Description of the active substance:
This information is a reference and it is not enough that the drug has been prescribed by a doctor ..
PHARMACHOLOGIC EFFECT
Antibiotic group of biosynthetic penicillins. The mechanism of action is associated with the inhibition of bacterial cell membrane synthesis. It is bactericidal. Acid-resistant.
It is active against aerobic Gram-positive bacteria: Staphylococcus spp., Streptococcus spp. (including Streptococcus pneumoniae), Enterococcus spp. (some strains), Clostridium spp., Corynebacterium spp., Erysipelothrix rhusiopathiae, Listeria spp., Bacillus anthracis, Actinomyces spp .; aerobic gram-negative bacteria: Neisseria meningitidis, Neisseria gonorrhoeae; Pasteurella multocida, Streptobacillus spp .; anaerobic bacteria: Peptococcus spp., Peptostreptococcus spp., Fusobacterium spp., Clostridium spp.
Also active against Spirullinum minus, Treponema pallidum, Borrelia spp., Leptospira interrogans.
Staphylococcus spp. Is resistant to phenoxymethylpenicillin. (strains producing penicillinase).
PHARMACOKINETICS
After ingestion, phenoxymethylpenicillin is rapidly absorbed from the digestive tract. C max in blood plasma is achieved within 30-60 minutes. Food intake has little effect on absorption.
Easily penetrates into the kidneys, lungs, skin, mucous membranes, muscles (especially in inflammatory processes), somewhat worse - into bone tissue.
The binding with plasma proteins is 80%.
T 1/2 is 30-60 minutes. Most of the phenoxymethylpenicillin is excreted in the urine unchanged, a small part - with bile.
In patients with severe renal dysfunction, T 1/2 may increase to 4 hours.
INDICATIONS
Infectious-inflammatory diseases caused by microorganisms sensitive to phenoxymethylpenicillin, incl. bronchitis, pneumonia, tonsillitis, scarlet fever, otitis media, gonorrhea, syphilis, tetanus, anthrax, purulent skin and soft tissue diseases.
For the purpose of prevention: wounds of various etiologies (including bites); burns; prevention of streptococcal infections and their complications (including rheumatism / rheumatic attack, small chorea /, polyarthritis, glomerulonephritis, endocarditis); prevention of bacterial endocarditis in patients with congenital or acquired rheumatic heart defects before and after small surgical interventions (tonsillectomy, tooth extraction); prevention of pneumococcal pneumonia in children with sickle-cell anemia; prevention of exacerbations of rheumatism.
DOSING MODE
Individual. With an infection of average severity, adults and children over 10 years of age - 3 million units / day. In severe infection, the dose is increased to 6-9 million units / day. Children under 10 years - 50 000-100 000 units / kg / day. Multiplicity of application - 3-6 times / day. The course of treatment on average - at least 5-7 days, for treatment of infections caused by beta-hemolytic streptococcus, - at least 7-10 days.
SIDE EFFECT
Allergic reactions: hives, erythema, Quincke's edema, rhinitis, conjunctivitis are possible; rarely - fever, joint pain, eosinophilia; extremely rare - anaphylactic shock. In rare cases, irritation of the mucous membrane of the mouth and throat (stomatitis, pharyngitis).
On the part of the digestive system: nausea, diarrhea, vomiting, feeling of stomach overflow, stomatitis, glossitis are possible.
From the hemopoietic system: rarely - eosinophilia, hemolytic anemia, leukopenia, thrombocytopenia, agranulocytosis.
CONTRAINDICATIONS
Aphthous stomatitis, pharyngitis, hypersensitivity to penicillins.
PREGNANCY AND LACTATION
Phenoxymethylpenicillin penetrates the placental barrier, in small quantities with breast milk. To date, there has been no adverse effect of phenoxymethylpenicillin on the fetus or the baby.
In pregnancy and lactation (breastfeeding), phenoxymethylpenicillin can be used according to indications. However, before starting treatment, the expected benefit of therapy for the mother and the potential risk to the fetus or the child should be carefully weighed.
In experimental studies , embryotoxic, teratogenic and mutagenic effects of phenoxymethylpenicillin have not been established.
SPECIAL INSTRUCTIONS
Use with caution in patients with allergic diseases (bronchial asthma, hay fever, diathesis), with anamnesis for allergic reactions to cephalosporin antibiotics (possibly a cross-allergic reaction).
When developing allergic reactions, phenoxymethylpenicillin should be discontinued and appropriate therapy prescribed.
It is necessary to avoid the use of phenoxymethylpenicillin in combination with bacteriostatic antibiotics. Combination with other antibiotics is allowed if an additive or synergistic effect is expected.
Phenoxymethylpenicillin is not prescribed for vomiting and diarrhea. In these cases, absorption is disrupted.
With prolonged treatment, the possibility of growing resistant strains of bacteria and fungi should be considered.
With persistent diarrhea, the possibility of developing pseudomembranous colitis should be considered.
With prolonged use, periodic monitoring of the pattern of peripheral blood and indicators of liver and kidney function is recommended.
When using phenoxymethylpenicillin, false-positive results of the reaction are possible in the non-enzymatic determination of glucose in urine and in the analysis for urobilinogen and the results of quantitative determination of amino acids in urine by the ninhydrin method.
DRUG INTERACTION
With the simultaneous use of phenoxymethylpenicillin weakens the effect of hormonal contraceptives.
With the simultaneous use of phenoxymethylpenicillin with NSAIDs (especially with indomethacin, phenylbutazone and salicylates in high doses), as well as with probenecid, there is a possibility of a crosstalk in the excretion of these substances.
