Qualitative and quantitative composition
Each vial contains 1000mg amoxicillin (as sodium salt) and 200mg clavulanic acid (as potassium salt).
Each ml of reconstituted solution contains 50mg amoxicillin (as sodium salt) and 10mg clavulanic acid (as potassium salt). Refer to section 6.6 for the method of reconstitution.
Each 1.2g vial of co-amoxiclav contains 1.0mmol of potassium and 3.1 mmol of sodium (approx).
For a full list of excipients, see section 6.1.
Pharmaceutical form
Powder for solution for injection or infusion.
Co-amoxiclav 1000mg/200mg Powder for Solution for Injection or Infusion is a white or almost white powder.
Clinical particulars
Therapeutic indications
Co-amoxiclav is indicated for the treatment of the following infections in adults and children (see sections 4.2, 4.4 and 5.1):
• Severe infections of the ear, nose and throat (such as mastoiditis, peritonsillar infections, epiglottitis and sinusitis when accompanied by severe systemic signs and symptoms)
• Acute exacerbations of chronic bronchitis (adequately diagnosed)
• Community acquired pneumonia
• Cystitis
• Pyelonephritis
• Skin and soft tissue infections in particular cellulitis, animal bites, severe dental abscess with spreading cellulitis.
• Bone and joint infections, in particular osteomyelitis
• Intra-abdominal infections
• Femal genital infections
Prophylaxis against infections associated with major surgical procedures in adults, such as those involving the:
• Gastrointestinal tract
• Pelvic cavity
• Head and neck
• Biliary tract surgery
Consideration should be given to the official guidance on the appropriate use of antibacterial agents.
Posology and method of administration
Doses are expressed throughout in terms of amoxicillin/clavulanic acid content except when doses are stated in terms of an individual component.
The dose of Co-amoxiclav that is selected to treat an individual infection should take into account:
• The expected pathogens and their likely susceptibility to antibacterial agents (see section 4.4)
• The severity and the site of the infection
• The age, weight and renal function of the patient as shown below.
The use of alternative presentations of Co-amoxiclav (e.g. those that provide higher doses of amoxicillin and/or different ratios of amoxicillin to clavulanic acid) should be considered as necessary (see sections 4.4 and 5.1)
This Co-amoxiclav powder for solution for injection or infusion provides a total daily dose of 3000mg amoxicillin and 600mg clavulanic acid when administered as recommended below. If it is considered that a higher daily dose of amoxicillin is required it is recommended that an alternative intravenous formulation of Co-amoxiclav is selected in order to avoid administration of unnecessarily high daily doses of clavulanic acid.
The duration of therapy should be determined by the response of the patient. Some infections (e.g. osteomyelitis) require longer periods of treatment. Treatment should not be extended beyond 14 days without review (see section 4.4 regarding prolonged therapy).
Consideration should be given to local guidelines on appropriate dosing frequencies for amoxicillin/clavulanic acid.
Adults and children ≥ 40kg
For treatment of infections as indicated in section 4.1: 1000 mg/ 200 mg every 8 hours
For surgical prophylaxis |
For procedures less than 1 hour in duration, the recommended dose of Co-amoxiclav is 1000 mg/200 mg to 2000 mg/200 mg given at induction of anaesthesia (Doses of 2000 mg/200 mg can be achieved by using an alternative intravenous formulation of Co-amoxiclav).
For procedures greater than 1 hour in duration, the recommended dose of Co-amoxiclav is 1000 mg/200 mg to 2000 mg/200 mg given at induction of anaesthesia, with up to 3 doses of 1000 mg/200 mg in 24 hours.
Clear clinical signs of infection at operation will require a normal course of intravenous or oral therapy post-operatively. |
Children < 40 kg
Recommended doses:
• Children aged 3 months and over: 25 mg/5 mg per kg every 8 hours
• Children aged less than 3 months or weighing less than 4 kg: 25 mg/5 mg per kg every 12 hours.
Elderly
No dose adjustment is considered necessary.
Renal impairment
Dose adjustments are based on the maximum recommended level of amoxicillin.
No dose adjustment is required in patients with creatinine clearance (CrCl) greater than 30 ml/min.
Adults and children ≥ 40kg
CrCl: 10-30 ml/min |
Initial dose of 1000 mg/200 mg and then 500 mg/100 mg given twice daily |
CrCl < 10 ml /min |
Initial dose of 1000 mg/200 mg and then 500 mg/100 mg given every 24 hours |
Haemodialysis |
Initial dose of 1000 mg/200 mg and then followed by 500 mg/100 mg every 24 hours, plus a dose of 500 mg/100 mg at the end of dialysis (as serum concentrations of both amoxicillin and clavulanic acid are decreased) |
Children < 40 kg
CrCl: 10 to 30 ml/min |
25 mg/5 mg per kg given every 12 hours |
CrCl < 10 ml /min |
25 mg/5 mg per kg given every 24 hours |
Haemodialysis |
25 mg/5 mg per kg given every 24 hours, plus a dose of 12.5 mg/2.5 mg per kg at the end of dialysis (as serum concentrations of both amoxicillin and clavulanic acid are decreased). | |