Ampicillin trihydrate - instructions for use, dose, side effects, contraindications

active substance: ampicillin trihydrate (in terms of ampicillin) - 250.0 mg, Excipients: potato starch, talcum, magnesium stearate, povidone (low molecular weight polyvinylpyrrolidone 12600 + 2700).

Description:Tablets of white color, biconvex form with a risk.

Pharmacotherapeutic group:Antibiotic, penicillin semisynthetic

ATX: & nbsp

J.01.C.A Penicillins of a wide spectrum of action

J.01.C.A.01 Ampicillin

Pharmacodynamics:

Semisynthetic penicillin, a broad spectrum of action, bactericidin. Acid-resistant. Suppresses the synthesis of the bacterial cell wall.

It is active against Gram-positive (alpha and beta-hemolytic streptococci, Streptococcus pneumoniae, Staphylococcus spp., Bacillus anthracis, Clostridium spp.), Listeria spp., and gram-negative (Haemophilus influenzae, Neisseria meningitidis, Proteus mirabilis, Yersinia multocida (formerly Pasteurella), many species Salmonella spp., Shigella spp., Escherichia coli) microorganisms, aerobic non-spore-forming bacteria.

Moderately active against most enterococci, incl. Enterococcus faecalis. Ineffective against penicillinase-producing strains Staphylococcus spp., all strains Pseudomonas aeruginosa, most strains Klebsiella spp. and Enterobacter spp.

Pharmacokinetics:

Absorption when ingested - high, bioavailability - 40%; the time to reach the maximum concentration for oral administration of 500 mg - 2 hours, the maximum concentration - 3-4 μg / ml. Connection with plasma proteins - 20%. It is evenly distributed in the organs and tissues of the body, it is found in therapeutic concentrations in pleural, peritoneal, amniotic and synovial fluids, cerebrospinal fluid, contents of blisters, urine (high concentrations), intestinal mucosa, bones, gall bladder, lungs, female genital tract, bile , in bronchial secretion (in the purulent bronchial secretion, the accumulation is weak), paranasal sinuses, middle ear fluid (with its inflammation), saliva, fetal tissues. Poor penetrates the blood-brain barrier, its permeability increases with inflammation. The half-life is 1-2 hours. kidneys (70-80%), and in the urine very high concentrations of unchanged antibiotic are created; partially - with bile, in nursing mothers - with milk. Do not cumulate. Removed during hemodialysis.

Indications:

Infectious inflammatory diseases caused by sensitive microorganisms: respiratory tract and ENT organs (sinusitis, tonsillitis, pharyngitis, otitis media, bronchitis, pneumonia, lung abscess), infections of the kidneys and urinary tract (pyelonephritis, pyelitis, cystitis, urethritis), gonorrhea, infections biliary system (cholangitis, cholecystitis), chlamydial infections in pregnant women (with erythromycin intolerance), cervicitis, skin and soft tissue infections (erysipelas, impetigo, secondarily infected dermatoses); infections of the musculoskeletal system; pasteurellosis, listeriosis, gastrointestinal tract infections (typhoid and paratyphoid, dysentery, salmonellosis, salmonella carcinoma).

Contraindications:

Hypersensitivity to penicillin and other beta-lactam antibiotics, infectious mononucleosis, lymphocytic leukemia, hepatic insufficiency, history of the gastrointestinal tract (especially colitis associated with the use of antibiotics), lactation, children under 3 years and / or body weight less than 20 kg.

Carefully:

Bronchial asthma, pollinosis and other allergic diseases, renal insufficiency, bleeding in the anamnesis.

Pregnancy and lactation:

In pregnancy, ampicillin can be used if the benefit to the mother exceeds the potential risk to the fetus. Ampicillin is excreted in breast milk in low concentrations. If you need to use ampicillin during lactation, you should decide whether to stop breastfeeding.

Dosing and Administration:

Inside for 0,5-1 h before meals with a little water. The dosage regimen is set individually, depending on the severity of the course and localization of the infection, the sensitivity of the pathogen to the drug.

Adults and children from 3 years old with a body weight of more than 20 kg - 250-500 mg every 6 hours. The maximum daily dose is 4 g / day.

With gonococcal urethritis - 3.5 g once.

The duration of treatment depends on the severity of the disease (from 5-10 days to 2-3 weeks, and in chronic processes - for several months).

Side effects:

From the digestive system: glossitis, stomatitis, gastritis, dry mouth, taste change, nausea, vomiting, diarrhea, abdominal pain, pseudomembranous enterocolitis, increased activity of "liver" transaminases.

Laboratory indicators: leukopenia, neutropenia, thrombocytopenia, agranulocytosis, anemia.

From the central nervous system: headache, tremor, convulsions (with high-dose therapy).

Allergic reactions: erythematous and maculopapular rash, exfoliative dermatitis, erythema multiforme, skin peeling, itching, urticaria, rhinitis, conjunctivitis, Quincke's edema, fever, arthralgia, eosinophilia; anaphylactic shock.

Other: interstitial nephritis, nephropathy, superinfection (especially in patients with chronic diseases or reduced resistance of the body), vaginal candidiasis.

Overdose:

Symptoms: manifestations of toxic effects on the central nervous system (especially in patients with renal insufficiency); nausea, vomiting, diarrhea, violation of water-electrolyte balance (as a consequence of vomiting and diarrhea).

Treatment: gastric lavage, Activated carbon, saline laxatives, medicines to maintain water electrolyte balance and symptomatic. It is excreted by hemodialysis.

Interaction:

Antacids, glucosamine, laxative drugs, food and aminoglycosides (with enteral administration) slow down and reduce absorption; ascorbic acid increases absorption. Bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, vancomycin, rifampicin) have a synergistic effect; bacteriostatic medicinal products (macrolides, chloramphenicol, lincosamides, tetracyclines, sulfonamides) - antagonistic. Increases the effectiveness of indirect anticoagulants (suppressing the intestinal microflora, reduces the synthesis of vitamin K. and prothrombin index); reduces the effectiveness of estrogen-containing oral contraception (must use additional methods of contraception), drugs which are metabolised formed para-aminobenzoic acid, ethinylestradiol (increased risk of bleeding "breakthrough" in the latter case). Diuretics, allopurinol, oxyphenbutazone, phenylbutazone, non-steroidal anti-inflammatory drugs and other drugs that block tubular secretion, increase the concentration of ampicillin in the plasma (by reducing tubular secretion). When combined with allopurinol increases the likelihood of skin rash.

Reduces clearance and increases the toxicity of methotrexate. Increases the absorption of digoxin.

Special instructions:

In course treatment it is necessary to monitor the status of the functions of the organs of hematopoiesis, liver and kidneys.

When using high doses in patients with renal insufficiency, a toxic effect on the central nervous system is possible.

In the treatment of patients with bacteremia (sepsis), the development of a bacteriolysis reaction (the Yarisch-Gerxheimer reaction) is possible.

In patients who are hypersensitive to penicillins, there may be cross-allergic reactions with cephalosporin antibiotics.

In the treatment of mild diarrhea against the background of course treatment, anti-diarrheal drugs should be avoided, which reduce intestinal peristalsis; You can use kaolin- or attapulgite-containing antidiarrhoeal drugs, the withdrawal of the drug is indicated. With severe diarrhea, you should see a doctor.

Effect on the ability to drive transp. cf. and fur:

Form release / dosage:

Tablets 250 mg.

Packaging:For 10 or 24 tablets are placed in a contour mesh package. 2 contourcell packagings No. 10 or 1 contour pack No. 24 together with the instruction for use are placed in a pack of cardboard.

Storage conditions:

List B. In a dry, dark place at a temperature of no higher than 25 ° C.

Keep out of the reach of children.

Shelf life:

2 years.

Do not use after expiry date.

Terms of leave from pharmacies:On prescription

Registration number:P N000161 / 02

Date of registration:18.05.2009

Expiration Date:Unlimited

The owner of the registration certificate:MOSHIMFARM PREPARATES them. N.А.Semashko, OJSC MOSHIMFARM PREPARATES them. N.А.Semashko, OJSC Russia

Manufacturer: & nbsp

MOSHIMFARM PREPARATES them. NA Semashko OJSC Russia

Information update date: & nbsp22.08.2017

Illustrated instructions

Instructions

Ampicillin trihydrate (Ampicillin Trihydrate)