How is amoxicillin dispensed

Aspirin, ASA; Oxycodone: Minor Due to the high protein binding of aspirin, it could displace or be displaced from binding sites by other highly protein-bound drugs, such as penicillins. Aspirin, ASA; Pravastatin: Minor Due to the high protein binding of aspirin, it could displace or be displaced from binding sites by other highly protein-bound drugs, such as penicillins.

Choline Salicylate; Magnesium Salicylate: Minor Due to high protein binding, salicylates could be displaced from binding sites, or could displace other highly protein-bound drugs such as penicillins, and sulfonamides. Colchicine; Probenecid: Minor Probenecid competitively inhibits renal tubular secretion and causes higher, prolonged serum levels of penicillins. In general, this pharmacokinetic interaction is not harmful and can be used therapeutically if needed.

Dichlorphenamide: Moderate Use dichlorphenamide and amoxicillin together with caution. Dichlorphenamide increases potassium excretion and can cause hypokalemia and should be used cautiously with other drugs that may cause hypokalemia including amoxicillin. Measure potassium concentrations at baseline and periodically during dichlorphenamide treatment. If hypokalemia occurs or persists, consider reducing the dose or discontinuing dichlorphenamide therapy. Dienogest; Estradiol valerate: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.

It was previously thought that antibiotics may decrease the effectiveness of OCs containing estrogens due to stimulation of metabolism or a reduction in enterohepatic circulation via changes in GI flora. One retrospective study reviewed the literature to determine the effects of oral antibiotics on the pharmacokinetics of contraceptive estrogens and progestins, and also examined clinical studies in which the incidence of pregnancy with OCs and antibiotics was reported.

It was concluded that the antibiotics ampicillin, ciprofloxacin, clarithromycin, doxycycline, metronidazole, ofloxacin, roxithromycin, temafloxacin, and tetracycline did not alter plasma concentrations of OCs. Antituberculous drugs e. Based on the study results, these authors recommended that back-up contraception may not be necessary if OCs are used reliably during oral antibiotic use.

Another review concurred with these data, but noted that individual patients have been identified who experienced significant decreases in plasma concentrations of combined OC components and who appeared to ovulate; the agents most often associated with these changes were rifampin, tetracyclines, and penicillin derivatives. These authors concluded that because females most at risk for OC failure or noncompliance may not be easily identified and the true incidence of such events may be under-reported, and given the serious consequence of unwanted pregnancy, that recommending an additional method of contraception during short-term antibiotic use may be justified.

During long-term antibiotic administration, the risk for drug interaction with OCs is less clear, but alternative or additional contraception may be advisable in selected circumstances. Data regarding progestin-only contraceptives or for newer combined contraceptive deliveries e. Digoxin: Minor Displacement of penicillins from plasma protein binding sites by highly protein bound drugs like digoxin will elevate the level of free penicillin in the serum.

The clinical significance of this interaction is unclear. It is recommended to monitor these patients for increased adverse effects. Drospirenone: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.

Drospirenone; Estradiol: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.

Drospirenone; Ethinyl Estradiol: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Drospirenone; Ethinyl Estradiol; Levomefolate: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Erythromycin; Sulfisoxazole: Minor Sulfonamides may compete with amoxicillin for renal tubular secretion, increasing amoxicillin serum concentrations.

Use this combination with caution, and monitor patients for increased side effects. Estradiol; Levonorgestrel: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.

Estradiol; Norethindrone: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Estradiol; Norgestimate: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.

Ethacrynic Acid: Minor Ethacrynic acid may compete with penicillin for renal tubular secretion, increasing penicillin serum concentrations. This combination should be used with caution and patients monitored for increased side effects. Ethinyl Estradiol: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.

Ethinyl Estradiol; Desogestrel: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Ethinyl Estradiol; Ethynodiol Diacetate: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Ethinyl Estradiol; Etonogestrel: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.

Ethinyl Estradiol; Levonorgestrel: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.

Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Ethinyl Estradiol; Norelgestromin: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Ethinyl Estradiol; Norethindrone Acetate: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.

Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.

Ethinyl Estradiol; Norethindrone: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Ethinyl Estradiol; Norethindrone; Ferrous fumarate: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.

Ethinyl Estradiol; Norgestimate: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Ethinyl Estradiol; Norgestrel: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Furosemide: Minor Furosemide may compete with penicillin for renal tubular secretion, increasing penicillin serum concentrations.

Indomethacin: Minor Indomethacin may compete with penicillin for renal tubular secretion, increasing penicillin serum concentrations. Lesinurad; Allopurinol: Minor Use of amoxicillin with allopurinol can increase the incidence of drug-related skin rash. Leuprolide; Norethindrone: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.

Levonorgestrel: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.

Magnesium Salicylate: Minor Due to high protein binding, salicylates could be displaced from binding sites, or could displace other highly protein-bound drugs such as penicillins, and sulfonamides. Mestranol; Norethindrone: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Methotrexate: Major Penicillins may reduce the renal clearance of methotrexate. Increased serum concentrations of methotrexate with concomitant hematologic and gastrointestinal toxicity have been observed with concurrent administration of high or low doses of methotrexate and penicillins.

Patients should be carefully monitored while receiving this combination. Mycophenolate: Moderate Drugs that alter the gastrointestinal flora may interact with mycophenolate by disrupting enterohepatic recirculation. Amoxicillin;Clavulanic Acid may decrease normal GI flora levels and thus lead to less free mycophenolate available for absorption. The effect of amoxicillin without clavulantic acid on mycophenolate kinetics is unclear. Norethindrone: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.

Norgestrel: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Oral Contraceptives: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Probenecid: Minor Probenecid competitively inhibits renal tubular secretion and causes higher, prolonged serum levels of penicillins.

Pyrimethamine; Sulfadoxine: Minor Sulfonamides may compete with amoxicillin for renal tubular secretion, increasing amoxicillin serum concentrations. Salsalate: Minor Due to high protein binding, salicylates could be displaced from binding sites or could displace other highly protein-bound drugs such as penicillins. Segesterone Acetate; Ethinyl Estradiol: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.

Sodium Benzoate; Sodium Phenylacetate: Moderate Antibiotics that undergo tubular secretion such as penicillins may compete with phenylacetlyglutamine and hippuric acid for active tubular secretion.

The overall usefulness of sodium benzoate; sodium phenylacetate is due to the excretion of its metabolites. An increase in metabolite concentrations could contribute to failed treatment and worsening of the patient's clinical status. This combination should be used with caution. Sodium picosulfate; Magnesium oxide; Anhydrous citric acid: Major Prior or concomitant use of antibiotics with sodium picosulfate; magnesium oxide; anhydrous citric acid may reduce efficacy of the bowel preparation as conversion of sodium picosulfate to its active metabolite bis- p-hydroxy-phenyl -pyridylmethane BHPM is mediated by colonic bacteria.

If possible, avoid coadministration. Certain antibiotics i. Therefore, these antibiotics should be taken at least 2 hours before and not less than 6 hours after the administration of sodium picosulfate; magnesium oxide; anhydrous citric acid solution.

Sulfadiazine: Minor Sulfonamides may compete with amoxicillin for renal tubular secretion, increasing amoxicillin serum concentrations. Sulfasalazine: Minor Sulfonamides may compete with amoxicillin for renal tubular secretion, increasing amoxicillin serum concentrations.

Sulfisoxazole: Minor Sulfonamides may compete with amoxicillin for renal tubular secretion, increasing amoxicillin serum concentrations. Sulfonamides: Minor Sulfonamides may compete with amoxicillin for renal tubular secretion, increasing amoxicillin serum concentrations. Tetracyclines: Major Avoid the coadministration of tetracycline antibiotics with penicillins as tetracyclines may interfere with the bactericidal action of penicillins. Typhoid Vaccine: Major Antibiotics which possess bacterial activity against salmonella typhi organisms may interfere with the immunological response to the live typhoid vaccine.

Allow 24 hours or more to elapse between the administration of the last dose of the antibiotic and the live typhoid vaccine. Warfarin: Moderate The concomitant use of warfarin with many classes of antibiotics, including penicillins, may result in an increased INR thereby potentiating the risk for bleeding. Inhibition of vitamin K synthesis due to alterations in the intestinal flora may be a mechanism; however, concurrent infection is also a potential risk factor for elevated INR.

Monitor patients for signs and symptoms of bleeding. Additionally, increased monitoring of the INR, especially during initiation and upon discontinuation of the antibiotic, may be necessary. Beta-lactam antibiotics such as amoxicillin are mainly bactericidal. Like other penicillins, amoxicillin inhibits the third and final stage of bacterial cell wall synthesis by preferentially binding to specific penicillin-binding proteins PBPs that are located inside the bacterial cell wall.

Penicillin-binding proteins are responsible for several steps in the synthesis of the cell wall and are found in quantities of several hundred to several thousand molecules per bacterial cell. Penicillin-binding proteins vary among different bacterial species. Thus, the intrinisic activity of amoxicillin, as well as the other penicillins, against a particular organism depends on their ability to gain access to and bind with the necessary PBP.

The aminopenicillins are able to penetrate gram-negative bacteria more readily than are the natural penicillins or penicillinase-resistant penicillins due to the presence of a free amino group within the structure. Like all beta-lactam antibiotics, amoxicillin's ability to interfere with PBP-mediated cell wall synthesis ultimately leads to cell lysis.

Lysis is mediated by bacterial cell wall autolytic enzymes i. The relationship between PBPs and autolysins is unclear, but it is possible that the beta-lactam antibiotic interferes with an autolysin inhibitor. Penicillin-resistant strains of S. The mechanism of resistance is mediated via the development of altered PBPs and the penicillin-resistant strains will generally be resistant to amoxicillin. The addition of clavulanic acid does not overcome this type of resistance. Increased dosages of amoxicillin may be necessary to overcome resistant S.

Community resistance patterns may determine the likelyhood of amoxicillin efficacy against S. Amoxicillin is administered orally. Amoxicillin is widely distributed into most body tissues and fluids, excluding the brain and spinal fluid except when meninges are inflamed. Amoxicillin does cross the placenta. A small percentage is excreted in breast milk. The unchanged drug and its metabolites are excreted into the urine primarily via tubular secretion and glomerular filtration.

In patients with normal renal function, the elimination half-life of amoxicillin is 1 to 1. Affected cytochrome P isoenzymes: none. Amoxicillin is stable against gastric acid and is rapidly absorbed.

Amoxicillin is more completely absorbed than ampicillin and, for this reason, is often the preferred oral aminopenicillin. Immediate-release formulations Peak concentrations are reached 1 to 2 hours after administration. Extended-release formulation Administration of the extended-release formulation results in slower amoxicillin absorption compared to immediate-release products; peak concentrations are reached approximately 3 hours after administration.

Amoxicillin exposure AUC achieved with the extended-release formulation is similar to that observed after oral administration of a comparable dose of immediate-release amoxicillin suspension.

Food decreases the rate, but does not alter the extent of absorption. PDR Search. Required field. Your Name Your name is required. Recipient's Email Separate multiple email address with a comma Please enter valid email address Recipient's email is required. Thank you. Your email has been sent. Jump to Section. Related Drug Information Drug Summary. Oral dosage Moxatag mg extended-release tablets.

Adults, Adolescents, and Children 12 years and older. Oral dosage immediate-release. Infants, Children, and Adolescents. However, the American Academy of Pediatrics AAP considers amoxicillin an option for children 2 years and older with uncomplicated disease in which antimicrobial resistance is not suspected. Children with moderate to severe disease, attending daycare, or who have recently been treated with antimicrobial therapy should receive high-dose amoxicillin; clavulanic acid.

Children and Adolescents 2 years and older standard-dose therapy. Children and Adolescents 2 years and older high-dose therapy. Children younger than 2 years. Infants older than 3 months, Children, and Adolescents.

Neonates and Infants 3 months and younger. For the treatment of acute otitis media. Re-evaluate patients failing to respond within 48 to 72 hours. Amoxicillin; clavulanate is the preferred therapy for children who have received amoxicillin within the past 30 days, who have purulent conjunctivitis, or who have a history of recurrent acute otitis media unresponsive to amoxicillin.

Infants, Children, and Adolescents 6 months to 17 years. Infants 4 to 5 months. Infants 1 to 3 months. For the treatment of skin and skin structure infections e. For mild to moderate infections caused by highly susceptible organisms. For severe infections or infections caused by less susceptible organisms.

For the treatment of nonspecific lower respiratory tract infections LRTIs. Infants, Children, and Adolescents 4 months to 17 years. Neonates and Infants 1 to 3 months. For the treatment of community-acquired pneumonia CAP. Infants and Children 4 months to 12 years. For the treatment of urinary tract infection UTI including cystitis. The American Academy of Pediatrics AAP states that routine antimicrobial prophylaxis for patients 2 to 24 months with vesicoureteral reflux is not supported by currently available data; however, antimicrobial prophylaxis is still utilized and has biological plausibility.

Further research is needed. Amoxicillin is not recommended beyond 2 months of age due to resistance concerns. Sulfamethoxazole; trimethoprim or nitrofurantoin are preferred agents for infants 2 months and older.

Neonates and Infants younger than 2 months. Children and Adolescents. Amoxicillin is similar to ampicillin in its bactericidal action against susceptible organisms during the stage of active multiplication.

It acts through the inhibition of biosynthesis of cell wall mucopeptide. Quantitative methods are used to determine antimicrobial minimum inhibitory concentrations MICs.

These MICs provide estimates of the susceptibility of bacteria to antimicrobial compounds. The MICs should be determined using a standardized procedure. Standardized procedures are based on a dilution method 1 broth or agar or equivalent with standardized inoculum concentrations and standardized concentrations of ampicillin powder. Ampicillin is sometimes used to predict susceptibility of S. Therefore, S.

The MIC values should be interpreted according to the following criteria:. NOTE : These interpretive criteria are based on the recommended doses for respiratory tract infections. This category implies possible clinical applicability in body sites where the drug is physiologically concentrated or in situations where high dosage of drug can be used. This category also provides a buffer zone, which prevents small uncontrolled technical factors from causing major discrepancies in interpretation.

Standardized susceptibility test procedures require the use of laboratory control microorganisms to control the technical aspects of the laboratory procedures.

Standard ampicillin powder should provide the following MIC values:. Quantitative methods that require measurement of zone diameters also provide reproducible estimates of the susceptibility of bacteria to antimicrobial compounds. One such standardized procedure 2 requires the use of standardized inoculum concentrations. This procedure uses paper disks impregnated with 10 mcg ampicillin to test the susceptibility of microorganisms, except S.

Interpretation involves correlation of the diameter obtained in the disk test with the MIC for ampicillin. Reports from the laboratory providing results of the standard single-disk susceptibility test with a 10 mcg ampicillin disk should be interpreted according to the following criteria:. An amoxicillin MIC should be determined on isolates of S. As with standard dilution techniques, disk diffusion susceptibility test procedures require the use of laboratory control microorganisms.

The 10 mcg ampicillin disk should provide the following zone diameters in these laboratory test quality control strains:. In vitro susceptibility testing methods and diagnostic products currently available for determining minimum inhibitory concentrations MICs and zone sizes have not been standardized, validated, or approved for testing H.

Culture and susceptibility testing should be obtained in patients who fail triple therapy. If clarithromycin resistance is found, a non-clarithromycin-containing regimen should be used. Infections of the ear, nose, and throat - due to Streptococcus spp. Infections of the genitourinary tract - due to E. Infections of the skin and skin structure - due to Streptococcus spp. Infections of the lower respiratory tract - due to Streptococcus spp. Gonorrhea, acute uncomplicated ano-genital and urethral infections - due to N.

Amoxicillin, in combination with clarithromycin plus lansoprazole as triple therapy, is indicated for the treatment of patients with H. Eradication of H. Amoxicillin, in combination with lansoprazole delayed-release capsules as dual therapy, is indicated for the treatment of patients with H.

To reduce the development of drug-resistant bacteria and maintain the effectiveness of amoxicillin capsules, amoxicillin for oral suspension, amoxicillin tablets chewable , and other antibacterial drugs, amoxicillin capsules, amoxicillin for oral suspension, and amoxicillin tablets chewable should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy.

In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy. Clostridium difficile associated diarrhea CDAD has been reported with use of nearly all antibacterial agents, including amoxicillin capsules, amoxicillin for oral suspension, or amoxicillin tablets chewable , and may range in severity from mild diarrhea to fatal colitis.

Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. Hypertoxin producing strains of C. CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents.

Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. The possibility of superinfections with mycotic or bacterial pathogens should be kept in mind during therapy. If superinfections occur, amoxicillin should be discontinued and appropriate therapy instituted.

A high percentage of patients with mononucleosis who receive ampicillin develop an erythematous skin rash. Thus, ampicillin-class antibiotics should not be administered to patients with mononucleosis. Prescribing amoxicillin capsules, amoxicillin for oral suspension, or amoxicillin tablets chewable in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.

As with any potent drug, periodic assessment of renal, hepatic, and hematopoietic function should be made during prolonged therapy. All patients with gonorrhea should have a serologic test for syphilis at the time of diagnosis.

Patients treated with amoxicillin should have a follow-up serologic test for syphilis after 3 months. Probenecid decreases the renal tubular secretion of amoxicillin.

Concurrent use of amoxicillin and probenecid may result in increased and prolonged blood levels of amoxicillin. Chloramphenicol, macrolides, sulfonamides, and tetracyclines may interfere with the bactericidal effects of penicillin.

This has been demonstrated in vitro ; however, the clinical significance of this interaction is not well documented. Following administration of ampicillin to pregnant women, a transient decrease in plasma concentration of total conjugated estriol, estriol-glucuronide, conjugated estrone, and estradiol has been noted.

This effect may also occur with amoxicillin. Long-term studies in animals have not been performed to evaluate carcinogenic potential. Studies to detect mutagenic potential of amoxicillin alone have not been conducted; however, the following information is available from tests on a mixture of amoxicillin and potassium clavulanate. Amoxicillin and potassium clavulanate was non-mutagenic in the Ames bacterial mutation assay, and the yeast gene conversion assay.

Amoxicillin and potassium clavulanate was weakly positive in the mouse lymphoma assay, but the trend toward increased mutation frequencies in this assay occurred at doses that were also associated with decreased cell survival.

Amoxicillin and potassium clavulanate was negative in the mouse micronucleus test, and in the dominant lethal assay in mice. Potassium clavulanate alone was tested in the Ames bacterial mutation assay and in the mouse micronucleus test, and was negative in each of these assays.

Reproduction studies have been performed in mice and rats at doses up to 10 times the human dose and have revealed no evidence of impaired fertility or harm to the fetus due to amoxicillin. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Oral ampicillin-class antibiotics are poorly absorbed during labor.

Studies in guinea pigs showed that intravenous administration of ampicillin slightly decreased the uterine tone and frequency of contractions but moderately increased the height and duration of contractions. However, it is not known whether use of amoxicillin in humans during labor or delivery has immediate or delayed adverse effects on the fetus, prolongs the duration of labor, or increases the likelihood that forceps delivery or other obstetrical intervention or resuscitation of the newborn will be necessary.

Penicillins have been shown to be excreted in human milk. Amoxicillin use by nursing mothers may lead to sensitization of infants. Caution should be exercised when amoxicillin is administered to a nursing woman. Because of incompletely developed renal function in neonates and young infants, the elimination of amoxicillin may be delayed. An analysis of clinical studies of amoxicillin was conducted to determine whether subjects aged 65 and over respond differently from younger subjects.

This analysis and other reported clinical experience have not identified differences in responses between the elderly and younger patients, but a greater sensitivity of some older individuals cannot be ruled out. This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.

Amoxicillin may be taken every 8 hours or every 12 hours, depending on the strength of the product prescribed. Patients should be counseled that antibacterial drugs, including amoxicillin capsules, amoxicillin for oral suspension, and amoxicillin tablets chewable , should only be used to treat bacterial infections.

They do not treat viral infections e. When amoxicillin capsules, amoxicillin for oral suspension, or amoxicillin tablets chewable are prescribed to treat a bacterial infection, patients should be told that although it is common to feel better early in the course of therapy, the medication should be taken exactly as directed.

Skipping doses or not completing the full course of therapy may: 1 decrease the effectiveness of the immediate treatment, and 2 increase the likelihood that bacteria will develop resistance and will not be treatable by amoxicillin capsules, amoxicillin for oral suspension, amoxicillin tablets chewable or other antibacterial drugs in the future.

Diarrhea is a common problem caused by antibiotics which usually ends when the antibiotic is discontinued. Sometimes after starting treatment with antibiotics, patients can develop watery and bloody stools with or without stomach cramps and fever even as late as 2 or more months after having taken the last dose of the antibiotic. If this occurs, patients should contact their physician as soon as possible. As with other penicillins, it may be expected that untoward reactions will be essentially limited to sensitivity phenomena.

They are more likely to occur in individuals who have previously demonstrated hypersensitivity to penicillins and in those with a history of allergy, asthma, hay fever, or urticaria. The following adverse reactions have been reported as associated with the use of penicillins:.

Serum sickness-like reactions, erythematous maculopapular rashes, erythema multiforme, Stevens-Johnson syndrome, exfoliative dermatitis, toxic epidermal necrolysis, acute generalized exanthematous pustulosis, hypersensitivity vasculitis and urticaria have been reported. NOTE: These hypersensitivity reactions may be controlled with antihistamines and, if necessary, systemic corticosteroids.

Whenever such reactions occur, amoxicillin should be discontinued unless, in the opinion of the physician, the condition being treated is life-threatening and amenable only to amoxicillin therapy. Hepatic dysfunction including cholestatic jaundice, hepatic cholestasis and acute cytolytic hepatitis have been reported. Hemic and Lymphatic Systems: Anemia, including hemolytic anemia, thrombocytopenia, thrombocytopenic purpura, eosinophilia, leukopenia, and agranulocytosis have been reported during therapy with penicillins.