Panklav - Instructions For The Use Of Tablets, Analogues, Reviews, Price

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

Panclave

Panklav: 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. Drug interactions
11. Analogs
12. Terms and conditions of storage
13. Terms of dispensing from pharmacies
14. Reviews
15. Price in pharmacies

Latin name: Panclav

ATX code: J01CR02

Active ingredient: Amoxicillin, Clavulanic acid (Amoxicillin, Clavulanic acid)

Manufacturer: Hemofarm (Serbia)

Description and photo update: 2019-13-08

Prices in pharmacies: from 289 rubles.

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Panklav is a broad spectrum antibacterial agent.

Release form and composition

Dosage form Panklav - film-coated tablets: oval, biconvex, white; tablets of 500 mg / 125 mg on one of the sides have the letters "A" and "K" inscribed and a risk (15 or 20 pieces in dark glass jars, sealed with a lid with a first opening control, in a cardboard box of 1 can).

Active substances in 1 Panklav tablet:

Amoxicillin (in the form of amoxicillin trihydrate) - 250 or 500 mg;
Clavulanic Acid (in the form of potassium clavulanate) 125 mg

Excipients: sodium carboxymethyl starch, colloidal silicon dioxide, magnesium stearate, microcrystalline cellulose.

Composition of the shell covering the tablets: propylene glycol, titanium dioxide (E171), hypromellose.

Pharmacological properties

Pharmacodynamics

Panklav contains two active components: amoxicillin, a semi-synthetic penicillin characterized by a wide spectrum of antibacterial activity, and clavulanic acid, an irreversible inhibitor of β-lactamases.

Amoxicillin belongs to the category of beta-lactam antibiotics. It provokes bacterial lysis, is a transpeptidase inhibitor and disrupts the production of peptidoglycan (a supporting protein of cell walls) during the growth and reproduction of cells. Clavulanic acid is an inhibitor of β-lactamases, enzymes synthesized by some bacteria and destroying penicillins and other β-lactam antibiotics.

The combination of amoxicillin and clavulanic acid prevents the inactivation of the antibiotic and increases its spectrum of action due to microorganisms whose resistance to amoxicillin is caused by the synthesis of β-lactamases. Clavulanic acid forms a stable pharmacologically inactive complex with β-lactamases and prevents a decrease in the antibacterial activity of amoxicillin caused by the production of β-lactamases by both co-pathogens and the main pathogens, and opportunistic microorganisms. Also, this compound has its own insignificant antibacterial activity.

Panklav has a broad spectrum of action and is active against the following microorganisms that are sensitive to amoxicillin (including strains synthesizing β-lactamases):

gram-negative aerobic microorganisms: Eikenella corrodensy, Bordetella pertussis, Helicobacter pylori, Brucella spp., Yersenia enterocolitica, Campylobacter jejuni, Vibrio cholerae, Escherichia coli, Shigella spp., Gardnerella vaginalis., Influenza spp., Gardnerella vaginalis., influenzaephilus. Klebsiella spp., Pasteur ella multocida, Moraxella catarrhalis, Neisseria meningitidis, Neisseria gonorrhoeae;
Gram-positive aerobic microorganisms: Enterococcus spp., Streptococcus bovis, Streptococcus pneumoniae, Streptococcus viridans, Streptococcus pyogenes, Staphylococcus saprophyticus, Staphylococcus epidermidis (excluding Staphylococcus epidermidis (excluding Staphylococcus epidermidis, excluding Staphylococcus epidermidis, excluding Staphylococcus epidermidis (excluding Staphylococcus epidermidis)
gram-negative anaerobic microorganisms: Bacteroides spp.;
gram-positive anaerobic microorganisms: Prevotella spp., Peptococcus spp., Fusobacterium spp., Peptostreptococcus spp., Actinomyces israelii, Clostridium spp.

Pharmacokinetics

The most important pharmacokinetic parameters of clavulanic acid and amoxicillin are similar. These substances are well absorbed from the digestive tract after oral administration, and food intake does not change the degree of absorption. Bioavailability is 70% for clavulanic acid and 90% for amoxicillin. The maximum plasma concentrations of active ingredients are reached approximately 1.5 hours after administration. The maximum blood level of amoxicillin is approximately 7 μg / ml, and that of clavulanic acid is 1.1 μg / ml. The half-life of Panklav's active ingredients is 1-1.5 hours.

Amoxicillin binds to plasma proteins by about 18%, and clavulanic acid by 25%. For amoxicillin, the apparent volume of distribution reaches 0.3-0.4 l / kg, for clavulanic acid - 0.2 l / kg.

Both components penetrate into many organs and tissues of the body, pathological secreted contents and biological fluids. Amoxicillin is found in exudate with inflammation of the paranasal sinuses and middle ear, palatine tonsils, bronchial secretions (in purulent discharge - to a lesser extent), sputum, lung tissue, peritoneal and pleural fluids, in the skin, the contents of skin blisters, fatty, muscle and subcutaneous tissues, in synovial fluid and bone tissues, bile, gallbladder, liver, intestinal mucosa, female genital organs, fetal tissues. Clavulanic acid is determined in purulent discharge, bile, palatine tonsils, peritoneal and synovial fluids, adipose, muscle and bone tissues, as well as abdominal organs. The active components of the drug and their metabolites do not show a tendency to cumulation in any tissues and organs.

For clavulanic acid and amoxicillin, the unchanged blood-brain barrier is a significant obstacle: they practically do not penetrate through it. However, these substances penetrate the placental barrier and into breast milk.

Approximately 10-25% of the absorbed dose of amoxicillin is involved in metabolic processes, forming inactive penicillic acid. Clavulanic acid is extensively metabolized, and its metabolites are excreted through the lungs, intestines and kidneys.

Amoxicillin is excreted mainly in the urine through glomerular filtration and tubular secretion. The total clearance of the amoxicillin / clavulanic acid combination is 25 l / h. During the first 6 hours after a single dose of Panclava, amoxicillin and clavulanic acid are excreted from the body unchanged in the amount of 60% and 40% of the dose, respectively.

Both active substances of Panklav are well excreted by hemodialysis, to a lesser extent by peritoneal dialysis.

In elderly patients, due to a possible decrease in renal function with age, Panclav should be used with caution.

In patients with severe renal failure, the half-life is increased to 4.5 hours for clavulanic acid and up to 7.5 hours for amoxicillin.

Indications for use

Panklav is a drug intended for the treatment of diseases of an infectious and inflammatory nature caused by microflora that is sensitive to a combination of active substances:

Infections of ENT organs and upper respiratory tract: pharyngitis, sinusitis (acute and chronic), tonsillitis, otitis media (acute and chronic);
Lower respiratory tract infections: pleural empyema, bronchitis and pneumonia (acute and chronic);
Skin and soft tissue infections, including phlegmon and wound infections;
Bone and joint infections, incl. chronic osteomyelitis;
Odontogenic infections;
Biliary tract infections: cholangitis and cholecystitis;
Urinary tract infections, including inflammation of the urethra, bladder, and kidneys;
Gynecological infections, incl. septic abortion, inflammation of the endometrium, appendages of the uterus and fallopian tube;
Sexually transmitted infections: chancroid and gonorrhea.

Contraindications

Strict:

Children under 12 years of age;
Infectious mononucleosis, including the presence of a measles-like rash;
Hypersensitivity to Panclave's components, cephalosporins or other beta-lactam antibiotics.

Carefully:

Severe liver failure;
Chronic renal failure
Diseases of the gastrointestinal tract, including colitis due to the use of penicillins in history;
Pregnancy;
Lactation.

Instructions for use of Panklava: method and dosage

The drug is intended for oral administration. Panklav should be taken with food: swallow the tablets whole without chewing and drink plenty of water.

Adults and adolescents over 12 years of age (weighing at least 40 kg) are usually prescribed:

Light and moderate course of the infectious process: 1 tablet 250 mg / 125 mg 3 times a day;
Severe infection: 1 tablet 500 mg / 125 mg 3 times a day.

Maximum daily doses:

Clavulanic acid: for adults - 600 mg, for children - 10 mg / kg;
Amoxicillin: for adults - 6000 mg, for children - 45 mg / kg.

The course of therapy is from 5 to 14 days.

For infections of the oral cavity, usually 1 tablet of 500 mg / 125 mg is prescribed 2 times a day (at intervals of 12 hours) for 5 days.

Panklava dosage for renal failure:

Creatinine clearance 10-30 ml / minute - 1 tablet of 500 mg / 125 mg every 12 hours or 1 tablet of 250 mg / 125 mg 2 times a day (with mild and moderate course);
Creatinine clearance less than 10 ml / minute - 1 tablet of 500 mg / 125 mg every 24 hours or 1 tablet of 250 mg / 125 mg 1 time per day (for mild and moderate course).

For patients with anuria, the intervals between taking the drug are increased to 48 hours or more.

It is important! 2 Panklav tablets 250 mg / 125 mg are not equivalent to 1 Panklav 500 mg / 125 mg tablet, because contain different amounts of clavulanic acid.

Side effects

Allergic reactions: pruritus, urticaria, erythematous rash; rarely - serum sickness, anaphylactic shock, erythema multiforme, angioedema, acute generalized exanthematous pustulosis, toxic epidermal necrolysis; in isolated cases - anaphylactic shock, Stevens-Johnson syndrome, exfoliative dermatitis;
From the central nervous system: headache, vertigo; in patients with impaired renal function and patients taking the drug in high doses - convulsions;
From the gastrointestinal tract: stomatitis, increased activity of hepatic transaminases, abnormal liver function, nausea, diarrhea, vomiting; in isolated cases - pseudomembranous colitis, hepatitis, cholestatic jaundice, increased levels of alkaline phosphatase;
Others: vaginitis, development of superinfection, candidiasis of the skin and mucous membranes, interstitial nephritis, reversible increase in prothrombin time.

Overdose

Symptoms of an overdose by Panklav include nausea, vomiting, possibly insomnia and agitation, in isolated cases - disturbances in water and electrolyte balance and seizures.

If the drug was taken less than 4 hours ago, it is necessary to rinse the stomach and take an absorbent. The effectiveness of hemodialysis has been clinically proven.

special instructions

Patients with hypersensitivity to penicillins are likely to develop cross-allergic reactions with cephalosporin antibiotics.

Due to the growth of insensitive microflora, the development of superinfection is possible. In this case, appropriate changes in the antibiotic therapy regimen are required.

During treatment with Panklav, amoxicillin is detected in the urine, which in high concentrations gives a false positive reaction to glucose in urine when using Benedict's reagent or Fehling's solution. If necessary, this study is recommended to use enzymatic reactions with glucose oxidase.

During the course of therapy, the state of the function of the liver, kidneys and hematopoiesis should be monitored.

According to the instructions, Panklav does not affect the speed of reactions and the ability to concentrate.

Application during pregnancy and lactation

Prescribing Panklav during pregnancy is possible only if the intended benefits of treatment for the mother significantly outweigh the potential risks to the fetus. If it is necessary to take the drug during lactation, decisions should be made to refuse treatment or to stop breastfeeding.

Drug interactions

With the simultaneous use of allopurinol, the risk of skin rash increases.

Ascorbic acid increases the absorption of Panklav; aminoglycosides, antacids, laxatives, glucosamine - slow down and reduce absorption.

With the combined use of phenylbutazone, allopurinol, diuretics, nonsteroidal anti-inflammatory drugs and other drugs that block tubular secretion, the concentration of amoxicillin increases.

With simultaneous use with Panklav, bacteriostatic drugs (tetracyclines, macrolides, sulfonamides, lincosamides, chloramphenicol) have an antagonistic effect; bactericidal antibiotics (for example, cephalosporins, aminoglycosides, rifampicin, vancomycin, cycloserine) - synergistic action.

Panklav increases the effect of indirect anticoagulants, therefore, when prescribing this combination, it is necessary to monitor blood coagulation indicators. The drug reduces the effectiveness of ethinyl estradiol, oral contraceptives and drugs, in the process of metabolism of which para-aminobenzoic acid is formed.

Analogs

Panklav's analogues are: Augmentin, Amoxiclav, Rapiklav, Flemoklav Solutab, Ekoklav.

Terms and conditions of storage

Store in a place protected from light and moisture, observing a temperature regime of 15-25 ºС. Keep out of the reach of children.

Shelf life is 2 years.

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews about Panclave

Today, reviews about Panklava are rare. Basically, patients respond positively about it, mentioning its effectiveness and gentle action. Despite the fact that the drug is a broad-spectrum antibiotic, its intake practically does not affect the state of the intestinal flora. Although Panklav is not considered a strong antibiotic, in many cases it has actually helped patients.

Price for Panklav in pharmacies

The approximate price for Panklav with a dosage of 500 mg + 125 mg in pharmacy chains is 358–399 rubles (per pack containing 20 tablets).

Panklav: prices in online pharmacies

Drug name

Price

Pharmacy

Panklav 500 mg + 125 mg film-coated tablets 20 pcs.

289 r

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Panklav 2X tablets p.o. 875mg + 125mg 14 pcs.

RUB 290

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Panklav 2X 875 mg + 125 mg film-coated tablets 14 pcs.

RUB 290

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Panklav tablets p.p. 500mg + 125mg 20 pcs.

373 r

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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!