Avloclav BID

Indications

Co-amoxiclav is prescribed for the short-term treatment of bacterial infections in various body parts, including:

• Upper Respiratory Tract Infections: Such as tonsillitis, sinusitis, and otitis media.
• Lower Respiratory Tract Infections: Including acute and chronic bronchitis, as well as lobar and bronchopneumonia.
• Genito-urinary Tract Infections: Like cystitis, urethritis, and pyelonephritis.
• Skin and Soft Tissue Infections.
• Bone and Joint Infections: Including osteomyelitis.
• Other Infections: Such as septic abortion, puerperal sepsis, and intra-abdominal infections.

Always use as prescribed by a registered healthcare professional.

Composition

Co-amoxiclav is available in various forms and strengths:

• 375 mg Tablet: Contains 250 mg Amoxicillin as Amoxicillin Trihydrate BP and 125 mg Clavulanic Acid as Diluted Potassium Clavulanate BP.
• 625 mg Tablet: Contains 500 mg Amoxicillin as Amoxicillin Trihydrate BP and 125 mg Clavulanic Acid as Diluted Potassium Clavulanate BP.
• 1 gm Tablet: Contains 875 mg Amoxicillin as Amoxicillin Trihydrate BP and 125 mg Clavulanic Acid as Diluted Potassium Clavulanate BP.
• Powder for Suspension:
  • Regular: Each 5 ml contains 125 mg Amoxicillin and 31.25 mg Clavulanic Acid.
  • Forte: Each 5 ml contains 400 mg Amoxicillin and 57.5 mg Clavulanic Acid.
• 1.2 gm Injection: Contains Amoxicillin Sodium (equivalent to 1 gm Amoxicillin) and Clavulanate Potassium (equivalent to 200 mg Clavulanic Acid).
• 0.6 gm Injection: Contains Amoxicillin Sodium (equivalent to 500 mg Amoxicillin) and Clavulanate Potassium (equivalent to 100 mg Clavulanic Acid).

Pharmacology

• Pharmacodynamics: Co-amoxiclav combines Amoxicillin, a broad-spectrum antibiotic, with Clavulanic Acid, a beta-lactamase inhibitor. This combination protects Amoxicillin from degradation by beta-lactamase enzymes produced by resistant bacteria, effectively extending the antibiotic’s range to fight both gram-positive and gram-negative organisms.
• Pharmacokinetics: Both Amoxicillin and Clavulanic Acid reach peak serum levels about one hour after oral administration. Absorption is optimized when taken at the start of a meal. Both components are minimally bound to serum proteins, leaving around 70% of the drugs free in the bloodstream. Doubling the dose of Co-amoxiclav doubles the serum concentration.

Dosage

Adults and Children over 12 years:

• Tablets:
  • 625 mg: One tablet every 12 hours or one 375 mg tablet every 8 hours.
  • For more severe infections, the dosage may be increased to one 1 gm tablet every 12 hours or one 625 mg tablet every 8 hours.
• Suspension:
  • Children (6-12 years): 2 teaspoonfuls every 8 hours.
  • Children (1-6 years): 1 teaspoonful every 8 hours.
  • Children under 1 year: 25 mg/kg/day, divided into doses every 8 hours. (e.g., a 7.5 kg child requires 2 ml of suspension three times a day.)
• Forte Suspension (for serious infections):
  • Children (2-12 years):
    • Mild to moderate infections: 25/3.6 mg/kg/day.
    • Serious infections: 45/6.4 mg/kg/day.
• IV Injection:
  • Adults: Usually 1.2 gm every 8 hours. For severe infections, increase to 1.2 gm every 6 hours.
  • Surgical Prophylaxis: 1.2 gm at induction, with up to 2-3 gm every 8 hours for high-risk surgeries.
  • Children:
    • 0-3 months: 30 mg/kg every 8 hours.
    • 3 months-12 years: 30 mg/kg every 8 hours, increasing to every 6 hours for serious infections.

Always follow the advice of your healthcare professional.

Administration

• Oral Dosage: Co-amoxiclav may be taken with or without food, although it is best absorbed when taken with a meal. To minimize gastrointestinal side effects, it is recommended to take it at the beginning of a meal.
• IV Injection: Not suitable for intramuscular or subcutaneous use. Reconstitute with 20 ml Water for Injection BP. The injection can be given intravenously either by a 2-minute injection or slow intravenous infusion over 30 minutes. Discard any unused material after 20 minutes.

Drug Interactions

• Bleeding Time: Co-amoxiclav may prolong bleeding time and prothrombin time in some patients.
• Oral Contraceptives: Co-amoxiclav may reduce the effectiveness of oral contraceptives.
• Allopurinol: When combined with amoxicillin, it may increase the likelihood of skin allergies.

Contraindications

• Penicillin Hypersensitivity: Do not use if you have a history of hypersensitivity to penicillins or beta-lactam antibiotics.
• Liver Issues: Not recommended for individuals with a history of penicillin-associated cholestatic jaundice.

Side Effects

Common side effects may include mild gastrointestinal symptoms such as diarrhea, nausea, and indigestion. Rare but serious side effects include liver issues, skin rashes, angioedema, and anaphylaxis.

Pregnancy & Lactation

Co-amoxiclav is considered safe for use during pregnancy only when absolutely necessary. Small amounts of Amoxicillin are excreted in breast milk, so caution is advised during lactation.

Precautions & Warnings

• Renal or Hepatic Impairment: Dosage adjustments may be necessary for patients with moderate or severe renal or hepatic dysfunction.
• Crystalluria: Ensure adequate fluid intake to reduce the risk of crystalluria when using high doses of Co-amoxiclav.

Overdose Effects

Co-amoxiclav overdose is rare, but symptoms may include gastrointestinal issues. In case of overdose, appropriate treatment should be sought, and the drug may be removed through hemodialysis.

Therapeutic Class

Broad-Spectrum Penicillins.

Storage Conditions

Store below 25°C, protected from light and moisture. After reconstitution, the suspension should be refrigerated (not frozen) and used within 7 days. IV injections should be used within 20 minutes of reconstitution.