Treatment:
there may be symptoms from the gastrointestinal tract and violations of the water-electrolyte balance. Amoxicillin crystalluria is described, which in some cases led to the development of renal failure (see "Special instructions").
symptoms from the gastrointestinal tract-symptomatic therapy, paying special attention to the normalization of the water-electrolyte balance. Amoxicillin and clavulanic acid can be removed from the bloodstream by hemodialysis.
a history of cholestatic jaundice and/or other liver disorders caused by amoxicillin/clavulanic acid,
For Amoxiclav dispersible tablets
phenylketonuria,
pseudomembranous colitis in the anamnesis, gastrointestinal diseases, liver failure, severe renal impairment, pregnancy, lactation, concomitant use with anticoagulants.
it should not be used simultaneously in combination with bacteriostatic antibiotics (macrolides, tetracyclines), sulfonamides due to a possible decrease in the effectiveness of the drug Amoxiclav.
®
Quicktab.
In patients receiving mycophenolate mofetil, after the start of the combination of amoxicillin with clavulanic acid, there was a decrease in the concentration of the active metabolite — mycophenolic acid, before taking the next dose of the drug by approximately 50%. Changes in this concentration may not accurately reflect the overall changes in mycophenolic acid exposure.
and aminoglycoside antibiotics are chemically incompatible.
Avoid mixing with solutions of dextrose, dextran, sodium bicarbonate, as well as with solutions containing blood, proteins, lipids.
Penicillins are able to slow the elimination of methotrexate from the body by inhibiting its tubular secretion, so the simultaneous use of the drug Augmentin
The literature describes rare cases of increased MHO in patients with the combined use of acenocumarol or warfarin and amoxicillin. If necessary, simultaneous administration or withdrawal of the drug Augmentin
film-coated tablets and powder for the preparation of a solution for intravenous administration
From the hematopoietic system and the lymphatic system:
Amoxiclav
hyperactivity. Anxiety, insomnia, behavior change, arousal.
Amoxiclav
Quicktab and Amoxiclav
rarely-reversible leukopenia (including neutropenia), thrombocytopenia, very rarely-eosinophilia, thrombocytosis, reversible agranulocytosis, increased bleeding time and reversible increase in PV, anemia, including reversible hemolytic anemia.
On the part of the immune system:
From the gastrointestinal tract:
From the skin:
From the urinary system: very rarely — crystalluria, interstitial nephritis, hematuria.
The adverse events listed below are listed according to the organ and organ system damage and frequency of occurrence. The frequency of occurrence is defined as follows: very often - ≥1/10, often - ≥1/100 and <1/10, infrequently - ≥1/1000 and <1/100, rarely - ≥1/10000 and <1/1000, very rarely - <1/10000, including individual cases. Frequency categories were formed based on clinical trials of the drug and post-registration follow-up.
very rarely-angioedema, anaphylactic reactions, a syndrome similar to serum sickness, allergic vasculitis.
The listed signs and symptoms usually occur during or immediately after the end of therapy, but in some cases they may not appear for several weeks after the end of therapy. Adverse events are usually reversible. Adverse events from the liver can be severe, in extremely rare cases, there have been reports of fatal outcomes. In almost all cases, these were patients with serious comorbidities or patients receiving potentially hepatotoxic drugs at the same time.
®
For all dosage forms
Infections caused by sensitive strains of microorganisms:
upper respiratory tract and ENT organs (including acute and chronic sinusitis, acute and chronic otitis media, pharyngeal abscess, tonsillitis, pharyngitis),
lower respiratory tract (including acute bronchitis with bacterial superinfection, chronic bronchitis, pneumonia),
urinary tract infections (e.g. cystitis, urethritis, pyelonephritis),
in gynecology,
skin and soft tissue, including human and animal bites,
bone and connective tissue,
bile ducts (cholecystitis, cholangitis),
odontogenic.
Amoxiclav®
For powder for preparation of solution for intravenous administration in addition
abdominal infections,
sexually transmitted infections (gonorrhea, mild chancre),
prevention of infections after surgical interventions.
The drug Augmentin® CP is indicated for the treatment of bacterial infections of the following localizations caused by microorganisms sensitive to the combination of amoxicillin with clavulanic acid:
respiratory tract infections, such as community-acquired pneumonia, exacerbation of chronic bronchitis, acute bacterial sinusitis, usually caused by Streptococcus pneumoniae (including penicillin-resistant strains), Haemophilus influenzae1, Moraxella catarrhalis1 and Streptococcus pyogenes,
prevention of local infections after surgery in dentistry.
1 Some strains of these bacteria produce beta-lactamases, which makes them insensitive to amoxicillin monotherapy.
Infections caused by amoxicillin-sensitive microorganisms can be treated with Augmentin® CP, since amoxicillin is one of its active ingredients. The drug Augmentin® CP is also indicated for the treatment of mixed infections caused by microorganisms sensitive to amoxicillin, as well as beta-lactamase-producing microorganisms sensitive to the combination of amoxicillin with clavulanic acid.
The drug Augmentin® CP demonstrated efficacy against strains S. pneumoniae, resistant to penicillin (strains with MPC ≥2 mg/l).
Drugs containing a combination of amoxicillin with clavulanic acid should be used in accordance with the Russian guidelines for antibiotic therapy and regional data on the sensitivity of pathogens to the combination of amoxicillin with clavulanic acid.
The sensitivity of bacteria to the combination of amoxicillin with clavulanic acid varies depending on the region and over time. Where possible, local sensitivity data should be taken into account. If necessary, microbiological samples should be collected and analyzed for bacteriological sensitivity.
It is also used for the prevention of infections that are associated with major surgical operations on the gastrointestinal tract, in the pelvis, head and neck, on the heart, kidneys, and bile ducts.
The drug Amoxiclavin vivo
- gram-positive airbags —
Enterobacter spp.**, Escherichia coli*, Haemophilus influenzae*
it has a bactericidal effect for the following microorganisms (however, the clinical significance is still unknown):
- gram-positive airbags — , species of the genus , other species of the genus ,
, species of the genus
, species of the genus , species of the genus
Fusobacterium*
- other — .
CP allows you to maintain the sensitivity of those strains S. pneumoniae, in which resistance to amoxicillin is due to penicillin-binding proteins (penicillin-resistant , or PRSP
Below is the activity of the combination of amoxicillin with clavulanic acid
,
Bordetella pertussis, Haemophilus influenzae
Bacteroides fragilis, Capnocytophaga spp., Eikenella corrodens, Fusobacterium spp.,
Bacteria that are likely to have acquired resistance to the combination of amoxicillin with clavulanic acid
1 incl. , Proteus spp.,
Gram-negative aerobes:
®
anaerobic gram-positive bacteria: Clostridium spp., Peptococcus spp., Peptostreptococcus spp, aerobic gram-negative bacteria (including beta-lactamase-producing strains): anaerobic gram-negative bacteria (including beta-lactamase-producing strains):
Clavulanic acid suppresses types II, III, IV and V of beta-lactamases, is inactive against type I beta-lactamases produced by Enterobacter spp., Pseudomonas aeruginosa, Serratia spp., Acinetobacter spp. Clavulanic acid has a high tropicity to penicillinases and forms a stable complex with the enzyme, which prevents the enzymatic degradation of amoxicillin under the influence of beta-lactamases.
Peak plasma concentrations are reached approximately 1 h after administration. Values of C
The plasma concentrations of amoxicillin/clavulanic acid are similar to those of oral administration of the corresponding doses of amoxicillin or clavulanic acid separately at equivalent doses.
Amoxicillin (like most penicillins) is excreted in breast milk. Trace amounts of clavulanic acid were also found in breast milk. Amoxicillin and clavulanic acid penetrate the placental barrier.
Amoxicillin is mainly excreted by the kidneys, whereas clavulanic acid is excreted by both the renal and extrarenal mechanisms. After a single oral administration of one tablet 250 125 mg or 500 125 mg, approximately 60-70% of amoxicillin and 40-65% of clavulanic acid are excreted unchanged in the urine for the first 6 hours. About 10-25% of the initial dose of amoxicillin is excreted in the urine as inactive penicillic acid. Clavulanic acid in the human body undergoes intensive metabolism with the formation of 2,5-dihydro-4 - (2-hydroxyethyl) - 5-oxo-1H-pyrrole-3-carboxylic acid and 1-amino-4-hydroxy-butane-2-one and is excreted in the urine and feces
Average T
The pharmacokinetic parameters of amoxicillin and clavulanic acid are summarized in Table 1.
| Dose, mg | |||||
| 875 | |||||
| Bi Moxal 1000 mg 62.5 mg×2 | ||||||
For bacteria with an MPC of 4 mg/l.
CP has a unique pharmacological profile, the T>MPC index characteristic of this drug is not achieved when taking tablets with immediate release of active substances containing a combination of amoxicillin and clavulanic acid.
As with the intravenous administration of a combination of amoxicillin and clavulanic acid, therapeutic concentrations of amoxicillin and clavulanic acid are created in various tissues and interstitial fluid (gallbladder, abdominal tissue, skin, adipose and muscle tissue, synovial and peritoneal fluid, bile, purulent discharge).
® CP in any body.
Amoxicillin, like most penicillins, penetrates into breast milk. Trace amounts of clavulanic acid were also found in breast milk. With the exception of the possibility of diarrhea and candidiasis of the oral mucosa, no other negative effects of amoxicillin and clavulanic acid on the health of infants fed with breast milk are known.
Studies of reproductive function in animals when taking the drug Augmentin
Studies have shown that, on average, about 60-70% of amoxicillin and about 40-65% of clavulanic acid is excreted unchanged by the kidneys.
The pharmacokinetics of amoxicillin and clavulanic acid are similar. After intravenous administration in doses of 1200 mg and 600 mg S
Bi Moxal
Amoxicillin, Clavulanic
Amoxiclav®
Film-coated tablets
Inside. 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.
The drug Amoxiclav® it is recommended to take it at the beginning of a meal for optimal absorption and to reduce possible side effects from the digestive system.
The course of treatment is 5-14 days. The duration of the course of treatment is determined by the attending physician. Treatment should not last more than 14 days without a second medical examination.
Children under 12 years old
The dose is prescribed depending on the age and body weight. The recommended dosage regimen is 40 mg / kg / day in 3 doses.
Children with a body weight of 40 kg or more should be prescribed the same doses as adults. For children aged less than 6 years, it is more preferable to take a suspension of the drug Amoxiclav®.
Adults and children over 12 years of age (or >40 kg of body weight)
The usual dose in the case of mild and moderate infection is 1 tab. 250 125 mg every 8 hours or 1 tab. 500 125 mg every 12 hours, in the case of severe infection and respiratory tract infections-1 tab. 500 125 mg every 8 hours or 1 tab. 875 125 mg every 12 hours.
Since the tablets of the combination of amoxicillin and clavulanic acid of 250 125 mg and 500 125 mg contain the same amount of clavulanic acid-125 mg, then 2 tables of 250 125 mg are not equivalent to 1 table of 500 125 mg.
Dosage for odontogenic infections
1 tab. 250 125 mg every 8 hours or 1 tab. 500 125 mg every 12 hours for 5 days.
Patients with impaired renal function
Dose adjustment is based on the maximum recommended dose of amoxicillin and is carried out taking into account the values of Cl creatinine:
- adults and children over 12 years of age (or ≥40 kg of body weight) (Table 2),
- with anuria, the interval between dosing should be increased to 48 hours or more,
- tablets 875 125 mg should be used only in patients with creatinine Cl >30 ml / min.
Table 2
| Creatinine clearance | Dosage regimen of Amoxiclav® |
| >30 ml / min | No dose adjustment is required |
| 10-30 ml / min | 1 tab. 50 125 mg 2 times a day or 1 tab. 250 125 mg (for mild and moderate infection) 2 times a day |
| <10 ml / min | 1 table. 500 125 mg 1 time per day or 1 table. 250 125 mg (for mild and moderate infection) 1 time per day |
| Hemodialysis | 1 table 500 125 mg or 2 table 250 125 mg every 24 hours 1 table 500 125 mg or 2 table 250 125 mg during dialysis and at the end of the dialysis session (due to a decrease in serum concentrations of amoxicillin and clavulanic acid) |
Patients with impaired liver function
Taking the drug Amoxiclav® it should be carried out with caution. It is necessary to conduct regular monitoring of liver function.
Powder for preparation of suspension for oral administration
Inside
The daily dose of suspensions is 125 31.25 mg/5 ml and 250 62.5 mg/5 ml (to facilitate correct dosing, a 5-ml graduated pipette with a 0.1-ml scale or a 5-ml dosing spoon with a 2.5-ml ring mark in the cavity is inserted into each package of suspensions 125 31.25 mg/5 ml and 250 62.5 mg/5 ml).
Newborns and children up to 3 months old — 30 mg / kg / day (according to amoxicillin), divided into 2 doses (every 12 hours).
Dosage of Amoxiclav® dosage pipette-calculation of single doses for the treatment of infections in newborns and children up to 3 months (Table 3).
Table 3
| Body weight, kg | 2 | 2,2 | 2,4 | 2,6 | 2,8 | 3 | 3,2 | 3,4 | 3,6 | 3,8 | 4 | 4,2 | 4,4 | 4,6 | 4.8 |
| Suspension 156.25, ml (2 times a day) | 1,2 | 1,3 | 1,4 | 1,6 | 1,7 | 1,8 | 1,9 | 2 | 2,2 | 2,3 | 2,4 | 2,5 | 2,6 | 2,8 | 2,9 |
| Suspension 312,5, ml (2 times a day) | 0,6 | 0,7 | 0,7 | 0,8 | 0,8 | 0,9 | 1 | 1 | 1,1 | 1,1 | 1,2 | 1,3 | 1,3 | 1,4 | 1,4 |
Children older than 3 months — from 20 mg / kg for mild and moderate infections to 40 mg / kg for severe infections and lower respiratory tract infections, otitis media, sinusitis (amoxicillin) per day, divided into 3 doses (every 8 hours).
Dosage of Amoxiclav® dosage pipette-calculation of single doses for the treatment of mild and moderate infections in children older than 3 months (at the rate of 20 mg/kg/day (according to amoxicillin) (Table 4).
Table 4
| Body weight, kg | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 | 21 | 22 |
| Suspension 156.25, ml (3 times a day) | 1,3 | 1,6 | 1,9 | 2,1 | 2,4 | 2,7 | 2,9 | 3,2 | 3,5 | 3,7 | 4 | 4,3 | 4,5 | 4,8 | 5,1 | 5,3 | 5,6 | 5,9 |
| Suspension 312,5, ml (3 times a day) | 0,7 | 0,8 | 0,9 | 1,1 | 1,2 | 1,3 | 1,5 | 1,6 | 1,7 | 1,9 | 2 | 2,1 | 2,3 | 2,4 | 2,5 | 2,7 | 2,8 | 2,9 |
| Body weight, kg | 23 | 24 | 25 | 26 | 27 | 28 | 29 | 30 | 31 | 32 | 33 | 34 | 35 | 36 | 37 | 38 | 39 | |
| Suspension 156.25, ml (3 times a day) | 6,1 | 6,4 | 6,7 | 6,9 | 7,2 | 7,5 | 7,7 | 8 | 8,3 | 8,5 | 8,8 | 9,1 | 9,3 | 9,6 | 9,9 | 10,1 | 10,4 | |
| Suspension 312,5, ml (3 times a day) | 3,1 | 3,2 | 3,3 | 3,5 | 3,6 | 3,7 | 3,9 | 4 | 4,1 | 4,3 | 4,4 | 4,5 | 4,7 | 4,8 | 4,9 | 5,1 | 5,2 |
Dosage of Amoxiclav® dosage pipette-calculation of single doses for the treatment of severe infections in children older than 3 months (at the rate of 40 mg / kg / day (according to amoxicillin) (Table 5).
Table 5
| Body weight, kg | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 | 21 | 22 |
| Suspension 156.25, ml (3 times a day) | 2,7 | 3,2 | 3,7 | 4,3 | 4,8 | 5,3 | 5,9 | 6,4 | 6,9 | 7,5 | 8 | 8,5 | 9,1 | 9,6 | 10,1 | 10,7 | 11,2 | 11,7 |
| Suspension 312,5, ml (3 times a day) | 1,3 | 1,6 | 1,9 | 2,1 | 2,4 | 2,7 | 2,9 | 3,2 | 3,5 | 3,7 | 4 | 4,3 | 4,5 | 4,8 | 5,1 | 5,3 | 5,6 | 5,9 |
| Body weight, kg | 23 | 24 | 25 | 26 | 27 | 28 | 29 | 30 | 31 | 32 | 33 | 34 | 35 | 36 | 37 | 38 | 39 | |
| Suspension 156.25, ml (3 times a day) | 12,3 | 12,8 | 13,3 | 13,9 | 14,4 | 14,9 | 15,5 | 16 | 16,5 | 17,1 | 17,6 | 18,1 | 18,7 | 19,2 | 19,7 | 20,3 | 20,8 | |
| Suspension 312,5, ml (3 times a day) | 6,1 | 6,4 | 6,7 | 6,9 | 7,2 | 7,5 | 7,7 | 8 | 8,3 | 8,5 | 8,8 | 9,1 | 9,3 | 9,6 | 9,9 | 10,1 | 10,4 |
Dosage of Amoxiclav® dosage spoon (in the absence of a dosage pipette) - recommended doses of suspensions depending on the child's body weight and the severity of the infection (Table 6).
Table 6
| Body weight, kg | Age (approximately) | Mild/moderate course | Heavy current | ||
| 125 31.25 mg/5 ml | 250 62.5 mg/5 ml | 125 31.25 mg/5 ml | 250 62.5 mg/5 ml | ||
| 5–10 | 3-12 months | 3 × 2.5 ml (½ spoon) | 3 × 1.25 ml | 3 × 3.75 ml | 3 × 2 ml |
| 10–12 | 1-2 years | 3 × 3.75 ml | 3 × 2 ml | 3 × 6.25 ml | 3 × 3 ml |
| 12–15 | 2-4 years old | 3 × 5 ml (1 spoon) | 3 × 2.5 ml (½ spoon) | 3 × 7.5 ml (1½ tablespoons) | 3 × 3.75 ml |
| 15–20 | 4-6 years old | 3 × 6.25 ml | 3 × 3 ml | 3 × 9.5 ml | 3 × 5 ml (1 spoon) |
| 20–30 | 6-10 years old | 3 × 8.75 ml | 3 × 4.5 ml | - | 3 × 7 ml |
| 30–40 | 10-12 years old | - | 3 × 6.5 ml | - | 3 × 9.5 ml |
| ≥40 | ≥12 years | Amoxiclav® tablets | |||
Daily dose of suspension 400 mg 57 mg/5 ml
The dose is calculated per kg of body weight, depending on the severity of the infection. From 25 mg / kg - for mild and moderate infections to 45 mg/kg-for severe infections and lower respiratory tract infections, otitis media, sinusitis (in terms of amoxicillin) per day, divided into 2 doses.
To facilitate correct dosing, a dosing pipette is inserted into each package of 400 mg 57 mg/5 ml suspension, graduated simultaneously into 1, 2, 3, 4, 5 ml and into 4 equal parts.
Suspension 400 mg 57 mg/5 ml is used in children older than 3 months.
Table 7
| Body weight, kg | Age (approximately) | Recommended dose, ml | |
| Heavy current | The course of moderate severity | ||
| 5–10 | 3-12 months | 2×2,5 | 2×1,25 |
| 10–15 | 1-2 years | 2×3,75 | 2×2,5 |
| 15–20 | 2-4 years old | 2×5 | 2×3,75 |
| 20–30 | 4 years — 6 years | 2×7,5 | 2×5 |
| 30–40 | 6-10 years old | 2×10 | 2×6,5 |
The exact daily doses are calculated based on the child's body weight, not their age.
The maximum daily dose of amoxicillin is 6 g for adults and 45 mg/kg for children.
The maximum daily dose of clavulanic acid (in the form of potassium salt) is 600 mg for adults and 10 mg/kg for children.
In patients with impaired renal function, the dose should be adjusted based on the maximum recommended dose of amoxicillin.
Patients with creatinine Cl >30 ml / min do not require any dose adjustment.
Adults and children weighing more than 40 kg (the specified dosage regimen is used for moderate and severe infections)
Patients with creatinine Cl 10-30 ml / min — 500/125 mg 2 times a day.
When creatinine Cl <10 ml / min, the recommended dose is 500/125 mg once a day.
For patients on hemodialysis, the recommended dose is 500/125 mg every 24 hours, plus 500/125 mg during dialysis and another dose at the end of dialysis (since serum concentrations of amoxicillin and clavulanic acid are reduced).
Children weighing less than 40 kg
With a creatinine Cl of 10-30 ml / min, the recommended dose is 15/3. 75 mg / kg 2 times a day (maximum 500/125 mg 2 times a day).
With creatinine Cl <10 ml / min, the recommended dose is 15/3. 75 mg / kg once a day (maximum 500/125 mg).
For hemodialysis, the recommended dose is 15/3. 75 mg / kg once a day. Before hemodialysis — 15/3. 75 mg/kg. To restore the appropriate concentrations of the drug in the blood,it is necessary to take another dose of 15/3. 75 mg/kg after hemodialysis.
The course of treatment is 5-14 days. The duration of the course of treatment is determined by the attending physician. Treatment should not last more than 14 days without a second medical examination.
Instructions for preparing the suspension
Powder for suspension preparation 125 31.25 mg/5ml - shake the bottle vigorously, add 86 ml of water in two doses (up to the mark), each time shaking well until the powder is completely dissolved.
Powder for suspension preparation 250 62.5 mg/5ml - shake the bottle vigorously, add 85 ml of water in two doses (up to the mark), shaking well each time until the powder is completely dissolved.
Suspension Preparation powder 400 mg 57 mg/5 ml - shake the bottle vigorously, add water in two steps (up to the label) in the amount indicated on the label and shown in the table, each time shaking well until the powder is completely dissolved.
Table 8
| Volume of the finished suspension, ml | Required amount of water, ml |
| 35 | 29,5 |
| 50 | 42 |
| 70 | 59 |
| 140 | 118 |
Shake vigorously before use!
To prepare the suspension, it is recommended to dilute the powder with boiled water at room temperature. It is recommended to place the finished suspension in the refrigerator.
It is not recommended to heat the suspension before use (it is necessary to bring the suspension to room temperature).
After taking the drug, it is recommended to rinse the dosage pipette with boiled water.
Powder for preparation of solution for intravenous administration
In/in.
Children: with a body weight of less than 40 kg-the dose is calculated depending on the body weight.
Under 3 months with a body weight of less than 4 kg - 30 mg / kg (in terms of the entire drug Amoxiclav®) every 12 hours.
Under 3 months with a body weight of more than 4 kg - 30 mg / kg (in terms of the entire drug Amoxiclav®) every 8 hours.
In children younger than 3 months, the drug Amoxiclav® it should be administered only slowly by infusion for 30-40 minutes.
Children from 3 months to 12 years old - 30 mg / kg (in terms of the entire drug Amoxiclav®) at intervals of 8 hours, in the case of severe infection - at intervals of 6 hours.
Children with impaired renal function
The dose adjustment is based on the maximum recommended dose of amoxicillin. In patients with creatinine Cl values above 30 ml/min, dose adjustment is not necessary.
Children weighing <40 kg:
| Creatinine Cl 10-30 ml / min | 25 mg/5 mg per 1 kg every 12 hours |
| Creatinine Cl <10 ml / min | 25 mg/5 mg per 1 kg every 24 hours |
| Hemodialysis | 25 mg / 5 mg per 1 kg every 24 hours plus a dose of 12.5 mg/2.5 mg per 1 kg at the end of the dialysis session (due to a decrease in the concentration of amoxicillin and clavulanic acid in the serum) |
Every 30 mg of Amoxiclav® they contain 25 mg of amoxicillin and 5 mg of clavulanic acid.
Adults and children over 12 years of age or weighing more than 40 kg - 1.2 g of the drug (1000-200 mg) at an interval of 8 hours, in case of severe infection - at an interval of 6 hours.
Prophylactic doses for surgical interventions: 1.2 g for introductory anesthesia (if the duration of the operation is less than 2 hours). For longer operations-1.2 g up to 4 times during the day.
For patients with renal insufficiency, the dose and / or interval between injections of the drug should be adjusted depending on the degree of insufficiency:
| Creatinine Cl | Dose and / or interval between injections |
| >0.5 ml / s (30 ml / min) | No dose adjustment is required |
| The first dose is 1.2 g (1000 200 mg), followed by 600 mg (500 100 mg) intravenously every 12 hours | |
| <0.166 ml / s (less than 10 ml / min) | The first dose is 1.2 g (1000 200 mg), followed by 600 mg (500 100 mg) intravenously every 24 hours |
| Anuria | The dosing interval should be increased to 48 hours or more |
Since 85% of the drug is removed by hemodialysis, the usual dose of Amoxiclav should be administered at the end of each hemodialysis procedure®. In peritoneal dialysis, dose adjustment is not required.
The course of treatment is 5-14 days. The duration of the course of treatment is determined by the attending physician. With a decrease in the severity of symptoms, it is recommended to switch to oral forms of the drug Amoxiclav to continue therapy®.
Preparation of solutions for intravenous injection. Dissolve the contents of the vial in water for injection: 600 mg (500 100 mg) - in 10 ml of water for injection or 1.2 g (1000 200 mg) - in 20 ml of water for injection. In/in enter slowly (within 3-4 minutes).
The drug Amoxiclav® it should be administered within 20 minutes after the preparation of solutions for intravenous administration.
Preparation of solutions for intravenous infusions. For infusion administration of the drug Amoxiclav® further dilution is necessary: prepared solutions containing 600 mg (500 100 mg) or 1.2 g (1000 200 mg) of the drug should be diluted in 50 or 100 ml of the infusion solution, respectively. The duration of the infusion is 30-40 minutes.
When using the liquids listed below in the recommended volumes, the necessary concentrations of the antibiotic are preserved in the infusion solutions:
| Liquids used | Stability period, h | |
| at 25 °C | at 5 °C | |
| Water for injection | 4 | 8 |
| 0.9% sodium chloride solution for intravenous infusions | 4 | 8 |
| Ringer Lactate solution for intravenous infusions | 3 | |
| Solution of calcium chloride and sodium chloride for intravenous infusions | 3 | |
Solution of the drug Amoxiclav® do not mix with dextrose, dextran, or sodium bicarbonate solutions.
Only clear solutions should be used. Prepared solutions should not be frozen.
Amoxiclav® Quicktab
Inside. The dosage regimen is set individually depending on the age, body weight, kidney function of the patient and the severity of the infection.
The tablets should be dissolved in half a glass of water (at least 30 ml) and thoroughly mixed, then drink or hold the tablets in your mouth until completely dissolved, then swallow.
In order to reduce the risk of side effects from the gastrointestinal tract, you should take the drug at the beginning of a meal.
Dispersible tablets of the drug Amoxiclav®Quicktab 500 mg/125 mg:
Adults and children over 12 years of age with a body weight of ≥40 kg
For the treatment of mild and moderate infections — 1 tablet (500 mg/125 mg) every 12 hours (2 times a day).
For the treatment of severe infections and respiratory infections — 1 tablet (500 mg/125 mg) every 8 hours (3 times a day).
Maximum daily dose of Amoxiclav®Quicktab is 1500 mg of amoxicillin/375 mg of clavulanic acid.
Patients with impaired renal function. In patients with a creatinine Cl above 30 ml/min, there is no need for dose adjustment.
Adults and children over 12 years of age with a body weight of ≥40 kg (the indicated dosage regimen is used for moderate and severe infections):
| Creatinine Cl, ml / min | Dose | |
| 10–30 | 500 mg/125 mg 2 times a day (for moderate to severe infection) | |
| <10 | 500 mg/125 mg 1 time per day (for moderate to severe infection) | |
| Hemodialysis | 500 mg / 125 mg every 24 hours, plus 500 mg/125 mg during the dialysis session, with repeated use at the end of the dialysis session (since plasma concentrations of amoxicillin and clavulanic acid decrease) |
Dispersible tablets of the drug Amoxiclav®Quicktab 875 mg/125 mg:
Adults and children over 12 years of age with a body weight of ≥40 kg
For severe infections and respiratory infections — 1 table (875 mg / 125 mg) every 12 hours (2 times a day).
Daily dose of Amoxiclav®Quicktab when used 2 times a day is 1750 mg of amoxicillin/250 mg of clavulanic acid.
Patients with impaired renal function. In patients with a creatinine Cl of more than 30 ml/min, there is no need for dose adjustment.
Patients with creatinine Cl less than 30 ml / min using dispersible tablets of Amoxiclav®Quicktab, 875 mg/125 mg is contraindicated.
Such patients should take the drug at a dosage of 500 mg/125 mg after a dose adjustment corresponding to the level of Cl creatinine.
Patients with impaired liver function. When taking the drug Amoxiclav®Quicktab should be careful. It is necessary to conduct regular monitoring of liver function. In the case of starting treatment with parenteral administration of the drug, therapy can be continued by taking tablets of the drug Amoxiclav®Quicktab.
The duration of the course of treatment is determined by the attending physician!
The minimum course of antibacterial therapy is 5 days. Treatment should not last more than 14 days without reviewing the clinical situation.
Inside, drinking water, at the beginning of a meal (in order to reduce the risk of side effects from the gastrointestinal tract), 2 times a day, strictly observing the interval between meals of 12 hours.
Film-coated tablets
Adults and children over 12 years of age (body weight ≥40 kg)
Take 1 tablet. 2 times a day, every 12 hours.
The maximum daily dose of amoxicillin for adults is 6 g, for children-45 mg / kg / day.
The maximum daily dose of clavulanic acid for adults (in the form of potassium clavulanate) is 600 mg, for children-10 mg/kg / day.
The course of treatment is 5-14 days, set individually, taking into account the characteristics of the pathogen, localization and severity of the infection. Treatment should not last more than 14 days without a second medical examination.
Dosage for renal failure
Tablets 875/125 mg should be used only in patients with a creatinine Cl of more than 30 ml / min, and no dose adjustment is required.
Patients on peritoneal dialysis do not need to adjust the dose. Patients on hemodialysis may need to adjust the dose of the drug.
Powder for preparation of suspension for oral administration
Dose with a measuring spoon, taking into account that 5 ml of the finished suspension contains amoxicillin 400 mg/clavulanic acid 57 mg. Drink 0.5-1 cup of water.
The dose of Panclav 2X is prescribed by a doctor, taking into account the characteristics of the pathogen, localization and severity of the infection. The dosage regimen is set individually, depending on age, body weight (for children) and kidney function. The course of treatment is 5-14 days, set individually.
For infections that require a long course of therapy (for example, osteomyelitis), exceeding the maximum recommended course of therapy of 14 days is possible only after a thorough assessment by the doctor of the patient's condition, the achieved and expected therapeutic effects and risks.
The maximum daily dose of amoxicillin for adults is 6 g, for children-45 mg / kg / day. The maximum daily dose of clavulanic acid for adults (in the form of potassium clavulanate) is 600 mg, for children-10 mg/kg / day.
Adults and children over 12 years of age (body weight ≥40 kg)
Standard dosage regimen for all indications:
2 scoops (800/114 mg) 2 times a day, every 12 hours.
Children from 2 to 12 years (body weight ≥40 kg)
| Daily dose (according to amoxicillin) | Child's weight | Age-appropriate | Quantity of finished suspension |
| 25 mg / kg | 13-21 kg | 2-6 years old | 2.5 ml 2 times a day |
| 22-40 kg | 7-12 years old | 5 ml 2 times a day | |
| 45 mg / kg | 13-21 kg | 2-6 years old | 5 ml 2 times a day |
| The daily dose is 25 mg / kg (according to amoxicillin) | ||
| 1.4 ml 2 times a day | ||
| 1.7 ml 2 times a day | ||
Children and adults with renal insufficiency
With a creatinine Cl of less than 30 ml / min, the drug at this dose is not recommended, with a creatinine Cl of more than 30 ml / min, there is insufficient evidence to develop special recommendations for the dosage regimen. It is allowed both to reduce the dose of the drug, and to increase the interval between doses.
In the bottle with the powder, gradually add water to the mark (distilled water or boiled and cooled) and shake until the powder is evenly wet (about 30 c). If the level of the prepared suspension is below the label on the bottle label, re-add water to the label and shake.
You should never take a double dose to make up for a missed medication!
Treatment should not last more than 14 days without reviewing the clinical situation.
The SRS have a dividing groove that allows them to be broken in half for ease of ingestion, but not to reduce the dose: both halves must be taken simultaneously. The recommended dose of the drug is 2 tablets. 2 times a day.
Respiratory tract infections: 2 table. 2 times a day for 7-10 days, including the following diseases:
- acute sinusitis of bacterial etiology — 2 tables. 2 times a day for 10 days.
Special patient groups
No dosage adjustment is required for creatinine Cl ≥30 ml/min. It is not recommended to prescribe the drug to patients with creatinine Cl <30 ml/min.
Children from 3 months to 12 years: 30 mg / kg every 8 hours, with more severe infections, the interval between injections is reduced to 6 hours.
30 mg of the intravenous drug contains 25 mg of amoxicillin and 5 mg of clavulanic acid.
With reduced renal function: adults with mild insufficiency (creatinine Cl > 30 ml / min) there is no need to reduce the dosage, with moderate insufficiency (Cl creatinine — 10-30 ml/min), treatment begins with the introduction of 1.2 g / in, then 600 mg / in every 12 hours, with severe renal insufficiency (Cl creatinine < 10 ml / min), treatment begins with the introduction of 1.2 g / in, then continue with 600 mg / in every 24 hours, dialysis reduces the concentration in the serum, so the drug is prescribed at a dosage of 600 mg / in during or after dialysis. The dosage for children is also reduced.
Inside, before or during a meal. Adults and children over 12 years of age: moderate infections-375 mg (1 table) 3 times a day, severe infections-625 mg 3 times a day. The duration of the course of treatment-no more than 14 days.
With impaired renal function, adults:
| No changes | |
| 10–30 | |
