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

Indications Iramox

It is used for microbial infections caused by bacteria sensitive to the drug: sinusitis, pleural empyema, otitis with tonsillitis, pneumonia, pharyngitis with pulmonary abscess, tonsillitis with bronchopneumonia, as well as cystitis, urethritis with pyelonephritis, gonorrhea, prostatitis, etc.

It is also prescribed in cases of chronic gastritis or ulcers in the gastrointestinal tract associated with the effects of 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 stages of the formation of the microbial cell membrane and the change in its shape during cell growth and division. Penicillins synthesize penicillin-binding proteins and lead to their inactivation, which causes 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. Among the microbes sensitive to it are: campylobacter, proteus mirabilis, chlamydia with intestinal sticks, hemophilic sticks, shigella and whooping cough sticks, as well as salmonella and Leptospira. [ 3 ]

In addition, it demonstrates activity against streptococci (from subcategories A and B, as well as C and G, I with H and M), as well as non-penicillinase-producing staphylococci, pneumococci, corynebacteria, neisseria, listeria with pasteurella multocida, erysipelothrix rhusiopatiae, anthrax bacilli with actinobacteria, spirochetes (treponemas, leptospira, borrelia, etc.), streptobacilli and small spirilla.

Along with this, it affects various anaerobes, including clostridia with peptococci, fusobacteria and peptostreptococci.

Pharmacokinetics

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

Amoxicillin is able to penetrate most biological fluids and tissues; in addition, it crosses the placenta and is excreted in breast milk.

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

Dosing and administration

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

For a child over 10 years old (weight over 40 kg) and an adult, 0.5 g of the drug is usually prescribed, with 8-hour breaks (1.5 g per day in total). If the infection is severe, doubling the dosage is allowed - 1 g of the drug 3 times a day with 8-hour breaks.

A child aged 5-10 years should take 250 mg of the substance 3 times a day, at 8-hour intervals.

If Iramox needs to be used in young children, it is recommended to use a suspension of the drug.

Therapy with antibiotics should be continued for 48-72 hours after the symptoms of the disease have been eliminated. On average, the treatment cycle lasts up to 7 days.

In the case of an active phase of gonorrhea that occurs without complications, 3 g of the medication is administered once (it is recommended to take 1000 mg of probenecid along with it).

In case of active infections of the digestive tract (typhoid or paratyphoid) or bile ducts, and also in case of gynecological diseases, adults should take 1.5-2 g of the drug 3 times a day or 1-1.5 g of the drug 4 times a day.

In 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.

For 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.

If the plasma CC level is less than 30 ml per minute, the dose of the drug is reduced or the interval between administrations is extended. If the CC values are in the range of 15-40 ml per minute, the interval between administrations should be at least 12 hours.

In individuals 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

Iramox may be prescribed to pregnant women only if strictly indicated.

When breastfeeding, the medication is used with caution; breastfeeding should be discontinued during therapy.

Contraindications

Among the contraindications:

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

Side effects Iramox

Main side effects:

• digestive and liver dysfunctions: diarrhea, pain in the anal area, nausea and itching. Glossitis, increased activity of liver transaminases in blood plasma and stomatitis are occasionally observed. Pseudomembranous colitis may occur;
• disorders of hematopoiesis: leukopenia or thrombocytopenia, agranulocytosis and eosinophilia;
• problems with the nervous system and psyche: severe fatigue and headaches. In epileptics or people with weakened renal function or meningitis, the likelihood of neurotoxic complications (convulsions), insomnia or agitation increases;
• signs of allergy: diarrhea or joint pain occasionally occur, as well as exfoliative dermatitis, urticaria, erythema multiforme and Quincke's edema; anaphylaxis is observed sporadically. Almost 70% of patients with infectious mononucleosis develop rubeoliform or morbiliform rash by the 5th day of therapy, which is not associated with allergy.

Overdose

Signs of poisoning are usually similar to those observed during the development of side effects (vomiting, disturbance of EBV indicators, diarrhea, nausea and neurotoxic reactions: hypertonicity, convulsions and changes in EEG readings).

If disorders occur, it is necessary to perform gastric lavage, prescribe enterosorbents and hemodialysis, and in addition, carry out symptomatic actions.

Interactions with other drugs

Combined use with bacteriostatic antibiotics (including erythromycin with tetracyclines, chloramphenicol, etc.) leads to mutual drug antagonism.

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

Combined use with allopurinol results in an increased incidence of epidermal allergy symptoms.

Use with probenecid slows the secretion of Iramox.

The drug weakens the therapeutic effect of steroid contraception.

Cross-sensitivity with cephalosporins and other penicillins may occur.

Combination with antacids reduces the absorption of the drug.

The drug reduces the therapeutic effect of orally administered estrogenic contraceptives, potentiates the absorption of digoxin and increases the toxic properties of methotrexate.

Storage conditions

Iramox must be stored in a dark and dry place, out of the reach of small children. Temperature values are in the range of +15/+25°C.

Shelf life

Iramox is permitted to be used for a period of 36 months from the date of sale of the medicinal substance.

Analogues

The analogs of the drug are Ampicillin, Amofast with Gramox-a, Amoxil and Ospamox with Amoxicillin, as well as Flemoxin and Ampiox with B-mox, Hikoncil and Pressmox.