Amoxicillin

Amoxicillin is a penicillin-type of antibiotic used to treat a variety of bacterial infections. It is effective in infections of the throat, ear, nasal sinuses, respiratory tract (e.g. pneumonia), urinary tract, skin and soft tissue, and typhoid fever. Amoxicillin is also used to prevent infection of the heart valves (bacterial endocarditis) in people with pre-existing heart disease. Additionally, it helps to eliminate H. pylori in people with peptic ulcer disease.

This medicine is best taken with a meal to reduce the chance of stomach upset. Take it regularly at evenly spaced intervals as per the schedule prescribed by your doctor. Do not skip any doses and finish the full course of treatment even if you feel better. Stopping the medicine too early may lead to the infection returning or worsening.

Rash, vomiting, allergic reactions, nausea and diarrhea may be seen as side effects. These are temporary and usually resolve quickly. This medicine is generally regarded as safe to use during pregnancy if used under a doctor's supervision.

• Throat, ear & sinus infections
• Respiratory tract infections (including pneumonia)
• Urinary tract infections
• Skin and soft tissue infections
• Typhoid fever
• H. pylori infection (peptic ulcer)
• Bacterial endocarditis prophylaxis
• Dental abscess
• Gonorrhea

Amoxicillin is a broad-spectrum antibiotic belonging to the penicillin class. It inhibits bacterial cell wall synthesis, leading to bacterial destruction. Amoxicillin binds to penicillin-binding proteins (PBPs) and inhibits the final transpeptidation step of peptidoglycan synthesis in the bacterial cell wall, resulting in bacterial lysis.

Amoxicillin is effective against both Gram-positive and Gram-negative bacteria. It is acid-stable and rapidly absorbed after oral administration.

Amoxicillin inhibits the formation of the peptidoglycan layer in the bacterial cell wall. The cell wall is essential for bacterial survival. Amoxicillin binds to penicillin-binding proteins and inactivates transpeptidase enzymes required for cell wall formation. When the cell wall becomes weak, bacteria undergo lysis and are destroyed. It is bactericidal and only effective against actively dividing bacteria.

Adult Dosage:

• Sensitive infections: 250-500 mg every 8 hours
• Severe/recurrent respiratory infections: 3 g twice daily
• Uncomplicated gonorrhea (with probenecid): 3 g as a single dose
• Dental abscess: 3 g, repeated once after 8 hours
• Uncomplicated acute UTI: 3 g, repeated once after 10-12 hours
• Endocarditis prophylaxis: 2 or 3 g as single dose 1 hour before dental procedure
• H. pylori infection: 500 mg 3 times daily with metronidazole/clarithromycin and bismuth or antisecretory drug
• IV/IM (sensitive infections): 500 mg every 8 hours
• Listerial meningitis: 2 g every 4 hours with other antibiotics (10-14 days)

Pediatric Dosage:

• Standard dose: 40-45 mg/kg/day (every 8-12 hours)
• High dose: 80-90 mg/kg/day, max 4 g/day (every 12 hours)
• Penicillin-resistant S. pneumoniae otitis media: 150 mg/kg/day (every 8 hours)

Renal Dose: Dose adjustment may be needed in severe renal impairment.

Take this medicine in the dose and duration as advised by your doctor. Take with food to reduce stomach upset. Do not chew, crush or break the tablet/capsule. Take at a fixed time for best results.

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.

• Rash (with fever)
• Vomiting
• Allergic reactions
• Nausea
• Diarrhea

Important Precautions:

• Inform your doctor if you are allergic to penicillin or penicillin-type medicines
• Complete the full course - do not stop even if you feel better
• Stop and inform your doctor immediately if you develop allergic reactions (rash, swelling of face/throat/tongue, breathing difficulties)
• Inform your doctor if you notice bloody stools or abdominal cramps
• Caution in infectious mononucleosis
• Caution in renal and hepatic disease

• Hypersensitivity to penicillin or cephalosporins
• Severe renal impairment (in certain cases)

• Probenecid: Reduces amoxicillin excretion, increasing serum levels
• Allopurinol: Increases risk of skin rash
• Oral contraceptives: May reduce contraceptive efficacy
• Methotrexate: May increase methotrexate levels
• Warfarin: May increase INR

[SAFE] Consuming alcohol with Amoxicillin does not cause any harmful side effects. However, alcohol may reduce immune function.

[SAFE IF PRESCRIBED] Amoxicillin is generally considered safe to use during pregnancy. Animal studies have shown low or no adverse effects to the developing baby; however, there are limited human studies. Use under doctor's supervision.

[SAFE IF PRESCRIBED] Amoxicillin is safe to use during breastfeeding. Human studies suggest that the drug does not pass into breastmilk in a significant amount and is not harmful to the baby.

Pediatric dose: 40-45 mg/kg/day. For severe infections: 80-90 mg/kg/day up to 4 g/day.

Elderly patients may have decreased renal function, so dose adjustment may be needed.

[CAUTION] Use with caution in kidney disease. Dose adjustment may be needed in severe renal impairment.

[CAUTION] Use with caution in liver disease. Regular monitoring of liver function tests is recommended.

Overdose may cause nausea, vomiting, diarrhea, and electrolyte imbalance. Consult your doctor if symptoms occur.

Store below 30°C, away from light and moisture. Keep out of reach of children.