequency of administration - 2 times / day; IV - 100-200 mg / kg / day. Patients with impaired renal function the dose and the interval between the injections need to be adjusted in accordance with the values of creatinine clearance.

Co-Amoxiclav (Amoxicillin Sodium) side effects, adverse reactions

Allergic reactions: urticaria, erythema, edema Quincke, rhinitis, conjunctivitis, rarely - fever, joint pain, eosinophilia, in rare cases - anaphylactic shock.

Side effects associated with chemotherapy effect: possible development of super-infection (particularly in patients with chronic diseases or low resistance of the organism).

With prolonged use at high doses: dizziness, ataxia, confusion, depression, peripheral neuropathy, seizures.

Mostly when Co-Amoxiclav (Amoxicillin Sodium) used in combination with metronidazole: nausea, vomiting, anorexia, diarrhea, constipation, epigastric pain, glossitis, stomatitis; rarely - hepatitis, pseudomembranous colitis, allergic reactions (urticaria, angioedema), interstitial nephritis, a violation of hematopoiesis.

Mostly when Co-Amoxiclav (Amoxicillin Sodium) used in combination with clavulanic acid: cholestatic jaundice, hepatitis, rarely - erythema multiforme, toxic epidermal necrolysis, exfoliative dermatitis.

Contraindications

Infectious mononucleosis, lymphatic leukemia, severe gastrointestinal infections, accompanied by diarrhea or vomiting, respiratory viral infection, allergic diathesis, bronchial asthma, hay fever, sensitivity to penicillin and / or cephalosporins.

For use in combination with metronidazole: diseases of the nervous system; hemodyscrasia, lymphocytic leukemia, an infectious mononucleosis; Hypersensitivity to nitroimidazole derivatives.

For use in combination with clavulanic acid: a history of instructions for liver problems and jaundice, associated with the reception of Co-Amoxiclav in combination with clavulanic acid.

Using during pregnancy and breastfeeding

Co-Amoxiclav (Amoxicillin Sodium) crosses the placenta, in small amounts excreted in breast milk.

If necessary the use of Co-Amoxiclav (Amoxicillin Sodium) during pregnancy should carefully weigh the potential benefits of therapy for the mother and the potential risk to the fetus.

With careful use Co-Amoxiclav (Amoxicillin Sodium) during lactation (breastfeeding).

Special instructions

With caution used in patients prone to allergic reactions.

Co-Amoxiclav in combination with metronidazole is not recommended to use in patients younger than 18 years should not be used for liver diseases.

In the combined therapy with metronidazole is recommended not to drink alcohol.

Precautionary measures

Treatment must continue 48-72 hours after the disappearance of clinical signs of disease, with streptococcal infections - 10 days.

During the course treatment is necessary to control the state functions of hematopoiesis, liver and kidneys.

Perhaps the development of superinfection due to growth insensitive to the drug microflora. In the case of superinfection requires removal of Co-Amoxiclav (Amoxicillin Sodium) and the corresponding change in antibiotic therapy. When treating patients with bacteremia may develop bacteriolysis reaction (reaction of Jarisch-Herxheimer).

Patients who have an increased sensitivity to penicillin, may be cross-allergic reactions to cephalosporin antibiotics.

In the treatment of mild diarrhea at the background of the treatment should be avoided antidiarrhoeal drugs that reduce intestinal motility; can use kaolin or attapulgite containing antidiarrhoeal stuff. Patients with severe diarrhea should consult a doctor.

With simultaneous use of Co-Amoxiclav (Amoxicillin Sodium) and oral contraceptives estrogensoderzhaschih and Co-Amoxiclav (Amoxicillin Sodium) should if possible to use additional methods of contraception.

Co-Amoxiclav drug interactions

Co-Amoxiclav (Amoxicillin Sodium) may decrease the effectiveness of contraceptives for oral administration.

With the simultaneous use of Co-Amoxiclav (Amoxicillin Sodium) with bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, vancomycin, rifampicin) appears synergies; with bacteriostatic antibiotic (including macrolides, chloramphenicol, lincosamides, tetracyclines, sulphonamide) - antagonism.

Co-Amoxiclav (Amoxicillin Sodium) increases the effects of indirect anticoagulants inhibiting intestinal microflora, reduces the synthesis of vitamin K and prothrombin index.

Co-Amoxiclav (Amoxicillin Sodium) reduces the effect of drugs, in the process of metabolism that produce PABA.

Probenecid, diuretics, allopurinol, phenylbutazone, NSAIDs decrease the tubular secretion of Co-Amoxiclav (Amoxicillin Sodium), which can be accompanied by an increase in its concentration in blood plasma.

Antacids, glucosamine, laxatives, aminoglycosides, slow down and reduce, and ascorbic acid increases the absorption of Co-Amoxiclav (Amoxicillin Sodium).

With the combined use of Co-Amoxiclav (Amoxicillin Sodium) and clavulanic acid pharmacokinetics of both components unchanged.

Co-Amoxiclav in case of emergency / overdose

Symptoms: nausea, vomiting, diarrhea, disruption of water and electrolyte balance (as a result of vomiting and diarrhea); for prolonged use at high doses - neurotoxic reactions and thrombocytopenia (these phenomena are reversible and disappear after drug withdrawal).

Treatment: gastric lavage, the prescription of activated charcoal, saline laxatives, correction of water and electrolyte balance; hemodialysis.