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Indications - Co-amoxiclav is indicated for short-term treatment of bacterial infections at the following sites: Upper respiratory tract infections (including ENT) e.g.tonsillitis,sinusitis,otitis media. Lower respiratory tract infections e.g.acute and chronic bronchitis, lobar and bronchopneumonia. Genito-urinary tract infections e.g.cystitis,urethritis,pyelonephritis. Skin and soft tissue infections. Bone and joint infections e.g.osteomyelitis. Other infections e.g.septic abortion,puerperal sepsis,intra-abdominal sepsis etc.

Dosage & Administration - Adults and children over 12 years: One Moxaclav® 375 mg tablet three times a day. In severe infection one Moxaclav® 625mg tablet three times a day or one Moxaclav® 1gm tablet two times a day. Children of 6-12 years: 2 teaspoonsful of Moxaclav® Powder for Suspension every 8 hours. Children of 1-6 years: 1 teaspoonful of Moxaclav® Powder for Suspension every 8 hours. Children below 1 year: 25 mg/kg/day in divided doses every 8 hours. Moxaclav® Forte Powder for Suspension: Children of 2-12 years: ½ to 2 teaspoonful b.i.d. Children of 2 months to 2 years: 25/3.6 mg/kg/day to 45/6.4 mg/kg/day b.i.d. Moxaclav® 1.2 IV Injection: 1.2 g every 6-8 hours, Children up to 3 months: 30 mg/kg every 8 hours (every 12 hours in the perinatal period and in premature infants); child 3 months-12 years, 30 mg/kg every 6-8 hours.

Side Effects - Side effects, as with Amoxicillin, are uncommon and mainly of a mild and transitory nature. Diarrhoea, pseudomembranous colitis, indigestion, nausea, vomiting and candidiasis have been reported, if gastrointestinal side effects occur with oral therapy, that may be reduced by taking Co-amoxiclav at the start of meals. Hepatitis and cholestatic jaundice have been reported rarely but are usually reversible. Urticarial and erythematous rashes sometimes occur. Rarely erythema multiforme, Stevens-Johnson Syndrome and exfoliative dermatitis have been reported. In common with other beta-lactam antibiotics, angioedema and anaphylaxis have been reported.

Contraindications - History of Penicillin hypersensitivity. Attention should be paid to possible cross-sensitivity with other beta-lactam antibiotics e.g. cephalosporins. Also contraindicated for patients with a previous history of Co-amoxiclav or Penicillin-associated cholestatic jaundice.

Others - Pregnancy & Lactation Animal studies with orally and parenterally administered Co-amoxiclav have shown no teratogenic effect. The drug has been used orally in human pregnancy in a limited number of cases with no untoward effect; however, the use of Co-amoxiclav in pregnancy is not recommended unless considered essential by the physician. During lactation, trace quantities of Amoxicillin can be detected in breast milk.