Formulary
Co-amoxiclav: Indications, Dosing, Side Effects and Interactions
The penicillins are bactericidal and act by interfering with bacterial cell wall synthesis.
MedNext Academy | 20 min read
Co-amoxiclav: Indications, Dosing, Side Effects and Interactions
The penicillins are bactericidal and act by interfering with bacterial cell wall synthesis.
Drug action
The penicillins are bactericidal and act by interfering with bacterial cell wall synthesis. They diffuse well into body tissues and fluids, but penetration into the cerebrospinal fluid is poor except when the meninges are inflamed. They are excreted in the urine in therapeutic concentrations.
Indications and dose
**Infections due to beta-lactamase-producing strains (where amoxicillin alone not appropriate) [doses**
- **Adult** (By Intravenous Infusion): for 2.2 g (2000/200 mg) injection] 1.1 g every 8 hours, alternatively 2.2 g every 12 hours, increased if necessary to 2.2 g every 8 hours.
**Acute diverticulitis [doses**
- **Adult** (By Intravenous Injection, Or By Intravenous Infusion): for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection] 1.2 g every 8 hours.
**Moderate or severe diabetic foot infection [doses**
- **Adult** (By Intravenous Injection, Or By Intravenous Infusion): for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection] 1.2 g every 8 hours.
**Leg ulcer infection [doses**
- **Adult** (By Intravenous Injection, Or By Intravenous Infusion): for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection] 1.2 g every 8 hours.
**Cellulitis [doses**
- **Adult** (By Intravenous Injection, Or By Intravenous Infusion): for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection], Erysipelas [doses for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection] 1.2 g every 8 hours.
**Prophylaxis of infection from human bites [doses**
- **Adult** (By Intravenous Injection, Or By Intravenous Infusion): for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection], Prophylaxis of infection from animal bites [doses for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection] 1.2 g every 8 hours.
**Treatment of infection from human bites [doses**
- **Adult** (By Intravenous Injection, Or By Intravenous Infusion): for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection], Treatment of infection from animal bites [doses for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection] 1.2 g every 8 hours.
**Severe dental infection with spreading cellulitis [doses**
- **Child** (By Mouth Using Tablets): for 375 mg (250/125 mg) tablets], Dental infection not responding to first-line antibacterial [doses for 375 mg (250/125 mg) tablets] 12-17 years 375 mg 3 times a day for 5 days.
- **Adult** (By Mouth Using Tablets): 375 mg 3 times a day for 5 days.
**Surgical prophylaxis [doses**
- **Adult** (By Intravenous Infusion): for 2.2 g (2000/200 mg) injection] 1.1-2.2 g for 1 dose, to be administered up to 30 minutes before the procedure, then 1.1 g every 8 hours for up to 3 further doses in high risk procedures.
**Community-acquired pneumonia [doses**
- **Adult** (By Intravenous Injection, Or By Intravenous Infusion): for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection] 1.2 g every 8 hours.
**Hospital-acquired pneumonia [doses**
- **Child** (By Mouth Using Oral Suspension): for 250/62 mg per 5 mL suspension] 6-11 years 0.3 mL/kilogram 3 times a day for 5 days then review, alternatively 10 mL 3 times a day for 5 days then review.
**Acute exacerbation of bronchiectasis [doses**
- **Adult** (By Intravenous Injection, Or By Intravenous Infusion): for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection] 1.2 g every 8 hours.
**Acute exacerbation of chronic obstructive pulmonary disease [doses**
- **Adult** (By Intravenous Injection, Or By Intravenous Infusion): for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection] 1.2 g every 8 hours.
**Acute sinusitis [doses**
- **Child** (By Mouth Using Oral Suspension): for 250/62 mg per 5 mL suspension] 6-11 years 0.15 mL/kilogram 3 times a day for 5 days, alternatively 5 mL 3 times a day for 5 days.
**Acute otitis media [doses**
- **Child** (By Mouth Using Oral Suspension): for 250/62 mg per 5 mL suspension] 6-11 years 0.15 mL/kilogram 3 times a day for 5-7 days, alternatively 5 mL 3 times a day for 5-7 days.
**Acute pyelonephritis [doses**
- **Adult** (By Intravenous Injection, Or By Intravenous Infusion): for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection], Urinary-tract infection (catheter-associated) [doses for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection] 1.2 g every 8 hours.
**Infections due to beta-lactamase-producing strains (where amoxicillin alone not appropriate) [doses for 375 mg (250/125 mg) or 625 mg (500/125 mg) tablets] for co-amoxiclav**
- **Child 12-17 years** (By mouth using tablets): 375 mg 3 times a day, alternatively 625 mg 3 times a day.
**Infections due to beta-lactamase-producing strains (where amoxicillin alone not appropriate) [doses for 1 g (875/125 mg) tablets] for co-amoxiclav**
- **Child 6-17 years (body-weight 25-39 kg)** (By mouth using tablets): 1 g twice daily.
- **Child 6-17 years (body-weight 40 kg and above)** (By mouth using tablets): 1 g twice daily, alternatively 1 g 3 times a day.
**Infections due to beta-lactamase-producing strains (where amoxicillin alone not appropriate) [doses for 125/31 mg per 5 mL suspension] for co-amoxiclav**
- **Neonate** (By mouth using oral suspension): 0.25 mL/kilogram 3 times a day.
- **Child 1-11 months** (By mouth using oral suspension): 0.25 mL/kilogram 3 times a day, dose doubled if necessary.
- **Child 1-5 years** (By mouth using oral suspension): 0.25 mL/kilogram 3 times a day, dose doubled if necessary, alternatively 5 mL 3 times a day, dose doubled if necessary.
**Infections due to beta-lactamase-producing strains (where amoxicillin alone not appropriate) [doses for 250/62 mg per 5 mL suspension] for co-amoxiclav**
- **Child 6-11 years** (By mouth using oral suspension): 0.15 mL/kilogram 3 times a day, dose doubled if necessary, alternatively 5 mL 3 times a day, dose doubled if necessary.
**Infections due to beta-lactamase-producing strains (where amoxicillin alone not appropriate) [doses for 400/57 mg per 5 mL suspension] for co-amoxiclav**
- **Child 2-23 months** (By mouth using oral suspension): 0.15 mL/kilogram twice daily, dose doubled if necessary.
- **Child 2-6 years (body-weight 13-21 kg)** (By mouth using oral suspension): 2.5 mL twice daily, dose doubled if necessary.
- **Child 7-12 years (body-weight 22-40 kg)** (By mouth using oral suspension): 5 mL twice daily, dose doubled if necessary.
- **Child 12-17 years (body-weight 41 kg and above)** (By mouth using oral suspension): 10 mL twice daily, alternatively 10 mL 3 times a day.
**Infections due to beta-lactamase-producing strains (where amoxicillin alone not appropriate) [doses for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection] for co-amoxiclav**
- **Neonate** (By intravenous injection, or by intravenous infusion): 30 mg/kg every 12 hours, intravenous infusion recommended in children less than 3 months.
- **Child 1-2 months** (By intravenous injection, or by intravenous infusion): 30 mg/kg every 12 hours, intravenous infusion recommended in children less than 3 months.
- **Child 3 months-17 years** (By intravenous injection, or by intravenous infusion): 30 mg/kg every 8 hours (max. per dose 1.2 g).
**Infections due to beta-lactamase-producing strains (where amoxicillin alone not appropriate) [doses for 2.2 g (2000/200 mg) injection] for co-amoxiclav**
- **Neonate** (By intravenous infusion): 55 mg/kg every 12 hours.
- **Child 1-2 months** (By intravenous infusion): 55 mg/kg every 12 hours.
- **Child 3 months-17 years (body-weight 4-39 kg)** (By intravenous infusion): 55 mg/kg every 8 hours.
- **Child 3 months-17 years (body-weight 40 kg and above)** (By intravenous infusion): 1.1 g every 8 hours, alternatively 2.2 g every 12 hours, increased if necessary to 2.2 g every 8 hours.
**Cellulitis [doses for 375 mg (250/125 mg) or 625 mg (500/125 mg) tablets], Erysipelas [doses for 375 mg (250/125 mg) or 625 mg (500/125 mg) tablets] for co-amoxiclav**
- **Child 12-17 years** (By mouth using tablets): 375 mg 3 times a day for 5-7 days then review (review after 7 days in severe infection or if infection near the eyes or nose), alternatively 625 mg 3 times a day for 5-7 days then review (review after 7 days in severe infection or if infection near the eyes or nose).
**Cellulitis [doses for 125/31 mg per 5 mL suspension], Erysipelas [doses for 125/31 mg per 5 mL suspension] for co-amoxiclav**
- **Child 1-11 months** (By mouth using oral suspension): 0.25 mL/kilogram 3 times a day for 5-7 days then review (review after 7 days in severe infection or if infection near the eyes or nose), dose doubled if necessary.
- **Child 1-5 years** (By mouth using oral suspension): 0.25 mL/kilogram 3 times a day for 5-7 days then review (review after 7 days in severe infection or if infection near the eyes or nose), dose doubled if necessary, alternatively 5 mL 3 times a day for 5-7 days then review (review after 7 days in severe infection or if infection near the eyes or nose), dose doubled if necessary.
**Cellulitis [doses for 250/62 mg per 5 mL suspension], Erysipelas [doses for 250/62 mg per 5 mL suspension] for co-amoxiclav**
- **Child 6-11 years** (By mouth using oral suspension): 0.15 mL/kilogram 3 times a day for 5-7 days then review (review after 7 days in severe infection or if infection near the eyes or nose), dose doubled if necessary, alternatively 5 mL 3 times a day for 5-7 days then review (review after 7 days in severe infection or if infection near the eyes or nose), dose doubled if necessary.
**Cellulitis [doses for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection], Erysipelas [doses for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection] for co-amoxiclav**
- **Child 1-2 months** (By intravenous injection, or by intravenous infusion): 30 mg/kg every 12 hours, intravenous infusion recommended in children less than 3 months.
- **Child 3 months-17 years** (By intravenous injection, or by intravenous infusion): 30 mg/kg every 8 hours (max. per dose 1.2 g).
**Prophylaxis of infection from human bites [doses for 375 mg (250/125 mg) or 625 mg (500/125 mg) tablets], Prophylaxis of infection from animal bites [doses for 375 mg (250/125 mg) or 625 mg (500/125 mg) tablets] for co-amoxiclav**
- **Child 12-17 years** (By mouth using tablets): 375 mg 3 times a day for 3 days, alternatively 625 mg 3 times a day for 3 days.
**Prophylaxis of infection from human bites [doses for 125/31 mg per 5 mL suspension], Prophylaxis of infection from animal bites [doses for 125/31 mg per 5 mL suspension] for co-amoxiclav**
- **Child 1-11 months** (By mouth using oral suspension): 0.25 mL/kilogram 3 times a day for 3 days.
- **Child 1-5 years** (By mouth using oral suspension): 0.25 mL/kilogram 3 times a day for 3 days, alternatively 5 mL 3 times a day for 3 days.
**Prophylaxis of infection from human bites [doses for 250/62 mg per 5 mL suspension], Prophylaxis of infection from animal bites [doses for 250/62 mg per 5 mL suspension] for co-amoxiclav**
- **Child 6-11 years** (By mouth using oral suspension): 0.15 mL/kilogram 3 times a day for 3 days, alternatively 5 mL 3 times a day for 3 days.
**Prophylaxis of infection from human bites [doses for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection], Prophylaxis of infection from animal bites [doses for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection] for co-amoxiclav**
- **Child 1-2 months** (By intravenous injection, or by intravenous infusion): 30 mg/kg every 12 hours, intravenous infusion recommended in children less than 3 months.
- **Child 3 months-17 years** (By intravenous injection, or by intravenous infusion): 30 mg/kg every 8 hours (max. per dose 1.2 g).
**Treatment of infection from human bites [doses for 375 mg (250/125 mg) or 625 mg (500/125 mg) tablets], Treatment of infection from animal bites [doses for 375 mg (250/125 mg) or 625 mg (500/125 mg) tablets] for co-amoxiclav**
- **Child 12-17 years** (By mouth using tablets): 375 mg 3 times a day for 5-7 days, alternatively 625 mg 3 times a day for 5-7 days.
**Treatment of infection from human bites [doses for 125/31 mg per 5 mL suspension], Treatment of infection from animal bites [doses for 125/31 mg per 5 mL suspension] for co-amoxiclav**
- **Child 1-11 months** (By mouth using oral suspension): 0.25 mL/kilogram 3 times a day for 5-7 days.
- **Child 1-5 years** (By mouth using oral suspension): 0.25 mL/kilogram 3 times a day for 5-7 days, alternatively 5 mL 3 times a day for 5-7 days.
**Treatment of infection from human bites [doses for 250/62 mg per 5 mL suspension], Treatment of infection from animal bites [doses for 250/62 mg per 5 mL suspension] for co-amoxiclav**
- **Child 6-11 years** (By mouth using oral suspension): 0.15 mL/kilogram 3 times a day for 5-7 days, alternatively 5 mL 3 times a day for 5-7 days.
**Treatment of infection from human bites [doses for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection], Treatment of infection from animal bites [doses for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection] for co-amoxiclav**
- **Child 1-2 months** (By intravenous injection, or by intravenous infusion): 30 mg/kg every 12 hours, intravenous infusion recommended in children less than 3 months.
- **Child 3 months-17 years** (By intravenous injection, or by intravenous infusion): 30 mg/kg every 8 hours (max. per dose 1.2 g).
**Severe dental infection with spreading cellulitis [doses for 375 mg (250/125 mg) tablets], Dental infection not responding to first-line antibacterial [doses for 375 mg (250/125 mg) tablets] for co-amoxiclav**
- **Child 12-17 years** (By mouth using tablets): 375 mg 3 times a day for 5 days.
**Community-acquired pneumonia [doses for 625 mg (500/125 mg) tablets] for co-amoxiclav**
- **Child 12-17 years** (By mouth using tablets): 625 mg 3 times a day for 5 days.
**Community-acquired pneumonia [doses for 125/31 mg per 5 mL suspension] for co-amoxiclav**
- **Child 1-11 months** (By mouth using oral suspension): 0.5 mL/kilogram 3 times a day for 5 days.
- **Child 1-5 years** (By mouth using oral suspension): 0.5 mL/kilogram 3 times a day for 5 days, alternatively 10 mL 3 times a day for 5 days.
**Community-acquired pneumonia [doses for 250/62 mg per 5 mL suspension] for co-amoxiclav**
- **Child 6-11 years** (By mouth using oral suspension): 0.3 mL/kilogram 3 times a day for 5 days, alternatively 10 mL 3 times a day for 5 days.
**Community-acquired pneumonia [doses for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection] for co-amoxiclav**
- **Child 1-2 months** (By intravenous injection, or by intravenous infusion): 30 mg/kg every 12 hours, intravenous infusion recommended in children less than 3 months.
- **Child 3 months-17 years** (By intravenous injection, or by intravenous infusion): 30 mg/kg every 8 hours (max. per dose 1.2 g).
**Hospital-acquired pneumonia [doses for 625 mg (500/125 mg) tablets] for co-amoxiclav**
- **Child 12-17 years** (By mouth using tablets): 625 mg 3 times a day for 5 days then review.
**Hospital-acquired pneumonia [doses for 125/31 mg per 5 mL suspension] for co-amoxiclav**
- **Child 1-11 months** (By mouth using oral suspension): 0.5 mL/kilogram 3 times a day for 5 days then review.
- **Child 1-5 years** (By mouth using oral suspension): 0.5 mL/kilogram 3 times a day for 5 days then review, alternatively 10 mL 3 times a day for 5 days then review.
**Hospital-acquired pneumonia [doses for 250/62 mg per 5 mL suspension] for co-amoxiclav**
- **Child 6-11 years** (By mouth using oral suspension): 0.3 mL/kilogram 3 times a day for 5 days then review, alternatively 10 mL 3 times a day for 5 days then review.
**Acute exacerbation of bronchiectasis [doses for 375 mg (250/125 mg) or 625 mg (500/125 mg) tablets] for co-amoxiclav**
- **Child 12-17 years** (By mouth using tablets): 375 mg 3 times a day for 7-14 days, alternatively 625 mg 3 times a day for 7-14 days.
**Acute exacerbation of bronchiectasis [doses for 125/31 mg per 5 mL suspension] for co-amoxiclav**
- **Child 1-11 months** (By mouth using oral suspension): 0.25 mL/kilogram 3 times a day for 7-14 days.
- **Child 1-5 years** (By mouth using oral suspension): 0.25 mL/kilogram 3 times a day for 7-14 days, alternatively 5 mL 3 times a day for 7-14 days.
**Acute exacerbation of bronchiectasis [doses for 250/62 mg per 5 mL suspension] for co-amoxiclav**
- **Child 6-11 years** (By mouth using oral suspension): 0.15 mL/kilogram 3 times a day for 7-14 days, alternatively 5 mL 3 times a day for 7-14 days.
**Acute exacerbation of bronchiectasis [doses for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection] for co-amoxiclav**
- **Child 1-2 months** (By intravenous injection, or by intravenous infusion): 30 mg/kg every 12 hours, intravenous infusion is recommended in children less than 3 months.
- **Child 3 months-17 years** (By intravenous injection, or by intravenous infusion): 30 mg/kg every 8 hours (max. per dose 1.2 g).
**Acute sinusitis [doses for 375 mg (250/125 mg) or 625 mg (500/125 mg) tablets] for co-amoxiclav**
- **Child 12-17 years** (By mouth using tablets): 375 mg 3 times a day for 5 days, alternatively 625 mg 3 times a day for 5 days.
**Acute sinusitis [doses for 125/31 mg per 5 mL suspension] for co-amoxiclav**
- **Child 1-11 months** (By mouth using oral suspension): 0.25 mL/kilogram 3 times a day for 5 days.
- **Child 1-5 years** (By mouth using oral suspension): 0.25 mL/kilogram 3 times a day for 5 days, alternatively 5 mL 3 times a day for 5 days.
**Acute sinusitis [doses for 250/62 mg per 5 mL suspension] for co-amoxiclav**
- **Child 6-11 years** (By mouth using oral suspension): 0.15 mL/kilogram 3 times a day for 5 days, alternatively 5 mL 3 times a day for 5 days.
**Acute otitis media [doses for 375 mg (250/125 mg) or 625 mg (500/125 mg) tablets] for co-amoxiclav**
- **Child 12-17 years** (By mouth using tablets): 375 mg 3 times a day for 5-7 days, alternatively 625 mg 3 times a day for 5-7 days.
**Acute otitis media [doses for 125/31 mg per 5 mL suspension] for co-amoxiclav**
- **Child 1-11 months** (By mouth using oral suspension): 0.25 mL/kilogram 3 times a day for 5-7 days.
- **Child 1-5 years** (By mouth using oral suspension): 0.25 mL/kilogram 3 times a day for 5-7 days, alternatively 5 mL 3 times a day for 5-7 days.
**Acute otitis media [doses for 250/62 mg per 5 mL suspension] for co-amoxiclav**
- **Child 6-11 years** (By mouth using oral suspension): 0.15 mL/kilogram 3 times a day for 5-7 days, alternatively 5 mL 3 times a day for 5-7 days.
**Acute pyelonephritis [doses for 375 mg (250/125 mg) or 625 mg (500/125 mg) tablets], Urinary-tract infection (catheter-associated) [doses for 375 mg (250/125 mg) or 625 mg (500/125 mg) tablets] for co-amoxiclav**
- **Child 12-15 years** (By mouth using tablets): 375 mg 3 times a day for 7-10 days, alternatively 625 mg 3 times a day for 7-10 days.
- **Child 16-17 years** (By mouth using tablets): 625 mg 3 times a day for 7-10 days.
**Acute pyelonephritis [doses for 125/31 mg per 5 mL suspension], Urinary-tract infection (catheter-associated) [doses for 125/31 mg per 5 mL suspension] for co-amoxiclav**
- **Child 3-11 months** (By mouth using oral suspension): 0.25 mL/kilogram 3 times a day for 7-10 days, dose doubled if necessary.
- **Child 1-5 years** (By mouth using oral suspension): 0.25 mL/kilogram 3 times a day for 7-10 days, dose doubled if necessary, alternatively 5 mL 3 times a day for 7-10 days, dose doubled if necessary.
**Acute pyelonephritis [doses for 250/62 mg per 5 mL suspension], Urinary-tract infection (catheter-associated) [doses for 250/62 mg per 5 mL suspension] for co-amoxiclav**
- **Child 6-11 years** (By mouth using oral suspension): 0.15 mL/kilogram 3 times a day for 7-10 days, dose doubled if necessary, alternatively 5 mL 3 times a day for 7-10 days, dose doubled if necessary.
**Acute pyelonephritis [doses for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection], Urinary-tract infection (catheter-associated) [doses for 600 mg (500/100 mg) or 1.2 g (1000/200 mg) injection] for co-amoxiclav**
- **Child 3 months-15 years** (By intravenous injection, or by intravenous infusion): 30 mg/kg every 8 hours (max. per dose 1.2 g).
- **Child 16-17 years** (By intravenous injection, or by intravenous infusion): 1.2 g every 8 hours.
Cautions
History of allergy Cautions For co-amoxiclav General cautions: Acute lymphocytic leukaemia (increased risk of erythematous rashes); chronic lymphocytic leukaemia (increased risk of erythematous rashes); cytomegalovirus infection (increased risk of erythematous rashes); glandular fever (erythematous rashes common); maintain adequate hydration with high doses (particularly during parental therapy) Specific cautions: With intravenous use Accumulation of electrolytes contained in parenteral preparations can occur with high doses
Contraindications
For co-amoxiclav History of co-amoxiclav-associated jaundice or hepatic dysfunction; history of penicillin-associated jaundice or hepatic dysfunction
Side effects
Common or very common Diarrhoea; hypersensitivity; nausea; skin reactions; thrombocytopenia; vomiting Uncommon Arthralgia; leucopenia Rare or very rare Agranulocytosis; angioedema; haemolytic anaemia; hepatic disorders; nephritis tubulointerstitial; neutropenia; pseudomembranous enterocolitis; seizure; severe cutaneous adverse reactions (SCARs) Side-effects, further information Diarrhoea frequently occurs during oral penicillin therapy. It is most common with broad-spectrum penicillins, which can cause antibiotic-associated colitis. Side-effects For co-amoxiclav General side-effects: Common or very common Increased risk of infection Uncommon Dizziness; dyspepsia; headache Frequency not known Acute kidney injury; antibiotic associated colitis; colitis haemorrhagic; crystalluria; enterocolitis; hypersensitivity vasculitis; Kounis syndrome; meningitis aseptic; pancreatitis acute Specific side-effects: Frequency not known With oral use Akathisia; black hairy tongue Side-effects, further information Hepatic events have been reported mostly in males and elderly patients and may be associated with prolonged treatment. Signs and symptoms usually occur during or shortly after treatment but in some cases may occur several weeks after discontinuation.
Pregnancy
For co-amoxiclav Specialist sources indicate not known to be harmful. Avoid in preterm prelabour rupture of the membranes (PPROM)-possible increased risk of necrotising enterocolitis in the neonate.
Breast feeding
For co-amoxiclav Trace amount in milk, but appropriate to use.
Hepatic impairment
For co-amoxiclav Manufacturer advises caution. Monitoring Monitor liver function in liver disease.
Renal impairment
For co-amoxiclav Risk of crystalluria with high doses (particularly during parenteral therapy). With intravenous use: Accumulation of electrolytes contained in parenteral preparations can occur in patients with renal failure. Dose adjustments See Prescribing in renal impairment . With oral use in adults: Co-amoxiclav 375 mg (250/125 mg) tablets or 625 mg (500/125 mg) tablets : if creatinine clearance 10-30 mL/minute, 375 mg twice daily or 625 mg twice daily; if creatinine clearance less than 10 mL/minute, 375 mg once daily or 625 mg once daily. M Co-amoxiclav 1 g (875/125 mg) tablets or 400/57 mg per 5 mL suspension : avoid if creatinine clearance less than 30 mL/minute. M With intravenous use in adults: Co-amoxiclav 600 mg (500/100 mg) injection or 1.2 g (1000/200 mg) injection : if creatinine clearance 10-30 mL/minute, 1.2 g initially, then 600 mg every 12 hours; if creatinine clearance less than 10 mL/minute, 1.2 g initially, then 600 mg every 24 hours. M Co-amoxiclav 2.2 g (2000/200 mg) injection : avoid if creatinine clearance less than 30 mL/minute. Except when used for Surgical prophylaxis: if creatinine clearance less than 30 mL/minute, 1.1-2.2 g for 1 dose only. M With oral use in children: Co-amoxiclav 375 mg (250/125 mg) tablets, 625 mg (500/125 mg) tablets, 125/31 mg per 5 mL suspension, or 250/62 mg per 5 mL suspension : use normal dose every 12 hours if estimated glomerular filtration rate 10-30 mL/minute/1.73 m 2 . Use the normal dose recommended for mild or moderate infections every 12 hours if estimated glomerular filtration rate less than 10 mL/minute/1.73 m 2 . Co-amoxiclav 1 g (875/125 mg) tablets or 400/57 mg per 5 mL suspension : avoid if creatinine clearance less than 30 mL/minute. M With intravenous use in children: Co-amoxiclav 600 mg (500/100 mg) injection or 1.2 g (1000/200 mg) injection : use normal initial dose and then use half normal dose every 12 hours if estimated glomerular filtration rate 10-30 mL/minute/1.73 m 2 ; use normal initial dose and then use half normal dose every 24 hours if estimated glomerular filtration rate less than 10 mL/minute/1.73 m 2 . Co-amoxiclav 2.2 g (2000/200 mg) injection : avoid if creatinine clearance less than 30 mL/minute. M
Medicinal forms
Tablet,Suspension,Solution,Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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