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Iba-mentin medicine containing Amoxicillin in the form of amoxicillin trihydrate is indicated in the treatment of infections caused by upper respiratory tract infections, lower respiratory tract infections, urinary tract infections, skin and soft tissue infections. .. Besides, Iba-mentin medicine can also cause some unwanted side effects such as: diarrhea, rash, itching, nausea and vomiting...
1. Mechanism of action of the drug Iba-mentin
Iba-mentin 500mg drug contains clavulanic acid and Amoxicillin - a semi-synthetic beta-lactam antibiotic with a fairly broad bactericidal spectrum against both Gram-positive and Gram-negative bacteria. But because the compound Amoxicillin is easily destroyed by beta-lactams, it is not effective against strains of bacteria that produce this enzyme.
Clavulanic acid helps prevent Amoxicillin from being destroyed by beta-lactamases, and effectively extends the antibacterial spectrum of Amoxicillin active ingredient against many bacteria normally resistant to Amoxicillin, other penicillins and cephalosporins.
Mechanisms of resistance to Amoxicillin include: inactivation by beta-lactamase-producing bacteria that are not inhibited by clavulanic acid groups B, C, and D and alteration of penicillin-binding proteins that decrease the drug's affinity for the target. pepper. Bacterial permeation or pump-out mechanisms can cause or contribute to bacterial resistance, especially gram-negative bacteria.
When Iba-mentin is taken into the body, it can be easily absorbed from the gastrointestinal tract. Serum concentrations of these two compounds can be maximal 1 to 2 hours after dosing. A dose of 250 mg or 500 mg will include 5 mcg/mL of Amoxicillin and 3 mcg of clavulanic acid in the serum. Absorption of Iba-mentin is not affected by food and is best taken before meals.
Oral bioavailability of the drug through two compounds Amoxicillin accounts for 90% and clavulanic acid is 75%. The biological half-life of drugs that include: Amoxicillin in serum is 1 to 2 hours and clavulanic acid in serum is about 1 hour. Iba-mentin is excreted in the urine in the active form with 55 to 70% of Amoxicillin and 30 to 40% of clavulanic acid.
In subjects with renal impairment, serum concentrations of both amoxicillin and clavulanic acid are higher and their half-lives are also prolonged. In patients with a creatinine clearance of 9 ml/min, the half-lives of Amoxicillin and clavulanic acid were 7.5 and 4.3 hours, respectively.
2. Indications and contraindications for the use of Iba-mentin
Iba-mentin is indicated for the treatment of bacterial infections with cases such as:
Upper respiratory tract infections with related diseases such as tonsillitis, sinusitis, otitis media that have been treated with common antibiotics but not cured Lower respiratory tract infections with diseases such as acute and chronic bronchitis, pneumonia. Severe infections of the urogenital tract with cystitis, urethritis, pyelonephritis In addition, there are other infections such as boils, abscesses, wound infections, osteomyelitis, fossa abscess. Teeth, or infection due to abortion... Iba-mentin drug may be contraindicated in cases of allergy to beta-lactamin antibiotics or cases of mononucleosis due to infection. Or patients with a history of jaundice, liver dysfunction...
3. Dosage and usage of Iba-mentin
The recommended dosage of Iba-mentin for adults and children with a body weight of 40 kg or more is about 500 to 1000 mg / time, and taken 2 to 3 times a day. For children under 40kg, the dose ranges from 20 to 60mg/kg/day and is divided into 3 times per day.
Children can receive therapeutic doses of Iba-mentin tablets or premixed powder.
For children aged 6 years and under or under 40kg, use Iba-mentin treatment in the form of ready-made powder.
For people with kidney failure, it is necessary to adjust the maximum amount of amoxicillin. But it should not be adjusted in patients with a clearance greater than 30 ml/min.
The case of Iba-mentin overdose can be less harmful, because the drug is tolerable even at high concentrations. However, in cases of diseases such as renal dysfunction or poor blood-brain barrier, injectable Iba-mentin can cause symptoms of toxicity. However, the possible acute reactions will depend on the hypersensitivity of each patient. But at too high a dose can cause hyperkalemia because clavulanic acid is taken as the potassium salt. In cases of overdose of Iba-mentin, hemodialysis can be used to remove the drug from the circulation.
4. Unwanted side effects when using Iba-mentin drugs
Iba-mentin can cause some unwanted side effects in about 5% of patients when using normal doses, including common manifestations such as diarrhea, rash, itching... Besides, Rare and rare reactions such as pruritus, erythema, eosinophilic rash, nausea, hepatitis, cholestatic jaundice, anaphylactic reactions, Stevens-Johnson syndrome, erythema may occur. polycythemia vera, atopic dermatitis, pseudomembranous colitis, thrombocytopenia, leukopenia...
Notes when using Iba-mentin: For those with liver dysfunction accompanied by signs Cholestatic jaundice can be aggravated by co-administration, although this is quite rare. With moderate or severe renal impairment, it is necessary to pay attention to the dose of Iba-mentin. People with a history of hypersensitivity to penicillin may have a severe reaction when using Iba-mentin. Prolonged use of Iba-mentin can cause bacteria to overgrow or cause antibiotic resistance.
According to experimental studies on the reproductive process of rats, it has been shown that oral or injectable inhibition of Iba-mentin does not cause malformations. However, studies on human use are limited, so sensitive subjects such as pregnant women and nursing mothers should carefully weigh the benefits and risks before use. Iba-mentin drug.
Iba-mentin drug interactions:
Iba-mentin drugs can cause prolonged bleeding and clotting time. Therefore, people who are on anticoagulant therapy are not indicated to use Iba-mentin at the same time. Iba-mentin drugs like other antibiotics have a fairly broad spectrum, but Iba-mentin combined with oral contraceptives can reduce the effectiveness of the drug, so if the patient uses these two drugs, it is necessary to be advance notice to have an appropriate treatment plan. Iba-mentin in combination with methotrexate can reduce the excretion of methotrexate, increasing the risk of toxicity to the body. Iba-mentin and probenecid should not be used concurrently. Because probenecid may reduce the renal tubular secretion of amoxicillin. Furthermore, concomitant use of Iba-mentin with probenecid may result in elevated and prolonged blood concentrations of amoxicillin. Iba-mentin may decrease the activity of Mycophenolate mofetil. In patients receiving mycophenolate mofetil, the drug caused approximately 50% reduction in the active metabolite concentrations of the previous dose when co-administered with Iba-mentin containing the two components Amoxicillin and clavulanic acid in oral tablet form. . Changes in previous dosing will not accurately reflect changes in overall MPA exposure. Therefore, alteration in doses of Mycophenolate mofetil is not usually necessary in the absence of clinical evidence of graft dysfunction. However, if the patient encounters this case, it is necessary to monitor more closely during treatment with the drug. Above information about the drug Iba-mentin, knowing the information will help the process of use achieve higher efficiency.
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