Co-amoxiclav

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How does it work? 

Augmentin injection, tablets, suspension and Augmentin-duo suspension all contain the active ingredients amoxicillin and clavulanic acid, which together are known as co-amoxiclav. (NB. Co-amoxiclav is also available without a brand name, ie as the generic medicine.) Amoxicillin is a penicillin-type antibiotic, and clavulanic acid is a medicine that prevents bacteria from inactivating the amoxicillin. Co-amoxiclav is used to treat infections caused by bacteria. 

Amoxicillin works by interfering with the ability of bacteria to form cell walls. The cell walls of bacteria are vital for their survival. They keep unwanted substances from entering their cells and stop the contents of their cells from leaking out. Amoxicillin impairs the bonds that hold the bacterial cell wall together. This allows holes to appear in the cell walls and kills the bacteria. 

Certain bacteria are resistant to penicillin-type antibiotics, because they have developed the ability to produce defensive chemicals called beta-lactamases. These interfere with the structure of penicillin-type antibiotics and stop them from working. 

Clavulanic acid is a type of medicine known as a beta-lactamase inhibitor. It is included in this medicine because it inhibits the action of the beta-lactamases produced by certain bacteria. It prevents these bacteria from inactivating the amoxicillin, and leaves the bacteria susceptible to attack. Clavulanic acid therefore increases the range of bacteria that amoxicillin can kill. 

Co-amoxiclav is a broad-spectrum antibiotic that kills a wide variety of bacteria that cause a wide variety of commonly-occuring infections. Co-amoxiclav may be used to treat infections of the upper or lower airways, skin or soft tissue, or ears. It may also be used to treat urine infections, certain sexually-transmitted infections, dental infections, and infections affecting the blood or internal organs. 

To make sure the bacteria causing an infection are susceptible to co-amoxiclav, your doctor may take a tissue sample, for example a swab from the throat or skin, or a urine or blood sample. 

Co-amoxiclav injection is used to treat more serious infections, or in cases where the medicine can't be taken by mouth. It may also given to prevent infection following surgery, particularly gastrointestinal, pelvic, major head and neck surgery and after limb amputation. The injection is given by injection or infusion (drip) into a vein.

  What is it used for? 

    * Bacterial infections of the upper respiratory tract (nasal passages, sinuses etc) eg sinusitis.

    * Bacterial infections of the lower respiratory tract (lungs, airways) eg bronchitis, pneumonia.

    * Bacterial infections of the ears, nose or throat, eg otitis media, tonsillitis.

    * Bacterial infections of the urinary tract, in particular recurrent cystitis.

    * Bacterial infections of the genital organs, including those following childbirth or abortion.

    * Bacterial infections inside the abdomen, eg peritonitis.

    * Bacterial infections of the skin and soft tissue, eg cellulitis, animal bites.

    * Dental abscesses.

    * Preventing infections following surgery (by injection).

 Warning! 

    * Augmentin tablets and suspensions are absorbed into the bloodstream better if taken at the start of a meal. This may also minimise any side effects on the gut.

    * People receving high doses of this medicine, particularly by injection, should make sure they drink plenty of fluid to reduce the risk of crystals forming in the urine. If in hospital, this fluid may be given via a drip.

    * Unless your doctor tells you otherwise, it is important that you finish the prescribed course of this antibiotic medicine, even if you feel better or it seems the infection has cleared up. Stopping the course early increases the chance that the infection will come back and that the bacteria will grow resistant to the antibiotic.

    * Broad-spectrum antibiotics can sometimes cause inflammation of the bowel (colitis). For this reason, if you get diarrhoea either during or after taking this medicine, particularly if it becomes severe or persistent, or contains blood or mucus, you should consult your doctor immediately.

    * Co-amoxiclav can rarely cause cholestatic jaundice either during or following treatment. For this reason, the duration of treatment should not exceed 14 days without review by your doctor. Consult your doctor if you experience any yellowing of the eyes or skin while taking this medicine, or in the few weeks after finishing treatment. This side effect is more common in people above the age of 65 years and in men.

    * People with impaired liver function should have their liver function monitored while receiving treatment with this medicine. 

Use with caution in 

    * Decreased kidney function.
    * Decreased liver function.
    * History of allergies.
    * Sodium restriction (injection only).
    * Augmentin suspensions and Augmentin Duo suspensions contain aspartame, which is a source of phenylalanine. As a result, these suspensions may not be suitable for people with an inherited disorder of protein metabolism called phenylketonuria. 

Not to be used in 

    * Allergy to penicillin or cephalosporin-type antibiotics.

    * History of liver problems or jaundice caused by previous use of this medicine or other penicillin antibiotics. 

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately. 

Pregnancy and breastfeeding 

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine. 

    * This medicine is not expected to be harmful when used during pregnancy. However, the manufacturer states that as with all medicines, use should be avoided during pregnancy unless considered essential by your doctor. Seek medical advice from your doctor.

    * The medicine passes into the breast milk, but at normal doses it is unlikely to harm the baby. Discuss with your doctor. 

Label warnings 

    * Take at regular intervals. Complete the prescribed course unless otherwise directed.

Side effects 

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect. 

    * Diarrhoea.
    * Indigestion.
    * Nausea.
    * Vomiting.
    * Overgrowth of the yeast Candida, which may cause infection such as thrush.
    * Allergic skin reactions such as rash, itching.
    * Yellowing of the skin and eyes (jaundice).
    * Inflammation of the liver (hepatitis).
    * Blood disorders.
    * Tooth discolouration, mainly with the suspension - this can be removed by brushing.
    * Inflammation of the wall of a vein with a blood clot forming in the affected segment of vein (thrombophlebitis) - injection only.
    * Dizziness.
    * Headache.
    * Hyperactivity.
    * Convulsions.
    * Severe allergic reactions, eg anaphylaxis. 

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist. 

How can this medicine affect other medicines? 

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe. 

There may be an increased risk of experiencing a rash as a side effect of this medicine if you are also taking allopurinol. 

Amoxicillin may decrease the removal of methotrexate from the body, increasing the risk of side effects. If you are taking methotrexate you should be well monitored by your doctor while you are taking a course of this antibiotic. 

Probenecid increases the blood level of amoxicillin, and people taking probenecid may be prescribed a lower dose of this medicine. 

Amoxicillin may rarely alter the anti-blood-clotting effects of anticoagulant medicines such as warfarin. Your doctor may want to monitor your blood clotting time more frequently if you are taking an anticoagulant in combination with this medicine. 

If you are taking a combined oral contraceptive pill or are using contraceptive patches, there may be a very low risk that this antibiotic may make it less effective at preventing pregnancy. Although the risk of this is very low, the personal and ethical consequences of an unwanted pregnancy can be very serious. For this reason, the Family Planning Association recommends that women using a combined contraceptive pill or patch should use an extra method of contraception (eg condoms) while taking a short course of broad-spectrum antibiotic, and for seven days after finishing the course. If the seven days run beyond the end of a pill packet, a new packet should be started without a break (in the case of ED pills the inactive tablets should be omitted). If the seven days run beyond the 3 weeks of patch treatment, a new treatment cycle should be started immediately without a patch-free break.

Other medicines containing the same active ingredients 

Co-amoxiclav tablets, suspension and injection are also available without a brand name, ie as the generic medicine.

Note : This product information is intended only for residents of the India. Taj Pharmaceuticals Limited, medicines help to treat and prevent a range of conditions—from the most common to the most challenging—for people around the world.