Co AMoXiCLAV

Co amoxiclav

CLINICAL USE

Antibacterial agent

DOSE IN NORMAL RENAL FUNCTION

IV: 1.2 g every 8 hours (increasing to every 6 hours in severe infections) Oral: 375–625 mg 3 times daily

PHARMACOKINETICS

Molecular weight :Amoxycillin: 365.4; clavulanic acid: 199.2

%Protein binding :Amoxycillin: 20; clavulanic acid: 25

%Excreted unchanged in urine : Amoxycillin: 60; clavulanic acid: 40

Volume of distribution (L/kg) :Amoxycillin: 0.3; clavulanic acid: 0.3

half-life – normal/ESRD (hrs) :Amoxycillin: 1–1.5/7–20; clavulanic acid: 1/3–4

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

30–50 Dose as in normal renal function 10–30 IV: 1.2 g every 12 hours Oral: Dose as in normal renal function

<10 : IV: 1.2 g stat followed by 600 mg every 8 hours or 1.2 g every 12 hours Oral: Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :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 GFR=10–30 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAnticoagulants: effects of coumarins are potentially enhancedOral contraceptives: potentially reduced efficacyMethotrexate: reduced excretion thereby increasing risk of toxicity

ADMINISTRATION

Reconstition

600 mg with 10 mL water for injection; 1.2 g with 20 mL water for injection

Route

Oral, IV

Rate of Administration

IV bolus: over 3–4 minutes Infusion: infuse over 30–40 minutes in 50–100 mL sodium chloride 0.9%

Comments

IV preparation is less stable in infusion solutions containing glucose, dextran or bicarbonate. May be injected into drip tubing over period of 3–4 minutesDo not mix with aminoglycosides

OTHER INFORMATION

CSM has advised that cholestatic jaundice may occur if treatment exceeds a period of 14 days or up to 6 weeks after treatment has been stopped. The incidence of cholestatic jaundice occurring with co-amoxiclav is higher in males than in females, and prevalent particularly in men over the age of 65 yearsThe probability of co-amoxiclav associated cholestatic jaundice is 6 times more common than with amoxicillin, and with higher doses of clavulanic acidEach 1.2 g vial contains: sodium 2.7 mmol, potassium 1 mmol

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