Флемоклав Солютаб Таблетки, 20 шт, 500+125 мг, для приготовления раствора, диспергируемые

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Амоксициллин действует бактерицидно, угнетает синтез пептидогликана клеточной стенки бактерий. Активен в отношении грамположительных и грамотрицательных микроорганизмов (включая штаммы, продуцирующие многие плазмидные и некоторые хромосомные β-лактамазы). Входящая в состав препарата клавулановая кислота ингибирует β-лактамазы II, III, IV и V типов, не активна в отношении β-лактамаз типа I, продуцируемых Enterobacter spp., Pseudomonas aeruginosa, Serratia spp., Acinetobacter spp. Клавулановая кислота обладает высокой тропностью к пенициллиназам, благодаря чему образует стабильный комплекс с ферментом, что предупреждает ферментативную деградацию амоксициллина под влиянием β-лактамаз и расширяет спектр его действия. 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Применение препарата во II и III триместрах беременности возможно после врачебной оценки риска/пользы. В I триместре беременности применения Флемоклава Солютаб следует избегать (только для таблеток диспергируемых 875 мг/125 мг). Таблетки диспергируемые 125 мг/31.25 мг, 250 мг/62.5 мг, 500 мг/125 мг в I триместре беременности должны назначаться с осторожностью. Амоксициллин и клавулановая кислота проникают через гемато-плацентарный барьер и выделяются с грудным молоком. Возможно применение препарата в период грудного вскармливания. В случае развития у ребенка сенсибилизации, диареи или кандидоза слизистых оболочек кормление грудью следует прекратить."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Для предотвращения появления побочных эффектов со стороны пищеварительной системы препарат рекомендуется принимать в начале приема пищи. Таблетку проглатывают целиком, запивая стаканом воды, или растворяют ее в половине стакана воды (минимум 30 мл), тщательно размешивая перед употреблением. Продолжительность лечения зависит от тяжести инфекции и без необходимости не должна превышать 14 дней. Взрослым и детям с массой тела более 40 кг препарат назначают по 500/125 мг 3 раза/сут. При тяжелых, хронических, рецидивирующих инфекциях эту дозу можно удвоить. Для детей с массой тела до 40 кг суточная доза обычно составляет 20-30 мг амоксициллина и 5-7.5 мг клавулановой кислоты на кг массы тела. При тяжелых инфекциях эти дозы можно удваивать (максимальная суточная доза составляет 60 мг амоксициллина и 15 мг клавулановой кислоты на кг массы тела)."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Инфекции: Не часто (≥ 1/1000, меньше 1/100): бактериальные или грибковые суперинфекции (при длительной терапии или повторных курсах терапии). Со стороны системы крови и органов кроветворения: Редко (≥ 1/10000, меньше 1/1000): тромбоцитоз, гемолитическая анемия. Очень редко (меньше 1/10000): лейкопения, гранулоцитопения, тромбоцитопения, панцитопения, анемия, увеличение протромбинового времени и времени кровотечения. Эти нежелательные реакции обратимы и исчезают после прекращения терапии. Аллергические реакции: Часто (≥ 1/100, меньше 1/10): кожные высыпания и зуд; кореподобная экзантема, появляющаяся на 5-11 день после начала терапии. Появление крапивницы сразу после начала приема препарата с высокой степенью вероятности является проявлением аллергической реакции и требует отмены препарата Редко (≥1/10000. меньше 1/1000); буллезный или эксфолиативный дерматит (мультиформная экссудативная эритема, синдром Стивенса-Джонсона, токсический эпидермальный некролиз), анафилактический шок; другие аллергические реакции – лекарственная лихорадка, эозинофилия, ангионевротический отек (отек Квинке), отек гортани, сывороточная болезнь, гемолитическая анемия, аллергический васкулит, интерстициальный нефрит. Со стороны нервной системы: Редко (≥1/10000, меньше 1/1000): головокружение, головная боль, судороги (в случая нарушения функции почек или передозировки препарата). Очень редко (меньше 1/10000): гиперактивность, беспокойство (тревога), бессонница, нарушение сознания, агрессивное поведение. Со стороны сердечно-сосудистой системы: Редко (≥1/10000, меньше 1/1000): васкулит. Реакции со стороны пищеварительной системы: Часто (≥1/100. меньше 1/10): боль в животе, тошнота (чаще при передозировке), рвота, метеоризм, диарея (в основном, реакции со стороны системы пищеварения носят преходящий характер и редко бывают выраженными; интенсивность их можно уменьшить, принимая препарат в начале приема пищи); псевдомембранозный колит (в случае тяжелой и стойкой диареи на фоне приема препарата или в течение 5 недель после завершения терапии), в большинстве случаев вызывается токсшшродуцирующими штаммами Clostridium difficile. Редко (≥1/10000, меньше 1/1000): кандидоз кишечника, геморрагический колит, дисколорация поверхностного слоя зубной эмали. Со стороны гепатобилиарной системы: Часто (≥1/100. меньше 1/10): незначительное повышение активности печеночных ферментов. Редко (≥1/10000, меньше 1/1000): гепатит и холестатическая желтуха. Симптомы нарушения функции печени возникают во время лечения или сразу после прекращения терапии, однако в некоторых случаях они могут проявляться через несколько недель после прекращения приема препарата; чаще наблюдаются у мужчин и пациентов старше 60 лет; у детей наблюдаются очень редко (меньше 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 (меньше 1/10000) (только у пациентов с тяжелыми сопутствующими заболеваниями или при одновременном приеме потенциально гепатотоксичных препаратов) могут привести к летальному исходу. Со стороны мочеполовой системы: Не часто (≥ 1/1000, меньше 1/100): зуд, жжение и выделения из влагалища; Редко (≥1/10000. меньше 1/1000): интерстициальный нефрит."}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Симптомы: тошнота, рвота, диарея с возможными нарушениями водного и электролитного баланса. Лечение: назначают активированный уголь и осмодиуретики, необходимо поддерживать водный и электролитный баланс, проводят симптоматическую терапию. При судорогах назначают диазепам. При почечной недостаточности тяжелой степени проводят гемодиализ."}}]},{"id":9,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"При приеме Флемоклава Солютаб существует возможность перекрестной устойчивости и повышенной чувствительности с другими пенициллинами или цефалоспоринами. В случае развития анафилактических реакций прием препарата следует немедленно прекратить и провести соответствующую терапию: для лечения анафилактического шока может потребоваться срочное введение эпинефрина (адреналина), ГКС и устранение дыхательной недостаточности. Возможно развитие суперинфекции (например, кандидоза), особенно у пациентов с хроническими заболеваниями и/или нарушениями функции иммунной системы. В случае возникновения суперинфекции прием препарата отменяют и/или соответствующим образом изменяют антибактериальную терапию. Пациентам с тяжелыми желудочно-кишечными расстройствами, сопровождающимися рвотой и/или диареей, назначение Флемоклава Солютаб нецелесообразно до тех пор, пока не будут устранены вышеуказанные симптомы, т.к. возможно нарушение абсорбции препарата из ЖКТ. Появление тяжелой и стойкой диареи может быть связано с развитием псевдомембранозного колита, в этом случае препарат отменяют и назначают необходимое лечение. В случае развития геморрагического колита также необходима немедленная отмена препарата и корригирующая терапия. Применение препаратов, ослабляющих перистальтику кишечника в этих случаях противопоказано. При нарушении функции печени препарат следует назначать с осторожностью и под постоянным медицинским наблюдением. Не следует применять препарат более 14 дней без оценки функции печени. В единичном исследовании профилактический прием амоксициллина/клавуланата у женщин с преждевременным разрывом плодных оболочек повышал риск развития некротизирующего энтероколита у новорожденных. На фоне приема препарата может отмечаться увеличение протромбинового времени. Поэтому Флемоклав Солютаб следует назначать с осторожностью пациентам, получающим терапию антикоагулянтами (необходимо следить за показателями свертываемости крови). В связи с высокой концентрацией амоксициллина в моче, он может осаждаться на стенках мочевого катетера, поэтому таким пациентам необходима периодическая смена катетеров. Форсированный диурез ускоряет выведение амоксициллина и уменьшает его концентрацию в плазме. В период применения Флемоклава Солютаб неферментные методы определения глюкозы в моче, а также тест на уробилиноген могут давать ложноположительные результаты. При курсовом лечении необходимо контролировать функции органов кроветворения, печени и почек. В случае появления судорог на фоне терапии препарат отменяют. Следует учитывать, что в 1 таблетке диспергируемой 875 мг/125 мг содержится 25 мг калия."}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"Антибиотик широкого спектра действия; комбинированный препарат амоксициллина и клавулановой кислоты - ингибитора β-лактамаз. Амоксициллин действует бактерицидно, угнетает синтез пептидогликана клеточной стенки бактерий. Активен в отношении грамположительных и грамотрицательных микроорганизмов (включая штаммы, продуцирующие многие плазмидные и некоторые хромосомные β-лактамазы). Входящая в состав препарата клавулановая кислота ингибирует β-лактамазы II, III, IV и V типов, не активна в отношении β-лактамаз типа I, продуцируемых Enterobacter spp., Pseudomonas aeruginosa, Serratia spp., Acinetobacter spp. Клавулановая кислота обладает высокой тропностью к пенициллиназам, благодаря чему образует стабильный комплекс с ферментом, что предупреждает ферментативную деградацию амоксициллина под влиянием β-лактамаз и расширяет спектр его действия. 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