Amoxicillin / clavulanate XR

Class
Antibiotics
Subclass
Penicillin / β-lactamase inhibitor combination
Substance name
Amoxicillin / clavulanate, co-amoxiclav, amox-clav XR
Brand names
Augmentin XR®
Contains
Amoxicillin
Clavulanate
Common formulations
Film-coated tablet
See also
Amoxicillin / clavulanate (Augmentin®)
Dosage and administration
Adults patients
Acute bacterial rhinosinusitis
•
2,000/125 mg PO BID for 5-7 days
Community-acquired pneumonia
•
2,000/125 mg PO BID for 7-10 days
Acute diverticulitis • Uncomplicated, outpatient, symptoms persisting or worsening after 48-72 hours • Off-label
•
875/125 mg PO BID for 7-10 days
Indications for use
Labeled indications
Adults
•
Treatment of acute bacterial rhinosinusitis
•
Treatment of community-acquired pneumonia
Off-label indications
Adults
•
Treatment of acute diverticulitis (uncomplicated, outpatient, symptoms persisting or worsening after 48-72 hours)
Safety risks
Contraindications
Hypersensitivity to amoxicillin/clavulanate or its components or to other β-lactams
History of cholestatic jaundice or hepatic dysfunction associated with amoxicillin/clavulanate
Mononucleosis
•
Do not use amoxicillin/clavulanate in patients with mononucleosis because of the risk of amoxicillin-induced rash.
Warnings and precautions
Antimicrobial resistance
•
Maintain a high level of suspicion, as the use of amoxicillin/clavulanate in the absence of a proven or strongly suspected bacterial infection increases the risk of developing drug-resistant bacteria.
C. difficile infection
•
Maintain a high level of suspicion, as nearly all antibiotics, including amoxicillin/clavulanate, are associated with an increased risk of C. difficile-associated diarrhea.
Exacerbation of phenylketonuria
•
Use caution in patients with phenylketonuria, as chewable tablets and powder for oral solution contain phenylalanine.
Hepatotoxicity
•
Use caution in patients with hepatic impairment.
Specific populations
Renal impairment
eGFR ≥ 30 mL/min/1.73 m²
•
No guidance available.
eGFR < 30 mL/min/1.73 m²
•
Do not use.
Renal replacement therapy
Any modality
•
Do not use.
Hepatic impairment
Any severity
•
Use with caution. Monitor liver function tests.
Pregnancy and breastfeeding
Pregnancy
All trimesters • Australia Category: B1
•
Generally acceptable for use. The 2020 ERS/TSANZ task force statement suggests that amoxicillin/clavulanate is compatible with pregnancy for the management of airway diseases. Do not use amoxicillin/clavulanate for preterm prelabor rupture of membranes due to the potential risk of necrotizing enterocolitis.
Breastfeeding
Use with caution during breastfeeding.
•
The 2020 ERS/TSANZ task force statement suggests that amoxicillin/clavulanate is compatible with breastfeeding for the management of airway diseases.
Unknown drug levels in breastfed infants.
May potentially cause adverse effects in breastfed infants.
Adverse reactions
Very common > 10%
•
Diarrhea
Common 1-10%
•
Nausea, vulvovaginal candidiasis
Unknown frequency
•
Gastritis, glossitis, enterocolitis, mucocutaneous candidiasis, Clostridioides difficile infection, serum sickness-like reaction, erythema multiforme, Stevens-Johnson syndrome, acute generalized exanthematous pustulosis, exfoliative dermatitis, hypersensitivity vasculitis, hepatic dysfunction, hepatitis, cholestatic jaundice, interstitial nephritis, hemolytic anemia, dyspepsia, black hairy tongue, angioedema, pruritus, ↑ serum TBIL, ↑ serum transaminases, ↑ serum ALP, hematuria, crystalluria, anemia, ↓ platelet count, ↑ blood eosinophil count, purpura, ↓ WBC count, agranulocytosis, seizure, anxiety, confusion, dizziness, agitation, behavioral or personality changes, hyperactivity, insomnia, tooth discoloration, skin rash, vomiting, urticaria, abdominal discomfort, flatulence, ↑ platelet count, headache
Interactions
Drug(s)
Check Interactions
Reset

What did you think about this content?

Create free account

Sign up for free to access the full drug resource