Manufacturer of Amoxicillin
generic
Also know under brand names: Amoxicot,
Amoxil,
Amoxil Pediatric Drops,
Biomox,
Dispermox,
Trimox,
Wymox
Active ingredient / generic name: amoxicillin
Approximate US Retail Price for Amoxicillin 250 mg/5ml (1 bottle, 150 ml): $12.99
500 mg (100 ea): $49.99
875 mg (30 ea): $24.99
250 mg (30 ea): $12.99
500 mg (30 ea): $12.99
125 mg (21 ea): $11.99
250 mg (30 ea): $13.99
400 mg (20 ea): $10.91
Short leafletAmoxicillin (INN) or amoxycillin (former BAN) is a moderate-spectrum, bacteriolytic, β-lactam antibiotic used to treat bacterial infections caused by susceptible microorganisms. It is usually the drug of choice within the class because it is better absorbed, following oral administration, than other beta-lactam antibiotics. Amoxicillin is susceptible to degradation by β-lactamase-producing bacteria, and so may be given with clavulanic acid to decrease its susceptibility (see below). It was developed by Beecham in 1972 and is currently marketed by GlaxoSmithKline (the inheritor company) under the original trade name Amoxil.
Amoxicillin acts by inhibiting the synthesis of bacterial cell walls. It inhibits cross-linkage between the linear peptidoglycan polymer chains that make up a major component of the cell wall of Gram-positive bacteria.
Amoxicillin is a moderate-spectrum antibiotic active against a wide range of Gram-positive, and a limited range of Gram-negative organisms. Some examples of susceptible and resistant organisms, from the Amoxil Approved Product Information (GSK, 2003), are listed below.
Streptococcus spp., penicillin-susceptible Streptococcus pneumoniae, non β-lactamase-producing Staphylococcus spp., and Enterococcus faecalis.
Non-β-lactamase producing strains of the following bacteria: Haemophilus influenzae, Neisseria gonorrhoeae, Neisseria meningitidis, Escherichia coli, Proteus mirabilis and Salmonella spp.
Penicillinase-producing organisms, particularly penicillinase-producing Staphylococcus spp. Penicillinase-producing N. gonorrhoeae and H. influenzae are also resistant.
All strains of Pseudomonas spp., Klebsiella spp., Enterobacter spp., indole-positive Proteus spp., Serratia marcescens, and Citrobacter spp. are resistant.
The incidence of β-lactamase-producing resistant organisms, including E. coli, appears to be increasing.
Doubling the routinely given concentration (in pediatrics) of Amoxicillin has been shown to eradicate intermediately resistant Streptococcus pneumoniae in selected infections.
Amoxicillin in trihydrate form is available as capsules, chewable and dispersable tablets plus syrup and paediatric suspension for oral use, and as the sodium salt for intravenous administration. It is one of the most common antibiotics issued to children, and the sweet-tasting liquid forms are helpful where the patient might find it difficult to take tablets or capsules. It has 3 ionizable groups.
To overcome the issue of β-lactamase production by resistant organisms, Amoxicillin (in either trihydrate or sodium salt forms) may be combined with clavulanic acid, typically as the potassium salt. This combination has activity against a very broad array of Gram-positive, Gram-negative, and anaerobic organisms. It is not active against MRSA, P. aeruginosa, or C. difficile. It is available in oral preparations worldwide and also in the intravenous preparation in some countries. The British Approved Name for this formulation is co-amoxiclav, but it is commonly referred to in practice by proprietary names such as Amoksiklav, Augmentin, Clamoxyl, Augclac, and Augmexx depending on country.
Side effects are as those for other beta-lactam antibiotics. Side effects include nausea, vomiting, and easy fatigue. Loose bowel movements (diarrhea) also may occur.
The onset of an allergic reaction to Amoxicillin can be very sudden and intense - emergency medical attention must be sought as quickly as possible. The initial onset of such a reaction often starts with a change in mental state; skin rash with intense itching (often beginning in fingertips and around groin area and rapidly spreading) and sensations of fever, nausea and vomiting. Any other symptoms that seem even remotely suspicious must be taken very seriously.
Somewhere between 3% to 10% of children taking Amoxicillin (or ampicillin) show a late-developing (>72 hours after beginning medication and having never taken penicillin-like medication previously) non-itchy rash, sometimes referred to as the "Amoxicillin rash." The rash is described as maculopapular or morbilliform (measles-like), and starts on the trunk and can spread from there. This rash is unlikely to be a true allergic reaction, and is not a contra-indication for future Amoxicillin usage, nor should current regimen necessarily be stopped. However, as mentioned above, this common Amoxicillin rash and a dangerous allergic reaction cannot easily be distinguished by inexperienced persons, and therefore a health professional should be consulted if a rash develops. (Pichichero, 2005; Schmitt 2005)
Non-allergic Amoxicillin rash 8 days after first dose, 24 hours after rash began. Diagnosed by pediactric resident at local university hospital.
8 hours after first photo. Individual spots have grown and begun to merge.
23 hours after first photo. Color apparently fading, much of rash has spread to confluence.
The patent for Amoxicillin has expired. Thus Amoxicillin is marketed under many trade names including: Actimoxi, Amoksibos, Amoxiclav Sandoz, Amoxil, Amoksiklav, Amoxibiotic, Amoxicilina, Apo-Amoxi, Bactox, Betalaktam, Cilamox, Curam, Dedoxil, Dispermox, Duomox, Isimoxin, Klavox, Lamoxy, Moxypen, Moxyvit, Novamoxin, Ospamox, Panklav, PAmoxicillin, Polymox, Samthongcillin, Senox, Sinacilin, Trimox, Tolodina, Wymox, Zerrsox and Zimox.
amoxicillin: Patient Education
Do not use this medication if you are allergic to amoxicillin or to any other penicillin
antibiotic, such as ampicillin (Omnipen, Principen), carbenicillin (Geocillin), dicloxacillin
(Dycill, Dynapen), oxacillin (Bactocill), penicillin (Beepen-VK, Ledercillin VK, Pen-V, Pen-Vee
K, Pfizerpen, V-Cillin K, Veetids), and others.
Before using amoxicillin, tell your doctor if you are allergic to cephalosporins such as
Ceclor, Ceftin, Duricef, Keflex, and others. Also tell your doctor if you have asthma, liver or
kidney disease, a bleeding or blood clotting disorder, mononucleosis (also called "mono"), or any
type of allergy.
Amoxicillin can make birth control pills less effective, which may result in
pregnancy. Before taking amoxicillin, tell your doctor if you use birth control pills.
Take this medication for the entire length of time prescribed by your doctor. Your
symptoms may get better before the infection is completely treated. Amoxicillin will not treat a
viral infection such as the common cold or flu.
Do not give this medication to another person, even if they have the same symptoms
you do.
Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you
have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop
the diarrhea unless your doctor has told you to.
Amoxicillin is an antibiotic in the penicillin group of drugs. It fights bacteria in your
body.
Amoxicillin is used to treat many different types of infections caused by bacteria, such as
ear infections, bladder infections, pneumonia, gonorrhea, and E. coli or salmonella infection.
Amoxicillin is also sometimes used together with another antibiotic called clarithromycin
(Biaxin) to treat stomach ulcers caused by Helicobacter pylori infection. This combination is
sometimes used with a stomach acid reducer called lansoprazole (Prevacid).
Amoxicillin may also be used for other purposes not listed in this medication guide.
Do not use this medication if you are allergic to amoxicillin or to any other penicillin
antibiotic, such as:
ampicillin (Omnipen, Principen);
carbenicillin (Geocillin);
dicloxacillin (Dycill, Dynapen);
oxacillin (Bactocill); or
penicillin (Beepen-VK, Ledercillin VK, Pen-V, Pen-Vee K,
Pfizerpen, V-Cillin K, Veetids, and others).
Before using amoxicillin, tell your doctor if you are allergic to any
drugs (especially cephalosporins such as Ceclor, Ceftin, Duricef, Keflex, and others), or if you
have:
asthma;
liver disease;
kidney disease;
a bleeding or blood clotting disorder;
mononucleosis (also called "mono");
a history of diarrhea caused by taking antibiotics; or
a history of any type of allergy.
If you have any of these conditions, you may need a dose adjustment
or special tests to safely take amoxicillin.
FDA pregnancy category B. This medication is not expected to be harmful to an
unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.
Amoxicillin can make birth control pills less effective, which may result in
pregnancy. Before taking amoxicillin, tell your doctor if you use birth control pills.
Amoxicillin can pass into breast milk and may harm a nursing baby. Do not use this
medication without telling your doctor if you are breast-feeding a baby.
The amoxicillin chewable tablet may contain phenylalanine. Talk to your doctor before
using this form of amoxicillin if you have phenylketonuria (PKU).
Take this medication exactly as it was prescribed for you. Do not take the medication in
larger amounts, or take it for longer than recommended by your doctor. Follow the directions on
your prescription label.
If you are taking amoxicillin with clarithromycin and/or lansoprazole to treat stomach
ulcer, use all of your medications as directed. Be sure to read the medication guide or patient
instructions provided with each of your medications. Do not change your doses or medication
schedule without advice from your doctor.
You may take amoxicillin with or without food.
Shake the oral suspension (liquid) well just before you measure a dose. To be sure
you get the correct dose, measure the liquid with a marked 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.
The dispersible tablet will not dissolve in your mouth. Place the tablet
in at least 2 teaspoons of water (do not use any other type of liquid). After the tablet has
completely broken apart, swirl the mixture and drink all of it right away.
To be sure this medication is helping your condition, your blood may need to be tested.
Your kidney or liver function may also need to be tested. Do not miss any scheduled visits to
your doctor.
If you are being treated for gonorrhea, your doctor may also have you tested for syphilis,
another sexually transmitted disease.
Take this medication for the entire length of time prescribed by your doctor. Your
symptoms may get better before the infection is completely treated. Amoxicillin will not treat a
viral infection such as the common cold or flu.
Do not give amoxicillin to another person, even if they have the same symptoms you
do.
This medication can cause you to have unusual results with certain medical tests. Tell any
doctor who treats you that you are using amoxicillin.
Store amoxicillin at room temperature away from moisture, heat, and light.
You may store liquid amoxicillin in a refrigerator but do not allow it to freeze.
Throw away any liquid amoxicillin that is not used within 14 days after it was mixed at the
pharmacy.
Take the missed dose as soon as you remember. If it is almost time for your next dose,
skip the missed dose and take the medicine at your next regularly scheduled time. Do
not take extra medicine to make up the missed dose.
Seek emergency medical attention if you think you have used too much of this
medicine.
Overdose symptoms may include confusion, behavior changes, a severe skin rash,
urinating less than usual, or seizure (black-out or convulsions).
Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you
have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop
the diarrhea unless your doctor has told you to.
Get emergency medical help if you have any of these signs of an allergic
reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any of these serious side effects:
fever, sore throat, and headache with a severe blistering, peeling,
and red skin rash;
nausea, stomach pain, low fever, loss of appetite, dark
urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
diarrhea that is watery or bloody;
fever, chills, body aches, flu symptoms;
easy bruising or bleeding, unusual weakness;
urinating less than usual or not at all;
agitation, confusion, unusual thoughts or behavior; or
seizure (black-out or convulsions).
Less serious side effects are more likely to occur, such as:
nausea, vomiting, stomach pain;
vaginal itching or discharge;
headache;
swollen, black, or "hairy" tongue; or
thrush (white patches or inside your mouth or throat).
This is not a complete list of side effects and others may occur. Tell
your doctor about any unusual or bothersome side effect.
Before taking amoxicillin, tell your doctor if you are using any of the following drugs:
methotrexate (Rheumatrex, Trexall);
probenecid (Benemid);
a sulfa drug (such as Bactrim or Septra);
an antibiotic such as azithromycin (Zithromax),
clarithromycin (Biaxin), erythromycin (E.E.S., E-Mycin, Ery-Tab, Erythrocin), telithromycin
(Ketek), or troleandomycin (Tao); or
a tetracycline antibiotic such as demeclocycline
(Declomycin), doxycycline (Adoxa, Doryx, Oracea, Vibramycin), minocycline (Dynacin,
Minocin, Solodyn, Vectrin), or tetracycline (Brodspec, Panmycin, Sumycin, Tetracap).
This list is not complete and there may be other drugs that can interact
with amoxicillin. Tell your doctor about all the prescription and over-the-counter medications
you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other
doctors. Do not start using a new medication without telling your doctor.
Your pharmacist can provide more information about amoxicillin.
Amoxicillin: Dosinginfections, bacterial: 500-875 mg PO q12h: Alt: 250-500 mg PO q8h; Info: dose, duration vary by infxn type/severity
gonorrhea, uncomplicated: 3 g PO x1: Info: for urethritis, cervicitis, rectal infxns only; refer to CDC STD guidelines
H. pylori treatment: 1 g PO bid x10-14 days: Info: for use w/ clarithromycin and omeprazole/lansoprazole; treatment regimens may vary
*endocarditis prophylaxis: 2 g PO x1: Info: give 30-60min before procedure
*anthrax: inhalational, GI, oropharyngeal: Dose: 500 mg PO q8h; Start: ciprofloxacin or doxycycline IV plus 1-2 additional abx; Info: not recommended as 1st line; give abx x60 days total
renal dosing: adjust dose frequency: CrCl 10-30: give q12h; CrCl <10: give q24h; HD: give usual dose as supplement both during and after dialysis; CAPD: 250 mg q12h; Info: do not use 875 mg tab for CrCl <30
amoxicillin: Drug Interactions
amoxicillin vs typhoid vaccine, live oral: avoid combo; delay vaccine until >3 days after abx course complete or complete vaccine >3 days before 1st abx dose: combo may result in inadequate immunologic vaccine response and abx effect may inactivate vaccine
amoxicillin vs chloroquine phosphate: caution advised w/ oral penicillins, separate admin by >2h: combo may decr. oral penicillin levels, efficacy and absorption decreased
amoxicillin vs exenatide: give oral antibiotic >1h before exenatide: combo may decr. oral antibiotic levels, efficacy and absorption possibly delayed/reduced
amoxicillin vs methotrexate: monitor CBC, signs of toxicity: combo may incr. methotrexate levels, risk of toxicity primarily w/ antineoplastic doses and renal excretion decreased
amoxicillin vs warfarin: monitor INR: combo may incr. INR, risk of bleeding and possibly altered vitamin K production by gut flora
amoxicillin vs aminoglycosides, parenteral: use for therapeutic advantage: combo may enhance efficacy and additive/synergistic effects. Aminoglycosides, parenteral: also know as amikacin, gentamicin, kanamycin, streptomycin, tobramycin
amoxicillin vs probenecid: use for therapeutic advantage: probenecid may incr. penicillin levels, prolong duration of action and renal excretion decreased
amoxicillin vs acetaminophen/tramadol: caution advised: combo w/ tramadol may incr. risk of seizures and additive effects
amoxicillin vs allopurinol: caution advised: combo may incr. risk of amoxicillin/ampicillin rash and mechanism unknown
amoxicillin vs bupropion: caution advised: combo may incr. risk of seizures and additive effects
amoxicillin vs contraceptives, oral combo: caution advised: abx may decr. hormonal contraceptive efficacy; best evid. for tetracyclines, ampicillin and enterohepatic recirculation possibly altered. Contraceptives, oral combo: also know as desogestrel/ethinyl estradiol, drospirenone/ethinyl estradiol, ethinyl estradiol/ethynodiol, ethinyl estradiol/levonorgestrel, ethinyl estradiol/norethindrone, ethinyl estradiol/norgestimate, ethinyl estradiol/norgestrel, mestranol/norethindrone
amoxicillin vs contraceptives, oral progestin: caution advised: abx may decr. hormonal contraceptive efficacy; best evid. for tetracyclines, ampicillin and enterohepatic recirculation possibly altered. Contraceptives, oral progestin: also know as norethindrone, norgestrel
amoxicillin vs contraceptives, other combo: caution advised: abx may decr. hormonal contraceptive efficacy; best evid. for tetracyclines, ampicillin and enterohepatic recirculation possibly altered. Contraceptives, other combo: also know as ethinyl estradiol/norelgestromin transdermal, etonogestrel/ethinyl estradiol vaginal
amoxicillin vs lindane topical: caution advised: combo may incr. risk of seizures and additive toxicity
amoxicillin vs mycophenolate mofetil: caution advised: combo may decr. mycophenolate efficacy and enterohepatic recirculation decreased
amoxicillin vs mycophenolic acid: caution advised: combo may decr. mycophenolic acid efficacy and enterohepatic recirculation decreased
amoxicillin vs proton pump inhibitors: caution advised w/ oral penicillin, ampicillin, dicloxacillin: combo may decr. antimicrobial levels, efficacy and absorption decreased. Proton pump inhibitors: also know as esomeprazole, lansoprazole, lansoprazole/amoxicillin/clarithromycin, omeprazole, omeprazole/sodium bicarbonate, pantoprazole, rabeprazole
amoxicillin vs sodium phenylacetate/sodium benzoate: caution advised: combo may incr. levels of active metabolites and renal excretion decr. by competition for active tubular transport
amoxicillin vs sodium phosphate: caution advised: combo may incr. risk of seizures and additive effects
amoxicillin vs tiagabine: caution advised, especially in non-epileptic pts: combo may incr. risk of seizures and additive effects
amoxicillin vs tramadol: caution advised: combo may incr. risk of seizures and additive effects
amoxicillin: Adverse Reactions
hypersensitivity rxn
anaphylaxis
serum sickness-like rxn
erythema multiforme
Stevens-Johnson syndrome
toxic epidermal necrolysis
exfoliative dermatitis
agranulocytosis
thrombocytopenia
leukopenia
anemia
superinfection
pseudomembranous colitis
seizures
hepatotoxicity
interstitial nephritis
nausea
vomiting
diarrhea
rash
urticaria
eosinophilia
elevated liver transaminases
black hairy tongue
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