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Brand Name :
Amoxil
(United States) [Available]Synonyms :
amoxicillin
Class :
Antimicrobials and Antiviral drugs; Penicillins
Brand Name :
Amoxil
(United States) [Available]Synonyms :
amoxicillin
Class :
Antimicrobials and Antiviral drugs; Penicillins
Dosage forms and strengths:Â Â
Oral solution Â
125 mg per 5 ml Â
200 mg per 5 ml Â
250 mg per 5 ml Â
400 mg per 5 ml Â
Group A Streptococcal (GAS) InfectionsÂ
500
mg
2 times a day or 1 g daily
10
days
ER: 775 mg daily for 10 days
Lower Respiratory Tract InfectionsÂ
Mild/moderate/severe:
875
mg
every 12 hrs or 500mg every 8hrs
Mild/moderate/severe:
3
g
as a single dose
Genitourinary Tract InfectionsÂ
Mild/Moderate:
500
mg
every 12 hrs or 250 mg every 8hrs
Severe: 875 mg every 12hrs or 500mg every 8hrs
Mild/Moderate:
500
mg
twice a day or 250mg 3 times a day
Severe: 875 mg 2 times a day or 500mg 3 times a day
Ear, Nose And Throat (ENT) InfectionsÂ
Mild/Moderate:
500
mg
2 times a day or 250mg every 8hrs
Severe: 875 mg 2 times a day or else 500mg 3 times a day
Dosage forms and strengths:Â Â
Oral solution Â
125 mg per 5 ml Â
200 mg per 5 ml Â
250 mg per 5 ml Â
400 mg per 5 ml Â
Group A Streptococcal (GAS) InfectionsÂ
Children and Adolescents: Â :
50 mg/kg/day orally daily or in divided doses 2 times a day for 10 days; may be increase up to 1,000 mg/day
Â
ER: 775 mg orally daily for 10 daysÂ
Ear, Nose And Throat (ENT) InfectionsÂ
Mild/Moderate:
25
mg/kg
day in divided doses every 12hrs or 20 mg per kg per day in divided doses 3 times a day
Severe: 45 mg/kg per day divided in doses every 12hrs or 40 mg/kg per a day in divided doses every 8hrs
Mild/Moderate:
25 mg/kg per day in divided doses every 12hrs or 20 mg/kg per day in equal divided doses every 8hrs
Severe: 45 mg/kg per day divided in doses every 12hrs or 40 mg/kg per day in divided doses every 8hrs
Genitourinary Tract InfectionsÂ
25 mg/kg per day in divided doses every 12hrs or 20 mg/kg per day in equal divided doses every 8hrs
Severe: 45 mg/kg per day divided in doses every 12hrs or 40 mg/kg per day in divided doses every 8hrs
Lower Respiratory Tract InfectionsÂ
Mild/moderate/severe :
45 mg/kg daily divided in doses for every 12hrs or 40 mg/kg per day in divided doses for every 8hrs
Community-acquired pneumonia (Off-label use)
<3 months: Safety and effectiveness have not been established
Age: ≥3 months
immediate release (IR):
Empirical treatment:
90 mg/kg/day orally, divided 2 times a day 10 days
maximum daily dose should not exceed 4,000 mg
Group A Streptococcus:
50-75 mg/kg/day orally, divided 2 times a day 10 days
maximum daily dose should not exceed 4,000 mg
H. influenza:
75-100 mg/kg/day orally, divided 3 times a day 10 days
maximum daily dose should not exceed 4,000 mg
S. pneumoniae:
90 mg/kg/day orally, divided 2 times a day 10 days or 45 mg/kg/day divided 2 times a day 10 days
maximum daily dose should not exceed 4,000 mg
may enhance the serum concentration
may diminish the excretion rate of amantadine
may enhance the concentration when combined with serum of selexipag
may enhance the concentration of serum when combined with treprostinil
meningococcal A C Y and W-135 diphtheria conjugate vaccine
may enhance the serum concentration of Betalactamase Inhibitors
may enhance the serum concentration of Betalactamase Inhibitors
may enhance the serum concentration of Betalactamase Inhibitors
may enhance the serum concentration of Betalactamase Inhibitors
may enhance the serum concentration of Betalactamase Inhibitors
When amoxicillin combines with doxycycline it decreases the effects of action of drug by antagonism effect.
When amoxicillin combines with eravacycline it decreases the effects of action of drug by antagonism effect.
When amoxicillin combines with minocycline it decreases the effects of action of drug by antagonism effect.
When amoxicillin combines with mycophenolate it decreases the effects of action of drug and it may result impairment of enterohepatic recirculation.
When amoxicillin combines with omadacycline it decreases the effects of action of drug by antagonism effect
When amoxicillin combines with pexidartinib it decreases the effects of action of drug and results in hepatotoxicity.
When amoxicillin combines with pretomanid it decreases the effects of action of drug and results in hepatotoxicity.
When amoxicillin combines with sarecycline it decreases the effects of action of drug by antagonism effect.
When amoxicillin combines with tetracycline it decreases the effects of the action of drug by antagonism effect.
When amoxicillin combines with typhoid vaccine it decreases the effects of action of vaccine by antagonism effect.
When amoxicillin combines with BCG vaccine it decreases the effects of action of vaccine by antagonism effect.
amoxicillin: it may increase the risk of QTc prolongation agents
amoxicillin: it may increase the risk of QTc prolongation agents
amoxicillin: it may increase the risk of QTc prolongation agents
amoxicillin: it may increase the risk of QTc prolongation agents
amoxicillin: it may increase the risk of QTc prolongation agents
When both drugs are combined, there may be a reduced therapeutic effect of amoxicillin
When both drugs are combined, there may be a decrease in levels of minocycline by inhibition of GI absorption  
when both drugs are combined, there may be a reduced effect of amoxicillin  
when both drugs are combined, there may be a decreased effects of amoxicillin
tetracycline may decrease the therapeutic effects of penicillins by interfering with its bactericidal effects
tetracycline may decrease the therapeutic effects of penicillins by interfering with its bactericidal effects
may enhance the concentration of serum when combined with CYP2C8 substrates
metronidazole/tetracycline/bismuth subsalicylateÂ
by way of pharmacodynamic antagonism, the activity of amoxicillin can be reduced by tetracycline
When amoxicillin combines with allopurinol it decreases the effects of the drug by resulting hypersensitivity reaction.
When amoxicillin combines with aspirin it decreases the effects of action of drug by plasma binding protein and results in lowering of renal clearance.
When amoxicillin combines with aspirin citric acid it decreases the effects of the action of drug and results in lowering of renal clearance.
When amoxicillin combines with bazedoxifene it decreases the effects of action of drug and results in changes of intestinal flora.
Choline magnesium Trisalicylate
When amoxicillin combines with choline magnesium tri salicylate it decreases the effects of action of drug by plasma binding protein and results in lowering of renal clearance.
When amoxicillin combines with dienogest it decreases the effects of action of drug and results in changes of intestinal flora.
When amoxicillin combines with ethinylestradiol it decreases the effects of action of the drug and results in changes of intestinal flora.
When amoxicillin combines with hydrochlorothiazide it decreases the effects of the action of drug by decreasing renal clearance.
When amoxicillin combines with levonorgestrel oral it decreases the effects of action of the drug and results in changes of intestinal flora.
When amoxicillin combines with mestranol it decreases the effects of action of the drug.
When amoxicillin combines with methotrexate it decreases the effects of the action of drug by decreasing renal clearance.
When amoxicillin combines with methyclothiazide it decreases the effects of the action of drug by decreasing renal clearance.
When amoxicillin combines with metolazone it decreases the effects of the action of drug by decreasing renal clearance.
When amoxicillin combines with rose hips it decreases the effects of the action of drug by decreasing renal clearance.
When amoxicillin combines with salicylates it decreases the effects of action of drug by plasma binding protein and results in lowering of renal clearance.
When amoxicillin combines with salsalate it decreases the effects of action of drug by plasma binding protein and results in lowering of renal clearance.
When amoxicillin combines with sodium phenylacetate it decreases the effects of the action of drug by decreasing renal clearance.
When amoxicillin combines with metolazone it decreases the effects of the action of drug and results in changing metabolism.
When amoxicillin combines with sulfasalazine it decreases the effects of action of drug by plasma binding protein and results in lowering of renal clearance.
When amoxicillin combines with warfarin it decreases the effects of the action of drug by increasing bleeding and results in renal and liver impairment.
antipyrine has the potential to reduce the rate of excretion of amoxicillin, leading to a potential elevation in the serum levels
It may enhance the risk of adverse effects when combined with cardiac glycosides
It may enhance the risk of adverse effects when combined with cardiac glycosides
It may enhance the risk of adverse effects when combined with cardiac glycosides
tinidazole has the potential to reduce the rate of excretion of amoxicillin, potentially leading to an elevation in level of serum
When amoxicillin is used together with capsaicin, this leads to enhanced risk or seriousness of methemoglobinemia
amoxicillin leads to a reduction in the rate of excretion of eucalyptus oil which leads to increased level of serum
cefpirome leads to a reduction in the rate of excretion of amoxicillin which leads to increased level of serum
amoxicillin leads to a reduction in the rate of excretion of chromous sulfate, which leads to an increased level of serum
amoxicillin leads to a reduction in the rate of excretion of pentaerythritol tetranitrate, which leads to an increased level of serum
acyclovir + amoxicillin
either raises the other's levels by lowering renal clearance
amoxicillin leads to a reduction in the rate of excretion of potassium acetate, which leads to an increased level of serum
amoxicillin leads to a reduction in the rate of excretion of potassium perchlorate, which leads to an increased level of serum
amoxicillin: it may increase the risk or severity of CNS depression
amoxicillin: it may increase the risk or severity of CNS depression
amoxicillin: it may increase the risk or severity of CNS depression
amoxicillin: it may increase the risk or severity of CNS depression
amoxicillin: it may increase the risk or severity of CNS depression
amoxicillin may decrease the excretion rate of almasilate, leading to higher serum levels
may diminish the therapeutic effect of drug
may diminish the therapeutic effect of drug
may diminish the therapeutic effect of drug
amoxicillin: it may increase the serum concentration of rosoxacin
acemetacin may increase the serum concentration of penicillins
penicillins may iincrease the anticoagulant effect of Vitamin K Antagonists
penicillins may decrease serum concentrations of the active metabolite(s) of mycophenolate
may diminish the serum concentration when combined with CYP2C8 substrates
allopurinol: they may increase the potential for allergic or hypersensitivity reactions to amoxicillin
may enhance the concentration of serum when combined with treprostinil
daprodustat: they may enhance the serum concentration of CYP2C8 Inhibitors
CYP2C8 Inhibitors: they may enhance the serum concentration of repaglinide
It may enhance the risk of adverse effects when combined with polypeptide antibiotic
may have a decrease in excretion when combined with amoxicillin
the risk of methemoglobinemia may be increased
amoxicillin might lead to a reduction in the rate of excretion of telavancin, potentially leading to elevated levels of serum
ceforanide: it may decrease the excretion rate of amoxicillin
tovorafenib cannot be taken with strong CYP2C8 Inhibitors
When amoxicillin combines with amiloride it decreases the effects of the action of drug by increasing GI absorption.
When amoxicillin combines with azithromycin it decreases the effects of action of drug by antagonism effect.
When amoxicillin combines with aztreonam it decreases the effects of action of drug by synergestic effect.
When amoxicillin combines with chloramphenicol it decreases the effects of the action of drug by antagonism effect.
When amoxicillin combines with clarithromycin it decreases the effects of action of drug by antagonism effect.
When amoxicillin combines with erythromycin ethyl succinate it decreases the effects of action of drug by antagonism effect.
When amoxicillin combines with erythromycin lactobionate it decreases the effects of action of drug by antagonism effect.
When amoxicillin combines with erythromycin stearate it decreases the effects of action of drug by antagonism effect
When amoxicillin combines with pyridoxine it decreases the effects of action of the drug and results in changes of intestinal flora.
probenecid has the potential to elevate the concentration serum of Beta-lactamase Inhibitors
Actions and spectrum:Â Â
It works by stopping proteases that build cell walls in bacteria. These proteins link molecules that make the walls strong. Without them, bacteria can’t form or fix their walls. Amoxicillin makes bacteria produce enzymes that break down walls. That causes bacteria to die. Amoxicillin is used to treat lower respiratory tract infections caused by Streptococcus species, Pneumococcus, Staphylococcus species, or Haemophilus influenzae. It is also used for acute bacterial sinusitis, skin and skin structure infections, and urinary tract infections. It is also recommended as a second-line agent for post-exposure prophylaxis for anthrax. Off-label uses include treating Lyme disease in patients who cannot take doxycycline, prophylaxis of infectious endocarditis in individuals with high-risk cardiac conditions and treating periodontitis when combined with metronidazole and also treats actinomycosis. The FDA approved the regimen of triple therapy like clarithromycin, amoxicillin, and lansoprazole (CAL).Â
Adverse reactions:Â
Frequency defined:Â
1% to 10%Â
AllergyÂ
Anaphylactic shockÂ
Contact dermatitisÂ
RashÂ
1% to 1.7%Â
DiarrheaÂ
NauseaÂ
HeadacheÂ
0.1% to 0.7% (very rare)Â
Vomiting Â
Abdominal painÂ
Frequency not defined:Â
AngioedemaÂ
AnxietyÂ
Bullous rash
C. difficile-associated diarrhea
ConvulsionsÂ
DizzinessÂ
Erythema multiformeÂ
Exfoliative dermatitisÂ
Hypersensitivity vasculitisÂ
InsomniaÂ
Maculopapular rash with erythemaÂ
Mucocutaneous candidiasisÂ
Pseudomembranous colitisÂ
Toxic epidermal necrolysisÂ
Serum sicknessÂ
Stevens Johnson Syndrome Â
UrticariaÂ
Note: Adverse reactions like urticaria, skin rashes and serum sickness can be controlled by antihistamines drugs. If these reactions occur, the intake of amoxicillin needs to be discontinued. The immediate use of intravenous steroids, oxygen, and epinephrine treatment is required for serious anaphylactic reactions.Â
Black Box Warning Â
No specific black box warnings are available for amoxicillin.Â
Contraindication:
The contraindication includes a history of hypersensitivity to any penicillin. Therefore, screening is needed for renal and hepatic function.
Cautions
PregnancyÂ
Category B.
The class penicillin drugs which are acceptable for the use in pregnancy women are used for different infections. As per the clinical studies, in pregnant women the use of amoxicillin has not found any amoxicillin exposure during pregnancy, birth defects, miscarriage and outcomes of fetal.Â
Lactation:Â
Recent studies state that low levels of amoxicillin are present in breast milk and the relative infant dose (RID) range is calculated 1% for amoxicillin. The range of RID less than 10% is always compatible for breast feeding. In breast fed infants the amoxicillin will not cause any adverse reactions. Â
Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester.Â
Category B: There was a lack of studies on pregnant women and no evidence of risk to the fetus in animal experiments.  Â
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   Â
Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.  Â
Category X: Drugs listed in this category outweigh the risks over benefits. Hence, these categories of drugs need to be avoided by pregnant women.   Â
Category N: There is no data available for the drug under this category
Pharmacology:Â Â
Amoxicillin treats infections that are caused by susceptible and beta-lactamase-negative isolates, treats ENT infections like tonsillitis, pharyngitis, and otitis media. It is also used for eradicating Helicobacter pylori and reducing the risk of duodenal ulcer recurrence.Â
Pharmacodynamics:Â Â
Amoxicillin is a beta-lactam antibiotics that inhibits transpeptidation which is a crucial step in bacterial cell wall synthesis and activating autolytic enzymes within the cell wall by leading to cell wall lysis and bactericidal killing a bacterial cell destruction mechanism.Â
Amoxicillin can be combined with beta-lactamase inhibitors like clavulanic acid or sulbactam which bind irreversibly to the enzyme catalytic site and preventing it from breaking down the beta-lactam ring of amoxicillin. Although these inhibitors don’t have bactericidal activity and their combination broadens amoxicillin’s spectrum.Â
Pharmacokinetics:Â Â
Absorption Â
Rapid absorption, bioavailability ranges from 74% to 92%, Peak levels for extended-release tablets is 3.1 hours, capsules 2 hours, and suspensions1 hour. Â
Distribution Â
17-20% attach to proteins, < 1% reaches the fluid surrounding the brain and spinal cord. Â
Metabolism Â
The liver breaks down amoxicillin by hydroxylation, oxidative deamination, decarboxylation, and glucuronidation.Â
Elimination and excretion Â
It is excreted primarily through urine 70-78%, half-life is 61.3 minutes. Â
Administration:Â
Amoxicillin is an orally administered antibiotic available in various forms of immediate-release, extended-release tablets, chewable tablets, and suspension. It should be mixed with cold drinks and taken immediately after mixing. ER tablets should be taken within an hour of a meal. In pediatrics amoxicillin is preferred when compared due to its pleasant taste. Amoxicillin is versatile and can be administered orally and IV/IM.Â
Patient information leaflet Â
Generic Name: amoxicillin Â
Why do we use amoxicillin? Â
Amoxicillin is a beta-lactam antibiotics mainly used in primary care settings to combat with antibiotic resistance. It is derived from penicillin and prescribed for infections which are caused by beta-lactamase negative susceptible bacteria. It is applied mainly for infections associated with ENT, Helicobacter pylori eradication, lower respiratory tracts, acute sinusitis, UTI, and skin and soft tissue. It also targets a wide range of gram-positive bacteria, and its effectiveness is enhanced by its ability to combat Listeria monocytogenes and Enterococcus species.Â
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