Amoxicillin

Also known as: Amoxycillin

Drug #51

Amoxicillin is oral semisynthetic aminopenicillin similar to ampicillin. Amoxicillin is more stable to gastric acids and more bioavailable than other penicillins. It inhibits the 3rd and final stage of bacterial cell wall synthesis by binding to specific penicillin-binding proteins PBPs that are located inside the bacterial cell wall and are responsible for several steps in the synthesis of the cell wall. Chemically Amoxicillin is D-(-)-a-amino-p-hydroxy-benzyl penicillin. Amoxicillin is a broad spectrum antibiotic and has bactericidal activity against many gram positive and gram negative bacteria. Antibiotics require constant drug level in body for therapeutic effect. This is achieved by taking the drug at regular intervals of time throughout the day and night as prescribed. Amoxicillin is important to take the drug for the full time period as prescribed. If you discontinue the drug it may result in ineffective treatment.

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Primary Characteristics

Amoxicillin is also known as Amoxycillin, Amoxicillin Trihydrate.

It is of Semi Synthetic origin and belongs to Penicillanic acid.

It belongs to Peptidoglycan synthesis inhibitor pharmacological group on the basis of mechanism of action and also classified in Antibiotic, Penicillin pharmacological group.

Molecular Weight: 419.5 · pK_a: 2.4, 7.4, 9.6 · Solubility in Water: 1 in 400 · Solubility in Alcohol: 1 in 1000 · Non-proprietary name: Amoxicillin.

Pharmacokinetics

Absorption: Amoxicillin has an oral bioavailability is 83% (±9%), pre-systemic (first-pass) metabolism accounts for 0.5% (±0.5%).

Distribution: Amoxicillin has a volume of distribution is 0.3 l/kg. plasma protein binding is 17-20%.

Elimination: it is metabolised via 10-20%, plasma half-life is 1hr, renal excretion is 60% (oral), 75% (parenteral).

Indications

Amoxicillin is primarily indicated in conditions like Abscesses, Acute bronchitis, Bacteriuria, Bronchitis, Carbuncles, Cellulitis, Chronic bronchitis, Cystitis, Dental abscess, Dental abscess (short-course), Endocarditis, Furunculosis, Gonorrhoea, Gynecological infections, Haemophilus influenzae infections, Helicobacter pylori eradication, Infected wounds, Inflammatory bowel disease, Lower respiratory tract infections, Meningitis, Metastatic, Metastatic colorectal cancer, Mild to moderate chronic heart failure, Muscle relaxation (short duration) for surgery, Muscle relaxation during intensive care, Muscle relaxation for surgery or intubation, Osteomyelitis, Otitis media, Parathyroid fever, Peritonitis, Pharyngitis, Pneumonia, Puerperal sepsis, Pyelonephritis, Septic abortion, Septicaemia, Sinusitis, Skin infections, Soft tissue infections, Surgical infections, Syphilis, Systemic infections, Tonsillitis, Typhoid, Urinary tract infection.

Contraindications

Amoxicillin is contraindicated in conditions like Lymphoma, Glandular fever.

Dosage

Amoxicillin's dosage details are as follows:

Dose	Single Dose	Frequency	Route	Instructions
Adult Dosage
0.375 g	0.375 g	Every 8h	PO,IV,IM	Doses vary according to indication. In typhoid fever and Meningitis , 150 mg/Kg/day in adults and 100-150 mg/kg/day in children should be given. Doses greater than 500 mg is given in divided doses.
Paediatric Dosage (20kg)
75 mg/kg	75 mg/kg	Every 6h	Intra Muscular
75 mg/kg	75 mg/kg	Every 6h	Intra Venous
30 mg/kg	30 mg/kg	Every 8h	Oral
Neonatal Dosage (3kg)
18.75 mg/kg	18.75 mg/kg	Every 6h	Intramuscular
18.75 mg/kg	18.75 mg/kg	Every 6h	Intravenous

Drug Interactions

Unknown2 interactions

4 interactions

Major1 interaction

Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

Side Effects

Amoxicillin in overdosage may give rise to further complications which include Pseudomembranous colitis , Nephrotic syndrome , Thrombocytopenia , Leucopenia, Agranulocytosis , Platelet dysfunction , Stevens johnson syndrome , Eosinophilia , Neutropenia , Seizures , Interstitial nephritis , Hemolysis .

Amoxicillin produces potentially life-threatening effects which include Anaphylactic shock. Careful monitoring is needed with proper medical management.

The signs and symptoms that are produced after acute overdosage of Amoxicillin are Hemorrhagic cystitis, Crystalluria .

Amoxicillin is known to cause more or less tolerable side effects which are usually transient. These include Abdominal pain, Anorexia , Arrhythmia, Bullous rash, Cholestatic Jaundice , Diarrhea, Dizziness, Elevation of liver enzymes, Fever, Gastritis, Headache, Hepatitis, Indigestion , Maculopapular rash, Nausea and vomiting, Pseudomembranous colitis , Rashes , Urticarial skin rash.

Warnings / Precautions

Amoxicillin should be used with caution in patients with medical history especially kidney disease, stomach or intestinal problems, blood disorders or drug allergies, especially allergies to other penicillin or cephalosporin antibiotics. Do not use amoxicillin repeatedly or for prolonged period, because use of this medication for prolonged or repeated periods may result in a secondary infection (e.g.oral, bladder or vaginal yeast infection). Use with extreme caution during pregnancy or lactation.

Available Brands

Click on a strength to view available brands.

Single Ingredient

Caps

125 mg 250 mg 500 mg

Drops

125 mg/1.25ml

Dry Susp

125 mg/5ml 250 mg/5ml

Inj

1 g 250 mg 500 mg

Oral Soln

125 mg/1.25ml

Susp

125 mg 125 mg/5ml 250 mg/5ml 500 mg/5ml

Tabs

1 g 200 mg 400 mg 500 mg

Multi-Ingredient Combinations

Caps

125 mg 250 mg

Drops

50 mg/5ml 50 mg/ml

Dry Susp

200 mg/5ml 250 mg/5ml

Inj

0.1 gm 1 g 125 mg 1500 mg 2 gm 250 mg 375 mg 500 mg 750 mg

Inj-IV

1 g 500 mg

Susp

125 mg/5ml 250 mg/5ml 400 mg/5ml

Syrup

125 mg/5ml 250 mg/5ml 400 mg/5ml

Tabs

1 g 250 mg 500 mg 750 mg 875 mg

Storage Conditions

Amoxicillin should be stored Caps. Inj (reconstituted soln). Oral Susp (reconstituted soln).

Drug Classification

1.6.2.1.1 — Penicillins