Stable under acidic conditions. The absorption in the small intestine – 30-60% bond to plasma proteins – 60-80%, continuously circulates in the blood, slowly penetrates the tissue. High concentrations are determined in the kidney, lower – in the liver, small intestine wall skin. Therapeutic blood equipoise steroid levels after oral administration are achieved after 30 min, and stored 3-6 hours. It is metabolized in the liver of 30-35%. The half – 30-45 minutes and is prolonged in infants, elderly patients, renal nedostochnosti. Excreted unchanged (25%) in the form of metabolites (35%), about 30% of the feces c.

 

Indications
Infections of the upper and lower respiratory tract infections (bronchitis, pneumonia), upper respiratory tract (tonsillitis, laryngitis, otitis media, sinusitis), mouth (a bacterial disease, periodontal disease, actinomycosis), skin and soft tissue (abscess, cellulitis, erysipelas , contagious impetigo, erythema migrans, abrasions, pseudoerysipelas); gonorrhea, syphilis, tetanus, anthrax, botulism, scarlet fever, leptospirosis, diphtheria, inflammation of lymph nodes (lymphadenitis);prevention of bacterial infections after surgery in frail patients, recurrence of rheumatic fever, bacterial endocarditis, rheumatic fever, chorea minor.

Contraindications:
Hypersensitivity (including to other beta-lactam antibiotics -. Penicillins, cephalosporins, carbapenems), aphthous stomatitis and sore throat, severe infections, gastrointestinal disease, accompanied by vomiting and diarrhea.

Dosage
Inside for 0.5-1 hour before meals, washed down with copious amounts of fluid. Adults and children over 12 years: 500-1000 mg (1 mg – 1610 IU) 3-4 times a day.
In severe chronic renal failure the interval between doses increased to 12 hours The course of treatment – 5-7 days.; infections equipoise steroid caused by beta-hemolytic streptococcus – at least 7-10 days and 3 days after normalization of body temperature.
For children under 1 year – a daily dose of 20-30 mg / kg; 1-6 years – 15-30 mg / kg, 6-12 -10-20 mg / kg; daily dose divided into 4-6 receptions. Children under 3 years of appointment, preferably in the form of a solution or suspension.
For the prevention of rheumatic fever or chorea minor -. 500 mg 2 times a day
for the prevention of postoperative complications in adults and children weighing more than 30 kg for 0.5-1 hours before surgery is prescribed 2 g, followed by 0.5 g every 6 hours for 2 days.

Side effects
: Allergic reactions: hives, skin flushing, angioedema, rhinitis, conjunctivitis, rarely – fever, serum sickness, arthralgia, eosinophilia, rarely – anaphylactic shock.
From the side of hematopoiesis: hemolytic anemia, leukopenia, agranulocytosis, thrombocytopenia, pancytopenia.
from the digestive system: the dyspeptic disorders (nausea, vomiting, diarrhea), glossitis, stomatitis, vesicular cheilitis (related to the irritating effect of the drug on the mucous membranes), decreased appetite, dry mouth, taste disturbance, rarely pseudomembranous enterocolitis.
Others: interstitial nephritis , pharyngitis, vasculitis.

Interaction with other drugs
increases the effectiveness of indirect anticoagulants (suppressing the intestinal microflora, reduces the formation of vitamin K); reduces the effectiveness of oral contraceptives and medicines during the metabolism that produce para-aminobenzoic acid.
It increases the risk of bleeding equipoise steroid “breakthrough” while taking ethinyl estradiol.
Antacids, glucosamine, laxatives, food, aminoglycosides slow down and reduce absorption; ascorbic acid increases it.
The bactericidal antibiotics (including cephalosporin, cycloserine, vancomycin, rifampin), aminoglycosides – a synergy of action; bacteriostatic antibiotics (including macrolides, chloramphenicol, lincosamides, tetracyclines) -. antagonism
Diuretics, allopurinol, phenylbutazone, nonsteroidal anti-inflammatory analgesics, and other drugs that reduce tubular secretion, increase the concentration of penicillin.
Allopurinol increases the risk of allergic reactions (skin rash) .

Cautions
Prolonged or re-appointment may cause superinfection development, pathogens which are resistant bacteria or fungi.
If during treatment or during the first weeks after the cessation of severe persistent diarrhea occurs, pseudomembranous colitis equipoise steroid should be exclude