Medoklav - Instructions For Use, Price, Tablets, Reviews, Analogues

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

Medoclav

Medoklav: instructions for use and reviews

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

Latin name: Medoclav

ATX code: J01CR02

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

Manufacturer: Medochemie, Ltd. (Medochemie, Ltd.) (Cyprus)

Description and photo update: 2019-08-10

Medoklav is an antibacterial drug of the broad-spectrum penicillin group, in combination with a β-lactamase inhibitor, for systemic use.

Release form and composition

• powder for preparation of a solution for intravenous (IV) administration: hygroscopic, from almost white to white (1000 mg / 200 mg each in a glass vial of type II with a volume of 20 ml, sealed with a rubber stopper, crimped with an aluminum cap; in a cardboard box 1, 5, 10 or 100 vials);
• film-coated tablets (875 mg / 125 mg, 500 mg / 125 mg, 250 mg / 125 mg): biconvex, capsule-like in shape, almost white or white; tablets 250 mg / 125 mg on one side with embossing "MC", on the other - with a dividing line (875 mg / 125 mg - 7 pcs. in a blister, 250 mg / 125 mg and 500 mg / 125 mg - 8 each pcs. in a blister; in a carton box 2 blisters);
• powder for preparation of a suspension for oral administration: from almost white to white with a slight fruity odor; when diluted in water, a suspension is formed from pale yellow to almost white with a characteristic fruity odor (11.78 g each in a brown glass bottle with a volume of 100 ml, with a screw cap; in a cardboard box 1 bottle complete with a dosing spoon of 5 ml).

Each pack also contains instructions for using Medoclav.

The powder for preparation of a solution for intravenous administration, contained in 1 bottle, contains the following active substances: amoxicillin sodium, equivalent to amoxicillin in an amount of 1000 mg; potassium clavulanate equivalent to clavulanic acid in an amount of 200 mg.

1 film-coated tablet contains:

• active substances: amoxicillin trihydrate - 1004/574/287 mg, which is equivalent to amoxicillin base in the amount of 875/500/250 mg, respectively; potassium clavulanate + microcrystalline cellulose (1 ÷ 1) - 297.8 mg, which is equivalent to clavulanic acid in the amount of 125 mg;
• additional components: colloidal silicon dioxide, sodium carboxymethyl starch, microcrystalline cellulose, magnesium stearate;
• film shell: hypromellose, macrogol (polyethylene glycol), titanium dioxide (E171), talc.

100 ml of the prepared suspension (by dissolving the powder in 1 bottle) contains:

• active substances: amoxicillin trihydrate - 3016 mg, in terms of amoxicillin - 2500 mg; potassium clavulanate - 783 mg, in terms of clavulanic acid - 625 mg;
• additional components: sodium saccharinate, colloidal silicon dioxide, xanthan gum, hypromellose, succinic acid, silicon dioxide; flavors: lemon, strawberry and peach.

Pharmacological properties

Pharmacodynamics

Medoklav is a combined preparation containing amoxicillin and clavulanic acid.

Amoxicillin belongs to the group of semi-synthetic antibiotics - aminopenicillins. The substance has a wide spectrum of bactericidal action against many gram-positive and gram-negative microorganisms.

Clavulanic acid belongs to natural β-lactams and exhibits the ability to break down (inactivate) a number of β-lactamases produced by microorganisms that are resistant to the action of a large number of penicillins and many cephalosporins.

The combination of clavulanic acid and amoxicillin ensures the resistance of the latter to the destructive effects of bacterial enzymes β-lactamases, and contributes to a significant expansion of the spectrum of antimicrobial activity of amoxicillin, including bacteria, which are usually resistant to it and many other β-lactam antibiotics …

Clavulanic acid inhibits type II, III, IV and V β-lactamases and does not show activity against type I β-lactamases produced by Pseudomonas aeruginosa, Enterobacter spp., Acinetobacter spp, Serratia spp. Also, this acid demonstrates a high affinity for the enzymes penicillinases, as a result of which it forms a stable complex with them, protecting amoxicillin and preventing its enzymatic degradation under the action of β-lactamases.

Spectrum of antibacterial activity of Medoclav:

• gram-positive bacteria: aerobes - Staphylococcus aureus (with the exception of methicillin-resistant strains), Enterococcus faecalis, Staphylococcus epidermidis (with the exception of methicillin-resistant strains), Streptococcus pyogenes, Streptococcus pneumoniaid, Streptococcus pneumoniae, Streptococcus virrocus Streptococcus bovis, Listeria spp., Enterococcus spp.; anaerobes - Actinomyces israelii, Clostridium spp. (excluding Clostridium difficile), Peptostreptococcus spp., Peptococcus spp., Propionibacterium spp.;
• gram-negative bacteria: aerobes - Brucella spp., Bordetella pertussis, Campylobacter coli, Campylobacter jejuni, Citrobacter spp. (moderately susceptible), Eikenella corrodens, Escherichia coli, Enterobacter species, Gardnerella vaginalis, Helicobacter pylori, Haemophilus influenzae, Haemophilus ducreyi, Klebsiella spp., Moraxella catarrhalis, Legionella pneumophila, Morganella spp. (moderately susceptible), Neisseria meningitidis, Neisseria gonorrhoeae, Proteus spp., Yersinia multocida, Shigella spp., Salmonella spp., Yersinia enterocolitica (moderately susceptible), Vibrio cholerae; anaerobes - Fusobacterium spp., Bacteroides spp. (including Bacteroides fragilis).

Pharmacokinetics

The main parameters of the pharmacokinetics of clavulanic acid and amoxicillin are similar and do not affect the pharmacokinetic properties of each of these substances. Both active ingredients are characterized by high bioavailability. When taken orally, 80–90% of amoxicillin trihydrate is absorbed from the gastrointestinal tract (GIT). The degree of absorption of amoxicillin does not depend on the time of food intake, since it remains stable in the presence of hydrochloric acid.

1 hour after oral administration, the maximum concentration (C _max) of amoxicillin in the blood is, depending on the dose taken, about 5 μg / ml, and the same indicator of clavulanic acid is on average 2 μg / ml. The half-life (T _1/2) after oral administration of Medoklav for amoxicillin is 1-1.5 hours (on average, 1.3 hours), for clavulanic acid - approximately 1 hour (0.8-1.2 hours).

With intravenous injections of the drug at a dose of 1000 mg / 200 mg, _{Cmax of} amoxicillin is 105.4 μg / ml, clavulanic acid is 28.5 μg / ml, T _{1/2 of} Medoclav is 0.9 hours. After IV and oral administration, both active components actively diffuse into a large number of tissues and body fluids, such as adipose tissue, pulmonary and muscle tissue, pleural fluid, tracheobronchial secretion, bile, synovial and peritoneal fluid.

Amoxicillin binds to plasma proteins by an average of 20% (17–21%), clavulanic acid by about 30% (for intravenous administration, the protein binding index is 13–20%). Both components pass through the placenta and are excreted in breast milk, do not accumulate.

Amoxicillin is eliminated mainly by the kidneys, clavulanic acid is also eliminated by the kidneys and partially in small amounts by the lungs and through the intestines. During the first 6 hours after oral administration and after a bolus injection, 50–70% and 60–70% of amoxicillin and 25–40% and 40–65% of clavulanic acid are excreted unchanged, respectively.

Amoxicillin at a dose corresponding to 10-25% of the substance introduced into the body is excreted in the form of inactive penicillic acid. As a result of intensive metabolism, clavulanic acid in the human body is converted into 2,5-dihydro-4- (2-hydroxyethyl) -5-oxo-1H-pyrrole-3-carboxylic acid and 1-amino-4-hydroxy-butane-2, which are excreted by the kidneys.

Indications for use

Medoclav is recommended for the treatment of infectious and inflammatory diseases, excited by strains of microorganisms sensitive to it:

• lower respiratory tract infections: lung abscess, pleural empyema pneumonia; for oral forms - acute and chronic bronchitis, lobar and bronchopneumonia; for parenteral use - exacerbation of chronic bronchitis;
• infections of the upper respiratory tract and ENT organs: otitis media, sinusitis, tonsillitis; additionally for oral forms - pharyngitis, pharyngeal abscess;
• infections of soft tissues and skin: impetigo, erysipelas, phlegmon, abscess, wound infection, secondarily infected dermatoses;
• infections of the genitourinary system and pelvic organs: urethritis, cystitis, pyelitis, pyelonephritis, prostatitis, salpingitis, cervicitis, salpingo-oophoritis, bacterial vaginitis, endometritis, septic abortion, gonorrhea; for oral forms - chancre; for parenteral use - tubo-ovarian abscess, pelvioperitonitis, postpartum sepsis;
• osteomyelitis.

Additionally for oral forms of Medoklav: intestinal infections (salmonella carriage, salmonellosis, dysentery); infections of the biliary tract (cholecystitis, cholangitis).

Medoclav in the form of a powder for preparing a solution for intravenous administration is also recommended for the prevention of infections in surgery.

Contraindications

Absolute:

• infectious mononucleosis (including when a measles rash occurs);
• age up to 12 years (for tablets);
• history of jaundice or liver dysfunction caused by the use of amoxicillin / clavulanic acid (with intravenous administration);
• chronic renal failure (CRF) with creatinine clearance (CC) below 30 ml / min (for tablets 875 mg / 125 mg);
• a history of hypersensitivity to β-lactam antibiotics, including antibiotics of the penicillin series, and to drugs containing clavulanic acid.

Relative (use Medoklav with extreme caution):

• burdened allergic history (with intravenous administration);
• liver failure;
• severe renal dysfunction (CC below 30 ml / min) (with the exception of tablets 875 mg / 125 mg);
• a history of pseudomembranous colitis;
• diseases of the gastrointestinal tract (with on / in the introduction).

Care should be taken to administer Medoclav solution IV to children whose mothers are hypersensitive to penicillin.

Medoklav, instructions for use: method and dosage

Powder for preparation of solution for intravenous administration

The solution prepared from Medoklav powder is injected intravenously as a slow injection (3-4 minutes each) directly into a vein or as an infusion for 30-40 minutes.

It is prohibited to use a solution for intramuscular injection.

The solution after dilution of the drug is administered drip or stream. The dose depends on body weight, age, kidney function, the severity of the infection, and is indicated in terms of amoxicillin.

The minimum course of treatment is 5 days, the maximum - 14 days, after which it is required to assess the effectiveness and tolerability of therapy.

Adults and adolescents over 12 years of age with a body weight of more than 40 kg are recommended to use 1000 mg every 8 hours a day, with a severe course of the infectious process - every 4-6 hours.

For the prevention of infections in surgery during operations lasting up to 1 hour, the solution is administered once intravenously, 1000 mg at a time during induction of anesthesia. For surgical interventions lasting more than 1 hour and with a high risk of infection, Medoclav is administered 1000 mg during induction of anesthesia, as well as up to 4 doses of 1000 mg for 24 hours, usually immediately after the operation, and then after 8, 16 and 24 hours. Against the background of an increased risk of infections, this therapeutic regimen can be observed for several days.

Children and adults with impaired renal function with CC above 30 ml / min do not require dose changes.

Dosing regimen of Medoklav for renal dysfunction, depending on the CC values in ml / min:

• CC is 10-30: initial dose of 1000 mg, then 500 mg every 12 hours;
• CC less than 10: initial dose of 1000 mg, then 500 mg every 24 hours.

Patients on hemodialysis are first given a dose of 1000 mg, and then 500 mg every 24 hours and in the same dose additionally at the end of the hemodialysis session (in order to compensate for the decrease in the plasma level of amoxicillin and clavulanic acid).

In children with body weight below 40 kg, the recommended single dose of Medoklav is 25 mg / kg, the frequency of injections is set depending on age and body weight:

• under 3 months, weight less than 4 kg: every 12 hours;
• under 3 months, weight over 4 kg: every 8 hours;
• from 3 months to 12 years, weight less than 40 kg: every 6-8 hours, taking into account the severity of the infection.

Children under 3 months old should be administered Medoclav only by slow infusion over 30-40 minutes.

Dosage regimen in children with impaired renal function, taking into account the CC value (ml / min):

• CC is 10–30: at a dose of 25 mg / kg 2 times a day;
• CC less than 10: at a dose of 25 mg / kg every 24 hours.

Children on hemodialysis are recommended to use 25 mg / kg every 24 hours and additionally at the end of the hemodialysis session at 12.5 mg / kg, then 25 mg / kg per day.

Before intravenous administration, the contents of 1 bottle (1200 mg) must be diluted in 20 ml of water for injection. In the process of dilution, a temporary pink color of the solution may appear, after complete dissolution, the latter acquires a pale yellow color. When performing an intravenous injection, the prepared preparation must be administered within 20 minutes after dissolution.

When carrying out intravenous infusion, the resulting solution should be diluted in 100 ml of infusion fluid, which can be various infusion solutions.

The concentration of antibacterial agent when using the infusion solutions below is maintained for the following periods if the prepared solution is stored at a temperature of 5 or 25 ° C, respectively:

• water for injection: 8 hours or 4 hours;
• sodium chloride 0.9%: 4 hours or 3 hours;
• sodium lactate for intravenous infusion (1.85%), Ringer's lactate (Hartman's solution): 2 hours - at 25 ° C;
• Ringer's solution: 4 hours or 2 hours;
• solution of sodium chloride (0.9%) and potassium chloride (0.3%): 8 hours or 3 hours.

The solution prepared at room temperature can be stored under the same conditions, but the infusion must be completed before the expiration date indicated above.

If the resulting solution is expected to be stored at 5 ° C, then it should be added to a pre-chilled bottle containing a suitable infusion fluid at a dose of 100 ml. Solutions stored at 5 ° C must be added immediately after they reach room temperature.

The solution must not be frozen.

In infusion solutions containing dextran, glucose or sodium bicarbonate, the drug is less stable. The Medoclav bottle is not intended for repeated use.

Film-coated tablets

Medoclav tablets are taken orally, regardless of meal time.

The dose is determined individually, taking into account the localization of the infection, the severity of the lesion and the sensitivity of the pathogen.

Adults and adolescents over the age of 12 years and weighing more than 40 kg with a mild and moderate course of the disease, as a rule, are prescribed 1 tablet 250 mg / 125 mg - 3 times a day or 500 mg / 125 mg - 2 times a day. In case of severe infection, it is recommended to take 1 tablet 500 mg / 125 mg 3 times a day or 875 mg / 125 mg 2 times a day.

The maximum daily dose of amoxicillin is 6000 mg, clavulanic acid (potassium salt) is 600 mg. The course of therapy can vary from 5 to 14 days, an average of 10 days.

Dosing regimen for chronic renal failure, taking into account CC, measured in ml / min:

• CC above 30: dose adjustment is not required;
• CC is 10-30: 2 times a day, 1 tablet 250 mg / 125 mg or 500 mg / 125 mg;
• CC below 10: once a day, 1 tablet 250 mg / 125 mg or 500 mg / 125 mg (taking into account the severity of the infection).

Medoclav tablets 875 mg / 125 mg are prescribed to patients with chronic renal failure only with CC more than 30 ml / min.

For children under 12 years of age, with a body weight of less than 40 kg, it is preferable to use Medoclav in the form of a suspension for oral administration.

Powder for oral suspension

A suspension made from Medoklav powder is used orally, regardless of food intake. However, in order to achieve optimal absorption and reduce the risk of developing adverse reactions from the gastrointestinal tract, the agent is recommended to be taken with meals.

The dose is set individually, depending on the severity of the infection, body weight and age of the patient. The standard daily dose is 20-40 mg / kg, divided into 3 doses.

Recommended single doses of Medoklav (calculated by amoxicillin) with a frequency of administration 3 times a day (taking into account age and body weight):

• under 1 year old, weight 2-9 kg: 1.5-2.5 ml (37.5-62.5 mg);
• 1–5 years old, weight 10–18 kg: 5–10 ml (125–250 mg);
• 6-9 years old, weight 19-28 kg: 10-15 ml (250-375 mg);
• 10–12 years old, weight 29–39 kg: 15–20 ml (375–500 mg);
• over 12 years old, weight more than 40 kg: against the background of a mild and moderate course of infection - 10 ml (250 mg) 3 times a day or 20 ml (500 mg) 2 times a day.

For children, the maximum daily dose of amoxicillin is 45 mg / kg, and clavulanic acid is 10 mg / kg. Therapy can last for about 10 days (5 to 14 days). In severe cases, it is allowed to increase the dose of Medoklav by 2 times.

With chronic renal failure, the dosage regimen is changed in accordance with QC. With a CC value above 30 ml / min, a dose change is not required for patients of all age groups.

Recommended dosing regimen for children with chronic renal failure under the age of 12 years: at a dose (15 mg + 3.75 mg) / kg (0.6 ml) 2 times a day with a CC 10-30 ml / min, and at the same dose 1 time per day with CC below 10 ml / min.

For children with renal impairment and infants under 3 months of age, it is recommended to use a graduated syringe for accurate dosing.

Patients receiving hemodialysis treatment are prescribed Medoclav 1 time per day at a dose (15 mg + 3.75 mg) / kg. Before and after a hemodialysis session, the suspension is taken additionally in the same dose.

The following dosage regimen is recommended for adolescents over 12 years old and adults with chronic renal failure: 500 mg (20 ml) or 250 mg (10 ml) 2 times a day with a CC equal to 10-30 ml / min, and in a similar dose 1 time a day with CC below 10 ml / min.

A suspension for oral administration must be prepared immediately before use. The powder contained in the bottle is diluted in boiled chilled water, gradually adding it to the mark on the bottle label and stirring. After that, the resulting mixture is allowed to stand for 5 minutes until complete dissolution. Before each dose, the bottle must be shaken well to resuspend the contents.

The prepared suspension should be stored in the refrigerator (at a temperature of 2–8 ° C) and taken for no more than 7 days.

Side effects

The use of Medoklav can cause the following negative side reactions from systems and organs:

• immune system: not often - itching, skin rash, erythematous rash, urticaria; rarely - anaphylactic shock, erythema multiforme exudative, angioedema; extremely rare - Stevens-Johnson syndrome, exfoliative dermatitis; with intravenous administration - allergic vasculitis, a syndrome similar to serum sickness, bullous exfoliative dermatitis, acute generalized exanthematous pustulosis, toxic epidermal necrolysis;
• digestive system: often - diarrhea; infrequently - vomiting, dyspepsia, nausea, moderate increase in the activity of aspartate aminotransferase (ACT) and / or alanine aminotransferase (ALT); extremely rarely - an increase in the activity of alkaline phosphatase and / or an increase in the level of bilirubin, glossitis, stomatitis, darkening of tooth enamel, candidiasis of the mucous membranes, enterocolitis, gastritis; black "hairy" tongue (with intravenous injection), cholestatic jaundice, hepatitis, hemorrhagic or pseudomembranous colitis;
• hematopoietic system: rarely - leukopenia (including neutropenia), thrombocytopenia; extremely rare - an increase in bleeding time and prothrombin time, hemolytic anemia, eosinophilia, thrombocytosis, agranulocytosis;
• nervous system: not often - headache, dizziness; extremely rarely - anxiety, insomnia, psychomotor agitation, hyperreactivity, convulsions (it may develop in patients with impaired renal function or who have taken large doses of Medoclav);
• genitourinary system: extremely rarely - crystalluria (mainly with intravenous administration in patients with reduced diuresis), interstitial nephritis, hematuria;
• others: candidiasis, development of superinfection; when taken orally - fever, joint pain, arthritis;
• local reactions: rarely - thrombophlebitis at the injection site.

Adverse events from the liver (hepatobiliary system) occurred most often in men and elderly patients, and could be associated with long-term treatment. These disorders, as a rule, appeared during the course of treatment or after a short period after its completion, but in some cases they were observed only several weeks after the completion of the course. These side reactions are usually reversible.

Overdose

Symptoms of an overdose of Medoklav may include disturbances in water and electrolyte balance and gastrointestinal function.

In case of suspicion of an overdose, symptomatic treatment is carried out, with oral administration, gastric lavage and intake of activated charcoal are prescribed. For the relief of acute overdose, hemodialysis can be effective, there is no specific antidote.

If high doses of amoxicillin are required, to reduce the risk of amoxicillin crystalluria (with parenteral therapy), it is necessary to maintain adequate fluid intake and control urine output.

special instructions

Before starting treatment with Medoclav, it is required to collect a detailed history and make sure that the patient has no previous hypersensitivity reactions to cephalosporins, penicillins or other allergens. There are descriptions of severe and sometimes fatal hypersensitivity reactions to penicillins. The threat of developing such reactions is especially high in patients with previously identified increased susceptibility to penicillin.

In case of an allergic reaction, it is necessary to stop using the drug and start treatment with an antibiotic of another group. To relieve allergic reactions, antihistamines can be used, or, if necessary, systemic glucocorticosteroids.

If there are suspicions of the development of infectious mononucleosis, they refrain from using Medoclav, due to the fact that in patients with this disease, aminopenicillin antibiotics can provoke the appearance of a measles-like skin rash, which makes diagnosis difficult. Long-term therapy can sometimes cause overgrowth of insensitive microorganisms.

With severe renal dysfunction, it is necessary to change the dose of Medoclav or increase the interval between its use.

Against the background of a long course of treatment, it is recommended to monitor the state of the hematopoietic system, kidney and liver function.

In the case of parenteral administration of the drug to patients on a diet with a reduced salt content, it should be remembered that sodium ions are present in the solution. Each vial of powder for solution for intravenous administration contains approximately 1 mmol of potassium and 2.7 mmol of sodium.

When using the drug orally, to reduce the likelihood of adverse effects from the gastrointestinal tract, it is recommended to take a coated tablet or suspension with meals.

In the course of treatment, it is necessary to take into account the risk of developing superinfection, in most cases caused by fungi of the genus Candida or bacteria of the genus Pseudomonas spp. With the development of this complication, it is required to discontinue drug therapy and / or conduct appropriate treatment.

The active components of Medoklav can lead to non-specific binding of immunoglobulins and albumin to the erythrocyte membrane, which can provoke a false positive reaction in the Coombs test.

It was found that prophylactic therapy with amoxicillin + clavulanic acid in the presence of premature rupture of membranes in women can aggravate the risk of developing necrotizing enterocolitis in newborns.

It must be remembered that taking 2 tablets of 250 mg / 125 mg does not correspond to taking 1 tablet of 500 mg / 125 mg, due to the content of different doses of clavulanic acid.

The use of Medoklav provides a high concentration of amoxicillin in the urine, which can cause false positive results in the determination of glucose in urine, including Benedict's test and Fehling's test. In this case, the glucose oxidase method should be used to establish the level of glucose in the urine.

Influence on the ability to drive vehicles and complex mechanisms

During the course of treatment, it is recommended to be careful while performing types of work that require increased concentration of attention and speed of psychomotor reactions, including when driving vehicles and other complex and potentially dangerous equipment.

Application during pregnancy and lactation

During pregnancy, Medoclav is allowed to be used only in cases where the expected benefit to the woman outweighs the possible risk to the fetus.

If it is necessary to use the drug during lactation, the issue of canceling breastfeeding should be resolved, since amoxicillin and clavulanic acid have been detected in human milk in small amounts.

Pediatric use

Medoklav in the form of film-coated tablets is contraindicated for patients under 12 years of age and weighing less than 40 kg.

Suspension for oral administration and solution for intravenous administration are used in pediatric practice as directed by a physician, according to indications, in compliance with the recommended dosage regimen.

With impaired renal function

Against the background of a decrease in renal function in the blood plasma, the accumulation of both active substances is observed.

Tablets at a dosage of 875 mg / 125 mg with chronic renal failure (CC below 30 ml / min) are contraindicated. The use of other dosage forms of Medoklav, including tablets with a lower dose of amoxicillin, for the treatment of patients with severe renal impairment (CC below 30 ml / min) requires dose adjustment and frequency of use of the drug, depending on the CC value.

For all oral forms of Medoklav with existing anuria, it is recommended to increase the interval between dosing to 48 hours or more.

For violations of liver function

In patients with hepatic insufficiency, Medoclav therapy must be carried out with caution, carrying out regular monitoring of liver activity. At present, there are insufficient data to make adjustments to the dosage regimen in patients of this group.

Patients with a history of the development of jaundice or liver dysfunction associated with the use of amoxicillin / clavulanic acid, the use of a solution for intravenous administration is contraindicated.

Drug interactions

• cephalosporins, aminoglycosides, vancomycin, cycloserine, rifampicin and other bactericidal antibiotics: there is a synergistic effect with Medoclav;
• sulfonamides, tetracyclines, macrolides, lincosamides, chloramphenicol and other bacteriostatic antibiotics: exhibit an antagonistic effect;
• probenecid: reduces the tubular secretion of amoxicillin, which in turn leads to an increase in its serum concentration; this combination is not recommended;
• aminoglycoside antibiotics: there is a loss of their activity, therefore, these funds should not be mixed in the same syringe with Medoclav's solution for intravenous administration;
• indirect anticoagulants: there is an increase in the action of these agents as a result of the suppression of the intestinal microflora by the antibiotic, a decrease in the production of vitamin K and the prothrombin index; it is required to carefully monitor the prothrombin time or the international normalized ratio (INR) when prescribing or canceling Medoclav;
• glucosamine, antacids, aminoglycosides, laxatives: there is a slowdown and decrease in the absorption of oral forms of Medoclav;
• ascorbic acid: there is an increase in drug absorption;
• phenylbutazone, allopurinol, diuretics, non-steroidal anti-inflammatory drugs and other drugs that lower tubular secretion: an increase in the concentration of amoxicillin is detected (clavulanic acid is excreted mainly through glomerular filtration);
• oral contraceptives: there is a decrease in the effectiveness of these funds;
• fatty emulsions for intravenous administration, blood products, other liquids containing protein (including protein hydrolysates): the pharmaceutical incompatibility of these drugs with the parenteral form of Medoclav has been established;
• methotrexate: there is an increase in its toxicity;
• allopurinol: the threat of skin rash, exanthema is aggravated; the mechanism of this phenomenon is still not clear;
• ethinylestradiol, drugs, during the metabolism of which para-aminobenzoic acid (PABA) is formed: the risk of breakthrough bleeding may increase;
• disulfiram: This combination is recommended to be avoided.

Analogs

The analogues of Medoklav are Augmentin, Rapiklav, Amoxiclav, Panklav, Amovikomb, Flemoklav Solutab, Ranklav, Amoxivan, Verklav, Klamosar, etc.

Terms and conditions of storage

Store in a place protected from moisture and light, out of reach of children, at a temperature not exceeding 25 ° C.

Shelf life:

• powder for preparation of solution for intravenous administration; a closed powder bottle for preparation of a suspension for oral administration; film-coated tablets, 875 mg / 125 mg - 2 years;
• film-coated tablets, 250 mg / 125 mg and 500 mg / 125 mg - 3 years.

The suspension prepared from the powder is stored for no more than 7 days.

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews about Medoclav

According to most of the reviews about Medoclav left by patients on specialized sites, the drug is an effective antibiotic with a fairly wide spectrum of action. They note that the drug helps to quickly cope with bacterial infections of the respiratory tract and ENT organs (including bronchitis, sinusitis, tonsillitis), infections of the genitourinary system (in particular with acute cystitis and pyelonephritis), infections of soft tissues and skin.

The disadvantages of Medoklav in some reviews include the development of adverse events from the gastrointestinal tract, as well as its absence in pharmacies.

Price for Medoclav in pharmacies

Since there is currently no drug in the pharmacy network, the actual cost of the drug is unknown. The last price for Medoclav for 16 coated tablets was 220 rubles for a dosage of 500 mg / 125 mg, and 37 rubles for a dosage of 250 mg / 125 mg.

The cost of an analogue of the drug, Rapiklava, coated tablets (500 mg + 125 mg) can be 310 rubles. per package containing 15 pcs.

Anna Kozlova Medical journalist About the author

Education: Rostov State Medical University, 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!