Uses, Dosage, Side Effects and Interactions

Amoxicillin is an antibiotic that doctors typically use to treat bacterial infections, especially those of the nose, ears, throat, lung, skin and urinary tract. They also prescribe it in combination with other medications for stomach ulcers H. pylori bacteria can cause.

What Is Amoxicillin?

Amoxicillin is in the penicillin family of antibiotics, made from penicillium mold. It’s often prescribed as a generic drug, but is also available under brand names Amoxil, Larotid and Moxatag in the U.S.

This antibiotic belongs to a specific class of drugs called beta-lactams. Beta-lactam antibiotics such as amoxicillin work by binding proteins and inhibiting certain processes in bacterial cells. This causes the cell walls to break down and destroys the bacteria, a process called bactericidal killing.

What Is Amoxicillin Used to Treat?

Amoxicillin is used to treat a variety of bacterial conditions. Its effectiveness against multiple strains of bacteria explains why physicians consider it a strong antibiotic. Among the bacteria it fights are E. coli, salmonella, streptococcus species, Listeria monocytogenes and Clostridial species.

The Food and Drug Administration has approved amoxicillin to treat a variety of infections of the ear, nose, throat, genitourinary tract, skin, skin structure and lower respiratory tract.

Amoxicillin is FDA approved to treat:

• Bacterial pharyngitis
• 
  Bronchitis
• 
  Tonsillitis
• 
  Pneumonia
• 
  Bacterial rhinosinusitis

Doctors sometimes prescribe amoxicillin for non-FDA-approved (off-label) uses. Examples are treatments for Lyme disease, infection prevention during certain surgeries (dental, hip, knee) and prevention of infectious endocarditis.

If you have questions about amoxicillin and off-label uses, speak with your doctor.

How to Take Amoxicillin

Doctors usually prescribe amoxicillin as an oral antibiotic, available in capsule, tablet and chewable tablet forms or as a suspension powder you can stir into a cold drink. You can take the drug before or after a meal, but it’s generally recommended that people with sensitive stomachs take it after eating.

In clinical or hospital settings, medical providers may give amoxicillin through an IV.

Amoxicillin dosages include:

• 125 mg and 250 mg chewable tablets
• 
  250 mg and 500 mg capsules
• 
  500 mg and 875 mg tablets
• 
  125 mg/5 mL and 250 mg/5mL oral suspension powder

Follow your doctor’s instructions about how to take amoxicillin, especially about daily dosages. Aim to take the medication at the same time every day as possible.

Recommended Dosages for Adults and Children

The right amoxicillin prescription or dosage depends on the specific infection and on the age and weight of the individual who needs it. Weight is a particularly important factor for children.

For maximum treatment benefits of amoxicillin, finish the full recommended doses your doctor prescribed. Even if you feel better midway through your prescription duration, it’s important to continue taking the drug.

Findings from one 2022 clinical research trial suggested that a short course of Amoxicillin (5 days) was just as effective as a longer course (10 days) for uncomplicated commonly acquired pneumonia in children under 10 years old.

Doubling up on a dose or taking two doses too close together to compensate for a missed dose is not advised. It’s safer to skip a missed dose and wait to take your next one.

Dosages for Impaired Kidney Function

Patients with chronic kidney disease (CKD), for example, have an impaired immune response and increased risk of infection. Antibiotics are commonly prescribed, however, CKD patients also experience impaired renal function, making metabolizing and eliminating medications such as antibiotics more challenging. This can lead to antibiotic accumulation and toxicity.

Doctors may prescribe lower doses than adults are typically prescribed. Sometimes individual doses are kept the same, but the time between doses is spaced out further. The mixed method combines these approaches to determine the correct balance of doses and their timing. 

Children 3 months old or younger typically are not prescribed more than a daily split dose of 30 mg/kg every 12 hours because their kidneys are underdeveloped.

Dosage for H. Pylori Infection

Doctors prescribe amoxicillin with clarithromycin and lansoprazole (Prevacid) to treat H. pylori infection. With triple therapy for adults, they usually recommend 500 mg clarithromycin, 30 mg lansoprazole, and 1 g amoxicillin. The dosage is twice a day (every 12 hours) for 14 days.

Patients on dual therapy for H. pylori infection should take 30 mg lansoprazole and 1 g amoxicillin three times a day (every eight hours) for 14 days.

Amoxicillin Overdose

You’re unlikely to experience any adverse effects from a mild overdose of amoxicillin. However, some people have experienced kidney problems that cause organ failure after overdosing on the antibiotic.

If you or a family member have a suspected overdose of amoxicillin, call the poison control center at (800) 222-1222, or visit the PoisonHelp.org website for helpful information.

Side Effects of Amoxicillin

Amoxicillin’s most common side effects are related to stomach upset and intestinal distress. These symptoms rarely require treatment beyond probiotics and over the counter medications, you should speak with your doctor if any side effects persist.

Common side effects of amoxicillin include:

• Diarrhea
• 
  Nausea and vomiting
• 
  Headache
• 
  Skin rash or hives
• 
  Stomach problems

Two of Amoxicillin’s serious side effects are hypersensitivity or allergic reactions and Clostridium difficile-associated diarrhea (CDAD). Anyone who experiences a severe side effect after taking amoxicillin should seek immediate medical treatment.

Serious side effects of amoxicillin are:

• Breathing difficulty
• 
  Swallowing difficulty
• 
  Blisters
• 
  Peeling skin
• 
  Inflammation or swelling of body parts (tongue, throat, eyes, face)
• 
  Stomach cramps
• 
  Wheezing
• 
  Watery stool with or without fever
• 
  Blood-stained stool

Stop taking amoxicillin and call 911 if you experience serious adverse reactions. Be sure to speak with your doctor or pharmacist about any other medications you may be taking to avoid amoxicillin drug interactions and potentially serious complications.

Amoxicillin Interactions

Check Amoxicillin’s label for a comprehensive list of medications that interact with it. Amoxicillin can strengthen or weaken other prescription and over-the-counter drugs. It can also create specific side effects.

• Probenecid: The concentration of amoxicillin in your blood may increase if you use it together with probenecid, a gout medication.
• 
  Allopurinol: Skin rashes are more prevalent for people who take the gout medication allopurinol with amoxicillin.
• 
  Oral anticoagulants (blood thinners): The blood-thinning effects of oral anticoagulants like warfarin can increase when mixed with amoxicillin. Doctors may adjust the dosage of the blood thinner after checking anticoagulation levels.
• 
  Oral birth control pills: Amoxicillin’s effects on gut flora can make a combined dose of oral estrogen/progesterone contraceptives less effective.
• 
  Antibacterials: The ability of penicillin to treat bacterial infections may weaken if combined with other antibiotics like sulfonamides, tetracyclines, macrolides or chloramphenicol.

Amoxicillin can also influence medical tests. Urine tests for blood sugar levels, including Clinitest, Fehling’s Solution and Benedict’s Solution may return false-positive results for people on amoxicillin medication. More accurate glucose tests for people with diabetes include Clinistix and TesTape and other procedures that check for enzymatic glucose oxidase reactions.

Before Taking Amoxicillin

Amoxicillin can have dangerous side effects when mixed with certain medications. Let your pharmacist or doctor know if you have any allergies to amoxicillin or penicillin and if you take other antibiotics or blood thinners. The same is true if you take herbal medicines, multivitamins or nutritional supplements.

Women who breastfeed or are pregnant should alert their doctors about their pregnancy before starting a round of amoxicillin. So should anyone with a history of kidney disease, phenylketonuria or mononucleosis.

Non-Penicillin Antibiotic Alternatives

People allergic to amoxicillin have alternative medications. Non-penicillin antibiotics include Bactrim (trimethoprim) for ear, urine, respiratory and intestinal infections, clarithromycin (Biaxin) for stomach infections and stomach ulcers and clindamycin (Cleocin) for infections of the lungs and other internal organs, plus skin and blood infections.

Certain cephalosporins, such as Suprax, Ceftin and Keflex, are also ideal alternatives to amoxicillin.

• Bactrim (sulfamethoxazole/trimethoprim)
• 
  Biaxin (clarithromycin)
• 
  Cleocin (clindamycin)
• 
  Fluoroquinolones (Cipro, Levaquin, Avelox)
• 
  Some drugs in the cephalosporin family, including Suprax (cefixime), Ceftin (cefuroxime), and Keflex (cephalexin). Note: Some people with allergies to penicillin may have a small chance of reacting to these medications
• 
  Zithromax, Zmax, Z-Pak (azithromycin)

Amoxicillin Facts

Please seek the advice of a medical professional before making health care decisions.

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Amoxicillin | VCA Animal Hospital

What is amoxicillin?

Amoxicillin (brand names: Amoxil®, Amoxi-Tabs®, Amoxi-Drop®, Bimox®, Moxatag®, Novamoxin®) is an aminopenicillin antibiotic used to treat certain bacterial infections. Most commonly it is used to treat skin, respiratory, and urinary tract infections.

Its use in cats and dogs to treat certain bacterial infections and at certain doses, as well as use in ferrets, birds, and reptiles is ‘off label’ or ‘extra label’. Many drugs are commonly prescribed for off label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully as their directions may be significantly different from those on the label.

How is amoxicillin given?

Amoxicillin is given by mouth in the form of a tablet, capsule, or liquid suspension. It can be given with or without food, however, if vomiting occurs when dosed on an empty stomach, give future doses with food. Give the medication for the entire prescribed duration unless otherwise directed. Measure liquid forms carefully, and shake well before administering.

This medication will take effect quickly, in about 1 to 2 hours. While effects may not be noted outwardly, gradual improvements are usually noticeable after a few days.

What if I miss giving my pet the medication?

If you miss a dose, give it when you remember, but if it is close to the time for the next dose, skip the dose you missed and give it at the next scheduled time, and return to the regular dosing schedule. Never give your pet two doses at once or give extra doses.

Are there any potential side effects?

Common side effects include gastrointestinal effects such as lack of appetite, vomiting, and diarrhea. Serious side effects include allergic reaction characterized by skin rash, fever, facial swelling, or difficulty breathing, incoordination while walking, or prolonged lack of appetite (in cats).

This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

Amoxicillin should not be used in pets that are allergic to it or other penicillins, cephalosporins, or other beta-lactam antibiotics. Do not use in rabbits, guinea pigs, chinchillas, hamsters, or other small mammals. Do not give by mouth to pets with a blood infection, shock, or other grave illnesses, is it will likely be ineffective. Use cautiously in pregnant or lactating pets, although use of this medication is likely safe.

Are there any drug interactions I should be aware of?

The following medications should be used with caution when given with amoxicillin: bacteriostatic antimicrobials, methotrexate, probenecid, or warfarin. Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.

Amoxicillin may also interact with certain urine glucose tests and cause false positive results.

Is there any monitoring that needs to be done with this medication?

There is no specific monitoring that needs to be done while your pet is taking this medication. Your veterinarian may monitor your pet to be sure that the medication is working.

How do I store amoxicillin?

Capsules, tablets, and powders should be stored at room temperature between 59°F and 86°F (15°C and 30°C) in a tight container and protected from moisture. The liquid suspension is best stored in the refrigerator, although it is not required. Discard unused portions of the liquid after 14 days.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.

swollen gums in case of tooth inflammation

Toothache: when to take antibiotics

Antibiotics are used when inflammation of the gums has begun, a complication after tooth extraction or other dental surgery. Drugs can also be prescribed for prevention. Antibacterial agents prevent the development of pathogenic microbes or completely destroy them. It is not worth self-medicating and prescribing such drugs for yourself, because at best it may be ineffective. Dentists, according to indications, prescribe antibiotics in the form of tablets, ointments, intramuscular injections.

Varieties of antibacterial agents

There are several pharmacological groups whose drugs are used to treat and eliminate the consequences of oral diseases. Chemotherapy includes:

1. Macrolides and azalides. Means are very often prescribed to patients with intolerance or insensitivity to penicillins. They are effective against pathogens such as streptococci, pneumococci, staphylococci. This group includes Sumamed, Azithromycin, Clarithromycin.
2. Lincosamides. These include “Clindamycin” and “Lincomycin”. The preparations are effective for the elimination of gram-positive, gram-negative and anaerobic bacteria.
3. Cephalosporins. The group is represented by several generations of antibiotics. The latter include “Ceftriaxone”, “Cefipim”, “Ceftaroline”. It is used for infections of bones, joints, skin, soft tissues.
4. Fluoroquinolones. These are the 3rd and 4th generations of quinolones – Levofloxacin and Moxifloxacin. They are effective against enterococci, streptococci, chlamydia, Pseudomonas aeruginosa. Used in maxillofacial surgery for soft tissue and skin infections
5. Penicillins. Combinations of these drugs with clavulanic acid are often used. The drugs include “Amoxiclav”, “Flemoclav Solutab”, “Augmentin”. The first from the list can be assigned to a child and a pregnant woman.
6. Tetracyclines. Means “Doxycycline” and “Unidox” are indicated for the treatment of osteomyelitis. All tetracyclines have similar properties, but the effectiveness largely depends on the sensitivity of the pathogen to the antibiotic.
7. Aminoglycosides. This group of drugs has a wide range of antimicrobial activity. They are able to eliminate gram-positive and gram-negative bacteria. Used for purulent-inflammatory process, osteomyelitis, stomatitis, periodontitis. These include Tobramycin, Amikacin.
8. Nitromidazole derivatives. These include “Metronidazole”, “Rozeks”, “Tinidazole”. These medicines fight against many pathogenic anaerobic microorganisms. They are prescribed for diseases of periodontal tissues, purulent inflammatory processes.

There are also non-specific antimicrobials that do not selectively target microbes but disinfect surfaces. These include Furacilin, Miramistin, boric acid, Resorcinol, Chlorhexidine, etc.

Medicines for advanced caries

This condition has serious consequences for the health of the teeth and the entire oral cavity. A tooth damaged by caries serves as a source of infection, which can spread to other organs and systems – the stomach, intestines, trachea. Running caries causes periodontitis – an acute inflammation of the connective tissue of the gums, as well as periostitis – an infectious process in the periosteum that causes flux. Without treatment, abscess formation and provoking oncology are possible.

Broad-spectrum antibiotics, such as Amoxiclav or Ciprofloxacin, are used to solve the problem with advanced caries. Periodontitis can be acute or chronic, which worsens, and in such cases, immediate help is needed. In addition to antibiotics, analgesics and antihistamines are used.

In the treatment of periostitis, not only antibacterial drugs are also used. Inflammation of the periosteum is more often observed in adults, this is a consequence of poor hygiene, ignoring toothache and incipient caries. Pathology, in the worst case, can also affect the sinuses, forming sinusitis, and also affect the membranes and tissues of the brain.

The accumulation of pus provokes a flux, this is expressed in cheek swelling and swelling. To eliminate bacteria that directly affect this process, antibiotics of one of the groups listed above are prescribed. The doctor selects the medicine individually, based on the degree of neglect of the pathology, anamnesis, the patient’s condition, contraindications. The desired effect can be achieved only by following the recommendations of the dentist.

Elimination of inflammation of the gums

Diseases such as gingivitis and periodontitis are characterized by changes in the soft and hard tissues of the oral cavity. Inflammation affects only the gums or a whole complex of tissues, without treatment it can lead to tooth loss. This primarily applies to periodontitis, which is asymptomatic at an early stage. It easily becomes chronic and is difficult to treat. Periodontitis in an acute form increases the risk of diseases of the gastrointestinal tract, heart, kidneys, as it is a source of infection. In order to eliminate it, antibiotics are used:

• from imidazole and nitromidazole derivatives;
• penicillins and cephalosporins;
• macrolides (“Erythromycin”, etc.). This option can also be used to treat children, pregnant and lactating women.

Systemic application allows the active substance to penetrate into all lesions, which ensures the prevention of pathological complications. Antibiotics can also be applied topically, in the form of dental gels. Any antibacterial drugs are prescribed for general unsatisfactory condition, exacerbation of periodontitis and suppuration. Chronic rheumatism, heart defects will serve as a mandatory indication for taking antibiotics for periodontitis.

Gingivitis has several varieties: catarrhal, hypertrophic, ulcerative necrotic. And each type must be eliminated according to a specific treatment regimen. The dentist establishes a clinical diagnosis and develops a plan for therapy and preventive measures. Antibiotics such as Azithromycin, Ciprofloxacin, Sumamed, Metronidazole, Lincomycin can be used. The choice depends on the severity of the pathology, epithelial defects, etc.

Antibiotics for prophylaxis

Medicines used before surgery are needed to prevent complications. The doctor may prescribe certain medications a few days before such procedures:

• tooth extraction;
• professional or deep cleaning;
• root canal treatment, etc.

Bacteria are found in the oral cavity of every person, and a healthy immune system copes well with them if necessary. But, once in the blood, microorganisms can cause infections in various human organs. Not in every case, the specialist will prescribe antibacterial agents for prevention; before that, he will familiarize himself with the patient’s history.

Medicines will be needed if a person suffers from: diabetes mellitus, rheumatic diseases, oncology, heart pathology. That is, it has an unstable immune system. The choice of drug will be associated with bactericidal action against the most significant microorganisms, with tolerability and an optimal ratio of safety and efficacy. For example, it may be an agent from the group of penicillins or cephalosporins.

Frequently prescribed drugs

The choice of an antibacterial agent for gingival flux for an adult is quite large. Effective modern drugs in dentistry include:

• Azithromycin. Medicine in tablets or capsules helps with purulent odontogenic infection;
• “Amoxiclav” or “Amoxicillin” with “Metronidazole”;
• Clindamycin. Despite its narrow spectrum of action, it is effective in inflammation of bone tissue, which is a plus for eliminating purulent formation.

It is impossible to say for sure which antibiotic will help in a given situation. This can only be done by the attending physician. It must also be remembered that such remedies cannot be a substitute for any operation, such as a gum incision to drain pus, because they do not belong to the main treatment. The therapy is complex and includes the use of several medications according to the prescription scheme.

An antibiotic for toothache will not help relieve it. Most often, discomfort is caused by inflammation of the nerve of the tooth or periodontitis. In such conditions, the doctor will prescribe drugs to relieve pain, and antibiotics will be needed in the process of dental treatment.

What to take for a child

In pediatric practice, any drug is selected with great care. Age, weight of a small patient, side effects are taken into account. There are drugs that are strictly prohibited for children to take.

Pain in childhood can be caused by many causes, from the eruption of the first teeth to caries or pulpitis. In babies, gums can also suffer, which are often damaged due to introduced bacteria. For young patients, convenient forms of various drugs have been developed: suspensions, drops, gels, suppositories. Often used anti-inflammatory, antiseptic, painkillers. Some of them also relieve fever, such as children’s “Nurofen” or “Paracetamol”.

But antibacterial agents cannot be prescribed to a child alone. Even if the instructions say that the medicine is used to treat children (“Amoxiclav”), in order to avoid disastrous consequences, you must first consult a doctor. The specialist will explain the effectiveness of the drug in a particular case, the need to take it and prescribe the exact dosage.

Side effects of medications

Antibiotics are absolutely necessary in some cases. This applies not only to the field of dentistry, but also to other areas of medicine. But their uncontrolled use is unacceptable because you can not only harm yourself, but also cause addictive bacteria and influence the emergence of resistant forms of microorganisms. A course of antibiotics is needed in such cases:

• treatment of bacterial infection;
• prevention of complications in any disease or after surgery;
• prevention of illness in a child in contact with an infectious patient.

Since all antibacterial agents have side effects of one kind or another, they must be carefully considered before use. The response of the human body to antibiotics is different and depends on the presence of chronic diseases, allergies, age and other factors.

Serious diseases of the gastrointestinal tract, heart, liver, kidneys, individual intolerance become restrictions on admission. Common side effects when taking medications include:

• diarrhea, abdominal pain, nausea, dysbacteriosis;
• disruption of the hematopoietic organs;
• allergic reaction manifested by itching, coughing;
• candidiasis, vaginal dysbacteriosis in women.

Therefore, in some cases, the doctor evaluates the risks of side effects, which should be lower than the benefits of a particular drug. Taking antibiotics is also always accompanied by the use of probiotics, which restore the microflora of the mucous membranes.

Medical myths: Is alcohol compatible with antibiotics?

• Claudia Hammond
• BBC Future

21 September 2015

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Image copyright Thinkstock

Medical studies show that alcohol does not block the effects of most medications and does not usually cause side effects when combined with medications. But we should not forget about some other important points, the correspondent warns
BBC Future .

Women in the early stages of pregnancy, not yet ready to share this joyful news with others, are well aware that others can easily guess everything themselves if the expectant mother refuses to drink at a party.

But there is a good excuse: you can tell colleagues and friends that you are being treated with antibiotics, and all questions will disappear. Even excessively curious acquaintances are unlikely to inquire why the medicine was prescribed.

But is it really necessary to abstain from alcohol in combination with a course of antibiotics?

(More BBC Future articles in Russian)

Some believe that alcohol can prevent the drug from working, others believe that this combination causes side effects.

The staff of one of the urogenital clinics in London interviewed 300 patients – it turned out that 81% of them adhered to the first point of view, and 71% – the second.

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But with most antibiotics, neither is true. From the point of view of doctors, it is much more dangerous when a patient who believes in one of these myths decides not to take the medicine after drinking a glass of wine.

Any factor that causes a drug to be skipped exacerbates the serious global problem of bacterial resistance to antibiotics.

In fact, alcohol does not interfere with most commonly used antibiotics.

But there are exceptions: for example, the drug of the cephalosporin group cefocetane slows down the process of splitting alcohol, resulting in an increase in the level of acetaldehyde in the body.

And this can lead to undesirable consequences in the form of dizziness, vomiting, flushing of the face, headaches, shortness of breath and chest pain.

Disulfiram, a drug sometimes used in the treatment of alcohol dependence, has similar side effects. The idea is that the patient in treatment begins to feel bad after drinking – which in theory should make him stop drinking further.

These sensations are unpleasant, therefore, during treatment with cefocetane and disulfiram (and for several days after the end of the course), you should abstain from alcohol.

Another antibiotic that is poorly compatible with alcohol is metronidazole. It is used in the treatment of infections in the mouth, infected leg ulcers and bedsores. It is believed that in combination with alcohol, it gives the same side effects as the already mentioned cephalosporins.

Photo caption,

Of course, there are different types of antibiotics. But most of them are not affected by alcohol in any way.0005

However, this view was called into question after a 2003 review of pharmacological studies. In addition, an experiment was made on a small control group of Finnish men, during which they consumed alcohol with metronidazole for five days without any unpleasant consequences.

However, the authors of this study acknowledge that the possibility of adverse effects cannot be completely ruled out, and medical professionals still do not recommend combining alcohol with metronidazole.

There are several other antibiotics that are best avoided when taking alcohol, such as tinedazole, linezolid, and erythromycin. But this incompatibility is well known, and doctors specifically warn patients about it when prescribing a medicine.

This leaves a long list of other antibiotics that are safe to drink. Of course, alcohol is unlikely to help cure the disease: it can make your body dehydrated and lethargic, but this has nothing to do with drugs.

Perhaps the myth about the incompatibility of antibiotics and alcohol appeared after some separate unpleasant cases, but there are two more interesting theories.

One is that antibiotics are used in the treatment of common sexually transmitted diseases, and doctors allegedly punished patients for their dissolute behavior by forbidding them to drink a glass or two.

There is another explanation given by James Bingham, one of the authors of the above-mentioned survey of patients at the London Urogenital Clinic.

He met with retired Brigadier General Ian Fraser, who began using penicillin to treat wounded soldiers in North Africa during World War II.

At that time, there was so little penicillin that after taking the drug inside, urine was taken from patients and the drug was again isolated from it.

The soldiers who were treated were allowed to drink beer, but this led to an increase in the volume of urine produced by the body and, as a result, complicated the extraction of medicine. According to General Fraser, therefore, the command decided to ban beer.

Agree, a good story, regardless of whether it influenced the spread of the myth about the incompatibility of alcohol and antibiotics.

But debunking myths is a double-edged sword. When a patient who cannot live without a glass of wine nevertheless diligently drinks a course of antibiotics, this is good, because it helps fight drug resistance in bacteria.