Amoxicillin + Clavulanic Acid

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Amoxicillin + Clavulanic acid: instructions for use and reviews

1. Release form and composition
2. Pharmacological properties
3. Indications for use
4. Contraindications
5. Method of application and dosage
6. Side effects
7. Overdose
8. Special instructions
9. Application during pregnancy and lactation
10. Use in childhood
11. In case of impaired renal function
12. For violations of liver function
13. Drug interactions
14. Analogs
15. Terms and conditions of storage
16. Terms of dispensing from pharmacies
17. Reviews
18. Price in pharmacies

Latin name: Amoxicillin + Clavulanic acid

ATX code: J01CR02

Active ingredient: amoxicillin + clavulanic acid (amoxicillin + clavulanic acid)

Manufacturer: Krasfarma (Russia), Aurobindo Pharma (India), Lek d.d. (Slovenia), Hemofarm A. D. (Serbia), Sandoz (Switzerland)

Description and photo update: 2018-26-10

Prices in pharmacies: from 48 rubles.

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Film-coated tablets, Amoxicillin + Clavulanic acid

Amoxicillin + Clavulanic acid is a broad-spectrum antibiotic.

Release form and composition

Dosage forms of Amoxicillin + Clavulanic acid:

film-coated tablets: oval, biconvex, almost white or white, engraved "A" on one side, "63" (tablets 250 mg + 125 mg), or "64" (tablets 500 mg + 125 mg), or engraving divided by a line - "6 | 5" (tablets 875 mg + 125 mg); the cross section shows a light yellow core surrounded by a white or almost white shell (7 pcs. in blisters, 2 blisters in a cardboard box);
powder for preparation of suspension for oral administration (strawberry): granular, almost white or white (at a dosage of 125 mg + 31.25 mg / 5 ml - 7.35 g each in translucent vials with a volume of 150 ml, at a dosage of 250 mg + 62, 5 mg / 5 ml - 14.7 g each in translucent 150 ml vials; each vial in a cardboard box);
powder for preparation of a solution for intravenous (IV) administration: from white to white with a yellowish tinge (in 10 ml vials, 1 or 10 vials in a cardboard box; packaging for hospitals - from 1 to 50 vials in a cardboard box) …

Composition of 1 tablet:

active ingredients: amoxicillin (in the form of trihydrate) - 250 mg, or 500 mg, or 875 mg, clavulanic acid (in the form of potassium clavulanate) - 125 mg;
auxiliary (inactive) components: sodium carboxymethyl starch, microcrystalline cellulose, magnesium stearate, colloidal silicon dioxide, white opadry 06B58855 (titanium dioxide, macrogol, hypromellose-15cP, hypromellose-5cP).

Composition of 5 ml suspension (made from powder for suspension preparation):

active ingredients: amoxicillin (in the form of trihydrate) - 125 mg and clavulanic acid (in the form of potassium clavulanate) - 31.25 mg, or amoxicillin - 250 mg and clavulanic acid - 62.5 mg;
auxiliary components: xanthan gum, silicon dioxide, hypromellose, aspartame, succinic acid, colloidal silicon dioxide, strawberry flavor.

The active ingredients in 1 powder bottle for preparing a solution for intravenous administration: amoxicillin - 500 mg and clavulanic acid - 100 mg, or amoxicillin - 1000 mg and clavulanic acid - 200 mg.

Pharmacological properties

Pharmacodynamics

The action of the drug Amoxicillin + Clavulanic acid is due to the properties of its active substances.

Amoxicillin is a semi-synthetic antibiotic. It has a wide spectrum of action, is active against many gram-negative and gram-positive microorganisms. It does not affect microorganisms that produce beta-lactamase enzymes, since it is destroyed under their action.

Clavulanic acid is a beta-lactamase inhibitor structurally related to penicillins. It has the ability to inactivate most of the beta-lactamases found in microorganisms resistant to the action of cephalosporins and penicillins. Clavulanic acid is quite effective against plasmid beta-lactamases, which are most often resistant, but inactive against chromosomal type 1 beta-lactamases.

Clavulanic acid in the composition of the drug protects amoxicillin from the destructive effects of beta-lactamases and expands the spectrum of its activity, including in relation to bacteria that are usually resistant to amoxicillin.

The following microorganisms are sensitive to the combination of amoxicillin + clavulanic acid:

gram-positive aerobes: Streptococcus agalactiae ^{1, 2}, Listeria monocytogenes, Bacillus anthracis, Nocardia asteroids, Enterococcus faecalis, Streptococcus pyogenes ^{1, 2}, methicillin-sensitive Staphylococcus aureus, methicillin-sensitive Staphylococcus aureus, methicillin-sensitive Staphylococcus s. spp. ^{1, 2};
gram-positive anaerobes: Clostridium spp., Peptostreptococcus magnus, Peptostreptococcus spp., Peptococcus niger, Peptostreptococcus micros;
gram-negative aerobes: Neisseria gonorrhoeae, Haemophilus influenzael, Vibrio cholerae, Pasteurella multocida, Moraxella catarrhalisl (Branhamella catarrhalis), Helicobacter pylori, Bordetella pertussis;
gram-negative anaerobes: Porphyromonas spp., Capnocytophaga spp., Prevotella spp., Eikenella corrodens, Bacteroides spp. (including Bacteroides fragilis), Fusobacterium spp., Fusobacterium nucleatum;
others: Leptospira icterohaemorrhagiae, Treponema pallidum, Borrelia burgdorferi.

Acquired resistance to the drug Amoxicillin + Clavulanic acid is likely for the following microorganisms:

gram-negative aerobes: Proteus spp. (including Proteus vulgaris and Proteus mirabilis), Escherichia coli ¹, Salmonella spp., Klebsiella spp. (including Klebsiella pneumoniae ¹ and Klebsiella oxytoca), Shigella spp.;
gram-positive aerobes: Enterococcus faecium, Streptococcus pneumonia ^{1, 2}, Corynebacterium spp., Streptococcus spp. group

The following microorganisms are naturally resistant to the action of amoxicillin in combination with clavulanic acid:

gram-negative aerobes: Stenotrophomonas maltophilia, Pseudomonas spp., Enterobacter spp., Yersinia enterocolitica, Legionella pneumophila, Hafnia alvei, Citrobacter freundii, Serratia spp., Providencia spp., Morganella morganii, Acinetobacter spp.;
others: Mycoplasma spp., Chlamydia psittaci, Chlamydia spp., Coxiella burnetii, Chlamydia pneumoniae.

Notes:

¹ For these bacteria, the effectiveness of the use of amoxicillin in combination with clavulanic acid has been established in clinical studies.

² Strains of these types of microorganisms do not produce beta-lactamases, are sensitive to amoxicillin, and therefore, presumably, to the combination of amoxicillin + clavulanic acid.

Pharmacokinetics

After taking the drug Amoxicillin + Clavulanic acid inside, the active substances are quickly and completely absorbed from the gastrointestinal tract. The maximum concentration is reached in 1–2 hours. Optimal absorption was observed when the drug was taken at the beginning of a meal.

When taken orally and intravenously, the active substances have a moderate degree of binding to plasma proteins: amoxicillin - 17–20%, clavulanic acid - 22–30%.

Both components are characterized by a good volume of distribution in body fluids and tissues. Found in the lungs, middle ear, pleural and peritoneal fluids, uterus, ovaries. They penetrate into the secret of the paranasal sinuses, palatine tonsils, synovial fluid, bronchial secretions, muscle tissue, prostate gland, gallbladder and liver. Amoxicillin is able to pass into breast milk, like most penicillins. Trace amounts of clavulanic acid have also been found in breast milk.

Amoxicillin and clavulanic acid cross the placental barrier. They do not penetrate the blood-brain barrier, provided that the meninges are not inflamed.

Both components are metabolized in the liver: amoxicillin - about 10% of the dose, clavulanic acid - about 50% of the dose.

Amoxicillin (50–78% of the dose) is excreted almost unchanged by the kidneys by glomerular filtration and tubular secretion. Clavulanic acid (25-40% of the dose) is excreted by glomerular filtration by the kidneys, partially in the form of metabolites and unchanged. Both components are eliminated within the first 6 hours. Small amounts can be excreted through the lungs and intestines.

In severe renal failure, the half-life increases: for amoxicillin - up to 7.5 hours, for clavulanic acid - up to 4.5 hours.

Both active substances of the antibiotic are removed by hemodialysis, in small quantities by means of peritoneal dialysis.

Indications for use

According to the instructions, Amoxicillin + Clavulanic acid is used to treat infectious and inflammatory diseases caused by microorganisms that are sensitive to a combination of active ingredients:

infections of ENT organs and upper respiratory tract: acute and chronic sinusitis, recurrent tonsillitis, acute and chronic otitis media, pharyngitis and pharyngeal abscess, usually caused by Streptococcus pyogenes, Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis;
lower respiratory tract infections: exacerbation of chronic bronchitis, acute bronchitis with bacterial superinfection, bronchopneumonia, pneumonia, usually caused by Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis;
bone and connective tissue and joint infections, including osteomyelitis, usually caused by Staphylococcus aureus;
biliary tract infections: cholangitis, cholecystitis;
infections of the genitourinary tract: pyelitis, pyelonephritis, urethritis, cystitis, chancre, prostatitis, gonorrhea (caused by Neisseria gonorrhoeae), infections of the female genital organs, usually caused by species of the Enterobacteriaceae family (mainly Escherichia coli), species of the genus Enterococcus, Staphylococcus spp. vaginitis, salpingitis, endometritis, salpingo-oophoritis, cervicitis, tubo-ovarian abscess, septic abortion;
infections of the skin and soft tissues: secondary infected dermatoses, phlegmon, erysipelas, abscess, impetigo and wound infections, usually caused by species of the genus Bacteroides, Streptococcus pyogenes, Staphylococcus aureus;
meningitis, peritonitis, endocarditis, sepsis;
odontogenic infections;
other mixed infections, for example, intra-abdominal infections, post-abortion or postpartum sepsis (as part of sequential therapy).

In surgery, an antibiotic is used to prevent postoperative infections.

Contraindications

infectious mononucleosis (including when a measles-like rash appears);
impaired liver function and cholestatic jaundice associated with the use of a combination of amoxicillin and clavulanic acid or a history of penicillin;
children under 12 years of age (for tablets);
phenylketonuria (for suspension);
creatinine clearance less than 30 ml / min (for tablets 875 mg + 125 mg);
hypersensitivity to the components of the drug, beta-lactam antibiotics, cephalosporins or penicillins.

The drug Amoxicillin + Clavulanic acid should be used with caution in the following cases:

severe liver failure;
chronic renal failure;
diseases of the gastrointestinal tract (including a history of colitis caused by the use of penicillins);
pregnancy and lactation.

Instructions for use Amoxicillin + Clavulanic acid: method and dosage

Film-coated tablets

In the form of tablets, the drug is indicated for oral administration. For optimal absorption and to reduce the risk of side effects from the digestive system, it is recommended to take the tablets at the beginning of a meal.

The doctor determines the dosage regimen individually, depending on the severity of the infectious process, the patient's age, body weight and kidney function.

If necessary, step-by-step therapy is carried out: first, the drug Amoxicillin + Clavulanic acid is administered intravenously, after which they switch to oral administration.

Recommended doses for adults and children over 12 years old or weighing more than 40 kg:

infections of mild to moderate severity: 250 mg + 125 mg every 8 hours or 500 mg + 125 mg every 12 hours;
severe infections, respiratory tract infections: 500 mg + 125 mg 3 times a day or 875 mg + 125 mg 2 times a day.

The maximum daily dose of amoxicillin should not exceed 6000 mg, clavulanic acid - 600 mg.

The minimum duration of treatment is 5 days, the maximum is 14 days. 2 weeks after the start of the therapeutic course, the doctor assesses the clinical situation and, if necessary, decides to continue treatment. The duration of therapy for uncomplicated acute otitis media is 5–7 days.

It is important to take into account that 2 tablets 250 mg + 125 mg in terms of clavulanic acid content are not equivalent to 1 tablet 500 mg + 125 mg.

In case of impaired renal function, the dose of amoxicillin is adjusted depending on the creatinine clearance (CC):

CC> 30 ml / min: no correction required;
CC 10-30 ml / min: 2 times a day, 1 tablet of 250 mg (for mild and moderate infections) or 1 tablet of 500 mg;
CC <10 ml / min: 1 tablet of 250 mg once a day (for mild and moderate infections) or 1 tablet of 500 mg.

Tablets 875 mg + 125 mg can only be used in patients with CC> 30 ml / min.

Adults on hemodialysis are prescribed 1 tablet of 500 mg + 125 mg or 2 tablets of 250 mg + 125 mg 1 time per day. An additional dose is given during the dialysis session and another dose at the end of the session.

Powder for oral suspension

Suspension Amoxicillin + Clavulanic acid is usually prescribed to children under the age of 12 years.

In this dosage form, the drug is intended for oral administration. A suspension is prepared from the powder: boiled drinking water cooled to room temperature is poured into a bottle 2/3, shaken well, then the volume is brought to the mark (100 ml) and again vigorously shaken. Shake the bottle before each dose.

For accurate dosing, the set includes a measuring cap with 2.5 ml, 5 ml and 10 ml notches. It must be washed with clean water after each use.

The doctor determines the dosage regimen individually, depending on the severity of the infectious process, the patient's age, body weight and kidney function.

For optimal absorption of active substances and to reduce the risk of side effects from the digestive system, it is recommended to take Amoxicillin + Clavulanic acid suspension at the beginning of a meal.

The duration of treatment is at least 5 days, but not more than 14 days. 2 weeks after the start of the therapeutic course, the doctor assesses the clinical situation and, if necessary, decides to continue treatment.

For children from 3 months to 12 years old or weighing up to 40 kg, the suspension is prescribed at a dose of 125 mg + 31.25 mg per 5 ml or 250 mg + 62.5 mg per 5 ml three times a day at intervals of 8 hours.

The minimum daily dose for amoxicillin is 20 mg / kg, the maximum is 40 mg / kg. In low doses, the drug is used for recurrent tonsillitis, skin and soft tissue infections. In high doses - for sinusitis, otitis media, infections of the lower respiratory tract, urinary tract, bones and joints.

For children from birth to 3 months, a daily dose of 30 mg / kg of amoxicillin is recommended. It should be divided into 2 doses.

There are no dosage recommendations for premature infants.

In case of impaired renal function, the dose of amoxicillin is adjusted depending on the CC:

CC> 30 ml / min: no correction required;
CC 10-30 ml / min: 15 mg + 3.75 mg per kg of body weight twice a day, but not more than 500 mg + 125 mg twice a day;
CC <10 ml / min: 15 mg + 3.75 mg per kg of body weight once a day, but not more than 500 mg + 125 mg.

Children on hemodialysis are prescribed 15 mg + 3.75 mg per kg of body weight once a day. Additionally, one dose is prescribed before the hemodialysis session, the second after the end of the session.

Powder for preparation of solution for intravenous administration

A solution for intravenous injection / infusion is prepared from the powder.

To prepare a solution for intravenous injection, the contents of the bottle are dissolved in water for injection: at a dose of 500 mg + 100 mg (600 mg) - in 10 ml, at a dose of 1000 mg + 200 mg (1200 mg) - in 20 ml. Enter slowly (within 3-4 minutes).

For infusion administration, further dilution of the drug is required: the resulting solutions are diluted in 50 ml (500 mg + 100 mg) or 100 ml (1000 mg + 200 mg) of the infusion solution. Ringer's solutions, sodium chloride or potassium chloride can be used as a solvent. The duration of the infusion is 30-40 minutes.

The doctor determines the dosage regimen individually, depending on the sensitivity of the pathogen, the severity and localization of the infection, the patient's age, body weight and kidney function.

Adults and adolescents from 12 years old are prescribed 1200 mg 3 times a day (at intervals of 8 hours), for severe infections - 4 times a day (at intervals of 6 hours).

The maximum allowable daily dose is 6000 mg.

Children from 3 months to 12 years old are prescribed 30 mg / kg (based on the entire drug) 3 times a day, with a severe course of the infectious process - 4 times a day.

Children under the age of 3 months are prescribed 30 mg / kg (based on the entire drug): in the postperinatal period - 3 times a day, for premature and in the perinatal period - 2 times a day.

The duration of treatment is 5-14 days.

For the prevention of postoperative infections, the drug Amoxicillin + Clavulanic acid is prescribed at a dose of 1200 mg during induction anesthesia during an operation lasting less than 1 hour, 1200 mg every 6 hours during the day - with longer operations. If there is a high risk of infection, it is possible to use the drug for several days.

For patients with renal insufficiency, the dose and / or the interval between injections are adjusted depending on the CC:

CC 10-30 ml / min: initial dose - 1200 mg, then - 600 mg every 12 hours;
CC <10 ml / min: initial dose - 1200 mg, then - 600 mg once a day.

For children, doses and frequency of administration are reduced in the same way.

For patients undergoing hemodialysis, an additional dose is indicated at the end of each session.

No dose adjustment is required with peritoneal dialysis.

Side effects

from the central nervous system: infrequently - headache, dizziness; very rarely - agitation, insomnia, anxiety, confusion, changes in behavior, reversible hyperactivity and seizures (seizures are possible in patients receiving the drug in high doses and in patients with impaired renal function);
from the gastrointestinal tract: very often - diarrhea; often - nausea and vomiting; infrequently - dyspeptic symptoms; very rarely - glossitis, black "hairy" tongue, stomatitis, enterocolitis, gastritis, antibiotic-associated pseudomembranous or hemorrhagic colitis;
from the hematopoietic system: rarely - reversible thrombocytopenia, reversible leukopenia (including neutropenia); very rarely - eosinophilia, anemia, reversible hemolytic anemia, thrombocytosis, thrombocytopenic purpura, reversible agranulocytosis, increased prothrombin time and bleeding time;
from the skin and subcutaneous tissues: infrequently - urticaria, itching, skin rash; rarely, erythema multiforme; very rarely - erythematous rash, erythema, allergic vasculitis, a syndrome similar to serum sickness, bullous exfoliative dermatitis, anaphylactic reactions, anaphylactic shock, angioedema, toxic epidermal necrolysis, Stevens-Johnson syndrome, acute pustular exanthemosis;
from the kidneys and urinary tract: very rarely - hematuria, crystalluria, interstitial nephritis;
from the liver *: infrequently - a moderate increase in the activity of alanine aminotransferase and / or aspartate aminotransferase; very rarely - an increase in the concentration of bilirubin and alkaline phosphatase, impaired liver function; with the simultaneous use of other penicillins and cephalosporins - cholestatic jaundice, hepatitis;
others: discoloration of teeth (yellow, gray or brown discoloration); often - candidiasis of the mucous membranes.

* Side effects from the liver are usually reversible, occurring during or shortly after treatment. They occur mainly in the elderly and men. May be associated with prolonged use of the drug. Liver dysfunction can be of varying severity, from mild to life-threatening (predominantly in patients with severe pre-existing diseases and people who have received potentially hepatotoxic drugs).

Overdose

In most cases, overdose causes gastrointestinal disturbances (diarrhea, abdominal pain, vomiting) and imbalances in water and electrolyte balance. Anxiety, dizziness, insomnia are also possible, in isolated cases (in patients receiving the drug in high doses and in patients with impaired renal function) - convulsive seizures. The development of amoxicillin crystalluria, in some cases leading to renal failure, has been described.

Overdose treatment is symptomatic. Particular attention is paid to the normalization of water and electrolyte balance. If necessary, hemodialysis is performed.

special instructions

Before starting antibiotic therapy, the physician should collect a detailed personal history of the patient regarding previous sensitivity reactions to the use of penicillins, cephalosporins or other allergens.

There are reports of the development of serious hypersensitivity reactions to penicillins, including fatal ones. The risk of such reactions is especially high in patients with a history of hypersensitivity reactions to penicillins. With the development of allergic reactions, the drug Amoxicillin + Clavulanic acid is immediately canceled and alternative therapy is prescribed. In case of serious anaphylactic reactions, it is necessary to urgently take appropriate measures (administration of epinephrine). Intravenous glucocorticosteroids, oxygen therapy, and airway management (intubation if necessary) may be required.

During therapy, it is necessary to remember about the possible development of superinfection (it is usually caused by Candida fungi and Pseudomonas bacteria). In this case, the drug is canceled and / or appropriate therapy is prescribed.

If you suspect an infectious mononucleosis, the drug Amoxicillin + Clavulanic acid is not recommended, since the risk of a measles-like skin rash is high, which complicates the diagnosis of the disease.

During long-term therapy, the growth of insensitive microorganisms is possible.

During prolonged treatment, it is recommended to periodically assess the functions of hematopoiesis, liver and kidneys.

Amoxicillin + Clavulanic acid, like other antibacterial drugs, can cause mild to life-threatening pseudomembranous colitis. In this regard, in case of diarrhea that occurs during or after treatment, the likelihood of pseudomembranous colitis must be assumed. If the diarrhea is severe or is observed for a long time, the drug is canceled and the patient is examined. You should not take drugs that inhibit intestinal motility.

In rare cases, in patients with reduced diuresis, crystalluria may develop, mainly during parenteral therapy. With the introduction of amoxicillin in high doses, it is recommended to drink plenty of fluids and maintain an adequate diuresis to reduce the risk of amoxicillin crystals.

Because of the clavulanic acid in the antibiotic, it can cause a false positive Coombs test.

Amoxicillin + Clavulanic acid in oral dosage forms leads to a high content of amoxicillin in the urine, which distorts the results when determining glucose in urine (for example, Fehling's test or Benedict's test). If it is necessary to carry out this diagnostic test, it is worth using the glucose oxidant method.

With the simultaneous appointment of anticoagulants, the prothrombin time or INR (international normalized ratio) must be carefully monitored. If necessary, their dose should be adjusted.

Amoxicillin + Clavulanic acid in oral dosage forms may cause discoloration of the surface layer of tooth enamel. To prevent this, you should provide adequate oral care (regularly and thoroughly brush your teeth).

Influence on the ability to drive vehicles and complex mechanisms

The drug Amoxicillin + Clavulanic acid can cause side effects from the central nervous system, therefore, care should be taken when performing any work requiring speed of reactions and / or attention.

Application during pregnancy and lactation

In the course of studies of reproductive function in animals with oral and parenteral administration of a combination of amoxicillin + clavulanic acid, no teratogenic effect was revealed. During a single study in women with premature rupture of membranes, it was found that prophylactic administration of amoxicillin in combination with clavulanic acid may increase the risk of developing necrotizing enterocolitis in newborns. During pregnancy, the drug is prescribed only if the expected benefit of therapy for the woman outweighs the potential risks to the fetus.

Amoxicillin + Clavulanic acid can be used during lactation. No adverse effects were observed in children receiving breastfeeding, with the exception of the risk of developing hypersensitivity reactions, candidiasis of the oral mucosa or diarrhea, which is due to the penetration of trace amounts of the active substances of the drug into breast milk. If these reactions occur in a child, breastfeeding should be discontinued for the duration of treatment.

Pediatric use

Amoxicillin + Clavulanic acid in tablet form is not used to treat children under the age of 12.

With impaired renal function

In chronic renal failure, the drug should be used with caution.

For violations of liver function

The drug Amoxicillin + Clavulanic acid is contraindicated in liver dysfunction and cholestatic jaundice associated with the use of a combination of amoxicillin and clavulanic acid or a history of penicillin.

In severe hepatic impairment, the drug should be used with caution. Treatment must be carried out under regular monitoring of liver function.

Drug interactions

Bacteriostatic agents (sulfonamides, macrolides, tetracyclines, lincosamides, chloramphenicol) have an antagonistic effect.

With the simultaneous use of bactericidal antibiotics (including cephalosporins, aminoglycosides, rifampicin, vancomycin, cycloserine), a synergistic effect is noted.

The drug Amoxicillin + Clavulanic acid enhances the effect of indirect anticoagulants (suppresses the intestinal microflora, reduces the prothrombin index and vitamin K synthesis). If it is necessary to use such a combination, blood clotting indicators should be monitored.

Diuretics, non-steroidal anti-inflammatory drugs, phenylbutazone, allopurinol and drugs that block tubular secretion, with simultaneous use, increase the concentration of amoxicillin.

The drug Amoxicillin + Clavulanic acid increases the toxicity of methotrexate, reduces the effect of oral contraceptives. When combined with ethinylestradiol or with drugs, the metabolism of which forms para-aminobenzoic acid, there is a risk of breakthrough bleeding.

Allopurinol increases the likelihood of developing allergic skin reactions.

At the same time, it is not recommended to prescribe disulfiram, probenecid.

The drug solution is pharmaceutically incompatible with solutions containing bicarbonate, glucose, dextran, lipids, proteins, blood. Incompatible with aminoglycosides. The solution should not be mixed with any other medicinal products in the same syringe / infusion bottle.

The absorption of amoxicillin and clavulanic acid is increased by ascorbic acid, reduced by laxatives, glucosamine, aminoglycosides, antacids.

Analogs

The analogs of Amoxicillin + Clavulanic acid are: Ekoklav, Augmentin SR, Augmentin EC, Augmentin, Amoxiclav, Amovikomb, Medoklav, Panklav 2X, Arlet, Amoxiclav Kviktab, Flemoklav Solutab, Novaklav, Rapiklav, Amoxicillin-Clavalavalanov, Klamosar, Bactoklav, Foraclav.

Terms and conditions of storage

Store in a dry, dark place at a temperature: tablets and powder for preparation of suspension for oral administration - up to 25 ° С, powder for preparation of solution for intravenous administration - up to 15 ° С. Keep out of the reach of children.

Shelf life of tablets and powder for preparation of solution for intravenous administration is 2 years, powder for preparation of suspension for oral administration is 1.5 years.

The suspension prepared from the powder can be stored for no more than 7 days in the refrigerator (at a temperature of + 6 ° C). Do not freeze.

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews about Amoxicillin + Clavulanic acid

The overwhelming majority of reviews about Amoxicillin + Clavulanic acid are positive. Patients confirm the high efficiency of the drug in the treatment of even the most complex infections. However, like other antibiotics, this remedy must be used only as directed by a doctor, having previously determined the sensitivity of the microorganisms that caused the development of the disease to it.

Price for Amoxicillin + Clavulanic acid in pharmacies

Prices for Amoxicillin + Clavulanic acid start at 45 rubles, depending on the dosage form, dosage and manufacturer of the drug.