There are hundreds of different antibiotics on the Russian pharmaceutical market, both domestic and imported. All of them are designed to fight bacterial infections. There are synthetic, semi-synthetic and natural antibiotics. The latter cause the least amount of side effects. But their action is directed, as a rule, against a small group of microbes.
There are also unprotected and protected antibiotics, which include additional substances that prevent bacteria from protecting themselves from the lethal action of the main therapeutic substance. What is the feature? Protected antibiotics can cope not only with a wide variety of infections, but also have more side effects than their unprotected counterparts.
In our article we will talk about the new protected semisynthetic preparation Flemoklav Solutab 875/125. The instruction to it explains how to use it, but not all medical terms in it can be understood by a wide circle of the population. We offer a detailed review of this drug, as well as an analysis of the reviews of it by patients and doctors directly working with this drug.
General information
The instructions attached to each package of Flemoklav Solyutab 875/125 informs that it is manufactured by a Dutch company known in the Russian pharmaceutical market and called Astellas Pharma Europe B.V.
The medicine is an antibiotic with the widest possible spectrum of action. It is available in cardboard packaging. Each pack contains only 2 blisters. In each of them 7 tablets are packed in airtight cells. They are quite large in size, oblong, convex, do not have dividing risks (that is, their division into parts during use is not provided). They have a company logo and the numbers "424". This knowledge will help you distinguish a natural product from a fake.
The color of the Dutch tablets should be either white or yellow-cream with brown spots. Their taste is quite specific, as reported by all respondents in their reviews. For complete clarity of the picture, we present several photos of Flemoklav Solyutab 875/125. The instruction prescribes tablets either to swallow, washed down with water, or to dissolve in water (100-150 ml) and to drink in the form of the received suspension as the preparation belongs to the category of dispersible medicines.
Let us explain what this medical term means. Dispersible tablets are medicines that do not have to be swallowed with water. They can dissolve in the oral cavity, and they can also be dissolved in water and make the medicine look like a suspension. This type of pill is designed for patients with dysphagia (having problems with swallowing), as well as for everyone who is more comfortable with this form of medication.
Therefore, the taste of such a drug is of great importance. Flemoklav Solyutab is produced in two types. To be more precise, with lemon and orange flavors. If the flavor of the tablets does not suit you at all and causes vomiting when using them in the form of a suspension, it is allowed to add honey or sugar to the solution to taste. It is also allowed to take this medicine with any product that you like (for example, with fruit whipped in a blender.
You can buy the drug at any pharmacy. He is released only on prescription. When buying a drug, special attention should be paid to the numbers following the name of the drug and always indicated on the package. The fact is that “Flemoklav Solyutab” the Dutch company produces in several forms.
So, there are tablets of this drug with dosages of amoxicillin and helping it destroy the clavulanic acid bacteria in the following proportions: 500/125, 250 / 62.5 and 125 / 31.25. All of them have the same healing properties. But if a package with a lower concentration of the main therapeutic components is purchased, the doctor must adjust the dosage of the drug.
A drug with a concentration of basic substances of 875/125 costs from 380 to 490 rubles, which depends on the margins of pharmacies caused by transportation and other expenses.
Chemical composition
The instructions to Flemoklav Solutab 875/125 indicate that there are only two main substances that act against bacteria in the preparation:
- Amoxicillin. Each pill contains 875 mg.
- Clavulanic acid: 125 mg in pills.
The numbers on the packaging “875” and “125” indicate precisely the content of these substances in the preparation. Additionally, each tablet contains:
- vanillin (1 mg);
- magnesium stearate (5 mg);
- saccharin (9 mg);
- crospovidone (100 mg)
- microporous cellulose 327 mg;
- apricot flavor.
The instruction for Flemoklav Solyutab 875/125 does not provide a description of each component. We fill this gap so that patients have an idea of what goes into their body with each tablet of the drug.
Amoxicillin
This is an antibiotic from the penicillin group. It belongs to the third subgroup, called aminopenicillins, and is a complex compound including, in addition to synthetic penicillins, substances such as ticarcillin and carbenicillin. This explains the unusually wide range of microorganisms with which he is able to fight.
The principle of their action is to destroy the walls of bacteria by blocking the synthesis of their main component - peptidoglycan.
According to the instructions to "Flemoklav Solyutab" 875/125, in the composition of tablets, the drug amoxicillin occupies a leading position. It should be borne in mind that although this substance is highly active against pathogenic microorganisms and is harmless to most people, it can cause allergic reactions in some patients: rash, laryngeal edema, fever up to 38 ° C, abdominal pain, digestive upset, even dangerous not only for health but also for life anaphylactic shock. In rare cases, patients experience vomiting, peeling, dizziness.
It should also be noted that such a strong antibiotic as amoxicillin, with prolonged use, can destroy not only pathogenic bacteria, but also the beneficial ones that inhabit the mucous membranes. This disrupts the normal balanced composition of microflora, providing tissues with the fulfillment of their functions. This can provoke the occurrence of dysbiosis, and in women additionally the appearance of diseases such as bacagnosis and candidiasis of the vagina.
Clavulanic acid
As the instruction "Flemoklava Solutab" 875/125 tells us, in the composition of the drug about 1/5 part is occupied by clavulanic acid. This substance is an inhibitor of beta-lactamase enzymes. Many bacteria produce them in order to ensure antibiotic resistance. By inhibiting the activity of these enzymes, clavulanic acid reduces the resistance of microbes and enhances the antimicrobial function of antibiotics. In addition, this component is able to destroy some types of bacteria: streptococci, chlamydia, staphylococci, genococci, legionella. When paired, clavulanic acid and amoxicillin are active against bacteria such as:
- streptococci (viridians, pyogenes, anthracis, pneumoniae);
- staphylococci (aureus, epidermidis);
- enterococci;
- corynebacteria;
- clostridiums;
- peptococci;
- peptostreptococcus;
- Shigella
- bordetella;
- gardnerella;
- Klebsiella;
- Salmonella
- Escherichia;
- proteuses;
- Helicobacter pylori.
This information is presented in the instruction "Flemoklava Solyutab" 875/125. However, it is not indicated there that acting together, amoxicillin and clavulanic acid used with it activate the intracellular bactericidal activity of leukocytes, stimulate their chemotaxis (movement to the source of the lesion) and leukocyte adhesion (cell adhesion). All this greatly enhances the effect of the drug. Especially these beneficial properties are manifested in the treatment of respiratory infections caused by the bacterium pneumococcus.
Additional substances in the composition of the drug
Crospovidone . This substance is called povidone in Russia. It belongs to the group of enterosorbents. Its properties are complexation. That is, povidone actively binds toxins: both coming from the outside, and formed during various reactions in the body itself. It does not enter the blood, it works only in the digestive tract. At the same time, it does not violate the mucous membranes, does not accumulate in the cells, and is excreted with feces.
Povidone was introduced into Flemoklava Solutab tablets to adsorb toxins secreted by pathogenic bacteria, as well as to remove other harmful substances from metabolic reactions, thereby improving the healing effect of the main drug constituents.
However, in some cases, povidone reduces the absorption of drugs. So that this does not happen when taking the drug in question, its quantitative content is precisely verified in it. Povidone has no contraindications, but in rare cases it can cause nausea and vomiting.
Microporous cellulose. According to the instructions to Flemoklav Solyutab 875/125, this substance in tablets is almost three times more than crospovidone. Microporous cellulose is a polysaccharide, it is not absorbed, not digested, does not cause allergic reactions. Once in the digestive tract, it, like a sponge, absorbs pathogenic organisms, that is, it acts as a sorbent.
Magnesium stearate . It is used as a filler and a former.
The remaining components of the drug give the tablets their palatability.
Application area
As the instruction describes, the medicine "Flemoklav Solutab" 875/125 is effective in the following diseases:
- respiratory infections (pneumonia, bronchitis, lung abscess);
- diseases of the ENT organs (otitis media, pharyngitis, sinusitis, tonsillitis);
- skin infections (erysipelas, dermatoses, impetigo, wound infections, phlegmon, abscesses);
- osteomyelitis;
- infections of the urinary and reproductive systems (cystitis, pyelitis, cervicitis, pyelonephritis, salpingitis, prostatitis, urethritis);
- some sexually transmitted diseases (gonorrhea, mild chancre);
- complications in obstetrics and surgery (postpartum sepsis, infection after surgery, septic abortion).
Pharmacokinetics
In the description of the drug "Flemoklav Solutab" 875/125, the instruction reports that, once in the stomach, clavulanic acid and the main remedy of this medicine quickly penetrate into the blood. In this case, the maximum plasma concentration for amoxicillin is 1.5 hours (12 μg / ml). Its absorption is 90% (when taken orally). Approximately 20% of such a substance binds to proteins present in blood plasma.
It has been experimentally determined that the half-life of a substance such as amoxicillin is 1.1 hours. It is excreted by the kidneys in an almost unchanged form, moreover, approximately 80% are removed from the body within 6 (maximum 6.5) hours after the tablet was drunk.
For clavulanic acid, the time to reach the maximum (3 μg / ml) plasma concentration is 1 hour. About 60% is absorbed in the stomach, and about 22% binds to plasma proteins. In the human body, this substance is metabolized by hydrolysis and decarboxylation reactions. That is, it is already displayed in a modified form. Moreover, in the first 6-6.5 hours, about 50% is removed from the body.
Dosage and rules of administration
Consider how to take "Flemoklav Solutab" 875/125. The dosage instructions and methods of administration indicate the following:
- For children from 12 years old, it is allowed to take the drug 1 tablet in the morning and 1 tablet in the evening. What time is it not so important to do this. The main thing is that at least 12 hours pass between receptions. In the reviews, most patients indicate that they took the medicine at 8 in the morning and at 8 in the evening.
- Children who are less than 12 years old, but weigh 40 kg or more, can also take tablets containing 875 mg of amoxicillin (Flemoklav Solutab 875/125). The instruction prescribes giving these children also 2 tablets per day: 250 mg for children under 2 years of age, 500 mg for everyone else. Kids should be given the medicine in the form of a syrup or a sweet suspension.
Adults should take the drug in the same way as children over 12 years of age, that is, a tablet in the morning and evening.
Taking the drug with food does not affect the absorption of active substances. However, many patients note that the medicine is better perceived by the body if taken immediately before the meal.
The duration of treatment is determined by the doctor, based on the severity of the disease. In most cases, the course does not exceed 14 days, but in special circumstances it can be longer.
For people suffering from kidney failure of any degree, the dosage of Flemoklav Solutab 875/125 may be adjusted. The instructions for use read if the patient has a so-called glomerular filtration rate of more than 30 ml / min, only then he is prescribed doses and frequency of administration on a common basis. In other words, 1 tablet in the morning and evening hours.
If the filtration rate is less than 30 ml / min, kidney excretion of clavulanic acid and amoxicillin is slower. Therefore, the patient is reduced the dose of the drug (prescribed "Flemoklav Solutab" with a content of amoxicillin 500 mg or can be used with 250 mg). Moreover, if the filtration rate is less than 30, but exceeds 10 mg per minute, the drug is taken 2 times a day, and if less than 10 mg / min - 1 time per day.
If the patient has renal failure, the drug is prescribed only if possible to constantly monitor liver function.
To those patients who undergo hemodialysis, Flemoklav Solutab is not contraindicated. Such people are prescribed a drug with an amoxicillin content of not more than 500 mg. Oral tablets are taken either twice a day (before and after the procedure), or 1 time per day. It depends on the condition of the patient.
Contraindications
Like other therapeutic agents, the Flemoklav Solutab 875/125 drug has a number of contraindications. The instruction says that it can not be taken in the following categories of patients:
- with hypersensitivity to any components included in the composition of the drug;
- allergic to any penicillin group drugs;
- those who have liver dysfunction after using the drug, turn yellow eyes and skin;
- suffering from infectious mononucleosis;
- patients diagnosed with lymphocytic leukemia;
- with a measles-like rash on the body;
- with phenylketonuria.
Recall that a similar drug with a concentration of basic substances of 875/125 can not be taken for children under 12 years of age and suffering from renal failure. In this case , glomerular filtration rate, which should not be lower than 10 mg / min, is taken into account.
Some categories of patients can be used with caution and only under the supervision of a doctor to take the medicine "Flemoklav Solutab" 875/125. The following categories of such patients are indicated in the instructions for use:
- having gastrointestinal diseases;
- patients with colitis;
- with chronic renal failure;
- with severe liver failure;
- during pregnancy;
- during breastfeeding.
A nursing mother can use this medicine for herself. But if the baby has diarrhea or candidiasis of the mucous membranes, the drug is canceled.
Adverse reactions
The adverse reactions that may appear on each component included in Flemoklav Solutab 875/125 have already been indicated above. The instructions for use of the drug report that, in general, the substances included in this medicine can cause the following undesirable reactions:
From the digestive system:
- nausea
- dysbiosis, manifested by diarrhea;
- vomiting
- hemorrhagic colitis;
- enterocolitis;
- hepatitis;
- gastritis;
- cholestatic jaundice.
From the organs responsible for blood formation:
- thrombocytosis;
- leukopenia;
- hemolytic anemia;
- thrombocytopenia;
- granulocytosis;
- eosinophilia.
From the side of the central nervous system:
- headaches;
- cramps
- dizziness;
- unexplained anxiety;
- difficulty falling asleep.
Other:
- hematuria;
- candidiasis;
- crystalluria;
- interstitial nephritis.
For some patients, the information presented in the instructions for Flemoklav Solutab 875/125 causes considerable concern. The doctors' comments on the drug also comment on a too large list of adverse reactions to this drug. We add that its use in many adults and children can cause a number of allergic manifestations:
- skin rash;
- Stevens-Johnson syndrome;
- exudative erythema;
- acute exanthematous pustulosis;
- allergic vasculitis;
- swelling
- exfoliative dermatitis ;
- anaphylactic shock.
Interaction with other medicines
Not with all medicines can be used, according to the instructions, "Flemoklav Solyutab". In the reviews, patients note that doctors did not always warn them about this, as a result of which there were undesirable reactions of the body:
- Sulfanilamides, lincosamides, macrolides, tetracyclines produce an antagonistic effect.
- Glucosamine, antacids, laxatives reduce absorption, and ascorbic acid increases it.
- Diuretics increase the amount of amoxicillin in the lymph.
- The drug reduces the effectiveness of oral contraception.
Analogs
The Flemoklav Solutab 875/125 preparation has many analogues that have a similar antibacterial effect. Among them are:
- "Panklav."
- "Ecoclave".
- "Augmentin."
- "Arlet."
They are available with different quantitative content of the main components. Therefore, the dosage and methods of administration may differ from those prescribed for Flemoklava Solutab. For treatment with analogues to be effective, it is necessary that the possibility of their use is determined by the attending physician. He must prescribe a dosage.
Flemoklav Solyutab 875/125: instructions, reviews of doctors and patients
In general, such a drug deserves attention and trust. Doctors and narrow specialists prescribe it quite often, since in most cases the effect of therapy is predictably high. With the help of such a drug, it is possible to cure patients from many serious bacterial infections and thereby avoid their complications. Doctors also note that such a medicine has proven itself in the prevention of the development of postoperative complications.
Patients have a slightly different opinion about Flemoklav Solutab 875/125. In the reviews of the instructions attached to the packages of the product, people note that it is sometimes difficult to understand when and how to give the drug to children.
But most of the negative reviews have been written about the many adverse reactions that cause interruption of treatment. In positive reviews, patients who did not experience any complications while taking the drug noted the high effectiveness of Flemoklava Solutab and its relatively low cost, which makes this medicine affordable for people with different income levels.