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Grinsil

Grinsil is an oral antibacterial combination consisting of amoxicillin and the beta lactamase inhibitor, clavulanate potassium (the potassium salt of clavulanic acid).

Other names for this medication:
Aclav, Alfoxil, Alphamox, Ambilan, Amimox, Amixen, Amobay, Amobiotic, Amocla, Amoclan, Amoclane, Amodex, Amoklavin, Amoksiklav, Amolin, Amorion, Amotaks, Amoval, Amoxal, Amoxan, Amoxibeta, Amoxicap, Amoxiclav, Amoxidal, Amoxidin, Amoxiduo, Amoxihexal, Amoxiplus, Amoxival, Amoxoral, Amoxsan, Amoxy, Amoxydar, Ampliron, Amylin, Atoksilin, Augmaxcil, Augmentin, Augmex, Augpen, Bactoclav, Betamox, Bioclavid, Biomox, Blumox, Cavumox, Cilamox, Clabat, Clamentin, Clamicil, Clamovid, Clamoxin, Claneksi, Clavam, Clavamel, Clavamox, Clavaseptin, Clavet, Clavinex, Clavipen, Clavobay, Clavubactin, Clavucid, Clavulin, Clavulox, Clavumox, Clonamox, Curam, Dexyclav, Dimopen, Duomox, Enhancin, Exten, Fabamox, Fleming, Fulgram, Germentin, Gimaclav, Gloclav, Glomox, Hiconcil, Himox, Homer, Hymox, Imadrax, Julmentin, Julphamox, Kesium, Klamoks, Klavox, Klavunat, Largopen, Macropen, Maxamox, Medoclav, Megamox, Megapen, Moxacil, Moxatag, Moxiclav, Moxilen, Moxilin, Moxypen, Myclav, Mymox, Natravox, Neomox, Nisamox, Noprilam, Noroclav, Novaclav, Novamox, Novax, Novocilin, Optamox, Oramox, Origin, Panklav, Pediamox, Pinaclav, Pinamox, Ranclav, Ranmoxy, Ranoxyl, Rapiclav, Ronemox, Sulbacin, Suprapen, Synulox, Topcillin, Trifamox, Ultramox, Unimox, Vetrimoxin, Vulamox, Xiclav, Zoxil

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Also known as:  Augmentin.

Description

Grinsil is a brand name for an antibiotic, called co-amoxiclav, that is used to treat a wide range of conditions, from bronchitis to Lyme disease. It is one of the most commonly prescribed antibiotics for children, frequently dispensed for ear infections.

The drug is a combination of two active ingredients: amoxicillin and clavulanic acid. Together, the drugs fight bacteria that would ordinarily be resistant to amoxicillin alone.

Dosage

Neonates and Infants: The recommended dose of Grinsil is 30 mg/kg/day divided every 12 hours, based on the amoxicillin component. Experience with the 200 mg/5 mL formulation in this age group is limited, and thus, use of the 125 mg/5 mL oral suspension is recommended.

Patients Aged 12 weeks (3 months) and Older: See dosing regimens provided in Table 1. The every 12 hour regimen is recommended as it is associated with significantly less diarrhea [see Clinical Studies (14.2)]. However, the every 12 hour suspension (200 mg/5 mL and 400 mg/5 mL) and chewable tablets (200 mg and 400 mg) contain aspartame and should not be used by phenylketonurics.

Patients Weighing 40 kg or More: Pediatric patients weighing 40 kg or more should be dosed according to adult recommendations.

The 250-mg tablet of Grinsil should not be used until the child weighs at least 40 kg,due to the different amoxicillin to clavulanic acid ratios in the 250-mg tablet of Grinsil (250/125) versus the 250-mg chewable tablet of Grinsil (250/62.5).

Overdose

If you take too much this medication, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If this medication is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

Storage

Store between 20 and 25 degrees C (68 and 77 degrees F) away from moisture and heat. Keep bottle closed tightly. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Grinsil are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving beta-lactam antibacterials, including Grinsil. These reactions are more likely to occur in individuals with a history of penicillin hypersensitivity and/or a history of sensitivity to multiple allergens. Before initiating therapy with Grinsil, careful inquiry should be made regarding previous hypersensitivity reactions to penicillins, cephalosporins, or other allergens. If an allergic reaction occurs, Grinsil should be discontinued and appropriate therapy instituted.

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Clinical treatment for blaKPC-positive Klebsiella pneumoniae isolates is challenging because the recommended antibiotic options are limited and are extraordinarily expensive. This study aimed to explore a new therapy for infection caused by KPC-producing K. pneumoniae.

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The in vitro activity of amoxycillin-clavulanic acid was compared with four comparator oral antimicrobial agents; ampicillin, azithromycin, cefuroxime and trimethoprim-sulphamethoxazole against 4536 recent clinical isolates covering 29 species isolated in the US and Canada between 1997 and 1999. Based upon Minimum inhibitory concentrations (MICs), amoxycillin-clavulanic acid was the most active agent against many Gram-positive species and phenotypes including methicillin susceptible Staphylococcus aureus (MSSA) Staphylococcus epidermidis, Enterococcus faecalis, Streptococcus pyogenes, Streptococcus pneumoniae including penicillin intermediate and macrolide resistant strains and was as active as ampicillin against Streptococcus agalactiae, penicillin resistant S. pneumoniae and viridans streptococci. Against Enterobacteriaceae amoxycillin-clavulanic acid in general, displayed weak activity with only Proteus mirabilis and Proteus vulgaris displaying levels of susceptibility above the 90th percentile. Amoxycillin-clavulanic acid had significant activity against many species of Gram-negative non-Enterobacteriaceae including Haemophilus influenzae, Haemophilus parainfluenzae and Moraxella catarrhalis but negligible activity against Burkholderia cepacia, Pseudomonas aeruginosa and Stenotrophomonas maltophilia. Amoxycillin-clavulanic acid continues to retain excellent activity against the majority of targeted pathogens despite 20 years of clinical use.

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The purpose of this study was to compare the use of amoxicillin (1g) vs amoxicillin and clavulanate (875/125mg) after extraction of retained third molars for prevention of infectious complications.

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Augmentin, a formulation of amoxycillin trihydrate 250 mg and sodium clavulanate 125 mg per tablet (A-CS) (Augmentin; Beecham), was used in treating 29 episodes of urinary tract infection occurring in 26 patients admitted to the Spinal Unit of the H. F. Verwoerd Hospital, Pretoria. Patients who had a urinary bacterial cell count of more than 105 of the same amoxycillin-resistant organism before and after the oral administration of amoxycillin 500 mg 3 times a day for 48 hours, received 2 A-CS 375 mg tablets orally, 3 times a day at the start if a meal for 5 days. The 29 strains of amoxycillin-resistant organisms treated in this study were: Escherichia coli (11), Klebsiella pneumoniae (11), Proteus mirabilis (4), Enterobacter cloacae (2), and Staphylococcus epidermidis (1). The bacteriological success rate 24 hours after therapy was 100% and 8 days after therapy 69%, dependent on patient management. In patients on free drainage and managed with condoms a bacteriological success rate of 55,5% was recorded and in patients managed by intermittent catheterization a bacteriological success rate of 75% was recorded. Side-effects were minimal; 1 patient complained of dizziness and no instances of nausea or vomiting were reported. Haematological, renal and hepatic monitoring before and after A-CS-therapy revealed no drug-related toxicity.

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Multicentre, randomised controlled, open labelled, parallel group, non-inferiority trial.

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Bacterial MIC levels remained constant among the three antibiotic treatment groups compared with baseline. Mean MIC90 values ranged from <0.02 to 0.11 microg/ml (amoxicillin/clavulanate potassium), <0.02 to 0.27 microg/ml (metronidazole), and <0.02 to 0.11 microg/ml (tetracycline). Observed changes in susceptibility were attributed to the elimination of single bacterial taxa in the subgingival environment after antibiotic therapy. There were no statistically significant differences in clinical parameters among the treatment groups. Single tetracycline MICs were 1.5- to 6-fold enhanced compared to amoxicillin/clavulanate potassium and metronidazole.

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To determine trends in ciprofloxacin resistance and co-resistance to other antibiotic classes in blood isolates of Escherichia coli, and to investigate if there is an ecological relationship to the community use of fluoroquinolones and other antibiotics.

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The activity of the new oral cephalosporin Bay v 3522 was compared to that of six other beta-lactam agents. Bay v 3522 inhibited methicillin-susceptible Staphylococcus aureus and Staphylococcus epidermidis at less than or equal to 2 micrograms/ml, compared to MICs of greater than or equal to 8 micrograms/ml for the other cephalosporins tested. It was more active against Streptococcus pyogenes (MIC less than or equal to 0.06 microgram/ml) than cefuroxime, cefixime, cephalexin and cefaclor. Groups B, C and G streptococci were inhibited at less than or equal to 0.12 microgram/ml, while the MI"90 for Streptococcus bovis and viridans streptococci was 0.5 and 2 micrograms/ml, respectively. The MIC90 for enterococci and Listeria monocytogenes was 8 micrograms/ml. Clostridium perfringens was inhibited by 0.12 microgram/ml, but most Bacteroides spp. were resistant. The MIC90 for beta-lactamase positive Escherichia coli (producing primarily TEM-1) was greater than 64 micrograms/ml and for beta-lactamase negative strains 16 micrograms/ml. The MIC90 for high-level beta-lactamase producing Klebsiella pneumoniae was greater than 64 micrograms/ml versus 4 micrograms/ml for other isolates. The MIC90 for Moraxella catarrhalis was 2 micrograms/ml, for Haemophilus influenzae 1 micrograms/ml, and for Neisseria gonorrhoeae 4 micrograms/ml. Enterobacter cloacae, Citrobacter freundii, Proteus mirabilis, Providencia spp. and Pseudomonas aeruginosa were resistant. Bay v 3522 was destroyed by TEM-1, SHV-1, TEM-3 and P99 beta-lactamases.

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The purpose of this study was to determine effect of repeated exposure to sub-inhibitory concentrations of amoxicillin/clavulanic acid on the development of resistance in Streptococcus pneumoniae. Other agents, azithromycin, cefaclor and levofloxacin, were also tested. Twenty S. pneumoniae were passaged for 9 days in the presence of sub-inhibitory concentrations of each antimicrobial agent and MICs determined by NCCLS macro-dilution method. There was a four-fold increase in amoxicillin/clavulanic acid MICs for 2 of 20 isolates. Three of 9 tested against cefaclor, 11 of 13 tested against azithromycin and 9 of 20 tested against levofloxacin showed > or =4-fold increase. Amoxicillin/clavulanic acid was the most stable of the agents tested. Cefaclor MICs were also fairly stable. Azithromycin and levofloxacin MICs were most affected.

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We used data from 152 patients of the placebo arm of a randomized trial of amoxicillin/clavulanate for exacerbations of mild to moderate COPD. Clinical response in relation to Anthonisen criteria and point-of-care serum C-reactive protein (CRP) tests (cutoff, 40 mg/L) was assessed with multivariate logistic regression analysis.

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Review of the data base revealed 207 cases of serious acute generalized exanthematous pustulosis leading to death in 4 cases (2%). Of these cases of acute generalized exanthematous pustulosis, only one drug was suspected in 107 cases (51.6%). The main drugs involved were: pristinamycin (18 cases), amoxicillin (+/- clavulanic acid) (16 cases), hydroxychloroquine (8 cases) and a combination of spiramycin + metronidazole (5 cases).

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Testimonials
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grinsil 875 mg 2016-08-01

Serious wound infection after thyroidectomy is uncommon, but actual incidence is not well documented in the literature. In the past a patient in our unit died secondary to fulminant Trifamox Duo Suspension Pediatrica streptococcal sepsis after thyroidectomy for benign disease. This prompted us to audit experience of serious wound infection among British Association of Endocrine Surgery (BAES) members.

grinsil duo 875 mg 2016-10-16

Seven children (age range: 6 to 14 years) were diagnosed as having BKC. All children received systemic Augmentin Duo 400/57 and showed considerable improvement within the first month of therapy. Six children had no recurrences during a mean follow-up of Cleocin Cream Dosage 6 months. No patients experienced any side effects from this treatment.

grinsil clav duo 875 mg 2017-04-30

Based on antimicrobial resistance patterns found in Swiss university hospitals, treatment with a third-generation cephalosporin is currently advised for Swiss Novaclav 625 Medicine children with urinary tract infection.

grinsil duo amoxicilina 750 mg 2017-06-06

This was an investigator-blind trial Cipro Drug Test in young children 6-24 months old with no history of recurrent AOM who were randomly assigned to amoxicillin/clavulanic acid (80 mg/kg/day amoxicillin) or cefdinir (14 mg/kg/day), both in two divided doses. The diagnosis of AOM was based on specific clinical criteria by validated otoscopists at two AOM research centres. The outcome measure for clinical cure was resolution of all symptoms and signs of AOM except for persistence of middle-ear effusion at test-of-cure (TOC) 11-14 days after initiation of antibiotic treatment. Clinical failure was defined as persistence of symptoms and signs of AOM and the need for additional antibiotic therapy. Subjects lost to follow up or who had not taken at least 80% of the prescribed medication were classified as having an indeterminate response. Compliance was monitored using Medical Electronic Monitoring System (MEMS) caps and antibiotic bottle volume measurement at the TOC visit. A logistic regression model was used to estimate the association of age with cure rate. Full interactions in terms of age with treatment were included to estimate any age gradient differential.

grinsil duo suspension 2016-01-23

Overall, a high resistance was observed for beta-lactam antibiotics. In addition, a high resistance was noted for ceftazidime Ceftas 200 Mg with A. baumannii species (n=16, 77%). However, for quinolones, the highest resistance to ciprofloxacin was observed for E. coli, A. baumannii, methicillin-resistant Staphylococcus aureus, and K. pneumoniae.

grinsil duo 500 mg 2015-03-23

A contemporary (2002-2003) national collection of 2100 strains of Streptococcus pneumoniae obtained from 30 sites in the nine United States (US) census regions were tested to determine the comparative antimicrobial properties of amoxicillin/clavulanate and 15 other antimicrobials. The rank order of antimicrobials with the lowest susceptibility rates was: penicillin (67.9%)or=41.1%), trimethoprim/sulphamethoxazole (38.9%), tetracyclines (22.2%) and clindamycin (10.0%). Geographical variation in the susceptibility patterns among US census zones was present with lowest penicillin and erythromycin susceptibility noted for West South Central and West North Central zones (or=+0.9%), sinus isolates (+2.7%), middle ear fluid isolates (+5.5%), penicillin-resistant strains (>or=+5.8%) and strains from patients <2 years of age (>or=+2.4%). Local and global surveillance studies of common respiratory pathogens such as S. Septra Pediatric Dosing Suspension pneumoniae remain instrumental to guide clinicians in appropriate empirical treatments and to emphasize the need for prudent antimicrobial use.

grinsil amoxicilina 500 mg para que sirve 2015-04-16

Antibiotic treatment following the drainage of an anorectal abscess has no protective effect regarding risk of fistula formation Medicine Azilide 500 .

grinsil suspension 2017-07-22

Results Metronidazole Medicine awaited.

grinsil amoxicilina 500 mg 2017-12-30

A randomized, double-blind, double-dummy, multicenter international study was conducted to assess the clinical and bacteriologic response, safety, and compliance of a single 60-mg/kg dose of azithromycin extended-release (ER) versus a 10-day regimen of amoxicillin/clavulanate 90/6.4 mg/kg per Bactrim Septra And Alcohol day in children with acute otitis media at high risk of persistent or recurrent middle ear infection.