Medication:
AMOXICILLIN (1889K)
Pregnancy SummaryMaternal use of amoxicillin has not been associated with an increased risk of congenital malformations or adverse pregnancy outcomes (1-6).
Amoxicillin is safe to use during pregnancy.
Amoxicillin is safe to use during pregnancy.
- 1st trimester
Safe to use - 2nd trimester
Safe to use - 3rd trimester
Safe to use - Category
A - Human placental transfer
Yes
Breastfeeding SummarySmall amounts of amoxicillin are excreted into the breast milk (1, 4), but no adverse effects have been reported in breastfed infants.
Amoxicillin is safe to use at the recommended doses during breastfeeding and observe the breastfed infant for adverse effects such as diarrhoea, vomiting, skin rashes or thrush.
Amoxicillin is safe to use at the recommended doses during breastfeeding and observe the breastfed infant for adverse effects such as diarrhoea, vomiting, skin rashes or thrush.
- Excreted into milk
Yes - Milk to plasma ratio
0.014 to 0.043 (7) - Relative infant dose
<1% (7) - Recommendation
Safe to use
- Peak time
1 to 2 hours (PO) (8); 60 minutes (IM) (9) - Half-life
61.3 minutes (PO) (6); ~1 hour (IV) (9) - Protein binding
20% (8) - Molecular weight
365.4 (base); 387.7 (sodium); 419.45 (trihydrate) (8) - pKa
2.4; 7.4; 9.6 (8) - Oral bioavailability
Unknown - Routes of administration
Injection and oral
https://thewomenspbmg-org-au.ezproxy1.acu.edu.au/medicines/amoxicillin-amoxycillin
Route & Typical Dose:
amoxicillin 500 mg capsule, 20 (PI, CMI)
May be taken with or without food. URTI, genitourinary tract, skin, soft tissue infection. Patients ≥ 20 kg: 250 mg every 8 hrs; children < 20 kg: 20 mg/kg/day in equally divided doses every 8 hrs. Severe infections, less susceptible organisms: may double dose. LRTI. Patients ≥ 20 kg: 500 mg every 8 hrs; children < 20 kg: 40 mg/kg/day in equally divided doses every 8 hrs. Urethritis, gonococcal; acute uncomplicated lower UTI in nonpregnant adult female: 3 g as single dose. Endocarditis prophylaxis: see full PI. Treatment duration: ≥ 48-72 hrs after bacterial eradication evidence or asymptomatic (≥ 10 days for haemolytic Streptococci infection). Renal impairment: may decr total daily dose; peritoneal dialysis: max 500 mg/day. British National Formulary for Children recommended doses (susceptible infections incl UTI, otitis media, sinusitis, uncomplicated CAP, salmonellosis, oral infections). Neonates 7-28 days: 30 mg/kg 3 times daily (max 125 mg/dose). 1-11 mths: 125 mg 3 times daily (may incr to 30 mg/kg 3 times daily). 1-4 yrs: 250 mg 3 times daily (may incr to 30 mg/kg 3 times daily). 5-11 yrs: 500 mg 3 times daily (may incr to 30 mg/kg 3 times daily, max 1 g/dose). 12-17 yrs: 500 mg 3 times daily (may incr to 1 g 3 times daily in severe infections)
May be taken with or without food. URTI, genitourinary tract, skin, soft tissue infection. Patients ≥ 20 kg: 250 mg every 8 hrs; children < 20 kg: 20 mg/kg/day in equally divided doses every 8 hrs. Severe infections, less susceptible organisms: may double dose. LRTI. Patients ≥ 20 kg: 500 mg every 8 hrs; children < 20 kg: 40 mg/kg/day in equally divided doses every 8 hrs. Urethritis, gonococcal; acute uncomplicated lower UTI in nonpregnant adult female: 3 g as single dose. Endocarditis prophylaxis: see full PI. Treatment duration: ≥ 48-72 hrs after bacterial eradication evidence or asymptomatic (≥ 10 days for haemolytic Streptococci infection). Renal impairment: may decr total daily dose; peritoneal dialysis: max 500 mg/day. British National Formulary for Children recommended doses (susceptible infections incl UTI, otitis media, sinusitis, uncomplicated CAP, salmonellosis, oral infections). Neonates 7-28 days: 30 mg/kg 3 times daily (max 125 mg/dose). 1-11 mths: 125 mg 3 times daily (may incr to 30 mg/kg 3 times daily). 1-4 yrs: 250 mg 3 times daily (may incr to 30 mg/kg 3 times daily). 5-11 yrs: 500 mg 3 times daily (may incr to 30 mg/kg 3 times daily, max 1 g/dose). 12-17 yrs: 500 mg 3 times daily (may incr to 1 g 3 times daily in severe infections)
indication:
Aminopenicillin, broad spectrum. Infections due to susceptible organisms incl skin, skin structure, respiratory, genitourinary tract, gonorrhoea (empirical therapy); endocarditis prophylaxis in individuals at risk eg history, prosthetic heart valve; see full PI
Mode of Action:
Presentation:
Management/administration considerations:
Interactions: Oral anticoagulants eg acenocoumarol, warfarin (monitor PT, INR); allopurinol; probenecid; COCs; bacteriostatics incl tetracycline (poss); false +ve Clinitest, Benedict, Fehling soln urine glucose tests
Side effect:
Renal impairment; lymphatic leukaemia; prolonged use (monitor renal, hepatic, haemopoietic function); high dose (ensure adequate hydration, urine output); superinfection risk; sore throat, pharyngitis (infectious mononucleosis risk); allergy history; chronic UTI (monitor bacteriology); gonorrhoea with suspected syphilis (pretreatment darkfield exam, monitor serology mthly for ≥ 4 mths); penicillin during previous mth in dental patients requiring general anaesthesia (refer to hospital); pregnancy, labour, delivery, lactation, neonate.
Adverse Reactions: Hypersensitivity incl anaphylaxis, SCAR; superinfection; pseudomembranous colitis (disc, investigate if prolonged/ significant diarrhoea, abdominal cramps); GI upset; blood dyscrasia; raised LFTs; crystalluria; rare: hepatitis, cholestatic jaundice, convulsion, interstitial nephritis, prolonged bleeding time, PT; very rare: superficial tooth discolouration (children); others, see full PI
Adverse Reactions: Hypersensitivity incl anaphylaxis, SCAR; superinfection; pseudomembranous colitis (disc, investigate if prolonged/ significant diarrhoea, abdominal cramps); GI upset; blood dyscrasia; raised LFTs; crystalluria; rare: hepatitis, cholestatic jaundice, convulsion, interstitial nephritis, prolonged bleeding time, PT; very rare: superficial tooth discolouration (children); others, see full PI
Contraindications:
β-Lactam antibiotic (eg penicillin, cephalosporin) hypersensitivity history