Co-amoxiclav

Broad-spectrum Penicillin · Broad-spectrum penicillin

Indications

Infections of the respiratory tract, ENT, UTI, skin and soft tissue.

Dosage

ORAL: Susp 156.25 mg: Children: Under 3 mth, not recommended; 3-9 mth, 2.5 mL half-strength; 9 mth-2 yr, 5 mL half-strength. 2-6 yr, 5 mL. All three times daily for up to fourteen days, then review. Susp 312.5 mg: Children: 6-12 yr, 5 mL. All three times daily for up to fourteen days, then review. Tab: Adults: In mild to moderate infections: 375 mg three times daily or 625 mg two times daily for up to fourteen days, then review. In severe infections: 625 mg three times daily or 1 gm two times daily. INJECTION: Adults: 1.2 gm by IV inj or intermittent infusion eight or six hourly. Treat up to 14 days then review. Children: Up to 3 mth, 30 mg/kg every twelve hr in premature and full term infants during the perinatal period, increasing to eight hr thereafter; 3 mth-12 yr, 30 mg/kg eight or six hourly. All by IV inj or intermittent infusion for up to 14 days, then revise.

Administration

By direct IV push over a period of 3-4 min used within 20 min of reconstitution. By IV intermittent infusion over 30-40 min and complete within 4 hours of reconstitution.

Adverse Effects

Hepatitis, cholestatic jaundice, erythema multiforme (including Stevens-Johnson syndrome), toxic epidermal necrolysis, exfoliative dermatitis, vasculitis, rarely prolongation of bleeding time, dizziness, headache, convulsions (particularly with high doses or in renal impairment), superficial staining of teeth with suspension, phlebitis at injection site, hypersensitivity reactions, GI upset, blood dyscrasias, CNS effects, antibiotic associated colitis.

Risk Factor (Pregnancy/Lactation)

Pregnancy: No evidence of risk in humans. Lactation: Caution advised or effect undetermined. Contraindications: Penicillin hypersensitivity, history of co-amoxiclav-associated or penicillin associated jaundice or hepatic dysfunction. Precautions: Hepatic impairment (monitor hepatic function). Risk of crystalluria with high doses, patient should be well hydrated. Do not dilute Syp below half-strength. Renal impairment. Infectious mononucleosis. Risk of acute generalised exanthematous pustulosis (discontinue permanently).

Interactions

Anticoagulants, allopurinol, probenecid, oral contraceptives, methotrexate, mycophenolate mofetil. Positive Coombs test.

Advice to Patient

Take with or without meals. Preferably taken with meals to prevent GI upset. Extended release tablets must be taken with meals. Take at regular intervals, as scheduled. Contact prescriber if there is unusual diarrhoea, vaginal pain/burning/itching, skin rash, unrelieved constipation or vomiting, fever or chills, unusual bruising or bleeding, jaundice, abdominal pain or if there is worsening of condition or no improvement. Complete full course of therapy, as prescribed, even if you feel better. Suspension bottles for small children may contain more amount of suspension than required, give for prescribed number of days.

Pharmacokinetics

AMOXICILLIN: Absorption: Oral: Immediate-release: Rapid with or without food. Extended-release: Rate of absorption is slower compared to immediate-release formulations; food reduces the rate but not extent of absorption. Half-life elimination: Adults: Immediate-release: 61.3 mins. Extended-release: 90 mins. Time to peak: Cap, oral susp: 1-2 hrs. Chewable tab: 1 hr. Extended-release: 3.1 hrs. Excretion: Urine. CLAVULANIC ACID: Half-life elimination: 1 hr. Time to peak: 1.5 hrs. Excretion: Urine.

Brands with this active ingredient

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.