The instruction for medical use
of AMPICILLIN medicine
the Trade name
the International unlicensed
name Ampicillin Dosage Form
of the Tablet of 250 mg
One tablet contains
active agent – Ampicillini trihdras
(in terms of ampicillin) 250 mg,
excipients: potato starch, magnesium stearate, povidone, polysorbate, talc.
of the Tablet of white color, the enterprises, ploskotsilindrichesky with a print of the trademark, on one party, risky and a facet – on other party.
Penicillin of a broad spectrum of activity.
The code of automatic telephone exchange J01CA01
Pharmacokinetics Later properties of intake ampicillin absorption fast, bioavailability – 40%, time of achievement of the maximum concentration at oral administration of 500 mg – 2 h, the maximum concentration in blood plasma – 3-4 ng/ml. Communication with proteins of blood plasma – 20%.
It is evenly distributed in bodies and body tissues, it is found in therapeutic concentration in pleural, peritoneal, amniotic and synovial liquids, liquor, contents of blisters, urine (high concentrations), a mucous membrane of intestines, bones, a gall bladder, lungs, tissues of female genitals, bile, in a bronchial secret (in a purulent bronchial secret accumulation weak), paranasal sinuses, saliva, fruit fabrics. Badly gets through a blood-brain barrier (the permeability increases at inflammation).
It is removed mainly by kidneys (70-80%), and in urine very high concentrations of not changed antibiotic, partially with bile, at nursing mothers are created – with milk. Does not kumulirut. Is removed at a hemodialysis.
Ampicillin – the antibacterial microbicide of a broad spectrum of activity from group of semi-synthetic penicillin received by acetylation of 6-aminopenicillanic acid by residue of aminophenylacetic acid, kisloustoychiv. Inhibits a polymerase of a peptidoglikan and transpeptidase, interferes with formation of peptide bonds and breaks late stages of synthesis of a cell wall of the sharing microorganism that leads to decrease in osmotic stability of a bacterial cell and causes its lysis.
Shows the greatest activity concerning gram-positive aerobic bacteria: Staphylococcus spp. (except the beta lactamazoproducing strains), Staphylococcus aureus (except the beta lactamazoproducing strains), Streptococcus pyogenes, Streptococcus viridans, Streptococcus agalactiae, Streptococcus pneumoniae, Listeria monocytogenes, Corynebacterium diphtheriae, Corynebacterium xerose, Bacillus anthracis, Enterococcus spp., gram-negative aerobic bacteria: Neisseria gonorrhoeae, Neisseria meningitides, Haemophilus influenzae, is moderately active concerning gram-negative Escherichia coli, Proteus mirabilis, Shigella spp., Salmonella spp., Leptospira spp., Borrelia spp., Treponema pallidum, Vibrio cholerae, gram-negative anaerobic cocci: Peptostreptococcus spp., Clostridium spp., Propionibacterium acnes, Fusobacterium spp.
The beta lactamazoproducing Staphylococcus spp strains are resistant to ampicillin. and other gram-negative bacteria, Pseudomonas aeruginosa, an indole – positive strains of Proteus spp., Bacteroides spp., Enterobacter aerogenes, Klebsiella pneumoniae, Rickettsia spp., Mycoplasma spp., Chlamydia spp., H. pylori, Mycobacterium tuberculosis. Now the majority of hospital strains of Escherichia coli and Proteus mirabilis are resistant to drug (level of stability of 20-30%).
– bronchitis, pneumonia, lung abscess
– sinusitis, tonsillitis, pharyngitis, average otitis
– pyelonephritis, a pyelitis, cystitis, an urethritis
– a cholangitis, cholecystitis
– a cervicitis
– the ugly face, impetigo which are again infected a dermatosis
– musculoskeletal system infections
– a typhoid and a paratyphoid, dysentery, salmonellosis, a salmonellonositelstvo, peritonitis.
The route of administration and doses
Inside, the adult – on 0.25 g 4 times a day for 0.5-1 h to food with a small amount of water, if necessary increase a dose to 3 g/days.
Infections of digestive tract and bodies of an urinogenital system: 0.5 g 4 times a day.
In a gonococcal urethritis – in 3.5 g once.
To children 6 years are more senior appoint 1-2 g a day. The daily dose is divided into 4-6 receptions.
Duration of treatment depends on disease severity (5-10 days).
– peeling of skin, an itching, urticaria, rhinitis, conjunctivitis, a Quincke’s edema
– dysbacteriosis, an abdominal pain, nausea, vomiting
– fever, an arthralgia, an eosinophilia, erythematic and makulopapulezny rash, exfoliative dermatitis, a multiformny exudative erythema, including Stephens-Johnson, the reactions similar to a serum disease
– stomatitis, gastritis, dryness in a mouth, change of taste, diarrhea, stomatitis, a glossitis, an abnormal liver function, moderate increase in level of hepatic transaminases, a pseudomembranous coloenteritis
– agitation or aggression, uneasiness, confusion of consciousness, change of behavior
– a leukopenia, a neutropenia, thrombocytopenia
– acute anaphylaxis.
– a depression, spasms (at therapy by high doses)
– an agranulocytosis, anemia
Other side reactions:
– candidiasis of a vagina
it is rare:
– interstitial nephrite, a nephropathy, superinfection (especially at patients with chronic diseases or reduced resistance of an organism)
– hypersensitivity to drug
– an infectious mononucleosis
– a lymphoid leukosis
– a liver failure
– digestive tract diseases in the anamnesis (especially the colitis connected with use of antibiotics)
– the lactation period
– children’s age (up to 6 years)
Antacids, a glycosamine, depletive, food slow down Medicinal interactions and reduce absorption, ascorbic acid increases Ampicillin absorption.
Bactericidal antibiotics (including aminoglycosides, cephalosporins, Cycloserinum, Vancomycinum, rifampicin) – sinergidny action, bacteriostatic drugs (macroleads, chloramphenicol, linkozamida, tetracyclines, streptocides) – antagonistic.
Ampicillin increases efficiency of indirect anticoagulants (suppressing intestinal microflora, reduces synthesis of vitamin K and the prothrombin ratio), reduces efficiency of estrogensoderzhashchy oral contraceptives (it is necessary to use additional methods of contraception), medicines in the course of which metabolism Paro – aminobenzoic acid is formed, ethinylestradiol (in the latter case risk of developing bleedings of break increases).
Diuretics, Allopyrinolum, oksifenbutazon, the phenylbutazone, non-steroidal anti-inflammatory drugs, drugs blocking canalicular secretion increase concentration (due to decrease in canalicular secretion) Ampitsillina.
At combined use with Allopyrinolum the risk of developing skin rash increases.
Ampicillin reduces clearance and increases toxicity of a methotrexate, strengthens digoxin absorption.
With care to apply: bronchial asthma, hay fever, etc. allergic diseases, a renal failure, bleedings in the anamnesis.
At course treatment it is necessary to carry out control a condition of function of bodies of a hemopoiesis, a liver and kidneys.
Development of superinfection due to growth of microflora, insensitive to it, is possible that demands corresponding change of antibacterial therapy.
At treatment of patients with bacteremia (sepsis) development of reaction of a bacteriolysis (Yarisha-Gerksgeymer’s reaction) is possible.
At the patients having hypersensitivity to penicillin cross allergic reactions with tsefalosporinovy antibiotics are possible.
At treatment of slight diarrhea against the background of course treatment it is necessary to avoid the antidiarrheal drugs reducing an intestines vermicular movement, it is possible to use a kaolin – or attapulgitsoderzhashchy antidiarrheal means.
Treatment has to continue surely for 48-72 more h after disappearance of clinical signs of a disease.
At simultaneous use of estrogensoderzhashchy oral contraceptives and ampicillin, it is necessary to use whenever possible other or additional methods of contraception.
Influence on laboratory indicators
At treatment false positive results when determining glucose in urine with use of solution of Benedict, Fekhtlinga can arise ampicillin. At an enzymatic way of determination of level of glucose the administration of ampicillin does not affect result of the analysis.
Use during pregnancy is possible only according to vital indications when the expected advantage for mother exceeds potential risk for a fruit. At intake of ampicillin the development of decrease in a tone and weakness of pains of a uterus in labor is possible.
Influence on ability to driving of motor transport and control of mechanisms.
During treatment it is necessary to abstain from driving of motor transport and occupation potentially dangerous types of activity demanding the increased concentration of attention and speed of psychomotor reactions.
Symptoms: manifestations of toxic action on the central nervous system (especially at patients with a renal failure), nausea, vomiting, diarrhea, disturbance of water and electrolytic balance (as a result of vomiting and diarrhea).
Treatment: gastric lavage, activated carbon, salt laxatives, drugs for maintenance of water and electrolytic balance and symptomatic.
It is removed by means of a hemodialysis.
A form of release and packing
of the Tablet on 250 mg. On 10 tablets in blister strip packagings. 1 blister strip packaging together with the instruction for medical use in the state and Russian languages is placed in a pack from cardboard.
To Store storage conditions in the dry place, at a temperature from + 15 to + 25 °C.
To store in the places inaccessible for children!
not to use a period of storage after an expiration date.
According to the prescription.
JSC Sintez producer
Russian Federation, 640008, Kurgan, Konstitutsii Avenue, 7.
ph./fax (3522) 48-16-89