Flemoklav solutab for kidney inflammation. Flemoklav Solutab: a famous antibiotic in a unique form

Astellas Pharma Europe B.V. Astellas Pharma Europe B.V./Ortat CJSC Yamanuchi Europe B.V.

Country of origin

Netherlands Netherlands/Russia

Product group

Antibacterial drugs

Antibiotic of the penicillin group wide range actions with a beta-lactamase inhibitor

Release forms

  • 4 - blisters (5) - cardboard packs 4 - blisters (5) - cardboard packs. 4 - blisters (5) - cardboard packs. 7 - blisters (2) - cardboard packs.

Description of the dosage form

  • Dispersible tablets Dispersible tablets oblong, Dispersible tablets oblong, from white to yellow in color with brown dotted spots, without marks, marked “424” and the company logo.

pharmachologic effect

Broad-spectrum antibiotic; a combination drug of amoxicillin and clavulanic acid, a beta-lactamase inhibitor. Active against gram-positive and gram-negative microorganisms (including strains producing beta-lactamases). Amoxicillin is bactericidal and inhibits the synthesis of peptidoglycan in the bacterial cell wall. Clavulanic acid inhibits beta-lactamases types II, III, IV and V). Not active against type I beta-lactamases produced by Enterobacter spp., Pseudomonas aeruginosa, Serratia spp., Acinetobacter spp. Clavulanic acid has a high tropism for penicillinases, due to which it forms a stable complex with the enzyme, which prevents the enzymatic degradation of amoxicillin under the influence of beta-lactamases and expands its spectrum of action. Flemoclav Solutab® is active against aerobic gram-positive bacteria: Streptococcus spp., Staphylococcus spp. (except methicillin-resistant strains), Enterococcus spp., Corynebacterium spp., Bacillus anthracis, Listeria monocytogenes; anaerobic gram-positive bacteria: Clostridium spp. (except Clostridium difficile), Peptococcus spp., Peptostreptococcus spp.; aerobic gram-negative bacteria: Escherichia coli, Klebsiella spp., Proteus spp., Yersinia enterocolitica, Salmonella spp., Shigella spp., Haemophilus influenzae, Haemophilus ducreyi, Neisseria gonorrhoeae, Neisseria meningitidis, Bordetella pertussis, Moraxella catarrhalis, Gardnerella vaginalis, Brucella spp., Pasteurella multocida, Vibrio cholerae, Helicobacter pylori; anaerobic gram-negative bacteria: Bacteroides spp., including Bacteroides fragilis, Fusobacterium spp.

Pharmacokinetics

Amoxicillin Absorption After oral administration, it is quickly absorbed from the gastrointestinal tract. Absorption of amoxicillin at oral administration is 90-94%. Absolute bioavailability reaches 94%. Concomitant food intake does not affect absorption. Cmax in blood plasma is achieved 1-2 hours after administration. After taking a single dose of 500 mg/125 mg (amoxicillin/clavulanic acid), the average concentration of amoxicillin (after 8 hours) is 0.3 mg/l. After a single dose of 875 mg/125 mg (amoxicillin/clavulanic acid), the Cmax of amoxicillin in blood plasma is 12 mcg/ml. Distribution After a single dose of 875 mg/125 mg (amoxicillin/clavulanic acid), the AUC of amoxicillin is 33 mcg? h/l. Serum protein binding is approximately 17-20%. Amoxicillin crosses the placental barrier and is excreted in small quantities into breast milk. Metabolism A small part of amoxicillin is metabolized by hydrolysis of the beta-lactam ring to inactive metabolites (the main ones are penicillic and penamaldic acids). Excretion Approximately 60-80% of amoxicillin is excreted through the kidneys during the first 6 hours after taking the drug. T1/2 is 0.9-1.2 hours. Pharmacokinetics in special clinical cases In case of impaired renal function (creatinine clearance within 10-30 ml/min), T1/2 is 6 hours, and in the case of anuria it ranges between 10 and 15 hours. It is excreted by hemodialysis. Clavulanic acid Absorption After oral administration, it is quickly absorbed from the gastrointestinal tract. Absolute bioavailability is approximately 60%. Concomitant food intake does not affect absorption. Cmax in blood plasma is achieved approximately 1-2 hours after administration. After taking a single dose of 500/125 mg (amoxicillin/clavulanic acid), the average concentration of clavulanic acid reaches 0.08 mg/l (after 8 hours). After a single dose of 875 mg/125 mg (amoxicillin/clavulanic acid), the Cmax of clavulanic acid in blood plasma is 3 mcg/ml. Distribution After a single dose of 875 mg/125 mg (amoxicillin/clavulanic acid), the AUC of clavulanic acid is 6 mcg? h/l. Serum protein binding is 22%. Clavulanic acid penetrates the placental barrier. There is no reliable data on excretion in breast milk. Metabolism Clavulanic acid undergoes extensive metabolism through hydrolysis and subsequent decarboxylation. Excretion Approximately 30-50% of clavulanic acid is excreted through the kidneys during the first 6 hours after taking the drug. T1/2 is approximately 1 hour. The total clearance for amoxicillin and clavulanic acid is 25 l/h. Pharmacokinetics in special clinical cases In case of impaired renal function (creatinine clearance from 20 to 70 ml/min), T1/2 is 2.6 hours, and with anuria it ranges between 3-4 hours. It is eliminated by hemodialysis.

Special conditions

When taking Flemoclav Solutab®, there is a possibility of cross-resistance and hypersensitivity with other penicillins or cephalosporins. If anaphylactic reactions develop, the drug should be stopped immediately and appropriate therapy administered: for treatment anaphylactic shock may require urgent administration of epinephrine (adrenaline), corticosteroids and elimination respiratory failure. Superinfection (eg, candidiasis) may develop, especially in patients with chronic diseases and/or dysfunction immune system. If superinfection occurs, the drug should be discontinued and/or adjusted accordingly. antibacterial therapy. Patients with severe gastrointestinal disorders accompanied by vomiting and/or diarrhea, the prescription of Flemoclav Solutab® is inappropriate until the above symptoms are eliminated, because Possible disruption of drug absorption from the gastrointestinal tract. The appearance of severe and persistent diarrhea may be associated with the development of pseudomembranous colitis, in which case the drug is discontinued and prescribed necessary treatment. In case of development of hemorrhagic colitis, immediate discontinuation of the drug and corrective therapy are also necessary. The use of drugs that weaken intestinal motility in these cases is contraindicated. If liver function is impaired, the drug should be prescribed with caution and under constant medical supervision. The drug should not be used for more than 14 days without assessing liver function. In a single study, prophylactic amoxicillin/clavulanate in women with premature rupture of membranes increased the risk of neonatal necrotizing enterocolitis. While taking the drug, an increase in prothrombin time may be observed. Therefore, Flemoklav Solutab® should be prescribed with caution to patients receiving anticoagulant therapy (blood clotting parameters must be monitored). Due to high concentration amoxicillin in the urine, it can be deposited on the walls urinary catheter Therefore, such patients require periodic catheter changes. Forced diuresis accelerates the elimination of amoxicillin and reduces its plasma concentration. During the period of use of Flemoclav Solutab®, non-enzymatic methods for determining glucose in urine, as well as a test for urobilinogen, may give false positive results. At course treatment it is necessary to monitor the functions of the hematopoietic organs, liver and kidneys. If seizures occur during therapy, the drug is discontinued. It should be taken into account that 1 dispersible tablet 875 mg/125 mg contains 25 mg of potassium.

Compound

  • 1 tab. Amoxicillin trihydrate 528.8 mg, which corresponds to the content of amoxicillin 500 mg Potassium clavulanate 148.9 mg, which corresponds to the content of clavulanic acid 125 mg Excipients: microcrystalline cellulose, crospovidone, vanillin, apricot flavor, saccharin, magnesium stearate. Amoxicillin trihydrate 1019.8 mg, which corresponds to the content of amoxicillin 875 mg Potassium clavulanate 148.9 mg, which corresponds to the content of clavulanic acid 125 mg Excipients: dispersed cellulose, microcrystalline cellulose, crospovidone, vanillin, tangerine flavor, lemon flavor, saccharin, magnesium stearate. Amoxicillin trihydrate 145.7 mg, which corresponds to the content of amoxicillin 125 mg Potassium clavulanate 37.2 mg, which corresponds to the content of clavulanic acid 31.25 mg Excipients: microcrystalline cellulose, crospovidone, vanillin, apricot flavor, saccharin, magnesium stearate. Amoxicillin trihydrate 291 mg, which corresponds to the content of amoxicillin 250 mg Potassium clavulanate 74.5 mg, which corresponds to the content of clavulanic acid 62.5 mg Excipients: microcrystalline cellulose, crospovidone, vanillin, apricot flavor, saccharin, magnesium stearate. Amoxicillin trihydrate 528.8 mg, which corresponds to the content of amoxicillin 500 mg Potassium clavulanate 148.9 mg, which corresponds to the content of clavulanic acid 125 mg Excipients: microcrystalline cellulose, crospovidone, vanillin, apricot flavor, saccharin, magnesium stearate. amoxicillin trihydrate 145.7 mg, which corresponds to the content of amoxicillin 125 mg potassium clavulanate 37.2 mg, which corresponds to the content of clavulanic acid 31.25 mg Excipients: microcrystalline cellulose, crospovidone, vanillin, apricot flavor, saccharin, magnesium stearate.

Flemoklav Solutab indications for use

  • Infectious and inflammatory diseases caused by microorganisms sensitive to the drug: - infections upper sections respiratory tract and ENT organs (incl. otitis media, sinusitis, tonsillitis, pharyngitis); - infections of the lower respiratory tract (including exacerbation of chronic bronchitis, COPD, community-acquired pneumonia); - infections of bones and joints, incl. osteomyelitis (only for tablets 875 mg/125 mg); - infections in obstetrics and gynecology (only for tablets 875 mg/125 mg); - infections of the skin and soft tissues; - kidney infections and urinary tract(including cystitis, pyelonephritis).

Flemoklav Solutab contraindications

  • - liver dysfunction (including jaundice) with a history of taking amoxicillin/clavulanic acid; - Infectious mononucleosis; - lymphocytic leukemia; - renal failure (glomerular filtration? 30 ml/min) - for dispersible tablets 875 mg/125 mg; - children under 12 years of age weighing less than 40 kg (for dispersible tablets 875 mg/125 mg); - hypersensitivity to amoxicillin, clavulanic acid and other components of the drug; - hypersensitivity to other beta-lactam antibiotics (penicillins and cephalosporins). The drug should be prescribed with caution in case of severe liver failure, chronic renal failure, gastrointestinal diseases (including a history of colitis associated with the use of penicillins).

Flemoklav Solutab dosage

  • 125 mg + 31.25 mg 125 mg + 31.25 mg, 250 mg + 62.5 mg, 500 mg + 125 mg 250 mg + 62.5 mg 500 mg + 125 mg 875 mg + 125 mg

Flemoklav Solutab side effects

  • From the hematopoietic system: rarely - thrombocytosis, hemolytic anemia; very rarely - leukopenia, granulocytopenia, thrombocytopenia, pancytopenia, anemia. These adverse reactions are reversible and disappear after discontinuation of therapy. From the coagulation system: very rarely - an increase in prothrombin time and bleeding time. These adverse reactions are reversible and disappear after discontinuation of therapy. From the nervous system: rarely - dizziness, headache, convulsions (in case of impaired renal function or drug overdose); very rarely - hyperactivity, restlessness, anxiety, insomnia, impaired consciousness, aggressive behavior. From the outside of cardio-vascular system: rarely - vasculitis. From the outside digestive system: often - abdominal pain, nausea (more often with overdose), vomiting, flatulence, diarrhea (generally, reactions from the digestive system are transient and rarely pronounced; their intensity can be reduced by taking the drug at the beginning of a meal); pseudomembranous colitis (in case of severe and persistent diarrhea while taking the drug or within 5 weeks after completion of therapy), in most cases caused by Clostridium difficile; rarely - intestinal candidiasis, hemorrhagic colitis, discoloration of the surface layer of tooth enamel. From the liver: often - a slight increase in the activity of liver enzymes; rarely - hepatitis and cholestatic jaundice. Symptoms of liver dysfunction occur

Drug interactions

When used simultaneously with some bacteriostatic drugs (for example, chloramphenicol, sulfonamides), antagonism with amoxicillin/clavulanic acid in vitro was observed. Amoxicillin/clavulanic acid should not be co-administered with disulfiram. The simultaneous use of drugs that inhibit the renal excretion of amoxicillin (probenecid, phenylbutazone, oxyphenbutazone and, to a lesser extent, acetylsalicylic acid, indomethacin and sulfinpyrazone) increases the concentration and longer presence of amoxicillin in the blood plasma and bile. The excretion of clavulanic acid is not impaired. When used simultaneously with Flemoklav Solutab®, antacids, glucosamine, laxatives, aminoglycosides slow down and reduce the absorption of amoxicillin, ascorbic acid increases the absorption of amoxicillin. Concomitant use of Flemoclav Solutab® with allopurinol may increase the risk of developing a skin rash.

Overdose

Symptoms: nausea, vomiting, diarrhea with possible disturbances in water and electrolyte balance. Treatment: prescribed Activated carbon and osmodiuretics, it is necessary to maintain water and electrolyte balance, carry out symptomatic therapy. For convulsions, diazepam is prescribed.

Storage conditions

  • store at room temperature 15-25 degrees
  • keep away from children
Information provided

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

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

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

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

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

Application

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

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

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

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

How to prepare the suspension

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

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

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

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

Special cases

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

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

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

Contraindications

Instructions for use include Flemoclav Solutab as contraindications:

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

Flemoklav Solutab is prescribed with special caution to children with illnesses gastrointestinal tract.

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

By-effect

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

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

In very rare cases, anaphylactic shock is possible.

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

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

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

Overdose

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

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

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

Drug substitutes

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

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

Which one of listed drugs Suitable for children of different ages, and what dosage is required is determined only by the attending physician.

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

Helper in the fight for health

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

Flemoklav Solutab and its analogues allow you to cope with various diseases and their consequences.

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

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

Broad-spectrum antibiotic, active against gram-positive and gram-negative microorganisms. Clavulanic acid, which is part of the drug, ensures the resistance of amoxicillin to the action of β-lactamases, expanding the spectrum of its antimicrobial activity. The drug is active against aerobic gram-positive bacteria: Staphylococcus aureus Staphylococcus epidermidis(including strains producing β-lactamases) , Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus viridans, Streptococcus agalactiae, Enterecoccus faecalis, Enterococcus faecium, Bacillus antrhracis, Nocardia asteroids, Corynebacterium spp., Listeria monocytogenes;
anaerobic gram-positive bacteria: Сlostridium spp., Peptococcus spp., Peptostreptococcus spp.;
aerobic gram-negative bacteria: Escherichia coli(including strains producing β-lactamases), Proteus mirabilis(including strains producing β-lactamases), Proteus vulgaris(including strains producing β-lactamases), Neisseria menengitidis, Neisseria gonorrhoeae(including strains producing β-lactamases), Moraxella catarrhalis (Branhamella catarrhalis), Haemophilus influenzae(including strains producing β-lactamases), Haemophilus ducreyi(including strains producing β-lactamases), Helicobacter pylori, Klebsiella spp.(including strains producing β-lactamases), Salmonella spp.(including strains producing β-lactamases), Shigella spp.(including strains producing β-lactamases), Bordetella pertussis, Yersinia enterocolitica(including strains producing β-lactamases), Gardnerella vaginalis, Brucella spp., Pasteurella multocida, kinds Legionella, Campylobacter jejuni, Vibrio cholerae;
anaerobic gram-negative bacteria: Bacteroides spp., including Bacteroides fragilis(including strains producing β-lactamases) , Fusobacterium spp.;
other microorganisms: Borrelia burgdorferi, Leptospira icterohaemorrhagiae, Treponema pallidum.
Amoxicillin
The absolute bioavailability of amoxicillin is dose dependent and varies up to approximately 94%. Bioavailability when used in the dose range of 250-750 mg is directly proportional to the dose. As the dose increases, the degree of absorption decreases. Absorption is independent of food intake. The maximum concentration in blood plasma is achieved 1-2 hours after administration. After a single dose of 500/125 mg amoxicillin/clavulanic acid, the average amoxicillin concentration after 8 hours is 0.3 mg/l. The volume of distribution is 0.3-0.4 l/kg body weight, the degree of binding to plasma proteins is 17-20%. Amoxicillin is excreted mainly in the urine (52±15% unchanged within 7 hours), a small amount is excreted in the bile. The total clearance is 250-370 ml/min. The half-life from the blood serum in patients with impaired renal function is about 1 hour (0.9-1.2 hours), and in anuria it is 10-15 hours. It is eliminated by hemodialysis.
Clavulanic acid
The absolute bioavailability of clavulanic acid is about 60%. Absorption is independent of food intake. The maximum concentration of clavulanic acid in the blood serum is achieved approximately 1-2 hours after oral administration. After a single dose of 500/125 mg of amoxicillin/clavulanic acid, the concentration of clavulanic acid in the blood serum reaches 0.08 mg/l after 8 hours. The volume of distribution is about 0.2 l/kg body weight, binding to plasma proteins is approximately 22%. Clavulanic acid penetrates the placental barrier. Penetrations into breast milk not noted. About 40% is excreted in the urine (18-38% unchanged). The total clearance is about 260 ml/min. The half-life in patients with impaired renal function is about 1 hour, with anuria - 3-4 hours. It is eliminated by hemodialysis.
Therapeutic concentrations of both substances are achieved in gallbladder, organ tissues abdominal cavity, skin, subcutaneous fat and muscle tissue, as well as in synovial and peritoneal fluid, bile and pus.

Indications for use of the drug Flemoklav solutab

Infections of the upper and lower respiratory tract (acute and chronic bronchitis, lobar pneumonia, bronchopneumonia, pleural empyema, lung abscess) and ENT organs (including otitis media, sinusitis, tonsillitis, pharyngitis); bacterial infections of the skin and soft tissues (including abscess, wound infection); infections of the genitourinary system (including cystitis, urethritis, pyelonephritis, salpingitis, salmetritis, bacterial vaginitis, septic abortion, postpartum sepsis, pelvioperitonitis, chancroid, gonorrhea); osteomyelitis, sepsis, intra-abdominal infections, peritonitis, postoperative infections.

Use of the drug Flemoklav solutab

To reduce the severity of dyspeptic symptoms, take before meals. The tablet is swallowed whole, chewed with a glass of water, or dissolved in 1/2 glass of water (at least 30 ml). The duration of treatment depends on the severity of the infection and should not exceed 14 days without reviewing the clinical situation.
Adults and children weighing more than 40 kg are prescribed 1 tablet 500/125 mg 2-3 times a day or 875/125 mg 2 times a day.
The daily dose for children aged 2-12 years (with a body weight of 13-37 kg) is 20-30 mg of amoxicillin and 5-7.5 mg of clavulanic acid per 1 kg of body weight.
For children aged 2-7 years (body weight - 13-25 kg), a single dose is 125/31.25 mg with a dosage frequency of 2-3 times a day; for children aged 7-12 years (body weight 25-37 kg) a single dose is 250/62.5 mg with a dosage frequency of 2-3 times a day. For more severe infections, these doses can be doubled (the maximum daily dose is 60 mg of amoxicillin and 15 mg of clavulanic acid per 1 kg of body weight).
In patients with impaired renal function, the elimination of clavulanic acid and amoxicillin is slowed down. Depending on the severity of renal failure, the dose of the drug should not exceed those given in the table.

Flemoklav Solutab at a dose of 875/125 mg can be prescribed only at a speed glomerular filtration 30 ml/min, with no need for dose adjustment.
In patients with impaired liver function, the combination of amoxicillin/clavulanic acid is prescribed with caution during continuous monitoring of liver function.

Contraindications to the use of the drug Flemoklav solutab

Hypersensitivity to amoxicillin, clavulanic acid and other components of the drug, as well as to other β-lactam antibiotics (penicillins, cephalosporins); a history of development of jaundice or impaired liver function after taking amoxicillin or clavulanic acid; children weighing up to 13 kg (due to the difficulty of precise dosing). In patients with mononucleosis or lymphocytic leukemia, the risk of developing a rash increases, therefore the combination of amoxicillin/clavulanic acid is not prescribed for these diseases.
In patients with infectious mononucleosis or lymphocytic leukemia, the risk of exanthema increases, therefore, the combination of amoxicillin/clavulanic acid is not recommended for these diseases.

Side effects of the drug Flemoklav solutab

They develop rarely and are usually mild and transient in nature.
Allergic reactions: urticaria, maculopapular rash. In some cases, a so-called five-day rash (measles-like rash) develops. The severity of the reaction depends on the dose of the drug and the patient's condition.
from the gastrointestinal tract: nausea, vomiting, diarrhea, liver dysfunction (increased activity of transaminases, alkaline phosphatase and bilirubin levels in the blood serum), which are more often observed in men and people over the age of 65 years (develops extremely rarely in children).
The risk of side effects increases when using the drug for more than 14 days. Symptoms occur during treatment or immediately after stopping it, but in some cases they may appear several weeks after stopping the drug. Side effects from the gastrointestinal tract are usually transient and minor, but sometimes they are pronounced.
Below is the frequency of side effects from different organs and systems:
Often
From the gastrointestinal tract: nausea, vomiting, diarrhea, abdominal pain;
from the immune system: type I hypersensitivity reactions (urticaria, purpura);
from the skin: rash.
Rarely
From the blood system: changes cellular composition peripheral blood(leukopenia, thrombocytopenia, hemolytic anemia), increased prothrombin time and increased bleeding time;
from the hepatobiliary system: hepatitis, including cholestatic;
from the immune system: serum sickness, angioedema, vasculitis;
from the nervous system: dizziness, headache, convulsions (in case of impaired renal function or overdose);
from the mental side: transient increased activity;
from the kidneys and urinary tract: interstitial nephritis.
Isolated cases
Pseudomembranous colitis, anaphylactic reactions, different shapes erythema (including Stevens-Johnson syndrome), exfoliative bullous dermatitis (including toxic epidermal necrolysis).

Special instructions for the use of the drug Flemoklav solutab

Elderly patients do not require dosage adjustment. The drug is prescribed with caution to patients with impaired liver function. Liver function must be constantly monitored.
There is a possibility of developing cross-resistance of microorganisms to other penicillins or cephalosporins. As with other broad-spectrum penicillins, superinfections may occur, especially in patients with chronic diseases and/or immune system dysfunction.
For persistent diarrhea, possible pseudomembranous and hemorrhagic colitis, appropriate measures should be taken. The use of antiperistaltic agents is contraindicated.
In patients with impaired renal function, the dose of the drug must be selected taking into account the severity of the condition.
In patients with impaired liver function, the amoxicillin/clavulanic acid combination should be administered with caution and under constant medical supervision. Flemoclav Solutab should not be used for more than 14 days without assessing liver function. An increase in prothrombin time is rarely noted.
Amoxicillin/clavulanic acid should be administered with caution to patients receiving anticoagulants.
It is necessary to consider the possibility of developing fungal or bacterial superinfection during therapy. If superinfection develops, stop taking the drug and prescribe appropriate therapy.
Due to the high concentration of amoxicillin in the urine, it can settle on the walls of the urinary catheter, so such patients need to change the catheter promptly.
Forced diuresis accelerates the elimination of amoxicillin and reduces its serum concentration.
Non-enzymatic methods for determining blood glucose, as well as the urobilinogen test, may give false positive results.
If seizures occur during therapy, stop taking the drug. One dispersed tablet Flemoklav Solutab 875/125 mg contains 25 mg of potassium.
During pregnancy and breastfeeding. When using the combination of amoxicillin/clavulanic acid during pregnancy, no negative influence for the fetus and newborn.
In a single study, prophylactic amoxicillin/clavulanic acid in women with premature rupture of membranes increased the risk of necrotizing enterocolitis in the newborn. Use in the second and third trimester of pregnancy is possible after a doctor has assessed the benefit/risk ratio of treatment. During the first trimester of pregnancy, the combination of amoxicillin/clavulanic acid at a dose of 875/125 mg should be avoided.
Both components of the drug penetrate the placental barrier and are excreted into breast milk (there is no data on the effect of clavulanic acid on a breastfed baby). It is possible to use the drug during breastfeeding. However, if the child develops diarrhea or a fungal infection of the mucous membranes, breastfeeding must be stopped. It is also necessary to take into account the possibility of sensitization of the child by the components of the drug during breastfeeding.
Negative influence the ability to drive vehicles and work with potentially dangerous mechanisms was not noted.

Interactions of the drug Flemoklav solutab

Antacids, glucosamine, laxatives, aminoglycosides slow down and reduce, and ascorbic acid increases the absorption of the drug components. Flemoklav Solutab should not be prescribed simultaneously with bacteriostatic drugs (tetracyclines, macrolides or chloramphenicol), especially in acute infections. A synergistic effect is possible when administered simultaneously with aminoglycosides, cephalosporins, cycloserine, rifampicin, vancomycin.
Medicines that inhibit the release of amoxicillin (probenecid, phenylbutazone, oxyphenbutazone and, to a lesser extent, acetylsalicylic acid, indomethacin and sulfinpyrazone) contribute to a longer presence of amoxicillin in the blood plasma. Flemoklav Solutab is not used in combination with probenecid. The use of allopurinol and amoxicillin increases the risk of rash. Amoxicillin is prescribed with caution in combination with disulfiram. The combined use of amoxicillin and digoxin causes an increase in the level of digoxin in the blood plasma. The drug reduces the effectiveness of oral contraceptives. Diuretics, allopurinol, phenylbutazone, NSAIDs and others medicines, blocking tubular secretion, increase the concentration of amoxicillin in the blood. When used simultaneously with anticoagulants, medical supervision of the patient is necessary, since this increases the prothrombin time.

Overdose of the drug Flemoklav solutab, symptoms and treatment

May manifest as nausea, vomiting and diarrhea with possible disturbances in water and electrolyte balance. In case of overdose, the stomach is washed, activated charcoal is prescribed, water and electrolyte balance is maintained, and symptomatic therapy is carried out. In case of severe renal failure, hemodialysis is performed.

Storage conditions for the drug Flemoklav solutab

At a temperature of 15-25 °C.

List of pharmacies where you can buy Flemoclav Solutab:

  • Saint Petersburg

A common drug prescribed by specialists for many infectious and inflammatory diseases bacterial etiology, is Flemoclav Solutab. When is the medicine prescribed and how to take it? Can pregnant and nursing mothers use it? How to use Flemoclav correctly?

Composition of the drug, pharmacological group and properties

The antibiotic is based on amoxicillin trihydrate. Another active substance included in the drug is the so-called clavulanic acid. The medicine also contains auxiliary components, such as apricot flavoring, crospovidone, microcrystalline cellulose, vanillin, saccharin and magnesium stearate.

The medicine belongs to the group antibacterial drugs, which have a wide range of effects. This drug is an antibiotic penicillin series(beta-lactamase inhibitor).

The active components of Flemoklav actively affect gram-negative and gram-positive pathogens. They destroy the integrity of the bacterial membrane cells, as a result of which their growth and reproduction decreases as the microorganisms begin to die. The antibiotic kills especially quickly.The drug is mainly excreted in the urine. It has the ability to pass into breast milk.

Flemoklav is available in tablets that are dispersible.

The blister contains four pieces. The color of the tablets is whitish-yellowish interspersed with a brown tint. Their shape is oblong.

Tablets are available in different dosages depending on the amoxicillin content in them - 500, 250 or 125 mg. They are placed in blisters of five pieces. Four blister packs are placed in a cardboard box.Flemoclav is also available in tablets that contain 875 mg of amoxicillin. They are packaged in blister packs of seven or five pieces.

It is recommended to store the medicine in a place that is difficult for children to reach. The drug should not be exposed to direct sunlight. The optimal temperature for storing antibiotics is no more than twenty-five degrees.The tablets are suitable for use for three years from the date of manufacture. During this period, brown dots or marbling may appear on the tablets.In pharmaceutical institutions, the drug is sold over-the-counter.

When is an antibiotic prescribed?

Flemoklav Solutab is usually prescribed for otolaryngological diseases, infections of the skin and soft tissues. Therapists prescribe medicine for infectious and inflammatory diseases of the upper and lower sections respiratory system. An antibiotic is also used for genitourinary diseases.

The antibiotic is used for the following diseases respiratory tract:

  • Bronchitis is acute or chronic.
  • Lung abscesses.
  • Empyema of the pleura.
  • Pneumonia.
  • Obstructive pulmonary disease.

In otolaryngology, Flemoclav is used to treat the following pathologies:

  • Rhinitis acute
  • Sphenoiditis
  • Rhinopharyngitis

The use of antibiotics is possible for diseases that affect soft fabrics and skin:

  • Impetigo
  • Phlegmon
  • Erysipelas
  • Secondary dermatitis
  • Abscesses

The drug is prescribed for infectious diseases urinary system and kidneys. These include:

  • Nephritis
  • Pyelonephritis
  • Cystitis
  • Urethritis

Indications for the drug may include pathological conditions such as osteomyelitis, sepsis, peritonitis, as well as infectious complications after surgical interventions.

Dosage of the drug and features of use

Flemoclav Solutab is intended for internal use.The dosage of Flemoclav is determined in each case by a specialist. It depends on the age criterion, the person’s body weight, and the nature of the disease.

The official instructions for taking the drug indicate the following doses: for children over twelve years of age and adults, the dose is 875 mg per 125 mg twice a day, that is, every 12 hours or 500 mg per 125 mg three times a day (every 8 hours).In severe cases of the disease or relapses, the dose may be increased.

For a child whose weight is up to forty kilograms, the antibiotic is prescribed in a lower dosage:

  • At the age of 3 months to two years with body weight up to 12 kg - 125/31.25 mg twice a day
  • Up to the age of seven and weighing less than 25 kg – 125/31.25 mg three times a day
  • Children under 12 years old weighing up to 37 kg – 250/62.5 mg three times a day

The dosage for children is calculated as follows: from 20 to 30 mg of medication per 1 kilogram of weight. Having calculated daily dose antibiotic, it is divided into three doses.

The duration of treatment with Flemoklav depends on the severity of the disease, but should not exceed two weeks.

It is recommended to swallow the tablet whole. It must be washed down with plenty of water. Another method of administration is also allowed - dissolving the tablet in half a cup of water. To do this, throw the tablet into water and stir thoroughly. After this, the medicine is drunk. The amount of water should be at least thirty milliliters.

Special instructions regarding taking antibiotics include:

  • Use Flemoklav every 8 or twelve hours, depending on the daily amount of antibiotic intake.
  • The drug must be taken for at least three days after the signs of the disease disappear.
  • With long-term use of the drug, it is necessary to monitor the functioning of the kidneys, liver, and blood properties.
  • In patients with a history of renal failure, the dosage should be adjusted. It depends on creatinine clearance - with a reading of ten to thirty milliliters per minute, a dose of 500 mg is prescribed twice a day. If creatinine clearance is less than ten milliliters, then this dose is taken once a day.
  • When using the drug by patients operating machinery, it is better to temporarily stop working.
  • The condition of patients who have catheters to remove urine requires medical supervision. This is because since amoxicillin is excreted primarily in the urine, it high level it provokes precipitation medicinal substances on the catheter walls. Therefore, frequent catheter changes are recommended for such patients.
  • To prevent digestive disorders, including dysbiosis, the patient is also prescribed probiotics. These include Linex, Laktovit, Bifidumbacterin, Yogurt and others.

Before using an antibiotic, it is important to read its official instructions, especially the section on the interaction of the drug with other medications. In addition, before prescribing a medicine, the specialist must be informed about what medications the patient is taking.

Use for the treatment of pregnant women and breastfeeding


When using Flemoklav Solutaba for the treatment of pregnant women negative impact was not observed on the fetus. However, it is important to remember that in the first three months, when the fetus is forming, the use of medications should be coordinated with a leading specialist.

Usually during this period it is not recommended to take any medications. Therefore, a specialist may advise taking more safe means alternative medicine.In the second and third trimester, the doctor takes into account the risks and benefits of the antibiotic during pregnancy before prescribing Flemoklav.

The active components of the drug pass into breast milk through the blood-placental barrier. Flemoklav Solutab can be used by nursing mothers, but if a baby develops adverse reactions, breastfeeding should be temporarily stopped.

Contraindications and side effects

There are some restrictions on the use of Flemoklav. Patients who have a history of the following pathologies are not allowed to take tablets:

  • Lymphocytic leukemia.
  • Mononucleosis of infectious etiology.
  • Kidney failure.
  • The tablets are contraindicated in patients whose liver function is impaired after taking amoxicillin, and jaundice is also observed.
  • Antibiotics should not be given to children weighing less than forty kilograms.
  • Contraindications are also individual intolerance to the components of the drug, hypersensitivity to penicillin and cephalosporin antibiotics.

Flemoklav Solutab is prescribed with caution for liver and kidney diseases, digestive disorders, and bronchial asthma.

The antibiotic is usually well tolerated by patients. However, the development of undesirable reactions is still possible. Most common side effects are:

  • Nausea
  • Gagging
  • Abdominal pain
  • Diarrhea
  • Colitis pseudomembranous
  • Flatulence
  • Elevated liver enzyme levels
  • Rashes on skin and their itching
  • Changing the shade of tooth enamel
  • Dry mouth
  • Change in taste
  • Dyspepsia

Allergic reactions include morbilliform exanthema, urticaria, dermatitis (exfoliative and bullous), Stevens-Johnson syndrome, eosinophilia, hemolytic anemia, angioedema, allergic vasculitis. If anaphylactic shock occurs and untimely assistance occurs, death can occur.

Useful video - Antibiotics for colds and flu:

In rare cases, other side effects may occur:

  • From the hematopoietic and coagulation systems: hemolytic anemia, thrombocytosis, thrombocytopenia, anemia, leukopenia, pancytopenia, granulocytopenia.
  • From the nervous system: headache, convulsions, dizziness, anxiety, sleep disturbance, loss of consciousness, aggressiveness and irritability.
  • From the digestive system: hemorrhagic colitis, intestinal candidiasis, cholestatic jaundice, hepatitis.
  • From the genital and urinary organs: burning sensation and itching of the external genitalia, the appearance of discharge, interstitial nephritis.

If these adverse reactions occur, treatment with Flemoclav should be discontinued. It is necessary to contact a specialist who will prescribe symptomatic treatment to eliminate adverse reactions, prescribe medications or antibiotics of a suitable group for the patient.

Overdose and actions for it

Cases of overdose with Flemoclav are rare. This usually happens when the rules for taking an antibiotic are violated. Signs of an overdose are nausea, diarrhea, vomiting, intoxication of the body, and convulsions. In rare cases, hemolytic disorders, renal failure, acidosis, crystalluria, and shock may occur. If the patient experiences such reactions, stop taking the medication and contact a clinic.

The first action in case of overdose should be gastric lavage. To eliminate the symptoms of overdose, the patient needs to drink activated charcoal or osmodiuretics and enterosorbent agents. It is important in such cases to maintain electrolyte and water balance in the body.

In case of overdose, specialists prescribe medications to relieve symptoms.

If the patient experiences convulsions, they are eliminated with the help of Diazepam. For severe kidney dysfunction, hemodialysis is performed.

To prevent cases of overdose, you should not determine the dose of the medicine yourself; it is better to entrust this to a specialist. It is mandatory to comply with all doctor's instructions and the recommended dose of antibiotic.

Analogues of Flemoklav Solutaba
  • Rapiklav
  • Trifamox
  • Theraclave
  • Amoklan
  • Clavocin
  • Moxiclave
  • Ranklav
  • Clavunat

    • These drugs belong to the penicillin group of antibacterial agents. They contain, like Flemoclav Solutab, amoxicillin and clavulanic acid, and therefore have a detrimental effect on various pathogens. The indications for use of the medicine are also identical.

    The advantage of these analogues may be a smaller list of contraindications and side effects.The prices for these drugs are average, about the same as for Flemoklav. It is important to note that in pharmacies you can also buy cheaper drugs that can replace Flemoclav, but when choosing them you should focus on the composition of the antibiotic - it is still better to take a medicine that combines both active components - ampicillin and clavulanic acid.If penicillin antibiotics are not suitable for the patient, then drugs of the macrolide or cephalosporin group are prescribed.

    Registration number: LSR-000392/09-300315
    Tradename: Flemoclav Solutab®
    INN or group name: amoxicillin + clavulanic acid

    Dosage form: dispersible tablets

    Compound
    One tablet contains:
    Active substance: amoxicillin (in the form of amoxicillin trihydrate) - 875 mg; clavulanic acid (in the form of potassium clavulanate) - 125 mg.
    Excipients: dispersed cellulose, microcrystalline cellulose, crospovidone, vanillin, tangerine flavor, lemon flavor, saccharin, magnesium stearate.

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

    Pharmacotherapeutic group: Antibiotic - polysynthetic penicillin + beta-lactamase inhibitor.

    ATX code: .

    Pharmacological properties


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

    Activity spectrum
    Gram-positive bacteria
    Streptococcus spp., Staphylococcus spp. (except methicillin-resistant strains), Enterococcus spp., Corynebacterium spp., Bacillus anthracis, Listeria monocytogenes;
    Clostridium spp. (except Clostridium difficile), Peptococcus spp., Peptostreptococcus spp.;
    Gram-negative bacteria
    Escherichia coli, Klebsiella spp., Proteus spp., Proteus vulgaris, Yersinia enterocolitica, Salmonella spp., Shigella spp., Haemophilus influenzae, Haemophilus ducreyi, Neisseria gonorrhoeae, Neisseria meningitides, Bordetella pertussis, Moraxella catarrhalis, Gardnerella vaginalis, Brucella spp., Pasteurella multocida, Vibrio cholerae, Helicobacter pylori;
    Bacteroides spp., including Bacteroides fragilis, Fusobacterium spp.


    After a single dose of Flemoklav Solutab® at a dose of 875/125 mg (amoxicillin/clavulanic acid), the maximum concentration of amoxicillin in the blood plasma is created after 1.5 hours (tmax), and is 12 μg/ml (Cmax), clavulanic acid - after 1 hour , amounting to 3 μg/ml. The AUC (area under the pharmacokinetic curve) of amoxicillin and clavulanic acid is 33 mcg h/l and 6 mcg h/l, respectively. Absorption of amoxicillin when administered orally reaches 90%, the absolute bioavailability of clavulanic acid averages 60%.
    Approximately 17-20% of amoxicillin and 22% of clavulanic acid are bound to plasma proteins. The total clearance for the two active substances is 25 l/h, the half-life (t1/2) of amoxicillin is 1.1 hours, clavulanic acid is 0.9 hours. Approximately 60-80% of amoxicillin and 30-50% of clavulanic acid are excreted through the kidneys within the first 6 hours after taking the drug. Amoxicillin is excreted predominantly unchanged, a small part is metabolized by hydrolysis of the beta-lactam ring to inactive metabolites (the main ones are penicillic and penamaldic acids). Clavulanic acid undergoes extensive metabolism through hydrolysis and subsequent decarboxylation.

    Indications for use

    Infectious and inflammatory diseases caused by microorganisms sensitive to the drug:
    - upper respiratory tract and ENT organs (including otitis media, sinusitis, tonsillitis, pharyngitis);
    - lower respiratory tract (including exacerbation of chronic bronchitis, chronic obstructive pulmonary disease, community-acquired pneumonia);
    - infections of the skin and soft tissues (including severe dental abscess with spreading cellulitis);
    - infections of bones and joints (including osteomyelitis);
    - infections of the urinary system (including cystitis, pyelonephritis);
    - infections in obstetrics and gynecology.

    Contraindications

    Hypersensitivity to amoxicillin, clavulanic acid and other components of the drug;
    Hypersensitivity to other beta-lactam antibiotics (penicillins and cephalosporins);
    History of jaundice or liver dysfunction while taking amoxicillin/clavulanic acid;
    Renal failure with glomerular filtration rate ≤ 30 ml/min;
    Children under 12 years of age weighing less than 40 kg;
    Infectious mononucleosis;
    Lymphocytic leukemia.

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

    Pregnancy and lactation

    There were no adverse effects of amoxicillin/clavulanate on the fetus or newborns when used by pregnant women. Use in the second and third trimesters of pregnancy is possible after a medical assessment of the risks/benefits of treatment. In the first trimester, the use of the drug should be avoided.
    Both components of the drug penetrate the hematoplacental barrier and are excreted into breast milk. It is possible to use the drug during breastfeeding.
    If a child develops sensitization, diarrhea or candidiasis of the mucous membranes, breastfeeding should be stopped.

    Directions for use and doses

    To prevent dyspeptic symptoms, Flemoclav Solutab® is prescribed at the beginning of a meal. The tablet is swallowed whole with a glass of water, or dissolved in half a glass of water (minimum 30 ml), stirring thoroughly before use.
    The duration of treatment depends on the severity of the infection and should not exceed 14 days unless absolutely necessary.

    Adults and children over 12 years of age, as well as children under 12 years of age weighing more than 40 kg Flemoklav Solutab® at a dosage of 875 mg/125 mg is prescribed 2 times a day.
    A single dose is taken at regular intervals, ideally every 12 hours.

    In patients with impaired renal function excretion of clavulanic acid and amoxicillin through the kidneys is slowed down. Flemoklav Solutab® at a dose of 875 mg/125 mg can only be used if the glomerular filtration rate is >30 ml/min. In this case, no dose adjustment is required.

    In patients with impaired liver function Flemoklav Solutab® should be administered with caution. Liver function should be constantly monitored.

    Children under 12 years of age weighing up to 40 kg Flemoklav Solutab® is prescribed with lower dosages: 125/31.25 mg; 250/62.5 mg; 500/125 mg.

    Side effect

    Infections:
    bacterial or fungal superinfections (with long-term therapy or repeated courses of therapy).

    From the blood system and hematopoietic organs:
    platelets, hemolytic anemia.
    leukopenia, granulocytopenia, thrombocytopenia, pancytopenia, anemia, increased prothrombin time and bleeding time. These adverse reactions are reversible and disappear after discontinuation of therapy.

    Allergic reactions:
    skin rashes and itching; morbilliform exanthema, appearing 5-11 days after the start of therapy. The appearance of urticaria immediately after starting to take the drug with high degree is likely a manifestation of an allergic reaction and requires discontinuation of the drug.
    bullous or exfoliative dermatitis (erythema multiforme exudative, Stevens-Johnson syndrome, toxic epidermal necrolysis), anaphylactic shock; other allergic reactions- drug fever, eosinophilia, angioedema (Quincke's edema), laryngeal edema, serum sickness, hemolytic anemia, allergic vasculitis, interstitial nephritis.

    From the nervous system:
    dizziness, headache, convulsions (in case of impaired renal function or drug overdose).
    hyperactivity, restlessness (anxiety), insomnia, impaired consciousness, aggressive behavior.

    From the cardiovascular system:
    vasculitis

    Reactions from the digestive system:
    abdominal pain, nausea (more often with overdose), vomiting, flatulence, diarrhea (generally, reactions from the digestive system are transient and rarely pronounced; their intensity can be reduced by taking the drug at the beginning of a meal); pseudomembranous colitis (in the case of severe and persistent diarrhea while taking the drug or within 5 weeks after completion of therapy), in most cases is caused by toxin-producing strains of Clostridium difficile.
    intestinal candidiasis, hemorrhagic colitis, discoloration of the surface layer of tooth enamel.

    From the hepatobiliary system:
    slight increase in liver enzyme activity.
    hepatitis and cholestatic jaundice. Symptoms of liver dysfunction occur during treatment or immediately after stopping therapy, but in some cases they may appear several weeks after stopping the drug; more often observed in men and patients over 60 years of age; observed very rarely in children (< 1/10000). Риск возникновения нежелательных реакций увеличивается при применении препарата более 14 дней. Нарушение функции печени, как правило, обратимые, однако иногда бывают тяжелыми и в очень редких случаях (< 1/10000) (только у пациентов с тяжелыми concomitant diseases or when simultaneous administration potentially hepatotoxic drugs) can be fatal.

    From the genitourinary system:
    itching, burning and vaginal discharge;
    interstitial nephritis.

    Overdose

    Symptoms: nausea, vomiting and diarrhea with possible disturbance of water and electrolyte balance.
    Treatment
    Activated carbon and osmodiuretics are prescribed. It is necessary to maintain water and electrolyte balances. For convulsions, diazepam is prescribed. Other symptoms are treated symptomatically. In case of severe renal failure, hemodialysis should be performed.

    Interaction with other drugs

    Other antimicrobials
    At joint use With some bacteriostatic drugs (for example, chloramphenicol, sulfonamides, etc.), antagonism with amoxicillin/clavulanic acid was observed in vitro.

    Disulfides
    Amoxicillin/clavulanic acid should not be used concomitantly with disulfiram.

    Medicines that inhibit the renal excretion of amoxicillin
    Simultaneous administration of probenecid, phenylbutazone, oxyphenbutazone and, to a lesser extent, acetylsalicylic acid, indomethacin and sulfinpyrazone helps to increase the concentration and longer presence of amoxicillin in the blood plasma and bile. The excretion of clavulanic acid is not impaired.

    Antacids, glucosamine, laxatives, aminoglycosides slow down and reduce absorption; ascorbic acid increases the absorption of amoxicillin.

    Allopurinol
    Prescription of allopurinol and amoxicillin may increase the risk of developing skin rash.

    Sulfasalazine
    Aminopenicillins may decrease serum concentrations of sulfasalazine.

    Methotrexate
    Amoxicillin reduces the renal clearance of methotrexate, which may lead to an increased risk of toxicity. When taken concomitantly with amoxicillin, monitoring of the concentration of methotrexate in the blood serum is necessary.

    Digoxin
    While taking amoxicillin/clavulanic acid, digoxin absorption may be increased.

    Anticoagulants
    When taken simultaneously with indirect anticoagulants, the risk of bleeding may increase.

    Hormonal contraceptives
    In rare cases, while taking amoxicillin, a decrease in the effectiveness of oral contraceptives has been observed, so patients should be advised to use non-hormonal methods of contraception.

    special instructions

    In patients with hypersensitivity to penicillins, anaphylactic reactions may occur (more often if there is a history of hypersensitivity). Treatment with Flemoclav Solutab® in such cases should be stopped immediately and replaced with other appropriate therapy. Treatment of anaphylactic shock may require urgent administration of adrenaline, glucocorticosteroids and elimination of respiratory failure.
    There is a possibility of cross-resistance and hypersensitivity with other penicillins or cephalosporins. As with the use of other broad-spectrum antibiotics, superinfections of fungal (in particular candidiasis) or bacterial origin may occur, especially in patients with chronic diseases and/or impaired immune system function. If superinfection develops, the drug is discontinued and/or corrective treatment is prescribed.
    For patients with severe gastrointestinal disorders accompanied by vomiting and/or diarrhea, the administration of Flemoclav Solutab® is not advisable until the above symptoms are eliminated, since absorption of the drug from the gastrointestinal tract may be impaired.
    The appearance of severe and persistent diarrhea may be associated with the development of pseudomembranous colitis, in which case the drug is discontinued and the necessary treatment is prescribed. In case of development of hemorrhagic colitis, immediate discontinuation of the drug and corrective therapy are also necessary. The use of drugs that weaken intestinal motility in these cases is contraindicated.
    In a single study, prophylactic amoxicillin/clavulanate in women with premature rupture of membranes increased the risk of neonatal necrotizing enterocolitis.
    Flemoklav Solutab® at a dose of 875/125 mg can be prescribed only if the glomerular filtration rate is >30 ml/min.
    In patients with impaired liver function, the amoxicillin/clavulanic acid combination should be administered with caution and under constant medical supervision. Flemoklav Solutab® should not be used for longer than 14 days without assessing liver function. With long-term use of the drug, it is necessary to regularly monitor peripheral blood parameters, kidney and liver function.
    While taking the drug, an increase in prothrombin time is sometimes observed, so in patients receiving anticoagulants in combination with amoxicillin/clavulanic acid, this indicator must be regularly monitored.
    Due to the high concentration of amoxicillin in the urine, it can be deposited on the walls of the urinary catheter, so such patients require periodic catheter changes.
    Forced diuresis accelerates the elimination of amoxicillin and reduces its plasma concentration.
    Non-enzymatic methods for determining urine sugar, as well as the urobilinogen test, can give false positive results.
    If seizures occur during therapy, the drug is discontinued. One dispersible tablet Flemoklav Solutab® 875/125 mg contains 25 mg of potassium.

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