Buy Trimox Online

Amoxicillin (amoxicillin)

OTHER BRAND NAMES

Amoxil (Discontinued), Trimox (Discontinued)

THERAPEUTIC CLASS

Semisynthetic ampicillin derivative

DEA CLASS

RX

INDICATIONS

Treatment of infections of the ear, nose, throat, and genitourinary tract (GU); skin and skin structure infections (SSSIs); lower respiratory tract infections (LRTIs); and acute, uncomplicated gonorrhea (anogenital and urethral infections) due to susceptible (β-lactamase negative) strains of microorganisms. Combination therapy for Helicobacter pylori eradication to reduce the risk of duodenal ulcer recurrence.

ADULT DOSAGE

Helicobacter pylori Eradication

W/ Duodenal Ulcer Disease:
Dual Therapy:
1g + 30mg lansoprazole, each q8h for 14 days
Triple Therapy: 1g + 30mg lansoprazole + 500mg clarithromycin, all q12h for 14 days

Ear/Nose/Throat Infection

Mild/Moderate: 500mg q12h or 250mg q8h
Severe: 875mg q12h or 500mg q8h

Genitourinary Tract Infections

Mild/Moderate: 500mg q12h or 250mg q8h
Severe: 875mg q12h or 500mg q8h

Skin and Skin Structure Infections

Mild/Moderate: 500mg q12h or 250mg q8h
Severe: 875mg q12h or 500mg q8h

Lower Respiratory Tract Infections

Mild/Moderate or Severe: 875mg q12h or 500mg q8h

Gonorrhea

Acute, Uncomplicated (Ano-Genital and Urethral Infections):
3g as a single dose

Treatment Duration

Continue for a minimum of 48-72 hrs beyond the time the patient becomes asymptomatic or evidence of bacterial eradication has been obtained

Streptococcus pyogenes Infections: Treat for at least 10 days

PEDIATRIC DOSAGE

Lower Respiratory Tract Infections

≤12 Weeks of Age:
Max: 30mg/kg/day divided q12h

>3 Months of Age:
<40kg: 45mg/kg/day divided q12h or 40mg/kg/day divided q8h
≥40kg: 875mg q12h or 500mg q8h

Gonorrhea

Acute, Uncomplicated (Ano-Genital and Urethral Infections):
Prepubertal Children >2 Years:
<40kg: 50mg/kg combined w/ 25mg/kg probenecid as a single dose
≥40kg: 3g as single dose

Ear/Nose/Throat Infection

≤12 Weeks of Age:
Max: 30mg/kg/day divided q12h

>3 Months of Age:
<40kg:
Mild/Moderate: 25mg/kg/day divided q12h or 20mg/kg/day divided q8h
Severe: 45mg/kg/day divided q12h or 40mg/kg/day divided q8h
≥40kg:
Mild/Moderate: 500mg q12h or 250mg q8h
Severe: 875mg q12h or 500mg q8h

Genitourinary Tract Infections

≤12 Weeks of Age:
Max: 30mg/kg/day divided q12h

>3 Months of Age:
<40kg:
Mild/Moderate: 25mg/kg/day divided q12h or 20mg/kg/day divided q8h
Severe: 45mg/kg/day divided q12h or 40mg/kg/day divided q8h
≥40kg:
Mild/Moderate: 500mg q12h or 250mg q8h
Severe: 875mg q12h or 500mg q8h

Skin and Skin Structure Infections

≤12 Weeks of Age:
Max: 30mg/kg/day divided q12h

>3 Months of Age:
<40kg:
Mild/Moderate: 25mg/kg/day divided q12h or 20mg/kg/day divided q8h
Severe: 45mg/kg/day divided q12h or 40mg/kg/day divided q8h
≥40kg:
Mild/Moderate: 500mg q12h or 250mg q8h
Severe: 875mg q12h or 500mg q8h

Treatment Duration

Continue for a minimum of 48-72 hrs beyond the time that patient becomes asymptomatic or evidence of bacterial eradication has been obtained

Streptococcus pyogenes Infections: Treat for at least 10 days

DOSING CONSIDERATIONS

Renal Impairment
GFR <30mL/min: Should not receive a 875mg dose
GFR 10-30mL/min: 250mg or 500mg q12h, depending on severity of infection
GFR <10mL/min: 250mg or 500mg q24h, depending on severity of infection
Hemodialysis: 250 or 500mg q24h, depending on severity of infection; give an additional dose during and at end of dialysis

ADMINISTRATION

Oral route

Sus
125mg/5mL: Reconstitute 80mL, 100mL, or 150mL bottle size w/ 62mL, 77mL, or 113mL of water respectively
200mg/5mL: Reconstitute 50mL, 75mL, or 100mL bottle size w/ 39mL, 57mL, or 75mL of water respectively
250mg/5mL: Reconstitute 80mL, 100mL, or 150mL bottle size w/ 47mL, 60mL, or 90mL of water respectively
400mg/5mL: Reconstitute 50mL, 75mL, or 100mL bottle size w/ 35mL, 51mL, or 67mL of water respectively
Add approximately 1/3 of the total amount of water to wet powder then shake vigorously
Add the remainder of the water and shake vigorously
Place directly on tongue for swallowing
Can be added to formula, milk, fruit juice, water, ginger ale, or cold drinks; take immediately
Shake well before use

HOW SUPPLIED

Cap: 250mg, 500mg; Sus: 125mg/5mL [80mL, 100mL, 150mL], 200mg/5mL [50mL, 75mL, 100mL], 250mg/5mL [80mL, 100mL, 150mL], 400mg/5mL [50mL, 75mL, 100mL]; Tab: 500mg, 875mg*; Tab, Chewable: 125mg, 250mg *scored

WARNINGS/PRECAUTIONS

Serious and occasionally fatal, hypersensitivity (anaphylactic) reactions reported with penicillin (PCN) therapy. Clostridium difficile-associated diarrhea (CDAD) reported; d/c if CDAD is suspected or confirmed. Avoid use with mononucleosis; erythematous skin rash may develop in these patients. May result in bacterial resistance if used in the absence of a proven/suspected bacterial indication; d/c and institute appropriate therapy if superinfection develops. Lab test interactions may occur. Caution in elderly; monitor renal function.

ADVERSE REACTIONS

N/V, diarrhea, rash.

DRUG INTERACTIONS

Decreased renal tubular secretion and increased/prolonged levels with probenecid. May reduce efficacy of combined oral estrogen/progesterone contraceptives. Chloramphenicol, macrolides, sulfonamides, and tetracyclines may interfere with bactericidal effects of PCN. PT prolongation (increased INR) reported with oral anticoagulants; dose adjustment of oral anticoagulant may be necessary. Increased incidence of rashes with allopurinol.

PREGNANCY AND LACTATION

Category B, caution in nursing.

MECHANISM OF ACTION

Ampicillin analog; has broad-spectrum bactericidal activity against susceptible organisms during active multiplication; acts through inhibition of biosynthesis of cell wall.

PHARMACOKINETICS

Absorption: Rapid. Cap: (250mg) Tmax=1-2 hrs, Cmax=3.5-5mcg/mL; (500mg) Tmax=1-2 hrs, Cmax=5.5-7.5mcg/mL. Tab: (875mg) Cmax=13.8mcg/mL, AUC=35.4mcg•hr/mL. Sus: (125mg/5mL) Tmax=1-2 hrs, Cmax=1.5-3mcg/mL; (250mg/5mL) Tmax=1-2 hrs, Cmax=3.5-5mcg/mL; (400mg/5mL) Tmax=1 hr, Cmax=5.92mcg/mL, AUC=17.1mcg•hr/mL. Tab, Chewable: (400mg) Tmax=1 hr, Cmax=5.18mcg/mL, AUC=17.9mcg•hr/mL. Distribution: Plasma protein binding (20%); found in breast milk. Elimination: Urine (60%, unchanged); T1/2=61.3 min.

ASSESSMENT

Assess for history of allergic reaction to PCNs, cephalosporins, or other allergens, mononucleosis, renal function, pregnancy/nursing status, and possible drug interactions.

MONITORING

Monitor for serious anaphylactic reactions, erythematous skin rash, development of drug-resistant bacteria or superinfection, and CDAD. Monitor renal function. Monitor PT and INR if coadministered with an oral anticoagulant.

PATIENT COUNSELING

Inform that drug treats only bacterial, not viral (eg, common colds), infections. Instruct to take exactly ud; inform that skipping doses or not completing full course of therapy may decrease effectiveness and increase resistance. Instruct to notify physician as soon as possible if watery and bloody stools (with/without stomach cramps and fever) develop, even as late as ≥2 months after having last dose. Advise patients that drug may cause allergic reactions.

STORAGE

20-25°C (68-77°F). (Sus) Discard any unused portion after 14 days. Refrigeration preferable but not required.

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