Tuesday, March 29, 2016

Augmentin: Renal Adjusment

Availability
  • Intravenous Co-Amoxiclav 1000mg (Amoxicillin) / 200mg (Potassium Clavulanate)
  • Tab Augmentin, 500mg (Amoxicillin) / 125mg (Clavulanate)
Elimination
  • amoxicillin : major route of elimination for is via the kidney,
  • clavulanate : both renal and non-renal mechanisms.
  • Approximately 60-70% of the amoxicillin and approximately 40-65% of the clavulanic acid are excreted unchanged in urine during the first 6 hours after administration of a single 500/125mg tablet or a single 500/100mg or a single 1000/200mg bolus intravenous injection.
  • Amoxicillin is also partly excreted in the urine as the inactive penicilloic acid in quantities equivalent to 10-25% of the initial dose.
Concerns
  • Amoxicillin crystalluria, in some cases leading to renal failure, has been observed (predominantly with parenteral therapy)
  • Amoxicillin has been reported to precipitate in bladder catheters after intravenous administration of large doses. A regular check of patency should be maintained.
  • AUGMENTIN can be removed from the circulation by haemodialysis.
Renal Dose Adjustment
References:
  1. https://www.medicines.org.uk/emc/medicine/13899
  2. Augmentin Datasheet
  3. Public Assessment Report, MHRA

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