Beamoxy Capsule 250 (A size 2, Maroon/Yellow, marked 'UPHA/BEAMOXY 250'
Beamoxy Capsule 500 (A size 0, Maroon/Yellow, marked 'UPHA/BEAMOXY
Beamoxy Tablet 250 (A capsule shape, scored, marked 'USP
250', yellow tablet)
Beamoxy Tablet 500 (A capsule shape, scored, marked 'UP/500',
Beamoxy Granules 125/Beamoxy Granules 250 (An almost white powder when
reconstituted forms a yellow, fruity flavoured, homogeneous suspension)
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
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:
• Biliary Tract Infections
• Uncomplicated Endocervical and Urethral Gonorrhoea (caused by susceptible
strains of Neisseria gonorrhoea)
• Acute Otitis Media
• Mouth Infections
• Urinary Tract Infections
• Gastro-enteritis (including E. Coli enteritis and Salmonella enteritis)
• Lyme Disease (early stages monotherapy and later stages in combination with
• 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.
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.
The usual adult dose is 250 - 500mg every 8 hours. The adult prescribing limit
is up to 4.5g a day.
|Severe or recurrent respiratory tract infections
||3g twice daily
|Uncomplicated endocervical and urethral gonorrhoea
||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
||250-500mg 3 or 4 times a day for 3 - 4 weeks.
|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
||6.7 - 13.3mg per kg of body weight every 8 hours for 10 - 30
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:
||125mg every 6 hours for 5 - 10 days
||250 - 500mg every 8 hours
||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.