Amoxynova Uses, Dosage, Side Effects and Interactions

Amoxynova Description and Composition

Amoxynova is a broad spectrum antibacterial antibiotic. It belongs to penicillin class of antibiotics.

It contains amoxicillin as its active pharmaceutical ingredient. It also contains inert ingredients called excipients in sufficient quantities.

It comes in different dosage forms. We have amoxicillin tablets, amoxicillin capsules, amoxicillin suspension, amoxicillin powder for injection.

It also come in different strengths. The strengths include:

  • Tablets 500 mg, 875 mg
  • Chewable tablets: 125 mg, 250 mg
  • Capsules: 250 mg, 500 mg
  • Suspension: 125 mg/5ml, 200 mg/5ml, 250 mg/5ml, 400 mg/5ml
  • Injection: 500 mg, 150 mg/1 ml of 100 ml vial.

See Also: Paxlovid Uses, dosage and side effects

Uses of Amoxynova

Amoxynova tablets, capsules, suspension and powder for injection are used to treat susceptible bacterial infections.

Amoxicillin is indicated in the following disease conditions:

  • Urinary tract infections
  • Upper respiratory tract infections
  • Bronchitis
  • Pneumonia
  • Otitis media
  • Dental abscess and other oral infections
  • Osteomyelitis
  • Lyme disease
  • Endocarditis prophylaxis
  • Post-splenectomy prophylaxis
  • Gynaecological infections
  • Gonorrhoea
  • Helicobacter pylori eradication (in triple therapy of peptic ulcer disease or type B gastritis)
  • Anthrax

Pharmacology of Amoxynova

Amoxynova is a semi-synthetic aminopenicillin of the beta-lactam group of antibiotics. 

It has a bactericidal action due to its inhibition of the synthesis of the bacterial cell wall.

It exerts a bactericidal effect against many Gram-positive and Gram-negative microorganisms.

Amoxicillin is not effective against beta-lactamase producing organisms.

Pharmacokinetics

Absorption

Amoxicillin is stable in the presence of gastric acid and rapidly absorbed from the gut to an extent of 72 to 93%.

Absorption is independent of food intake. Peak blood levels are achieved 1 to 2 hours after administration.

Distribution

Amoxicillin is not highly protein bound. Approximately 18% of total plasma drug content is bound to protein.

Amoxicillin diffuses readily into most body tissues and fluids, including sputum and saliva but not the brain and spinal fluid.

Inflammation generally increases the permeability of the meninges to penicillins and this may apply to amoxicillin.

Amoxicillin diffuses across the placenta and a small percentage is excreted into the breast milk.

Metabolism:

Amoxicillin is excreted mainly via the urine where it exists in a high concentration.

It is also partly excreted in the urine as the inactive penicilloic acid in quantities equivalent to 10 to 25% of the initial dose. Small amounts of the drug are also excreted in faeces and bile.

Concentrations in the bile may vary and are dependent upon normal biliary function.

Excretion

Approximately 60 to 70% of amoxicillin is excreted unchanged in urine during the first 6 hours after administration of a standard dose.

The elimination half life is approximately 1 hour. Concurrent administration of probenecid delays amoxicillin excretion.

In patients with end-stage renal failure, the half-life ranges between 5 to 20 hours. The substance is haemo-dialysable.

Dosage of Amoxynova

Ear, Nose, and Throat Infections

Adults

Mild to moderate infections

  • 500 mg per oral 12 hourly or 250 mg per oral 8 hourly for 10-14 days

Severe infections

  • 875 mg per oral 12 hourly or 500 mg per oral 8 hourly for 10-14 days

Children 

Mild to moderate infections

  • <3 months: ≤30 mg/kg/day per oral divided 12 hourly for 48-72 hours; for ≥10 days for S pyogenes infections
  • >3 months and <40 kg: 25 mg/kg/day per oral divided 12 hourly or 20 mg/kg/day per oral divided 8 hourly
  • >40 kg: 500 mg per oral 12 hourly or 250 mg per oral 8 hourly for 10-14 days

Severe infections

  • <3 months: <30 mg/kg/day per oral divided 12 hourly for 48-72 hours; for ≥10 days for S pyogenes infections
  • >3 months and <40 kg: 45 mg/kg/day per oral divided 12 hourly or 40 mg/kg/day per oral divided 8 hourly
  • >40 kg: 875 mg per oral 12 hourly or 500 mg per oral 8 hourly for 10-14 days

Acute Otitis Media

  • >3 months and <40kg: 80-90 mg/kg/day per oral divided 8 to 12 hourly
  • >40 kg: 500 mg PO q12hr or 250 mg per oral 8 hourly for 10-14 days

Genitourinary Tract Infections

Mild to moderate infections

  • 500 mg per oral 12 hourly or 250 mg per oral 8 hourly

Severe infections

  • 875 mg per oral 12 hourly or 500 mg per oral 8 hourly 

Spectrum of action

  • E coli, P mirabilis, or E faecalis

Skin and Skin Structure Infections

Mild to moderate infections

  • 500 mg per oral 12 hourly or 250 mg per oral 8 hourly

Severe infections

  • 875 mg per oral 12 hourly or 500 mg per oral 8 hourly

Lower Respiratory Tract Infections

Adults

  • 875 mg per oral 12 hourly or 500 mg per oral 8 hourly for 10-14 days

Children

Mild, moderate, or severe infections

  • <3 months: <30 mg/kg/day per oral divided 12 hourly for 48-72 hours; for ≥10 days for S pyogenes infections
  • >3 months and <40 kg: 45 mg/kg/day per oral divided 12 hourly or 40 mg/kg/day per oral divided 8 hourly
  • >40kg: 875 mg per oral 12 hourly or 500 mg per oral 8 hourly for 10-14 days 
  • Pneumonia, community-acquired (Off-label):
    • <3 months: Safety and efficacy not established
    • ≥3 months: Immediate release tablet
      • Empiric treatment: 90 mg/kg/day per oral divided 12 hourly for 10 days; not to exceed 4,000 mg/day
  • Group A Streptococcus:
    • 50-75 mg/kg/day per oral divided 12 hourly for 10 days; not to exceed 4,000 mg/day
  • H. influenza:
    • 75-100 mg/kg/day per oral divided 8.hourly for 10 days; not to exceed 4,000 mg/ day
  • S. pneumoniae (mild infection)
    • 90 mg/kg/day per oral divided 12 hourly or 45 mg/kg/day divided 8 hourly for 10 days; not to exceed 4,000 mg/day

Helicobacter Pylori

H pylori infection and active or 1-year history of duodenal ulcer

Triple therapy

  • 1 g per oral 12 hourly for 14 days with lansoprazole (30 mg) and clarithromycin (500 mg)

Dual therapy

  • 1 g per oral 8 hourly  for 14 days with lansoprazole (30 mg) in patients intolerant of, or resistant to, clarithromycin

Anthrax

Adults

Postexposure inhalational prophylaxis

  • 500 mg per oral 8 hourly

Infective Endocarditis

Prophylaxis 

Adults

  • 2 g per oral 30-60 min before procedure

Children

  • <40 kg: 15 mg/kg per oral 8 hourly (minimum recommended dose; should not be <45 mg/kg/day or > 8 hourly
  • >40 kg: 500 mg per oral 8 hourly
  • 80 mg/kg/day per oral divided 8 hourly for 4 weeks (with concomitant vaccine) or for 60 days (without vaccine)

Lyme Disease (Off-label)

Adults

Erythema migrans and other symptoms of early dissemination

  • 500 mg per oral 8 hourly (depending on size of patient) for 3-4week
  • 50 mg/kg/day 8 hourly in divided doses; maximum 500 mg/dose

Children 

Erythema migrans and other symptoms of early dissemination

  • <3 months: Safety and efficacy not established
  • >3 months and 40 kg: 25-50 mg/kg/day divided 8 hourly; not to exceed 500 mg

Chlamydial Infection in Pregnant Women (Off-label)

First trimester: 500 mg per oral 8 hourly for 7 days

Dosage Modifications

Renal impairment

No dosage adjustment necessary in mild to moderate renal impairment. This when the Creatinine clearance is ≥ 30 ml/min

Dosage modification is important in severe renal impairment. This is when CrCl is between 10 to 30 mL/min):

Dosage in this case:

  • 250-500 mg 12 hourly
  • Depending on severity of infection; the dose should not receive 875 mg

When Creatinine clearance is less than 10ml/min (CrCl <10 mL/min) or in patients on hemodialysis, the dose should be 250-500 mg once daily.

Depending on severity of infection; patients on hemodialysis should receive an additional dose both during and at the end of dialysis

Side Effects of Amoxynova

The following are some side effects you may have while on this drug:

  • Nausea and vomiting, diarrhoea;
  • Rashes (rashes could be due to hypersensitivity to amoxicillin or toxic response. It may be serious a reaction. If this is the case, you should discontinue treatment.
  • Hypersensitivity reactions including urticaria, angioedema, anaphylaxis, serum sickness-like reactions, haemolytic anaemia, interstitial nephritis
  • Antibiotic-associated colitis: this occurs rarely
  • Neutropenia, thrombocytopenia, coagulation disorders
  • Rarely, CNS disorders including convulsions associated with high doses or impaired renal function.

Precautions

The following are situations where precautions should be observed while using amoxicillin

  • History of allergy
  • Renal impairment
  • Erythematous rashes common in glandular fever, cytomegalovirus infection, chronic lymphatic leukaemia, and possibly HIV infection;
  • Maintain adequate hydration with high doses (risk of crystalluria);

Amoxynova use in pregnancy and when breastfeeding.

Amoxynova is considered low risk at all stages of pregnancy.

It is secreted into breast milk in low amounts that have not been found to be harmful to the breastfed infant.

Drug Interactions with Amoxynova

Allopurinol: Concurrent administration of amoxicillin and allopurinol may increase the risk of allergic skin reactions.

  • Anticoagulants (e.g. Warfarin): Concomitant administration with anticoagulants may increase the incidence of bleeding due to prolongation of prothrombin time.
  • Appropriate monitoring should be undertaken when anticoagulation treatment is prescribed concurrently and the dose of the anticoagulant adjusted as necessary.
  • Bacteriostatic agents (e.g. Macrolides, Tetracyclines, Sulphonamides or Chloramphenicol): Concurrent use of these drugs with amoxicillin may antagonise the bactericidal action of amoxicillin.
  • Digoxin: Concurrent administration may lead to an increase in the absorption of digoxin. Dosage adjustment of digoxin may be necessary.
  • Methotrexate: Amoxicillin decreases the renal clearance of methotrexate, probably by competition at the common tubular secretion system.
  • This may lead to methotrexate toxicity. Monitor serum methotrexate levels closely in patients treated with both drugs.
  • Probenecid decreases the renal tubular secretion of amoxicillin. Concurrent use with amoxicillin may result in increased and prolonged levels of amoxicillin in serum and bile.
  • Oral contraceptives: Administration of amoxicillin can transiently decrease the plasma level of estrogens and progesterone, and may reduce the efficacy of oral contraceptives.
  • Supplemental non-hormonal contraceptive measures should be recommended while on the antibiotic therapy

Frequently Asked Questions About Amoxynova

Amoxynova and alcohol: can they be used together?

Do not use them together.

How long does it take for Amoxynova to work?

It begins to work after some minutes of taking the first dose.

However, you as a person may not notice any effect but the bacteria infection will.

You may start getting better after 24 to 48 hours of use. The time you will notice this will be dependent on the severity.

Note that you will have to complete the dose even if you feel better few days of starting your treatment.

Treatment usually last 7 to 10 days. Refer to dosage section to learn more about this.

Does Amoxynova treat UTI?

Yes, Amoxynova treats urinary tract infections. Please refer to its uses above for details.

Does Amoxynova make you tired?

Yes, Amoxynova makes some persons tired after taking it. The number of persons who feel tired after taking it are however very small.

Tiredness is not a major side effect of amoxicillin.

Please contact your doctor immediately if you feel extremely tired after taking amoxicillin. 

Amoxynova dosage for tooth infection

The dosage for tooth infection in adults is usually 500 mg 8 hourly or 1 g 12 hourly.

Drugs dosing are better individualized. So, your dentist will use your body weight to determine the best dose for you.

Is Amoxynova penicillin?

It belongs to antibiotics class called penicillin.

Does Amoxynova expire?

Yes, it expires. Do not use after it must have expired.

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