In the article, we consider the side effects of Amoxicillin, as well as instructions for it. This is a semi-synthetic broad-spectrum antibiotic from the pharmacological category of penicillins. This tool is effective against gram-positive and gram-negative anaerobic microorganisms. In its chemical properties, the main element is close to ampicillin, however, it has a higher bioavailability when taken orally.
The medication is often prescribed to patients during various infectious diseases. Many people complain of the development of numerous side effects from Amoxicillin. Frequent reactions of the body include severe dry mouth, the development of urticaria, and diarrhea. Patients report: “I feel like a drug addict after Amoxicillin.” However, before asserting that these symptoms arose while taking this medication, it is necessary to clarify its main characteristics and understand how it acts on the body, as well as what substances from its composition can cause similar physiological conditions.
Structure
The medicine "Amoxicillin" in a dosage of 500 mg is produced in two forms: capsules and tablets.
One capsule contains the active element - amoxicillin in a dose of 500 mg (in the form of amoxicillin trihydrate) and such auxiliary substances as sodium lauryl sulfate, magnesium stearate, sodium starch glycolate. The gelatin capsule contains purified water, sodium lauryl sulfate, bronopol, povidone, gelatin, ponso 4 R (E124), shiny blue FCF (E133), titanium dioxide (E171), quinoline yellow (E104).
The composition of one tablet includes amoxicillin trihydrate as an active element, as well as excipients: talc, potato starch, tween, magnesium stearate.
Pharmacological properties
According to the instructions for the use of 500 mg Amoxicillin tablets, this is an antibacterial acid-resistant bactericidal agent of broad action from the category of semisynthetic penicillins. It contributes to the suppression of transpeptidase, disruption of the synthesis of peptidoglycan (supporting protein of the cell walls) during the period of growth and division, and provokes the lysis of bacterial cells. Clinically significant microorganisms of the gram-negative series, sensitive to the main substance of this medication: Escherichia coli, Klebsiella spp., Salmonella, Proteus mirabilis, Shigella, Haemophilus influenzae, Campilobacter, Leptospira, Neis-seria gonorrhoeae, Chlamydiaidisidissa Neeria.
In addition, the drug is highly active against gram-positive aerobic microorganisms: Streptococcus spp., Staphylococcus spp. (with the exception of penicillinase producing strains). Amoxicillin also has activity against Helicobacter pylori, but does not affect indole-positive Proteus strains. Mycoplasmas, rickettsiae, viruses are also resistant to its action. Microorganisms with the ability to produce penicillinase are resistant to amoxicillin. The effect of the medication develops 15-30 minutes after administration and lasts approximately 8 hours.
The active element is quickly absorbed after administration. The effect of food on the absorption of amoxicillin has been studied in part. Amoxicillin penetrates most fluids and tissues, with the exception of cerebrospinal fluid and the brain, except when the membranes of the brain are affected by the inflammatory process. The half-life of amoxicillin is 1 hour. The main part is excreted in the urine, binds to plasma proteins by 20%. The maximum level in the blood is observed after 1-2 hours and is approximately 3.5 μg / ml - 5 μg / ml. About 60% of the substance is excreted by the kidneys.
Indications for use
What else can you learn from the instructions for use with Amoxicillin 500 mg tablets? The medicine is prescribed for inflammatory diseases of infectious origin, such as:
- infections of ENT organs and upper respiratory canals (sinusitis, pharyngitis, tonsillitis, acute otitis media);
- infection of the lower respiratory canals (chronic and acute bronchitis, pneumonia);
- infectious diseases of the genitourinary system (pyelitis, chronic and acute pyelonephritis, cystitis, gonorrhea, urethritis);
- gynecological diseases (cervicitis, endometritis);
- digestive tract infections (typhoid fever, enterocolitis, salmonellosis, shigellosis, salmonella carriage);
- peptic ulcer, chronic gastritis, provoked by Helicobacter pylori as part of a combination treatment;
- bile duct infections (cholecystitis, cholangitis);
- infections of soft tissues and skin surface (impetigo, erysipelas, secondarily infected dermatosis);
- leptospirosis;
- latent and acute listeriosis;
- borreliosis (Lyme disease);
- endocarditis of an infectious nature of origin, for example enterococcal.
Dosage and route of administration
Indications and dosage of Amoxicillin should be strictly observed. The medication is taken orally. Children after 10 years (body weight more than 40 kg) and adult patients are prescribed 500 mg 3 times a day; with a complex course of infectious disease - 1 g 3 times a day. The interval between doses of the medication should be strictly observed - 8 hours. The maximum dose per day should not be more than 6 g. The course of drug therapy is from 5 to 12 days. Reception of the drug is recommended to continue for another 48-72 hours after stabilization of body temperature or significant destruction of the infectious agent.
With uncomplicated acute gonorrhea, men are prescribed 3 g of the drug once. Women are recommended to take this dose twice with an interval of 10-12 hours due to the likelihood of multiple lesions and the presence of an ascending inflammatory process with a transition to organs located in the pelvis.
Children's dosages
At the age of less than 10 years, this medication is mainly prescribed in the form of a suspension, since the dosage of the drug in capsules is difficult.
In pediatrics, “Amoxicillin” in capsule form is applicable only if the daily dosage is not less than 500 mg. If this dose is taken in the morning and evening, it is best to use tablets that can be divided into two parts - 250 mg each.
If the drug is missed, you should take it as soon as possible, without waiting for the next dose, and then observe equal intervals of time between doses.
Side effects of Amoxicillin
When taking a pharmacological drug, such side effects may occur:
- Allergic phenomena: skin hyperemia, urticaria, erythema, rhinitis, angioedema, conjunctivitis, joint pain, febrile syndrome, fever, eosinophilia, exudative polyformal erythema, Stevens-Johnson syndrome, anaphylactic shock. Urticaria after Amoxicillin is a fairly common occurrence. This is confirmed by numerous reviews about the drug. And it happens both in children and in adults. Allergic dermatitis also occurs after Amoxicillin, which is also quite unpleasant.
- Digestive system: taste change, dysbiosis, nausea, vomiting, glossitis, stomatitis, impaired liver functional properties, moderate increase in liver transaminase activity, itching in the anus, pseudomembranous colitis. Many patients had diarrhea after Amoxicillin. Somehow, this drug has an extremely negative effect on the digestive tract.
- Nervous system: psychomotor agitation or agitation, anxiety, ataxia, insomnia, confusion, depression, behavior change, cephalgia, peripheral neuropathy, dizziness, aseptic type meningitis, convulsions. What other side effects of Amoxicillin are there?
- Urinary system: acute interstitial nephritis, crystalluria.
- Laboratory values: neutropenia, leukopenia, agranulocytosis, anemia, thrombocytopenic purpura.
- Other side effects: shortness of breath, candidiasis of the mucous membrane of the oral cavity and vagina, tachycardia, superinfection (more often in patients with chronic pathologies or reduced body resistance), tooth discoloration in children.
Next, find out if Amoxicillin has contraindications.
List of contraindications
The medicine is contraindicated for use in such cases:
- lymphocytic leukemia;
- a history of a digestive tract (especially colitis due to the use of antibiotics);
- Infectious mononucleosis;
- high sensitivity to the components of the composition (including other penicillins, carbapenems, cephalosporins).
During pregnancy and lactation
The instruction prohibits the use of "Amoxicillin" during breastfeeding. The antibiotic passes into milk and may harm the baby. If there is a need for therapy, feeding should be suspended. The use of the drug during pregnancy has its own characteristics. Penicillins can penetrate the placenta and accumulate in it. The concentration of Amoxicillin in the amniotic fluid reaches 25-30 percent of the plasma level of a pregnant woman, this is a big risk for the development of the fetus.
Drug interaction
If severe side effects occur, it is necessary to take into account not only the direct effect of the given drug on the body, but also its interaction with other medicines.
The active element of this drug is not destroyed in an acidic stomach. Glucosamine, antacids, laxatives, aminoglycosides reduce and slow down the absorption of Amoxicillin, and vitamin C enhances it.
Bactericidal antibiotics (in particular, cephalosporins, aminoglycosides, rifampicin, vancomycin) have a synergistic effect, bacteriostatic medicines (macrolides, sulfanilamides, lincosamides, chloramphenicol, tetracyclines) are antagonistic.
This medicine increases the effect of indirect anticoagulants (suppresses the intestinal microflora, reduces the prothrombin index and the synthesis of vitamin K), reduces the effect of oral estrogen-containing contraceptives.
"Amoxicillin" reduces clearance and increases the toxicity of methotrexate, enhances the absorption of digoxin.
Allopurinol, diuretics, oxyphenbutazone, non-steroidal anti-inflammatory drugs, phenylbutazone, tubular secretion blockers increase the level of amoxicillin in the blood. Allopurinol is more likely to cause a skin rash.
Special recommendations
Of course, it is important to find out all about the contraindications of Amoxicillin before starting treatment. But there are other recommendations. In accordance with the instructions for use, this medication should be used with caution in the presence of allergic pathologies, high sensitivity to penicillins, carbopenems, cephalosporins, bleeding and a history of renal failure.
With prolonged treatment, it is recommended to periodically monitor the function of the liver, kidneys, and conduct blood tests. In patients with kidney failure and the elderly, excretion of the main substance from the body may slow down, so some caution must be exercised when prescribing a medication to these groups of patients. In patients with reduced diuresis, crystalluria may occur, and therefore it is advisable to take a large amount of fluid during administration.
When treating with this medication, it is also necessary to take into account the likelihood of superinfection with bacterial and mycotic pathogens. In this case, it is recommended to cancel the medication and prescribe the appropriate therapy.
During the treatment period, false-positive results can be observed in the case of the use of chemical methods for studying the level of glucose in the urine.
Overdose
Often, people mistakenly take the symptoms of an overdose of a particular medication for side effects. With an increase in the dose of the drug, not agreed with the doctor, the following conditions may occur:
- Dyspeptic disorders (vomiting, nausea), diarrhea, a change in water-electrolyte balance (as a result of vomiting and diarrhea).
- Often, patients have a fever. Dry mouth after Amoxicillin is also common.
In case of an overdose, the patient should be provided with appropriate medical care, which consists in urgent gastric lavage, taking activated charcoal, saline laxatives, and drugs to maintain electrolyte balance. In severe cases, hemodialysis is used.
Analogs
The main analogues of the drug "Amoxicillin 500 mg" may be funds from the group of fluoroquinolones and macrolides, including:
- "Azithromycin";
- "Sumamed";
- "Fromilide";
- "Erythromycin";
- Macropen.
These drugs are also prescribed if treatment with Amoxicillin did not give a positive result, that is, this antibiotic could not destroy pathogenic microorganisms. In addition, it is replaced by analogues in the case when the patient has pronounced side effects.
What do the doctor's say?
Doctors note that patients' complaints about side effects from taking Amoxicillin are common. This is due to the fact that any antibiotic is toxic, and the human body reacts to this rather painfully. With prolonged use of the antibiotic, dysbiosis can occur, which is accompanied by complaints of abdominal pain and frequent diarrhea. A common complaint is that a rash appeared after taking Amoxicillin. Sometimes there are such side effects as a violation of the digestive processes, which manifests itself in the form of heartburn, nausea, belching. Often, patients experience diarrhea, which is caused by the death of beneficial bacteria on the intestinal mucosa.
Some patients have kidney pain after Amoxicillin. According to doctors, people who do not have problems with the urinary system usually tolerate this drug well. If there are any kidney diseases, the patient may feel pain in the back, urination impairment, etc. This is because the process of removing the drug from the body is difficult.
Many are interested in the question of whether it is normal that after taking "Amoxicillin" the temperature rose. Specialists point out that hyperthermia is a reaction of the immune system to pathogen cells. Therefore, the drug itself cannot increase the temperature, however, it is able to provoke allergic reactions.