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