Amoxicillin EXPRESS
Amoxicillin EXPRESS: 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. Use in the elderly
- 14. Drug interactions
- 15. Analogs
- 16. Terms and conditions of storage
- 17. Terms of dispensing from pharmacies
- 18. Reviews
- 19. Price in pharmacies
Latin name: Amoxicillin EXPRESS
ATX code: J01CA04
Active ingredient: amoxicillin (Amoxicillin)
Manufacturer: CJSC "LEKKO" (Russia)
Description and photo update: 2020-28-05
Prices in pharmacies: from 245 rubles.
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Amoxicillin EXPRESS is an antibacterial drug with a wide spectrum of bactericidal action.
Release form and composition
The drug is produced in the form of dispersible tablets: oval, biconvex, from white to light yellow, have a light fruity taste; tablets with a dosage of 250 mg - with a line on one side (in blisters of 10 pcs., in a cardboard box 2 packs; in polypropylene vials of 10 pcs. with a dosage of 1000 mg and 20 pcs. with a dosage of 125, 250 and 500 mg, in cardboard box 1 bottle Each box also contains instructions for the use of Amoxicillin EXPRESS).
1 tablet contains:
- active substance: amoxicillin - 125, 250, 500 or 1000 mg (in the form of amoxicillin trihydrate - 143.47; 286.95; 573.89 and 1147.78 mg, respectively);
- auxiliary components: saccharin, vanillin, crospovidone, magnesium stearate, microcrystalline cellulose, lemon flavor, tangerine flavor.
Pharmacological properties
Pharmacodynamics
Amoxicillin EXPRESS is a broad-spectrum antibacterial drug. Its active ingredient - amoxicillin, belongs to the group of semi-synthetic penicillins, is a 4-hydroxyl analogue of ampicillin, has a bactericidal effect.
The following microorganisms are sensitive to amoxicillin:
- aerobic gram-positive bacteria: Staphylococcus speciales (spp.) (except for strains producing penicillinase), Streptococcus spp.;
- aerobic gram-negative bacteria: Neisseria meningitidis, Neisseria gonorrhoeae, Escherichia coli, Salmonella spp., Shigella spp., Klebsiella spp.
In relation to Helicobacter pylori, it exhibits antibacterial action in combination with metronidazole. It is believed that amoxicillin inhibits the formation of resistance of Helicobacter pylori to metronidazole.
The spectrum of activity of Amoxicillin EXPRESS expands when used simultaneously with clavulanic acid (a beta-lactamase inhibitor). This combination increases the effectiveness of amoxicillin against bacteria such as Legionella spp., Bacteroides spp., Nocardia spp. and Pseudomonas (Burkholderia) pseudomallei. But a large number of other gram-negative bacteria, including Pseudomonas aeruginosa and Serratia marcescens, remain resistant to it.
Amoxicillin EXPRESS is not active against microorganisms producing penicillinase.
Cross-resistance occurs with simultaneous use with ampicillin.
Pharmacokinetics
After oral administration, amoxicillin is not destroyed in the acidic environment of the stomach, but is rapidly and completely absorbed from the gastrointestinal tract (GIT). The total absorption in the presence of food in the stomach does not decrease. The maximum concentration (C max) of amoxicillin in the blood plasma is reached after 1-2 hours. If the dose is doubled, the concentration level also doubles. With parenteral (intravenous and intramuscular administration) and oral administration of amoxicillin, similar blood concentrations are achieved.
Plasma protein binding is approximately 20%.
It is widely distributed in tissues and body fluids, in high concentrations found in the liver.
With inflammation of the pia mater, small amounts of amoxicillin penetrates the blood-brain barrier. It overcomes the placental barrier, excreted in breast milk.
The half-life (T 1/2) from plasma is 1-1.5 hours.
About 60% of the dose taken is excreted through the kidneys unchanged by glomerular filtration and tubular secretion. The concentration level of amoxicillin in urine while taking the drug at a dose of 250 mg is more than 0.3 mg / ml. Some amoxicillin is excreted through the intestines.
It should be borne in mind that in elderly patients and newborns, T 1/2 may increase. With renal failure, T 1/2 can be from 7 to 20 hours.
With hemodialysis, amoxicillin is removed from the body.
Indications for use
The use of Amoxicillin EXPRESS is indicated as monotherapy and in combination with clavulanic acid in the treatment of infectious and inflammatory diseases caused by sensitive microorganisms, including bronchitis, pneumonia, tonsillitis, pyelonephritis, urethritis, gastrointestinal infections, gynecological infectious pathologies, gonorrhea, listeriosis, skin leptospirosis, infections and soft tissues.
In addition, in combination with metronidazole, the drug is prescribed during an exacerbation of chronic gastritis and gastric ulcer and duodenal ulcer associated with Helicobacter pylori.
Contraindications
Absolute:
- Infectious mononucleosis;
- lymphocytic leukemia;
- severe gastrointestinal infections accompanied by diarrhea or vomiting;
- respiratory viral infections;
- allergic diathesis;
- bronchial asthma;
- hay fever;
- established individual intolerance to penicillins and / or cephalosporins;
- hypersensitivity to the components of the drug.
Additional contraindications for the use of Amoxicillin EXPRESS tablets in combination therapy with metronidazole:
- diseases of the nervous system;
- disorders of hematopoiesis;
- liver disease;
- age up to 18 years;
- hypersensitivity to nitroimidazole derivatives.
The use of the drug in combination with clavulanic acid is contraindicated in patients with a history of liver dysfunction or jaundice caused by the simultaneous administration of amoxicillin and clavulanic acid.
Amoxicillin EXPRESS should be used with caution in case of a history of allergic reactions, a history of gastrointestinal diseases, hepatic / renal failure, during pregnancy and lactation, in premature infants, in old age.
Amoxicillin EXPRESS, instructions for use: method and dosage
Dispersible tablets Amoxicillin EXPRESS are taken orally, after dissolving them in a small amount of water (at least 50 ml), regardless of the meal.
The doctor determines the dose and duration of treatment individually, taking into account clinical indications, the age and weight of the patient.
The recommended dosage has the following age restrictions:
- adults and children over 10 years of age (body weight over 40 kg): 250–500 mg 3 times a day at regular intervals. In severe cases, an increase in a single dose to 1000 mg is shown;
- children aged 5 to 10 years: 250 mg 3 times a day at regular intervals;
- children aged 2 to 5 years: 125 mg 3 times a day at regular intervals.
Depending on the indications and the clinical situation, for children with a body weight of less than 40 kg, the daily dose can be determined at the rate of 20-100 mg per 1 kg of body weight and taken in 2-3 doses.
In acute uncomplicated gonorrhea, Amoxicillin EXPRESS is prescribed in combination with probenecid at a dose of 3000 mg once.
In case of impaired renal function, the frequency of taking a single dose of the drug must be adjusted in accordance with the following values of the creatinine clearance (CC) indicator:
- CC 10–40 ml / min: 2 times a day at regular intervals;
- CC less than 10 ml / min: once a day.
Side effects
The frequency of adverse events of Amoxicillin EXPRESS is defined as follows: very often (≥ 1/10); often (from ≥ 1/100 to <1/10); infrequently (from ≥ 1/1000 to <1/100); rarely (from ≥ 1/10 000 to <1/1000); extremely rare (<1/10 000); with an unknown frequency (based on the available data, the incidence of adverse reactions cannot be estimated).
- immune system: extremely rarely - severe allergic reactions such as anaphylaxis, angioedema, allergic vasculitis and serum sickness; with an unknown frequency - Kounis syndrome (acute coronary syndrome associated with hypersensitivity), the Jarisch-Herxheimer reaction;
- blood and lymphatic system: extremely rarely - reversible thrombocytopenia, reversible leukopenia (including agranulocytosis and severe neutropenia), hemolytic anemia, prolongation of prothrombin time and bleeding time;
- nervous system: extremely rarely - dizziness, hyperkinesia, convulsions; with an unknown frequency - aseptic meningitis;
- digestive system (based on clinical research data): often - nausea, diarrhea; rarely - vomiting; extremely rarely (based on the data obtained in the post-registration period) - superficial discoloration of tooth enamel, black "hairy" tongue, colitis associated with taking antibiotics (including hemorrhagic and pseudomembranous);
- skin and subcutaneous tissue (based on clinical data): often - skin rash; rarely - itching, urticaria; extremely rare (based on data obtained in the post-registration period) - exfoliative and bullous dermatitis, Stevens-Johnson syndrome, erythema multiforme, acute generalized exanthematous pustulosis, toxic epidermal necrolysis (Lyell's syndrome), DRESS syndrome (drug rash with eosinophilia and systemic symptoms);
- liver and biliary tract: extremely rare - cholestatic jaundice, hepatitis, moderate increase in AST (aspartate aminotransferase) and / or ALT (alanine aminotransferase) activity in blood plasma;
- kidneys and urinary tract: extremely rare - crystalluria, interstitial nephritis;
- infectious and parasitic pathologies: extremely rarely - candidiasis of the mucous membranes and skin, superinfection (more often with reduced body resistance or the presence of chronic diseases);
- allergic reactions: Quincke's edema, conjunctivitis, rhinitis; rarely - fever, eosinophilia, joint pain; isolated cases - anaphylactic shock;
- others: with prolonged use of high doses - confusion, dizziness, depression, ataxia, convulsions, peripheral neuropathies; mainly in combination with metronidazole - stomatitis, glossitis, epigastric pain, nausea, vomiting, diarrhea, constipation, anorexia, in rare cases - allergic reactions (urticaria, angioedema), hepatitis, interstitial nephritis, pseudomembranous colitis, hematopoietic disorders; mainly in combination with clavulanic acid - hepatitis, cholestatic jaundice, in rare cases - toxic epidermal necrolysis, erythema multiforme, exfoliative dermatitis.
Overdose
Symptoms: nausea, vomiting and / or diarrhea, contributing to imbalance in water and electrolyte balance, amoxicillin-associated crystalluria, renal failure, in patients with impaired renal function - convulsions.
Treatment: immediate gastric lavage or artificial vomiting, intake of activated charcoal and osmotic laxatives (sodium sulfate). If necessary, hemodialysis and measures to restore the water-electrolyte balance are indicated.
special instructions
Before starting therapy with Amoxicillin EXPRESS, you should pay attention to the presence of hypersensitivity reactions to cephalosporins, penicillins and other beta-lactam antibiotics in history.
Some patients treated with penicillin have experienced severe and sometimes fatal hypersensitivity reactions (including severe skin reactions and anaphylactic reactions). Reactions of this type more often occurred in patients with atopy and those with a history of hypersensitivity to penicillins. In the event of an allergic reaction, amoxicillin therapy should be interrupted immediately and an appropriate alternative treatment should be prescribed.
There are rare reports of the development during therapy with amoxicillin associated with hypersensitivity acute coronary syndrome, or Kounis syndrome. The appearance of this reaction is the reason for the withdrawal of the drug and the appointment of an appropriate alternative treatment.
For some infections, it is required to first establish the type of pathogen and its sensitivity to the drug, or to make sure that the pathogen is likely to respond to treatment with Amoxicillin EXPRESS. In particular, this applies to patients with severe ear, throat and nose infections and urinary tract infections.
In patients with impaired renal function, in patients receiving high doses of Amoxicillin EXPRESS, or with predisposing factors (a history of seizures, treatment of meningitis or epilepsy, etc.), seizures may occur during therapy.
Patients with renal impairment need to adjust the dose of amoxicillin according to the degree of renal impairment.
The appearance at the initial stage of treatment of generalized erythema with fever, accompanied by pustules, can serve as a symptom of OGE (acute generalized exanthematous pustulosis). In this case, therapy with amoxicillin is immediately stopped, in the future, its use is contraindicated in any situation.
Amoxicillin EXPRESS should not be prescribed to patients with suspected infectious mononucleosis, as this can lead to the appearance of a measles-like rash (exanthema), which is a consequence of the use of amoxicillin for this disease.
In patients with Lyme disease after the use of amoxicillin, the Jarisch-Herxheimer reaction was observed. This reaction is associated with the bactericidal effect that Amoxicillin EXPRESS has on the causative agents of Lyme disease - the spirochete Borrelia burgdorferi. Patients need to be told that this reaction is a common side effect of antibiotic treatment for Lyme disease and usually resolves on its own.
With prolonged use of Amoxicillin EXPRESS, excessive growth of microorganisms insensitive to amoxicillin is possible (development of superinfection).
When using almost all antibacterial drugs, it is possible to develop colitis associated with taking antibiotics. The severity of the disease can range from mild to severe (that is, life threatening). In this regard, it is important to consider the possibility of this diagnosis when patients develop diarrhea during or after the use of antibiotics. In the event of diarrhea, Amoxicillin EXPRESS should be discontinued, seek medical advice and appropriate treatment should be initiated. In this situation, any drugs that inhibit peristalsis are contraindicated.
When carrying out long-term therapy, it is necessary to regularly monitor the state of the function of the hematopoietic organs, liver and kidneys. There are reports of a change in the number of blood cells and an increase in the activity of liver enzymes.
In rare cases, an increase in prothrombin time was observed in patients receiving amoxicillin. With the combined use of Amoxicillin EXPRESS with anticoagulants, appropriate monitoring is required, while in order to maintain the required blood coagulation level, an adjustment of the dose of oral anticoagulants may be required.
Crystalluria was occasionally observed in patients with reduced diuresis, mainly during parenteral therapy. Patients taking high doses of Amoxicillin EXPRESS should maintain adequate fluid intake and diuresis in order to reduce the likelihood of developing crystalluria associated with the use of amoxicillin. In patients with a catheterized bladder, catheter patency should be checked periodically.
An increase in serum and urine amoxicillin levels may affect some laboratory tests. High concentrations of amoxicillin in urine are often the cause of false positive results in chemical analysis methods.
To determine the level of glucose in urine during therapy with amoxicillin, it is recommended to use enzymatic glucose oxidase tests.
Taking Amoxicillin EXPRESS may affect the results of the quantitative determination of estradiol in urine in pregnant women.
It is not recommended to consume alcoholic beverages while using Amoxicillin EXPRESS in combination with metronidazole.
Influence on the ability to drive vehicles and complex mechanisms
With prolonged use of high doses of Amoxicillin EXPRESS, patients should be careful when performing potentially hazardous activities, including driving, due to the possible appearance of dizziness, convulsions, confusion.
Application during pregnancy and lactation
In animal studies, no direct or indirect harmful effects of amoxicillin in relation to reproductive toxicity have been identified. The limited data available on its use in humans during gestation do not confirm the presence of an increased risk of congenital malformations. Nevertheless, Amoxicillin EXPRESS during pregnancy can only be prescribed by a doctor after a mandatory assessment of the benefits and risks of the therapy.
It is known that amoxicillin is excreted in breast milk in small quantities, therefore, if necessary, it can be used during breastfeeding. However, it should be borne in mind that breastfed babies whose mothers take Amoxicillin EXPRESS may develop undesirable symptoms such as diarrhea, sensitization and fungal infection of the mucous membranes. If these symptoms are observed, you should immediately stop taking the drug, or interrupt breastfeeding.
In connection with the above, the use of Amoxicillin EXPRESS during pregnancy and breastfeeding is allowed only in exceptional cases when the expected therapeutic effect for the mother outweighs the potential risk to the fetus and child.
Pediatric use
The use of Amoxicillin EXPRESS in combination with metronidazole is contraindicated for the treatment of patients under the age of 18 years.
The drug should be used in children according to the dosage regimen prescribed by the doctor.
With impaired renal function
Amoxicillin EXPRESS should be prescribed with caution in case of impaired renal function. The dose and the interval between doses of the drug must be adjusted in strict accordance with the CC values.
For violations of liver function
The use of Amoxicillin EXPRESS in combination with metronidazole is contraindicated in liver diseases.
In patients with hepatic insufficiency, drug therapy is carried out with caution. Regular monitoring of liver function is required.
Use in the elderly
For elderly patients, dose adjustment is not required.
Caution should be exercised when carrying out therapy in persons of this age group.
Drug interactions
- oral contraceptives: a possible decrease in their effectiveness should be considered;
- cephalosporin, cycloserine, aminoglycosides, vancomycin, rifampicin: these drugs and other bactericidal antibiotics in combination with amoxicillin contribute to the manifestation of synergy;
- macrolides, chloramphenicol, lincosamides, tetracyclines, sulfonamides: these and other bacteriostatic antibiotics in combination with amoxicillin antagonize the action;
- allopurinol: when used simultaneously with amoxicillin, the likelihood of developing allergic skin reactions increases;
- methotrexate: antibiotics of the penicillin series help to reduce the excretion of methotrexate, thereby increasing its toxic effect on the body;
- indirect anticoagulants: the effect of indirect anticoagulants and the suppression of intestinal microflora are enhanced, the prothrombin index and the synthesis of vitamin K decrease;
- NSAIDs (non-steroidal anti-inflammatory drugs), probenecid, diuretics, phenylbutazone, allopurinol: against the background of concomitant therapy with each of these drugs, the tubular secretion of amoxicillin decreases, the risk of an increase in its concentration in blood plasma increases;
- laxatives, antacids, glucosamine, aminoglycosides: help to slow down and reduce the absorption of amoxicillin;
- ascorbic acid: combination with ascorbic acid increases the absorption of amoxicillin;
- clavulanic acid: when combined with clavulanic acid, the pharmacokinetics of both components are not impaired.
In addition, it should be borne in mind that when combined with amoxicillin, the clinical effect of drugs decreases, during the metabolism of which para-aminobenzoic acid (vitamin B 10) is formed.
Analogs
Amoxicillin EXPRESS analogs are Amoxicillin, Amoxicillin DS, Amoxicillin Sandoz, Amoxicillin Ekobol, Amosin, Ospamox, Panklav, Amoxiclav, Flemoxin Solutab, Hikontsil, etc.
Terms and conditions of storage
Keep out of the reach of children.
Store at temperatures up to 25 ° C.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Amoxicillin EXPRESS
Reviews about Amoxicillin EXPRESS on the Internet are rare. In them, users positively characterize the drug, indicating its merits. The drug is considered effective, affordable and inexpensive.
Price for Amoxicillin EXPRESS in pharmacies
The price of Amoxicillin EXPRESS for a package containing 20 dispersible tablets can be: dosage 125 mg - from 208 rubles; dosage 250 mg - from 246 rubles; dosage of 500 mg - from 284 rubles; dosage 1000 mg - from 368 rubles.
Amoxicillin EXPRESS: prices in online pharmacies
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Drug name Price Pharmacy |
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Amoxicillin express dispersion tablets. 250mg 20pcs 245 RUB Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
