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Beamoxy

DESCRIPTION

Beamoxy Capsule 250 (A size 2, Maroon/Yellow, marked 'UPHA/BEAMOXY 250' capsule)

Beamoxy Capsule 500 (A size 0, Maroon/Yellow, marked 'UPHA/BEAMOXY 500' capsule)

Beamoxy Tablet 250 (A capsule shape, scored, marked 'USP 250', yellow tablet)

Beamoxy Tablet 500 (A capsule shape, scored, marked 'UP/500', yellow tablet)
Beamoxy Granules 125/Beamoxy Granules 250 (An almost white powder when reconstituted forms a yellow, fruity flavoured, homogeneous suspension)

 

INDICATIONS
Amoxycillin is an aminopenicillin, which has activity against penicillin-sensitive gram-positive bacteria, as well as Escherichia coli, Proteus mirabilis, Salmonella sp., Shigella sp., and Haemophilus influenzae. However, many Enterobacteriacaea, H. Influenzae, Salmonella and Shigella species are resistant to this penicillin because of beta-lactamase production by these organisms. Amoxycillin can he administered orally for the treatment of the following caused by susceptible bacterial organisms:
Bronchitis
Biliary Tract Infections
Uncomplicated Endocervical and Urethral Gonorrhoea (caused by susceptible strains of Neisseria gonorrhoea)
Acute Otitis Media
Mouth Infections
Pharyngitis
Pneumonia
Sinusitis
Urinary Tract Infections
Gastro-enteritis (including E. Coli enteritis and Salmonella enteritis)
Lyme Disease (early stages monotherapy and later stages in combination with prohenecid)
Typhoid Fever


Amoxycillin is a possible alternative to erythromycin, for chlamydial infections in pregnant women.

 

Amoxycillin is also indicated as prophylaxis for spleen disorders (pneumococcal infection) and bacterial endocarditis and adjunct for Helicobacter pylori-associated peptic ulcer.

 

MECHANISMS OF ACTION
Amoxycillin is bactericidal and acts by inhibiting bacterial cell wall synthesis. Its action is dependent on its ability to reach and bind penicillin-binding proteins (PBPs) located on the inner membrane of the bacterial cell wall. PBPs are enzymes responsible for the assembling and reshaping of the bacterial cell wall during growth and division. PBPs inactivation by amoxycillin results in the weakening and lysis of the bacterial cell wall.

 

PHARMACOLOGY
Amoxycillin is fairly well absorbed from the GIT It is more rapidly and more completely absorbed than ampicillin orally. Amoxycillin is acid-stable. Peak plasma concentrations of about 5 microgram per ml have been observed 1-2 hours after a dose of 250mg, with detectable amounts present for up to 8 hours. Doubling the dose can double the concentration. Total amount absorbed is not significantly affected by food. About 20% is plasma protein bound. The plasma half-life is about 1-1.5 hours and this increases in renal failure, neonates and the elderly. Amoxycillin is widely distributed at varying concentrations in body tissues and fluids, including peritoneal fluid, blister fluid, pleural fluid, middle ear fluid, intestinal mucosa, bone, gallbladder, urine(high concentrations), lung, female reproductive tissue and bile. It crosses the placenta and small amounts are excreted in breast milk. Little amoxycillin passes into the CSF unless the meninges are inflamed. Amoxycillin is metabolised to a limited extent to penicilloic acid which is excreted in the urine. About 60% of an oral dose is excreted unchanged in the urine in 6 hours by glomerular filtration and tubular secretion; urinary concentrations above 300 microgram per ml have been reported after a dose of 250mg. High concentrations have been reported in bile; some may he excreted in the faeces.

 

DOSAGE
The usual adult dose is 250 - 500mg every 8 hours. The adult prescribing limit is up to 4.5g a day.

Adults:

Severe or recurrent respiratory tract infections 3g twice daily
Uncomplicated endocervical and urethral gonorrhoea (gonococci-sensitive) Single dose of 3g with probenecid 1g
Dental abscesses/Uncomplicated urinary tract infections A dose of 3g repeated once after 8 or 10 to 12 hours
Chlamydia (in pregnant women) 500mg 4 times a day or 750mg 3 times a day for 7 to 10 days
Prophylaxis of endocarditis 3 g one hour before dental procedures under local or no anaesthesia then 1.5g 6 hours after the initial dose
Helicobacter pylori associated gastritis or peptic ulcer 500mg 4 times a day or 750mg 3 times a day
Lyme disease 250-500mg 3 or 4 times a day for 3 - 4 weeks.

 

Children:

Children up to 10 years 125 - 250mg every 8 hours
Children under 20kg body-weight 20 - 40 per kg daily
Otitis media (children 3 - 10 years ) 750mg twice daily for days
Uncomplicated endocervical and urethral gonorrhoea 50mg per kg of body weight and 24mg of probenecid per kg of body weight simultaneously as a single dose in prepubertal children
Lyme disease 6.7 - 13.3mg per kg of body weight every 8 hours for 10 - 30 days

 

OVERDOSAGE
There is no specific antidote, treatment of amoxycillin overdose should be symptomatic and supportive. Amoxycillin may be removed from circulation by haemodialysis. Serious hypersensitivity reactions have been reported in patients on penicillin therapy. Serious anaphylactic reactions require immediate emergency treatment with parenteral epinephrine, oxygen, intravenous corticosteroids or air management (including inTubation).


For Clostridium difficile colitis, mild cases may respond to discontinuation of the medication alone. Moderate to severe cases may require fluid, electrolyte, and protein replacement. In cases not responding to the above measures, oral doses of the following may be used:

 

Vancomycin 125mg every 6 hours for 5 - 10 days
Metronidazole 250 - 500mg every 8 hours
Cholestyramine 4g four times a day


If diarrhoea occurs, administration of antiperistaltic antidiarrhoeals (e.g. opioids, diphenoxylate and atropine combination, loperamide, paregoric) is not recommended since they may delay the removal of toxins from the colon, thereby prolonging and/ or worsening the condition.


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