Side effects, dosage, uses, and more

1. Amoxicillin is an antibiotic. It’s used to treat infections caused by certain types of bacteria.
2. Amoxicillin oral tablet comes as immediate-release (IR), extended-release (ER), or chewable tablets. The chewable tablet and IR tablet are only available as generic drugs. The ER tablet is only available as the brand-name drug Moxatag.
3. Amoxicillin also comes as a capsule and a suspension. All forms are taken by mouth.

Amoxicillin oral tablet does not cause drowsiness, but it can cause other side effects.

More common side effects

The more common side effects of amoxicillin oral tablet can include:

• nausea
• vomiting
• diarrhea
• rash
• vaginal yeast infection

If these side effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Hypersensitivity reactions. Symptoms can include:
  • flu-like symptoms, such as fever, body aches, or sore throat
  • a painful red or purple rash that spreads
  • blisters that could cause the skin to break down and cause open sores
• Liver damage. This effect is rare. Symptoms can include:
  • increased liver enzymes shown on a blood test
  • pain in the abdomen (stomach area)
  • yellowing of the skin and eyes
  • tiredness

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

• Finishing therapy: It’s important to finish the entire course of treatment as prescribed by your doctor. Do not stop taking this drug or skip doses if you start to feel better. This could cause your infection to last longer. You could also develop a resistance to the medication. This means that if you get a bacterial infection in the future, you may not be able to treat it with amoxicillin.
• Diarrhea: Amoxicillin may cause diarrhea. Call your doctor if you have bloody or watery diarrhea, with or without stomach cramps and fever.
• Serious allergic reaction: This drug can cause a serious allergic reaction. This reaction can be fatal (cause death). If you’re allergic to other antibiotics, such as penicillins or cephalosporins, your risk for an allergic reaction may be higher. Call your doctor right away if you have trouble breathing or swelling of your throat or tongue while you’re taking this drug.

Amoxicillin is a prescription antibiotic. It’s used to treat infections caused by a certain type of bacteria. It may be used as part of a combination therapy. This means you may need to take it with other medications.

The oral tablet comes as an immediate-release (IR) tablet, extended-release (ER) tablet, and chewable tablet. The chewable tablet and IR tablet are only available as generic drugs. The ER tablet is only available as the brand-name drug Moxatag.

Generic drugs usually cost less. In some cases, they may not be available in every strength or form as their brand-name versions.

Amoxicillin also comes as a capsule and a suspension. All forms are taken by mouth.

Why it’s used

Amoxicillin is an antibiotic. It’s used to treat infections caused by a certain type of bacteria.

Amoxicillin may be used as part of a combination therapy. This means you may need to take it with other medications.

How it works

Amoxicillin belongs to a class of drugs called penicillins. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Amoxicillin works by killing bacteria and stopping its growth in your body.

Amoxicillin oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking.

To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with amoxicillin are listed below.

Drugs that increase the risk of side effects from amoxicillin

Taking amoxicillin with certain medications raises your risk of side effects from amoxicillin. This is because the amount of amoxicillin in your body may be increased. Examples of these drugs include:

• Probenecid: If you use these drugs together, your doctor will likely keep your dosage of amoxicillin the same.
• Allopurinol: If you use these drugs together, you may develop a rash.

Interactions that increase the risk of side effects from other drugs

Taking amoxicillin with certain medications raises your risk of side effects from these medications. Amoxicillin increases the amount of these drugs in your body.

Examples of these drugs include drugs to treat blood clots. If you use them with amoxicillin, you have a higher risk of bleeding.

Interactions that can make your drugs less effective

When amoxicillin is less effective: When amoxicillin is used with certain drugs, it may not work as well. This is because the amount of amoxicillin in your body may be decreased. Examples of these drugs include:

• Chloramphenicol
  • If you use these drugs together, your doctor will likely keep your dosage of amoxicillin the same.
• Macrolides, such as erythromycin, clarithromycin, or azithromycin
  • If you use these drugs together, your doctor will likely keep your dosage of amoxicillin the same.
• Sulfonamides, such as sulfamethoxazole
  • If you use these drugs together, your doctor will likely keep your dosage of amoxicillin the same.
• Tetracyclines, such as tetracycline or doxycycline
  • If you use these drugs together, your doctor will likely keep your dosage of amoxicillin the same.

When other drugs are less effective: When certain drugs are used with amoxicillin, they may not work as well. This is because the amount of these drugs in your body may be decreased. Examples of these drugs include:

• Oral contraceptives (birth control)
  • If you need to take amoxicillin, your doctor may prescribe a different form of birth control for you.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you’re taking.

This drug comes with several warnings.

Allergies

Amoxicillin can cause a severe allergic reaction. Symptoms can include:

• trouble breathing
• swelling of your throat or tongue

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 911 or go to the nearest emergency room. Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Warnings for people with certain health conditions

For people with mononucleosis (mono or kissing disease): Amoxicillin raises your risk of developing a severe rash.

For people with diabetes: Amoxicillin may cause you to have a false-positive reaction when testing for glucose (sugar) in the urine. Talk with your doctor about how to manage your blood sugar while taking amoxicillin.

For people with kidney disease: If you have severe kidney disease, your kidneys may not clear this drug from your body quickly. As a result, levels of amoxicillin may build up in your body. To help prevent this, your doctor may give you a lower dose of this drug.

Warnings for other groups

For pregnant women: Amoxicillin is a category B pregnancy drug. That means two things:

1. Research in animals has not shown a risk to the fetus when the mother takes the drug.
2. There aren’t enough studies done in humans to show if the drug poses a risk to the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. Animal studies do not always predict the way humans would respond. Therefore, this drug should only be used in pregnancy if clearly needed.

Call your doctor right away if you become pregnant while taking this drug.

For women who are breastfeeding: Amoxicillin may pass into breast milk and may cause side effects in a child who is breastfed. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

For seniors: The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

This dosage information is for amoxicillin oral tablet. All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

• your age
• the condition being treated
• how severe your condition is
• other medical conditions you have
• how you react to the first dose

Forms and strengths

Generic: Amoxicillin

• Form: oral tablet
• Strengths: 500 mg, 875 mg

• Form: oral chewable tablet
• Strengths: 125 mg, 200 mg, 250 mg, 400 mg

Brand: Moxatag

• Form: oral extended-release tablet
• Strengths: 775 mg

Dosage for infections of the ears, nose, and throat

IMMEDIATE-RELEASE TABLET AND CHEWABLE TABLET

Adult dosage (ages 18–64 years)

Typical dosage is 500 mg every 12 hours, or 250 mg every 8 hours.

Child dosage (ages 3 months–17 years)

Typical dosage is 25 mg/kg/day in divided doses every 12 hours, or 20 mg/kg/day in divided doses every 8 hours.

The children’s dosage listed here is meant for children who weigh less than 88 pounds (40 kg). Children who weigh more than 88 pounds should be dosed according to the adult recommendations.

Child dosage (ages 0–2 months)

Maximum dosage is 30 mg/kg/day. Your child’s doctor can tell you more about dosage.

EXTENDED-RELEASE TABLET

Adult dosage (ages 18–64 years)

• Typical dosage is 775 mg once per day for 10 days.
• Take within 1 hour of finishing a meal.

Child dosage (ages 12–17 years)

• Typical dosage is 775 mg once per day for 10 days.
• Take within 1 hour of finishing a meal.

Child dosage (ages 0–11 years)

It has not been confirmed that amoxicillin extended-release tablets are safe and effective for use in people younger than 12 years of age.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lower dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for urinary tract infections

Adult dosage (ages 18–64 years)

Typical dosage is 500 mg every 12 hours, or 250 mg every 8 hours.

Child dosage (ages 3 months–17 years)

Typical dosage is 25 mg/kg/day in divided doses every 12 hours, or 20 mg/kg/day in divided doses every 8 hours.

Child dosage (ages 0–2 months)

Maximum dosage is 30 mg/kg/day. Your child’s doctor can tell you more about dosage.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lower dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Special considerations

• For children’s dosage: The children’s dosage listed here is meant for children who weigh less than 88 pounds (40 kg). Children who weigh more than 88 pounds should be dosed according to the adult recommendations.

Dosage for skin infections

Adult dosage (ages 18–64 years)

Typical dosage is 500 mg every 12 hours, or 250 mg every 8 hours.

Child dosage (ages 3 months–17 years)

Typical dosage is 25 mg/kg/day in divided doses every 12 hours, or 20 mg/kg/day in divided doses every 8 hours.

The dosage listed here is meant for children who weigh less than 88 pounds (40 kg). Children who weigh more than 88 pounds should be dosed according to the adult recommendations.

Child dosage (ages 0–2 months)

Maximum dosage is 30 mg/kg/day. Your child’s doctor can tell you more about dosage.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lower dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for lower respiratory tract infections

Adult dosage (ages 18–64 years)

Typical dosage is 875 mg every 12 hours, or 500 mg every 8 hours.

Child dosage (ages 3 months–17 years)

Typical dosage is 45 mg/kg/day in divided doses every 12 hours, or 40 mg/kg/day in divided doses every 8 hours.

Child dosage (ages 0–2 months)

Maximum dosage is 30 mg/kg/day. This is meant for children who weigh less than 88 pounds (40 kg). Children who weigh more than 88 pounds should be dosed according to the adult recommendations. Your child’s doctor can tell you more about dosage.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lower dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for gonorrhea

Adult dosage (ages 18–64 years)

Typical dosage is 3 g as a single dose.

Child dosage (ages 24 months–17 years)

Typical dosage is 50 mg/kg amoxicillin combined with 25 mg/kg probenecid as a single dose. The children’s dosage listed here is meant for children who weigh less than 88 pounds (40 kg).

Children who weigh more than 88 pounds should be dosed according to the adult recommendations.

Child dosage (ages 0–23 months)

This medication should not be used in children younger than 2 years of age for treatment of gonorrhea.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lower dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for stomach and intestinal ulcers

Adult dosage (ages 18–64 years)

• Typical dosage for triple therapy: 1 g amoxicillin with 500 mg clarithromycin and 30 mg of lansoprazole, all given twice per day for 14 days.
• Typical dosage for dual therapy: 1 g amoxicillin and 30 mg of lansoprazole, given three times per day for 14 days.

Child dosage (ages 0–17 years)

This drug has not been studied in children to treat stomach and intestinal ulcers.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lower dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Amoxicillin oral tablet is used for short-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all: Your bacterial infection may not heal or may get worse.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

It’s important to finish the entire course of treatment as prescribed by your doctor. Do not stop taking the drug or skip doses if you start to feel better. This could cause your infection to last longer.

You could also develop a resistance to the medication. This means if you get a bacterial infection in the future, you may not be able to treat it with amoxicillin.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: The symptoms of your infection should improve.

Keep these considerations in mind if your doctor prescribes amoxicillin oral tablet for you.

General

• Take this drug at the time(s) recommended by your doctor.
• You can take the amoxicillin capsule, tablet, chewable tablet, or suspension with or without food.
• You should take amoxicillin extended-release tablets within 1 hour of finishing a meal.
• Don’t crush, cut, or chew the extended-release tablets. You can crush, cut, or chew the regular or chewable tablets.

Storage

Store amoxicillin at room temperature between 59°F and 86°F (15°C and 30°C).Keep this drug away from light.Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication may be refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

• Always carry your medication with you. When flying, never put it in a checked bag. Keep it in your carry-on bag.
• Don’t worry about airport X-ray machines. They can’t hurt your medication.
• You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
• Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

You and your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. These issues include your:

• Kidney function. Blood tests can check how well your kidneys are working. If your kidneys aren’t working well, your doctor may decide to lower your dosage of this drug.
• Liver function. Blood tests can check how well your liver is working. If your liver isn’t working well, your doctor may lower your dosage of this drug.

The cost of these blood tests will depend on your insurance coverage.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Uses, Dosage, Side Effects and Interactions

Amoxicillin is one of the most commonly prescribed antibiotics. It’s similar to penicillin and can kill a wide variety of bacteria including Streptococcus species, Listeria monocytegenes, Enterococcus, Haemophilus influenzae, some E. coli, Actinomyces, Clostridial species, Shigella, Salmonella, and Corynebacteria.

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.

Fact

Amoxicillin doesn’t work against the flu, colds or other viral infections, and taking amoxicillin and other antibiotics for these illnesses increases the risk of developing antibiotic-resistant infections.

Amoxicillin begins to work quickly after a patient takes it, and it reaches peak blood concentrations in about one or two hours, according to the drug’s label. However, improvement in symptoms will take longer. People should see their symptoms improve within 72 hours, or about three days, but could see improvement as early as 24 hours, according to licensed pharmacist Brian Staiger.

If patients don’t see an improvement in three days, they should speak to their medical provider about other treatment options.

How to Take Amoxicillin

Instructions for how to take amoxicillin are different depending on the condition being treated. Amoxicillin is typically prescribed in its generic form, but it’s available in the following brand names in the United States: Amoxil, Larotid and Moxatag.

This medicine is an oral antibiotic, which means it has to be taken by mouth. It comes in capsules, tablets, chewable tablets or a suspension that can be mixed into cold drinks.

People can take this drug with or without food.

Amoxicillin comes in the following strengths:

• Chewable tablets: 125 mg, 250 mg
• 
  Capsules: 250 mg, 500 mg
• 
  Powder for oral suspension: 50 mg/mL, 125 mg/5 mL, 200 mg/5 mL, 250 mg/5 mL, 400 mg/5 mL
• 
  Tablet: 500 mg, 875 mg

Recommended Dosages

In general, patients should continue taking amoxicillin for the full length of time as prescribed by their doctor, even if they feel better sooner.

Make sure to follow your medical provider’s instructions on how to take the medicine, and try to take it at the same time each day. Take any missed doses as soon as you remember to. But if it’s almost time for the next dose, skip the missed dose and take your next scheduled dose. Don’t try to make up for a missed dose by taking two doses at the same time.

Recommendations for Adults and Children

Source:

Source: U.S. National Library of Medicine

Dosages for Impaired Kidney Function

Medical providers will adjust the dosage for people with severe kidney impairment.

Because children younger than three months of age have incomplete kidney development, medical providers should not exceed a dosage of 30 mg/kg/day divided every 12 hours.

Dosage for H. Pylori Infection

Medical providers combine amoxicillin with clarithromycin and lansoprazole — known by the brand name Prevacid — to treat H. pylori infections.

For triple therapy, the recommended dose for adults is 500 mg clarithromycin, one gram amoxicillin and 30 mg lansoprazole. All of these medications are given twice daily (every 12 hours) for 14 days.

For dual therapy, the recommended dose for adults is 30 mg lansoprazole and one gram amoxicillin each given three times daily (every 8 hours) for 14 days.

Overdose

In general, people who mildly overdose on amoxicillin don’t suffer serious problems, according to the drug’s label. In a study of 51 children at a poison control center, research suggests that an overdose of less than 250 mg/kg body weight doesn’t cause serious issues.

But kidney disorders resulting in organ failure after overdose have been reported in a small number of patients.

Help for an Overdose

In case of overdose, contact your local poison control center, call 1-800-222-1222 or visit PoisonHelp.org.

What Is It Used to Treat?

The FDA approved amoxicillin to treat several types of bacterial infections. The agency also approved it to treat and prevent H. pylori infections in combination with clarithromycin and lansoprazole.

The Centers for Disease Control and Prevention recommend that people exposed to anthrax take amoxicillin to prevent getting sick, according to an article by Drs. Bobak J. Akhavan and Praveen Vijhani published in the U.S. Library of Medicine.

Approved uses of amoxicillin include:

• Genitourinary tract infections
• 
  Ear infections
• 
  Nose infections
• 
  Throat infections
• 
  Lower respiratory tract infections
• 
  Bacterial pharyngitis
• 
  Bronchitis
• 
  Tonsillitis
• 
  Skin and skin stricture infections
• 
  Bacterial rhinosinusitis
• 
  Pneumonia

In addition to FDA-approved uses, some medical providers prescribe it for off-label uses, such as erysipeloid (a bacterial infection of the skin among people who handle fish and meat) and for prevention of infectious endocarditis.

People with hip replacements, knee replacements or other prosthetic joints may take it to prevent infection during dental procedures. Medical providers may prescribe it with metronidazole to treat periodontitis.

Amoxicillin may also treat Lyme disease, according to the CDC.

Common Side Effects

The most common amoxicillin side effects reported in clinical trials occurred in more than one percent of trial participants. Clinical trials also reported common side effects in patients who used amoxicillin in combination with clarithromycin and lansoprazole (triple therapy) and with lansoprazole (dual therapy).

This isn’t a complete list of potential side effects. Contact your medical provider if you experience any side effects that won’t go away or interfere with your daily activities.

The most common side effects of amoxicillin include:

• Diarrhea
• 
  Upset stomach
• 
  Vomiting
• 
  Rash
• 
  Headache
• 
  Nausea

Common triple therapy side effects include:

• Diarrhea (7 percent)
• 
  Headache (6 percent)
• 
  Taste perversion (5 percent)

Common dual therapy side effects include:

• Diarrhea (8 percent)
• 
  Headache (7 percent)

Serious Side Effects

Amoxicillin may cause rare, serious side effects related to hypersensitivity reactions and Clostridium difficile-associated diarrhea (CDAD). If you experience any of these side effects, the National Institutes of Health and U.S. Library of Medicine recommend stopping the medication and seeking emergency medical help.

• Difficulty swallowing or breathing
• 
  Hives
• 
  Itching
• 
  Rash
• 
  Severe diarrhea
• 
  Skin peeling or blisters
• 
  Swelling of the throat, face, tongue, eyes and lips
• 
  Watery or bloody stools with or without fever and stomach cramps
• 
  Wheezing

Allergic Reactions

Some people who take amoxicillin have had serious and occasionally fatal allergic reactions. This is more common in people with a history of allergic reactions to penicillin. Discontinue the drug immediately and seek treatment for allergic reactions (rash, swelling of the throat, face, tongue, eyes and lips).

Clostridium Difficile-Associated Diarrhea (CDAD)

Treatment with amoxicillin affects the normal bacteria in the colon and may lead to overgrowth of toxin-producing bacteria called C. difficile. These toxins cause diarrhea that can occur over two months after taking antibiotics.

It can range from mild diarrhea to fatal colitis. Some patients may require colectomy, a surgery to remove part of the colon.

Medical providers will likely stop therapy and treat symptoms with hydration, nutrition and antibiotics that treat C. difficile. They will also evaluate the need for surgery.

Interactions

Amoxicillin’s drug label provides a list of drugs that may interact with the antibiotic. Tell your doctor about any vitamins, supplements and medications you take before taking amoxicillin.

Probenecid

Using amoxicillin and probenecid together may increase blood levels of amoxicillin.

Oral Anticoagulants

There have been reports that taking amoxicillin with oral anticoagulants (blood thinners) such as warfarin may increase blood-thinning effects. Medical providers may need to adjust blood thinner doses and test blood levels for proper anticoagulation levels.

Allopurinol

Taking allopurinol with amoxicillin increases the incidence of rashes compared to receiving amoxicillin alone.

Oral Birth Control

Because amoxicillin affects gut flora it may reduce the effectiveness of combined oral estrogen/progesterone contraceptives.

Other Antibacterials

Other antibacterial drugs such as macrolides, chloramphenicol, tetracyclines and sulfonamides may interfere with penicillin’s bacterial-killing effects. Researchers have seen the effect in test tubes and petri dishes (in vitro), but they aren’t sure how or if the effect works in the human body.

Amoxicillin and Laboratory Tests

Using amoxicillin may cause false-positive reactions when testing blood glucose using urine tests such as Clintest, Benedict’s Solution, or Fehling’s Solution. People with diabetes should use Clinistix, TesTape or other glucose tests based on enzymatic glucose oxidase reactions instead.
Pregnant women taking amoxicillin had a transient decrease in blood levels of total conjugated estriol, estradiol, estriol-glucuronide and conjugated estrone.

Before Taking Amoxicillin

Amoxicillin might not be safe or effective for everyone. Before taking this medicine, make sure to tell your doctor or pharmacist about any medications you are taking, if you are allergic to penicillin and about any health conditions you have.

Tell your medical provider or pharmacist:

• If you are allergic to amoxicillin, penicillin antibiotics, cephalosporin antibiotics or any of the ingredients in amoxicillin tablets, capsules or suspension. Make sure to get a list of ingredients from your pharmacist.
• 
  About other prescription medications, nutritional supplements, vitamins, herbal products and nonprescription medicines you are taking or plan to take, especially allopurinol, other antibiotics, blood thinners, birth control pills, and probenecid.
• 
  If you have a virus called mono (mononucleosis).
• 
  If you have or have ever had kidney disease or allergic reactions such as rashes or hives.
• 
  If you are breastfeeding, are pregnant or plan to get pregnant.
• 
  If you have phenylketonuria, also known as PKU. Some amoxicillin chewable tablets contain aspartame, an artificial sweetener that forms phenylalanine.

Non-Penicillin Antibiotic Alternatives

People who are allergic to penicillin or amoxicillin have a few alternative antibiotic choices. The alternative you take may depend on the condition you are treating.

Make sure to ask a medical provider about your options. The following are some of the most common alternatives.

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

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Amoxicillin | Health Navigator NZ

Amoxicillin is an antibiotic used to treat different infections caused by bacteria. Find out how to take it safely and possible side effects. Amoxicillin is also called Alphamox.

What is amoxicillin?

Amoxicillin is an antibiotic used to treat different infections caused by bacteria, such as chest infections, dental infections and infections of the throat, ear and sinus. It works by killing or stopping the growth of bacteria (bugs) and gets rid of the infection. Amoxicillin is sometimes used to get rid of Helicobacter pylori, an infection often found in people with stomach ulcers. It is not effective against infections caused by viruses. Amoxicillin belongs to a group of antibiotics called penicillins. In New Zealand amoxicillin is available as capsules and liquid and can be given as an injection in the hospital. 

Dose

• The dose of amoxicillin will be different for different people depending on the type of infection and your age. 
• Adults: the usual dose in adults is 250 or 500 milligrams 3 times a day.
• Children: the dose for children will depend on their body weight. It is usually given 3 times a day.
• Your doctor will advise you how long to take amoxicillin for (usually 3 to 7 days).
• Always take your amoxicillin exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it and any special instructions.

How to take amoxicillin

• You can take amoxicillin with or without food.
• Capsules: swallow the capsules with a glass of water or milk. Do not chew them. 
• Liquid: shake the medicine well. Measure the right amount using an oral syringe or medicine spoon. You can get these from your pharmacy. Do not use a kitchen spoon as it will not give you the right amount. Read more: Tips on how to give medicines to babies and children.
• Timing: Amoxicillin is usually given 3 times a day. Try to space the doses evenly throughout the day, such as the first thing in the morning, early afternoon and at bedtime. Ideally these times should be at least 4 hours apart.  
• Missed dose: If you forget to take your dose at the correct time, take one as soon as you remember. Try to take the correct number of doses each day, leaving at least 4 hours between doses. Do not take 2 doses at the same time to make up for a forgotten dose.
• If you are sick: If you are sick (vomit) less than 30 minutes after having a dose of amoxicillin, take the same dose again. But, if you are sick (vomit) and it is more than 30 minutes after having a dose of amoxicillin, you do not need to take another dose. Wait until the next normal dose. 
• Finish the course. It is best to take the whole course of antibiotics for the number of days your doctor has told you to. Do not stop taking it, even if you feel your infection has cleared up. 

Precautions when taking amoxicillin

Before starting amoxicillin

• Do you have glandular fever?
• Have ever had an allergic reaction to a medicine, especially a penicillin antibiotic?
• Are you pregnant or breastfeeding?
• Do you have problems with the way your kidneys work?
• Are you taking any other medicines? This includes any medicines you are taking that you can buy without a prescription, as well as herbal and complementary medicines.

If so, it’s important that you tell your doctor or pharmacist before you start amoxicillin. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

While taking amoxicillin

Store your capsules in a cool, dry place, away from direct heat and light. if you have been given liquid medicine, this will have been made up by the pharmacy and you may need to keep it in the fridge – check the instructions on the bottle. Make sure the medicine does not freeze.

Side effects

Like all medicines, amoxicillin can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Interactions

Amoxicillin may interact with some medicines and herbal supplements, so check with your doctor or pharmacist before starting amoxicillin. If you are taking the contraceptive pill, its effectiveness can be reduced if you have a bout of being sick (vomiting) or diarrhoea that lasts for more than 24 hours. If this happens, ask your doctor or pharmacist for advice about contraception over the following few days. 

Learn more

The following links have more information on amoxicillin.

New Zealand Formulary Patient Information:

References

1. Amoxicillin New Zealand Formulary
2. Antibiotics – choices for common infections BPAC, NZ, 2017

Amoxicillin (Amoxil) – Side Effects, Interactions, Uses, Dosage, Warnings

Use Amoxicillin (Amoxil) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Take this medicine at the same time each day.

Some forms of amoxicillin may be taken with or without food. Check your medicine label to see if you should take your amoxicillin with food or not.

Shake the oral suspension (liquid) before you measure a dose.

Measure liquid medicine with the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon). You may mix the liquid with water, milk, baby formula, fruit juice, or ginger ale. Drink all of the mixture right away. Do not save for later use.

You must chew the chewable tablet before you swallow it.

Swallow the regular tablet whole and do not crush, chew, or break it.

You will need frequent medical tests.

If you are taking amoxicillin with clarithromycin and/or lansoprazole to treat stomach ulcer, use all of your medications as directed. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor’s advice.

Use this medicine for the full prescribed length of time, even if your symptoms quickly improve. Skipping doses can increase your risk of infection that is resistant to medication. Amoxicillin will not treat a viral infection such as the flu or a common cold.

Do not share this medicine with another person, even if they have the same symptoms you have.

This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using amoxicillin.

Store at room temperature away from moisture, heat, and light.

You may store liquid amoxicillin in a refrigerator but do not allow it to freeze. Throw away any liquid amoxicillin that is not used within 14 days after it was mixed at the pharmacy.

Amoxicillin Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Nausea, vomiting, or diarrhea may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Use of this medication for prolonged or repeated periods may result in oral thrush or a new vaginal yeast infection (oral or vaginal fungal infection). Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge or other new symptoms.

Tell your doctor right away if any of these rare but serious side effects occur: dark urine, persistent nausea or vomiting, stomach/abdominal pain, yellowing eyes or skin, easy bruising or bleeding, persistent sore throat or fever.

This medication may rarely cause a severe intestinal condition due to a bacteria called C. difficile. This condition may occur during treatment or weeks to months after treatment has stopped. Tell your doctor right away if you develop: diarrhea that doesn’t stop, abdominal or stomach pain/cramping, blood/mucus in your stool.

If you have these symptoms, do not use anti-diarrhea or opioid products because they may make symptoms worse.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Amoxicillin can commonly cause a mild rash that is usually not serious. However, you may not be able to tell it apart from a rare rash that could be a sign of a severe allergic reaction. Therefore, get medical help right away if you develop any rash.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US –

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Amoxicillin for infections | Medicine

What is amoxicillin?

Amoxicillin is given to treat a bacterial infection. It is mainly prescribed for sinus and chest infections, urine infections, ear infections, and some dental infections. You may also be prescribed it to prevent an infection from occurring if you are at particular risk of getting an infection. Amoxicillin is a penicillin antibiotic which treats infection by killing the germs (bacteria) responsible for the infection.

Amoxicillin is sometimes used to get rid of Helicobacter pylori. This is an infection often found in people with stomach ulcers. If you are prescribed it for this reason, you will also be prescribed other medicines to take alongside it.

Before taking amoxicillin

Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking amoxicillin it is important that your doctor knows:

• If you suspect you may have glandular fever (the symptoms are high temperature (fever), sore throat, swollen glands).
• If you have an allergic condition, or if you have ever had an allergic reaction to a medicine. This is especially important if you have ever had a bad reaction to any penicillin antibiotic.
• If you have any problems with the way your kidneys work.
• If you are pregnant or breastfeeding. Amoxicillin is not known to be harmful to babies; however, it is still important that you tell your doctor if you are expecting or breastfeeding a baby.
• If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

How to take amoxicillin

• Before you start the treatment, read the manufacturer’s printed information leaflet from inside the pack. It will give you more information about amoxicillin and will provide you with a full list of the side-effects which you may experience from taking it.
• Take amoxicillin exactly as your doctor tells you to. It is usually taken three times daily, every eight hours. Your dose will be different to this if you are being treated with sachets of amoxicillin powder, or if you are being treated for a stomach ulcer. Your doctor or pharmacist will tell you how you should take the medication, and this information will be printed on the label of the pack to remind you. It is important that you space out the doses evenly during the day.
• If you have been given liquid medicine for a child, read the directions carefully to make sure you measure out the correct amount of medicine.
• You can take amoxicillin either with or without food. The capsules should be swallowed whole with a drink of water.
• If you have been supplied amoxicillin oral powder sachets, stir the powder from the sachet into 10-20 ml of water. Drink the solution as soon as possible after mixing it.
• If you forget to take a dose at the correct time, take one as soon as you remember. Try to take the correct number of doses each day, leaving at least four hours between doses. Do not take two doses at the same time to make up for a forgotten dose.

Getting the most from your treatment

• If you (or your child) have been prescribed the oral liquid medicine, you may find that it causes some staining of the teeth. Brushing the teeth regularly helps to prevent this. Any staining usually disappears soon after the course of antibiotics is finished.
• Even if you feel your infection has cleared up, keep taking the antibiotic until the course is finished (unless a doctor tells you to stop). This is to prevent the infection from coming back.
• Antibiotics are prescribed in short courses of treatment. Your doctor will tell you how long your course of treatment will last – this is not usually for longer than 14 days. If you still feel unwell after finishing the course, go back to see your doctor.
• Some people develop redness and itching in the mouth or vagina (thrush) after taking a course of antibiotics. If this happens to you, speak with your doctor or pharmacist for advice.
• If you are taking the contraceptive ‘pill’ at the same time as this antibiotic, the effectiveness of the ‘pill’ can be reduced if you have a bout of being sick (vomiting) or diarrhoea which lasts for more than 24 hours. If this should happen, ask your doctor or pharmacist for advice about what additional contraceptive precautions to use over the following few days. There is no need to use additional precautions for any bouts of sickness or diarrhoea which last for less than 24 hours.
• Amoxicillin can stop the oral typhoid vaccine from working. If you are due to have any vaccinations, make sure the person treating you knows that you are taking this antibiotic.

Amoxicillin side-effects

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with amoxicillin. You will find a full list in the manufacturer’s information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Important: if you develop an itchy rash, swollen face or mouth, or have difficulty breathing, these may be signs that you are allergic to a penicillin antibiotic. Do not take any more amoxicillin and speak with your doctor or go to your local accident and emergency department straightaway.

If you experience any other symptoms which you think may be due to the antibiotic, speak with your doctor or pharmacist for further advice.

How to store amoxicillin

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.
• If you have been given liquid medicine, this will have been made up by the pharmacy and lasts for 14 days. Make sure you check the expiry date on the bottle and do not use it after this date. 

Important information about all medicines

Amoxicillin dosage instructions

Dosage information for amoxicillin

▪️ The dose of amoxicillin and how long you need to take it for depends on the type and severity of infection you have, your age, weight and kidney function. Always follow the instructions given by your doctor. These will be printed on the label that your pharmacist has put on the packet of medicine.

▪️ Amoxicillin is usually taken three times a day. Space your doses evenly over the day (during the hours you are awake). For example, adults who’ve been prescribed a dose three times a day could take one dose at 7am, one at 3pm and one at 11pm. However, children prescribed a dose three times a day could be given the medicine at 7am, 1pm and 7pm.

▪️ A typical dose to treat infection in an adult is 250mg to 500mg three times a day. For some infections, such as treatment for H pylori eradication you may be advised to take amoxicillin twice a day in combination with other antibiotics.

▪️ Amoxicillin capsules should be swallowed with a drink of water. Amoxicillin sachets should be mixed into half a glass of water just before taking.

▪️ Amoxicillin can be taken either with or without food.

▪️ It is safe to drink alcohol while taking amoxicillin – it won’t affect the medicine.

▪️ Missed dose: If you forget to take a dose of amoxicillin at the correct time, take it as soon as you remember and then space the rest of your doses over the remaining part of the day. Always try to take the correct number of doses each day, leaving at least four hours between doses. Don’t take two doses together to make up for a missed dose.

▪️ It is important that you finish the prescribed course of amoxicillin, even if you feel better or it seems the infection has cleared up. Stopping the course early makes it more likely that your infection will come back and that the bacteria will grow resistant to the antibiotic.

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Read more about amoxicillin

What is amoxicillin used for and how does it work?

What should I know before taking amoxicillin?

Can I take amoxicillin while pregnant or breastfeeding?

What are the possible side effects of amoxicillin?

Can I take other medicines with amoxicillin?

Last updated: 01/05/2019

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90,000 Answers to common questions about COVID-19

1. They say that antibiotics cannot be cured of coronavirus infection. It’s true?

Chief Therapist of the Ministry of Health of Russia, Director of the National Medical Research Center of Therapy and Preventive Medicine of the Ministry of Health of Russia Oksana Drapkina:

The very name “coronavirus infection” contains the word “virus”, which means that the disease is caused by a virus. Antibiotics are drugs that treat diseases caused by bacteria.Thus, antibiotics cannot act on the virus. With a mild and uncomplicated course of coronavirus infection, the use of antibiotics is not necessary. It can even be dangerous as these drugs have many contraindications and side effects.

Sometimes bacterial inflammation can join the coronavirus infection, or complications arise. Then additional antibiotic prescription is often required.

2. If you have a high fever, what can you take on your own before visiting a doctor?

Increased body temperature is a protective reaction of the body, it helps it to cope with the virus faster.Therefore, the temperature should not be drastically reduced. You can take paracetamol if the temperature is over 38. But, of course, it is always necessary to remember that self-medication is dangerous, and you need to consult a doctor in a timely manner.

3. Some people are now taking antibiotics to prevent coronavirus infection. Can this be done?

No, this should never be done for several reasons. First, antibiotics work on bacteria, not viruses.And in the case of prevention (that is, prevention of infection), they are all the more useless. Secondly, any uncontrolled intake of antibiotics is dangerous. They have contraindications for use, some of them cannot be used in children, adolescents, the elderly. Many antibiotics have serious side effects.

4. I think I have a coronavirus infection. Where should I go first?

First of all, try not to panic and evaluate your well-being.If the body temperature is less than 38, there is no shortness of breath, feelings of shortness of breath and compression in the chest, there is no need to call an ambulance.

Contact your local doctor. At the visit, he will assess your condition, if necessary, appoint an examination and write out the necessary directions for them.

Remember that it is important to stay at home if you feel unwell and suspect a coronavirus infection.

Here is a checklist of common symptoms of coronavirus infection:

– High body temperature

– Shortness of breath

– Sneezing, coughing and nasal congestion

– Pain in muscles and chest

– Headache and weakness

– Possible nausea, vomiting, diarrhea

– Possible loss of smell.

90,000 “More than 98% of patients recover without any treatment” | Articles

Self-medication for COVID-19 can lead to much more problems than the coronavirus itself. For example, injections of interferon at home can lead to a mental disorder, and the use of antibiotics can cause a surge in bacterial infections. Moreover, it is too early to comment on the results of the therapeutic use of Remdesivir, Favipiravir and Polyoxidonium . How not to get confused in scientific publications, YouTube videos and tips for curing coronavirus, as well as the effectiveness of popular drugs used in the treatment of this infection, the head of the course of applied pharmacology and pharmacotherapy of the Faculty of Health Sciences of the University told in an interview with Izvestia OsloMet (Norway), head of international projects on patient safety and personalized medicine Yuri Kiselev.

– What are the world’s most popular combinations and medications currently being used to treat COVID-19?

– Antiviral therapy, drugs to suppress excessive inflammation, as well as ancillary treatment, primarily drugs for the prevention of thrombosis.

Coronaviruses have been known for a long time, but there were no effective remedies against them before the current pandemic began. We tried several options, including drugs for malaria and HIV.But research has not confirmed either the therapeutic or prophylactic efficacy of these drugs. These drugs, especially anti-malarial drugs, are not only useless, but also potentially dangerous.

Photo: TASS / Zuma

– Why is there still a problem of creating an effective antiviral drug?

– To destroy a pathogenic microorganism, you need to “beat” into a specific molecule or mechanism that is characteristic only of this pathogen, but is absent in humans, otherwise we will harm the patient.For example, in bacteria, penicillins act on a certain cell wall protein that our cells do not have. Viruses are parasites, they exist and multiply at the expense of the host. They have very few of their own unique “targets” on which drugs can be “hit” without fear of powerful side effects. Hence the difficulties with the development of any antiviral drugs.

– Recently, French scientists announced that the main characteristic feature in patients with severe COVID-19 course was revealed – increased inflammation and interferon deficiency.Is it possible to carry out prophylaxis with the introduction of these substances ?

– Interferons are one of the elements of antiviral defense in the body. It is still unknown if their deficiency could be a cause or a consequence of severe COVID-19. Some experts disagree with the findings of the French and provide opposite data.

One thing is for sure: you cannot use injectable forms of interferon on your own. These are drugs with frequent and severe side effects. For example, the number of white blood cells – those blood cells that protect us from infections – can dramatically decrease.Severe weakness, hair loss and skin rashes, gastrointestinal and even psychiatric disorders are possible. The latter include depressive states and sleep disorders, less often mania and suicidal thoughts are manifested. In addition, the introduction of interferon-beta very often causes symptoms similar to ARVI, and it is difficult for a doctor to distinguish them from the true manifestations of the disease.

– Recently, the British company Synairgen issued a press release on the first results of a study of inhaled interferon in the treatment of hospitalized patients with COVID-19.Is that also dangerous ?

– The idea was to deliver interferon molecules directly to the lungs – a focus of the disease with a rapid multiplication of the virus. In terms of side effects, this is better: less drug will enter the bloodstream than with an injection. But the study included only 101 patients, which is very few. The risk of being ventilated or dying was 79% lower with interferon versus placebo. If this data is confirmed, it will revolutionize treatment.

– During COVID-19, excessive, hyperactive inflammation is noted. What tools work here?

– Of the most proven approaches to date, I would like to note the use of the well-known steroid hormone “Dexamethasone”, used, for example, in life-threatening allergic reactions. In the UK, this drug has shown a reduction in mortality in severely hospitalized patients. But not all COVID-19 patients are the same: in the same study, Dexamethasone did not benefit patients who breathed on their own and without an oxygen mask.The US National Institutes of Health has spoken out against its use in patients with mild COVID-19. This is due to a wide range of side effects of this drug: increased pressure, impaired adrenal function, increased blood sugar, risk of infections. That is, the total prescription of such drugs is not recommended for all patients and is dangerous.

Photo: REUTERS / Benoit Tessier

– How do you feel about the practice of using antibiotics against coronavirus infection?

– Already, it seems, preschoolers know that antibiotics do not work on viruses.However, in real Russian practice of treating COVID-19 , they are used very widely. There are two reasons: for “Azithromycin” there are laboratory data on its immunomodulatory effect, and other antibiotics are prescribed in case the patient has combined viral-bacterial pneumonia.

Antibiotics must be used deliberately, selectively, because their general use in coronavirus infection only contributes to the further spread of a more dangerous problem – the resistance of bacteria to them. Excessive use of antibiotics in COVID hospitals will aggravate the already very unfavorable situation with nosocomial resistant infections, and it is extremely difficult to get rid of the flora once rooted in the department.

– Governments of different countries rely on different drugs. So, in the USA, Remdesivir came to the fore. What is the latest data on its effectiveness of ?

– American guidelines support the appointment of Remdesivir to hospitalized patients with coronavirus with a decrease in saturation (saturation of hemoglobin with oxygen.- “Izvestia”) below 95% and patients who have a need for oxygen therapy. Its effect in ventilated patients is not yet clear. The European Medicines Agency draws attention to the possible risk of renal toxicity. This drug should also not be used together with hydroxychloroquine, which is still popular in Russia.

– In Russia, Favipiravir is the headliner of the coronavirus remedies. How promising is it?

– Recently, there have been reports from Japan about the unimpressive first results of the Favipiravir randomized trial in COVID-19 .In Russia, they are more optimistic and point to the advantages of domestic research. Neither in either case is there yet access to a full description of the results, and therefore it is impossible to comment on something. At least in outpatients with a mild course of the disease, its use seems to me risky, since the effectiveness of the drug has not yet been proven, and there are questions about safety.

I would like to remind you: women of childbearing age should be tested for possible pregnancy before prescribing the drug or receive effective contraception, as it can lead to fetal pathology.

– What can you say about Arbidol?

– I am concerned that this drug is registered in a very small number of countries. But, as far as I know, it is used only in Russia and China. A logical question arises: why hasn’t it taken over the world yet, since it is so effective?

Some data have been published on it in the laboratory. It was seen as one of the molecules that could potentially be useful in the coronavirus as well. But that was at the preclinical level.In China, it was examined in a clinic on patients. But the research itself is of low quality. For example, in one of them, “Arbidol” was compared with an HIV drug, which itself was ineffective. There is a lot of rubbish in publications now, and you need to approach them critically. In general, the effectiveness of this drug for COVID-19 has not yet been proven.

Photo: REUTERS / Amr Abdallah Dalsh

– Recently, the Russian immunomodulator Polyoxidonium also passed the first part of the tests in the context of the coronavirus.What can you say about him?

– From the point of view of pharmacology, I have nothing to comment on. The scientific literature does not describe a specific molecular mechanism of its action, there are no studies on patients with COVID-19. And in general, immunity is not a car, here you cannot take and add gas. This is a very complex system of checks and balances that cannot be strengthened with a single pill.

– There are also alternative approaches to the treatment of coronavirus – with the help of vitamins, natural compounds, and so on.What do you think of them?

– With regard to COVID-19 in recent months, there has been a lot of talk about three things – vitamin C, zinc and vitamin D. For ascorbic acid, which we are used to using for colds and flu, the news is not very positive. Even with ordinary acute respiratory viral infections, additional intake of vitamin C did not show any effectiveness. It may be justified in severe disease when oxidative stress develops and the antioxidant properties of ascorbic acid may be beneficial.

British studies have shown no link between vitamin D levels and the risk of coronavirus. By the way, daily intake of high doses of vitamin D (4000 IU and more) can lead to a decrease in bone density and other side effects, which has been shown in studies.

As tempting as the laboratory results may look, for zinc there is also no evidence of curative or prophylactic efficacy against COVID-19 .

– What advice would you give ordinary people to prevent COVID-19?

– Today we observe what, in the words of one of my colleagues, can be called a “pharmacological bacchanalia”. I would like to reiterate the well-known rule: do not take prescription drugs without a doctor’s prescription. Do not inject yourself with the blood-thinning drugs left over from your grandmother after the operation, do not ask the nurse-neighbor to drip at home “ Dexamethasone ” , do not ask the pharmacist to sell four different antibiotics and do not take them in handfuls – these are all examples from life. And, most importantly, remember that more than 98% of coronavirus patients recover, and most without any treatment other than banal antipyretic drugs.We have a reliable ally – our immunity, and should not be underestimated. But we also have an enemy – this is panic, which is sometimes difficult not to succumb to, but it is dangerous for both the patient and the doctor.

How to take medicines correctly – Rossiyskaya Gazeta

We take pills easily. Headache? I drank the painkiller. Did you catch a cold? I dripped my nose, “zapshikal” throat, antipyretic – from the temperature. And if it’s some kind of chronic disease, it happens that we drink half a dozen different pills.But how do these drugs work together in the body? Alas, we do not always heed the recommendations when the doctor explains how to take the medicine. And in vain. “Meeting” in the body, the pills can form a dangerous “cocktail”. Professor Douglas S. Paauw of the University of Washington in Seattle summarized data on dangerous drug combinations, the results of this work were published by the portal www.medscape.com. Here are just a few examples of potentially unsafe combinations.

St. John’s wort

We drink medicinal herbs often and usually don’t hold them for “serious” medicines.But, for example, the popular St. John’s wort (Hypericum perforatum) contains substances that weaken the effect of certain drugs:

1. For depression, drugs are prescribed that increase the level of the “joy hormone” serotonin (serotonin reuptake inhibitors). St. John’s wort, which is also used as a “mild and safe” antidepressant, weakens their effect. Treatment can go down the drain.

2. When taking hormonal contraceptives simultaneously with St. John’s wort, their concentration in the blood decreases, which is fraught with unplanned pregnancy.

3. Reduces the effectiveness of antiretroviral drugs used by HIV patients.

4. Suppresses the action of immunosuppressants (cyclosporine), which can lead to the rejection of transplanted organs in patients after transplantation.

So if you like St. John’s wort tea, do not forget to warn your doctor about it.

Grapefruit juice

What do we drink pills with? Well, if just water. But often compote, tea, and juice are also used.But, for example, grapefruit juice increases the time of elimination of drugs from the body and the patient is at risk of overdose.

1. Definitely not drinking juice and eating grapefruit while taking anti-arrhythmia drugs (felodipine and amiodarone).

90,002,240,000 deaths due to drug misuse are reported annually in the United States. In Russia, such statistics are not kept

2. This juice is not combined with statins (simvastatin, lovastatin, to a lesser extent atorvastatin).The dangers of combining with pravastatin have not yet been proven, but why take the risk?

3. Need to be careful and hypertensive patients taking antihypertensive drugs (amlodipine, nifedipine).

The effects of the interaction of these drugs with grape fruit juice have already been well studied. Doctors usually warn patients about the risk.

Statins

Statins are the most prescribed drugs for lowering blood cholesterol levels. They are used in patients with cardiovascular disease to reduce the risk of heart attack and stroke.But doctors warn: the threat of drug interactions in this group of drugs is high. One of the most serious complications, even with statin monotherapy, is muscle weakness and muscle tissue destruction. The risk is even higher if certain other medications are taken with statins.

1. In the risk group, fibrates is another group of drugs that normalize lipid metabolism (we are talking, in particular, about gemfibrozil).

2. Be careful with certain antibiotics (especially erythromycin and clarithromycin).

3. It is unsafe to use certain cardiovascular drugs: lowering blood pressure (verapamil, diltiazem), treating arrhythmia (amiodarone).

4. Statins are not combined with some antiviral drugs (ritonavir).

But there is no need to panic: you can reduce the harmful effect of “incompatible” drugs. For this, a non-competitive admission scheme is used. Simply put, drugs are “diluted” by the time they enter the body. Statins are drunk at night, before bedtime.This means that the doctor will advise you to take the second medicine in the morning, after 12 hours, or at another suitable time.

Paracetamol

What do we take for colds, flu, for pain relief? Most often, paracetamol, which you can safely buy at the pharmacy without a prescription. Doctors also often recommend it over non-steroidal anti-inflammatory drugs (NSAIDs), which can cause gastrointestinal bleeding. But paracetamol is by no means a harmless medicine.

One of the dangerous combinations is paracetamol and warfarin, an anticoagulant that is constantly taken when there is a threat of blood clots.Warfarin is prescribed to many people: after operations on the heart and blood vessels, after heart attacks and strokes, with thrombophilia.

But with regular intake of paracetamol, blood clotting increases and warfarin stops “working”.

“Unexplained” complications are sometimes associated with errors in medication

Such consequences can be “tracked” if the INR is regularly monitored – this analysis shows how the blood coagulation system works and how high the likelihood of a blood clot is.If you drink paracetamol from time to time, this usually does not affect blood clotting. But it is still better to warn patients who are constantly receiving warfarin to be more careful about paracetamol.

Anti-inflammatory drugs

We use aspirin, ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs) very often. But not everyone knows: taking them can increase blood pressure. And in hypertensive patients to reduce the effectiveness of treatment, since NSAIDs are not “friendly” with many very popular antihypertensive drugs.

In our country, NSAIDs can be safely bought at a pharmacy – they are among the non-prescription drugs. Therefore, “unexplained” pressure surges, hypertensive crises can actually have a simple reason: an unsuccessful drug combination.

1. Indomethacin, piroxicam and naproxen have the most significant effect on blood pressure.

2. Less risky are ibuprofen, rofecoxib and celecoxib (although research on their properties is ongoing).

3. As for aspirin, experts say that it does not increase blood pressure even in severe hypertensive patients.

Often, cardiologists prescribe a combination of two drugs with different mechanisms of action for hypertensive patients. And this is an additional risk of getting a complication. The so-called triple therapy (a combination of a diuretic, another antihypertensive drug and NSAIDs) increases the risk of acute renal failure by 31%.

Scientists recommendation: Doctors and pharmacists should ask hypertensive patients if they are taking NSAIDs and warn about possible risks.Moreover, this should be done if the patient’s hypertension is difficult to treat.

Arpimed

Driving and operating machinery

Amlodipine may affect the ability to drive vehicles or operate machinery. If after taking the pills you feel unwell, dizzy, tired or have a headache, do not drive, do not operate machinery and contact your doctor immediately.

The drug contains less than 1 mmol of sodium (23 mg) per tablet, i.e.That is, it practically does not contain sodium.

How to take Amlodipine

Always take this medicine exactly as recommended by your doctor or pharmacist. If you have any doubts about taking a drug, consult your doctor or pharmacist.

The recommended starting dose of Amlodipine is 5 mg once a day. The dose of Amlodipine can be increased to 10 mg once a day.

This medicinal product can be used both before and after meals and drinks.This drug should be taken at the same time of day with water. Do not take Amlodipine with grapefruit juice.

Use in children and adolescents

For children and adolescents (6 to 17 years old), the recommended starting dose is 2.5 mg once a day. The maximum recommended dose is 5 mg once a day. Amlodipine 5 mg tablets can be divided into two equal doses.

It is important not to stop taking the drug.Do not wait until you run out of pills before going to the doctor.

If you took more Amlodipine than you recommended

Taking too many pills can cause a drop in blood pressure, up to alarming values. This may cause dizziness, weakness, or fainting. When blood pressure drops too much, shock can develop. This causes the skin to become cold and clammy and may develop unconsciousness.If you have taken too many Amlodipine tablets, seek medical attention immediately.

If you forget to take Amlodipine

Don’t worry. If you forget to take a tablet, skip this dose. Take your next dose at the right time. Do not take a double dose of the drug to make up for the missed dose.

If you stop taking Amlodipine

Your doctor will tell you how long to take this medicine.If you stop taking this drug earlier than the recommended time, a relapse is possible.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

90,000 The effect of drugs on the liver. Why is self-medication dangerous?

If you live in Russia, then, most likely, at least once you have “prescribed” a medicine for yourself or have used the advice of friends, colleagues and neighbors. Or the choice of treatment was guided by advertisements and reviews on the Internet.

It would seem that ordinary paracetamol or nurofen from temperature, diclofenac from sciatica, antifungal agent from thrush, antibiotic from angina? Not every time to run to the doctor, waste time in line, take tests to relieve an exacerbation or “drown” a headache. You can just pop into the pharmacy after work.

Why is this approach costly for your liver?

More than 1,000 drugs are known to cause serious and sometimes fatal diseases.Pay attention to the sad statistics: every fourth patient of a hepatologist suffers from medicinal liver damage. 25% of cases of acute liver failure, when the liver ceases to cope with its work – due to drugs. Moreover, according to the results of the latest multicenter study, one in three Russians has an unhealthy liver.

“Warned – armed”: how are drugs rendered harmless?

The liver detoxifies drugs in 3 phases.This is a cascade of complex biochemical reactions, the purpose of which is to transform, neutralize and remove a chemical that has entered the body. Complex enzyme systems are involved in these reactions, and in the process, even more toxic substances are often formed, which the liver also needs to neutralize.

For example, alcohol increases the activity of the first phase enzymes. If you took “harmless” paracetamol at the same time, the toxicity of its metabolic products, i.e. direct damage to the liver, increases 1000 times.

When the liver is systematically overloaded – with alcohol, malnutrition, prolonged and uncontrolled intake of large amounts of drugs, the neutralization system ceases to cope with its work. As a result, the toxicity of drugs increases, they provoke inflammation, fat accumulation, impaired outflow of bile and death of liver cells. And, what is important, all this passes hidden, having little effect on the state of health.

Not all medicines are created equal – what are the dangers you should be aware of?

Absolutely safe drugs, be they chemicals, herbs or dietary supplements, do not exist.Under certain conditions, they are all capable of damaging the liver. We will tell you about the most common drugs and the consequences of taking them.

• Anti-inflammatory drugs – paracetamol, nurofen, diclofenac sodium, aspirin and other drugs from the NSAID group. There are hundreds of names, thousands of combinations. Everything that you run to the pharmacy for when you have a headache, “grabbed” your back, “aching” joints or a fever. Every fifth inhabitant of the Earth takes these drugs. And they are all toxic to the liver.Moreover, the harm depends on the dose, and the consequences develop from asymptomatic drug hepatitis to severe liver failure.
• Antibiotics are the “heavy artillery” of modern medicine. They have saved millions of lives, and are able to save from bacterial infections. However, they are often used without reason, for “prevention”. Or the patients themselves “prescribe” them. And the liver pays for everything. Antibiotics, depending on their chemical structure, can damage the liver in different ways.Some cause damage to the cell membranes of hepatic cells, others disrupt the flow of bile and thicken it, others cause a malfunction in the immune system when it begins to attack and destroy its own liver. Often several negative effects are combined in one antibiotic. Especially dangerous for the liver: amoxicillin + clavulanic acid, rifampicin, erythromycin, tetracyclines. You can feel the consequences of taking them even after the medication is discontinued. The higher the dose and the longer the course, the more attentive you should be to your condition.Never use these drugs without good reason.
• Medicines that lower blood pressure – hypotensive. More than half of the population over 60 suffers from high blood pressure. Every third person does not know about it. And, of course, it is not treated. Those who take the drugs prevent the complications of hypertension – heart attacks, strokes and kidney failure. Drugs used to treat hypertension generally rarely cause liver damage. Exceptions are hydralazine and methyldopa, which cause drug-induced hepatitis.However, you should not combine even relatively safe drugs for hypertension with alcohol, or take “swoops”. The exact dose and regularity of administration is the key to successful treatment.
• Contraceptives. It was they who made a splash 50 years ago, giving freedom of choice. It would seem how convenient – and “critical days” you can survive without painkillers, and protect yourself from unwanted pregnancy, and prevent uterine and breast cancer. And all at the same time! Just take a small pill in the morning.However, hormonal contraceptives are not as harmless. In addition to the risk of thrombosis, a couple of extra pounds, and “jumps” in mood, the liver also suffers greatly from them. The tendency to stagnation of bile and stones, the risk of the formation of a benign tumor in the liver – adenoma, and even damage to the liver cells – this is what the liver “pays” for your quiet life. And those whose liver is initially out of order should not take contraceptives without consulting a hepatologist. Therefore, do not assign them yourself. And don’t take too long.
• Antiallergic medicines. Allergy sufferers more and more every year. In Russia, almost half of those who suffer from unusual, too strong reactions to ordinary factors (namely, this is considered an allergy). Asthma – every 12th Russian. Allergy medications are among the most sought after in the world. Allergies and liver function are closely related. The cause of allergies is precisely in the violation of the liver’s detoxification of toxins and the initiation of immune reactions to “attack” one’s own body.Therefore, by suppressing the symptoms of allergies and loading the liver with medications, allergies cannot be cured. Although the antiallergic drugs themselves, in general, cause little damage to the liver. This is especially true for drugs of the latest generations, which are taken once a day. However, an allergy medication should be prescribed by a doctor and only after examination. This is an axiom.

Whatever you take, even safe valerian, remember: the liver is strong but vulnerable. Do not waste its resource by swallowing a handful of pills, a headache will hurt a little.Deal with the reason.

Who needs to be extremely careful with any medication?

The damage to the liver from taking drugs depends on several factors – the drug itself, the state of the body, and others.

A. Medicine – the longer you take it, the greater the harm. Therefore, if you have a chronic pathology, the doctor should choose the least toxic medicine for you. Toxicity is directly dose dependent. In addition, the route of administration is important: if the substance enters the blood immediately, the effect will be maximum.And, the more drugs – the more damage to the liver.

B. Health status – it is important, first of all, gender, age, genetic characteristics of the liver enzyme systems, and what diseases there are. The liver is most vulnerable in women, children under 3 years of age and in everyone over 40. Those who have suffered acute or have chronic liver disease – viral, autoimmune, toxic hepatitis, alcoholic liver disease, steatosis, diabetes, fibrosis, cirrhosis and others – also in the risk group for medicinal liver damage.If you are overweight, there is an excess of fat in the liver, which is more difficult to cope with the load due to fatty hepatosis.

Other factors

Pregnancy, chronic stress, dietary habits (irregular, lack of vitamins, protein, and a lot of saturated fats), alcohol – all this must be taken into account when prescribing medication.

For example, if you drink citrus juices with medicines, the toxicity of the medicines increases.Taking coffee along with a popular asthma medication can cause caffeine poisoning. Medicines can only be taken with plain water!

How to recognize a hazard when you are taking medication?

Are you taking medications, and weakness, nausea, appetite disappeared, urine became darker, feces lighter, and your skin turned yellow? Even one of these signs is a reason to see a doctor immediately. If you are taking medication for a long time, it makes sense to be examined periodically, even if nothing bothers you.This is the only way you will know in time how you can help your liver.

Here is a list of recommended examinations that will allow you to determine at an early stage whether the liver is healthy:

• examination and examination by a hepatologist
• analyzes: general blood and urine analysis, biochemistry: ALT, AST, GGTP, ALP, bilirubin, protein fractions , lipidogram, glycosylated hemoglobin
• examinations: ultrasound of the abdominal cavity and liver elastography

You can undergo an examination and find out everything about the condition of your liver and the risks of taking medications in just 1 day.If these data reveal deviations, it is worth doing a more detailed examination. Experienced specialists of the Polyclinic EXPERT are ready to give you maximum information about your condition. And also – a forecast of how your liver will feel further, and recommend competent treatment to protect it.

How to “cover” the liver?

Hepatoprotectors – drugs – “protectors” of the liver. They are able to eliminate the harmful effects of drugs.
Almost 700 such drugs are registered in Russia. They compensate for the deficiency of substances necessary to neutralize toxic metabolic products of drugs, prevent the destruction of cell membranes, eliminate inflammation, improve blood circulation in the liver and outflow of bile, slow down the development of fibrosis and reduce it.

There are several groups of drugs that restore liver health, undermined by drugs:

• silymarin preparations (from milk thistle)
• essential phospholipids
• preparations of other groups – ademetionine, bile acids, amino acids, glycyrrhizic acid combinations

Each of the drugs has its own indications and limitations. It is important to remember that only a competent doctor after the examination can prescribe the optimal course of treatment for your problem.

How to “cleanse” the liver?

You can often read advice on this topic on the Internet or listen to those who are engaged in such “cleansing” on a regular basis. Even in spite of the fact that hepatologists say: there is no “golden pill”. The liver is a unique and complex organ that cannot be cleaned, its functions are restored with a healthy lifestyle and the correct treatment of a specific problem.

Of course, there are drugs to improve liver function. But these are also medications, which means that in addition to benefits, they have contraindications and side effects.As with popular folk herbal recipes or dietary supplements. And if you use them incorrectly and not according to the testimony of a doctor, you can harm yourself.

Therefore, when and how to “cleanse the liver”, how to eat during “cleansing” – your hepatologist decides, based on your condition and examination results.

Remember: the liver does not hurt until the very last stages. Don’t push it to the extreme – the next time you take a pill for a headache or “prescribe” yourself an antibiotic, think about the liver.The hepatologists of the EXPERT gastro-hepatocenter are ready to help avoid danger.

SUMAMED – treatment of respiratory tract infections

Pliva’s stand at the Clinical Antibiotic Therapy conference

More than 20 years have passed since the scientific laboratories of the pharmaceutical company “Pliva” (Croatia) developed a new antibacterial drug of the macrolide class – azithromycin, which received the trade name SUMAMED.During this time, the drug has won truly worldwide recognition. It has proven itself in the treatment of various infectious diseases and is currently used in almost all regions of the world. In 1999, azithromycin was the most prescribed macrolide drug in the world (IMS Drug Monitor, 1999). Today, its sales exceed $ 1 billion (Balaji K. // Pharma.frost.com (Frost & Sullivan), 2002). Such wide popularity of SUMAMEDA is primarily due to its truly unique pharmacokinetic characteristics, which allows for effective short courses of antibiotic therapy for infections of the upper and lower respiratory tract, acute otitis media, urogenital chlamydial infection, skin diseases, Helicobacter pylori infection . Today in the world there is no other antibacterial drug that would be used for only 3 days in the treatment of community-acquired pneumonia, exacerbation of chronic bronchitis of bacterial etiology, acute otitis media. Moreover, the effectiveness of this dosing regimen is confirmed by the results of multicenter clinical trials (Gris P.J., 1996; Contopoulos-Ioannidis D. et al., 2001).

Despite a wide range of antibacterial drugs, the emergence of new effective drugs on the market, SUMAMED still occupies one of the leading places in the treatment of various infectious diseases and is recommended as a first-line drug for community-acquired pneumonia (Infections Diseases Society of America (IDSA) Guidelines, 2000; American Thoracic Society (ATS) Guidelines, 2001).

In this publication I would like to touch upon some issues of the use of SUMAMED in clinical practice.

EFFECTIVENESS OF MACROLIDES IN RESPIRATORY INFECTIONS

On October 3-4, 2002, the IV International Conference “Clinical Antibiotic Therapy” was held in the Main Military Clinical Hospital of the Ministry of Defense of Ukraine. As noted at the conference, the prevalence of respiratory tract infections, including community-acquired pneumonia and chronic bronchitis, remains very high (A.I., Beloborodov V.B., 2002). Macrolides are the drugs of choice in the treatment of community-acquired pneumonia. On the one hand, this is primarily due to their effectiveness and safety, on the other, the increasing importance of intracellular pathogens, which, along with pneumococcus, play a major role in the development of pneumonia (Beloborodov V.B., 2002).

SUMAMED ® azithromycin 3 days of administration provide a therapeutic effect, which lasts for 10 days Simple and convenient dosing regimen for 1 tablet 1 time per day for 3 days High efficiency and safety of treatment

According to many scientists, intracellular pathogens such as mycoplasma, legionella and chlamydia account for about 40% of all pneumonia cases (Patrick P.Gleason, 2000).

It was emphasized that laboratory methods for the detection of atypical pathogens are rarely used in outpatient practice due to their laboriousness, high cost, and, moreover, they do not give a quick result. Macrolides, especially new members of this class, such as azithromycin (SUMAMED) and clarithromycin, are highly active against intracellular microorganisms and pneumococcus, which is especially important when conducting empirical antibacterial therapy of community-acquired pneumonia (V.B., 2002). Hence, they have advantages over other classes of antibacterial drugs.

COMPLIANCE WITH THE DOCTOR’S REGULATIONS REGARDING THE RECEPTION OF MEDICINAL PREPARATIONS BY PATIENTS (COMPLIANCE)

Most patients with upper and lower respiratory tract infections are on outpatient treatment. Often, when the state of health improves or the symptoms of the disease disappear, usually after 2-5 days from the start of treatment, patients independently stop taking antibacterial agents (Pichichero M., 2001). Moreover, if the drug must be taken 2-3 times a day, then this regimen is observed by fewer patients than with the appointment once a day. Therefore, when choosing an antibacterial drug among the agents of a comparable spectrum of action, preference should be given to those of them that need to be taken once a day in short courses – no more than 3-5 days. This ensures that a complete course of therapy is carried out without the risk of clinical failure of treatment and the emergence of resistant bacterial strains.From this point of view, SUMAMED is still the only antibacterial drug recommended for a 3-day course of treatment for upper and lower respiratory tract infections (Price E., 1994; Gris P.J. 1996). In addition, due to the unique pharmacokinetic properties of the drug, the effect of the drug continues for 5-7 days after the end of its administration.

In conclusion, we present some excerpts from the works of foreign authors on rational antibiotic therapy in the treatment of respiratory infections.

“Empiric antibiotic therapy for community-acquired pneumonia should include an antibacterial drug that is active against atypical pathogens” (Patrick P. Gleason, 2002).

“Azithromycin is recommended by the American Thoracic Society (ATS) as the first line drug for the treatment of community-acquired pneumonia” (Guidelines for the Management of Adults with Community-Acquired Pneumonia, 2001).

“If untreated, exacerbations of chronic bronchitis can lead to progressive deterioration of lung function” (Christopher J., 2002).

“Long-term antibiotic therapy has a negative impact on patient compliance” (Klapan I. et al., 1999).

“While different antibiotic regimens are equally effective, the least difficult should be preferred” (Cockburn et al., 1987).

Based on materials provided by the Pliva representative office in Ukraine

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