📋 Indications & Clinical Dosage
*Infections due to beta-lactamase-producing strains(where amoxicillin alone not appropriate), including respiratory tract infections, bone and joint infections, genito-urinary and abdominal infections, skin and soft tissue infection, cellulitis and animal bites:*
ORAL TAB: Adult &Children 12-17 yrs: 250/125 mg every 8 hours; increased to 500/125 mg every 8 hours, increased dose used for severe infection.
BY IV INJ, OR BY IV INF: Adult: 1.2 g every 8 hours.
Children 1-2 months: 30 mg/kg every 12 hours; 3 months-17 years: 30 mg/kg every 8 hours (max.per dose 1.2 g every 8 hours)
ORAL SUSP 125/3: Children 1-11 months: 0.25 ml/kg 3 times a day, dose doubled in severe infection; 1-5 years: 0.25 ml/kg 3 times a day, alternatively 5 ml 3 times a day, dose doubled in severe infection
ORAL SUSP 250/62: Children 6-11 years: 0.15 ml/kg 3 times a day, alternatively 5 ml 3 times a day, dose doubled in severe infection.
ORAL SUSP 400/57: Children 2 months-1 year: 0.15 ml/kg twice daily, doubled in severe infection; 2-6 years (body-weight 13-21 kg): 2.5 ml twice daily, doubled in severe infection; 7-12 years (body-weight 22-40 kg): 5 ml twice daily, doubled in severe infection; 12-17 years (body-weight 41 kg and above): 10 ml twice daily; increased if necessary to 10 ml 3 times a day, increased frequency to be used in severe infection.
Adult: 10 ml twice daily; increased if necessary to10 ml 3 times a day, increased frequency to be used in severe infection.
*Severe dental infection with spreading cellulitis, Dental infection not responding to first-line antibacterial:*
ORAL TAB: Adult &Children 12-17 years: 250/125 mg every 8 hours for 5 days.
*Surgical prophylaxis:*
BY IV INJ, OR BY IV INF: Adult: 1.2 g, to be administered up to 30 minutes before the procedure, then 1.2 g every 8 hours for up to2-3 further doses in high risk procedures.
💊 Mode of Administration
By direct IV push over a period of 3-4 min used within 20 min of reconstitution, By IV intermittent infusion over 30-40 min and complete within 4 hours of reconstitution.
⛔ Contraindications
Penicillin hypersensitivity, history of coamoxiclav-associated or penicillin associated jaundice or hepatic dysfunction.
⚠️ Precautions & Warnings
Hepatic impairment (monitor hepatic function), risk of crystalluria with high doses, patient should be well hydrated. Do not dilute Syp below half- strength.
🔄 Drug Interactions
Anticoagulants, allopurinol, probenecid, oral contraceptives, methotrexate.
⚠️ Adverse Reactions / Side Effects
Dizziness, headache, hepatitis, cholestatic jaundice, convulsions (particularly with high doses or in renal impairment), superficial staining of teeth with suspension, phlebitis at injecction site, erythema multiforme (including Stevens-Johnson syndrome), toxic epidermal necrolysis, exfoliative dermatitis, vasculitis, rarely prolongation of bleeding time
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
No evidence of risk
Lactation / Breastfeeding:
Contraindicated