Amoxicillin
(uh-MOX-ih-sil-in)
Trade Name(s):
Amoxil
Tablets, chewable 125 mg (as trihydrate)
Tablets, chewable 200 mg (as trihydrate)
Tablets, chewable 250 mg (as trihydrate)
Tablets, chewable 400 mg (as trihydrate)
Tablets 500 mg (as trihydrate)
Tablets 875 mg (as trihydrate)Capsules
250 mg (as trihydrate)Capsules
500 mg (as trihydrate)Powder for oral suspension
125 mg/5 mL (as trihydrate) when reconstitued
Powder for oral suspension 200 mg/5 mL (as trihydrate)
when reconstitutedPowder for oral suspension
250 mg/5 mL (as trihydrate) when reconstituted
Powder for oral suspension 400 mg/5 mL (as trihydrate)
when reconstituted
Amoxil Pediatric Drops
Powder for oral suspension 50 mg/mL (as trihydrate)
when reconstituted
Trimox
Capsules 250 mg (as trihydrate)
Capsules 500 mg (as trihydrate)Powder for oral suspension 125 mg/5 mL (as trihydrate) when reconstituted
Powder for oral suspension 250 mg/5 mL (as trihydrate) when reconstituted
Trimox Pediatric Drops
Powder for oral suspension 50 mg/mL (as trihydrate)
when reconstituted
Wymox
Capsules 250 mg (as trihydrate)
Capsules 500 mg (as trihydrate)Powder for oral suspension 125 mg/5 mL (as trihydrate) when reconstituted
Powder for oral suspension 250 mg/5 mL (as trihydrate) when reconstituted
APO-Amoxi
Lin-Amnox
Novamoxin
Nu-Amoxi
Pro-Amox
Indicates Canadian trade names.
Class: AntibioticPenicillin
Action:
Inhibits bacterial cell wall mucopeptide synthesis.
Indications:
Treatment of infections caused by susceptible strains of certain microorganisms.
Contraindications:
Hypersensitivity to penicillins, cephalosporins or imipenem. Not used to treat severe pneumonia, empyema, bacteremia, pericarditis, meningitis and purulent or septic arthritis during acute stage.
Route/Dosage:
Adults:
PO
250 to 500 mg q 8 hr.
Children:
PO
20 to 40 mg/kg/day in divided doses given q 8 hr.
Gonococcal Infections
Adults:
PO
3 g plus 1 g probenecid followed by doxycycline.
Bacterial Endocarditis Prophylaxis
Adults:
IM/IV
3 g 1 hr before invasive procedure, then
PO/IM/IV 1.5 g 6 hr after initial dose.
Children:
IM/IV
50 mg/kg 1 hr before invasive procedure, then
PO/IM/IV
25 mg/kg 6 hr after initial dose.
Unlabeled Use
Chlamydia Trachomatous in Pregnancy:
PO
500 mg tid for 7 days.
Interactions:
Contraceptives, oral:
May reduce efficacy of oral contraceptives.
Tetracyclines:
May impair bactericidal effects of amoxicillin.
Lab Test Interferences:
May cause false-positive urine glucose test results with
Benedict's Solution, Fehling's Solution, or Clinitest tablets (enzyme-based tests, eg,
Clinistix, Tes-Tape, are recommended);
false-positive direct Coombs' test result in certain patient groups; false-positive protein reactions with sulfosalicylic acid and boiling test, acetic acid test, biuret reaction and nitric acid test (bromphenol blue test, Multi-Stix, is recommended).
Adverse Reactions:
- CNS:
- Dizziness; fatigue; insomnia; reversible hyperactivity.
- DERM:
- Urticaria; maculopapular to exfoliative dermatitis; vesicular eruptions; erythema multiforme; skin rashes.
- EENT:
- Itchy eyes; glossitis; stomatitis; sore or dry mouth or tongue; black "hairy"
tongue; abnormal taste sensation; laryngospasm; laryngeal edema.
- GI:
- Gastritis; anorexia; nausea; vomiting; abdominal pain or cramps; epigastric distress; diarrhea or bloody diarrhea; rectal bleeding; flatulence; enterocolitis;
pseudomembranous colitis.
- GU:
- Interstitial nephritis (eg, oliguria, proteinuria, hematuria, hyaline casts, pyuria); nephropathy; vaginitis.
- HEMA:
- Anemia; hemolytic anemia; thrombocytopenia; thrombocytopenic purpura; eosinophilia; leukopenia; granulocytopenia; neutropenia; bone marrow depression; agranulocytosis; reduced hemoglobin or hematocrit; prolonged bleeding and prothrombin time; increased or decreased lymphocyte count; increased monocytes, basophils, platelets.
- HEPA:
- Transient hepatitis; cholestatic jaundice.
- META:
- Elevated serum alkaline phosphatase and hypernatremia; reduced serum potassium, albumin, total proteins and uric acid.
- OTHER:
- Hyperthermia.
Precautions:
Pregnancy:
Category B.
Lactation:
Excreted in breast milk.
Hypersensitivity:
Reactions range from mild to life threatening. Use cautiously in cephalosporin-sensitive patients because of possible cross-allergenicity.
Streptococcal infections:
Min 10 days required for effective treatment.
Superinfection:
May result in overgrowth of nonsusceptible bacterial or fungal organisms.
Patient Care Considerations
Administration/Storage:
- Use liquid preparations for patients with swallowing difficulties. Shake liquid preparations well before using.
- Time doses for equal distribution throughout day to achieve optimal blood levels.
- Be certain chewable tablets are crushed or chewed before swallowing. Supply water after each dose.
- Refrigerate liquid preparations as indicated after reconstitution. Discard after 14 days. Use tight lid to avoid evaporation of moisture.
Assessment/Interventions:
- Obtain patient history, including drug history and any known allergies.
- Review results of culture and sensitivity testing as available.
- Monitor patient closely for several hours after administering first dose even when there is no history of allergy. Notify health care provider of any signs of potential hypersensitivity or anaphylactic reaction.
- Monitor renal and GI function. Notify health care provider of severe GI distress.
OVERDOSAGE: SIGNS & SYMPTOMS
Hyperexcitability, convulsions
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Patient/Family Education:
- Instruct patient to time doses evenly over a 24-hr period.
- Inform patient that the medication works best on empty stomach but may be taken with food if there is GI upset.
- Instruct patient to increase fluid intake to 2000 to 3000 mL/day unless contraindicated.
- Advise patient to discard oral liquid preparations that are >
14 days old.
- If therapy is changed because of allergic reaction, explain significance of penicillin allergy and inform patient of potential sensitivity to cephalosporins.
- Instruct patient to report the following symptoms to health care provider: rash, difficulty breathing.
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