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Amoxicillin comes as a capsule, a tablet, a chewable tablet, and as a suspension (liquid) to take by mouth. It is usually taken every 12 hours (twice a day) or every 8 hours (three times a day) with or without food. The length of your treatment depends on the type of infection that you have.If you take too much
Taking an extra dose of amoxicillin is unlikely to harm you or your child, but speak to your pharmacist or doctor if you’re worried.However, nowadays it is frequently prescribed as once or twice daily doses. If once or twice daily amoxicillin, with or without clavulanate, is as effective for acute otitis media as three or four times a day, it may be more convenient to give the medication once or twice a day to children and hence improve compliance.
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You’re sick and want quick relief, but are antibiotics the solution? Our Dr. Freda Lewis-Hall has the answer. On The Doctors, she reveals the dos and don’ts for taking antibiotics and what you need to know for cold \u0026 flu season.
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What happens if you take 2 doses of amoxicillin?
If you take too much
Taking an extra dose of amoxicillin is unlikely to harm you or your child, but speak to your pharmacist or doctor if you’re worried.
Can I take amoxicillin twice a day instead of 3?
However, nowadays it is frequently prescribed as once or twice daily doses. If once or twice daily amoxicillin, with or without clavulanate, is as effective for acute otitis media as three or four times a day, it may be more convenient to give the medication once or twice a day to children and hence improve compliance.
Do you take amoxicillin 500 mg once or twice a day?
Adults, teenagers, and children weighing 40 kilograms (kg) or more—250 to 500 milligrams (mg) every 8 hours, or 500 to 875 mg every 12 hours. Children and infants older than 3 months of age weighing less than 40 kg—Dose is based on body weight and must be determined by your doctor.
Can antibiotics be taken 2 times a day?
Studies show that taking antibiotics such as penicillin or erythromycin two or three times a day instead of the usual four works just fine. If taking medicines more than once or twice a day is hard to remember — as it is for many people — ask your doctor if there’s an alternative drug that you could take less often.
Is amoxicillin good for tooth infection?
Amoxicillin is usually the first choice for tooth infection treatment. If your tooth infection is more serious, your dentist may prescribe a combination of amoxicillin and another drug called Clavulanate. This combination is stronger and more effective against tooth infections.
How quickly does amoxicillin work?
How Fast Does Amoxicillin Work? Amoxicillin starts addressing the bacteria that are causing your infection immediately, but you will not feel better immediately. Amoxicillin will typically help you to start feeling better within a few days. However, it may take up to 4-5 days before your symptoms improve.
Can I take 500mg of amoxicillin 2 times a day?
Amoxicillin is usually taken three times a day, but may be given twice a day. Amoxicillin can be taken with or without food – food has no effect on the medicine.
Why amoxicillin is given twice a day?
However, nowadays it is frequently prescribed as once or twice daily doses. If once or twice daily amoxicillin, with or without clavulanate, is as effective for acute otitis media as three or four times a day, it may be more convenient to give the medication once or twice a day to children and hence improve compliance.
What happens if you take antibiotics too close together?
There’s an increased risk of side effects if you take 2 doses closer together than recommended. Accidentally taking 1 extra dose of your antibiotic is unlikely to cause you any serious harm. But it will increase your chances of getting side effects, such as pain in your stomach, diarrhoea, and feeling or being sick.
How many amoxicillin 500mg should I take a day?
Official answer. The recommended dose of amoxicillin for a moderate chest infection in a normal healthy adult is 500mg every 8 hours (or three times a day) or 875 mg every 12 hours. Amoxicillin is a type of penicillin antibiotic that fights bacteria.
How many amoxicillin should i take for tooth infection?
The American Dental Association (ADA) recommends: Oral amoxicillin (if you are not allergic to penicillin): 500 mg three times a day for 3 to 7 days. Oral penicillin (as a second option): 500 mg four times per day for 3 to 7 days.
Can you take amoxicillin 500mg 4 times a day?
Typical dosage is 500 mg every 12 hours, or 250 mg every 8 hours. Typical dosage is 25 mg/kg/day in divided doses every 12 hours, or 20 mg/kg/day in divided doses every 8 hours. Maximum dosage is 30 mg/kg/day. Your child’s doctor can tell you more about dosage.
How many hours apart should you take amoxicillin 2 times a day?
It is usually taken every 12 hours (twice a day) or every 8 hours (three times a day) with or without food. The length of your treatment depends on the type of infection that you have. Take amoxicillin at around the same times every day.
Do you have to take antibiotics exactly 12 hours apart?
The general rule is if you are more than 50% of the way toward your next dose, you should skip. So for example, if you are supposed to take your antibiotic every 12 hours, you could take it if it’s less than six hours away from your next scheduled dose.
Does amoxicillin make you sleepy?
Antibiotics that may have a side effect of tiredness
Response to antibiotics — or any medication — varies by individual. Side effects, such as fatigue, aren’t uniform or universal. Although it’s rare, some of the antibiotics that may have a side effect of tiredness or weakness include: amoxicillin (Amoxil, Moxatag)
Amoxicillin: MedlinePlus Drug Information
Amoxicillin comes as a capsule, a tablet, a chewable tablet, and as a suspension (liquid) to take by mouth. It is usually taken every 12 hours (twice a day) or every 8 hours (three times a day) with or without food. The length of your treatment depends on the type of infection that you have. Take amoxicillin at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take amoxicillin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Shake the suspension well before each use to mix the medication evenly. The suspension may be placed directly on the child’s tongue or added to formula, milk, fruit juice, water, ginger ale, or another cold liquid and taken immediately.
The chewable tablets should be crushed or chewed thoroughly before they are swallowed.
Swallow the tablets and capsules whole with a full glass of water; do not chew or crush them.
You should begin to feel better during the first few days of treatment with amoxicillin. If your symptoms do not improve or get worse, call your doctor.
Take amoxicillin until you finish the prescription, even if you feel better. If you stop taking amoxicillin too soon or skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.
Amoxicillin: antibiotic to treat bacterial infections
The usual dose of amoxicillin capsules is 250mg to 500mg, taken 3 times a day. The dose may be lower for children.
Carry on taking this medicine until you’ve completed the course, even if you feel better. If you stop your treatment early, the infection could come back.
How to take it
Try to space the doses evenly throughout the day. If you take it 3 times a day, this could be first thing in the morning, mid-afternoon and at bedtime.
You can take amoxicillin before or after food.
Swallow amoxicillin capsules whole with a drink of water. Do not chew or break them.
Amoxicillin is available as a liquid for children and people who find it difficult to swallow capsules.
If you or your child are taking liquid amoxicillin, it will usually be made up for you by your pharmacist. The medicine will come with a plastic syringe or spoon to help you measure out the right dose. If you do not have one, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount.
If you forget to take it
If you forget to take a dose, take it as soon as you remember, unless it’s nearly time for your next dose. In this case, just leave out the missed dose and take your next dose at the usual time.
Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.
If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to remember your medicines.
If you take too much
Taking an extra dose of amoxicillin is unlikely to harm you or your child, but speak to your pharmacist or doctor if you’re worried.
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Amoxicillin (Oral Route) Proper Use
Description and Brand Names
Drug information provided by: IBM Micromedex
US Brand Name
Amoxicot Amoxil DisperMox Moxatag Moxilin Trimox
Canadian Brand Name
Amoxil Pediatric Apo-Amoxi Apo-Amoxi Sugar-Free Gen-Amoxicillin Med Amoxicillin Novamoxin Novamoxin Reduced Sugar Nu-Amoxi Riva-Amoxicillin Scheinpharm Amoxicillin Zimamox
Descriptions
Amoxicillin is used to treat bacterial infections in many different parts of the body. It is also used with other medicines (e.g., clarithromycin, lansoprazole) to treat H. pylori infection and duodenal ulcers.
Amoxicillin belongs to the group of medicines known as penicillin antibiotics. It works by killing the bacteria and preventing their growth. However, this medicine will not work for colds, flu, or other virus infections.
This medicine is available only with your doctor’s prescription.
This product is available in the following dosage forms:
Tablet
Powder for Suspension
Tablet, Chewable
Tablet, Extended Release
Capsule
Before Using
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Allergies
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Pediatric
Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of amoxicillin in children. However, newborns and infants 3 months of age and younger have incompletely developed kidney functions, which may need a lower dose of this medicine.
Geriatric
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of amoxicillin in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving amoxicillin.
Breastfeeding
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Drug Interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Chlortetracycline
Cholera Vaccine, Live
Demeclocycline
Desogestrel
Dienogest
Doxycycline
Drospirenone
Eravacycline
Estradiol
Ethinyl Estradiol
Ethynodiol
Gestodene
Levonorgestrel
Lymecycline
Meclocycline
Mestranol
Methacycline
Methotrexate
Minocycline
Mycophenolate Mofetil
Nomegestrol
Norethindrone
Norgestimate
Norgestrel
Omadacycline
Oxytetracycline
Rolitetracycline
Sarecycline
Sulfasalazine
Tetracycline
Tigecycline
Venlafaxine
Warfarin
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Acenocoumarol
Khat
Probenecid
Other Interactions
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other Medical Problems
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
Allergy to penicillins or cephalosporin antibiotics (e.g., cefaclor, cefadroxil, cephalexin, Ceftin®, or Keflex®) or
Mononucleosis (viral infection)—Should not be used in patients with these conditions.
Kidney disease, severe—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
Phenylketonuria (PKU)—The chewable tablet contains phenylalanine, which can make this condition worse.
Proper Use
Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.
You may take this medicine with or without food.
For patients using the oral liquid:
Shake the bottle well before each use. Measure the dose with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid.
You may mix the oral liquid with a baby formula, milk, fruit juice, water, ginger ale, or another cold drink. Be sure the child drinks all of the mixture immediately.
Keep using this medicine for the full treatment time, even if you feel better after the first few doses. Your infection may not clear up if you stop using the medicine too soon.
Dosing
The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
For oral dosage forms (capsules, powder for suspension, and tablets): For bacterial infections: Adults, teenagers, and children weighing 40 kilograms (kg) or more—250 to 500 milligrams (mg) every 8 hours, or 500 to 875 mg every 12 hours. Children and infants older than 3 months of age weighing less than 40 kg—Dose is based on body weight and must be determined by your doctor. The usual dose is 20 to 40 milligrams (mg) per kilogram (kg) of body weight per day, divided and given every 8 hours, or 25 to 45 mg per kg of body weight per day, divided and given every 12 hours. Infants 3 months of age and younger—Dose is based on body weight and must be determined by your doctor. The usual dose is 30 mg per kg of body weight per day, divided and given every 12 hours. For treatment of gonorrhea: Adults, teenagers, and children weighing 40 kilograms (kg) or more—3-grams (g) taken as a single dose. Children 2 years of age and older weighing less than 40 kg—Dose is based on body weight and must be determined by your doctor. The usual dose is 50 milligrams (mg) per kilogram (kg) of body weight per day, combined with 25 mg per kg of probenecid, taken as a single dose. Children younger than 2 years of age—Use is not recommended. For treatment of H. pylori infection: Adults— Dual therapy: 1000 milligrams (mg) of amoxicillin and 30 mg of lansoprazole, each given three times a day (every 8 hours) for 14 days. Triple therapy: 1000 mg of amoxicillin, 500 mg of clarithromycin, and 30 mg of lansoprazole, all given two times a day (every 12 hours) for 14 days. Children—Use and dose must be determined by your doctor.
Missed Dose
If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Storage
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
You may store the oral liquid in the refrigerator. Throw away any unused medicine after 14 days. Do not freeze.
Precautions
If your or your child’s symptoms do not improve within a few days, or if they become worse, check with your doctor.
This medicine may cause a serious allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a skin rash; itching; shortness of breath; trouble with breathing; trouble with swallowing; or any swelling of your hands, face, mouth, or throat after you or your child receive this medicine.
Amoxicillin may cause diarrhea, and in some cases it can be severe. It may occur 2 months or more after you stop taking this medicine. Do not take any medicine or give medicine to your child to treat diarrhea without first checking with your doctor. Diarrhea medicines may make the diarrhea worse or make it last longer. If you have any questions about this or if mild diarrhea continues or gets worse, check with your doctor.
Before you have any medical tests, tell the doctor in charge that you or your child are taking this medicine. The results of some tests may be affected by this medicine.
In some young patients, tooth discoloration may occur while using this medicine. The teeth may appear to have brown, yellow, or gray stains. To help prevent this, brush and floss your teeth regularly or have a dentist clean your teeth.
Birth control pills may not work while you are using this medicine. To keep from getting pregnant, use another form of birth control along with your birth control pills. Other forms include a condom, a diaphragm, or a contraceptive foam or jelly.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Incidence not known
Abdominal or stomach cramps or tenderness back, leg, or stomach pains black, tarry stools bleeding gums blistering, peeling, or loosening of the skin bloating blood in the urine bloody nose chest pain chills clay-colored stools cough dark urine diarrhea diarrhea, watery and severe, which may also be bloody difficulty with breathing difficulty with swallowing dizziness fast heartbeat feeling of discomfort fever general body swelling headache heavier menstrual periods hives or welts increased thirst inflammation of the joints itching joint or muscle pain loss of appetite muscle aches nausea or vomiting nosebleeds pain pain in the lower back pain or burning while urinating painful or difficult urination pale skin pinpoint red spots on the skin puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue rash red, irritated eyes redness, soreness, or itching skin shortness of breath sore throat sores, ulcers, or white spots in the mouth or on the lips sores, welting, or blisters sudden decrease in the amount of urine swollen, lymph glands tenderness tightness in the chest unpleasant breath odor unusual bleeding or bruising unusual tiredness or weakness unusual weight loss vomiting of blood watery or bloody diarrhea wheezing yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Bad, unusual, or unpleasant (after) taste change in taste
Incidence not known
Agitation black, hairy tongue changes in behavior confusion convulsions discoloration of the tooth (brown, yellow, or gray staining) dizziness sleeplessness trouble with sleeping unable to sleep white patches in the mouth or throat or on the tongue white patches with diaper rash
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
SHOULD ANTIBIOTICS BE TAKEN ON A STRICT SCHEDULE?
Q. Does it matter if I miss taking a dose of an antibiotic?
If the directions call for taking one pill every six hours, do I have to take the pills exactly six hours apart?
For me, this would mean staying up late and also setting my alarm to get up early.
A. In general, you should follow the directions on your prescription.
But please don’t hesitate to ask your doctor or pharmacist whether you can vary your dosing schedule somewhat to make it more convenient for you.
Most medicines work best when their level in your bloodstream is fairly steady. Your levels of medication shouldn’t get too high, which may cause harmful effects; on the other hand, they shouldn’t get too low, which may result in reduced effectiveness.
Luckily, however, most medicines aren’t so critical that being late or missing a dose would lead to serious problems. Even for a drug like zidovudine (AZT), which is used to treat AIDS, the dose is every four hours while awake and not around the clock.
As a rule, if you miss a dose of an antibiotic, you can take it as soon as you realize you’ve forgotten. In many cases, you can double up on the next dose safely.
But be sure to check with your doctor, pharmacist or at the very least a book on prescription drugs to see if it’s safe to do so. Books for the public about prescription drugs often have advice on what to do if you miss a dose of whatever medicine you’re taking.
In many cases, drugs that have traditionally been prescribed four times a day have been found to work just as well when larger doses are taken twice a day, as in the case of strep throat medication.
Studies show that taking antibiotics such as penicillin or erythromycin two or three times a day instead of the usual four works just fine.
If taking medicines more than once or twice a day is hard to remember — as it is for many people — ask your doctor if there’s an alternative drug that you could take less often. If there isn’t, ask your doctor or pharmacist for practical tips on how to remember. Jay Siwek, a family physician from Georgetown University, practices at the Fort Lincoln Family Medicine Center and Providence Hospital in Northeast Washington. Consultation is a health education column and is not a substitute for medical advice from your physician. Send questions to Consultation, Health Section, The Washington Post, 1150 15th St. NW, Washington, D.C. 20071. Questions cannot be answered individually.
Amoxicillin: antibiotic to treat bacterial infections
The usual dose of amoxicillin capsules is 250mg to 500mg, taken 3 times a day. The dose may be lower for children.
Carry on taking this medicine until you’ve completed the course, even if you feel better. If you stop your treatment early, the infection could come back.
How to take it
Try to space the doses evenly throughout the day. If you take it 3 times a day, this could be first thing in the morning, mid-afternoon and at bedtime.
You can take amoxicillin before or after food.
Swallow amoxicillin capsules whole with a drink of water. Do not chew or break them.
Amoxicillin is available as a liquid for children and people who find it difficult to swallow capsules.
If you or your child are taking liquid amoxicillin, it will usually be made up for you by your pharmacist. The medicine will come with a plastic syringe or spoon to help you measure out the right dose. If you do not have one, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount.
If you forget to take it
If you forget to take a dose, take it as soon as you remember, unless it’s nearly time for your next dose. In this case, just leave out the missed dose and take your next dose at the usual time.
Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.
If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to remember your medicines.
If you take too much
Taking an extra dose of amoxicillin is unlikely to harm you or your child, but speak to your pharmacist or doctor if you’re worried.
Amoxicillin (Oral Route) Proper Use
Description and Brand Names
Drug information provided by: IBM Micromedex
US Brand Name
Amoxicot Amoxil DisperMox Moxatag Moxilin Trimox
Canadian Brand Name
Amoxil Pediatric Apo-Amoxi Apo-Amoxi Sugar-Free Gen-Amoxicillin Med Amoxicillin Novamoxin Novamoxin Reduced Sugar Nu-Amoxi Riva-Amoxicillin Scheinpharm Amoxicillin Zimamox
Descriptions
Amoxicillin is used to treat bacterial infections in many different parts of the body. It is also used with other medicines (e.g., clarithromycin, lansoprazole) to treat H. pylori infection and duodenal ulcers.
Amoxicillin belongs to the group of medicines known as penicillin antibiotics. It works by killing the bacteria and preventing their growth. However, this medicine will not work for colds, flu, or other virus infections.
This medicine is available only with your doctor’s prescription.
This product is available in the following dosage forms:
Tablet
Powder for Suspension
Tablet, Chewable
Tablet, Extended Release
Capsule
Before Using
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Allergies
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Pediatric
Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of amoxicillin in children. However, newborns and infants 3 months of age and younger have incompletely developed kidney functions, which may need a lower dose of this medicine.
Geriatric
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of amoxicillin in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving amoxicillin.
Breastfeeding
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Drug Interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Chlortetracycline
Cholera Vaccine, Live
Demeclocycline
Desogestrel
Dienogest
Doxycycline
Drospirenone
Eravacycline
Estradiol
Ethinyl Estradiol
Ethynodiol
Gestodene
Levonorgestrel
Lymecycline
Meclocycline
Mestranol
Methacycline
Methotrexate
Minocycline
Mycophenolate Mofetil
Nomegestrol
Norethindrone
Norgestimate
Norgestrel
Omadacycline
Oxytetracycline
Rolitetracycline
Sarecycline
Sulfasalazine
Tetracycline
Tigecycline
Venlafaxine
Warfarin
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Acenocoumarol
Khat
Probenecid
Other Interactions
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other Medical Problems
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
Allergy to penicillins or cephalosporin antibiotics (e.g., cefaclor, cefadroxil, cephalexin, Ceftin®, or Keflex®) or
Mononucleosis (viral infection)—Should not be used in patients with these conditions.
Kidney disease, severe—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
Phenylketonuria (PKU)—The chewable tablet contains phenylalanine, which can make this condition worse.
Proper Use
Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.
You may take this medicine with or without food.
For patients using the oral liquid:
Shake the bottle well before each use. Measure the dose with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid.
You may mix the oral liquid with a baby formula, milk, fruit juice, water, ginger ale, or another cold drink. Be sure the child drinks all of the mixture immediately.
Keep using this medicine for the full treatment time, even if you feel better after the first few doses. Your infection may not clear up if you stop using the medicine too soon.
Dosing
The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
For oral dosage forms (capsules, powder for suspension, and tablets): For bacterial infections: Adults, teenagers, and children weighing 40 kilograms (kg) or more—250 to 500 milligrams (mg) every 8 hours, or 500 to 875 mg every 12 hours. Children and infants older than 3 months of age weighing less than 40 kg—Dose is based on body weight and must be determined by your doctor. The usual dose is 20 to 40 milligrams (mg) per kilogram (kg) of body weight per day, divided and given every 8 hours, or 25 to 45 mg per kg of body weight per day, divided and given every 12 hours. Infants 3 months of age and younger—Dose is based on body weight and must be determined by your doctor. The usual dose is 30 mg per kg of body weight per day, divided and given every 12 hours. For treatment of gonorrhea: Adults, teenagers, and children weighing 40 kilograms (kg) or more—3-grams (g) taken as a single dose. Children 2 years of age and older weighing less than 40 kg—Dose is based on body weight and must be determined by your doctor. The usual dose is 50 milligrams (mg) per kilogram (kg) of body weight per day, combined with 25 mg per kg of probenecid, taken as a single dose. Children younger than 2 years of age—Use is not recommended. For treatment of H. pylori infection: Adults— Dual therapy: 1000 milligrams (mg) of amoxicillin and 30 mg of lansoprazole, each given three times a day (every 8 hours) for 14 days. Triple therapy: 1000 mg of amoxicillin, 500 mg of clarithromycin, and 30 mg of lansoprazole, all given two times a day (every 12 hours) for 14 days. Children—Use and dose must be determined by your doctor.
Missed Dose
If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Storage
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
You may store the oral liquid in the refrigerator. Throw away any unused medicine after 14 days. Do not freeze.
Precautions
If your or your child’s symptoms do not improve within a few days, or if they become worse, check with your doctor.
This medicine may cause a serious allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a skin rash; itching; shortness of breath; trouble with breathing; trouble with swallowing; or any swelling of your hands, face, mouth, or throat after you or your child receive this medicine.
Amoxicillin may cause diarrhea, and in some cases it can be severe. It may occur 2 months or more after you stop taking this medicine. Do not take any medicine or give medicine to your child to treat diarrhea without first checking with your doctor. Diarrhea medicines may make the diarrhea worse or make it last longer. If you have any questions about this or if mild diarrhea continues or gets worse, check with your doctor.
Before you have any medical tests, tell the doctor in charge that you or your child are taking this medicine. The results of some tests may be affected by this medicine.
In some young patients, tooth discoloration may occur while using this medicine. The teeth may appear to have brown, yellow, or gray stains. To help prevent this, brush and floss your teeth regularly or have a dentist clean your teeth.
Birth control pills may not work while you are using this medicine. To keep from getting pregnant, use another form of birth control along with your birth control pills. Other forms include a condom, a diaphragm, or a contraceptive foam or jelly.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Incidence not known
Abdominal or stomach cramps or tenderness back, leg, or stomach pains black, tarry stools bleeding gums blistering, peeling, or loosening of the skin bloating blood in the urine bloody nose chest pain chills clay-colored stools cough dark urine diarrhea diarrhea, watery and severe, which may also be bloody difficulty with breathing difficulty with swallowing dizziness fast heartbeat feeling of discomfort fever general body swelling headache heavier menstrual periods hives or welts increased thirst inflammation of the joints itching joint or muscle pain loss of appetite muscle aches nausea or vomiting nosebleeds pain pain in the lower back pain or burning while urinating painful or difficult urination pale skin pinpoint red spots on the skin puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue rash red, irritated eyes redness, soreness, or itching skin shortness of breath sore throat sores, ulcers, or white spots in the mouth or on the lips sores, welting, or blisters sudden decrease in the amount of urine swollen, lymph glands tenderness tightness in the chest unpleasant breath odor unusual bleeding or bruising unusual tiredness or weakness unusual weight loss vomiting of blood watery or bloody diarrhea wheezing yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Bad, unusual, or unpleasant (after) taste change in taste
Incidence not known
Agitation black, hairy tongue changes in behavior confusion convulsions discoloration of the tooth (brown, yellow, or gray staining) dizziness sleeplessness trouble with sleeping unable to sleep white patches in the mouth or throat or on the tongue white patches with diaper rash
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Amoxicillin for ear infection: Take how many times a day?
“Usual Adult Dose for Otitis Media:
250 mg to 500 mg orally 3 times a day for 10 to 14 days; alternatively, 500 to 875 mg orally twice a day may be administered”
Amoxicillin is usually taken three times a day, but may be given twice a day.
https://www.drugs.com/dosage/amoxicillin.html#Usual_Adult_Dose_for_Otitis_Media
Amoxicillin can be taken with or without food – food has no effect on the medicine.
Amoxicillin: Side effects, dosage, uses, and more
Highlights for amoxicillin Amoxicillin is an antibiotic. It’s used to treat infections caused by certain types of bacteria. Amoxicillin oral tablet comes as immediate-release (IR) or chewable tablets. The chewable tablet and IR tablet are only available as generic drugs. Amoxicillin also comes as a capsule and a suspension. All forms are taken by mouth.
Amoxicillin side effects Amoxicillin oral tablet does not cause drowsiness, but it can cause other side effects. More common side effects The more common side effects of amoxicillin oral tablet can include: nausea
vomiting
diarrhea
rash
vaginal yeast infection If these side effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist. Serious side effects Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following: Hypersensitivity reactions. Symptoms can include: flu-like symptoms, such as fever, body aches, or sore throat a painful red or purple rash that spreads blisters that could cause the skin to break down and cause open sores
Liver damage. This effect is rare. Symptoms can include: increased liver enzymes shown on a blood test pain in the abdomen (stomach area) yellowing of the skin and eyes tiredness
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare professional who knows your medical history.
Important warnings Finishing therapy: It’s important to finish the entire course of treatment as prescribed by your doctor. Do not stop taking this drug or skip doses if you start to feel better. This could cause your infection to last longer. You could also develop a resistance to the medication. This means that if you get a bacterial infection in the future, you may not be able to treat it with amoxicillin.
It’s important to finish the entire course of treatment as prescribed by your doctor. Do not stop taking this drug or skip doses if you start to feel better. This could cause your infection to last longer. You could also develop a resistance to the medication. This means that if you get a bacterial infection in the future, you may not be able to treat it with amoxicillin. Diarrhea: Amoxicillin may cause diarrhea. Call your doctor if you have bloody or watery diarrhea, with or without stomach cramps and fever.
Amoxicillin may cause diarrhea. Call your doctor if you have bloody or watery diarrhea, with or without stomach cramps and fever. Serious allergic reaction: This drug can cause a serious allergic reaction. This reaction can be fatal (cause death). If you’re allergic to other antibiotics, such as penicillins or cephalosporins, your risk for an allergic reaction may be higher. Call your doctor right away if you have trouble breathing or swelling of your throat or tongue while you’re taking this drug.
What is amoxicillin? Amoxicillin is a prescription antibiotic. It’s used to treat infections caused by a certain type of bacteria. It may be used as part of combination therapy. This means you may need to take it with other medications. The oral tablet comes as an immediate-release (IR) tablet and chewable tablet. These are only available as generic drugs. Generic drugs usually cost less. Amoxicillin also comes as a capsule and a suspension. All forms are taken by mouth. Why it’s used Amoxicillin is an antibiotic. It’s used to treat infections caused by a certain type of bacteria. Amoxicillin may be used as part of combination therapy. This means you may need to take it with other medications. How it works Amoxicillin belongs to a class of drugs called penicillins. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions. Amoxicillin works by killing bacteria and stopping its growth in your body.
Amoxicillin may interact with other medications Amoxicillin oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well. To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk with your doctor or pharmacist. Examples of drugs that can cause interactions with amoxicillin are listed below. Drugs that increase the risk of side effects from amoxicillin Taking amoxicillin with certain medications raises your risk of side effects from amoxicillin. This is because the amount of amoxicillin in your body may be increased. Examples of these drugs include: Probenecid: Taking probenecid with amoxicillin could lead to increased blood levels of amoxicillin. A doctor may need to decrease the dose of amoxicillin in some patients.
Taking probenecid with amoxicillin could lead to increased blood levels of amoxicillin. A doctor may need to decrease the dose of amoxicillin in some patients. Allopurinol: If you use these drugs together, you may develop a rash. Interactions that increase the risk of side effects from other drugs Taking amoxicillin with certain medications raises your risk of side effects from these medications. Amoxicillin increases the amount of these drugs in your body. Examples of these drugs include drugs to treat blood clots. These are called anticoagulants and include warfarin (Coumadin), apixaban (Eliquis), Heparin, and others. If you use them with amoxicillin, you have a higher risk of bleeding. Your doctor may adjust your dose of amoxicillin as a result. Interactions that can make your drugs less effective When amoxicillin is less effective: When amoxicillin is used with certain drugs, it may not work as well. In vitro studies have shown potential interactions that can cause the amount of amoxicillin in your body may be decreased. Because in vitro studies are only conducted in a lab and not on live subjects, it is not clear whether this can significantly impact you if you’re taking amoxicillin with these drugs. Nevertheless, examples of these drugs include: Chloramphenicol If you use these drugs together, your doctor will likely keep your dosage of amoxicillin the same.
Macrolides, such as erythromycin, clarithromycin, or azithromycin If you use these drugs together, your doctor will likely keep your dosage of amoxicillin the same.
Sulfonamides, such as sulfamethoxazole If you use these drugs together, your doctor will likely keep your dosage of amoxicillin the same.
Tetracyclines, such as tetracycline or doxycycline If you use these drugs together, your doctor will likely keep your dosage of amoxicillin the same.
When other drugs are less effective: When certain drugs are used with amoxicillin, they may not work as well. This is because the amount of these drugs in your body may be decreased. Examples of these drugs include: Oral contraceptives (birth control) If you need to take amoxicillin, you should consider using a barrier method of birth control while on amoxicillin. Or, your doctor may prescribe a different form of birth control for you.
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare professional about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you’re taking.
Amoxicillin warnings This drug comes with several warnings. Allergies Amoxicillin can cause a severe allergic reaction. Symptoms can include: trouble breathing
swelling of your throat or tongue If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 911 or go to the nearest emergency room. Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death). Warnings for people with certain health conditions For people with mononucleosis (mono or kissing disease): Amoxicillin raises your risk of developing a severe rash. For people with diabetes: Amoxicillin may cause you to have a false-positive reaction when testing for glucose (sugar) in the urine. Talk with your doctor about how to manage your blood sugar while taking amoxicillin. For people with kidney disease: If you have severe kidney disease, your kidneys may not clear this drug from your body quickly. As a result, levels of amoxicillin may build up in your body. To help prevent this, your doctor may give you a lower dose of this drug. Warnings for other groups For pregnant people: Research in animals has not shown adverse effects on the fetus when the mother takes amoxicillin. There haven’t been enough studies done on humans to be certain if the drug poses a risk to the fetus. However, you may want to still speak to your doctor if you’re pregnant or planning to become pregnant. For people who are nursing: Amoxicillin may pass into breast milk and may cause side effects in a child who is breastfed. Talk with your doctor if you are nursing your child. You may need to decide whether to stop nursing or stop taking this medication. For seniors: The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.
How to take amoxicillin This dosage information is for amoxicillin oral tablet. All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on: your age
the condition being treated
how severe your condition is
other medical conditions you have
how you react to the first dose Forms and strengths Generic: Amoxicillin Form: oral tablet
oral tablet Strengths: 500 mg, 875 mg Form: oral chewable tablet
oral chewable tablet Strengths: 125 mg, 250 mg Dosage for infections of the ears, nose, and throat IMMEDIATE-RELEASE TABLET AND CHEWABLE TABLET Adult dosage (ages 18–64 years) Typical dosage is 500 mg every 12 hours, or 250 mg every 8 hours. Child dosage (ages 3 months–17 years) Typical dosage is 25 mg/kg/day in divided doses every 12 hours, or 20 mg/kg/day in divided doses every 8 hours. The children’s dosage listed here is meant for children who weigh less than 88 pounds (40 kg). Children who weigh more than 88 pounds should be dosed according to the adult recommendations. Child dosage (ages 0–2 months) Maximum dosage is 30 mg/kg/day. Your child’s doctor can tell you more about dosage. Dosage for urinary tract infections Adult dosage (ages 18–64 years) Typical dosage is 500 mg every 12 hours, or 250 mg every 8 hours. Child dosage (ages 3 months–17 years) Typical dosage is 25 mg/kg/day in divided doses every 12 hours, or 20 mg/kg/day in divided doses every 8 hours. Child dosage (ages 0–2 months) Maximum dosage is 30 mg/kg/day. Your child’s doctor can tell you more about dosage. Senior dosage (ages 65 years and older) The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects. Your doctor may start you on a lower dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body. Special considerations For children’s dosage: The children’s dosage listed here is meant for children who weigh less than 88 pounds (40 kg). Children who weigh more than 88 pounds should be dosed according to the adult recommendations. Dosage for skin infections Adult dosage (ages 18–64 years) Typical dosage is 500 mg every 12 hours, or 250 mg every 8 hours. Child dosage (ages 3 months–17 years) Typical dosage is 25 mg/kg/day in divided doses every 12 hours, or 20 mg/kg/day in divided doses every 8 hours. The dosage listed here is meant for children who weigh less than 88 pounds (40 kg). Children who weigh more than 88 pounds should be dosed according to the adult recommendations. Child dosage (ages 0–2 months) Maximum dosage is 30 mg/kg/day. Your child’s doctor can tell you more about dosage. Senior dosage (ages 65 years and older) The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects. Your doctor may start you on a lower dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body. Dosage for lower respiratory tract infections Adult dosage (ages 18–64 years) Typical dosage is 875 mg every 12 hours, or 500 mg every 8 hours. Child dosage (ages 3 months–17 years) Typical dosage is 45 mg/kg/day in divided doses every 12 hours, or 40 mg/kg/day in divided doses every 8 hours. Child dosage (ages 0–2 months) Maximum dosage is 30 mg/kg/day. This is meant for children who weigh less than 88 pounds (40 kg). Children who weigh more than 88 pounds should be dosed according to the adult recommendations. Your child’s doctor can tell you more about dosage. Senior dosage (ages 65 years and older) The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects. Your doctor may start you on a lower dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body. Dosage for gonorrhea Adult dosage (ages 18–64 years) Typical dosage is 3 g as a single dose. Child dosage (ages 24 months–17 years) Typical dosage is 50 mg/kg amoxicillin combined with 25 mg/kg probenecid as a single dose. The children’s dosage listed here is meant for children who weigh less than 88 pounds (40 kg). Children who weigh more than 88 pounds should be dosed according to the adult recommendations. Child dosage (ages 0–23 months) This medication should not be used in children younger than 2 years of age for treatment of gonorrhea. Senior dosage (ages 65 years and older) The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects. Your doctor may start you on a lower dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body. Dosage for stomach and intestinal ulcers Adult dosage (ages 18–64 years) Typical dosage for triple therapy: 1 g amoxicillin with 500 mg clarithromycin and 30 mg of lansoprazole, all given twice per day for 14 days.
1 g amoxicillin with 500 mg clarithromycin and 30 mg of lansoprazole, all given twice per day for 14 days. Typical dosage for dual therapy: 1 g amoxicillin and 30 mg of lansoprazole, given three times per day for 14 days. Child dosage (ages 0–17 years) This drug has not been studied in children to treat stomach and intestinal ulcers. Senior dosage (ages 65 years and older) The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects. Your doctor may start you on a lower dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body. Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.
Take as directed Amoxicillin oral tablet is used for short-term treatment. It comes with serious risks if you don’t take it as prescribed. If you stop taking the drug suddenly or don’t take it at all: Your bacterial infection may not heal or may get worse. If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times. It’s important to finish the entire course of treatment as prescribed by your doctor. Do not stop taking the drug or skip doses if you start to feel better. This could cause your infection to last longer. You could also develop a resistance to the medication. This means if you get a bacterial infection in the future, you may not be able to treat it with amoxicillin. If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose may not be significant at less than 250 mg/kg. In higher-dose cases, it may lead to kidney failure. If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away. What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects. How to tell if the drug is working: The symptoms of your infection should improve.
Important considerations for taking amoxicillin Keep these considerations in mind if your doctor prescribes amoxicillin oral tablet for you. General Take this drug at the time(s) recommended by your doctor.
You can take the amoxicillin capsule, tablet, or suspension with or without food.
You should take amoxicillin extended-release tablets within 1 hour of finishing a meal.
Don’t crush, cut, or chew the extended-release tablets. You can crush, cut, or chew the regular or chewable tablets. Storage Store amoxicillin at room temperature between 59°F and 86°F (15°C and 30°C). Keep this drug away from light. Don’t store this medication in moist or damp areas, such as bathrooms. Refills A prescription for this medication may be refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription. Travel When traveling with your medication: Always carry your medication with you. When flying, never put it in a checked bag. Keep it in your carry-on bag.
Don’t worry about airport X-ray machines. They can’t hurt your medication.
You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold. Clinical monitoring You and your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. These issues include your: Kidney function. Blood tests can check how well your kidneys are working. If your kidneys aren’t working well, your doctor may decide to lower your dosage of this drug.
Blood tests can check how well your kidneys are working. If your kidneys aren’t working well, your doctor may decide to lower your dosage of this drug. Liver function. Blood tests can check how well your liver is working. If your liver isn’t working well, your doctor may lower your dosage of this drug. The cost of these blood tests will depend on your insurance coverage.
How does twice-daily compare with once-daily amoxicillin for GAS pharyngitis?
A recent study demonstrated that amoxicillin, given once daily, is not inferior to amoxicillin, given twice daily, to treat group A streptococcal (GAS) pharyngitis. The study was conducted over two years in 652 children between 3 and 18 years old who visited a single pediatric practice with symptoms and signs of GAS pharyngitis, which was confirmed by rapid GAS testing.
Investigators first stratified the children into two groups by weight: less than 40 kg and 40 kg or more. (Children who weighed less than 40 kg were more likely than those of higher weight to have a rash.) Half the children in each of the weight groups then were assigned to receive amoxicillin once daily or twice daily, for 10 days. For children under 40 kg, the amoxicillin dosage was 750 mg once daily or 375 mg twice daily; for children 40 kg or more, the amoxicillin dosage was 1,000 mg once daily or 500 mg twice daily. At a second visit, 14 to 21 days after treatment was begun, and at a third visit, 28 to 35 days later, investigators determined the bacteriologic failure rate for GAS in the pharynx (by means of throat culture) and assessed subjects for clinical cure and recurrence.
At the second visit, all patients had achieved clinical cure, and the bacteriologic failure rate for evaluable patients was comparable in the two treatment groups: 20.1% for the once-daily group and 15.5% for the twice-daily group. At the third visit, rates of bacteriologic relapse and clinical recurrence were low in all patients. Patients in the twice-daily groups had a higher bacteriologic failure rate (7.1% vs 2.8% for the once-daily group), however. No risk factors for bacteriologic failure were apparent. Each treatment group had only two late clinical recurrences.
Commentary Amoxicillin has a narrow spectrum of activity, which may minimize bacterial resistance in your community. It is inexpensive, tastes good, and, with once-a-day dosing, may provide better adherence than other antibiotics do. Once-a-day amoxicillin may be worth a try for group A strep pharyngitis.
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