Amoxicillin

CLINICAL USE


Antibacterial agent

DOSE IN NORMAL RENAL FUNCTION


250 mg – 1 g every 8 hours (maximum 6 g per
day, up to 12 g in endocarditis)

PHARMACOKINETICS


  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    365.4
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    20
  • %Excreted unchanged in urine &nbsp &nbsp :
    60
  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :
    0.3
  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :
    1–1.5/7–20

    DOSE IN RENAL IMPAIRMENT


    GFR (mL/MIN)


  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp :
    250 mg – 1 g every 8 hours
    (Maximum 6 g per day in
    endocarditis)

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES


  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:
    Not dialysed. Dose as in
    GFR <10 mL/min

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL/
    min
  • HDF/high flux &nbsp :
    Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL/
    min
  • CAV/VVHD &nbsp &nbsp &nbsp:
    Dialysed. Dose as in normal renal
    function

    IMPORTANT DRUG INTERACTIONS


    Potentially hazardous interactions with other drugs

  • Amoxicillin can reduce the excretion of

    methotrexate (increased risk of toxicity)

    ADMINISTRATION


    Reconstition

  • IV: Dissolve each 250 mg in 5 mL water for

    injection

  • IV Infusion: Dilute in 100 mL glucose 5%

    or sodium chloride 0.9%

  • IM: Dissolve 250 mg in 1.5 mL water for

    injection; 500 mg in 2.5 mL water for
    injection; 1 g in 2.5 mL water for injection
    or 1% sterile lidocaine hydrochloride

    Route


    Oral, IV, IM

    Rate of Administration

  • Slow bolus IV over 3–4 minutes
  • Infusion over 30–60 minutes

    Comments


    Stability in infusion depends upon diluent

    OTHER INFORMATION


    Sodium – 3.3 mmol/g vial of Amoxil

    Do not mix with aminoglycosides