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Amoxicillin: Drug information

Amoxicillin: Drug information
(For additional information see "Amoxicillin: Patient drug information" and see "Amoxicillin: Pediatric drug information")

For abbreviations and symbols that may be used in Lexicomp (show table)
Brand Names: US
  • Moxatag [DSC]
Brand Names: Canada
  • AG-Amoxicillin;
  • APO-Amoxi;
  • APO-Amoxi Sugar Free;
  • Auro-Amoxicillin;
  • DOM-Amoxicillin;
  • JAMP-Amoxicillin;
  • MYLAN-Amoxicillin [DSC];
  • Novamoxin;
  • PMS-Amoxicillin;
  • Polymox;
  • PRO Amox-500;
  • PRO-Amox-250
Pharmacologic Category
  • Antibiotic, Penicillin
Dosing: Adult

Note: Amoxicillin 775 mg ER tablets (brand and generic) have been discontinued in the United States for >1 year.

Note: Unless otherwise specified, all dosing recommendations based on immediate-release product formulations.

Usual dosage range:

Immediate release: Oral: 500 mg to 1 g every 8 to 12 hours.

Extended release: Oral: 775 mg once daily.

Actinomycosis (off-label use):

Note: For initial therapy of mild infection or step-down therapy following parenteral treatment of severe infection.

Oral: 500 mg 3 to 4 times daily or 1 g 3 times daily (Brook 2020; Martin 1984; Paulo 2018); higher doses of 4 to 6 g/day in divided doses have been utilized in case reports (Moghimi 2013; Valour 2014). Optimal duration is uncertain; some experts suggest total durations of 2 to 6 months for mild infection and 6 to 12 months for severe or extensive infection (Brook 2020).

Anthrax (alternative agent [susceptible strains only]) (off-label use):

Note: Consult public health officials for event-specific recommendations. A high index of suspicion for emergent beta-lactam resistance during therapy is warranted (CDC [Hendricks 2014]).

Inhalational exposure postexposure prophylaxis (PEP): Oral: 1 g every 8 hours (CDC [Hendricks 2014]); duration depends on anthrax vaccine status and series completion, age, immune status, and pregnancy/breastfeeding status. For those who have not previously received anthrax vaccine, duration ranges from 42 to 60 days (CDC [Bower 2019]).

Note: Anthrax vaccine should also be administered to exposed individuals (CDC [Bower 2019]; CDC [Hendricks 2014]).

Cutaneous, without systemic involvement, treatment: Oral: 1 g every 8 hours; duration is 7 to 10 days after naturally acquired infection and 60 days following biological weapon-related event. Note: Patients with extensive edema or cutaneous lesions of the head or neck should be treated with a parenteral regimen recommended for systemic involvement (CDC [Hendricks 2014]).

Asplenia, prophylaxis against bacterial infection in select high-risk patients (off-label use): Oral: Based on expert opinion: 500 mg twice daily. Duration varies based on patient-specific factors (Pasternack 2020).

Bronchiectasis (off-label use):

Treatment of pulmonary exacerbations in patients without beta-lactamase-positive Haemophilus influenzae or Pseudomonas aeruginosa: Oral: 500 mg 3 times daily (Barker 2020; Finegold 1981) or 1 g 3 times daily (Prigogine 1988) for up to 14 days (Barker 2020; ERS [Polverino 2017]).

Prevention of pulmonary exacerbations: Oral: 500 mg twice daily; dosing based on expert opinion (Barker 2020). Note: Recommended for patients with ≥3 exacerbations per year who are not colonized with P. aeruginosa and not candidates for long-term macrolide therapy (Barker 2020; ERS [Polverino 2017]).

Endocarditis, prophylaxis (dental or invasive respiratory tract procedures) (off-label use): Oral: 2 g 30 to 60 minutes before procedure. Note: Only recommended for patients with cardiac conditions associated with the highest risk of an adverse outcome from endocarditis and who are undergoing a procedure likely to result in bacteremia with an organism that has the potential ability to cause endocarditis (AHA [Wilson 2007]).

Helicobacter pylori eradication: Oral:

Clarithromycin triple regimen: Amoxicillin 1 g twice daily in combination with clarithromycin 500 mg twice daily, plus a standard-dose or double-dose proton pump inhibitor; continue regimen for 14 days. Note: Avoid use in patients with risk factors for macrolide resistance (eg, prior macrolide exposure or local clarithromycin resistance rates ≥15%, which is assumed in the United States) (ACG [Chey 2017]; Fallone 2016).

Concomitant regimen: Amoxicillin 1 g twice daily in combination with clarithromycin 500 mg twice daily, either metronidazole or tinidazole 500 mg twice daily, plus a standard-dose proton pump inhibitor twice daily; continue regimen for 10 to 14 days (ACG [Chey 2017]).

Sequential regimen (alternative regimen): Amoxicillin 1 g twice daily plus a standard-dose proton pump inhibitor twice daily for 5 to 7 days; followed by clarithromycin 500 mg twice daily, either metronidazole or tinidazole 500 mg twice daily, plus a standard-dose proton pump inhibitor twice daily for 5 to 7 days; some experts prefer the 10-day regimen due to the lack of data showing superiority of the 14-day sequential regimen in North America (ACG [Chey 2017]; Crowe 2020).

Hybrid regimen (alternative regimen): Amoxicillin 1 g twice daily, plus a standard-dose proton pump inhibitor twice daily for 7 days; followed by amoxicillin 1 g twice daily, clarithromycin 500 mg twice daily, either metronidazole or tinidazole 500 mg twice daily, plus a standard-dose proton pump inhibitor twice daily for 7 days (ACG [Chey 2017]).

Levofloxacin triple regimen (salvage regimen): Amoxicillin 1 g twice daily in combination with a standard-dose proton pump inhibitor twice daily plus levofloxacin 500 mg once daily; continue regimen for 10 to 14 days (ACG [Chey 2017]).

High-dose dual therapy (salvage regimen): Amoxicillin 750 mg 4 times daily or 1 g 3 times daily; in combination with a standard-dose or double-dose proton pump inhibitor 3 to 4 times daily for 14 days (ACG [Chey 2017]).

Lyme disease (Borrelia spp. infection) (off-label use):

Erythema migrans: Oral: 500 mg 3 times daily for 14 days (IDSA/AAN/ACR [Lantos 2021]).

Carditis (initial therapy for mild disease [first-degree atrioventricular block with PR interval <300 msec] or step-down therapy after initial parenteral treatment for more severe disease once PR interval <300 msec): Oral: 500 mg 3 times daily for 14 to 21 days (IDSA/AAN/ACR [Lantos 2021]).

Arthritis without neurologic involvement: Oral: 500 mg 3 times daily for 28 days (IDSA/AAN/ACR [Lantos 2021]).

Odontogenic infection (eg, periodontitis, severe) (off-label use): Oral: 500 mg every 8 hours in combination with metronidazole for 7 to 14 days; use in addition to periodontal debridement (Borges 2017; Chow 2020; Silva-Senem 2013; Wilder 2020).

Otitis media, acute (alternative agent): Limited data: Oral: 500 mg every 8 hours or 875 mg every 12 hours (WHO 2001; manufacturer's labeling). Some experts use 1 g every 8 hours for patients at high risk of severe infection or resistant Streptococcus pneumoniae. Duration is 5 to 7 days for mild to moderate infection and 10 days for severe infection (Limb 2021).

Note: Some experts recommend amoxicillin/clavulanate over amoxicillin alone because of concern for decreased penicillin susceptibility in Streptococcus pneumoniae and other otopathogens (Limb 2021).

Pneumonia, community acquired:

Empiric therapy, outpatient (patients without comorbidities or risk factors for antibiotic-resistant pathogens):

Oral: 1 g 3 times daily (ATS/IDSA [Metlay 2019]); some experts prefer use of amoxicillin in combination with an antibiotic that targets atypical pathogens (File 2020a).

Oral step-down therapy following initial parenteral therapy, inpatient:

Oral: 1 g 3 times daily; some experts use lower doses (500 mg 3 times daily or 875 mg twice daily) for patients without risk factors for drug-resistant S. pneumoniae (eg, age <65 years without comorbidities) (Andes 1998; File 2021b; Musher 2001).

Duration is for a minimum of 5 days; patients should be clinically stable with normal vital signs before therapy is discontinued (ATS/IDSA [Metlay 2019]).

Prosthetic joint infection, chronic suppression (off-label use):

Note: For infection caused by beta-hemolytic streptococci, penicillin-susceptible Enterococcus spp., or Cutibacterium spp. (following pathogen-specific IV therapy in patients undergoing 1-stage exchange or debridement with retention of prosthesis).

Oral: 500 mg 3 times daily (IDSA [Osmon 2013]; Siqueria 2015); duration depends on patient-specific factors (Berbari 2019).

Rhinosinusitis, acute bacterial:

Note: In uncomplicated acute bacterial rhinosinusitis, initial observation and symptom management without antibiotic therapy is appropriate in most patients. Reserve antibiotic therapy for poor follow-up or lack of improvement over the observation period (AAO-HNS [Rosenfeld 2015]; ACP/CDC [Harris 2016]). For initial therapy of nonsevere infection in patients without risk factors for pneumococcal resistance or poor outcome (eg, ≥65 years of age, recent hospitalization or antibiotic use, multiple comorbidities, high endemic resistance) (AAO-HNS [Rosenfeld 2015]; Patel 2021).

Oral: 500 mg every 8 hours or 875 mg every 12 hours for 5 to 7 days (AAO-HNS [Rosenfeld 2015]; Garbutt 2012; Lindbaek 1996; Patel 2021).

Skin and soft tissue infection:

Erysipelas, treatment of mild infection or step-down therapy after initial parenteral therapy:

Oral: 500 mg 3 times daily or 875 mg twice daily; total duration is 5 days, with extension to 14 days for slow response, severe infection, or immunosuppression (Spelman 2020; manufacturer's labeling).

Erysipeloid (localized cutaneous Erysipelothrix rhusiopathiae infection):

Oral: 500 mg 3 times daily for 5 to 10 days (IDSA [Stevens 2014]; Reboli 2020).

Streptococcal pharyngitis (group A): Oral: 500 mg twice daily or 1 g once daily for 10 days (AHA [Gerber 2009]; IDSA [Shulman 2012]).

Extended release: 775 mg once daily for 10 days.

Urinary tract infection:

Note: Not recommended for empiric therapy given decreased efficacy compared to first-line agents and high prevalence of resistance (IDSA/ESCMID [Gupta 2011]).

Asymptomatic bacteriuria (≥105 CFU per mL) in pregnancy (eg, group B Streptococcus): Oral: 500 mg every 8 hours or 875 mg every 12 hours for 4 to 7 days (ACOG 797 2020; Hooton 2021a; IDSA [Nicolle 2019]).

Cystitis, acute uncomplicated or acute simple cystitis (infection limited to the bladder without signs/symptoms of upper tract, prostate, or systemic infection) due to Enterococcus spp.: Oral: 500 mg every 8 hours or 875 mg every 12 hours for 5 days (Cole 2015; Hooton 2021b; Murray 2021; Swaminathan 2010).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Renal Impairment: Adult

The renal dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.

Altered kidney function:

Oral: Immediate release:

Amoxicillin Dose Adjustments in Kidney Impairment

GFR (mL/minute)

If the normal recommended dose is 250 to 500 mg every 8 hoursa

If the normal recommended dose is 875 mg to 1 g every 12 hoursb

If the normal recommended dose is 1 g every 8 hoursb,c

aGolightly 2013; Szeto 2017; manufacturer's labeling; expert opinion

bExpert opinion

cKeller 2015

dDialyzable (30% to 47% with low flux filters [Davies 1988; Francke 1979]). If utilizing a 24-hour dosing interval, administer dose after dialysis or give an additional dose after dialysis on dialysis days.

≥30

No dosage adjustment necessary

No dosage adjustment necessary

No dosage adjustment necessary

10 to 30

250 to 500 mg every 12 hours

500 mg every 12 hours

1 g every 12 hours

<10

250 to 500 mg every 12 to 24 hours

500 mg every 12 to 24 hours

500 mg every 12 hours

Hemodialysis, intermittent (thrice weekly)d

250 to 500 mg every 12 to 24 hours

500 mg every 12 to 24 hours

500 mg every 12 hours

Peritoneal dialysis

250 to 500 mg every 12 hours

500 mg every 12 hours

500 mg every 12 hours

Oral: Extended release:

CrCl ≥30 mL/minute: There are no dosage adjustments provided in the manufacturer's labeling (has not been studied).

CrCl <30 mL/minute: Not recommended.

Hemodialysis, intermittent (thrice weekly): Not recommended.

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Pediatric

(For additional information see "Amoxicillin: Pediatric drug information")

Note: Unless otherwise specified, all pediatric dosing recommendations based on immediate-release product formulations (oral suspension, chewable tablet, tablet, and capsule). Amoxicillin 775 mg ER tablets (brand [Moxatag] and generic) have been discontinued in the US for >1 year.

General dosing, susceptible infection:

Mild to moderate infection:

Infants ≤3 months: Oral: 25 to 50 mg/kg/day in divided doses every 8 hours (Red Book [AAP 2015]). Note: Manufacturer's labeling recommends a maximum daily dose of 30 mg/kg/day divided into 2 doses per day for this age group.

Infants >3 months, Children, and Adolescents:

AAP recommendations (Red Book [AAP 2015]): Oral: 25 to 50 mg/kg/day in divided doses every 8 hours; maximum dose: 500 mg/dose.

Manufacturer's labeling: Oral: 20 to 40 mg/kg/day in divided doses every 8 hours (maximum dose: 500 mg/dose) or 25 to 45 mg/kg/day in divided doses every 12 hours (maximum dose: 875 mg/dose).

Severe infection (as step-down therapy): Infants, Children, and Adolescents: Oral: 80 to 100 mg/kg/day in divided doses every 8 hours; maximum dose: 500 mg/dose for most indications (Red Book [AAP 2015]).

Anthrax:

Cutaneous, without systemic involvement: Infants, Children, and Adolescents: Oral: 75 mg/kg/day in 3 divided doses. Maximum dose: 1,000 mg/dose. Duration of therapy: 7 to 10 days for naturally acquired infection, up to 60 days for biological weapon-related exposure (AAP [Bradley 2014]).

Inhalational, postexposure prophylaxis: Infants, Children, and Adolescents: Oral: 75 mg/kg/day in divided doses every 8 hours for 60 days after exposure; maximum dose: 1,000 mg/dose (AAP [Bradley 2014]).

Catheter (peritoneal dialysis), exit-site or tunnel infection: Infants, Children, and Adolescents: Oral: 10 to 20 mg/kg once daily; maximum dose: 1,000 mg/dose (ISPD [Warady 2012]).

Endocarditis, prophylaxis: Note: AHA guidelines (Baltimore 2015) limit the use of prophylactic antibiotics to patients at the highest risk for infective endocarditis (IE) or adverse outcomes (eg, prosthetic heart valves, patients with previous IE, unrepaired cyanotic congenital heart disease, repaired congenital heart disease with prosthetic material or device during first 6 months after procedure, repaired congenital heart disease with residual defects at the site or adjacent to site of prosthetic patch or device, heart transplant recipients with cardiac valvulopathy):

Dental or oral procedures or respiratory tract procedures (eg, tonsillectomy, adenoidectomy): Infants, Children, and Adolescents: Oral: 50 mg/kg 30 to 60 minutes before procedure; maximum dose: 2,000 mg/dose (AHA [Wilson 2007]).

Helicobacter pylori eradication: Limited data available: Note: Use as part of an appropriate combination regimen; usual duration of therapy is 14 days (NASPGHAN/ESPGHAN [Jones 2017]).

Standard-dose regimen:

Weight-directed dosing: Children and Adolescents: Oral: 25 mg/kg/dose twice daily; maximum dose: 1,000 mg/dose (Bontems 2011; Butenko 2017; Iwańczak 2016; Koletzko 2011; Kutluk 2014; Szajewska 2009).

Fixed dosing (NASPGHAN/ESPGHAN [Jones 2017]): Children and Adolescents:

15 to <25 kg: Oral: 500 mg twice daily.

25 to <35 kg: Oral: 750 mg twice daily.

≥35 kg: Oral: 1,000 mg twice daily.

High-dose regimen:

Note: For use in combination with a proton pump inhibitor and metronidazole when susceptibility is unknown or when H. pylori isolate is resistant to clarithromycin AND metronidazole. Fixed (weight-band) dosing based on a target dose of ~75 mg/kg/day divided twice daily; maximum dose reported: 100 mg/kg/day divided twice daily (NASPGHAN/ESPGHAN [Jones 2017]; Schwarzer 2011).

Children and Adolescents (NASPGHAN/ESPGHAN [Jones 2017]; Schwarzer 2011):

15 to <25 kg: Oral: 750 mg twice daily.

25 to <35 kg: Oral: 1,000 mg twice daily.

≥35 kg: Oral: 1,500 mg twice daily.

Lyme disease ( Borrelia spp. infection): Infants, Children, and Adolescents: Oral: 50 mg/kg/day in divided doses every 8 hours; maximum dose: 500 mg/dose. Duration of therapy depends on clinical syndrome; treat erythema migrans and borrelial lymphocytoma for 14 days, carditis for 14 to 21 days, arthritis (initial, recurrent, or refractory) for 28 days, and acrodermatitis chronica atrophicans for 21 to 28 days (IDSA/AAN/ACR [Lantos 2021]).

Otitis media, acute (AOM): Infants ≥2 months and Children: Oral: 80 to 90 mg/kg/day in divided doses every 12 hours; variable duration of therapy, if <2 years of age or severe symptoms (any age): 10-day course; if 2 to 5 years of age with mild to moderate symptoms: 7-day course; ≥6 years of age with mild to moderate symptoms: 5- to 7-day course; some experts recommend initiating with 90 mg/kg/day (AAP [Lieberthal 2013]; Red Book [AAP 2015]); a maximum dose is not provided in the Guidelines for The Diagnosis and Management of Acute Otitis Media (AAP [Lieberthal 2013]); however, some experts suggest a maximum daily dose of 4,000 mg/day for high-dose amoxicillin therapy (Bradley 2015).

Peritonitis (peritoneal dialysis), prophylaxis for patients requiring invasive dental procedures: Infants, Children, and Adolescents: Oral: 50 mg/kg administered 30 to 60 minutes before dental procedure; maximum dose: 2,000 mg/dose (ISPD [Warady 2012]).

Pneumonia, community-acquired: Infants ≥3 months, Children, and Adolescents:

Empiric therapy for presumed bacterial pneumonia: Oral: 90 mg/kg/day in divided doses every 12 hours; maximum daily dose: 4,000 mg/day (IDSA [Bradley 2011]).

Group A Streptococcus, mild infection or step-down therapy: Oral: 50 to 75 mg/kg/day in divided doses every 12 hours; maximum daily dose: 4,000 mg/day (IDSA [Bradley 2011]).

Haemophilus influenzae, mild infection or step-down therapy: Oral: 75 to 100 mg/kg/day in divided doses every 8 hours; maximum daily dose: 4,000 mg/day (IDSA [Bradley 2011]).

Streptococcus pneumonia, mild infection or step-down therapy (penicillin MIC ≤2 mcg/mL): Oral: 90 mg/kg/day in divided doses every 12 hours or 45 mg/kg/day in divided doses every 8 hours; maximum daily dose: 4,000 mg/day (IDSA [Bradley 2011]).

Streptococcus pneumonia, relatively resistant (penicillin MIC = 2 mcg/mL): Oral: 90 to 100 mg/kg/day in divided doses every 8 hours; dosing based on pharmacokinetic modeling; Monte Carlo simulations show that this dose provides optimal lung exposures to increase efficacy (Bradley 2010; IDSA [Bradley 2011]).

Pneumococcal infection prophylaxis for anatomic or functional asplenia [eg, sickle cell disease (SCD)] (Price 2007; Red Book [AAP 2015]):

Before 2 months of age (or as soon as SCD is diagnosed or asplenia occurs) through 5 years of age: Oral: 20 mg/kg/day in divided doses every 12 hours; maximum dose: 250 mg/dose.

Children ≥6 years and Adolescents: Oral: 250 mg every 12 hours; Note: The decision to discontinue penicillin prophylaxis after 5 years of age in children who have not experienced invasive pneumococcal infection and have received recommended pneumococcal immunizations is patient and clinician dependent.

Rhinosinusitis, acute bacterial; uncomplicated: Note: AAP guidelines recommend amoxicillin as first-line empiric therapy for pediatric patients 1 to 18 years with uncomplicated cases and where resistance is not suspected; however, the IDSA guidelines consider amoxicillin/clavulanate as the preferred therapy (IDSA [Chow 2012]; AAP [Wald 2013]):

Low dose: Children ≥2 years and Adolescents: Oral: 45 mg/kg/day in divided doses every 12 hours; Note: Only use for uncomplicated, mild to moderate infections in children who do not attend daycare and who have not received antibiotics within the last month (AAP [Wald 2013]).

High dose (use reserved for select patients; see Note): Children ≥2 years and Adolescents: Oral: 80 to 90 mg/kg/day in divided doses every 12 hours; maximum dose: 2,000 mg/dose; Note: Should only use for mild to moderate infections in children who do not attend daycare and who have not received antibiotics within the last month and live in communities with a high prevalence of nonsusceptible S. pneumoniae resistance (AAP [Wald 2013]).

Tonsillopharyngitis; Group A streptococcal infection, treatment and primary prevention of rheumatic fever:

Immediate release (oral suspension, chewable tablets, tablets, capsules): Children and Adolescents 3 to 18 years: Oral: 50 mg/kg once daily or 25 mg/kg twice daily for 10 days; maximum daily dose: 1,000 mg/day (AHA [Gerber 2009]; IDSA [Shulman 2012]).

Extended-release tablets: Children ≥12 years and Adolescents: Oral: 775 mg once daily for 10 days; Note: Patient must be able to swallow tablet whole.

UTI, prophylaxis (hydronephrosis, vesicoureteral reflux): Infants ≤2 months: Oral: 10 to 15 mg/kg once daily; some suggest administration in the evening (drug resides in bladder longer); Note: Due to resistance, amoxicillin should not be used for prophylaxis after 2 months of age (Belarmino 2006; Greenbaum 2006; Mattoo 2007).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Renal Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling; however, the following guidelines have been used by some clinicians (Aronoff 2007): Oral:

Immediate release: Infants, Children, and Adolescents:

Mild to moderate infection: Dosing based on 25 to 50 mg/kg/day divided every 8 hours:

GFR >30 mL/minute/1.73 m2: No adjustment required

GFR 10 to 29 mL/minute/1.73 m2: 8 to 20 mg/kg/dose every 12 hours

GFR <10 mL/minute/1.73 m2: 8 to 20 mg/kg/dose every 24 hours

Hemodialysis: Moderately dialyzable (20% to 50%); ~30% removed by 3-hour hemodialysis: 8 to 20 mg/kg/dose every 24 hours; give after dialysis

Peritoneal dialysis: 8 to 20 mg/kg/dose every 24 hours

Severe infection (high dose): Dosing based on 80 to 90 mg/kg/day divided every 12 hours:

GFR >30 mL/minute/1.73 m2: No adjustment required

GFR 10 to 29 mL/minute/1.73 m2: 20 mg/kg/dose every 12 hours; do not use the 875 mg tablet

GFR <10 mL/minute/1.73 m2: 20 mg/kg/dose every 24 hours; do not use the 875 mg tablet

Hemodialysis: Moderately dialyzable (20% to 50%); ~30% removed by 3-hour hemodialysis: 20 mg/kg/dose every 24 hours; give after dialysis

Peritoneal dialysis: 20 mg/kg/dose every 24 hours

Extended release: Children ≥12 years and Adolescents: CrCl <30 mL/minute: Not recommended

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Geriatric

Refer to adult dosing.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Capsule, Oral:

Generic: 250 mg, 500 mg

Suspension Reconstituted, Oral:

Generic: 125 mg/5 mL (80 mL, 100 mL, 150 mL); 200 mg/5 mL (50 mL, 75 mL, 100 mL); 250 mg/5 mL (80 mL, 100 mL, 150 mL); 400 mg/5 mL (50 mL, 75 mL, 100 mL)

Tablet, Oral:

Generic: 500 mg, 875 mg

Tablet Chewable, Oral:

Generic: 125 mg, 250 mg

Tablet Extended Release 24 Hour, Oral:

Moxatag: 775 mg [DSC] [contains cremophor el, fd&c blue #2 aluminum lake]

Generic Equivalent Available: US

May be product dependent

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Capsule, Oral:

Polymox: 250 mg, 500 mg

Generic: 250 mg, 500 mg

Suspension Reconstituted, Oral:

Polymox: 125 mg/5 mL (150 mL); 250 mg/5 mL (150 mL)

Generic: 125 mg/5 mL (15 mL, 75 mL, 100 mL, 150 mL); 250 mg/5 mL (15 mL, 75 mL, 100 mL, 150 mL)

Tablet Chewable, Oral:

Generic: 125 mg [DSC], 250 mg

Product Availability

Amoxicillin 775 mg ER tablets (brand and generic) have been discontinued in the United States for >1 year.

Administration: Adult

Oral: Administer around-the-clock to promote less variation in peak and trough serum levels.

Extended release: Administer within 1 hour of finishing a meal; do not chew or crush tablet.

Bariatric surgery: Some institutions may have specific protocols that conflict with these recommendations; refer to institutional protocols as appropriate. Switch to IR formulation.

Suspension: Shake well before use; may be mixed with formula, milk, fruit juice, water, ginger ale, or cold drinks; administer dose immediately after mixing.

Administration: Pediatric

Oral:

Immediate release: May be administered on an empty or full stomach; may be mixed with formula, milk, cold drink, or juice; administer dose immediately after mixing; shake suspension well before use.

Extended release: Take within 1 hour of finishing a meal; do not chew or crush tablet.

Use: Labeled Indications

Ear, nose, and throat infections (pharyngitis/tonsillitis, otitis media):

Immediate release: Treatment of infections due to beta-lactamase-negative Streptococcus spp. (alpha- and beta-hemolytic isolates only), Streptococcus pneumoniae, Staphylococcus spp., or Haemophilus influenzae.

Extended release: Treatment of tonsillitis and/or pharyngitis due to Streptococcus pyogenes in adults and pediatric patients ≥12 years of age.

Helicobacter pylori eradication: Immediate release: Eradication of H. pylori to reduce the risk of duodenal ulcer recurrence as a component of combination therapy in patients with active or 1-year history of duodenal ulcer disease.

Lower respiratory tract infections (including pneumonia): Immediate release: Treatment of infections of the lower respiratory tract due to beta-lactamase-negative Streptococcus spp. (alpha- and beta-hemolytic strains only), S. pneumoniae, Staphylococcus spp., or H. influenzae.

Rhinosinusitis, acute bacterial: Immediate release: Treatment of infections due to beta-lactamase-negative Streptococcus spp. (alpha- and beta-hemolytic isolates only), S. pneumoniae, Staphylococcus spp., or H. influenzae.

Skin and skin structure infections: Immediate release: Treatment of infections of the skin and skin structure due to beta-lactamase-negative Streptococcus spp. (alpha- and beta-hemolytic strains only), Staphylococcus spp., or Escherichia coli.

Urinary tract infection: Immediate release: Treatment of infections of the genitourinary tract due to beta-lactamase-negative E.coli, Proteus mirabilis, or Enterococcus faecalis.

Use: Off-Label: Adult

Actinomycosis; Anthrax; Asplenia, prophylaxis against bacterial infection in high-risk patients; Bronchiectasis; Endocarditis, prophylaxis; Lyme disease (Borrelia spp. infection); Odontogenic infection (eg, periodontitis, severe); Prosthetic joint infection, chronic suppression

Medication Safety Issues
Sound-alike/look-alike issues:

Amoxicillin may be confused with amoxapine, Augmentin

Amoxil may be confused with amoxapine

International issues:

Fisamox [Australia] may be confused with Fosamax brand name for alendronate [US, Canada, and multiple international markets] and Vigamox brand name for moxifloxacin [US, Canada, and multiple international markets]

Limoxin [Mexico] may be confused with Lanoxin brand name for digoxin [US, Canada, and multiple international markets]; Lincocin brand name for lincomycin [US, Canada, and multiple international markets]

Zimox: Brand name for amoxicillin [Italy], but also the brand name for carbidopa/levodopa [Greece]

Zimox [Italy] may be confused with Diamox which is the brand name for acetazolamide [Canada and multiple international markets]

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

1% to 10%:

Central nervous system: Headache (1%)

Gastrointestinal: Diarrhea (2%), nausea (1%), vomiting (1%)

Genitourinary: Vulvovaginal infection (2%)

Frequency not defined:

Cardiovascular: Hypersensitivity angiitis

Central nervous system: Agitation, anxiety, behavioral changes, confusion, dizziness, insomnia, reversible hyperactivity, seizure

Dermatologic: Acute generalized exanthematous pustulosis, erythematous maculopapular rash, erythema multiforme, exfoliative dermatitis, skin rash, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria

Gastrointestinal: Clostridioides difficile associated diarrhea, Clostridioides difficile colitis, hemorrhagic colitis, melanoglossia, mucocutaneous candidiasis, staining of tooth

Genitourinary: Crystalluria

Hematologic & oncologic: Agranulocytosis, anemia, eosinophilia, hemolytic anemia, immune thrombocytopenia, leukopenia, thrombocytopenia

Hepatic: Cholestatic hepatitis, cholestatic jaundice, hepatitis (acute cytolytic), increased serum alanine aminotransferase, increased serum aspartate aminotransferase

Hypersensitivity: Anaphylaxis

Immunologic: Serum sickness-like reaction

<1%, postmarketing, and/or case reports: Abdominal pain

Contraindications

Serious hypersensitivity to amoxicillin (eg, anaphylaxis, Stevens-Johnson syndrome) or to other beta-lactams, or any component of the formulation

Canadian labeling: Additional contraindications (not in US labeling): Infectious mononucleosis (suspected or confirmed)

Warnings/Precautions

Concerns related to adverse effects:

• Anaphylactic/hypersensitivity reactions: Serious and occasionally severe or fatal hypersensitivity (anaphylactic) reactions have been reported in patients on penicillin therapy, including amoxicillin, especially with a history of beta-lactam hypersensitivity (including severe reactions with cephalosporins) and/or a history of sensitivity to multiple allergens.

• Superinfection: Prolonged use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea (CDAD) and pseudomembranous colitis; CDAD has been observed >2 months postantibiotic treatment.

Disease-related concerns:

• Infectious mononucleosis: A high percentage of patients with infectious mononucleosis develop an erythematous rash during amoxicillin therapy; avoid use in these patients.

• Renal impairment: Use with caution in patients with renal impairment; dosage adjustment recommended in patients with GFR <30 mL/minute. Avoid extended release 775 mg tablet and immediate release 875 mg tablet in patients with GFR <30 mL/minute or patients requiring hemodialysis.

Dosage form specific issues:

• Benzyl alcohol and derivatives: Some dosage forms may contain sodium benzoate/benzoic acid; benzoic acid (benzoate) is a metabolite of benzyl alcohol; large amounts of benzyl alcohol (≥99 mg/kg/day) have been associated with a potentially fatal toxicity (“gasping syndrome”) in neonates; the “gasping syndrome” consists of metabolic acidosis, respiratory distress, gasping respirations, CNS dysfunction (including convulsions, intracranial hemorrhage), hypotension, and cardiovascular collapse (AAP ["Inactive" 1997]; CDC 1982); some data suggests that benzoate displaces bilirubin from protein binding sites (Ahlfors 2001); avoid or use dosage forms containing benzyl alcohol derivative with caution in neonates. See manufacturer's labeling.

• Chewable tablets: May contain phenylalanine; see manufacturer's labeling.

Warnings: Additional Pediatric Considerations

Epstein-Barr virus infection (infectious mononucleosis), acute lymphocytic leukemia, or cytomegalovirus infection increases risk for amoxicillin-induced maculopapular rash. Appearance of a rash should be carefully evaluated to differentiate a nonallergic amoxicillin rash from a hypersensitivity reaction. Amoxicillin rash occurs in 5% to 10% of children receiving amoxicillin and is a generalized dull, red, maculopapular rash, generally appearing 3 to 14 days after the start of therapy. It normally begins on the trunk and spreads over most of the body. It may be most intense at pressure areas, elbows, and knees. A high percentage (43% to 100%) of patients with infectious mononucleosis have developed rash during therapy; amoxicillin-class antibiotics are not recommended in these patients.

In a meta-analysis of pediatric acute otitis media trials, high-dose amoxicillin regimens were associated with a higher incidence of adverse effects compared to standard-dose; the incidence of diarrhea was 18.9% with high-dose amoxicillin/clavulanate, 13.8% with high-dose amoxicillin, and 8.7% with standard-dose amoxicillin; the incidence of generalized rash was 6.5% with high-dose amoxicillin, 4.9% with high-dose amoxicillin/clavulanate, and 2.9% with standard-dose amoxicillin; however, significant heterogeneity was observed (Hum 2019).

Metabolism/Transport Effects

None known.

Drug Interactions

Acemetacin: May increase the serum concentration of Penicillins. Risk C: Monitor therapy

Allopurinol: May enhance the potential for allergic or hypersensitivity reactions to Amoxicillin. Risk C: Monitor therapy

Aminoglycosides: Penicillins may decrease the serum concentration of Aminoglycosides. Primarily associated with extended spectrum penicillins, and patients with renal dysfunction. Risk C: Monitor therapy

BCG (Intravesical): Antibiotics may diminish the therapeutic effect of BCG (Intravesical). Risk X: Avoid combination

BCG Vaccine (Immunization): Antibiotics may diminish the therapeutic effect of BCG Vaccine (Immunization). Risk C: Monitor therapy

Cholera Vaccine: Antibiotics may diminish the therapeutic effect of Cholera Vaccine. Management: Avoid cholera vaccine in patients receiving systemic antibiotics, and within 14 days following the use of oral or parenteral antibiotics. Risk X: Avoid combination

Dichlorphenamide: Penicillins may enhance the hypokalemic effect of Dichlorphenamide. Risk C: Monitor therapy

Lactobacillus and Estriol: Antibiotics may diminish the therapeutic effect of Lactobacillus and Estriol. Risk C: Monitor therapy

Methotrexate: Penicillins may increase the serum concentration of Methotrexate. Risk C: Monitor therapy

Mycophenolate: Penicillins may decrease serum concentrations of the active metabolite(s) of Mycophenolate. This effect appears to be the result of impaired enterohepatic recirculation. Risk C: Monitor therapy

Probenecid: May increase the serum concentration of Penicillins. Risk C: Monitor therapy

Sodium Picosulfate: Antibiotics may diminish the therapeutic effect of Sodium Picosulfate. Management: Consider using an alternative product for bowel cleansing prior to a colonoscopy in patients who have recently used or are concurrently using an antibiotic. Risk D: Consider therapy modification

Tetracyclines: May diminish the therapeutic effect of Penicillins. Risk C: Monitor therapy

Typhoid Vaccine: Antibiotics may diminish the therapeutic effect of Typhoid Vaccine. Only the live attenuated Ty21a strain is affected. Management: Avoid use of live attenuated typhoid vaccine (Ty21a) in patients being treated with systemic antibacterial agents. Postpone vaccination until 3 days after cessation of antibiotics and avoid starting antibiotics within 3 days of last vaccine dose. Risk D: Consider therapy modification

Vitamin K Antagonists (eg, warfarin): Penicillins may enhance the anticoagulant effect of Vitamin K Antagonists. Risk C: Monitor therapy

Pregnancy Considerations

Amoxicillin crosses the placenta (Muller 2009; Zareba-Szczudlik 2017). Maternal serum concentrations are significantly greater than the umbilical cord, placenta, and amniotic fluid concentrations when amoxicillin is administered orally prior to delivery (Buckingham 1975; Zareba-Szczudlik 2017).

Due to pregnancy-induced physiologic changes, some pharmacokinetic parameters of oral amoxicillin may be altered. Renal clearance is increased in the second and third trimester compared to postpartum values. In addition, oral absorption is decreased during labor. Maternal adipose tissue and the presence of anemia may influence maternal serum and amniotic fluid concentrations. Although minimum inhibitory concentrations can be reached, higher oral doses (or a parenteral antibiotic) may be needed based on the specific maternal infection or if treating an infection of the fetus and/or placenta (Andrew 2007; Buckingham 1975; Zareba-Szczudlik 2017).

As a class, penicillin antibiotics are widely used in pregnant women. Based on available data, penicillin antibiotics are generally considered compatible for use during pregnancy (Ailes 2016; Bookstaver 2015; Crider 2009; Damkier 2019; Lamont 2014; Muanda 2017a; Muanda 2017b).

Amoxicillin may be used for the management of Bacillus anthracis in pregnant women when penicillin susceptibility is documented. Maternal infection with B. anthracis may cause preterm labor, fetal infection, fetal distress, or fetal loss. Maternal death may also occur. Amoxicillin is an alternative agent for the treatment of cutaneous anthrax without systemic involvement and for the postexposure prophylaxis of B. anthracis during pregnancy. The dose and duration of amoxicillin therapy in pregnant and postpartum women is the same as in nonpregnant adults. Adjustments in dose for pregnancy are not recommended until additional pharmacokinetic data become available (Meaney-Delman 2014).

Untreated chlamydial disease can cause pelvic inflammatory disease, ectopic pregnancy, and infertility. In addition, treatment of maternal disease usually prevents transmission to the neonate during birth. Amoxicillin is an alternative antibiotic for the treatment of chlamydial infections in pregnancy (CDC [Workowski 2015]).

Amoxicillin is used for the treatment of Lyme disease. Vertical transmission from mother to fetus is not well documented; it is unclear if infection increases the risk of adverse pregnancy outcomes. When treatment for Lyme disease in pregnancy is needed, the indications and dosing of amoxicillin are the same as in nonpregnant patients (IDSA/AAN/ACR [Lantos 2021]; Lambert 2020; SOGC [Smith 2020]).

Untreated urinary tract infections (UTIs) during pregnancy are associated with an increased risk of developing pyelonephritis, low birth weight, and preterm labor. Amoxicillin may be an option for the treatment of UTI during pregnancy (de Rossi 2020; IDSA [Nicolle 2019]).

Amoxicillin is used in the management of H. pylori eradication. H. pylori is associated with hyperemesis gravidarum and may be linked to other adverse maternal and fetal outcomes. Treatment in patients with mild or no symptoms is generally delayed until after delivery; however, amoxicillin may be considered as part of a treatment regimen when otherwise appropriate (Cardaropoli 2014; Nguyen 2019; Zhan 2019).

Amoxicillin can also be used in the management of preterm prelabor rupture of membranes (PROM); treatment with antibiotics is used to prolong pregnancy and decrease maternal and newborn infections (ACOG 217 2020). Amoxicillin may also be used in certain situations prior to vaginal delivery in women at high risk for endocarditis (ACOG 199 2018).

Amoxicillin is considered compatible for the treatment airway diseases in pregnant women (ERS/TSANZ [Middleton 2020]).

Breast-Feeding Considerations

Amoxicillin is present in breast milk (Kafetzis 1981).

The relative infant dose (RID) of amoxicillin is 0.15% to 0.54% when calculated using the highest average breast milk concentration located and compared to an infant therapeutic dose of 25 to 90 mg/kg/day.

In general, breastfeeding is considered acceptable when the RID is <10% (Anderson 2016; Ito 2000).

The RID of amoxicillin was calculated using a milk concentration of 0.9 mcg/mL, providing an estimated daily infant dose via breast milk of 0.135 mg/kg/day. This milk concentration was obtained following maternal administration of a single oral dose of amoxicillin 1,000 mg (Kafetzis 1981).

Self-limiting diarrhea, rash, and somnolence have been reported in nursing infants exposed to amoxicillin (Benyamini 2005; Goldstein 2009; Ito 1993); the manufacturer warns of the potential for allergic sensitization in the infant. In general, antibiotics that are present in breast milk may cause non-dose-related modification of bowel flora. Monitor infants for GI disturbances, such as thrush or diarrhea (WHO 2002).

Although the manufacturer recommends that caution be exercised when administering amoxicillin to breastfeeding women, amoxicillin is considered compatible with breastfeeding when used in usual recommended doses (WHO 2002).

Amoxicillin may be used to treat mastitis in breastfeeding women. The treatment of mastitis with antibiotics is generally not considered unless symptoms do not improve with conservative management or the woman is acutely ill. When antibiotics are clinically indicated for treatment, amoxicillin is one of the suggested therapies for gram-negative organisms (WHO 2000).

Recommendations for using amoxicillin for the treatment of B. anthracis in breastfeeding women are the same as in pregnancy. Exposure to anthrax is not considered a contraindication to breastfeeding. However, if there are active cutaneous lesions on the breast, contact with the infant should be avoided and feeding from the affected breast should not occur until >48 hours of appropriate antibiotic therapy (Meaney-Delman 2014).

Dietary Considerations

Some products may contain phenylalanine.

Monitoring Parameters

With prolonged therapy, monitor renal, hepatic, and hematologic function periodically; assess patient at beginning and throughout therapy for infection; monitor for signs of anaphylaxis during first dose

Mechanism of Action

Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs) which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested.

Pharmacodynamics and Pharmacokinetics

Absorption: Oral:

Immediate release: Rapid with or without food.

Extended release: Rate of absorption is slower compared to immediate release formulations; food decreases the rate but not extent of absorption.

Distribution: Readily into liver, lungs, prostate, muscle, middle ear effusions, maxillary sinus secretions, bone, gallbladder, bile, and into ascitic and synovial fluids; poor CSF penetration (except when meninges are inflamed).

Vd:

Neonates, including preterm (GA: 25 to 42 weeks; PNA: 0 to 9 days): 0.65 ± 0.13 L/kg (Pullen 2006).

Infants ≥3 months of age and children ≤5 years of age: 1.44 ± 0.37 L/kg (Canafax 1998).

Protein binding: ~20%.

Half-life elimination: Adults: Immediate release: 61.3 minutes; extended release: 90 minutes.

Time to peak: Capsule, oral suspension: 1 to 2 hours; chewable tablet: 1 hour; extended release: 3.1 hours.

Excretion: Urine (60% as unchanged drug) lower in neonates.

Pharmacodynamics and Pharmacokinetics: Additional Considerations

Anti-infective considerations:

Parameters associated with efficacy:

Time dependent; associated with time free drug concentration (fT) > minimum inhibitory concentration, goal: ≥40% to 50% (bactericidal) (Andes 1998; Craig 1996; Craig 1998; Gustafsson 2001).

Expected drug exposure in normal renal function:

Infants ≥3 months of age and children ≤4 years of age, Cmax (peak):

15 mg/kg/dose 3 times daily, steady state: 7.9 ± 3.5 mg/L (Fonseca 2003).

25 mg/kg/dose twice daily, steady state: 10.6 ± 5.1 mg/L (Fonseca 2003).

Adults, Cmax (peak):

125 mg, single dose (125 mg per 5 mL suspension): 1.5 to 3 mg/L.

250 mg, single dose (capsule or 250 mg per 5 mL suspension): 3.5 to 5 mg/L.

400 mg, single dose (chewable tablet): 5.18 ± 1.64 mg/L.

400 mg, single dose (400 mg per 5 mL suspension): 5.92 ± 1.62 mg/L.

500 mg, single dose: 5.5 to 7.5 mg/L.

875 mg, single dose: 13.8 ± 4.1 mg/L.

Postantibiotic effect:

H. influenzae: <1 hour; S. pneumoniae: 0.3 to 5.8 hours; viridans streptococci: 0.7 to 2 hours (Davies 2000; Dubois 2000; Lee 2000).

Pricing: US

Capsules (Amoxicillin Oral)

250 mg (per each): $0.13 - $0.25

500 mg (per each): $0.19 - $5.88

Chewable (Amoxicillin Oral)

125 mg (per each): $0.34

250 mg (per each): $0.67

Suspension (reconstituted) (Amoxicillin Oral)

125 mg/5 mL (per mL): $0.04

200 mg/5 mL (per mL): $0.09

250 mg/5 mL (per mL): $0.06

400 mg/5 mL (per mL): $0.10

Tablets (Amoxicillin Oral)

500 mg (per each): $0.50

875 mg (per each): $0.87

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Brand Names: International
  • A.M. Mox (TH);
  • Abiolex (CL);
  • Acilina (PY);
  • Acimox (MX);
  • Adbiotin (CO);
  • Alemox (EG);
  • Alfamox (IT);
  • Almacin (HR);
  • Almorsan (AR);
  • Alphamox (AU);
  • Amicil (MX);
  • Amimox (SE);
  • Amitron (ES);
  • Amixen (AR);
  • Amixozan (DK);
  • Ammimox (TH);
  • Amobay (MX);
  • Amobiotic (CL);
  • Amoclan (JO, SA);
  • Amodex (FR);
  • Amoksilav (TR);
  • Amolin (JP);
  • Amorion (FI);
  • Amosin (RU);
  • Amotaks (PL);
  • Amoval (PE, PY);
  • Amox (IT);
  • Amoxa (SG);
  • Amoxal (CO, VE);
  • Amoxapen (ET, HK, MT);
  • Amoxar (DK);
  • Amoxcillin (TH);
  • Amoxen (ZW);
  • Amoxi-SAAR (DE);
  • Amoxibay (CO);
  • Amoxibel (JO);
  • Amoxibeta (DE);
  • Amoxicap (HK, PK, ZA);
  • Amoxicid (EG);
  • Amoxicilina (CO, EC);
  • Amoxiclin (PE);
  • Amoxidal (AR, UY);
  • Amoxidin (AE);
  • Amoxidin 7 (PE);
  • Amoxidrex (LB);
  • Amoxifur (MX);
  • Amoxiga (CO, VE);
  • Amoxigran (HK);
  • Amoxil (AE, AU, BH, BR, EC, EG, ET, GB, GR, ID, IE, JO, KW, LT, MT, MX, NZ, PE, PT, QA, SA, UA, ZA);
  • Amoxilan (AT, VE);
  • Amoxilin (CN);
  • Amoximex (LB);
  • Amoxin (FI, IS);
  • Amoxipen (AE, PE, VN);
  • Amoxipenil (CL);
  • Amoxisol (MX);
  • Amoxistad (AT);
  • Amoxitab (HK);
  • Amoxivan (IN);
  • Amoxivet (MX);
  • Amoxsan (ID);
  • Amoxy (CN);
  • Amoxy Care Forte (IL);
  • Amoxydar (AE, JO, QA, SA);
  • Ampin (PK);
  • Amyn (LK);
  • Anamox (PY);
  • Apimox (BD);
  • Aproxal (GR, JO);
  • Aramox (EG);
  • Aroxin (SG);
  • Atak (BR);
  • Atoksilin (TR);
  • Avlomox (BD);
  • Bactox (LV);
  • Bactox Ge (FR);
  • Balmox (ZW);
  • Beamoxy (MY);
  • Berlimox (ID);
  • Betamox (MY);
  • Betmox (IN);
  • Brumox (PH);
  • Bufamoxy (ID);
  • Cilamox (AU);
  • Cipamox (PK, PT);
  • Clamoxyl (BE, CH, ES, FR, LU, PT);
  • Clonamox (HU, IE);
  • Coamox (TH);
  • Danoxilin (ID);
  • Devamox (TR);
  • Dimopen (MX);
  • Duomox (BG, CZ, HU, PL, RO);
  • Duzimicin (BR);
  • Dymoxin (TH);
  • E-Mox (AE, ET, QA, SA);
  • Ecobol (RU);
  • Edamox (HK);
  • Elmox (PK);
  • Ethimox (ID);
  • Fabamox (PY, UY);
  • Fisamox (AU);
  • Flemoxin (AE, BE, DK, KW, PT, QA, RU, UA);
  • Foxolin (KR);
  • Geramox (IE);
  • Gexcil (PH);
  • Gimalxina (MX);
  • Glomox (AE, LB, QA, SA);
  • Gramox (RU, UA);
  • Grinsul (AR);
  • Grunamox (EC);
  • Hiconcil (LT, LV, PL, VN);
  • Hikoncil (UA);
  • Hymox (AE, JO, KW, QA, SA);
  • Hypher (CN);
  • Ibiamox (NZ, TH);
  • Ikamoxyl (ID);
  • Imacillin (DK, NO, SE);
  • Imadrax (DK);
  • Imox (ET, ZW);
  • InfectoMox (DE);
  • J Mox (BD);
  • Julphamox (AE, JO, KW, LB, QA, SA);
  • Jutamox (DE);
  • Kemox (IN);
  • Kymoxin (KR);
  • Lamoxy (IN);
  • Largopen (ET);
  • Linmox (VE);
  • Loxyl (BD);
  • Magnimox (PE);
  • Manmox (TH);
  • Max (IN);
  • Maxamox (AU);
  • Medomox (ZW);
  • Meixil (TH);
  • Mexylin (ID);
  • Miloxy (ZW);
  • Mopen (IT);
  • Morgenxil (ES);
  • Mox (IN);
  • Moxatid (BD);
  • Moxi (LK);
  • Moxicor (LK);
  • Moxifar (UY);
  • Moxilen (HK, JO, LB, LV, MT, MY, RO, SG, VN);
  • Moxilin (BD);
  • Moxiram (JO);
  • Moxol (LK);
  • Moxtam (UY);
  • Moxxo (TH);
  • Moxylin (EC);
  • Moxypen (IL, ZA);
  • Moxyvit (IL);
  • Mymox (LV);
  • Neomox (AE, BH, KW, SA);
  • Nobactam (AR);
  • Novamox (CL);
  • Novamoxin (KW);
  • Novax (ID);
  • Numoxylin (LK);
  • Ocylin (BR);
  • Opimox (ID);
  • Opimox Forte (ID);
  • Optamox (CL);
  • Oramox (IE);
  • Ospamox (AE, AT, BG, BH, CZ, EE, HR, HU, ID, JO, KW, LB, LT, LV, MY, NZ, PL, PT, QA, RU, SA, SI, SK, UA, VE);
  • Pamocil (IT, MT);
  • Pamoxin (KR);
  • Pasetocin (JP);
  • Penamox (AE, BH, ET, JO, KW, LB, QA, SA);
  • Pinamox (IE);
  • Pondnoxcill (TH);
  • Pyramox (TH);
  • Ranmoxy (AU, NZ, ZA);
  • Ranoxyl (AE, TH, ZW);
  • Remox (SA);
  • Remoxil (TR);
  • Ri Ao (CN);
  • Rivamox (ET);
  • Sanet (PY);
  • Sapox (BD);
  • Sawacillin (JP);
  • Sia-mox (TH);
  • Sinot (UY);
  • Sintopen (IT);
  • Solpenox (ID);
  • Strimox (SG, ZW);
  • Taimox (PH);
  • Telmox (AR);
  • Teramoxyl (PH);
  • Trifamox (AR);
  • Trimoxal (VE);
  • Ultramox (JO, KW);
  • Unimox (SG);
  • Velamox (BR, PE);
  • Widecillin (ID, JP);
  • Winpen (LV);
  • Yomax (ZA);
  • Zai Lin (CN);
  • Zeemox (PK);
  • Zerrsox (PH);
  • Zimox (IT);
  • Zymoxyl (PH)


For country abbreviations used in Lexicomp (show table)

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