augmentin

Written by Dr. Zohaib Tahir [Pharm-D, Gomal University, Dera Ismail Khan, Pakistan]

Brand Name

• Augmentin

Generic Name

• Amoxicillin and Clavulanate Potassium

Available Dosage Forms & Their Doses

• Tablets:

• 250 mg/125 mg = 375mg

• 500 mg/125 mg = 625mg

• 875 mg/125 mg = 1g

• Chewable Tablets:

• 125 mg/31.25 mg

• 200 mg/28.5 mg

• 250 mg/62.5 mg

• 400 mg/57 mg

• Oral Suspensions:

• 156 mg/5 mL

• 312.5 mg/5 mL

• 457 mg/5 mL

• Drops:

• 62.5mg/mL

• Injection:

• 1.2g

• 600mg

Prices & Packing Size:

• Drop 62.5 mg/mL: 20 mL: Rs. 170.71

• Inj 1.2 gm: 10 Vial (011523): Rs. 1802.0

• Inj 1.2 gm: Vial (011523): Rs. 180.2

• Inj 600 mg: 10 Vial (010338): Rs. 1035.4

• Inj 600 mg: Vial (010338): Rs. 104.0

• Susp 156.25 mg/5 mL: 60 mL (009264): Rs. 70.0

• Susp 156.25 mg/5 mL: 90 mL (009264): Rs. 368.08

• Susp 312.5 mg/5 mL: 60 mL (018360): Rs. 131.0

• Susp 312.5 mg/5 mL: 90 mL (018360): Rs. 540.0

• Susp 457 mg/5 mL: 35 mL: Rs. 200.13

• Susp 457 mg/5 mL: 70 mL: Rs. 404.29

• Tab 1 gm: 6's (022244): Rs. 362.54

• Tab 375 mg: 6's (006747): Rs. 220.46

• Tab 625 mg: 2x3's (017297): Rs. 278.82

• Tab BD 1 gm: 2x3's (022244): Rs. 339.0

• Tab Blister 1 gm: 2x6's (022244): Rs. 664.08

• Tab Blister 375 mg: 6's (006747): Rs. 268.92

• Tab BL 375 mg: 18's (006747): Rs. 723.82

• Tab BL 625 mg: 12's (017297): Rs. 510.79

Therapeutic Class

• Antibacterial Agent/Antibiotics

Pharmacological Class

• Beta-lactam Antibiotic + Beta-lactamase Inhibitor

Manufacturer

• Manufacturer: Dr. Reddy’s Laboratories Inc., USA (Licensed from GlaxoSmithKline)

Storage

• Store below 25°C.

• Keep in the original container.

Prescription Drug

• Yes – Prescription-only medication

Clinical Pharmacology (Mechanism of Action)

• Amoxicillin inhibits bacterial cell wall synthesis.

• Clavulanic acid inhibits β-lactamase enzymes, extending amoxicillin’s spectrum.

• Together they combat resistant bacteria effectively.

Indications

• Respiratory tract infections,

• Otitis media

• Sinusitis

• Skin and soft tissue infections

• Urinary tract infections.

Contraindication

• Allergy to any penicillin

• History of cholestatic jaundice due to Augmentin

• History of hepatic dysfunction associated with Augmentin

Warnings

• Do not use Augmentin if you have severe kidney disease.

• Avoid use if you have had liver problems or jaundice during previous treatment with amoxicillin and clavulanate.

• Contraindicated in patients allergic to penicillins or cephalosporins (e.g., Amoxil, Ceftin, Cefzil, Moxatag, Omnicef).

• If switching between tablet forms (regular vs. extended-release), use only the prescribed form and strength.

• Improper use of tablet forms may reduce effectiveness or be harmful.

• Augmentin can pass into breast milk and may harm a nursing infant — inform your doctor if you are breastfeeding.

• Augmentin may reduce the effectiveness of birth control pills — use non-hormonal contraception (e.g., condom, diaphragm, spermicide) during treatment.

Dosages:

• Mild/moderate: 250 mg q8h or 500 mg q12h

• Severe: 500 mg q8h or 875 mg q12h

• Note: Take at the meal's start to improve absorption and reduce side effects.

Special Population

Renal Impairment

• CrCl <30 mL/min:

Do not use 875/125 mg tablets or extended-release tablets.

• CrCl 10–30 mL/min:

250–500/125 mg orally every 12 hours (q12h)

• CrCl <10 mL/min:

250–500/125 mg orally every 24 hours (q24h)

Hemodialysis:

250–500/125 mg orally every 24 hours (q24h)

Administer an additional dose during and after dialysis

Hepatic Impairment

• Use with caution

• Monitor liver function regularly

Children

Oral Suspension

• 6-12 yr, 5 mL.

• All three times daily for up to fourteen days, then review.

Injection

• Up to 3 months

• 30 mg/kg every twelve hr in premature and full-term infants during the perinatal period, increasing to eight hr thereafter;

• 3 mth-12 yr

• 30 mg/kg eight or six hourly.

• All are done by IV or intermittent infusion for up to 14 days, then revised.

  
  

Elderly Patients

Elderly patients can receive the same adult doses of Augmentin, but dose adjustments may be necessary based on their renal and hepatic function.

Side Effects

• Common:

• Diarrhea

• Nausea

• Rash

• Headache

• Vaginitis

• Serious (rare):

• Liver dysfunction

• Anaphylaxis

• Colitis

• Seizures

• Hypersensitivity

Drug Interactions

• Probenecid increases amoxicillin levels.

• Allopurinol increases the risk of rash.

• May reduce the efficacy of oral contraceptives.

• May prolong prothrombin time with anticoagulants.

Use in Pregnancy and Lactation

• Pregnancy: Category B – Use only if needed.

• Lactation: Present in breast milk – Use with caution.

Precautions

• Avoid penicillin allergy.

• Caution in liver disease.

• Monitor for superinfections.

• Avoid mononucleosis due to rash risk.

How To Take

• Take exactly as prescribed by your doctor.

• Follow all directions on the label and read the medication guide.

• Best taken at the start of a meal for improved effectiveness.

• Take the medicine every 12 hours.

• Do not crush or chew extended-release tablets.

• You may break the tablet in half but take both halves one at a time.

• Inform your doctor if you have trouble swallowing pills.

• Shake oral suspension well before use.

• Use the provided syringe or a proper measuring device — not a kitchen spoon.

• Augmentin may affect lab test results — inform your healthcare provider.

• Complete the full course of medication, even if symptoms improve early.

• Skipping doses may cause resistant infections.

• Does not work against viral infections (e.g., flu, cold).

• Store tablets at room temperature, away from moisture and heat.

• Store liquid form in the refrigerator and discard after 10 days.

Counseling Points

• Take with meals to reduce GI upset.

• Complete full course of therapy.

• Report prolonged or severe diarrhea.

• Do not skip doses to prevent resistance.

• Use backup contraception if on oral contraceptives.