Drug Detail:Amoxil (Amoxicillin [ am-ox-i-sil-in ])
Generic Name: AMOXICILLIN 250mg in 5mL
Dosage Form: capsules, tablets, chewable tablets, and powder for oral suspension
Drug Class: Aminopenicillins
Capsules, chewable tablets, and oral suspensions of AMOXIL may be given without regard to meals. The 400-mg suspension, 400-mg chewable tablet, and the 875-mg tablet have been studied only when administered at the start of a light meal. However, food effect studies have not been performed with the 200-mg and 500-mg formulations.
Neonates and Infants Aged ≤ 12 Weeks (≤ 3 Months)
Due to incompletely developed renal function affecting elimination of amoxicillin in this age group, the recommended upper dose of AMOXIL is 30 mg/kg/day divided q12h.
Infection | Severitya | Usual Adult Dose | Usual Dose for Children > 3 Monthsb |
Ear/Nose/Throat | Mild/Moderate | 500 mg every 12 hours or 250 mg every 8 hours |
25 mg/kg/day in divided doses every 12 hours or 20 mg/kg/day in divided doses every 8 hours |
Severe | 875 mg every 12 hours or 500 mg every 8 hours |
45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours |
|
Lower Respiratory Tract | Mild/Moderate or Severe | 875 mg every 12 hours or 500 mg every 8 hours |
45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours |
Skin/Skin Structure | Mild/Moderate | 500 mg every 12 hours or 250 mg every 8 hours |
25 mg/kg/day in divided doses every 12 hours or 20 mg/kg/day in divided doses every 8 hours |
Severe | 875 mg every 12 hours or 500 mg every 8 hours |
45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours |
|
Genitourinary Tract | Mild/Moderate | 500 mg every 12 hours or 250 mg every 8 hours |
25 mg/kg/day in divided doses every 12 hours or 20 mg/kg/day in divided doses every 8 hours |
Severe | 875 mg every 12 hours or 500 mg every 8 hours |
45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours |
|
Gonorrhea Acute, uncomplicated ano-genital and urethral infections in males and females |
3 grams as single oral dose |
Prepubertal children: 50 mg/kg AMOXIL, combined with 25 mg/kg probenecid as a single dose. NOTE: SINCE PROBENECID IS CONTRAINDICATED IN CHILDREN UNDER 2 YEARS, DO NOT USE THIS REGIMEN IN THESE CASES. |
a Dosing for infections caused by less susceptible organisms should follow the recommendations for severe infections.
b The children’s dosage is intended for individuals whose weight is less than 40 kg. Children weighing 40 kg or more should be dosed according to the adult recommendations.
After reconstitution, the required amount of suspension should be placed directly on the child’s tongue for swallowing. Alternate means of administration are to add the required amount of suspension to formula, milk, fruit juice, water, ginger ale, or cold drinks. These preparations should then be taken immediately. To be certain the child is receiving full dosage, such preparations should be consumed in entirety.
All patients with gonorrhea should be evaluated for syphilis. (See PRECAUTIONS: Laboratory Tests.)
Larger doses may be required for stubborn or severe infections.
General
It should be recognized that in the treatment of chronic urinary tract infections, frequent bacteriological and clinical appraisals are necessary. Smaller doses than those recommended above should not be used. Even higher doses may be needed at times. In stubborn infections, therapy may be required for several weeks. It may be necessary to continue clinical and/or bacteriological follow-up for several months after cessation of therapy. Except for gonorrhea, treatment should be continued for a minimum of 48 to 72 hours beyond the time that the patient becomes asymptomatic or evidence of bacterial eradication has been obtained. It is recommended that there be at least 10 days’ treatment for any infection caused by Streptococcus pyogenes to prevent the occurrence of acute rheumatic fever.
H. pylori Eradication to Reduce the Risk of Duodenal Ulcer Recurrence
Triple Therapy
AMOXIL/clarithromycin/lansoprazole
The recommended adult oral dose is 1 gram AMOXIL, 500 mg clarithromycin, and 30 mg lansoprazole, all given twice daily (q12h) for 14 days. (See INDICATIONS AND USAGE.)
Dual Therapy
AMOXIL/lansoprazole
The recommended adult oral dose is 1 gram AMOXIL and 30 mg lansoprazole, each given three times daily (q8h) for 14 days. (See INDICATIONS AND USAGE.)
Please refer to clarithromycin and lansoprazole full prescribing information for CONTRAINDICATIONS and WARNINGS, and for information regarding dosing in elderly and renally impaired patients.
Dosing Recommendations for Adults with Impaired Renal Function
Patients with impaired renal function do not generally require a reduction in dose unless the impairment is severe. Severely impaired patients with a glomerular filtration rate of < 30 mL/min. should not receive the 875-mg tablet. Patients with a glomerular filtration rate of 10 to 30 mL/min. should receive 500 mg or 250 mg every 12 hours, depending on the severity of the infection. Patients with a less than 10 mL/min. glomerular filtration rate should receive 500 mg or 250 mg every 24 hours, depending on severity of the infection.
Hemodialysis patients should receive 500 mg or 250 mg every 24 hours, depending on severity of the infection. They should receive an additional dose both during and at the end of dialysis.
There are currently no dosing recommendations for pediatric patients with impaired renal function.
Directions for Mixing Oral Suspension
Prepare suspension at time of dispensing as follows: Tap bottle until all powder flows freely. Add approximately 1/3 of the total amount of water for reconstitution (see table below) and shake vigorously to wet powder. Add remainder of the water and again shake vigorously.
250 mg/5 mL |
|
Bottle Size |
Amount of Water Required for Reconstitution |
100 mL |
74 mL |
150 mL |
111 mL |
Each teaspoonful (5 mL) will contain 250 mg amoxicillin.
400 mg/5 mL |
|
Bottle Size |
Amount of Water Required for Reconstitution |
100 mL |
71 mL |
Each teaspoonful (5 mL) will contain 400 mg amoxicillin.
Directions for Mixing Pediatric Drops
Prepare pediatric drops at time of dispensing as follows: Add the required amount of water (see table below) to the bottle and shake vigorously. Each mL of suspension will then contain amoxicillin trihydrate equivalent to 50 mg amoxicillin.
Bottle Size |
Amount of Water Required for Reconstitution |
30 mL |
23 mL |
NOTE: SHAKE BOTH ORAL SUSPENSION AND PEDIATRIC DROPS WELL BEFORE USING. Keep bottle tightly closed. Any unused portion of the reconstituted suspension must be discarded after 14 days. Refrigeration preferable, but not required.