Buy Amoxicillin Online Over The Counter

Pharmacodynamics

Antibacterial bactericidal acid-resistant broad-spectrum agent from the group of semi-synthetic penicillins. Inhibits transpeptidase, disrupts the synthesis of peptidoglycan (supporting cell wall protein) during division and growth; causes bacterial lysis. Due to the breadth of the spectrum of action, the drug is active against both gram-positive and gram-negative microorganisms. Clinically significant, gram-negative organisms sensitive to amoxicillin include. Escherichia coli, Proteus mirabilis, Salmonella, Shigella, Campylobacter, Haemophilus influenzae, Bordetella pertussis, Leptospira, Chlamydia.

In addition, amoxicillin is active against all microorganisms sensitive to penicillin G, for example, group A, B, C, G, H, I, M streptococci, Streptococcus pneumoniae, staphylococci and Neisseria spp that do not produce penicillinase, Erysipelothrix rhysiopathiae, Corynebacterium, Bacillus anthracis, Actinomycetes, Streptobacilli, Spirillium minus, Pastereulla multocida, Listeria, Spirochaeta (Leptospira, Treponema, Borrelia) and others, as well as various anaerobic microorganisms (including Peptococcus, Peptostreptococcus, Clostridia and Fuso bacteria).

Pharmacokinetics

Absorption - fast, high (93%), food intake does not affect absorption, is not destroyed in the acidic environment of the stomach. When taken orally at a dose of 125 and 250 mg, the maximum concentration is 1.5-3 mcg / ml and 3.5-5 mcg / ml, respectively. The action develops 15-30 minutes after application and lasts 8 hours. The time to reach the maximum concentration after oral administration is 1-2 hours.

It has a large volume of distribution - high concentrations are found in plasma, sputum, bronchial secretions (poor distribution in purulent bronchial secretions), pleural and peritoneal fluid, urine, skin blisters, lung tissue, intestinal mucosa, female genital organs, prostate, fluid middle ear, bone, adipose tissue, gallbladder (with normal liver function), fetal tissues. When the dose is increased by 2 times, the concentration also increases by 2 times. The concentration in bile exceeds the concentration in plasma by 2-4 times. In the amniotic fluid and vessels of the umbilical cord, the concentration of amoxicillin is 25-30% of the level in the plasma of a pregnant woman. Poorly penetrates the blood-brain barrier, with inflammation of the meninges (meningitis), the concentration in the cerebrospinal fluid is about 20%. Communication with plasma proteins - 17%.

Partially metabolized with the formation of inactive metabolites. The half-life is 1-1.5 hours. It is excreted by 50-70% by the kidneys unchanged by tubular excretion (80%) and glomerular filtration (20%), by the liver - 10-20%. A small amount is excreted in breast milk. In case of impaired renal function (creatinine clearance less than or equal to 15 ml / min), the half-life increases to 8.5 hours. Amoxicillin is removed by hemodialysis.

Indications

Bacterial infections caused by microorganisms sensitive to amoxicillin: infections of the respiratory tract and upper respiratory tract (sinusitis, pharyngitis, tonsillitis, acute, otitis media; bronchitis, pneumonia), genitourinary system (pyelonephritis, pyelitis, cystitis, urethritis, gonorrhea, endometritis, cervicitis) , gastrointestinal tract (peritonitis, enterocolitis, typhoid fever, cholangitis, cholecystitis), skin and soft tissue infections (erysipelas, impetigo, secondarily infected dermatoses), leptospirosis, acute and latent listeriosis, Lyme disease (borreliosis), dysentery, salmonellosis, salmonella carriage, bacterial meningitis (depending on the results of the susceptibility test. Especially in children), infective endocarditis, for example, enterococcal (alone or in combination with aminoglycosides), septicemia caused by microorganisms sensitive to amoxicillin.

Сonsult your doctor before you decide to buy amoxicillin over the counter. Never take medication without visiting a doctor!

Contraindications

Hypersensitivity to the components of the drug (including other penicillins, cephalosporins, carbapenems), allergic diseases (including history), bronchial asthma, hay fever, infectious mononucleosis, lymphocytic leukemia, liver failure, colitis associated with the use of antibiotics, including including history, lactation period, children under 10 years of age weighing less than 40 kg.

Carefully

Pregnancy, allergic reactions, (including history), diseases of the gastrointestinal tract in history, renal failure, as well as indications of a history of bleeding.

Pregnancy and lactation

Amoxicillin may be used during pregnancy if the benefit to the mother outweighs the potential risk to the fetus.

Amoxicillin is excreted in breast milk in low concentrations. If it is necessary to use the drug during lactation, the issue of stopping breastfeeding should be decided.

Dosage and administration

Inside, before or after a meal.

Adults and children over 10 years old (weighing more than 40 kg) are prescribed 0.5 g 3 times a day; in severe infections - 0.75-1 g 3 times a day.

In acute uncomplicated gonorrhea, 3 g is prescribed once; in the treatment of women, repeated administration of the indicated dose is recommended.

In acute infectious diseases of the gastrointestinal tract (paratyphoid, typhoid fever) and biliary tract, with gynecological infectious diseases in adults - 1.5-2 g 3 times a day or 1-1.5 g 4 times a day.

In severe infections (meningitis, septicemia) for adults - up to 6 g per day in 3-4 doses. Children - 250-500 mg 3 times a day. The duration of treatment depends on the indications and the clinical picture and is usually 5-7 days. With otitis media and similar infections in children, a two-time dose of Amoxicillin is sufficient. In cases of chronic diseases, recurrent infections, severe infections, adults are prescribed 750 mg - 1 g 3 times a day, children up to 60 mg / kg per day divided into 3 doses.

With leptospirosis for adults - 0.5-0.75 g 4 times a day for 6-12 days. With listeriosis, adults 0.5 g 3 times a day for 6-12 days.

With salmonella carriage in adults - 1.5-2 g 3 times a day for 2-4 weeks.

For the prevention of endocarditis in minor surgical interventions for adults - 3-4 g 1 hour before the procedure. If necessary, a second dose is prescribed after 8-9 hours.

In children, the dose is halved.

In patients with impaired renal function with a creatinine clearance of 15-40 ml / min, the interval between doses is increased to 12 hours; with creatinine clearance below 10 ml / min, the dose is reduced by 15-50%; with anuria - the maximum dose is 2 g / day.

Сonsult your doctor before you decide to buy amoxicillin over the counter

Side effects

Allergic reactions: skin rash, hyperemia, itching, urticaria, erythema, angioedema, rhinitis, conjunctivitis; fever, joint pain, eosinophilia, exfoliative dermatitis, erythema multiforme exudative, Stevens-Johnson syndrome; reactions similar to serum sickness, toxic epidermal necrolysis, generalized exanthematous pustulosis, allergic vasculitis, anaphylactic shock.

On the part of the digestive system: dysbacteriosis, change in taste, vomiting, nausea, diarrhea, stomatitis, glossitis, liver dysfunction, moderate increase in the activity of "liver" transaminases, cholestatic jaundice, hepatic cholestasis, acute cytolytic hepatitis, pseudomembranous colitis.

From the nervous system: agitation, anxiety, insomnia, ataxia, confusion, behavior change, depression, peripheral neuropathy, headache, dizziness, convulsions.

Laboratory indicators: leukopenia, neutropenia, thrombocytopenic purpura, anemia.

Other: shortness of breath, tachycardia, interstitial nephritis, crystalluria, eosinophilia, agranulocytosis, vaginal candidiasis, superinfection (especially in patients with chronic diseases or reduced body resistance).

Overdose

Symptoms: nausea, vomiting, diarrhea, disturbance of water and electrolyte balance (as a result of vomiting and diarrhea).

Treatment: gastric lavage, activated charcoal, saline laxatives, drugs to maintain water and electrolyte balance; hemodialysis.

Interaction

Antacids, glucosamine, laxatives, food, aminoglycosides slow down and reduce absorption; ascorbic acid increases absorption. Bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, vancomycin, rifampicin) - a synergistic effect; bacteriostatic drugs (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 contraceptives, drugs, in the process of metabolism of which para-aminobenzoic acid is formed, ethinyl estradiol - the risk of bleeding "breakthrough".

Diuretics, allopurinol, oxyphenbutazone, phenylbutazone non-steroidal anti-inflammatory drugs; drugs that block tubular secretion - reducing tubular secretion, increase the concentration.

Allopurinol increases the risk of skin rashes. Reduces clearance and increases the toxicity of methotrexate. Enhances the absorption of digoxin.

Special instructions

During the course of treatment with amoxicillin online, it is necessary to monitor the state of the function of the hematopoietic organs, liver and kidneys.

Perhaps the development of superinfection due to the growth of microflora insensitive to it, which requires a corresponding change in antibiotic therapy.

In the treatment of patients with bacteremia, the development of a reaction, bacteriolysis (the Jarisch-Herxheimer reaction) is possible. In patients with hypersensitivity to penicillins, cross-allergic reactions with cephalosporin antibiotics are possible.

In the treatment of mild diarrhea against the background of course treatment, antidiarrheal drugs that reduce intestinal motility should be avoided; kaolin or attapulgite-containing antidiarrheals may be used. For severe diarrhea, see a doctor.

Treatment necessarily continues for another 48-72 hours after the disappearance of clinical signs of the disease.

With the simultaneous use of estrogen-containing oral contraceptives and amoxicillin, if possible, other or additional methods of contraception should be used.

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