Drug information of FARMENTIN

FARMENTIN

Drug group:

Amoxicillin/clavulanic acid, also known as co-amoxiclav, is an antibiotic useful for the treatment of a number of bacterial infections. It is a combination consisting of amoxicillin, a β-lactam antibiotic, and potassium clavulanate, a β-lactamase inhibitor

Mechanism of effect

Clavulanic acid binds and inhibits beta-lactamases that inactivate amoxicillin resulting in amoxicillin having an expanded spectrum of activity. Amoxicillin inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs) which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested

Pharmacodynamic

Protein binding: ~25%

Pharmacokinetics

Distribution: Readily into liver, lungs, prostate, muscle, middle ear effusions, maxillary sinus secretions, bone, gallbladder, bile, and into ascitic and synovial fluids; poor CSF penetration (except when meninges are inflamed)
Protein binding: ~20%
Half-life elimination: Adults: Immediate-release: 61.3 minutes; Extended-release: 90 minutes
Time to peak: Capsule, oral suspension: 1 to 2 hours; Chewable tablet: 1 hour; Extended-release: 3.1 hours
Excretion: Urine (60% as unchanged drug) lower in neonates

Drug indications

pneumonia , Bronchopulmonary Dysplasia

 Rhinosinusitis, acute bacterial
Skin and skin structure infections
Urinary tract infections   
Bite Wound 
Pneumonia
   Otitis media

Dosage

4:1 formulation: 20 to 40 mg amoxicillin/kg/day in divided doses 3 times daily; maximum daily dose: 1,500 mg/day.
7:1 formulation: 25 to 45 mg amoxicillin/kg/day in divided doses twice daily; maximum daily dose: 1,750 mg/day.
14:1 formulation: 90 mg amoxicillin/kg/day in divided doses twice daily; maximum daily dose: 4,000 mg/day.
Extended-release formulation (16:1): Children and Adolescents >40 kg: Oral: 2,000 mg amoxicillin every 12 hours.

Side effects

Diarrhea , Headache , abdominal pain , vomiting , Diarrhea , skin rush , vaginitis

 Gastrointestinal: Diarrhea 
Dermatologic: Diaper rash, skin rash, urticaria
Gastrointestinal: Abdominal distress, loose stools, nausea, vomiting
Genitourinary: Vaginitis
Infection: Candidiasis, vaginal mycosis

Acemetacin: May increase the serum concentration of Penicillins. Risk C: Monitor therapy
Allopurinol: May enhance the potential for allergic or hypersensitivity reactions to Amoxicillin. Risk C: Monitor therapy
BCG (Intravesical): Antibiotics may diminish the therapeutic effect of BCG (Intravesical). Risk X: Avoid combination
BCG Vaccine (Immunization): Antibiotics may diminish the therapeutic effect of BCG Vaccine (Immunization). Risk C: Monitor therapy
Cholera Vaccine: Antibiotics may diminish the therapeutic effect of Cholera Vaccine. Management: Avoid cholera vaccine in patients receiving systemic antibiotics, and within 14 days following the use of oral or parenteral antibiotics. Risk X: Avoid combination
Dichlorphenamide: Penicillins may enhance the hypokalemic effect of Dichlorphenamide. Risk C: Monitor therapy
Lactobacillus and Estriol: Antibiotics may diminish the therapeutic effect of Lactobacillus and Estriol. Risk C: Monitor therapy
Methotrexate: Penicillins may increase the serum concentration of Methotrexate. Risk C: Monitor therapy

Alerts

Epstein-Barr virus infection (infectious mononucleosis), acute lymphocytic leukemia, or cytomegalovirus infection increase risk for penicillin-induced maculopapular rash. Appearance of a rash should be carefully evaluated to differentiate a nonallergic ampicillin rash from a hypersensitivity reaction; rash occurs in 5% to 10% of children and is a generalized dull red, maculopapular rash, generally appearing 3 to 14 days after the start of

therapy. It normally begins on the trunk and spreads over most of the body. It may be most intense at pressure areas, elbows, and knees. A high percentage (43% to 100%) of patients with infectious mononucleosis have developed rash during therapy; ampicillin-class antibiotics are not recommended in these patients.

Points of recommendation

  •  If you have an allergy to amoxicillin, clavulanate potassium, any penicillin, or any other part of this drug.
  •  If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
  •  If you have kidney disease.
  •  If you have turned yellow or had liver side effects with this drug before.
  •  If you have mono.
  •  If you are taking probenecid.
  • This is not a list of all drugs or health problems that interact with this drug.
  • Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor

Pregnancy level

B

Breast feeding warning

Amoxicillin is present in breast milk following administration amoxicillin/clavulanate

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