Flemoklav solutab application. Special groups of patients. Drugs with similar effects

Catad_pgroup Antibiotics penicillins

Flemoklav Solutab - official instructions by application

Registration number:

LSR-000392/09 - 060516

Tradename:

Flemoklav Solutab ®

INN or group name:

amoxicillin + clavulanic acid

Dosage form:

dispersible tablets

Compound:

One tablet contains:

Active substance: amoxicillin trihydrate (which corresponds to amoxicillin base) - 1019.8 mg (875.0 mg); potassium clavulanate (which corresponds to clavulanic acid) -148.9 mg (125 mg).

Excipients: dispersed cellulose - 30.4 mg, microcrystalline cellulose - 125.9 mg, crospovidone - 64.0 mg, vanillin - 1.0 mg, tangerine flavor - 9.0 mg, lemon flavor - 11.0 mg, saccharin - 13, 0 mg, magnesium stearate - 6.0 mg.

Description

Dispersible tablets oblong shape from white to yellow color, without risks, marked “425” and a graphic part of the company logo. Brown dotted spots are allowed.

Pharmacotherapeutic group:

Antibiotic - semi-synthetic penicillin + beta-lactamase inhibitor.

CodeATX:

PHARMACOLOGICAL PROPERTIES

Pharmacodynamics

Mechanism of action

Amoxicillin is a semisynthetic broad-spectrum antibiotic that is active against many fam-positive and fam-negative microorganisms. At the same time, amoxicillin is susceptible to destruction by beta-lactamases, and therefore the spectrum of activity of amoxicillin does not extend to microorganisms that produce this enzyme. Clavulanic acid is a beta-lactamase inhibitor, structurally related to penicillins, has the ability to inactivate wide range beta-lactamases found in microorganisms resistant to penicillins and cephalosporins.

Clavulanic acid is sufficiently effective against plasmid beta-lactamases, which most often cause bacterial resistance, and is not effective against type 1 chromosomal beta-lactamases, which are not inhibited by clavulanic acid. The presence of clavulanic acid in the drug Flemoklav Solutab protects amoxicillin from destruction by enzymes - beta-lactamases, which allows expanding the antibacterial spectrum of amoxicillin. Below is the activity of the combination of amoxicillin and clavulanic acid in vitro.

Bacteria usually susceptible to the combination of amoxicillin and clavulanic acid

Gram-positive aerobes:

Bacillus anthracis
Enterococcus faecalis
Listeria monocytogenes
Nocardia asteroides
Streptococcus pyogenes 1,2
Streptococcus agalactiae 1,2
Streptococcus spp.(other beta-hemolytic streptococci) 1,2
Staphylococcus aureus(methicillin sensitive) 1
Staphylococcus saprophyticus(methicillin sensitive)

Coagulase-negative staphylococci, (sensitive to methicillin).

Gram-positive anaerobes:

Clostridium spp.
Peptococcus niger
Peptostreptococcus magnus
Peptostreptococcus micros
Peptostreptococcus spp.

Gram-negative aerobes:

Bordetella pertussis
Haemophilus influenzae 1
Helicobacter pylori
Moraxella catarrhalis 1
Neisseria gonorrhoeae
Pasteurella multocida
Vibrio cholerae.

Gram-negative anaerobes:

Bacteroides fragilis
Bacteroides spp.
Capnocytophaga spp.
Eikenella corrodens
Fusobacterium nucleatum
Fusobacterium spp.
Porphyromonas spp.
Prevotella spp.

Others:

Borrelia burgdorferi
Leptospira icterohaemorrhagiae
Treponema pallidum.

Bacteria for which acquired resistance to the combination of amoxicillin and clavulanic acid is likely

Gram-negative aerobes:

Escherichia coli 1
Klebsiella oxytoca
Klebsiella pneumoniae 1
Klebsiella spp.
Proteus mirabilis
Proteus vulgaris,
Proteus spp.
Salmonella spp.
Shigella spp.

Gram-positive aerobes:

Corynebacterium spp.
Enterococcus faecium
Streptococcus pneumoniae 1.2

group streptococci Viridans 2

Bacteria that are naturally resistant to the combination of amoxicillin andclavulanic acid

Gram-negative aerobes:
Acinetobacter spp.
Citrobacter freundii
Enterobacter spp.
Hafnia alvei
Legionella pneumophila
Morganella morganii
Providencia spp.
Pseudomonas spp.
Serratia spp.
Stenotrophomonas maltophilia
Yersinia enterocolitica.

Others:
Chlamydia pneumoniae
Chlamydia psittaci
Chlamydia spp.
Coxiella burnetii
Mycoplasma spp.

1 - for these types of microorganisms clinical effectiveness the combination of amoxicillin with clavulanic acid has been demonstrated in clinical studies.

2 - strains of these types of bacteria do not produce p-lactamases. Sensitivity during amoxicillin monotherapy suggests similar sensitivity to the combination of amoxicillin and clavulanic acid.

Pharmacokinetics

Suction

Both active ingredients and the drug Flemoklav Solutab®, amoxicillin and clavulanic acid, are quickly and completely absorbed from gastrointestinal tract(gastrointestinal tract) after oral administration. Absorption of active substances is optimal if the drug is taken at the beginning of a meal.

After a single dose of Flemoklav Solutab® at a dose of 875/125 mg (amoxicillin/clavulanic acid), the maximum concentration of amoxicillin in the blood plasma is created after 1.5 hours (t max), and is 12 μg/ml (Cmax), clavulanic acid - after 1 hour, amounting to 3 μg/ml. The PFC (area under the pharmacokinetic curve) of amoxicillin and clavulanic acid is 33 µg/l and 6 µg/l, respectively. Absorption of amoxicillin at oral administration reaches 90%, the absolute bioavailability of clavulanic acid averages 60%.

Distribution

As with intravenous administration combinations of amoxicillin with clavulanic acid, therapeutic concentrations of amoxicillin and clavulanic acid are found in various tissues and interstitial fluid (in gallbladder, fabrics abdominal cavity, skin, fat and muscle tissue, synovial and peritoneal fluids, bile, purulent discharge). Amoxicillin and clavulanic acid have weak degree binding to blood plasma proteins. Approximately 17-20% of amoxicillin and 22% of clavulanic acid are bound to plasma proteins.

In animal studies, no accumulation of the components of the drug Flemoklav Solutab was found in any organ.

Amoxicillin, like most penicillins, penetrates breast milk. Trace amounts of clavulanic acid have also been found in breast milk. With the exception of the possibility of sensitization, diarrhea or candidiasis of the oral mucosa, there are no other known negative effects of amoxicillin and clavulanic acid on the health of breastfed infants. Research reproductive function in animals it has been shown that amoxicillin and clavulanic acid cross the placental barrier. However, it was not revealed negative influence for the fruit.

Metabolism

10-25% of the initial dose of amoxicillin is excreted in the urine in the form of an inactive metabolite (penicillic acid). Clavulanic acid is extensively metabolized to 2,5-dihydro-4-(2-hydroxyethyl)-5-oxo-1H-pyrrole-3-carboxylic acid and 1-amino-4-hydroxy-butan-2-one and is excreted by the kidneys , through the gastrointestinal tract, as well as with exhaled air in the form of carbon dioxide.

Removal

The total clearance for the two active substances is 25 l/h, the half-life (t1/2) of amoxicillin is 1.1 hours, clavulanic acid is 0.9 hours.

Approximately 60-80% of amoxicillin and 30-50% of clavulanic acid are excreted through the kidneys within the first 6 hours after taking the drug.

Simultaneous administration of probenecid slows down the elimination of amoxicillin, but not clavulanic acid (see section “Interaction with other drugs”).

INDICATIONS FOR USE

The combination of amoxicillin with clavulanic acid is indicated for the treatment bacterial infections the following localizations caused by microorganisms sensitive to the combination of amoxicillin and clavulanic acid:

Infections of the upper respiratory tract(including infections of the ENT organs), for example, recurrent tonsillitis, sinusitis, otitis media, usually called Streptococcus pneumoniae, Haemophilus influenzae #, Moraxella catarrhalis# And Streptococcus pyogenes.

Infections lower sections respiratory tract, for example, exacerbations chronic bronchitis, lobar pneumonia and bronchopneumonia, usually caused by Streptococcus pneumoniae, Haemophilus influenzae # And Moraxella catarrhalis # .

Genitourinary tract infections, e.g. cystitis, urethritis, pyelonephritis, infections of the female genital tract, usually caused by species of the family Enterobacteriaceae 1 (mostly Escherichiacoli # ), Staphylococcussaprophyticus and species of the genus Enterococcus, A also gonorrhea, caused Neisseria gonorrhoeae#

Skin and soft tissue infections usually caused by Staphylococcus aureus # , Streptococcus pyogenes and species of the genus Basteroides # .

Bone and joint infections, such as osteomyelitis, usually caused by Staphylococcus aureus # , if necessary, long-term therapy is possible.

Odonogenic infections, for example, periodontitis, odontogenic maxillary sinusitis, severe dental abscesses with spreading cellulitis.

Other mixed infections (eg, septic abortion, postpartum sepsis, intra-abdominal sepsis) as part of stepwise therapy.

Some representatives of this genus of microorganisms produce beta-lactamase, which makes them insensitive to amoxicillin (see also section " Pharmacological properties"). Infections caused by microorganisms sensitive to amoxicillin can be treated with Flemoklav Solutab, since amoxicillin is one of its active ingredients. Flemoclav Solutab 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 sensitivity of bacteria to the combination of amoxicillin and clavulanic acid varies regionally and over time. Where possible, local sensitivity data should be taken into account. If necessary, microbiological samples should be collected and bacteriological susceptibility testing should be carried out.

CONTRAINDICATIONS

• History of hypersensitivity to amoxicillin, clavulanic acid, other components of the drug, beta-lactam antibiotics (for example, penicillins, cephalosporins);
• history of previous episodes of jaundice or impaired liver function when using a combination of amoxicillin and clavulanic acid;
• childhood up to 12 years or body weight less than 40 kg;
• renal dysfunction (creatinine clearance< 30 мл/мин).

Carefully: heavy liver failure, diseases of the gastrointestinal tract (including a history of colitis associated with the use of penicillins), chronic renal failure.

USE IN PREGNANCY AND BREASTFEEDING

Pregnancy

In animal reproductive studies, oral and parenteral administration The drug amoxicillin + clavulanic acid did not cause teratogenic effects. In a single study of women with premature rupture of membranes, it was found that preventive therapy the drug may be associated with an increased risk of developing necrotizing enterocolitis in newborns. Like all medications, Flemoklav Solutab is not recommended for use during pregnancy, except in cases where the expected benefit to the mother outweighs the potential risk to the fetus.

Breastfeeding period

Flemoclav Solutab can be used during breastfeeding. With the exception of the possibility of sensitization, diarrhea or candidiasis of the oral mucosa associated with the penetration of trace amounts of the active ingredients of this drug into breast milk, there are no other adverse effects in children who are on breastfeeding, was not observed. If adverse effects occur in breastfed infants, breastfeeding should be discontinued.

METHOD OF APPLICATION AND DOSES

To prevent dyspeptic symptoms, Flemoklav Solutab® is prescribed at the beginning of a meal. The tablet is swallowed whole with a glass of water, or dissolved in half a glass of water (minimum 30 ml), stirring thoroughly before use.

For oral administration.

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.

Treatment should not continue for more than 14 days without reviewing the clinical situation.

If necessary, it is possible to carry out stepwise therapy (initially, parenteral administration of the drug, followed by switching to oral administration).

Adults and children 12 years and older or weighing 40 kg or more

1 tablet 875 mg/125 mg 2 times a day.

Special groups patients

Children under 12 years of age weighing less than 40 kg

Elderly patients

No dosage regimen adjustment is required. In elderly patients with impaired renal function, the dose should be adjusted as indicated below for adults with impaired renal function.

Patients with impaired renal function

Tablets 875 mg/125 mg should be used only in patients with creatinine clearance more than 30 ml/min, and no dosage adjustment is required.

In most cases, whenever possible, preference should be given to parenteral therapy. Patients with impaired renal function may experience seizures (see section " Side effects", "Overdose").

Patients with liver dysfunction

Treatment is carried out with caution; regularly monitor liver function. There is insufficient data to change the recommended dosage regimen in these patients.

SIDE EFFECTS

Adverse reactions, presented below, are listed in accordance with the damage to organs and organ systems and the frequency of occurrence. The frequency of occurrence is determined as follows: Often(>1/10), often(>1/100, <1/10), infrequently(>1/1000, <1/100), rarely(>1/10 000, <1/1000), very rarely(<1/10 000). Категории частоты были сформированы на основании клинических исследований препарата и пострегистрационного наблюдения.

Frequency of occurrence of adverse reactions

Rare: reversible leukopenia (including neutropenia), reversible thrombocytopenia.

Very rare: reversible agranulocytosis and reversible hemolytic anemia, prolongation of bleeding time and prothrombin time, anemia, eosinophilia, thrombocytosis.

Immune system disorders

Very rare: angioedema, anaphylactic reactions, serum sickness-like syndrome, allergic vasculitis.

Nervous system disorders

Uncommon: dizziness, headache.

Very rare: reversible hyperactivity, seizures. Seizures may occur in patients with impaired renal function, as well as in those receiving high doses of the drug (see section "Dosage and Administration" - Patients with impaired renal function,"Overdose"). Insomnia, agitation, anxiety, behavior changes.

Gastrointestinal disorders

Adults:

Very common: diarrhea. Common: nausea, vomiting.

Children:

Common: diarrhea, nausea, vomiting.

Whole population:

Nausea was most often associated with the use of high doses of the drug. If, after starting to take the drug, undesirable reactions from the gastrointestinal tract occur, they can be eliminated by taking Flemoklav Solutab at the beginning of a meal.

Uncommon: indigestion.

Very rare: antibiotic-associated colitis (including pseudomembranous colitis and hemorrhagic colitis) (see section “Special Instructions”), black “hairy” tongue, gastritis, stomatitis.

Disorders of the liver and biliary tract

Uncommon: moderate increase in aspartate aminotransferase and/or alanine aminotransferase (AST and/or ALT) activity. This reaction has been observed in patients receiving beta-lactam antibiotic therapy, but its clinical significance is unknown.

Very rare: hepatitis and cholestatic jaundice. These reactions are observed in patients receiving therapy with penicillin antibiotics and cephalosporins. Increased concentrations of bilirubin and alkaline phosphatase.

Adverse reactions from the liver were observed mainly in men and elderly patients and may be associated with long-term therapy. These adverse reactions are very rarely observed in children.

The listed signs and symptoms usually occur during or immediately after completion of therapy, but in some cases they may not appear for several weeks after completion of therapy. Adverse reactions are usually reversible. Adverse reactions from the liver can be severe, and deaths have been reported in extremely rare cases. In almost all cases, these were individuals with serious comorbidities or patients receiving concurrent potentially hepatotoxic drugs.

Skin and subcutaneous tissue disorders

Uncommon: rash, itching, urticaria.

Rarely: erythema multiforme.

Very rare: Stevens-Johnson syndrome, toxic epidermal necrolysis, bullous exfoliative dermatitis, acute generalized exanthematous pustulosis.

Renal and urinary tract disorders

Very rare: interstitial nephritis, crystalluria (see section “Overdose”), hematuria.

OVERDOSE

Symptoms

Gastrointestinal symptoms and water and electrolyte imbalance may occur. Amoxicillin crystalluria has been described, in some cases leading to the development of renal failure (see section "Special instructions and precautions"). Convulsions may occur in patients with impaired renal function, as well as in those receiving high doses of the drug (see section "Dosage and Administration" - Patients withrenal dysfunction,"Side effects").

Treatment

Gastrointestinal symptoms - symptomatic therapy, paying special attention to normalizing water and electrolyte balance. Amoxicillin and clavulanic acid can be removed from the bloodstream by hemodialysis.

The results of a prospective study that was conducted in 51 children at a poison control center showed that amoxicillin administered at a dose of less than 250 mg/kg did not lead to significant clinical symptoms and did not require gastric lavage.

INTERACTIONS WITH OTHER MEDICINES

The simultaneous use of Flemoklav Solutab® and probenecid is not recommended. Probenecid reduces the tubular secretion of amoxicillin, and therefore the simultaneous use of the drug Flemoklav Solutab® and probenecid can lead to an increase and persistence in the blood concentration of amoxicillin, but not clavulanic acid.

Concomitant use of allopurinol and amoxicillin may increase the risk of allergic skin reactions. Currently, there is no data in the literature on the simultaneous use of a combination of amoxicillin with clavulanic acid and allopurinol. Penicillins can slow down the elimination of methotrexate from the body by inhibiting its tubular secretion, therefore, simultaneous use of the drug Flemoklav Solutab and methotrexate may increase the toxicity of methotrexate. Like other antibacterial drugs, the drug Flemoklav Solutab® can affect the intestinal microflora, leading to a decrease in the absorption of estrogens from the gastrointestinal tract and a decrease in the effectiveness of combined oral contraceptives.

The literature describes rare cases of an increase in the international normalized ratio (INR) in patients with the combined use of acenocoumarol or warfarin and amoxicillin. If it is necessary to simultaneously prescribe the drug Flemoklav Solutab® with anticoagulants, prothrombin time or MHO should be carefully monitored when prescribing or discontinuing the drug Flemoklav Solutab; dose adjustment of anticoagulants for oral administration may be required.

In patients receiving mycophenolate mofetil, after starting the combination of amoxicillin and clavulanic acid, a decrease in the concentration of the active metabolite, mycophenolic acid, was observed before taking the next dose of the drug by approximately 50%. Changes in this concentration may not accurately reflect overall changes in mycophenolic acid exposure.

SPECIAL INSTRUCTIONS

Before starting treatment with Flemoclav Solutab®, it is necessary to collect a detailed history regarding previous hypersensitivity reactions to penicillins, cephalosporins or other substances that cause an allergic reaction in the patient. Serious and sometimes fatal hypersensitivity reactions (anaphylactic reactions) to penicillins have been described. The risk of such reactions is highest in patients with a history of hypersensitivity reactions to penicillins. If an allergic reaction occurs, treatment with Flemoclav Solutab should be discontinued and appropriate alternative therapy should be initiated. For severe hypersensitivity reactions, the patient should be given epinephrine immediately. Oxygen therapy, intravenous corticosteroids, and airway management, including intubation, may also be required.

If allergic skin reactions occur, treatment with Flemoclav Solutab should be discontinued.

If infectious mononucleosis is suspected, Flemoclav Solutab should not be used, since amoxicillin can cause a measles-like skin rash in patients with this disease, which makes diagnosing the disease difficult.

Long-term treatment with Flemoklav Solutab can lead to excessive proliferation of insensitive microorganisms.

Cases of pseudomembranous colitis have been described when taking antibiotics, the severity of which can vary from mild to life-threatening. Therefore, it is important to consider the possibility of developing pseudomembranous colitis in patients with diarrhea during or after antibiotic use. If diarrhea is prolonged or severe and the patient experiences abdominal cramps, treatment should be stopped immediately and the patient should be examined.

In general, the drug Flemoklav Solutab® is well tolerated and has the low toxicity characteristic of all penicillins. During long-term therapy with Flemoclav Solutab®, it is recommended to periodically evaluate renal, liver and hematopoietic function. In patients receiving a combination of amoxicillin and clavulanic acid together with indirect (oral) anticoagulants, an increase in prothrombin time (increase in MHO) has been reported in rare cases. When co-prescribing indirect (oral) anticoagulants with a combination of amoxicillin and clavulanic acid, monitoring of relevant indicators is necessary.

Dosage adjustments may be required to maintain the desired effect of oral anticoagulants. In patients with reduced diuresis, crystalluria very rarely occurs, mainly during parenteral therapy. During administration of high doses of amoxicillin, it is recommended to take sufficient fluids and maintain adequate diuresis to reduce the likelihood of amoxicillin crystal formation (see section "Overdose").

Taking Flemoklav Solutab® orally leads to a high level of amoxicillin in the urine, which can lead to false-positive results when determining glucose in the urine (for example, Benedict's test, Fehling's test). In this case, it is recommended to use the glucose oxidant method for determining the concentration of glucose in the urine. Clavulanic acid may cause nonspecific binding of immunoglobulin G and albumin to red blood cell membranes, leading to false-positive Coombs test results.

One dispersible tablet Flemoklav Solutab® 875/125 mg contains 0.64 mmol (25 mg) potassium. Potassium intake of more than 1 mmol per day requires special attention in patients with reduced renal function and in those on a controlled potassium diet.

Drug abuse and dependence

There was no drug dependence, addiction or euphoric reactions associated with the use of the drug Flemoklav Solutab.

INFLUENCE ON THE ABILITY TO DRIVE VEHICLES,MECHANISMS

No studies have been conducted to study the effect on the ability to drive vehicles and operate machinery. Since the drug may cause side effects (for example, allergic reactions, dizziness, convulsions) (see section "Side Effects"), patients should be warned about precautions when driving or working with moving machinery.

RELEASE FORM

Dispersible tablets 875 mg + 125 mg. 7 tablets in a blister, 2 blisters along with instructions for use are placed in a cardboard box.

STORAGE CONDITIONS

Store at a temperature not exceeding 25 °C. Keep out of the reach of children.

Best before date

2 years. Do not use after the expiration date stated on the package.

CONDITIONS OF VACATION FROM PHARMACIES

On prescription.

OWNER OF REGISTRATION CERTIFICATES

Astellas Pharma Europe B.V.
Silviusweg 62, 2333 BE Leiden, The Netherlands

MANUFACTURER

Astellas Pharma Europe B.V.,
Hogemaat 2, 7942 JG Meppel, The Netherlands

PACKED AND/OR PACKED

Astellas Pharma Europe B.V., the Netherlands or ORTAT CJSC, Russia

Quality claims are accepted by the Representative Office of the Private Limited Liability Company "Astellas Pharma Europe B.V." (Netherlands) in Moscow at the address:

109147 Moscow, Marksistskaya st., 16, “Mosalarko Plaza-1” business center, floor 3.

Tradename: Flemoklav Solutab ®

Dosage form: dispersible tablets

Compound
Active substance: amoxicillin trihydrate (which corresponds to amoxicillin base) - 145.7 mg (125 mg), 291 mg (250 mg), 528.8 mg (0.5 g); potassium clavulanate (which corresponds to clavulanic acid) 37.2 mg (31.25 mg), 74.5 mg (62.5 mg), 148.9 mg (125 mg).
Excipients: microcrystalline cellulose, crospovidone, vanillin, apricot flavor, saccharin, magnesium stearate.

Description
Tablets of oblong shape from white to yellow with brown dotted spots without marks and marked: “421” - at a dosage of 125 mg + 31.25 mg; “422” -250 mg+62.5 mg; “424” - 0.5 g + 125 mg and company logo.

Pharmacotherapeutic group: antibiotic, semisynthetic penicillin + beta-lactamase inhibitor.
CodeATX: .

Pharmacological properties
Pharmacodynamics
A broad-spectrum antibiotic, a combination drug of amoxicillin and clavulanic acid, a beta-lactamase inhibitor. It has a bactericidal effect and inhibits the synthesis of the bacterial wall. Active against gram-positive and gram-negative microorganisms (including strains producing beta-lactamases). Clavulanic acid, which is part of the drug, suppresses types II, III, IV and V beta-lactamases, and is inactive against type I beta-lactamases produced by Enterobacter spp., Pseudomonas aeruginosa, Serratia spp., Acinetobacter spp. Clavulanic acid has a high affinity for penicillinases, due to which it forms a stable complex with the enzyme, which prevents the enzymatic degradation of amoxicillin under the influence of beta-lactamases and expands its spectrum of action.

Flemoklav Solutab ® is active against:
Aerobic gram-positive bacteria: Streptococcus pyogenes, Streptococcus viridans, Streptococcus pneumoniae, Staphylococcus aureus (including beta-lactamase-producing strains), Staphylococcus epidermidis (including beta-lactamase-producing strains) Enterococcus faecalis, Corynebacterium spp., Bacillus anthracis, Listeria monocytogenes

Anaerobic gram-positive bacteria: Clostridium spp., Peptococcus spp., Peptostreptococcus spp.

Aerobic gram-negative bacteria: Escherichia coli, Klebsiella spp., Proteus mirabilis, Proteus vulgaris, Yersinia enterocolitica, Salmonella spp., Shigella spp., Haemophilus influenzae, Haemophilus ducreyi, Neisseria gonorrhoeae (including strains of the above bacteria that produce beta-lactamases), Neisseria meningitides, Bordetella pertussis, Gardnerella vaginalis, Brucella spp., Branhamella catarrhalis, Pasteurella multocida, Campylobacter jejuni, Vibrio cholerae, Moraxella catarrhalis, Helicobacter pylori

Anaerobic gram-negative bacteria: Bacteroides spp., including Bacteroides fragilis (including beta-lactamase producing strains).

Pharmacokinetics:
Amoxicillin:
The absolute bioavailability of amoxicillin reaches 94%. Absorption is independent of food intake. The maximum plasma concentration is observed 1-2 hours after taking amoxicillin. After taking a single dose of 500/125 mg (amoxicillin/clavulanic acid), the average concentration of amoxicillin (after 8 hours) is 0.3 mg/l. Serum protein binding is approximately 17-20%. Amoxicillin crosses the placental barrier and passes into breast milk in small quantities.

Amoxicillin is metabolized in the liver (10% of the administered dose), mostly excreted through the kidneys (52 ± 15% of the dose unchanged within 7 hours) and a small amount is excreted in the bile. The serum half-life in patients with normal renal function is approximately 1 hour (0.9-1.2 hours), in patients with creatinine clearance in the range of 10-30 ml/min it is 6 hours, and in the case of anuria it ranges between 10 and 15 for hours. The drug is eliminated by hemodialysis.

Clavulanic acid:
The absolute bioavailability of clavulanic acid is approximately 60%. Absorption is independent of food intake. The maximum concentration of clavulanic acid in the blood is observed 1-2 hours after administration. After taking a single dose of 0.5 g/125 mg (amoxicillin/clavulanic acid), the average maximum concentration of clavulanic acid reaches 0.08 mg/l after 8 hours. Plasma protein binding is 22%. Clavulanic acid penetrates the placental barrier. There is no reliable data on penetration into breast milk.

Clavulanate is metabolized in the liver (50-70%) and about 40% is excreted through the kidneys (18-38% unchanged). The total clearance is approximately 260 ml/min. The half-life in patients with normal renal function is approximately 1 hour, in patients with creatine clearance 20 - 70 ml/min - 2.6 hours, and in anuria - within 3-4 hours. The drug is eliminated by hemodialysis.

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

• upper respiratory tract and ENT organs (including otitis media, sinusitis, tonsillitis, pharyngitis);
• lower respiratory tract: chronic bronchitis and its exacerbations, community-acquired pneumonia;
• skin and soft tissues;
• kidneys and lower genitourinary tract.

Contraindications
Hypersensitivity to amoxicillin, clavulanic acid or other components. Hypersensitivity to other beta-lactam antibiotics such as penicillins and cephalosporins. History of jaundice or liver dysfunction while taking amoxicillin/clavulanate. Patients with infectious mononucleosis or lymphocytic leukemia have an increased risk of exanthema, so amoxicillin/clavulanic acid should not be prescribed in the presence of these diseases.

Carefully: severe liver failure, gastrointestinal diseases (including a history of colitis associated with the use of penicillins), chronic renal failure.

Pregnancy and lactation
No harmful effects of amoxicillin/clavulanate on the fetus or newborns were observed when used by pregnant women. Use in the second and third trimesters of pregnancy is considered safe. During the first trimester, the drug should be prescribed with caution.

Amoxicillin is excreted in breast milk. There is no data on the excretion of clavulanic acid in breast milk. There were no harmful effects on the baby during breastfeeding while taking a combination of amoxicillin and clavulanic acid.

Directions for use and doses
To prevent dyspeptic symptoms, Flemoclav Solutab is prescribed at the beginning of a meal. The tablet is swallowed whole with a glass of water, or dissolved in half a glass of water (minimum 30 ml), stirring thoroughly before use.

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

Adults and children weighing more than 40 kg the drug is prescribed at 0.5 g/125 mg 3 times a day. For severe, recurrent and chronic infections, these doses can be doubled.

For children aged 3 months to 2 years(with a body weight of approximately 5-12 kg) the daily dose is 20-30 mg of amoxicillin and 5-7.5 mg of clavulanic acid per kg of body weight. This usually amounts to a dose of 125/31.25 mg 2 times a day.

For children aged 2 to 12 years(with a body weight of approximately 13-37 kg) the daily dose is 20-30 mg of amoxicillin and 5-7.5 mg of clavulanic acid per kg of body weight. Typically this is a dose of 125/31.25 mg 3 times/day for children aged 2 to 7 years (body weight about 13-25 kg) and 250/62.5 mg 3 times/day for children aged 7-12 years (body weight body about 25-37 kg). For severe infections, these doses can be doubled (the maximum daily dose is 60 mg amoxicillin and 15 mg clavulanic acid per kg body weight).

Patients with impaired renal function
In patients with renal failure, the excretion of clavulanic acid and amoxicillin through the kidneys is slow. Depending on the severity of renal failure, the total dose of Flemoklav Solutab ® (expressed as a dose of amoxicillin) should not exceed the amounts presented in the table:

Patients with liver dysfunction
The combination of amoxicillin/clavulanic acid should be administered with caution to patients with liver damage. Liver function should be constantly monitored.

Side effects
Allergic skin reactions: urticaria, erythematous rashes, rarely - exudative erythema multiforme, extremely rarely - exfoliative dermatitis, malignant exudative erythema (Stevens-Johnson syndrome), in some cases the so-called “fifth day rash” (measles exanthema) appears. Reactions depend on the dose of the drug and the patient's condition.

Reactions from the digestive system: nausea, vomiting, diarrhea, impaired liver function, increased activity of “liver” transaminases, in isolated cases - cholestatic jaundice, hepatitis, pseudomembranous colitis. An increase in the activity of transaminases (AST and ALT), bilirubin and alkaline phosphatase is usually observed in males and in elderly patients, especially over 65 years of age. To prevent side effects, it is recommended to take the drug at the beginning of a meal. The risk of such changes increases when taking the drug for more than 14 days. These phenomena are very rarely observed in children. The above changes usually appear during treatment or immediately after. Sometimes they may appear several weeks after stopping the drug. Basically, reactions from the digestive system are transient and minor, but sometimes they are pronounced.

Others: candidiasis, development of superinfection, reversible increase in prothrombin time.

The following list shows, in descending order, possible side effects:
Often
Gastrointestinal tract: nausea, vomiting, diarrhea, abdominal pain
Immune reactions: hives
Leather and soft tissue: exanthema

Rarely
Blood and lymphatic system: changes in blood composition (leukopenia, thrombocytopenia, hemolytic anemia)
Hepato-biliary system: cholestatic jaundice, hepatitis
The immune system: angioedema, vasculitis
Blood coagulation system: prolongation of prothrombin time
Urinary system: interstitial nephritis

Isolated cases
Anaphylactic shock, angioedema, pseudomembranous colitis, erythema multiforme, exfoliative dermatitis.

Overdose
Overdose may lead to gastrointestinal symptoms such as nausea, vomiting and diarrhea with possible fluid and electrolyte imbalance.

Treatment
Activated carbon is prescribed. It is necessary to maintain water and electrolyte balances. For convulsions, diazepam is prescribed. Other symptoms are treated symptomatically. In case of severe renal failure, hemodialysis should be performed.

Interaction with other drugs
Antacids, glucosamine, laxatives, aminoglycosides slow down and reduce absorption; ascorbic acid increases absorption.
Bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, vancomycin, rifampicin) have a synergistic effect; bacteriostatic drugs (macrolides, chloramphenicol, lincosamides, tetracyclines, sulfonamides) - antagonistic.

Increases the effectiveness of indirect anticoagulants (suppressing intestinal microflora, reduces the synthesis of vitamin K and the prothrombin index). When taking anticoagulants simultaneously, it is necessary to monitor blood clotting indicators.
Reduces the effectiveness of oral contraceptives, drugs, during the metabolism of which para-aminobenzoic acid is formed, ethinyl estradiol - the risk of developing breakthrough bleeding.

Diuretics, allopurinol, phenylbutazone, non-steroidal anti-inflammatory drugs and other drugs that block tubular secretion increase the concentration of amoxicillin (clavulanic acid is excreted mainly by glomerular filtration).

Allopurinol increases the risk of developing skin rashes.
Amoxicillin should not be given with disulfiram.
The simultaneous use of amoxicillin and digoxin may lead to an increase in the concentration of digoxin in the blood plasma.

special instructions
When treated with penicillins, anaphylactic reactions may occur in patients with hypersensitivity to them. Treatment with Flemoklav Solutab ® in such cases should be stopped immediately and replaced with other appropriate therapy. Treatment of anaphylactic shock may require urgent administration of epinephrine, corticosteroids and management of respiratory failure.

There is a possibility of cross-resistance and hypersensitivity with other penicillins or cephalosporins. As with the use of other broad-spectrum penicillins, superinfections of fungal or bacterial origin (in particular candidiasis) may occur, especially in patients with chronic diseases and/or impaired immune system function. If superinfection occurs, the drug is discontinued and/or appropriate therapy is selected.

In patients with impaired renal function, the dose must be adjusted based on the severity of the condition.

In patients with impaired liver function, the amoxicillin/clavulanic acid combination should be administered with caution and under constant medical supervision. Flemoklav Solutab ® should not be used for more than 14 days without assessing liver function.

An increase in prothrombin time is rarely observed. Amoxicillin/clavulanic acid should be administered with caution to patients receiving anticoagulation therapy.

Non-enzymatic methods for determining urine sugar, as well as the urobilinogen test, can give false positive results.

Release form
Dispersible tablets: 125 mg + 31.25 mg, or 250 mg + 62.5 mg, or 500 mg + 125 mg. 4 tablets (one dosage) in a blister made of polyamide and polyvinyl chloride films, which are laminated on both sides with aluminum foil and polyurethane adhesive. 5 blisters along with instructions for use are placed in a cardboard box.

Storage conditions
List B. Store at a temperature not exceeding 25°C, out of the reach of children.

Best before date
3 years. Do not use after the expiration date stated on the package.

Conditions for dispensing from pharmacies
by doctor's prescription

Manufacturer
Astellas Pharma Europe B.V., The Netherlands Elisabethof 19, Laiderdorp

Packaged and/or packaged:
Astellas Pharma Europe B.V., Netherlands
Or: ORTAT CJSC, Russia

Quality claims are accepted by the representative office in Moscow.
Moscow representative office:
109147 Moscow, Marksistskaya st. 16 “Mosalarko Plaza-1” business center, 3rd floor.

This drug is a broad-spectrum antibiotic. It has become widespread in medical practice. It is loved by doctors and parents for its quick and effective treatment of various diseases. Flemoklav Solutab contains amoxicillin and clavulanic acid. This medicine is available in the form of dispersible tablets in dosages of 125 mg, 250 mg, 500 mg and 875 mg. The dosage (given in terms of amoxicillin) when prescribed depends on the age and body weight of each patient (and the severity of the disease).

Flemoklav Solutab (has analogues in composition) is used orally for infections:

• respiratory tract (bronchitis, pneumonia, pleural empyema, lung abscess);
• ENT organs (sinusitis, tonsillitis, otitis media);
• genitourinary system (pyelonephritis, pyelitis, cystitis, urethritis and others);
• soft tissues (erysipelas, impetigo, secondary infected dermatoses, abscesses);
• joints and bones (including osteomyelitis);
• postoperative.

The doctor decides how to take the drug in each individual case.

It is especially important to remember this when the appointment is made to a child.

Application

Flemoklav Solutab tablets are taken immediately before meals, without chewing (whole) and with a whole glass of water. It is better and easier for children to give the drug in the form of a suspension. To do this, the instructions for use recommend thoroughly dissolving the dispersible tablets in water (0.5 cups).

The dosage of Flemoklav Solutab for children under 3 months of age is 20 mg per unit of the child’s weight per day (to be divided into 2 doses). For a child from 3 months to 2 years – 25 mg per unit of weight per day (also in 2 doses).

Children aged 2 to 7 years, weighing 13-25 kg, need to take a single dose of 125 mg (two or three times a day). From 7 to 12 years (weight 25-37 kg) – 1 tablet of 250 mg (or 2 of 125) 2 to 3 times a day. The exact dose is determined by the doctor.

For children over 12 years of age whose weight exceeds 40 kg (and for adults), the dosage of Flemoklav Solutab is 1 tablet of 250 mg (or 2 tablets of 125) three times a day. In severe forms of the disease, it is possible to increase the dose - 1 tablet of 500 mg (2 tablets of 250 or 4 tablets of 125) three times a day.

How to prepare the suspension

Let's calculate the dosage of the suspension for a 2-month-old child weighing about 5 kg. To do this, you will need Flemoklav Solutab dispersible tablet with a dosage of 125 mg and 125 ml of boiled water (strictly at room temperature). Dissolve the tablet in a glass of water, stirring thoroughly.

Since the daily dose for a 2-month-old baby is 20 mg for each unit of weight, then 20 5 = 100.

Therefore, 100 ml of the resulting Flemoclav Solutab solution must be divided into 2 doses (50 ml each) and given to the infant at equal intervals. Use a bottle and a nipple with a large hole for this.

The suspension is stored in a cool, dark place for no more than one day.

Special cases

For patients with renal impairment, the daily dose of Flemoclav Solutab should be less than the values ​​​​indicated in the table.

In this case, the dosage of Flemoklav Solutab requires adjustment by the attending physician. He also gives recommendations for use and decides how long to use the drug.

Patients with problems with liver function must strictly monitor its functions. Consequently, strict medical supervision is also carried out.

Contraindications

Instructions for use include Flemoklav Solutab as contraindications:

• increased sensitivity of the patient to the components of the drug;
• hypersensitivity to penicillin and cephalosporin antibiotics;
• mononucleosis (infectious);
• jaundice or liver dysfunction after taking amoxicillin or clavulanic acid.

Flemoklav Solutab is prescribed with extreme caution to children with diseases of the gastrointestinal tract.

Parents need to remember that a developing child’s body requires careful attention.

By-effect

When using a medication at a dosage of 125 or 250 mg, the child’s body may experience such negative manifestations as:

• skin allergy– urticaria, erythematous rashes, exanthema;
• gastrointestinal organs– vomiting, nausea, abdominal pain, diarrhea;
• blood and lymph– leukopenia, hemolytic anemia, thrombocytopenia;
• hepatobiliary system– jaundice (cholestatic), hepatitis;
• the immune system– vasculitis, angioedema;
• urinary system– interstitial nephritis.

In very rare cases, anaphylactic shock is possible.

It should be noted that all of the listed reactions to the drug Flemoklav Solutab, as a rule, occur immediately during treatment.

However, there is a possibility of their manifestations after some time (about a week).

In any case, parents should immediately notify the attending physician about this and seek advice on the advisability of further use of the medicine.

Overdose

Toxication is possible if the instructions for use of the drug Flemoklav Solutab are not followed and entails nausea, vomiting, and diarrhea.

To eliminate such symptoms, children are advised to urgently lavage the stomach and then take sorbent drugs (activated carbon).

We emphasize once again that the dosage for a child is determined by the doctor depending on weight and age. Parents must strictly adhere to the instructions.

Drug substitutes

Analogs of the drug Flemoklav Solutab are known on the domestic market of medical drugs. : Amoxiclav 2X, Amoxil - K 625, Amoxiclav Quiktab, Augmentin (BD), Augmentin (SR), Baktolkav, Klavam, Clavamitin, Medoclav, Panclave, Rapiclav, Rekut, Trifamox IBL.

All of them have a similar ATC code and active ingredients.

Which of the listed drugs is suitable for a child of different ages, and what dosage is required, is determined only by the attending physician.

Parents should never make this decision on their own. Since each medication requires an individual approach.

Helper in the fight for health

The time has long passed when the use of antibiotics was considered an out-of-the-ordinary event. Modern pharmacology can boast of the latest developments in the field of such medications.

Flemoclav Solutab and its analogues allow you to cope with various diseases and their consequences in the shortest possible time.

The only rule that all patients need to remember is that antibiotics require strict dosage.

And then they will bring only benefits, without any side effects.

They not only help in a short time to stop the adverse effects of microflora on the body, but also completely destroy it.

Today, the antibiotic market is filled with a huge number of drugs that differ in potency and other characteristics. In today's material, our resource decided to take a closer look at such popular medications as Flemoxin and Flemoklav, and also highlight the most significant differences between them.

Flemoxin Solutab - composition, properties and release form

Flemoxin Solutab is a broad-spectrum antibacterial agent

Before analyzing the effects of drugs on the human body and highlighting the differences between them, it would be a good idea to consider each antibiotic separately. Let's start looking at medications with Flemoxin.

So, the trade name of this antibiotic looks like “Flemoxin Solutab”. The drug belongs to the group of antibacterials based on the active substance “amoxicillin” (the pharmacological group of the drug is penicillin, semi-synthetic antibiotics). Flemoxin is produced in white or slightly yellow tablets, which have an oval shape and an image of the manufacturer’s logo, as well as a digital designation. The latter is identification and indicates how much active substance the tablet contains.

Digital identification has the following grouping:

The tablets are sorted into rectangular packages and similar blisters, which contain 5 tablets each and are presented in 2 or 4 copies.

The active ingredient in the drug "Flemoxin Solutab" is represented by amoxicillin, which is contained in the drug in the dosages mentioned above.

In addition, the drug contains dispersible cellulose, microcrystalline cellulose, crospovidone, vanillin, saccharin, magnesium stearate and some flavorings.

The properties of Flemoxin Solutab are standard for its pharmacological group. In simple terms, this drug stops the development of the bacterial microflora that caused the disease, and over time reduces its adverse effects on the patient’s body to a minimum. Thanks to this, the antibiotic is accepted for its excellent bactericidal properties all over the world.

More information about the drug Flemoxin Solutab can be found in the video:

You can take Flemoxin Solutab for pathologies of bacterial etiology in such human organs as:

• respiratory system organs
• genitourinary system organs
• organs of the gastrointestinal tract
• leather and other soft tissues

It is important to take the drug taking into account the recommendations of the treating specialist and the background information provided in the instructions for the antibiotic. It is in the latter that you can learn in more detail about contraindications, dosages and other things related to Flemoxin Solutab.

Flemoklav Solutab - composition, properties and release form

Flemoxin Solutab effectively treats respiratory diseases caused by bacterial infection

Flemoklav Solutab, in turn, is not much different from its opponent in terms of release form. This antibiotic is also available in tablets similar in size to Flemoxin. However, the tablets are divided into 4 per blister, which can be from 4 to 8 in one package. At the same time, Flemoklav contains slightly less active substance (the same amoxicillin) than in the previously considered drug.

Depending on the form of release, the antibiotic may contain from 125 to 875 mg of active substance, supplemented by an appropriate dose of a special substance - clavulanic acid.

The composition of Flemoklav Solutab includes:

• active substance – amoxicillin trihydrate
• clavulanic acid
• microcrystalline cellulose
• vanillin
• saccharin
• magnesium stearate
• flavorings

Similar to Flemoxin, Flemoklav has antibacterial properties with a wide spectrum of effects, since both drugs belong to the same pharmacological group - penicillin, semi-synthetic antibiotics.

Despite this similarity, the medication is taken in fewer situations.

Thus, Flemoklav is widely used in the treatment of the following pathologies:

• respiratory diseases
• diseases of the genitourinary system
• lesions of the skin and soft tissues
• rarely – gastrointestinal pathologies

The dosage for use is determined solely by the doctor based on the severity of the disease and the age of the patient. It is worth understanding that correct use is a fundamental factor in successful therapy, therefore it is necessary to take Flemoklav taking into account the recommendations of the treating specialist and the manufacturer of the drug. You can find out about contraindications, expiration dates and similar things about a medication by carefully reading the instructions for it.

Flemoxin and Flemoklav - what is the difference?

It would seem that after receiving general information about both Flemoxin and Flemoklav, it is extremely difficult to identify any differences between the drugs. However, this is a rather erroneous judgment, since, delving into the study of antibiotics more deeply, a number of differences can be identified between them. Our resource has carried out this procedure and is ready to present you with its results.

First of all, we note that Flemoclav Solutab contains clavulanic acid, but its opponent does not. This difference makes the first antibiotic more resistant in the fight against bacterial microflora, since it is clavulanic acid that binds to bacterial beta-lactamases, which helps protect the antibiotic from the adverse effects of particularly strong microorganisms and their enzymes that can destroy the drug and neutralize its effects. Such a minor nuance puts Flemoklav Solutab in a more honorable position relative to his today's opponent.

In addition, the combined use of clavulanic acid and amoxicillin allows Flemoclav to provide additional benefits:

• increase the versatility of the drug, that is, this antibiotic is able to fight a larger list of bacteria than its opponent - Flemoxin
• reduce the dose of the antibiotic taken, since amoxicillin is supplemented with an appropriate dose of clavulanic acid (for example, 250 + 62.5 Mg or 875 + 125 Mg)

Despite the smaller list of pathologies for the treatment of which Flemoklav is used, it is more universal, especially in the treatment of respiratory tract pathologies. It is worth noting that both drugs we are considering are produced by the same pharmacological company from Holland. In fact, they are close analogues with slight differences in composition, which modify the method and effect of the drugs.

Comparing the statistical data collected by specialists regarding treatment with Flemoxin and Flemoclav, the following can be highlighted:

• When using the first antibiotic, about 50% of people notice a noticeable effect from the drug
• when using a medication containing clavulanic acid, this effect is noted by more than 60% of patients

There are no other differences between the drugs, except for their cost. On average, Flemoklav costs % more than its opponent when used in similar situations.

Do not forget that both antibiotics are quite potent and should not be prescribed for self-medication by the patient himself or his relatives.

Which of them is most optimal for use in a particular case can only be determined by the attending physician who has the necessary information about the pathology and clinical picture of the patient’s illness. Improper organization of antibacterial therapy is a dangerous practice that can cause some complications in the patient, remember this.

Summarizing today's material, we note that Flemoxin and Flemoklav are highly soluble and very similar antibiotics, but they still have differences between themselves. The most significant of these is the general principle of influencing unfavorable microflora. It can be stated that Flemoklav is a more universal antibiotic that will perform slightly better than its opponent. Despite this, the final choice between two drugs should be made only by the treating specialist, taking into account all the characteristics of the patient’s disease. We hope that the previously presented material was useful to you. Good luck in treating your illnesses!

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The medical information published on this page is strictly not recommended for self-medication. If you feel negative changes in your health, immediately contact an ENT specialist. All articles published on our resource are for informational purposes only. If you use this material or a fragment of it on your website, an active link to the source is required.

How to take Flemoxin Solutab for sore throat

Flemoxin solutab is an antibiotic used to treat sore throat in adults and children. There are five types of sore throat, differing in degree of complexity. Its purulent variety is especially dangerous, which can cause complications in other organs. Flemoxin successfully treats all of them. It is prescribed to eliminate the inflammatory process and pathogenic infections. It belongs to the group of penicillin antibiotics. This drug can also be taken during pregnancy. You should drink it as prescribed by your doctor, who will indicate the correct dosage.

Action

It is effective against this disease because it consists of amoxicillin, which can eliminate streptococcal bacteria. Azalides, to which this drug belongs, are semi-synthetic drugs produced from erythromycin. They have fewer side effects than other penicillin antibiotics.

The medicine has a gentle effect on the body and has a pleasant citrus taste and aroma. When taken, the tablets can be dissolved or chewed. For quick and effective treatment, Flemoxin is taken together with B vitamins, anti-inflammatory and antihistamine drugs. They have a striking effect on the source of inflammation, destroy its pathogens and relieve swelling of the tonsils. If improvement occurs already on the second day, you should still continue to take the medicine until the disease completely passes.

Most antibiotics have a negative effect on the stomach and intestines, and after their use, a long restoration of the microflora of these organs is required.

Therefore, many conscientious parents resort to treating their child with antibiotics as a last resort. But if you use Flemoxin Solutab, you don’t have to worry about this, it does not cause dysbacteriosis.

The video describes the use of Flemoxin Solutab for sore throat:

The drug is quickly and completely absorbed into the blood in just five minutes.

Instructions for use

Before using this medicine, you should first undergo tests and check the sensitivity of microorganisms to the components of the antibiotic. Only after receiving the test results will the doctor be able to determine the advisability of using this medicine. The question arises whether it helps with sore throat and whether it can be drunk/taken. The drug helps not only with sore throat, but is also used for infectious diseases of the respiratory system, intestines, genital organs, and various skin diseases. Here you can read about the treatment of sinusitis with antibiotic tablets. These antibiotics are also prescribed for otitis media in adults and children.

It can be taken by pregnant women, but nursing mothers should take it with caution so that the fetus does not receive a large dose and has an allergic reaction.

Compound

Its main active ingredient is amoxicillin, which is used in an easily digestible form as a trihydrate. Its excipients are: vanillin, saccharin, microcrystalline cellulose, magnesium stearate, dispersible cellulose and two shock absorbers: tangerine and lemon. The antibiotic for angina Amoxicillin is also used; it can replace Flemoxin. Although it does not contain a number of excipients.

Release form

Flemoxin solutab is available in tablet form for adults and children, and there is also a suspension. Unlike other children's antibiotics, there is no powder form of this product. For ease of use, manufacturers have divided the tablets into four types according to dosage. Each of which contains 125, 250, 500 and 1000 mg of the main active ingredient, respectively.

The time for taking the medicine must be strictly adhered to. It can be an hour before a meal or at least three hours after it. In a mild form, the drug should be taken for a week, and more acute types of the disease require two weeks of treatment with this drug.

Dosage for children

A streptococcal infection will not go away immediately, so it must be destroyed within 10 days. But for each little patient, the doctor prescribes an individual course of treatment and its duration. On average, children recover in five days. Children take the tablets three times a day:

• from 1 to 3 years, 125 mg;
• from three to 10 years – 250 mg. Or you can drink it twice a day, but then 375 mg.

The pediatrician may prescribe other dosages. On average, 30 mg of medication is considered per 1 kg of child weight. The calculated dose is divided into two or three doses, depending on the preferences of the parents.

In more complex cases, the doctor may increase the daily dose or, conversely, at the first signs of improvement in the condition, reduce it. For children with poor kidney function, it is recommended to reduce the amount of the drug by half. If, instead of a suspension, tablets were purchased for the child or the remaining ones with a normal shelf life are used, then for ease of use they can be dissolved in water. You need to take 100 ml of liquid and after dissolving the medicine you will get the required consistency.

Doses of the drug for adults

The tablets must be chewed, and if this does not work, then they should be dissolved in water. For mild to moderate severity of the disease, the daily dose for an adult patient is from 0.5 to 2 grams. This amount of medicine must be taken in two doses. For severe illnesses, the dosage is determined by the therapist.

Contraindications

The main undesirable indicator is individual hypersensitivity to the ingredients of the drug. It should be taken with caution by people suffering from kidney failure, colitis, allergies, as well as nursing women and pregnant women.

This drug should not be combined with the following medications:

• laxatives;
• estrogen-containing contraceptives;
• bactericidal antibiotics;
• antacids;
• non-steroidal anti-inflammatory drugs;
• indirect anticoagulant medications.

Side effects include: diarrhea, nephritis and dyspepsia. Sometimes allergic reactions occur in the form of skin rashes. However, this does not happen as often as after using ampicillin.

Flemoxin solutab is an ideal option for the treatment of sore throat, especially in children. The effectiveness and easy tolerability of the drug by children of different ages have earned it particular popularity among antibiotics. More and more people prefer this particular medicine. It also influences the fact that this drug can be used not only for the treatment of sore throat, but also in the complex therapy of otitis media, pneumonia and bronchitis. Treatment of bronchitis with antibiotics is described here. Here you can read about the treatment of acute pharyngitis with antibiotics. Follow the link to find a list of antibiotics for tonsillitis in children.

At what age can bioparox be used for children?

Is it possible to combine Flemoxin and alcohol?

Flemoxin Solutab and alcohol is a combination that is not recommended. Treatment of infectious diseases with antibiotics is becoming increasingly popular in the modern world. This group of drugs allows you to slow down or completely stop the process of reproduction of harmful agents, as well as destroy certain types of pathogens.

Flemoxin Solutab belongs to the category of antibacterial agents of the latest generation, has a wide spectrum of action, and is a representative of the penicillin group. It also exhibits a minimal number of side effects, and it is for this feature that it is very popular among medical specialists.

But patients are more concerned with the question “Can I drink Flemoxin Solutab and alcohol?”, is this combination dangerous, and what consequences may there be.

Brief characteristics of the drug

The dosage form contains amoxicillin and is available in tablet form, which can dissolve in the mouth. On pharmacy shelves you can find the following dosages of the drug: 125 mg, 250 mg, 500 mg and 1000 mg.

The active substance of Flemoxin exhibits its activity against gram-positive and gram-negative microorganisms, these include: meningococci, streptococci, staphylococci, Helicobacter pylori and clostridia. The mechanism of action of the drug is based on the ability to disrupt metabolism in a pathogenic cell.

Flemoxin Solutab affects harmful agents in the body, without harm to human cells. The medicine is able to influence the process of formation of bacterial macromolecules, and also affects the bacterial walls, gradually destroying them, and thus the pathogenic organism dies. The advantage of this drug is its safe relationship to structures of organic origin and the complete absence of negative effects on them.

Alcohol during treatment with Flemoxin

Taking Flemoxin Solutab with alcohol is not recommended, and doctors even prohibit it. But, unfortunately, a modern person cannot imagine his life without alcoholic beverages; he is not even bothered by taking medications.

All alcohol affects all human organs and systems in one way or another. The immune system is primarily affected. And during the period of illness, the body cannot properly resist the influence of viral agents.

If you combine alcohol and Flemoxin Solutab, then negative consequences may develop. Below we will go into more detail about how each of the body systems suffers if you use this combination.

central nervous system

According to the instructions for use, after taking Flemoxin, a person may become more irritable, aggressive towards others, and thought processes are disrupted. And if you combine taking Flemoxin with alcohol, then this condition will worsen by half.

Sleep becomes short and sometimes completely absent; symptoms of depression appear, which can be so deep that they can lead to the appearance of epileptic convulsions. In the process of treating an infectious pathology with an antibiotic and taking alcohol together, the development of psychosis and delusional states cannot be ruled out.

Circulatory system

Compatibility between Flemoxin and alcohol is impossible, since all doctors prohibit combining them together. If the patient neglects the doctor’s recommendations and drinks alcohol immediately after taking the medicine, he can expect the following consequences:

• bleeding from the nasal passages;
• gastrointestinal bleeding;
• rapid decrease in platelet count.

As a result, severe cardiovascular diseases can develop and death is possible.

Genitourinary system

Those patients who believe that Flemoxin is compatible with alcohol may develop an inflammatory process in the renal tubules and intersterile tissues. In addition, this combination of an antibiotic with alcohol can lead to such serious consequences as: malignant neoplasms in the bladder and kidneys.

Changes in the body occur as Flemoxin and alcohol accumulate in the body; the more of them in the body, the expression of the pathological condition. The victim loses his appetite and becomes tired and lethargic.

Digestive system

The digestive system includes not only the gastrointestinal tract, but also the liver. All people know what a detrimental effect alcohol has on the liver, especially in those people who drink alcohol every day. If you do not follow the treatment regimen and combine Flemoxin with alcohol, cholestatic jaundice may develop. Bile stops flowing into the intestines, urine turns dark, feces become discolored, and all skin begins to itch. And the outcome of this situation is not very favorable.

From the gastrointestinal tract, nausea develops, sometimes turning into vomiting. The patient refuses to take food and water, and problems with bowel movements begin. Severe stomach upset may occur, leading to dehydration.

You can drink alcohol after Flemoxin after at least one week, and preferably two. And if a person drank alcohol before starting a course of antibiotic therapy, then it is worth waiting two days until ethyl alcohol is completely removed from the body.

You should not rely on reviews from friends who claim that nothing will happen when Flemoxin interacts with alcohol, since the compatibility of these components is impossible. All treatment recommendations and information about how the drug reacts with other drugs, including alcoholic beverages, are provided exclusively by the attending physician. All antibacterial medications are available by prescription; you should not self-medicate. Flemoxin is not compatible with any type of alcohol.

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IMPORTANT. The information on the site is provided for informational purposes only. Do not self-medicate. At the first sign of disease, consult a doctor.

Antibiotic Flemoxin Solutab - treating the child correctly

Flemoxin Solutab is a broad-spectrum antibacterial drug. The medicine is effective for acute respiratory diseases and their complications, for urinary tract infections and intestinal infections. Prescribed for children, including newborns.

Flemoxin Solutab is a broad-spectrum antibiotic.

Action

Flemoxin contains the active substance amoxicillin trihydrate. Amoxicillin is a bactericidal semisynthetic antibiotic belonging to the penicillin group.

The drug is prescribed as an etiological treatment, i.e. treatment that eliminates the cause of bacterial infectious diseases.

Amoxicillin kills bacteria and inhibits their growth and reproduction. The higher the sensitivity of the pathogen to it, the higher the effectiveness of the antibiotic.

Preapart is often used to treat infections of the respiratory tract and ENT organs.

Bacterial sensitivity

Bacteria of the following groups are usually sensitive to Flemoxin Solutab:

• streptococci;
• staphylococci (with the exception of resistant strains that secrete penicillinase);
• Klebsiella;
• influenza;
• Helicobacter;
• gonorrhea;
• salmonella;
• causative agents of dysentery.

Properties

Flemoxin Solutab is the preferred antibiotic in pediatrics and has the following properties:

1. Non-toxicity, due to which it can be prescribed to newborns and even premature babies if indicated.
2. High bioavailability. The medicine is well absorbed from the intestines regardless of the presence of food. Its maximum content in the blood is reached 2 hours after administration. Unlike non-synthetic penicillins, this allows you to take Flemoxin in tablets as effectively as in the form of injections.
3. Acid resistance. It is stable in an acidic environment and is not destroyed in the stomach.
4. High distribution. It creates a high concentration not only in blood plasma, but also in lung tissue, bronchial secretions, pleural fluid, middle ear, kidney and prostate tissue, bile, intestinal mucosa and genital organs.
5. Does not accumulate in the body. It is quickly excreted by the kidneys: in children from 0 to 6 months after 6–8 hours, in adults after 2–4 hours. The elimination period increases with renal failure. The main route of drug elimination (50-70%) is through the kidneys.
6. Partially passes through the placenta. The antibiotic is found in amniotic fluid.
7. Difficult to penetrate the blood-brain barrier, i.e. into the brain. Low effectiveness in the treatment of inflammation of the meninges, since only 20% of the active substance penetrates them.

Indications for children

Diseases caused by a bacterial infection sensitive to amoxicillin.

1. Diseases of the ENT organs:
   • external, middle and internal otitis;
   • inflammation of the sinuses (sinusitis, ethmoiditis, frontal sinusitis, sinusitis);
   • pharyngitis, tonsillitis, tonsillitis.
2. Acute respiratory diseases:
   • tracheitis;
   • bronchitis;
   • pneumonia.
3. Diseases of the urinary system:
   • pyelonephritis;
   • glomerulonephritis;
   • cystitis and urethritis.
4. Intestinal infections. Sometimes the medicine is used to combat pathogens of intestinal infections.
5. Purulent skin diseases (pyoderma).

Contraindications

The drug is contraindicated in the following cases:

• penicillin intolerance;
• manifestation of an allergic reaction to Flemoxin Solutab;
• ulcerative colitis;
• renal failure in the stage of decompensation;
• pregnancy.

During pregnancy, it is prescribed only when the potential harm to the fetus from an infectious disease of the mother is higher than from the action of the antibiotic.

There is no evidence that amoxicillin negatively affects the development of the fetus, therefore, if there are indications for antibiotic therapy in pregnant women, doctors usually choose Flemoxin.

Side effects

In some cases, taking Flemoxin causes the following side effects:

• An allergic reaction most often manifests itself in the form of a rash and itching, sometimes in the form of swelling and anaphylactic shock.
• Dyspeptic symptoms - loss of appetite, nausea, vomiting.
• Hematopoietic disorders - if the dosage is observed, this is extremely rare.

If your child has an allergic reaction, call your doctor.

Complications

Complications usually develop when the antibiotic is used incorrectly.

Dysbacteriosis

The development is due to the suppression of not only pathogens, but also bacteria beneficial to the body. Symptoms of dysbiosis:

• stomach ache;
• frequent and loose stools;
• nausea.

Abdominal pain is one of the symptoms of dysbiosis.

Development of fungal infection

Fungal infection is a complication of dysbiosis. When natural flora is suppressed, fungi multiply in its place. Symptoms:

• in infants, the development of thrush in the mouth (curdled discharge, redness of the mucous membrane and itching);
• development of thrush in the form of vaginitis in girls (cheesy discharge, redness of the mucous membrane, pinching and itching, painful urination).

Formation of bacterial resistance and superinfection

The reasons for the formation of resistance are the incorrect use of antibiotics:

Prevention of complications is compliance with medical recommendations, taking probiotics and antifungal drugs as prescribed by a doctor.

While taking antibiotics, your doctor may prescribe your child Linex, a source of probiotic microorganisms.

You can read more about the recovery of the body after antibiotic therapy here.

Dosage

The detailed dosage of a single dose of the drug is described in its annotation. Before using the medicine, carefully read the instructions.

Daily dose by age:

• for children under 1 year of age is calculated based on the formula - from 30 to 60 mg per 1 kg of child’s weight;
• for children from 1 to 3 years - from 250 mg to 375 mg;
• for children from 3 to 9 years old - from 500 mg to 750 mg;
• for children from 9 to 13 years old - from 1000 mg to 1125 mg;
• for children over 13 and adults - from 1000 mg to 1500 mg.

The daily dosage is divided into 2 or 3 equal parts and taken in 2 or 3 doses, respectively.

The tablets quickly dissolve in water, resulting in a white suspension with a pleasant aroma.

For frequently recurrent chronic diseases and severe infections, the dosage of the drug may be higher than standard and is prescribed by the doctor individually.

The duration of treatment is usually from 5 to 10 days.

Example of dose selection

An 11 month old child weighing 10 kg.

1. The daily dose according to the instructions ranges from 10 kg × 30 mg = 300 mg to 10 kg × 60 mg = 600 mg.
2. The average daily dose will be (300 + 600) / 2 = 450 mg.
3. A single dose in two doses will be approximately 225 mg. It will be more convenient to take 250 mg tablets 2 times a day, which will be 500 mg per day. A slight excess in one dose is not scary, as long as the total amount of the drug per day is within the age and weight norm. A single serving for three doses will be equal to 150 mg. It is more convenient to take 125 mg tablets 3 times a day. In this case, the daily dose will be slightly lower than the calculated average and equal to 375 mg.
4. Daily doses of 500 mg and 375 mg fall within the range of 300–600 mg. The choice between them will be determined by the severity of the disease.

Mode of application

Take tablets with clean water 2-3 times a day, regardless of meals, but it is better immediately after meals.

The tablets are easily divided into 2 equal parts, or can be divided into quarters.

For small children, the tablet can be ground into powder and diluted with 10–20 ml of warm boiled water. The result is a suspension with a fruity aroma.

The tablet can be crushed into powder or added to water or another drink.

Release form

Flemoxin Solutab is available in oval dispersible tablets with a release strip, in dosages of 125 mg, 250 mg, 500 mg and 1000 mg per tablet. Packed in cardboard boxes of 20 pieces with dosage indication.

Dispersibility means that they can be diluted with water before use.

The average price in pharmacies in different cities of Russia for 1 package: 125 mg - 220 rubles, 250 mg - 290 rubles, 500 mg - 380 rubles, 1000 mg - 480 rubles.

Analogs

Analogues of Flemoxin are antibiotics with a similar sensitivity spectrum and the same active ingredient amoxicillin.

Some of them are listed below:

• Amoxicillin in tablets, capsules, suspensions (Russia, Serbia, Switzerland);
• Amosin in tablets, capsules, powders for suspensions (Russia);
• Hiconcil in capsules (Austria);
• Ospamox in suspension (Austria);
• Ecobol tablets (Russia).

Amoxicillin is a cheaper analogue of Flemoxin Solutab tablets.

Reviews

Svetlana, 28 years old:

“Flemoxin Solutab was prescribed to my daughter (3 years old) for a sore throat and a temperature of 39 degrees. The medicine helped well: on the second day the plaque in my throat disappeared, and on the third the temperature became normal. We continued to drink for another 4 days, feeling well, but at the end of the course my tummy began to hurt. Then I had to be treated for dysbacteriosis.”

“Flemoxin was prescribed to my 11-year-old son because of purulent otitis media that arose after self-treatment of acute respiratory infections. The drug was taken for only 7 days. It helped already on the third day - the pain stopped. We didn’t notice any side effects.”

Oksana M., 31 years old:

“I was breastfeeding a 4 month old baby. She herself fell ill with an acute respiratory infection and practically did not receive treatment because of the child, now it has come to advanced bronchitis and sinusitis. As prescribed by the doctor, I took Flemoxin Solutab for 10 days. He helped me, plus they pierced my maxillary sinuses. In connection with my treatment, the pediatrician prescribed Enterol for the child. The baby's bowel movements are fine, but she refused to breastfeed (((".

Conclusion

Flemoxin Solutab is an effective antibiotic. It helps fight serious bacterial infections. However, remember that illiterate self-medication with antibiotics can harm the body.

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Flemoxin - a well-known antibiotic in an innovative form

Flemoxin is a generic version of one of the most popular antibiotics in the world - Amoxicillin. The original drug was developed by British pharmacists in the 60s of the last century. Amoxicillin appeared on the pharmaceutical market in the early 70s.

Before you continue reading: If you are looking for an effective method of getting rid of a runny nose, pharyngitis, tonsillitis, bronchitis or colds, then be sure to look at this section of the site after reading this article. This information has helped so many people, we hope it will help you too! So, now back to the article.

Amoxicillin is, without a doubt, one of the safest broad-spectrum antibacterial drugs. According to some reports, this penicillin antibiotic is almost the most prescribed medicine in pediatrics. Almost every reputable pharmaceutical company considers it its duty to release its own Amoxicillin. The Japanese corporation Astellas Pharma also succeeded in this matter by developing Flemoxin.

Flemoxin Solutab stands out from the monotonous background of Amoxicillins due to its release form. After all, the drug is available in the form of dispersible tablets, which have many advantages compared to the pills we are used to.

In this article we will try to understand how Flemoxin differs from its analogues, and also clarify the positive aspects of the drug. And let’s not ignore the negative qualities, which, of course, are also present.

Astellas Pharma: new life for antibiotics

Astellas Pharma is the largest Japanese pharmaceutical concern. It appeared in 2005 thanks to the merger of two well-known Japanese companies: Fujisawa Pharmaceutical Co and Yamanouchi Pharmaceutical Co.

Today, Astellas Pharma works in various areas of medicine, creating both original drugs and analogues of well-known brands. The company also produces several antibiotics, which have become widely known due to their dispersible form.

Each of these medicines has an additional word in the name indicating a special form - solutab. Dispersible drugs include:

• cephalosporin antibiotic Ceforal solutab;
• Unidox Solutab, widely known in Russia;
• Vilprafen solutab;
• Flemoxin Solutab and Flemoklav Solutab are two related drugs containing Amoxicillin as the active ingredient.

I would like to note that Flemoxin Solutab is registered only in Germany, Iceland, Portugal and the CIS countries.

Flemoxin solutab: composition of the drug

So, Flemoxin contains, as you already understood, the only active component - Amoxicillin - in the form of a stable compound (trihydrate).

Amoxicillin is a semi-synthetic penicillin, which in its chemical structure and spectrum of activity is very similar to Ampicillin.

As additional substances, Flemoxin contains chemical substances, which, in fact, ensure its solubility in a minimum volume of solvent. These include cellulose and MCC - microcrystalline cellulose.

Note that Flemoxin tablets have a pleasant citrus taste due to the addition of tangerine and lemon flavoring.

The color of the tablet can vary from pure white to yellowish or even light yellow. A change in color does not mean that the drug was stored incorrectly. Or, moreover, it is a crude fake. The color variations of Flemoxin are associated with the presence of cellulose compounds in it, in which color changes are allowed.

Forms of release of Flemoxin - for both children and adults

The wide range of Flemoxin includes both children's and adult forms of release, which differ only in dosage.

Unlike conventional oral antibiotics, Flemoxin is not presented in powder form for the preparation of a children's suspension. Therefore, parents of young patients are practically deprived of the opportunity to show their hidden pharmaceutical abilities, calculating the volume of water and diluting the white powder with trembling hands.

So, let’s list the release forms of Flemoxin Solutab.

Children's release forms:

• Flemoxin solutab dosage 125 mg;
• Flemoxin solutab at a dose of 250 mg.

Adult release forms:

• Flemoxin solutab 500 mg;
• Flemoxin solutab at a dose of 1000 mg.

Why can’t you split a Flemoxin tablet?

The oblong tablet of Flemoxin has a cross mark. Most patients believe that the score is needed in order to split the tablet in half. And get a dosage exactly half the original one.

I would like to explain to readers why experts persistently warn patients against such a division.

There may be two reasons why you should not divide the tablet into two parts. Firstly, many tablets are coated with a protective coating that protects them from the destructive properties of hydrochloric acid. However, this does not apply to Flemoxin - it is not coated, so we can go further.

The second and main reason is that when dividing a tablet, it is technically impossible to find out the dosage of the resulting parts. Even if you have a pharmacy scale at hand, and you were able to absolutely accurately divide a 1000 milligram tablet of Flemoxin into two equal parts, the amount of the active substance remains unknown. Why do you think?

Take another look at the drug packaging or instructions for Flemoxin. The composition of any tablet drug (as, by the way, most others) often contains many other substances in addition to the main active component. Using the example of Flemoxin Solutab at a dosage of 125 mg, we see that the content of cellulose, microcellulose (or MCC), as well as flavorings and saccharin is about 17% of the share of Amoxicillin. In this case, the active substance is distributed unevenly, and therefore the left half of the tablet may contain N percent more active substance than the right half. Or vice versa.

Accordingly, the effectiveness of different parts of the Flemoxin tablet may, to put it mildly, be different. And side effects too.

Now let’s remember that we are not dealing with ascorbic acid vitamins, but with a drug, the dose of which is carefully selected depending on age and the severity of the infection. And let’s remember the unshakable rule of pharmaceuticals: dividing a tablet in order to reduce the dosage is simply prohibited!

Exceptions may include some cardiac medications. In such cases, the manufacturers themselves take into account all the nuances and technologically achieve uniform distribution of all the components of the tablet.

Dispersible tablet: what is it?

Many patients, when they first encounter the name “dispersible tablet,” have difficulty imagining what it is. Meanwhile, more and more pharmaceutical companies are trying to put older drugs into dispersible form. Dispersible vitamins, antibiotics, and even erectile dysfunction drugs are appearing on the market.

Dispersible tablets were originally created for patients who had difficulty swallowing. This condition, which is medically called dysphagia, occurs in 35% of the general population and in 60% of older people.

The first dispersible tablets dissolved in the mouth to produce gas. Subsequently, new forms were developed, which included cellulose and its compounds. We have already mentioned that Flemoxin solutab is one of these drugs.

Advantages of dispersible form

So, let's figure out how Flemoxin dispersible tablets differ from regular Amoxicillin and what their advantage is.

So, the dispersible form of Flemoxin:

Flemoxin dispersible tablets are absorbed in the oral cavity directly into the blood, bypassing the gastrointestinal tract. Due to this, the bioavailability of orally soluble tablets is an order of magnitude higher than that of oral tablets;

• quickly reaches peak concentration.

Oral tablets begin to be absorbed into the blood within 15–20 minutes after administration, at best. Dispersible dosage forms (including Flemoxin) are absorbed within 5 minutes after dissolving in the mouth;

• more convenient for pharmaceutical substances that are unstable in water.

An excellent example is children's Flemoxin Solutab 125 mg, which is much more convenient in the form of soluble tablets than Amoxicillin suspension;

• can be used for newborns and infants;
• does not require additional manipulations before use, unlike, for example, a suspension that needs to be prepared;
• may be dissolved in breast milk;
• Requires very little water to dissolve.

Every parent knows how important it is that the medicine is not only effective, but also tasty. A mother who is trying to pour the hated bitter medicine into a sick child while the father is holding the child by the arms and legs is a very sad picture. And not that rare.

Astellas Pharma pharmacists masked the traditionally bitter taste of Amoxicillin with citrus flavors and saccharin. Therefore, Flemoxin Solutab is a tasty medicine for children.

Flemoxin pharmacokinetic data provide convincing evidence of its benefits

The pharmacokinetic properties of drugs largely determine their effectiveness. This is an axiom that does not require proof.

For example, one of the most negative aspects of Flemoxin's predecessor, Ampicillin, is low absorption and short half-life. Imagine that two-thirds of the antibiotic is not absorbed at all. That is, you drink one gram of a drug that is not the safest, but only 300 mg enters the blood. The remaining part is excreted from the body, simultaneously “working” in the intestines on your previously quite viable microflora. Not the most pleasant prospect, is it?

Therefore, one of the main tasks of modern pharmaceuticals is the search for new drugs and forms that have a high level of bioavailability. And Flemoxin Solutab, without any doubt, can be called one of these drugs.

Flemoxin is absorbed into the blood very quickly - within 5-10 minutes - and almost completely. The bioavailability of dispersible Amoxicillin is close to 93%. Note that for oral dosage forms such figures are practically record-breaking. In comparison with oral Amoxicillin, Flemoxin also clearly wins in this indicator. Thus, the bioavailability of conventional tablet forms of Amoxicillin rarely exceeds 75-80%.

Flemoxin packaging: tightness is a condition of preservation

Flemoxin dispersible tablets are extremely sensitive to moisture. To protect the tablet from moisture in the air, it is necessary to ensure that the packaging is completely sealed. Flemoxin is packaged in aluminum blisters, which guarantee protection of the antibiotic from premature decomposition.

If you accidentally squeezed a Flemoxin tablet out of the cell, it is better to either take it immediately or dispose of it, that is, mercilessly throw it in the trash.

It should be remembered that due to the high cellulose content, there is a possibility of gradual dissolution of the tablet in air moisture. And we know that any antibiotic, including Flemoxin, is unstable in a dissolved state.

Therefore, a Flemoxin tablet that was stored in damaged packaging or, even worse, without it, may turn out to be, at best, a harmless dummy.

Flemoxin solutab: spectrum of pharmacological activity

Amoxicillin, the active ingredient in Flemoxin, is active against many gram-positive and gram-negative bacteria. Among them:

• streptococci - Streptococcus pyogenes and Streptococcus pneumonia;
• staphylococci, including Staphylococcus aureus;
• clostridia;
• gonorrhea pathogens Neisseria gonorrhoeae;
• listeria;
• causative agent of peptic ulcer Helicobacter pylori.

Low activity of Flemoxin is recorded against most pathogens of intestinal infections:

And finally, Proteus, Enterobacteriaceae, and microorganisms that produce beta-lactamases are absolutely insensitive to the action of Flemoxin.

Beta-lactamases and Flemoxin: a fight for life

In the instructions for Flemoxin and other penicillin, as well as cephalosporin antibiotics, the term “beta-lactamase” is often used. Usually, patients who carefully study the annotations intuitively understand that lactamase is probably something very bad. But it is not always possible to clearly understand what it is and what, exactly, the harm of beta-lacatmaz is.

Let's try to find out who or what this beta-lactamase is. Let's start by remembering when the first penicillins began to be used.

The history of antibiotics goes back more than 70 years. During this period, many microorganisms learned to recognize the destructive antibacterial substance. Modern strains of bacteria already synthesize antidotes for at least two groups of antibiotics - penicillins and cephalosporins. The role of “antidote” is played by special enzymes from the group of beta-lactamases (penicillinases), which destroy the beta-lactam ring of the antibiotic. As a result, the drug is completely inactivated and has no antibacterial effect.

The first bacteria that learned to produce penicillinase were staphylococci. And, if in 1944 only 5% of Staphylococcus aureus strains produced the enzyme, now this figure has increased many times and is almost 90%!

In addition, bacteria that produce beta-lactamase include streptococci, as well as many gram-negative microorganisms, including Klebsiella, Enterobacteriaceae, Pseudomonas and other pathogens.

So, when infected with microorganisms that produce beta-lactamases, neither Flemoxin, nor other analogues of Amoxicillin, nor Ampicillin are absolutely effective.

Therefore, a correct assessment by a doctor when prescribing unprotected penicillins is so important. The specialist’s task is to differentiate the pathogen and “not to miss” in choosing an antibiotic.

Flemoxin or Flemoklav, which is better?

The Astellas Pharma company produces another antibiotic containing Amoxicillin - Flemoclav. Both the name and packaging of the drug are very similar to Flemoxin, however, there is a significant difference between these drugs. Let's figure out how these seemingly similar antibiotics differ.

We have already found out that some strains of microorganisms produce beta-lactamase, which inactivates Flemoxin. Therefore, for many infectious diseases, Amoxicillin, the active ingredient in Flemoxin, is absolutely ineffective.

Researchers from the British company Beecham, which developed Amoxicillin, have managed to find a substance that blocks beta-lactamases. This substance turned out to be clavulanic acid. Scientists have proven that the combination of clavulanic acid and penicillin antibiotics is effective against strains of bacteria that produce beta-lactamase.

This is how a new antibacterial drug with an extended spectrum of action appeared. The original antibiotic was released by Glaxo under the name Augmentin. By the way, thanks to the protective effect of clavulanates, complex antibiotics began to be called protected. After all, clavulanic acid really serves as a real protection for the lactam penicillin ring from destruction!

The Japanese corporation Astellas Pharma has developed a dispersible form of protected Amoxicillin - Flemoklav.

Patients often wonder: which antibiotic is preferable - Flemoxin or Flemoklav? Only a specialist who relies not only on theoretical, but also on practical knowledge can resolve this dilemma.

When deciding on the selection of a particular antibiotic, the doctor evaluates the history of the current disease, as well as experience in treating previous infections. The most important stage in selecting an antibiotic is differentiation of the pathogen. An error leads to incorrect prescription of the drug, and, therefore, to ineffective treatment.

Making a decision is complicated by the fact that in the vast majority of cases the pathogen is calculated empirically, that is, based on the symptoms of the disease. A qualified doctor will undoubtedly be able to do this. But a medical amateur is definitely not able to do this. Therefore, patients should remember: the decision to prescribe antibiotics and the choice of a specific drug should be entrusted to the doctor or clinical pharmacist. And no one else!

Flemoxin solutab: when to take?

Indications for the use of Flemoxin are primarily related to the spectrum of pharmacological activity of the drug. Note that Amoxicillin is included in the treatment protocols for many infectious diseases.

Modern semi-synthetic penicillin - Flemoxin solutab - is the drug of choice for uncomplicated pathologies of the respiratory tract of bacterial origin. I would like to place special emphasis on the word “uncomplicated”. In case of a moderately severe disease or a severe, complicated course of infection, protected penicillins or antibiotics of other groups are preferred to Flemoxin.

So, let's list the main diseases for which Flemoxin Solutab is indicated:

Acute otitis media is an inflammation of the middle ear.

In the initial treatment of acute otitis media, Flemoxin is the first-line drug, that is, the preferred antibiotic. However, if the disease is aggravated by severe otalgia (ear pain), a temperature above 39 degrees, then the doctor may suspect infection with beta-lactamase producing strains of Haemophilus influenzae and Moraxella catarrhalis. In such cases, the drug of choice is Flemoclav, that is, protected Amoxicillin.

Pharyngitis and tonsillitis - inflammation of the mucous membrane of the pharynx and tonsils.

As a rule, these diseases are caused by Streptococcus pyogenes, which are highly sensitive to Amoxicillin. Standard treatment protocols indicate that for bacterial tonsillitis Flemoxin solutab is the drug of choice. However, if the disease is recurrent in nature, that is, it recurs periodically over, for example, one year, then preference is given to a combination with clavulanates, as well as macrolides or cephalosporins.

Lower respiratory tract infections.

The main causative agents of pneumonia and bacterial bronchitis - alpha and beta hemolytic streptococci, Streptococcus pneumoniae, Staphylococcus aureus and Haemophilus influenzae - are sensitive to Flemoxin. Therefore, for uncomplicated bronchitis and pneumonia, Flemoxin Solutab can be used.

Skin infections caused by susceptible streptococci, Staphylococcus aureus and Escherichia coli.

Urinary tract infections.

Flemoxin is effective for inflammatory diseases of the kidneys and bladder if they are caused by sensitive enterococci Enterococcus faecalis, Escherichia coli or Proteus. For the treatment of uncomplicated urinary tract infections caused by enterococcus, Flemoxin is the drug of choice.

However, it is worth considering that some strains of E. coli are resistant, that is, completely insensitive to Amoxicillin. Meanwhile, cystitis - inflammation of the bladder - in most cases is caused by E. coli. Therefore, Flemoxin is prescribed with caution for urological infections.

Typhoid fever and salmonellosis.

Flemoxin is considered an alternative antibiotic for these infections and is used when first-line drugs are contraindicated. Note that the drugs of choice are fluoroquinolone antibiotics and third-generation cephalosporins.

Flemoxin is used in cases of early localized Lyme disease.

Treatment of peptic ulcer with Flemoxin

Long gone are the days when peptic ulcer disease was considered an incurable chronic disease that truly aggravated the patient’s life. Ulcer sufferers no longer need to be teetotalers, drink potato juice on an empty stomach, or poison themselves with vinylin. And especially to lie down on the operating table.

Thanks to the discovery of the role of a banal infection in the formation of ulcers in the wall of the stomach or duodenum, quick and effective therapy for these diseases has become possible. Helicobacter pylori infection, the causative agent of which is the microorganism Helicobacter pylori, is the cause of peptic ulcer disease in almost 90% of cases. In addition, Helicobacter provokes the development of atrophic gastritis, a dangerous inflammatory disease of the stomach wall, which is a risk factor for ulcers and even stomach cancer.

For a long time, scientists could not even imagine that anything living could survive in a highly hydrochloric acid environment. It turned out that Helicobacter pylori not only survives, but also actively reproduces. The bacterium synthesizes a special enzyme that neutralizes the hydrochloric acid of the stomach - that’s the whole secret of survival.

Meanwhile, Helicobacter responds well to therapy. The complex treatment regimen for infection includes two antibacterial drugs (one of which is Flemoxin), as well as a proton load inhibitor. The last medicine is necessary in order to completely neutralize hydrochloric acid in the stomach. Otherwise, healing of the inflamed area is simply impossible.

So, one of the most effective treatment regimens for peptic ulcer disease includes Amoxicillin (Flemoxin Solutab), Clarithromycin and a proton pump inhibitor (for example, Omeprazole, Lanzaprozole and other drugs). If you are intolerant to Clarithromycin, use a two-component regimen or add Metronidazole as an antimicrobial agent.

STD treatment

The abbreviation STD hides not the most pleasant diseases - diseases that are sexually transmitted.

Flemoxin is used only for two infections, and only in special cases. Let's look at them in more detail:

Amoxicillin was previously widely used to treat uncomplicated cases of gonorrhea. But recently, penicillin-resistant strains of Neisseria gonorrhoeae have emerged, so Flemoxin is often replaced with another antibiotic.

Flemoxin is a first-line treatment for uncomplicated urethritis (inflammation of the urethra) and cervicitis (inflammation of the cervical canal) during pregnancy. Note that in most cases of chlamydia in pregnant women, instead of Flemoxin or other Amoxicillin, Sumamed is still used, which is considered the drug of choice.

Flemoxin is usually prescribed in case of individual intolerance to macrolides.

Standard dosages of Flemoxin according to the instructions for use

Let us immediately emphasize that any antibacterial drug is dosed individually. And Flemoxin is no exception to the rule. In each specific case, the doctor assesses the severity of the disease, medical history, that is, medical history, as well as concomitant diseases. And based on this information, he selects the correct dosage.

However, there are still standard dosages of Flemoxin - something like the average body temperature in the ward. We emphasize that they are necessary for the doctor, not for the patient. And even more so, you should not rely on this information in order to prescribe the most correct treatment regimen for yourself.

So, according to the instructions for use of Flemoxin, the following dosages are recommended:

• For children from 1 to 3 years old, Flemoxin 250 mg tablets are used twice a day. An alternative prescription may be 125 mg of Flemoxin three times a day at regular intervals;
• The maximum dose of Flemoxin for a child is 60 mg per kilogram of weight per day. This dosage is indicated for severe infectious processes;
• for children from 3 to 10 years old, 375 mg of Flemoxin is prescribed twice or 250 mg three times a day;
• for children over 10 years of age and adults, the average dosage of Flemoxin is 500–750 mg twice or 375–500 mg three times a day.

For severe infections, Flemoxin can be used up to 3 grams per day, certainly divided into three doses.

The duration of treatment, as well as the dosage of Flemoxin, is selected individually. Please note that the minimum course of therapy should not be less than five days. The standard treatment regimen consists of a weekly course of antibiotics. If the infection is caused by the streptococcus Streptococcus pyogenes, Flemoxin is used for at least 10 days.

It is worth emphasizing that antibiotic treatment should not be stopped immediately after the symptoms of the disease disappear. This haste is fraught with the formation of resistant strains from among selected and strong bacteria, on which Flemoxin simply does not have time to act.

In order to avoid complications, it is necessary to continue treatment with Flemoxin for two days after the manifestations of the infection stop. At the same time, we must not forget that the minimum course should not be less than five days.

Chew, swallow, dissolve, or what is the best way to take Flemoxin?

When encountering dispersible tablets for the first time, many patients wonder what is the best way to take Flemoxin. We will try to answer this question and clarify whether there is a difference between the methods of taking this drug.

So, one of the most significant advantages of Flemoxin Solutab is the ability to choose a method of use that is convenient for the patient.

Depending on the individual characteristics and personal preferences of each Flemoxin tablet, you can:

• chew in the mouth;
• suck like a lollipop;
• dissolve in a small amount of cool boiled or simply purified water;
• dissolve in breast milk - for infants;
• dissolve in any juice, compote, tea and other drink. The only condition is that the drink should not be hot.

Let us immediately note that there is no fundamental difference in the methods of application. The rate of absorption, bioavailability and metabolism of Flemoxin do not depend on how long you chewed the tablet or how much juice you diluted in.

In addition, the pharmacokinetic properties of Flemoxin are not affected by food intake. You can take the tablet before meals, during lunch or after dinner, and in all cases the bioavailability of the antibiotic will be the same.

Contraindications to taking Flemoxin

Do not forget that Flemoxin is an antibacterial drug that has both side effects and contraindications. However, in fairness, it is worth noting that Amoxicillin is one of the safest antibiotics.

So, we list the absolute contraindications to taking Flemoxin:

Individual sensitivity to penicillin antibiotics.

The likelihood of an allergic reaction to Flemoxin is low. However, if you are allergic to medications, especially antibiotics, do not forget to warn your doctor about this. A specialist will be able to assess the risk and choose the right antibacterial agent.

In addition, do not forget about cross-sensitivity between penicillins and cephalosporins. If you have had an allergic reaction, for example, to ceftriaxone or any other antibiotic from the cephalosporin group, then it is also better to replace Flemoxin.

Erroneous prescription of Flemoxin and other penicillins for this disease leads to the appearance of an erythematous rash. Note that the symptoms of infectious mononucleosis are similar to those of bacterial pharyngitis and tonsillitis. However, mononucleosis is caused by a virus and does not require antibiotic treatment. Only a doctor can make the correct diagnosis and prescribe the correct medication.

Flemoxin during pregnancy: risks and benefits

Flemoxin is one of the antibiotics conditionally approved for use during pregnancy. The instructions for Flemoxin indicate that the drug can be used in cases where the risk to the child is less than the expected benefit to the mother.

Don't be afraid of this wording. It is caused solely by the fact that clinical trials of Flemoxin on pregnant women have not been carried out, and it is unlikely that they will ever be carried out for obvious reasons.

Nevertheless, Flemoxin is considered one of the safest antibiotics that can be used during pregnancy. And quite a long experience of using it is excellent proof of this. But let us emphasize once again that any antibiotic, including Flemoxin, can only be prescribed by a doctor. Think about your health and the health of your unborn child.

Side effects associated with treatment with Flemoxin

Flemoxin is one of the antibiotics that is well tolerated. However, there is a possibility of adverse events during or after treatment with the drug. Among them:

in 1-10% of cases the following are registered:

• development of vulvovaginal fungal infection (in 2% of patients). In such situations, during treatment with Flemoxin, parallel use of antifungal drugs, for example, Fluconazole, is recommended;
• diarrhea (in 1.7% of patients). As a rule, this symptom does not require discontinuation of Flemoxin and goes away on its own;
• nausea (in 1.3% of patients);
• headache (in 1% of cases).

in less than 1% of cases the following are possible:

In less than 1% of cases treated with Flemoxin, a rather serious side effect may develop - pseudomembranous colitis. The cause of this condition is a change in the composition of the intestinal flora and the proliferation of opportunistic microorganisms Clostridium difficile. Clinically, pseudomembranous colitis is manifested by severe diarrhea, which is fraught with general dehydration of the body.

When such symptoms appear, the first thing the patient should do is to immediately notify the attending physician. Usually in such cases, the only possible solution is to discontinue Flemoxin and prescribe another antibiotic or antimicrobial drug to which clostridia are sensitive. In addition, restoring the water-salt balance in the body plays an important role.

Flemoxin solutab - analogues

The pharmaceutical market is replete with generics of Amoxicillin from a variety of manufacturers. Let's try to list those Flemoxin analogues that have earned positive reviews from doctors:

• Amoxicillin produced by the Serbian company Hemofarm;
• Amoxicillin Sandoz, which is produced by the French corporation Sandoz;
• Hiconcil, a drug from the Slovak company KRKA;
• Ospamox produced by the Austrian pharmaceutical concern Biochemi;
• Amosin, Russian pharmaceutical company Synthesis.

Despite the abundance of analogues of Flemoxin Solutab, very few drugs have the same dispersible form. These include the Austrian Ospamox DT.

And the last thing I would like to note. Despite the wide selection of Flemoxin analogues, one should not forget that the prerogative of both prescribing an antibiotic and selecting a generic belongs exclusively to the doctor.

The article above and comments written by readers are for informational purposes only and do not encourage self-medication. Consult a specialist regarding your own symptoms and illnesses. When taking any medicine, you should always use the instructions that come with the medicine and your doctor's advice as a guide.

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Do you want to get rid of your nose, throat, lung and cold diseases? Then be sure to check it out here.

It is also worth paying attention to other medications:

I didn’t notice any side effects: we didn’t have diarrhea, although we didn’t take Linex. The doctor said that Flemoxin does not cause dysbacteriosis, and he was right.

Be careful! Especially with children!

By the way, having exceeded the dose of the drug (this happened (((, severe cough with vomiting, I thought that the drug was not absorbed and repeated taking the medicine again.) we were covered with a rash, recalculated the dose for that day and that’s it, the rash went away and we were treated for 5 days.

Mother of two sons (2.5 and 5 years old).

Repeated administration caused anaphylactic shock. Pale face, blue lips, leg and arm cramps, respiratory arrest and loss of consciousness. Unfortunately, there are doctors who “earn their living” in front of drug companies, without thinking about the life and safety of young patients.

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When selecting treatment for a child, we try to use as few pharmaceutical drugs as possible. But there are times when the disease requires serious intervention. If the baby has a severe cough and fever, and tests show the presence of a bacterial infection, doctors prescribe antibiotics. Flemoclav Solutab is one of them. Our review is dedicated to him.

Flemoklav Solutab is a broad-spectrum antibiotic.

Composition and action

The active ingredients of the drug are amoxicillin and clavulanic acid.

The first is a broad-spectrum antibiotic with bactericidal properties. Thanks to it, the synthesis of the substance responsible for its protection is disrupted in the wall of the harmful cell, and as a result, it dies.

Amoxicillin is a so-called beta-lactam antibiotic (the name is due to its structure). And among harmful bacteria there are those that are able to resist the effects of antibiotics of this series. They contain enzymes called beta-lactamases. Amoxicillin will not be effective against such bacteria.

The manufacturers of Flemoklav foresaw this and included a second active ingredient in the product - clavulanic acid, which increases the bactericidal capabilities of amoxicillin and contributes to the death of pathogenic microorganisms.

Additional components:

• microcrystalline cellulose;
• povidone;
• vanillin;
• apricot flavor;
• sweetener saccharin;
• filler magnesium stearate.

Manufacturers, prices, release forms

The drug is produced by the Dutch pharmaceutical company Astellas Pharma Europe in tablet form.

Pay attention to the dosage!

Depending on the concentration of active ingredients, there are 4 types of tablets. There are 2 numbers indicated on the package: the first is the concentration of amoxicillin, the second is clavulanic acid.

1. 125 mg + 31.25 mg. Oblong tablets that easily dissolve in the mouth, labeled 421.
2. 250 mg + 62.5 mg. The same tablets, but labeled 422.
3. 500 mg + 125 mg. Here, each pill is marked “424”.
4. 875 mg + 125 mg. Elongated tablets marked “425”.

The manufacturer's logo is embossed on the tablets. All forms of Flemoclav are packed in blisters of 4 pieces. A cardboard pack contains 5 blisters. The cost of the drug is from 310 to 500 rubles.

What does it treat?

Flemoclav Solutab is prescribed for respiratory infections caused by bacteria:

An antibiotic will help with otitis media.

• Chronical bronchitis;
• obstructive pulmonary disease in chronic form;
• pneumonia.

With the help of Flemoclav, infectious lesions of the skin, soft tissues, kidneys and ureters are also treated.

Dosage and administration

According to the instructions for use (), the dosage of Flemoklav Solutab depends on the weight of the child and the severity of the infection. The doctor must choose the treatment tactics.

The product should be taken before meals, to reduce the risk of intestinal problems. The tablet can be swallowed whole with a glass of liquid. To give medicine to a child who cannot swallow tablets, dissolve a single dose in a small amount of water (at least 30 ml).

You can dissolve the tablet in a small amount of water.

The drug Flemoklav Solutab is prescribed for children from 3 months. The table shows an approximate dosage regimen, where the amount of amoxicillin required for treatment is indicated in milligrams.

Flemoklav should be given to a child under 3 months in smaller doses, and only when there is an urgent need. The dosage will be calculated by the attending physician.

The doctor will prescribe the dosage!

The course of taking the drug should not last more than two weeks. Usually it is 5–7 days.

After treatment with any antibiotics, the child requires.

Contraindications

Flemoklav Solutab should not be used for:

• hypersensitivity or intolerance to the components of the drug and to other antibiotics of the penicillin and cephalosporin group;
• infectious mononucleosis;
• lymphocytic leukemia.

The 875 ml/125 ml form is contraindicated for use by children under 12 years of age and weighing less than 40 kg.

Side effects

Sometimes undesirable reactions are observed from the gastrointestinal tract to Flemoklav Solutab:

• nausea;
• abdominal pain;
• vomit;

Taking the drug may cause nausea, vomiting or diarrhea.

• diarrhea;
• colitis;
• intestinal candidiasis.

From the nervous system: the child may experience dizziness, sleep disturbance, hyperactivity, anxiety, aggressive behavior, headache.

Taking the drug can cause disruptions in the functioning of the hematopoietic system and liver.

Itching and burning in the groin area and interstitial nephritis are extremely rare when treated with Flemoklav.

The product can provoke allergies in the form of rash, itching, dermatitis, hemolytic anemia, laryngeal edema, Quincke's edema, anaphylactic shock.

Skin allergies may appear the first time you use the medicine.

If the first symptoms of side effects appear, stop using Flemoklav Solutab and consult a doctor.

Overdose

If the dose of medication required for the child is exceeded, undesirable effects may occur in the form of nausea, vomiting and diarrhea, sometimes. Doctors recommend treatment with activated carbon or other sorbents, as well as osmodiuretics - diuretics that direct fluid from the intercellular space into the blood.

Interaction with other drugs

Flemoklav is not compatible with some anti-inflammatory drugs (aspirin, drugs containing phenylbutazone, sulfinpyrazone, indomethacin, probenecid). When taken simultaneously, these drugs can cause an increase in the content of amoxicillin in the blood and bile, as they inhibit its excretion by the kidneys.

The antitumor drug Methotrexate, when taken together, is eliminated from the body more slowly, which can cause overdose symptoms in a child.

Flemoklav enhances the effect of drugs that reduce blood clotting.

Do not use the drug together with other antibiotics.

Analogs

Many parents notice a significant external resemblance between Flemoklav Solutab and. These products really have a lot in common, including the manufacturer. The only significant difference is that Flemoxin does not contain clavulanic acid. Although, in fact, it can be considered an analogue of Flemoclav. The antibiotic is also available in tablets. There are 4 types of the drug, and they differ in the concentration of the active substance: 125 mg, 250 mg, 500 mg and 1000 mg. The dosages are the same as for Flemoklav. The price of Flemoxin ranges from 240 to 500 rubles, depending on the type.

Analogue of Flemoklav Solutab - Flemoxin Solutab.

Let's consider other means with a similar effect. Most of the antibiotics listed below are available in the form of a suspension - that is, they are convenient for treating a child.

• - a drug that will replace Flemoclav, because in addition to amoxicillin it also contains clavulanic acid. You can buy Amoxiclav at a price from 120 to 850 rubles, depending on the amount of bactericidal substance in the drug.
• also contains not only amoxicillin, but also clavulanic acid. The dosage is calculated in the same way as for Flemoklav. The cost, depending on the concentration of the active substance, is from 70 to 400 rubles.
• Sold in pharmacies in the form of tablets, capsules and granules for diluting a suspension. It is dosed depending on the severity of the disease and the age of the patient. Average single dose for a child:
  . The active ingredient is clarithromycin. Available in the form of tablets, powder and lyophilisate. They treat children from 6 months. Price - from 370 rubles.
• Vilprafen is available in the form of tablets containing 500 or 1000 mg of josamycin, a bacteriostatic natural antibiotic. The drug is contraindicated in children weighing less than 10 kg. The dosage instructions indicate only adults and children over 14 years of age. You can buy the drug for an average of 540 rubles (500 mg) and 660 rubles (1000 mg). Dispensed by prescription.
• Available in the form of tablets and capsules of 250 and 500 mg of the active substance, as well as powder for suspension of 100, 200 and 500 mg. The dosage of the medicine is calculated by the doctor based on the age, weight of the child and the severity of the disease. The average children's daily dose is 5-10 mg of azithromycin per 1 kg of weight. Among the contraindications, only individual intolerance to the active substance and others like it are indicated. The cost of packaging the medicine ranges from 35 to 190 rubles.

Before choosing an analogue, consult your pediatrician.