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DRUGS & SUPPLEMENTS
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Amoxicillin Trihydrate:
Somac-MA is an antibiotic of group semisynthetic penicillins a wide spectrum of action. It is a 4-hydroxyl analog of ampicillin. It has bactericidal action. Somac-MA (Amoxicillin Trihydrate) is active against aerobic gram-positive bacteria: Staphylococcus spp. (except strains producing penicillinase), Streptococcus spp; aerobic gram-negative bacteria: Neisseria Gonorrhoeae, Neisseria Meningitidis, Escherichia Coli, Shigella spp., Salmonella spp., Klebsiella spp.
Microorganisms producing penicillinase is resistant to Somac-MA (Amoxicillin Trihydrate).
In combination with metronidazole Somac-MA (Amoxicillin Trihydrate) is active against Helicobacter Pylori. It is believed that inhibits the development of Somac-MA (Amoxicillin Trihydrate) resistance of Helicobacter pylori to metronidazole.
There is a cross-resistance between amoxycillin and ampicillin.
The spectrum of antibacterial action while expanding the application of Somac-MA (Amoxicillin Trihydrate) and beta-lactamase inhibitor clavulanic acid. This combination increased the activity of Somac-MA (Amoxicillin Trihydrate) against Bacteroides spp., Legionella spp., Nocardia spp., Pseudomonas (Burkholderia) Pseudomallei. However, Pseudomonas Aeruginosa, Serratia Marcescens, and many other gram-bacteria are resistant.
When Somac-MA (Amoxicillin Trihydrate) administered orally Somac-MA (Amoxicillin Trihydrate) rapidly and completely absorbed from the gastrointestinal tract and is not destroyed in the acidic environment of the stomach. Cmax of Somac-MA (Amoxicillin Trihydrate) in the blood plasma is reached after 1-2 h. When increasing doses of 2 times the concentration also increased by 2 times. In the presence of food in the stomach does not reduce the overall removals. Similar concentrations of Somac-MA (Amoxicillin Trihydrate) reached in the blood when administered orally, IV and IM.
The binding of Somac-MA (Amoxicillin Trihydrate) to plasma proteins is about 20%.
Widely distributed in tissues and body fluids. Reported high concentrations of Somac-MA (Amoxicillin Trihydrate) in the liver.
T1/2 from the plasma is 1-1.5 h. About 60% of the dose adopted by mouth, is excreted unchanged in the urine by glomerular filtration and tubular secretion, with a dose of 250 mg of Somac-MA (Amoxicillin Trihydrate) concentration in urine exceeds 300 micrograms / ml. A number of Somac-MA (Amoxicillin Trihydrate) is determined in feces.
T1/2 for Newborns and the elderly can be longer.
In renal insufficiency T1/2 may be 7-20 hours.
In small quantities Somac-MA (Amoxicillin Trihydrate) penetrates through BBB in inflammation of the pia mater.
Somac-MA (Amoxicillin Trihydrate) is removed by hemodialysis.
For use Somac-MA (Amoxicillin Trihydrate) as monotherapy and in combination with clavulanic acid: an infectious-inflammatory diseases caused by susceptible microorganisms, including bronchitis, pneumonia, tonsillitis, pyelonephritis, urethritis, infections of the gastrointestinal tract, gynecological infections, infections of the skin and soft tissue, listeria, leptospirosis, gonorrhea.
For use Somac-MA (Amoxicillin Trihydrate) in combination with metronidazole: chronic gastritis in acute, peptic ulcer and duodenal ulcer in acute, associated with Helicobacter Pylori.
Individual. For oral single dose for adults and children over 10 years is 250-500 mg, in case of serious illness - up to 1 g. For children aged 5-10 years, a single dose of 250 mg in age from 2 to 5 years - 125 mg for children aged under 2 years of daily dose is 20 mg / kg. For adults and children interval is 8 h. In the treatment of acute uncomplicated gonorrhea - 3 g once (in combination with probenecid). Patients with impaired renal function in creatinine clearance 10-40 ml / min interval between doses should be increased to 12 h and if creatinine clearance is less than 10 ml / min interval between doses should be 24 hours.
When parenteral use in adults IM - 1 g 2 times / day, IV (with normal renal function) - 2.12 g / day. Children IM 50 mg / kg / day, single dose - 500 mg, the frequency of administration - 2 times / day; IV - 100-200 mg / kg / day. Patients with impaired renal function the dose and the interval between the injections need to be adjusted in accordance with the values of creatinine clearance.
Allergic reactions: urticaria, erythema, edema Quincke, rhinitis, conjunctivitis, rarely - fever, joint pain, eosinophilia, in rare cases - anaphylactic shock.
Side effects associated with chemotherapy effect: possible development of super-infection (particularly in patients with chronic diseases or low resistance of the organism).
With prolonged use at high doses: dizziness, ataxia, confusion, depression, peripheral neuropathy, seizures.
Mostly when Somac-MA (Amoxicillin Trihydrate) used in combination with metronidazole: nausea, vomiting, anorexia, diarrhea, constipation, epigastric pain, glossitis, stomatitis; rarely - hepatitis, pseudomembranous colitis, allergic reactions (urticaria, angioedema), interstitial nephritis, a violation of hematopoiesis.
Mostly when Somac-MA (Amoxicillin Trihydrate) used in combination with clavulanic acid: cholestatic jaundice, hepatitis, rarely - erythema multiforme, toxic epidermal necrolysis, exfoliative dermatitis.
Infectious mononucleosis, lymphatic leukemia, severe gastrointestinal infections, accompanied by diarrhea or vomiting, respiratory viral infection, allergic diathesis, bronchial asthma, hay fever, sensitivity to penicillin and / or cephalosporins.
For use in combination with metronidazole: diseases of the nervous system; hemodyscrasia, lymphocytic leukemia, an infectious mononucleosis; Hypersensitivity to nitroimidazole derivatives.
For use in combination with clavulanic acid: a history of instructions for liver problems and jaundice, associated with the reception of Somac-MA in combination with clavulanic acid.
Somac-MA (Amoxicillin Trihydrate) crosses the placenta, in small amounts excreted in breast milk.
If necessary the use of Somac-MA (Amoxicillin Trihydrate) during pregnancy should carefully weigh the potential benefits of therapy for the mother and the potential risk to the fetus.
With careful use Somac-MA (Amoxicillin Trihydrate) during lactation (breastfeeding).
With caution used in patients prone to allergic reactions.
Somac-MA in combination with metronidazole is not recommended to use in patients younger than 18 years should not be used for liver diseases.
In the combined therapy with metronidazole is recommended not to drink alcohol.
Treatment must continue 48-72 hours after the disappearance of clinical signs of disease, with streptococcal infections - 10 days.
During the course treatment is necessary to control the state functions of hematopoiesis, liver and kidneys.
Perhaps the development of superinfection due to growth insensitive to the drug microflora. In the case of superinfection requires removal of Somac-MA (Amoxicillin Trihydrate) and the corresponding change in antibiotic therapy. When treating patients with bacteremia may develop bacteriolysis reaction (reaction of Jarisch-Herxheimer).
Patients who have an increased sensitivity to penicillin, may be cross-allergic reactions to cephalosporin antibiotics.
In the treatment of mild diarrhea at the background of the treatment should be avoided antidiarrhoeal drugs that reduce intestinal motility; can use kaolin or attapulgite containing antidiarrhoeal stuff. Patients with severe diarrhea should consult a doctor.
With simultaneous use of Somac-MA (Amoxicillin Trihydrate) and oral contraceptives estrogensoderzhaschih and Somac-MA (Amoxicillin Trihydrate) should if possible to use additional methods of contraception.
Somac-MA (Amoxicillin Trihydrate) may decrease the effectiveness of contraceptives for oral administration.
With the simultaneous use of Somac-MA (Amoxicillin Trihydrate) with bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, vancomycin, rifampicin) appears synergies; with bacteriostatic antibiotic (including macrolides, chloramphenicol, lincosamides, tetracyclines, sulphonamide) - antagonism.
Somac-MA (Amoxicillin Trihydrate) increases the effects of indirect anticoagulants inhibiting intestinal microflora, reduces the synthesis of vitamin K and prothrombin index.
Somac-MA (Amoxicillin Trihydrate) reduces the effect of drugs, in the process of metabolism that produce PABA.
Probenecid, diuretics, allopurinol, phenylbutazone, NSAIDs decrease the tubular secretion of Somac-MA (Amoxicillin Trihydrate), which can be accompanied by an increase in its concentration in blood plasma.
Antacids, glucosamine, laxatives, aminoglycosides, slow down and reduce, and ascorbic acid increases the absorption of Somac-MA (Amoxicillin Trihydrate).
With the combined use of Somac-MA (Amoxicillin Trihydrate) and clavulanic acid pharmacokinetics of both components unchanged.
Symptoms: nausea, vomiting, diarrhea, disruption of water and electrolyte balance (as a result of vomiting and diarrhea); for prolonged use at high doses - neurotoxic reactions and thrombocytopenia (these phenomena are reversible and disappear after drug withdrawal).
Treatment: gastric lavage, the prescription of activated charcoal, saline laxatives, correction of water and electrolyte balance; hemodialysis.
Metronidazole:
Somac-MA is an anti protozoal agent. It is believed that the mechanism of action is associated with DNA damage-sensitive microorganisms. Active against Trichomonas vaginalis, Gardnerella vaginalis, Giardia lamblia, Entamoeba histolytica, and obligate anaerobic bacteria (including Bacteroides spp., Fusobacterium spp.).
Aerobic bacteria are resistant to Somac-MA (Metronidazole).
In combination with amoxicillin Somac-MA (Metronidazole) is active against Helicobacter pylori. It is believed that amoxicillin inhibits the development of resistance of Helicobacter pylori to Somac-MA (Metronidazole).
Somac-MA (Metronidazole) well absorbed after oral administration. The bioavailability is 80%. Somac-MA (Metronidazole) is distributed in tissues and body fluids. This medication crosses the placental barrier and the BBB. Binding to plasma proteins is 20%. Somac-MA (Metronidazole) is metabolized in the liver by oxidation and binding to glucuronic acid. T1/2 is 8 hours. This drug is excreted in the urine (60-80%) and feces (6-15%).
Trichomonazice vaginitis and urethritis in women, trichomonazice urethritis in men, giardiasis, amoebic dysentery, anaerobic infections caused by metronidazole-sensitive organisms, combination therapy of severe mixed aerobic-anaerobic infections. Preventing anaerobic infection in surgery (particularly abdominal, urinary tract). Chronic alcoholism.
Somac-MA (Metronidazole) in combination with amoxicillin: chronic gastritis in acute phase, gastric ulcer and duodenal ulcer in acute phase, associated with Helicobacter pylori.
For external and topical use: treatment of acne vulgaris and pink, bacterial vaginosis, treatment of long-term healing of wounds and trophic ulcers.
Somac-MA is administered for oral use for adults and children over 12 years in 7.5 mg / kg every 6 h or 250-750 mg 3-4 times / day. For children up to 12 years the dose is 5-16.7 mg / kg 3 times / day. For IV injections for adults and children over 12 years starting dose is 15 mg / kg, followed by 7.5 mg / kg every 6 hours or depending on the etiology of the disease - by 500-750 mg every 8 hours. The duration of treatment and frequency of tests is determined individually.
Intravaginally - 500 mg 1 time a night.
In combination with amoxicillin (2.25 g / day) daily dose of Somac-MA (Metronidazole) is 1.5 g; multiplicity of admission - 3 times / day. For patients with severe renal impairment (creatinine clearance less than 30 ml / min) and / or liver daily dose of Somac-MA (Metronidazole) is 1 g (amoxicillin - 1.5 g / day), the multiplicity of the reception is 2 times / day. This medication takes for external and local use 2 times / day, doses are determined individually.
The maximum daily dose for adults when taken orally and IV is 4 g.
Digestive system: nausea, vomiting, anorexia, metallic taste in the mouth.
CNS and peripheral nervous system: headache, nervousness, irritability, insomnia, dizziness, ataxia, weakness, confusion, depression, peripheral neuropathy, seizures, hallucinations.
Allergic reactions: skin rash, itching, hives.
Hemopoietic system: leucopenia.
Local reactions: irritation.
Other: arthralgia, burning sensation in the urethra.
Organic CNS lesions, blood diseases, liver problems, I trimester of pregnancy, hypersensitivity to Somac-MA (Metronidazole).
Somac-MA is rapidly crosses the placental barrier. In II and III trimester of pregnancy Somac-MA (Metronidazole) is used only for health reasons.
Somac-MA (Metronidazole) is excreted in breast milk. If necessary, use during lactation should solve the issue of termination of breastfeeding.
Patients should with careful use of Somac-MA (Metronidazole) in liver diseases.
In combination with amoxicillin this medication is not recommended for patients younger than 18 years. During the treatment period it is necessary the regular control of pattern of peripheral blood.
During the treatment of Trichomonas vaginitis in women and Trichomonas urethritis in men patients should refrain from sexual activity, simultaneous treatment of both partners is mandatory.
During the taking of Somac-MA (Metronidazole) there is a more dark staining of urine.
During treatment with Somac-MA (Metronidazole) should avoid alcohol because to violations of the oxidation of alcohol can accumulate acetaldehyde. As a result may develop reactions similar to those characteristic of disulfiram (abdominal cramps, nausea, vomiting, headache, a sudden rush of blood to the face).
Simultaneous administration of Somac-MA (Metronidazole) with:
Symptoms: nausea, vomiting, ataxia, in severe cases - peripheral neuropathy and seizures.
Treatment: symptomatic, there is no specific antidote.
Pantoprazole Sodium:
Indication: Short-term (up to 16 weeks) treatment of erosive esophagitis.
Somac-MA (Pantoprazole Sodium) is a substituted benzimidazole indicated for the short-term treatment (up to 16 weeks) in the healing and symptomatic relief of erosive esophagitis. Somac-MA (Pantoprazole Sodium) is a proton pump inhibitor (PPI) that suppresses the final step in gastric acid production.
Depending on the reaction of the Somac-MA after taken, if you are feeling dizziness, drowsiness or any weakness as a reaction on your body, Then consider Somac-MA not safe to drive or operate heavy machine after consumption. Meaning that, do not drive or operate heavy duty machines after taking the capsule if the capsule has a strange reaction on your body like dizziness, drowsiness. As prescribed by a pharmacist, it is dangerous to take alcohol while taking medicines as it exposed patients to drowsiness and health risk. Please take note of such effect most especially when taking Primosa capsule. It's advisable to consult your doctor on time for a proper recommendation and medical consultations.
Is Somac-MA addictive or habit forming?Medicines are not designed with the mind of creating an addiction or abuse on the health of the users. Addictive Medicine is categorically called Controlled substances by the government. For instance, Schedule H or X in India and schedule II-V in the US are controlled substances.
Please consult the medicine instruction manual on how to use and ensure it is not a controlled substance.In conclusion, self medication is a killer to your health. Consult your doctor for a proper prescription, recommendation, and guidiance.
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The information was verified by Dr. Rachana Salvi, MD Pharmacology