Amoxicillin
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 :
365.4
%Protein binding :
20
%Excreted unchanged in urine :
60
Volume of distribution (L/kg) :
0.3
half-life – normal/ESRD (hrs) :
1–1.5/7–20
DOSE IN RENAL IMPAIRMENT
GFR (mL/MIN)
20 to 50 : Dose as in normal renal function
10 to 20 : Dose as in normal renal function
<10 :
250 mg – 1 g every 8 hours
(Maximum 6 g per day in
endocarditis)
DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD :
Not dialysed. Dose as in
GFR <10 mL/min
HD :
Dialysed. Dose as in GFR <10 : mL/
min
HDF/high flux :
Dialysed. Dose as in GFR <10 : mL/
min
CAV/VVHD :
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
See how to identify renal failure stages according to GFR calculation
See how to diagnose irreversible renal disease
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