Iramox

Iramox contains the element amoxicillin, which is a semi-artificial penicillin antibiotic and has a wide range of medicinal effects.

The processes of its inactivation occur under the action of β-lactamases (penicillinases) produced by individual microbial strains. [1]

The drug demonstrates a bactericidal effect and inhibits the binding of microbial cell membranes. This effect is associated with the ability of penicillins to reach and synthesize proteins of the penicillin-binding type, located on the inner side of the membranes of bacterial cells. [2]

Indications Iramox

It is used for microbial infections that appear under the influence of bacteria sensitive to the drug: sinusitis , pleural empyema, otitis media with angina , pneumonia, pharyngitis with pulmonary abscess, tonsillitis with bronchopneumonia, and besides this cystitis, urethritis with pyelonephritis, gonorrhea, prostatitis, etc.

It is also prescribed in the case of chronic gastritis or ulcers in the gastrointestinal tract associated with exposure to H. Pylori (combination therapy).

Release form

The drug is released in the form of capsules with a volume of 0.25 or 0.5 g.

Pharmacodynamics

Penicillin-binding proteins, which contain carboxypeptidases and transpeptidases with endopeptidases, are enzymes involved in the final phases of the formation of the membrane of a microbial cell and changes in its shape during cell growth and division. Penicillins synthesize penicillin-binding proteins and lead to their inactivation, which leads to a violation of the strength of the cell membrane and the development of lysis.

The drug affects the activity of gram-positive and -negative bacteria. Microbes sensitive to it include Campylobacter, Proteus mirabilis, Chlamydia with Escherichia coli, Haemophilus influenzae, Shigella and whooping cough, as well as Salmonella and Leptospira. [3]

In addition, it demonstrates the effect on streptococci (from subcategories A and B, as well as C and G, I with H and M), as well as staphylococci that do not produce penicillinase, pneumococci, corynebacteria, Neisseria, Listeria with Pasteurella multicide, Erysipelothrix rhusiopatiae, anthrax with actinobacteria, spirochetes (treponema, Leptospira, borrelia, etc.), streptobacilli and small spirilla.

At the same time, it affects various anaerobes, including clostridia with peptococci, fusobacteria and peptostreptococci.

Pharmacokinetics

After oral administration, the drug is almost completely and at high speed absorbed inside the gastrointestinal tract, without disintegrating under the influence of stomach acid. Plasma Cmax values are recorded after 1-2 hours from the moment the capsule is consumed. Food intake has no significant effect on drug absorption.

Amoxicillin is able to pass into most biological fluids, as well as tissues; in addition, it crosses the placenta and is excreted in the mother's milk.

The excretion of most of the drugs is realized through the kidneys (about 50% of the unchanged element is excreted in the urine), and small volumes of it are excreted in the bile. The half-life is 1–2 hours; in the case of renal dysfunction, the excretion of the drug slows down (it is 4.5 hours with CC values in the range of 10-30 ml per minute, and in the case of a CC level less than 10 ml per minute - 12.6 hours).

Dosing and administration

Portions are selected personally, taking into account the severity of the pathology, the localization of infection and the sensitivity of the pathogen microbe.

For a child over the age of 10 (weight more than 40 kg) and an adult, 0.5 g of medication is usually prescribed, with 8-hour breaks (1.5 g per day in general). If the infection is severe, it is allowed to double the dosage - 1 g of drugs 3 times a day at 8-hour intervals.

A child 5-10 years of age should be administered 250 mg of the substance 3 times a day, with an 8-hour interval.

If you need to use Iramox in young children, it is recommended to use a suspension of the medication.

It is necessary to continue therapy with the use of an antibiotic in the period 48-72 hours after the elimination of the symptoms of the disease. On average, the treatment cycle lasts up to 7 days.

In the case of the active phase of gonorrhea, proceeding without complications, 3 g of the medication is injected once (it is recommended to take 1000 mg of probenecid with it).

In the case of infections of the digestive tract organs in the active stage (typhoid fever or paratyphoid fever) or bile ducts, and in addition, for diseases of the gynecological type, adults should use 1.5-2 g of the medication 3 times a day or 1-1.5 g of LS 4 - once a day.

In the case of leptospirosis, an adult needs to take 0.5-0.75 g of Iramox 4 times a day for a period of 6-12 days.

In case of infections associated with the action of β-hemolytic streptococcus, the medication is prescribed in standard doses for a period of at least 10 days.

Use in people with renal dysfunction.

In the case of a plasma QC level of less than 30 ml per minute, a portion of the medication is reduced or prolonged the interval between the use of drugs. With CC values in the range of 15-40 ml per minute, the interval between injections should be at least 12 hours.

In persons with anuria, the daily dosage of the drug should be a maximum of 2000 mg.

• Application for children

The medication is not used in persons under 5 years of age.

Use Iramox during pregnancy

It is allowed to prescribe Iramox to pregnant women only with strict indications.

When breastfeeding, the medication is used carefully; you should refuse to breastfeed during therapy.

Contraindications

Among the contraindications:

• intolerance to β-lactam antibiotics (cross-type allergy may develop);
• leukemoid symptoms of the lymphatic form;
• mononucleosis of infectious genesis;
• lymphocytic leukemia.

Side effects Iramox

The main side symptoms:

• digestive and hepatic dysfunctions: diarrhea, pain in the anus, nausea and itching. Occasionally, glossitis, an increase in the activity of liver transaminases inside the blood plasma, and stomatitis are observed. Colitis of a pseudomembranous form may appear;
• disorders of hematopoietic processes: leuko- or thrombocytopenia, agranulocytosis and eosinophilia;
• problems with the work of the National Assembly and the psyche: severe fatigue and headaches. Epileptics or people with impaired renal function or meningitis are more likely to develop neurotoxic-type complications (seizures), insomnia, or agitation;
• signs of allergies: occasionally diarrhea or joint pain occurs, and in addition, exfoliative type dermatitis, urticaria, erythema polyformis and Quincke's edema; anaphylaxis is singularly noted. Almost 70% of patients with mononucleosis of an infectious origin by the 5th day of therapy develop a rubeoliform or morbiliform rash, which is not associated with allergies.

Overdose

Symptoms in case of poisoning are usually similar to those observed with the development of side effects (vomiting, disorder of EBV parameters, diarrhea, nausea and neurotoxic reactions: hypertonicity, convulsions and changes in EEG readings).

When disorders appear, it is necessary to carry out gastric lavage, prescribe the intake of enterosorbents and perform hemodialysis, and in addition to this, carry out symptomatic actions.

Interactions with other drugs

Combined use with antibiotics of a bacteriostatic nature (among them erythromycin with tetracyclines, chloramphenicol, etc.) leads to mutual drug antagonism.

The introduction of drugs together with aminoglycosides causes synergistic antimicrobial activity.

Combined use with allopurinol leads to an increased incidence of epidermal allergy symptoms.

Used together with probenecid, it slows down the secretion of Iramox.

The medication weakens the therapeutic effect of steroid contraception.

Cross-sensitivity with cephalosporins and other penicillins may occur.

The combination with antacids reduces the absorption of the drug.

The drug reduces the therapeutic effect of oral estrogenic contraceptive drugs, potentiates the absorption of digoxin and increases the toxic properties of methotrexate.

Storage conditions

Iramox is required to be stored in a dark and dry place, closed from the penetration of small children. Temperature values - in the range + 15 / + 25 ° С.

Shelf life

Iramox is allowed to be used for a 36-month term from the date of sale of the drug substance.

Analogs

Analogues of the drug are the drugs Ampicillin, Amofast with Gramox-a, Amoxil and Ospamox with Amoxicillin, and in addition Flemoxin and Ampiox with B-mox, Hikontsil and Pressmox.