Actions of Axl-250 in details
Axl-250 Pharmaniaga is an antibiotic of group semisynthetic penicillins a wide spectrum of action. It is a 4-hydroxyl analog of ampicillin. It has bactericidal action. Axl-250 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 Axl-250.
In combination with metronidazole Axl-250 Pharmaniaga is active against Helicobacter Pylori. It is believed that inhibits the development of Axl-250 resistance of Helicobacter pylori to metronidazole.
There is a cross-resistance between Axl-250 and ampicillin.
The spectrum of antibacterial action while expanding the application of Axl-250 and beta-lactamase inhibitor clavulanic acid. This combination increased the activity of Axl-250 against Bacteroides spp., Legionella spp., Nocardia spp., Pseudomonas (Burkholderia) Pseudomallei. However, Pseudomonas Aeruginosa, Serratia Marcescens, and many other gram-bacteria are resistant.
How should I take Axl-250?
Take Axl-250 exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.
The recommended dose of Axl-250 is one 775 mg tabet taken once daily with food. The tablet should be taken within one hour of finishing a meal.
Take Axl-250 around the same time every day for 10 days. Complete the full 10-day course of therapy for effective treatment. Do not skip any doses or stop taking Axl-250 until you finish your prescribed treatment, unless you have a serious allergic reaction or your doctor tells you to stop.
Do not crush, chew, or break a Axl-250 extended-release tablet. Swallow it whole. Breaking the tablet may cause too much of the Axl-250 to be released at one time.
While using this medicine, you may need frequent blood tests. Your kidney and liver function may also need to be checked.
Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Axl-250 will not treat a viral infection such as the flu or a common cold.
Do not share this medicine with another person, even if they have the same symptoms you have.
This medicine can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using Axl-250.
Store at room temperature away from moisture, heat, and light.
Axl-250 administration
Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.
You may take Axl-250 with or without food.
Shake the oral suspension (liquid) well just before you measure a dose. Measure the liquid with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.
You may place the liquid directly on the tongue, or you may mix it with water, milk, baby formula, fruit juice, or ginger ale. Drink all of the mixture right away. Do not save any for later use.
The chewable tablet should be chewed before you swallow it.
Do not crush, chew, or break an extended-release tablet. Swallow it whole. Breaking the pill may cause too much of the drug to be released at one time.
To be sure this medicine is helping your condition and is not causing harmful effects, your blood will need to be tested often. Your liver and kidney function may also need to be tested. Visit your doctor regularly.
If you are being treated for gonorrhea, your doctor may also have you tested for syphilis, another sexually transmitted disease.
If you are taking Axl-250 with clarithromycin and/or lansoprazole to treat stomach ulcer, use all of your medications as directed. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice.
Take this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Axl-250 will not treat a viral infection such as the common cold or flu.
Do not share this medication with another person, even if they have the same symptoms you have.
This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using Axl-250.
Store at room temperature away from moisture, heat, and light.
You may store liquid Axl-250 in a refrigerator but do not allow it to freeze. Throw away any liquid Axl-250 that is not used within 14 days after it was mixed at the pharmacy.
Axl-250 pharmacology
Mechanism of Action
Axl-250 is an antibacterial drug.
Pharmacokinetics
Axl-250 is an extended-release formulation of Axl-250 intended to provide once-daily dosing. Following the administration of Axl-250 with a low-fat meal in healthy subjects, mean Axl-250 AUC0-∞, Cmax, and Tmax values were 29.8 μg•h/mL, 6.6 μg/mL and 3.1 hours, respectively. The mean plasma concentration-time curve is shown below in Figure 1.
Figure 1. Mean Axl-250 Plasma Concentrations Following a Single
Oral Dose of Axl-250 With a Low-Fat Meal in Healthy Subjects (N=20)
Administration of Axl-250 with food decreases the rate, but not the extent of Axl-250 absorption. Compared to immediate-release Axl-250 suspension, the rate of Axl-250 absorption following administration of Axl-250 was slower, resulting in a lower Cmax and longer Tmax. Total Axl-250 exposure (AUC) achieved with Axl-250 is similar to that observed after oral administration of a comparable dose of immediate-release Axl-250 suspension.
Axl-250 diffuses readily into most body tissues and fluids, with the exception of brain and spinal fluid, except when meninges are inflamed. Axl-250 is approximately 20% protein bound in human serum.
Axl-250 is primarily cleared by renal excretion. Approximately 60% of an oral dose of immediate-release Axl-250 is eliminated unchanged in urine. The half-life of Axl-250 after oral administration of Axl-250 is approximately 1.5 hours, similar to that of immediate-release Axl-250. No accumulation of Axl-250 was observed after once-daily dosing of 775 mg of Axl-250 for 7 days.
Drug Interactions
In a study of healthy adult subjects, Axl-250 AUC was similar whereas Cmax increased approximately 35% following the administration of lansoprazole with Axl-250 given with food.
Probenecid decreases the renal tubular secretion of Axl-250. Concurrent use of Axl-250 and probenecid may result in increased and prolonged blood levels of Axl-250. The clinical relevance of this finding has not been evaluated.
Microbiology
Mechanism of Action
Axl-250 is similar to penicillin in its bacterial action against susceptible organisms during the stage of active multiplication. It acts through the inhibition of cell wall biosynthesis that leads to the death of the bacteria.
Mechanism of Resistance
To date there are no known mechanisms of resistance to penicillin or Axl-250 in Streptococcus pyogenes.
Axl-250 has been shown to be active in vitro against isolates of the microorganism S. pyogenes and in clinical infections as described in the INDICATIONS AND USAGE section.
Gram-Positive Bacteria:
Streptococcus pyogenes
The following in vitro data are available, but their clinical significance is unknown. At least 90% of the following microorganisms exhibit an in vitro minimum inhibitory concentration (MIC) less than or equal to the susceptibility breakpoint of Axl-250 (as determined by susceptibility tests using the class representative agents penicillin or ampicillin).
Gram-Positive Bacteria:
Streptococcus spp. (Group B, C, and G; Beta-hemolytic)
Susceptibility Test Methods:
When available, the clinical microbiology laboratory should provide cumulative in vitro susceptibility test results for antimicrobial drugs used in local hospitals and practice areas to the physician as periodic reports that describe the susceptibility profile of nosocomial and community-acquired pathogens. These reports should aid the physician in selecting the most effective antimicrobial.
Dilution Techniques
Quantitative methods are used to determine antimicrobial MICs. These MICs provide estimates of the susceptibility of bacteria to antimicrobial compounds. The MICs should be determined using a standardized method (broth or agar)1,2.
Susceptibility of beta-hemolytic streptococcal isolates to Axl-250 may be inferred by testing penicillin. An organism that is susceptible to penicillin can be considered susceptible to Axl-250 when used for approved indications2. If testing is performed, any beta hemolytic streptococcal isolate found to be nonsusceptible should be reidentified, retested, and if confirmed, submitted to a public health laboratory.
Quality Control
Standardized susceptibility test procedures1,2 require the use of laboratory controls to monitor and ensure the accuracy and precision of the supplies and reagents used in the assay, and the techniques of the individuals performing the test. Standard Axl-250 powder should provide the following range of MIC values provided in Table 2. For the disk diffusion technique, the criteria in Table 2 should be achieved.
| aQC limits for testing E. coli 35218 when tested on Haemophilus Test Medium (HTM) are greater than 256 mcg/mL for Axl-250; testing Axl-250 may help to determine if the isolate has maintained its ability to produce beta-lactamase2. | ||
| bATCC = American Type Culture Collection | ||
| Quality Control Organism | Minimum Inhibitory Concentrations (mcg/mL) | Disk Diffusion Zone Diameters (mm) |
| Streptococcus pneumoniae ATCCb 49619 | 0.03–0.12 | --- |
| Klebsiella pneumoniae ATCC 700603 | >128 | --- |
References
- DailyMed. "AMOXICILLIN; CLAVULANATE POTASSIUM: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- NCIt. "Amoxicillin Anhydrous: NCI Thesaurus (NCIt) provides reference terminology for many systems. It covers vocabulary for clinical care, translational and basic research, and public information and administrative activities.". https://ncit.nci.nih.gov/ncitbrowser... (accessed September 17, 2018).
- EPA DSStox. "Amoxicillin: DSSTox provides a high quality public chemistry resource for supporting improved predictive toxicology.". https://comptox.epa.gov/dashboard/ds... (accessed September 17, 2018).
Reviews
The results of a survey conducted on ndrugs.com for Axl-250 are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Axl-250. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.User reports
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Information checked by Dr. Sachin Kumar, MD Pharmacology
