Инфекционный мононуклеоз (в т.ч. при кореподобной сыпи)
Повышенная чувствительность к компонетам препарата, к цефалоспоринам и другим бета-лактамным антибиотикам
С осторожностью назначают препарат пациентам с тяжелой печеночной недостаточностью, заболеваниями ЖКТ (в т.ч. при указании в анамнезе на колит, связанный с применением пенициллинов), с хронической ...
Амоксициллин (в форме тригидрата) 500 мг; клавулановая кислота (в форме калиевой соли) 125 мг; Вспомогательные вещества: кремния диоксид коллоидный, целлюлоза микрокристаллическая, натрия кроскармеллоза, магния стеарат, гипромеллоза, дибутилфталат, тальк очищенный, титана диоксид, изопропанол, метилена хлорид.
Фармакологические свойства
Антибактериальный препарат, представляет собой комбинацию амоксициллина - полусинтетического пенициллина с широким спектром антибактериальной активности и клавулановой кислоты - необратимого ингибитора β-лактамаз (II, III, IV, V типа; в отношении I типа неактивен). Клавулановая кислота образует стойкий инактивированный комплекс с указанными ферментами и предотвращает потерю антибактериальной активности амоксициллина, вызванной продукцией β-лактамаз как основными возбудителями и ко-патогенами, так и условнопатогенными микроорганизмами. Данная комбинация обеспечивает высокую бактерицидную активность Рапиклава.; Препарат обладает широким спектром антибактериального действия. Активен в отношении чувствительных к амоксициллину и продуцирующих β-лактамазы штаммов грамположительные аэробов: Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus viridans, Streptococcus bovis, Staphylococcus aureus (кроме метициллин-резистентных штаммов), Staphylococcus epidermidis (кроме метициллин-резистентных штаммов), Listeria spp., Enteroccocus spp.; грамотрицательных аэробов: Bordetella pertussis, Brucella spp., Campylobacter jejuni, Escherichia coli, Gardnerella vaginalis, Haemophilus influenzae, Haemophilus ducreyi, Klebsiella spp., Moraxella catarrhalis, Neisseria gonorrhoeae, Neisseria meningitidis, Pasteurela multocida, Proteus spp., Salmonella spp., Shigella spp., Vibriocholerae, Yersenia enterocolitica; анаэробов: Peptococcus spp., Peptostreptococcus spp., Clostridium spp., Bacteroides spp., Actinimyces israelli.
Показания к применению
Лечение инфекционно-воспалительных заболеваний, вызванных чувствительными к комбинации препарату возбудителями:
Инфекции ЛОР-органов (острый и хронический синусит, острый и хронический отит, тонзиллит, фарингит)
Инфекции органов дыхания (острые и хронические бронхиты и пневмонии, эмпиема плевры)
Инфекции мочевыводящих путей (в т.ч. циститы, уретриты, пиелонефриты)
Гинекологические инфекции (в т.ч. сальпингит, сальпингоофорит, эндометрит, септический аборт, пельвиоперитонит)
Инфекции костей и суставов (в т.ч. хронический остеомиелит)
Инфекции кожи и мягких тканей (в т.ч. флегмона, раневая инфекция)
Инфекции желчных путей (холецистит, холангит)
Заболевания, передаваемые половым путем (гонорея, шанкроид)
Одонтогенные инфекции
Противопоказания
Инфекционный мононуклеоз (в т.ч. при кореподобной сыпи)
Повышенная чувствительность к компонетам препарата, к цефалоспоринам и другим бета-лактамным антибиотикам
С осторожностью назначают препарат пациентам с тяжелой печеночной недостаточностью, заболеваниями ЖКТ (в т.ч. при указании в анамнезе на колит, связанный с применением пенициллинов), с хронической почечной недостаточностью.
Применение при беременности и в период грудного вскармливания
С осторожностью назначают препарат при беременности и в период лактации (грудного вскармливания).
Способ применения и дозы
Таблетки следует принимать внутрь во время еды, не разжевывая, запивая небольшим количеством воды.; Взрослым и детям старше 12 лет(или с массой тела более 40 кг) средняя доза для лечения инфекций легкой и средней степени тяжести составляет 1 таб. 250 мг/125 мг 3 раза/сут.; При тяжелых инфекциях назначают по 2 таб. 250 мг/125 мг 3 раза/сут или по 1 таб. 500 мг/125 мг 3 раза/сут.; Максимальная суточная доза клавулановой кислоты (в форме калиевой соли) составляет для взрослых - 600 мг и для детей - 10 мг/кг массы тела.; Максимальная суточная доза амоксициллина составляет для взрослых - 6 г и для детей - 45 мг/кг массы тела.; Курс лечения составляет 5-14 дней и устанавливается индивидуально в зависимости от клинической ситуации. Препарат нельзя принимать более 14 дней без повторного медицинского осмотра.; При одонтогенных инфекциях препарат назначают по 1 таб. 500 мг/125 мг каждые 12 ч в течение 5 дней.; При почечной недостаточности и КК 10-30 мл/мин препарат назначают по 1 таб. 500 мг/125 мг каждые 12 ч, при КК менее 10 мл/мин - по 1 таб. 500 мг/125 мг каждые 24 ч.; При анурии интервал между приемом препарата следует увеличить до 48 ч и более.
Побочное действие
Со стороны пищеварительной системы: тошнота, рвота, диарея, нарушение функции печени, повышение активности печеночных трансаминаз; в единичных случаях - холестатическая желтуха, гепатит, псевдомембранозный колит.; Аллергические реакции: крапивница, эритематозные высыпания; редко – многоформная эритема, анафилактический шок, отек Квинке, синдром Стивенса-Джонсона; крайне редко - эксфолиативный дерматит.; Местные реакции: в отдельных случаях - флебит в месте в/в введения.; Прочие: кандидоз, развитие суперинфекции, обратимое увеличение протромбинового времени.
Передозировка
Симптомы: нарушение функции ЖКТ и водно-электролитного баланса.; Лечение: при необходимости проводят симптоматическую терапию. Гемодиализ эффективен.
Особые указания
При курсовом лечении необходимо проводить контроль показателей состояния системы кроветворения, функции печени и почек.; С целью снижения риска развития побочных эффектов со стороны ЖКТ препарат следует принимать во время еды.; Возможно развитие суперинфекции за счет роста нечувствительной к препарату микрофлоры, что требует соответствующего изменения антибактериальной терапии.; При назначении препарата пациентам с сепсисом возможно развитие реакции бактериолиза (реакция Яриша-Гейксгеймера).; У пациентов, имеющих повышенную чувствительность к пенициллинам, возможны перекрестные аллергические реакции с цефалоспориновыми антибиотиками.; Прием Рапиклава приводит к появлению амоксициллина в моче. Высокие концентрации амоксициллина дают ложно-положительную реакцию на глюкозу мочи при использовании реактива Бенедикта или раствора Феллинга. Рекомендуется проводить ферментативные реакции с глюкозооксидазой.
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