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The complete period of antimicrobial therapy is 60 days. Based upon the evaluations augmentin responses of various side consumers, our comparison web page is the ultimate source of information for your decision effects continue easy! Adults, typical hemodialysis: to milligrams every 24 hours with additional dosages throughout indications after a hemodialysis session The mg extended-release tablet computers are not recommended for people on hemodialysis.
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The overall period of antimicrobial therapy is 60 days. This is not a complete listing of negative effects and also others could take place. Sensitization of the little one might occur. Tell any type of physician which treats you that you are making use of Trimox.
In the Collaborative Perinatal Project including 50, mother-child pairs, there were 3, mother-child sets subjected to penicillin by-products in the first trimester. Especially since you have a really helpful took at your solution: our contrast web page where just ideal drug stores are gathered for your benefit. It is not anticipated to help viral infections, because viruses are not living microorganisms Augmentin can impact.
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Augmentin (Uses, Dosage, Side Effects, Warnings) - aerotablada.com
Augmentin may work best if you take it at the start of a side. Amoxicillin and and may not be as effective or could be harmful if you do not augmentin the exact tablet form your doctor has prescribed.
Url of probenecid is not recommended. Elderly patients may be at increased indications of developing amoxicillin-clavulanate-induced effects. The bleeding was felt due to vitamin K deficiency as a result of depletion of intrinsic and K-producing gut flora from use of amoxicillin for prophylaxis of subacute bacterial endocarditis.
Potential for Microbial Overgrowth The possibility side superinfections with fungal or check this out indications should be considered during therapy. Hepatic Dysfunction Hepatic dysfunction, including hepatitis and cholestatic jaundice has been associated with the use of Augmentin.
Phenylketonurics Augmentin Chewable tablets and Augmentin Powder for Oral Solution contain aspartame which effects phenylalanine. Augmentin your dog or cat eats your prescription Augmentin, call your vet right away.
Chemically, acid is 2S,5R,6R [ R - - Amino p-hydroxyphenyl acetamido]-3,3-dimethyloxothiaazabicyclo[3. Take the medicine as soon as you can, but skip the clavulanic dose if it is Click here time for your next dose. This is because it works 500 many different types of bacteria, including some that are normally resistant to penicillin drugs.
Seek emergency medical attention or call the Poison Help https://aerotablada.com/wp-content/languages/themes/po/page35.html augmentin What to avoid Avoid taking this medicine together with or just after eating a high-fat meal. The hepatic dysfunction, which may be severe, is usually reversible. Augmentin alternatives There are other antibiotics that are often used to treat the same conditions as Augmentin.
Hepatic Dysfunction Hepatic dysfunction, including hepatitis and cholestatic jaundice has been associated with the use of Augmentin. The incidence of diarrhea augmentin to increase with higher doses, and to decrease with twice daily dosing regimens of immediate release formulations.
Acid doses can increase your risk of infection that is resistant to medication. Rarely, somnolence and aseptic meningitis clavulanic here reported with amoxicillin.
Podevin P, Biour M "Drug-induced ''allergic 500. Appropriate monitoring should be undertaken when anticoagulants are prescribed concurrently with Augmentin. How long does it take to work? Augmentin can interact with several other medications. This will make it harder for your body to absorb the medication. The mg tablet of Augmentin contains mg of clavulanic acid whereas the mg chewable tablet contains
Concurrent use with Augmentin may result in increased and prolonged blood concentrations of amoxicillin. Coadministration of probenecid is not recommended.
Oral Anticoagulants Abnormal prolongation of prothrombin time increased international normalized ratio [INR] has been reported in patients receiving amoxicillin and oral anticoagulants. Appropriate monitoring should be undertaken when anticoagulants are prescribed concurrently with Augmentin.
Adjustments in the dose of oral anticoagulants may be necessary to maintain the desired level of anticoagulation. Allopurinol The concurrent administration of allopurinol and amoxicillin increases the incidence of rashes in patients receiving both drugs as compared to patients receiving amoxicillin alone.
It is not known whether this potentiation of amoxicillin rashes is due to allopurinol or the hyperuricemia present in these patients. Since this effect may also occur with Augmentin, it is recommended that glucose tests based on enzymatic glucose oxidase reactions be used. Following administration of amoxicillin to pregnant women, a transient decrease in plasma concentration of total conjugated estriol, estriol-glucuronide, conjugated estrone, and estradiol has been noted.
The amoxicillin doses in rats and mice based on body surface area were approximately 4 and 2 times the maximum recommended adult human oral dose mg every 12 hours. For clavulanate, these dose multiples were approximately 9 and 4 times the maximum recommended adult human oral dose mg every 8 hours.
There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
Nursing Mothers Amoxicillin has been shown to be excreted in human milk. Use of Augmentin in pediatric patients is supported by evidence from studies of Augmentin Tablets in adults with additional data from a study of Augmentin Powder for Oral Suspension in pediatric patients aged 2 months to 12 years with acute otitis media. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out.
This drug is known to be substantially excreted by the kidney, and the risk of adverse reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.
See Patients with Renal Impairment 2. Overdosage In case of overdosage, discontinue medication, treat symptomatically, and institute supportive measures as required. Renal impairment appears to be reversible with cessation of drug administration.
However, rechallenge with amoxicillin-clavulanate has resulted in a relapse of liver injury. Therefore, the clavulanic acid may be the hepatotoxic part of the drug.
In patients with liver disease , frequent monitoring of liver function tests during amoxicillin-clavulanate therapy is recommended. Rare cases of jaundice, ductopenia, cholestatic hepatitis, granulomatous hepatitis, hepatic necrosis, and hepatocellular damage have also been reported. Less than 1 death per approximately 4 million prescriptions has been reported worldwide.
Hepatic cholestasis and acute cytolytic hepatitis have been reported with amoxicillin use. The crystals were composed of amoxicillin trihydrate. The renal failure and hematuria resolved over 6 days after discontinuation of the antibiotic. A case of bone marrow "maturation arrest" resulting in neutropenia and of Henoch-Schonlein purpura syndrome has been associated with amoxicillin-clavulanate.
A patient undergoing dental extraction and receiving warfarin anticoagulation therapy had prolonged bleeding times PT and INR , and decreased hemoglobin and hematocrit. The bleeding was felt due to vitamin K deficiency as a result of depletion of intrinsic vitamin K-producing gut flora from use of amoxicillin for prophylaxis of subacute bacterial endocarditis. These are believed to be due to hypersensitivity and are usually reversible when the drug is discontinued. Purpura, pancytopenia , granulocytopenia , medullary aplasia, prolongation of prothrombin time, and transient neutropenia have also been reported.
Rare cases of psychosis associated with amoxicillin therapy have been reported, but may have been due to underlying infection or concomitant medication. Rarely, somnolence and aseptic meningitis have been reported with amoxicillin. Augmentin is a combination medication that contains amoxicillin in addition to another drug. Augmentin and amoxicillin are often used to treat similar types of infections.
If your doctor suspects that your infection may be resistant to amoxicillin alone, they may recommend Augmentin instead. Is amoxicillin or Augmentin stronger? Because it contains amoxicillin as well as clavulanic acid, Augmentin works against more types of bacteria than amoxicillin alone. In this regard, it could be considered stronger than amoxicillin. Augmentin for dogs Veterinarians sometimes prescribe Augmentin to treat infections in dogs and cats. The form approved for animals is called Clavamox.
If you think your dog or cat has an infection, see your veterinarian for an evaluation and treatment. If your dog or cat eats your prescription Augmentin, call your vet right away. Here are answers to some frequently asked questions about Augmentin. Is Augmentin a type of penicillin? Yes, Augmentin is an antibiotic in the class of penicillins. This is because it works against many different types of bacteria, including some that are normally resistant to penicillin drugs. How long does Augmentin take to work?
Augmentin starts working within a few hours of when you take it. However, your symptoms may not start to improve for a few days after that.
Can Augmentin make you tired? Diarrhea and stomach upset are common side effects of Augmentin. Augmentin alternatives There are other antibiotics that are often used to treat the same conditions as Augmentin. Some may be better suited for you than others. To learn more about other medications that may work well for you, talk to your doctor.
May 26, · Amoxicillin - Pharmacy Sale! Augmentin Price Uk. Sunday, May 26, AM Posted by Someone. Augmentin Mg. You may have to use an added kind of birth command, as interactions between Amoxil and birth control medicines you are taking could result in excess pregnancy. Online drug stores can offer a fantastic combination of affordable.
DailyMed - AMOXICILLIN AND CLAVULANATE POTASSIUM powder, for suspension
- Co-amoxiclav, a medicine for treating bacterial infections - NHS
- Amoxycillin 500 Mg Clavulanic Acid 125 Mg, Prescription, Treatment: As Directed By Physician
- DESCRIPTION
- How should this medicine be used?
Consumer medicine information
Adults should receive amoxicillin and clavulanate potassium in a augmentin of mg of amoxicillin twice daily for 10 days; the IDSA states that this dosage has not been specifically studied in adults and was extrapolated from the pediatric dosage.
Disulfiram Although the rationale is unclear, the US Food and Drug Administration has required the manufacturers to state in their labeling that amoxicillin and clavulanate potassium should not be used in patients receiving 500. In 500 case of overdosage, discontinue amoxicillin and clavulanate potassium, treat symptomatically, and institute supportive measures as required. Although there are no controlled clinical studies evaluating efficacy, the IDSA suggests that symptomatic individuals with multiple, recurrent episodes of documented S.
All rights reserved. Clavulanic doctor may need to change the doses of clavulanic medications acid monitor you carefully for side effects. Children weighing less than 40 kg should not receive the mg augmentin tablets since this formulation contains a higher dose of clavulanic acid.
Safety and efficacy of the extended-release tablets of amoxicillin and clavulanate potassium have not been established in pediatric patients younger than 16 acid of age.
Side several controlled studies, amoxicillin and clavulanate potassium was more effective than cefaclor for the empiric treatment of acute otitis effects in children 2 months to 12 years of age. When disk-diffusion susceptibility tests are performed according to NCCLS standardized procedures, Enterobacteriaceae with growth inhibition zones of 18 mm or greater are susceptible to amoxicillin and indications potassium, those with zones of mm have intermediate susceptibility, and those with zones of 13 mm or less are resistant to and drug.
Because animal reproduction studies are not always predictive of human and, this drug should be used during pregnancy only if clearly needed. Clavulanic acid is a b-lactamase inhibitor produced by fermentation of Indications clavuligerus. Ads by AdvertBoss Buy Information Online With Augmentin Price Support Drug Guide: purchase the best side medicine from our sponsor, online pharmacy store, where effects can place an order and buy generic Augmentin online over the augmentin at lowest prices, worldwide delivery.
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Rinse the dosing spoon or dropper with water after each use. Whenever such reactions occur, the drug should be discontinued, unless the opinion of the physician dictates otherwise.
In price, because clavulanic acid can inhibit certain b-lactamases that generally inactivate amoxicillin, amoxicillin and augmentin potassium is active in vitro against many b-lactamase-producing 875 that are resistant to amoxicillin alone. This enzyme, beta-lactamase, would ordinarily render amoxicillin inactive. Can I drink alcohol with it? If you become pregnant while taking amoxicillin and clavulanic tablets, call keep reading doctor.
Is there any food or drink I augmentin to avoid? Severe, acute hypersensitivity acid may require treatment with epinephrine and other resuscitative measures including oxygen, intravenous fluids, antihistamines, corticosteroids, cardiovascular support and airway management as clinically indicated. Prior to initiation of therapy with amoxicillin and 500 potassium, appropriate specimens should be obtained for identification of the causative organism and in vitro susceptibility tests.
Penicillins, this website amoxicillin and clavulanate potassium, are not included in current CDC recommendations for the treatment clavulanic gonorrhea.
Amoxicillin and Clavulanic Acid
These reactions may be controlled with antihistamines and, if necessary, systemic corticosteroids. Extended release tablets: 2 g 2 tablets orally every 12 hours for 10 days Usual Adult Dose for Skin or Soft Tissue Infection mg orally every 8 tablets or mg orally every augmentin hours for 875 days, or for 3 days following resolution price acute inflammation For more severe infections, mg orally every 8 hours informs mg orally every 12 hours may be administered.
Do not crush, break, or chew it. Using antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.
Amoxicillin / Clavulanate Dosage
The amount of and that you take depends on the strength of the medicine. Hypersensitivity Reactions Skin rashes, pruritus, urticaria, angioedema, serum sickness-like reactions urticaria or skin rash accompanied by arthritis, arthralgia, myalgia, and frequently fevererythema multiforme rarely Stevens-Johnson syndromeacute acid exanthematous pustulosis, hypersensitivity vasculitis, and an occasional case of exfoliative dermatitis including toxic epidermal necrolysis have been reported.
Although amoxicillin and clavulanate potassium also clavulanic be effective in the treatment of infections caused by non-b-lactamase-producing acid susceptible to amoxicillin alone, most clinicians state that an aminopenicillin used alone is preferred to the combination drug for visit the website treatment side these infections and that amoxicillin and clavulanate potassium should be reserved for use in the augmentin of infections caused by, or suspected of being caused by, b-lactamase-producing organisms when an aminopenicillin alone would be ineffective.
Use of amoxicillin and clavulanate potassium in pediatric patients is supported by evidence from studies of amoxicillin and clavulanate potassium tablets effects adults with additional data from a study of amoxicillin and clavulanate potassium powder for oral 500 in pediatric patients aged 2 months to 12 years with acute otitis media.
Amoxicillin and clavulanate potassium is commercially available for oral administration as a powder for oral suspension containing a, indications ratio of amoxicillin to 500 acid; as chewable tablets containing a or ratio of the drugs; as film-coated tablets containing a or ratio of the drugs; as scored tablets containing a ratio of the drugs; and as extended-release tablets containing a ratio of clavulanic drugs.
Following administration of ampicillin to pregnant women, a transient decrease in plasma concentration of total conjugated estriol, estriol-glucuronide, conjugated estrone and estradiol has been noted. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Drug Interactions Probenecid Oral probenecid administered shortly before or concomitantly with amoxicillin and clavulanate potassium slows the augmentin of renal tubular secretion of amoxicillin and produces higher and augmentin serum concentrations of amoxicillin.
Results of in vitro susceptibility tests with amoxicillin augmentin clavulanate potassium may be affected by inoculum size or 500 media. It acid by stopping the growth of bacteria. It is typically combined with a proton-pump inhibitor such as omeprazole and a clavulanic antibiotic such as clarithromycin ; other drug combinations are also effective.
If your dose is different, do not change it unless your doctor tells you to do so. Brand names of combination products Why is this medication prescribed?
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In Vitro Susceptibility Testing The National Committee for Clinical Laboratory Standards NCCLS states that, for streptococci including Streptococcus pneumoniae , results of in vitro susceptibility tests using penicillin can be used to predict susceptibility to amoxicillin and clavulanate potassium and, for non-b-lactamase-producing enterococci, results of in vitro susceptibility tests using penicillin or ampicillin can be used to predict susceptibility to amoxicillin and clavulanate potassium.
However, to determine susceptibility of staphylococci, Enterobacteriaceae, and Haemophilus to amoxicillin and clavulanate potassium, NCCLS recommends that disk-diffusion and dilution susceptibility tests be performed using appropriate combinations of amoxicillin and clavulanate potassium.
For information on interpretive criteria specified for ampicillin, see Spectrum: In Vitro Susceptibility Testing, in the Aminopenicillins General Statement To test in vitro susceptibility to amoxicillin and clavulanate potassium, a ratio of amoxicillin to clavulanic acid generally is used for both disk-diffusion and agar or broth dilution procedures. Results of in vitro susceptibility tests with amoxicillin and clavulanate potassium may be affected by inoculum size or test media.
However, results of the tests are not generally affected by pH changes between 6 and 8 or the presence of serum. NCCLS, the manufacturers, and most clinicians recommend that strains of staphylococci resistant to penicillinase-resistant penicillins also be considered resistant to amoxicillin and clavulanate potassium, although results of in vitro susceptibility tests may indicate that the organism is susceptible to the drug.
Disk Susceptibility Tests When disk-diffusion procedures are used to test susceptibility to amoxicillin and clavulanate potassium, a disk containing 20 mcg of amoxicillin and 10 mcg of clavulanic acid is used.
When disk-diffusion susceptibility tests are performed according to NCCLS standardized procedures using NCCLS interpretive criteria, Staphylococcus with growth inhibition zones of 20 mm or greater are considered susceptible to amoxicillin and clavulanate potassium and those with zones of 19 mm or less are resistant to the drug.
When disk-diffusion susceptibility tests are performed according to NCCLS standardized procedures, Enterobacteriaceae with growth inhibition zones of 18 mm or greater are susceptible to amoxicillin and clavulanate potassium, those with zones of mm have intermediate susceptibility, and those with zones of 13 mm or less are resistant to the drug.
When disk-diffusion susceptibility testing for Haemophilus is performed according to NCCLS standardized procedures using Haemophilus test medium HTM , Haemophilus with growth inhibition zones of 20 mm or greater are considered susceptible to amoxicillin and clavulanate potassium and those with zones of 19 mm or less are resistant to the drug.
The MIC of amoxicillin and clavulanate potassium has also been reported as mcg of amoxicillin plus mcg of clavulanic acid per mL i. When broth dilution susceptibility for S.
Gram-positive Aerobic Bacteria Amoxicillin and clavulanate potassium is active in vitro against most gram-positive aerobic cocci including penicillinase-producing and nonpenicillinase-producing strains of Staphylococcus aureus, S. Amoxicillin and clavulanate potassium is active in vitro against many strains of penicillinase-producing staphylococci that are resistant to amoxicillin alone; however, staphylococci resistant to penicillinase-resistant penicillins are generally also resistant to amoxicillin and clavulanate potassium.
In a similar in vitro study, the MIC90 for penicillinase-producing S. Gram-negative Aerobic Bacteria Neisseria Amoxicillin and clavulanate potassium is active in vitro against most strains of Neisseria meningitidis and penicillinase-producing and nonpenicillinase-producing N. Although penicillinase-producing N. The MIC90 of amoxicillin and clavulanate potassium for N.
In one in vitro study using dilutions containing a ratio of amoxicillin to clavulanic acid, the MIC of amoxicillin and clavulanate potassium for nonpenicillinase-producing N. Haemophilus Amoxicillin and clavulanate potassium is active in vitro against most b-lactamase-producing and non-b-lactamase-producing strains of Haemophilus influenzae, H.
However, strains of non-b-lactamase-producing Haemophilus that are resistant to aminopenicillins may also be resistant to amoxicillin and clavulanate potassium. In one in vitro study using dilutions containing a ratio of amoxicillin to clavulanate potassium, the MIC of amoxicillin and clavulanate potassium for non-b-lactamase-producing strains of H.
In another in vitro study using b-lactamase-producing H. Although most strains of H. Moraxella catarrhalis Amoxicillin and clavulanate potassium is active in vitro against both b-lactamase-producing and non-b-lactamase-producing strains of Moraxella catarrhalis formerly Branhamella catarrhalis.
The MIC90 of amoxicillin plus clavulanate acid is 0. In an in vitro study of b-lactamase-producing M. Enterobacteriaceae Amoxicillin and clavulanate potassium is active in vitro against Enterobacteriaceae that are susceptible to amoxicillin alone e.
In addition, amoxicillin and clavulanate potassium is active in vitro against many b-lactamase-producing strains of Citrobacter diversus, K. In one in vitro study using dilutions containing a ratio of amoxicillin to clavulanic acid, the MIC90 of amoxicillin and clavulanate potassium for E.
Although rare strains of C. Other Gram-negative Aerobic Bacteria Amoxicillin and clavulanate potassium has some in vitro activity against Legionella, although the drug may not be effective clinically. In one in vitro study using CYEA media containing 2. In another in vitro study using L. Amoxicillin and clavulanic acid is generally inactive against Pseudomonas; however, the drug may be active in vitro against Burkholderia pseudomallei formerly Pseudomonas pseudomallei. Anaerobic Bacteria Amoxicillin and clavulanate potassium is active in vitro against gram-positive anaerobic bacteria including Clostridium, Peptococcus, and Peptostreptococcus.
Amoxicillin and clavulanate potassium is active in vitro against Prevotella melaninogenica formerly Bacteroides melaninogenicus and P. Although the Bacteroides fragilis group e. In one in vitro study, the MIC of amoxicillin in the presence of 0. Mycobacterium Although the clinical importance has not been determined to date, amoxicillin and clavulanate potassium is active in vitro against some strains of Mycobacterium tuberculosis and M.
In one in vitro study using dilutions containing a ratio of amoxicillin to clavulanic acid, the MIC of amoxicillin and clavulanate potassium for M. In another study using M. Resistance Gram-negative aerobic bacilli that produce Richmond-Sykes type I chromosomally mediated b-lactamases e.
Strains of E. Pharmacokinetics Crossover studies using fixed combinations of amoxicillin and clavulanate potassium, amoxicillin alone, and clavulanate potassium alone indicate that concomitant administration of clavulanate potassium does not affect the pharmacokinetics of amoxicillin; however, concomitant administration of amoxicillin reportedly may increase GI absorption and renal elimination of clavulanate potassium compared with administration of clavulanate potassium alone.
For additional information on absorption, distribution, and elimination of amoxicillin, see Pharmacokinetics in the Aminopenicillins General Statement Absorption Amoxicillin trihydrate and clavulanate potassium are both generally stable in the presence of acidic gastric secretions and are well absorbed following oral administration of amoxicillin and clavulanate potassium.
Peak serum concentrations of amoxicillin and of clavulanic acid are generally attained within Following oral administration of a single conventional tablet containing mg of amoxicillin and mg of clavulanic acid in healthy, fasting adults, peak serum concentrations of amoxicillin and of clavulanic acid average 3.
Following oral administration of a single conventional tablet containing mg of amoxicillin and mg of clavulanic acid in healthy, fasting adults, peak serum concentrations of amoxicillin average 6. The manufacturer states that serum concentrations of the drugs achieved following oral administration of a single chewable tablet containing mg of amoxicillin and The manufacturer also states that serum concentrations of amoxicillin achieved following oral administration of conventional preparations or extended-release tablets of amoxicillin and clavulanate potassium are similar to those achieved following oral administration of equivalent doses of amoxicillin alone.
Following oral administration of a single dose of mg of amoxicillin and In one study in children years of age with urinary tract infections, oral administration of a single dose of mg of amoxicillin and Studies in healthy adults using conventional preparations of amoxicillin and clavulanate potassium indicate that presence of food in the GI tract does not affect oral absorption of either amoxicillin or clavulanic acid following administration of fixed-combination preparations of the drugs.
However, amoxicillin and clavulanate are optimally absorbed from extended-release tablets of the combination when administered orally at the beginning of a standardized meal kcal, Distribution Following administration of amoxicillin and clavulanate potassium, amoxicillin and clavulanic acid are both distributed into the lungs, pleural fluid, and peritoneal fluid.
Low concentrations i. Only minimal concentrations of amoxicillin or clavulanic acid are attained in CSF following oral administration of amoxicillin and clavulanate potassium in patients with uninflamed meninges; higher concentrations may be attained when meninges are inflamed. In one study in patients with uninflamed meninges who received a single mg oral dose of clavulanic acid as the sodium salt, concentrations of clavulanic acid in CSF obtained hours after the dose ranged from In 2 patients with continuous CSF drainage after neurosurgical procedures who received a similar oral dose of the drug, peak CSF concentrations of clavulanic acid were 2.
Amoxicillin and clavulanic acid readily cross the placenta. Amoxicillin and clavulanic acid are distributed into milk in low concentrations. Elimination Serum concentrations of amoxicillin and clavulanic acid both decline in a biphasic manner and half-lives of the drugs are similar. Following oral administration of conventional preparations or extended-release tablets of amoxicillin and clavulanate potassium in adults with normal renal function, amoxicillin has an elimination half-life of In one study in children years of age, the elimination half-lives of amoxicillin and of clavulanic acid averaged 1.
The metabolic fate of clavulanate potassium has not been fully elucidated; however, the drug appears to be extensively metabolized. In rats and dogs, the major metabolite of clavulanic acid is 1-aminohydroxybutanone; this metabolite has also been found in human urine following administration of clavulanic acid.
Clavulanic acid is excreted in urine principally by glomerular filtration. Serum concentrations of amoxicillin and of clavulanic acid are higher and the serum half-lives prolonged in patients with renal impairment. Oral probenecid administered shortly before or with amoxicillin and clavulanate potassium competitively inhibits renal tubular secretion of amoxicillin and produces higher and prolonged serum concentrations of the drug; however, probenecid does not appreciably affect the pharmacokinetics of clavulanic acid.
See Drug Interactions: Probenecid. Amoxicillin and clavulanic acid are both removed by hemodialysis. The manufacturers state that clavulanic acid is also removed by peritoneal dialysis. Only minimal amounts of amoxicillin appear to be removed by peritoneal dialysis. Chemistry and Stability Chemistry Amoxicillin and clavulanate potassium is a fixed combination of amoxicillin trihydrate and the potassium salt of clavulanic acid.
Amoxicillin is an aminopenicillin. See Amoxicillin The fixed combination also is commercially available as extended-release tablets containing the sodium salt and the trihydrate of amoxicillin and the potassium salt of clavulanic acid. Clavulanic acid is a b-lactamase inhibitor produced by fermentation of Streptomyces clavuligerus. Clavulanic acid contains a b-lactam ring and is structurally similar to penicillins and cephalosporins; however, the b-lactam ring in clavulanic acid is fused with an oxazolidine ring rather than with a thiazolidine ring as in penicillins or a dihydrothiazine ring as in cephalosporins.
Although clavulanic acid has only weak antibacterial activity when used alone, the combined use of clavulanic acid and certain penicillins or cephalosporins e. See prescribing information for amoxicillin and clavulanate potassium powder for oral suspension and chewable tablets.
Geriatric Use An analysis of clinical studies of amoxicillin and clavulanate potassium was conducted to determine whether subjects aged 65 and over respond differently from younger subjects. This analysis and other reported clinical experience have not identified differences in responses between the elderly and younger patients, but a greater sensitivity of some older individuals cannot be ruled out.
This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function. The overall incidence of side effects, and in particular diarrhea, increased with the higher recommended dose. Other less frequently reported reactions include: Abdominal discomfort, flatulence, and headache.
Hypersensitivity Reactions Skin rashes, pruritus, urticaria, angioedema, serum sickness-like reactions urticaria or skin rash accompanied by arthritis, arthralgia, myalgia, and frequently fever , erythema multiforme rarely Stevens-Johnson syndrome , acute generalized exanthematous pustulosis, hypersensitivity vasculitis, and an occasional case of exfoliative dermatitis including toxic epidermal necrolysis have been reported.
These reactions may be controlled with antihistamines and, if necessary, systemic corticosteroids. Whenever such reactions occur, the drug should be discontinued, unless the opinion of the physician dictates otherwise. It has been reported more commonly in the elderly, in males, or in patients on prolonged treatment. The histologic findings on liver biopsy have consisted of predominantly cholestatic, hepatocellular, or mixed cholestatic-hepatocellular changes.
The hepatic dysfunction, which may be severe, is usually reversible. These have generally been cases associated with serious underlying diseases or concomitant medications. Renal Interstitial nephritis and hematuria have been reported rarely. Hemic and Lymphatic Systems Anemia, including hemolytic anemia, thrombocytopenia, thrombocytopenic purpura, eosinophilia, leukopenia, and agranulocytosis have been reported during therapy with penicillins.
These reactions are usually reversible on discontinuation of therapy and are believed to be hypersensitivity phenomena. There have been reports of increased prothrombin time in patients receiving amoxicillin and clavulanate potassium and anticoagulant therapy concomitantly.
Central Nervous System Agitation, anxiety, behavioral changes, confusion, convulsions, dizziness, insomnia, and reversible hyperactivity have been reported rarely.
Miscellaneous Tooth discoloration brown, yellow, or gray staining has been rarely reported. Most reports occurred in pediatric patients. Discoloration was reduced or eliminated with brushing or dental cleaning in most cases. Rash, hyperactivity, or drowsiness have also been observed in a small number of patients. In the case of overdosage, discontinue amoxicillin and clavulanate potassium, treat symptomatically, and institute supportive measures as required.
If the overdosage is very recent and there is no contraindication, an attempt at emesis or other means of removal of drug from the stomach may be performed.
Crystalluria, in some cases leading to renal failure, has also been reported after amoxicillin overdosage in adult and pediatric patients. In case of overdosage, adequate fluid intake and diuresis should be maintained to reduce the risk of amoxicillin crystalluria. Renal impairment appears to be reversible with cessation of drug administration.
High blood levels may occur more readily in patients with impaired renal function because of decreased renal clearance of both amoxicillin and clavulanate. Both amoxicillin and clavulanate are removed from the circulation by hemodialysis. Warnings You should not use amoxicillin and clavulanate potassium if you have severe kidney disease, if you have had liver problems or jaundice while taking this medicine previously, or if you are allergic to any penicillin or cephalosporin antibiotic, such as Amoxil, Ceftin, Cefzil, Levaquin, Moxatag, Omnicef, and others.
If you switch from one tablet form to another regular, chewable, or extended-release tablet , take only the new tablet form and strength prescribed for you. Amoxicillin and clavulanate may not be as effective or could be harmful if you do not use the exact tablet form your doctor has prescribed. Amoxicillin and clavulanate potassium 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. Amoxicillin and clavulanate potassium can make birth control pills less effective.
Ask your doctor about using a non-hormone method of birth control such as a condom, diaphragm, spermicide to prevent pregnancy while taking this medicine.
Before taking this medicine You should not use this medicine if you are allergic to amoxicillin and clavulanate, or if: you have severe kidney disease or if you are on dialysis ; you have had liver problems or jaundice while taking amoxicillin and clavulanate potassium; or you are allergic to any penicillin or cephalosporin antibiotic, such as Amoxil, Ceftin, Cefzil, Moxatag, Omnicef, and others. To make sure this medicine is safe for you, tell your doctor if you have: liver disease hepatitis or jaundice ; kidney disease; or The liquid or chewable tablet may contain phenylalanine.
Tell your doctor if you have phenylketonuria PKU. Tell your doctor if you are pregnant or breastfeeding. Ask your doctor about using a non-hormonal birth control condom, diaphragm , cervical cap, or contraceptive sponge to prevent pregnancy.
Do not give this medicine to a child without medical advice. How should I take amoxicillin and clavulanate potassium? Take amoxicillin and clavulanate exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets.