Flemoklav solutab for kidney inflammation. Flemoklav Solutab: a well-known antibiotic in a unique form

Astellas Pharma Europe B.V. Astellas Pharma Europe B.V. / Ortat ZAO Yamanouchi 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

Forms of issue

  • 4 - blisters (5) - packs of cardboard 4 - blisters (5) - packs of cardboard. 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 with brown dotted spots, without risks, with the marking "424" and the company logo.

pharmachologic effect

Broad-spectrum antibiotic; a combined preparation of amoxicillin and clavulanic acid - a beta-lactamase inhibitor. Active against gram-positive and gram-negative microorganisms (including strains producing beta-lactamases). Amoxicillin acts bactericidal, inhibits the synthesis of peptidoglycan of the bacterial cell wall. Clavulanic acid inhibits beta-lactamases II, III, IV and V types). 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. Flemoklav 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 meningitrax cat. 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 rapidly 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 within 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) Cmax of amoxicillin in blood plasma is 12 μg / ml. Distribution After a single dose of 875 mg / 125 mg (amoxicillin / clavulanic acid), the AUC of amoxicillin is 33 μg? h / l. Serum protein binding is approximately 17-20%. Amoxicillin crosses the placental barrier and is excreted in breast milk in small amounts. 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 within 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 (CC within 10-30 ml / min) T1 / 2 is 6 hours, and in case of anuria it ranges between 10 and 15 hours. It is excreted during hemodialysis. Clavulanic acid Absorption After oral administration, it is rapidly absorbed from the gastrointestinal tract. The absolute bioavailability is approximately 60%. Concomitant food intake does not affect absorption. Cmax in blood plasma is reached 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) Cmax of clavulanic acid in blood plasma is 3 μg / ml. Distribution After a single dose of 875 mg / 125 mg (amoxicillin / clavulanic acid), the AUC of clavulanic acid is 6 μg? h / l. Serum protein binding is 22%. Clavulanic acid crosses the placental barrier. There are no reliable data on excretion in breast milk. Metabolism Clavulanic acid is extensively metabolized by 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 (CC from 20 to 70 ml / min) T1 / 2 is 2.6 hours, and with anuria it fluctuates within 3-4 hours. It is excreted during hemodialysis.

Special conditions

When taking Flemoklav Solutab®, there is a possibility of cross-resistance and hypersensitivity with other penicillins or cephalosporins. If anaphylactic reactions develop, the drug should be discontinued immediately and appropriate therapy should be carried out: for treatment anaphylactic shock may require urgent administration of epinephrine (adrenaline), glucocorticosteroids and elimination respiratory failure... Superinfection (eg, candidiasis) may develop, especially in patients with chronic diseases and / or functional impairment immune system... In case of superinfection, the drug should be canceled and / or changed accordingly. antibiotic therapy... Patients with severe gastrointestinal disorders accompanied by vomiting and / or diarrhea, the appointment of Flemoklav Solutab® is inappropriate until the above symptoms are eliminated, because a violation of the absorption of the drug from the gastrointestinal tract is possible. 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 withdrawal of the drug and corrective therapy are also necessary. The use of drugs that weaken intestinal motility in these cases is contraindicated. In case of impaired liver function, the drug should be prescribed with caution and under constant medical supervision. Do not use the drug for more than 14 days without assessing liver function. In a single study, prophylactic use of amoxicillin / clavulanate in women with premature rupture of membranes increased the risk of necrotizing enterocolitis in newborns. While taking the drug, there may be an increase in prothrombin time. Therefore, Flemoklav Solutab® should be prescribed with caution to patients receiving anticoagulant therapy (it is necessary to monitor blood clotting indicators). In connection with high concentration amoxicillin in urine, it can deposit on the walls urinary catheter therefore, these patients require periodic catheter changes. Forced diuresis accelerates the excretion of amoxicillin and reduces its concentration in plasma. During the period of application of Flemoklav Solutab®, non-enzymatic methods for determining glucose in urine, as well as a test for urobilinogen, can give false positive results... At course treatment it is necessary to monitor the functions of the hematopoietic organs, liver and kidneys. In case of seizures during therapy, the drug is canceled. It should be borne in mind 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 Clavulanate potassium 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, sugar 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 divisions 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 875 mg / 125 mg tablets); - 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) when taking amoxicillin / clavulanic acid in history; - 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 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 side of 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, anxiety, anxiety, insomnia, impaired consciousness, aggressive behavior... From the side of cardio-vascular system: rarely - vasculitis. From the side digestive system: often - abdominal pain, nausea (more often with an overdose), vomiting, flatulence, diarrhea (mainly, reactions from the digestive system are transient and rarely severe; 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 the end 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

With simultaneous use with some bacteriostatic drugs (for example, chloramphenicol, sulfonamides), antagonism with amoxicillin / clavulanic acid was observed in vitro. Amoxicillin / clavulanic acid should not be administered concomitantly with disulfiram. The simultaneous administration 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 a longer stay of amoxicillin in the blood plasma and bile. The excretion of clavulanic acid is not impaired. With simultaneous use with Flemoklav Solutab® antacids, glucosamine, laxatives, aminoglycosides slow down and reduce the absorption of amoxicillin, vitamin C increases the absorption of amoxicillin. The simultaneous use of Flemoklav Solutab® with allopurinol may increase the risk of developing skin rashes.

Overdose

Symptoms: nausea, vomiting, diarrhea with possible imbalance 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 seizures, diazepam is prescribed.

Storage conditions

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

This drug belongs to broad-spectrum antibiotics. Widespread in medical practice... Loved by doctors and parents for the quick and effective treatment various diseases. Flemoklav Solutab contains amoxicillin and clavulanic acid. This medicine is available in the form of dispersible tablets with a dosage 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, secondarily infected dermatoses, abscesses);
  • joints and bones (including osteomyelitis);
  • postoperative.

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

This is especially important to remember when an appointment is made to a child.

Application

Tablets of the medicine Flemoklav Solutab are taken immediately before meals, without chewing (whole) and drinking a whole glass of water. For children, the drug is better and easier to give in the form of a suspension. For this, the instructions for use recommend that the dispersible tablets be thoroughly dissolved in water (0.5 cups).

The dosage of Flemoklav Solutab for children under 3 months of age is 20 mg for each unit of the child's weight per day (should be divided into 2 doses). A child from 3 months to 2 years old - 25 mg for each unit of weight per day (also for 2 doses).

Children aged 2 to 7 years, weighing 13-25 kg, need to take 125 mg one time (two or three times a day). From 7 to 12 years old (weight 25-37 kg) - 1 tablet 250 mg (or 2 x 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 a severe form of the disease, an increase in the dose is possible - 1 tablet of 500 mg (2 tablets of 250 or 4 tablets of 125) three times a day.

How to prepare a suspension

Let's calculate the dosage of the suspension for a child of 2 months, weighing about 5 kg. This will require 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 per unit of weight, then 20 5 = 100.

Therefore, 100 ml of the resulting Flemoklav Solutab solution must be divided into 2 doses (50 ml each) and given to the baby at regular intervals. Use a bottle and a teat with a large opening for this.

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

Special cases

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

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

Patients who have problems with the functioning of the liver, it is strictly necessary to monitor its functions. Consequently, strict medical supervision is also carried out.

Contraindications

Instructions for use include Flemoklav Solutab as contraindications:

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

With extreme caution, Flemoklav Solutab is prescribed to children with diseases gastrointestinal tract.

Parents need to remember that a developing child's body requires an attentive attitude towards itself.

Side effect

When using a medical product with a dosage of 125 or 250 mg in a child's body, such negative manifestations as:

  • skin allergy- urticaria, erythematous rash, 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 consult about the advisability of further use of the medication.

Overdose

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

To eliminate such symptoms, children are shown urgent gastric lavage and the subsequent intake of sorbent preparations (activated carbon).

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

Drug substitutes

On the domestic market of medical preparations, analogues of the medicine Flemoklav Solutab are known : Amoxiclav 2X, Amoxil - K 625, Amoxiclav Kviktab, Augmentin (BD), Augmentin (SR), Baktolkav, Klavam, Klavamitin, Medoklav, Panklav, Rapiklav, Rekut, Trifamox IBL.

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

Which one of the listed drugs suitable for a child of different ages, and what dosage will be required is determined only by the attending physician.

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

Health Assistant

Long gone are the days when the use of antibiotics was given overwhelming importance. Modern pharmacology boast the latest developments in the field of similar medicines.

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

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

And then they will only be beneficial, 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: Clostridium 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 depends on the dose and varies up to approximately 94%. Bioavailability when used in the dose range of 250-750 mg is directly proportional to the dose. When the dose is increased, the degree of absorption decreases. Absorption is independent of food intake. The maximum concentration in blood plasma is reached within 1-2 hours after administration. After a single dose of 500/125 mg of amoxicillin / clavulanic acid, the average concentration of amoxicillin after 8 hours is 0.3 mg / l. The volume of distribution is 0.3-0.4 l / kg of body weight, the degree of binding to blood 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 of blood serum in patients with impaired renal function is about 1 hour (0.9-1.2 hours), and with anuria - 10-15 hours. It is excreted during 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 reached approximately 1-2 hours after ingestion. 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 of body weight, binding to blood plasma proteins is approximately 22%. Clavulanic acid crosses the placental barrier. Penetration into breast milk not marked. 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 excreted during hemodialysis.
Therapeutic concentrations of both substances are achieved in gallbladder, organ tissues abdominal cavity, skin, subcutaneous adipose tissue and muscle tissue, as well as in synovial and peritoneal fluids, bile and pus.

Indications for the use of the drug Flemoklav Solutab

Upper and lower respiratory tract infections (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.

Application 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 revising 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 (weighing 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 frequency of administration 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 frequency of administration 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 excretion 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 rate glomerular filtration 30 ml / min, while there is no need for dose adjustment.
In patients with impaired liver function, the combination of amoxicillin / clavulanic acid is prescribed with caution when conducting 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); development of jaundice or liver dysfunction after taking amoxicillin or clavulanic acid in history; children weighing up to 13 kg (due to the complexity of accurate dosing). In patients with mononucleosis or lymphocytic leukemia, the risk of developing a rash is increased, therefore, for these diseases, the combination of amoxicillin / clavulanic acid is not prescribed.
In patients with infectious mononucleosis or lymphocytic leukemia, the risk of exanthema increases, therefore, in these diseases, the combination of amoxicillin / clavulanic acid is not recommended.

Side effects of the drug Flemoklav Solutab

They rarely develop and are usually mild and transient.
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 digestive tract: nausea, vomiting, diarrhea, liver dysfunction (increased activity of transaminases, alkaline phosphatase and serum bilirubin levels), which are more often observed in men and people over the age of 65 (it develops extremely rarely in children).
The risk of developing side effects increases with the use of 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 the drug is discontinued. Side effects from the gastrointestinal tract are usually transient and minor, but sometimes severe.
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 side: rash.
Rarely
On the part of 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 side of the psyche: 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 need to adjust the dosage regimen. 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 can develop, especially in patients with chronic diseases and / or dysfunction of the immune system.
With persistent diarrhea, possible pseudomembranous and hemorrhagic colitis, appropriate measures should be taken. The use of antiperistaltic drugs is contraindicated.
In patients with impaired renal function, the dose of the drug should be selected taking into account the severity of the condition.
In patients with impaired liver function, the combination of amoxicillin / clavulanic acid should be prescribed with caution and under constant medical supervision. Flemoklav 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 used with caution in patients receiving anticoagulants.
It is necessary to take into account the possibility of developing fungal or bacterial superinfection during therapy. With the development of superinfection, the drug is discontinued and appropriate therapy is prescribed.
Due to the high concentration of amoxicillin in the urine, it can settle on the walls of the urinary catheter, therefore, such patients need to change the catheter in a timely manner.
Forced diuresis accelerates the elimination of amoxicillin and reduces its serum concentration.
Non-enzymatic blood glucose tests as well as the urobilinogen test can give false positive results.
In case of seizures during therapy, the drug is discontinued. One dispersed tablet Flemoklav Solutab 875/125 mg contains 25 mg of potassium.
During pregnancy and breastfeeding. When using a combination of amoxicillin / clavulanic acid during pregnancy, it was not noted negative influence on the fetus and newborn.
In a single study, prophylactic use of amoxicillin / clavulanic acid combination in women with premature rupture of membranes increased the risk of necrotizing enterocolitis in the newborn. Application in the II and III trimester of pregnancy is possible after a doctor evaluates the benefit / risk ratio of treatment. During the first trimester of pregnancy, the appointment of a 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 baby has diarrhea or a fungal infection of the mucous membranes, breastfeeding should 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 administered concurrently 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 stay 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. With simultaneous use with anticoagulants, medical supervision of the patient is necessary, since this increases the prothrombin time.

Overdose of the drug Flemoklav Solutab, symptoms and treatment

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

Storage conditions of the drug Flemoklav solutab

At a temperature of 15-25 ° C.

List of pharmacies where you can buy Flemoklav Solutab:

  • Saint Petersburg

A common drug prescribed by specialists for many infectious and inflammatory diseases bacterial etiology, is Flemoklav Solutab. When is the medicine prescribed and how is it taken? Can be used by pregnant and lactating mothers? How to use Flemoklav correctly?

Composition of the drug, pharmacological group and properties

The antibiotic is based on amoxicillin trihydrate. Another active ingredient in the drug is the so-called clavulanic acid. Contained in the drug and auxiliary components, such as apricot flavor, crospovidone, microcrystalline cellulose, vanillin, saccharin and magnesium stearate.

The medicine belongs to the group antibacterial drugs that have a wide range of effects. This drug is an antibiotic penicillin(a 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 is reduced, as the microorganisms begin to die. Especially quickly, the antibiotic kills and.The drug is mainly excreted in the urine. It has the ability to pass into breast milk.

Flemoklav is produced 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 content of amoxicillin in them - 500, 250 or 125 mg each. They are placed in blisters of five. Four cell packages are placed in a cardboard box.Flemoklav is also available in tablets that contain 875 mg of amoxicillin. They are packaged in cell packs of seven or five pieces.

It is recommended to store the medicine out of the reach of children. The drug should not be exposed to direct sunlight. The optimum temperature for storing an antibiotic is no more than twenty-five degrees.The tablets are usable for three years from the date of manufacture. During this period, brown spots or marbling may appear on the tablets.In pharmaceutical institutions, the drug is dispensed over the counter.

When an antibiotic is prescribed

Flemoklav Solutab is usually prescribed for otolaryngological diseases, infections of the skin and soft tissues. Therapists prescribe medication 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:

  • Acute or chronic bronchitis.
  • Lung abscesses.
  • Empyema of the pleura.
  • Pneumonia.
  • Obstructive pulmonary disease.

In otolaryngology, Flemoklav is used to treat such pathologies:

  • Rhinitis is acute
  • Sphenoiditis
  • Nasopharyngitis

The use of an antibiotic is possible for diseases that affect soft tissue 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, and infectious complications after surgery.

Drug dosage and application features

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

The official instructions for taking the drug indicate the following doses: for children from twelve years old and for 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).With a severe form of the disease, relapses, the dose may be increased.

A child whose weight is up to forty kilograms is prescribed an antibiotic in a lower dosage:

  • At the age from 3 months to two years with a body weight of up to 12 kg - 125 / 31.25 mg twice a day
  • Up to seven years of age, 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 the drug per 1 kilogram of weight. By calculating daily dose antibiotic, it is divided into three doses.

The duration of treatment with Flemoklav depends on the severity of the disease, but should be no more than two weeks.

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

Special instructions for taking an antibiotic are:

  • The use of Flemoklav every 8 or twelve hours, depending on the daily amount of antibiotic intake.
  • The drug must be taken at least three days after the symptoms of the disease disappear.
  • With prolonged use of the drug, it is necessary to monitor the functioning of the kidneys, liver, as well as the properties of the blood.
  • For a patient with a history of renal failure, the dosage should be adjusted. It depends on creatinine clearance - with an indicator of ten to thirty milliliters per minute, a dose of 500 mg is prescribed twice a day. If the creatinine clearance is less than ten milliliters, then this dose is taken once a day.
  • When using the drug by patients operating mechanisms, it is better to temporarily stop working.
  • The condition of patients with catheters for urine removal requires medical supervision. This is due to the fact that since amoxicillin is excreted mainly 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, Lactovit, Bifidumbacterin, Yogurt and others.

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

Use for the treatment of pregnant women and with hepatitis B


When using Flemoklav Solutaba for the treatment of pregnant women negative impact the fetus was not observed. However, it is important to remember that in the first three months, when the fetus is forming, the use of drugs 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, before prescribing Flemoklav, takes into account the risks and benefits of an antibiotic during pregnancy.

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 occurs adverse reactions, breastfeeding should be temporarily stopped.

Contraindications and side effects

There are some restrictions on the use of Flemoklav. It is not allowed to use pills for patients who have a history of the following pathologies:

  • Lymphocytic leukemia.
  • Mononucleosis of infectious etiology.
  • Renal failure
  • Tablets are contraindicated in patients who, after taking amoxicillin, disrupt liver function, and also have jaundice.
  • Do not give an antibiotic to children who weigh less than forty kilograms.
  • A contraindication is also an individual intolerance to the components of the drug, hypersensitivity to antibiotics of the penicillin and cephalosporin series.

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

Usually the antibiotic is well tolerated by patients. However, the development of undesirable reactions is still possible. The most frequent side effects are:

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

Among allergic reactions, measles-like exanthema, urticaria, dermatitis (exfoliative and bullous), Stevens-Johnson syndrome, eosinophilia, hemolytic anemia, angioedema, allergic vasculitis are possible. In the event of anaphylactic shock and untimely assistance, it can be fatal.

Useful video - Antibiotics for flu and colds:

In rare cases, other side effects may also 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 genital organs, the appearance of discharge, interstitial nephritis.

When these adverse reactions appear, treatment with Flemoklav should be discontinued. It is necessary to contact a specialist who will prescribe symptomatic treatment to eliminate adverse reactions, prescribe medications or an antibiotic suitable for the patient group.

Overdose and actions with it

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

The first action in case of an overdose should be gastric lavage. To eliminate the symptoms of an overdose, the patient needs to drink activated charcoal or osmodiuretics and enterosorbents. 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 has convulsions, then they are eliminated with the help of Diazepam. In case of severe renal impairment, hemodialysis is performed.

To prevent cases of overdose, you should not independently determine the dose of the medicine for yourself, it is better to entrust this to a specialist. It is imperative that all prescriptions of the doctor and the recommended dose of the antibiotic be observed.

Analogs of Flemoklav Solutaba
  • Rapiklav
  • Trifamox
  • Teraclav
  • Amoklan
  • Clavocin
  • Moxiclav
  • Ranclave
  • Clavunath

    • These drugs belong to the penicillin group of antibacterial agents. In their composition, they contain, like Flemoklav Solutab, amoxicillin and clavulanic acid, therefore, they have a destructive effect on various pathogenic organisms. The indications for the use of the drug are also identical.

    The advantage of these analogs 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 cheaper drugs can be purchased in pharmacies that can replace Flemoklav, however, when choosing them, you should be guided by the composition of the antibiotic - it is still better to take a medicine where both active ingredients are combined - ampicillin and clavulanic acid.If antibiotics of the penicillin series are not suitable for the patient, then drugs of the macrolide or cephalosporin group are prescribed.

    Registration number: LSR-000392 / 09-300315
    Tradename: Flemoklav Solutab®
    INN or grouping 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 (as potassium clavulanate) 125 mg
    Excipients: dispersed cellulose, microcrystalline cellulose, crospovidone, vanillin, tangerine flavor, lemon flavor, saccharin, magnesium stearate.

    Description
    Dispersible tablets oblong form from white to yellowish, without risks, having the marking "GBR 425" and the 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 combined preparation of amoxicillin and clavulanic acid - a beta-lactamase inhibitor.
    Amoxicillin acts bactericidal, inhibits the synthesis of peptidoglycan of the bacterial cell wall. It is 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, inhibits types II, III, IV and V of beta-lactamases, 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.

    Spectrum of activity
    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 meningisard. 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 PFC (area under the pharmacokinetic curve) of amoxicillin and clavulanic acid is 33 μg h / l and 6 μg h / l, respectively. Absorption of amoxicillin after oral administration reaches 90%, the absolute bioavailability of clavulanic acid averages 60%.
    Approximately 17-20% of amoxicillin and 22% of clavulanic acid binds to blood plasma proteins. The total clearance for 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 mainly 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 is extensively metabolized by 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 cellulite);
    - 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 ≤ 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 was no adverse effect of amoxicillin / clavulanate on the fetus and newborns when used by pregnant women. Application in the II and III trimesters of pregnancy is possible after a medical assessment of the risk / benefit of treatment. In the first trimester, the use of the drug should be avoided.
    Both components of the drug penetrate the blood-placental barrier and are excreted into breast milk. It is possible to use the drug during breastfeeding.
    If the child develops sensitization, diarrhea or candidiasis of the mucous membranes, breastfeeding should be stopped.

    Method of administration and dosage

    To prevent dyspeptic symptoms, Flemoklav 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 (at least 30 ml), stirring thoroughly before use.
    The duration of treatment depends on the severity of the infection and should not, unnecessarily, exceed 14 days.

    Adults and children over 12 years old, as well as children under 12 years old with a body weight of 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 at a glomerular filtration rate> 30 ml / min. In this case, dose adjustment is not required.

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

    Children under 12 years old weighing up to 40 kg appoint Flemoklav Solutab® 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).

    On the part of 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; measles-like exanthema, appearing 5-11 days after the start of therapy. The appearance of urticaria immediately after the start of taking the drug with high degree the likelihood is a manifestation of an allergic reaction and requires discontinuation of the drug.
    bullous or exfoliative dermatitis (erythema multiforme, 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, anxiety (anxiety), insomnia, impaired consciousness, aggressive behavior.

    On the part of the cardiovascular system:
    vasculitis.

    Digestive system reactions:
    abdominal pain, nausea (more often with an overdose), vomiting, flatulence, diarrhea (mainly, reactions from the digestive system are transient and rarely severe; 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 the end 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:
    a slight increase in the activity of liver enzymes.
    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 old; are very rare 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 at simultaneous reception 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 disruption of water and electrolyte balance.
    Treatment
    Activated charcoal and osmodiuretics are prescribed. It is necessary to maintain water and electrolyte balances... For seizures, diazepam is prescribed. Other symptoms are treated symptomatically. In severe renal failure, hemodialysis should be performed.

    Interaction with other medicinal products

    Other antimicrobial drugs
    At joint application 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
    The simultaneous administration of probenecid, phenylbutazone, oxyphenbutazone and, to a lesser extent, acetylsalicylic acid, indomethacin and sulfinpyrazone increases the concentration and a longer stay 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; vitamin C increases the absorption of amoxicillin.

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

    Sulfasalazine
    Aminopenicillins can reduce the serum sulfasalazine concentration.

    Methotrexate
    Amoxicillin reduces the renal clearance of methotrexate, which may increase the risk of its toxic effect. When taken simultaneously with amoxicillin, it is necessary to monitor the concentration of methotrexate in the blood serum.

    Digoxin
    While taking amoxicillin / clavulanic acid, an increase in the absorption of digoxin is possible.

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

    Hormonal contraceptives
    In rare cases, while taking amoxicillin, there was a decrease in the effectiveness of oral contraceptives, therefore, 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 Flemoklav Solutab® in such cases should be stopped immediately and replaced with another suitable therapy. For the treatment of anaphylactic shock, urgent administration of adrenaline, glucocorticosteroids and the elimination of respiratory failure may be required.
    Possibility of cross-resistance and hypersensitivity with other penicillins or cephalosporins exists. As with the use of other broad-spectrum antibiotics, superinfections of fungal (in particular, candidiasis) or bacterial genesis may occur, especially in patients with chronic diseases and / or dysfunction of the immune system. 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 appointment of Flemoklav Solutab® is inappropriate until the above symptoms are eliminated, since the 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 withdrawal 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 use of amoxicillin / clavulanate in women with premature rupture of membranes increased the risk of necrotizing enterocolitis in newborns.
    Flemoklav Solutab® at a dose of 875/125 mg can be prescribed only at a glomerular filtration rate> 30 ml / min.
    In patients with impaired liver function, the combination of amoxicillin / clavulanic acid should be prescribed with caution and under constant medical supervision. Flemoklav Solutab® should not be used for more than 14 days without liver function assessment. With prolonged use of the drug, it is necessary to regularly monitor the parameters of peripheral blood, kidney and liver function.
    While taking the drug, there is sometimes an increase in prothrombin time, therefore, in patients receiving anticoagulants in combination with amoxicillin / clavulanic acid, this indicator should be regularly monitored.
    Due to the high concentration of amoxicillin in the urine, it can be deposited on the walls of the urinary catheter, therefore, such patients need periodic replacement of catheters.
    Forced diuresis accelerates the elimination of amoxicillin and decreases its plasma concentration.
    Non-enzymatic methods for determining urine sugar, as well as a test for urobilinogen, can give false positive results.
    In case of seizures during therapy, the drug is canceled. One dispersible tablet Flemoklav Solutab® 875/125 mg contains 25 mg of potassium.

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