Friday, September 23, 2016

ampicillin



Generic Name: ampicillin (am pi SIL in)

Brand names: Principen, Totacillin, Omnipen, Omnipen-N, Totacillin-N


What is ampicillin?

Ampicillin is an antibiotic in the penicillin group of drugs. It fights bacteria in your body.


Ampicillin is used to treat many different types of infections caused by bacteria, such as ear infections, bladder infections, pneumonia, gonorrhea, and E. coli or salmonella infection.


Ampicillin may also be used for purposes not listed in this medication guide.


What is the most important information I should know about ampicillin?


Do not use this medication if you are allergic to ampicillin or to any other penicillin antibiotic, such as amoxicillin (Amoxil), carbenicillin (Geocillin), dicloxacillin (Dycill, Dynapen), oxacillin (Bactocill), penicillin (Beepen-VK, Ledercillin VK, Pen-V, Pen-Vee K, Pfizerpen, V-Cillin K, Veetids), and others.

Before using ampicillin, tell your doctor if you are allergic to cephalosporins such as Ceclor, Ceftin, Duricef, Keflex, and others, or if you have asthma, kidney disease, a bleeding or blood clotting disorder, mononucleosis (also called "mono"), or a history of any type of allergy.


Ampicillin can make birth control pills less effective, which may result in pregnancy. Before taking ampicillin, tell your doctor if you use birth control pills. Take this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Ampicillin will not treat a viral infection such as the common cold or flu. Do not share this medication with another person, even if they have the same symptoms you have.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking ampicillin and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.


What should I discuss with my healthcare provider before taking ampicillin?


Do not use this medication if you are allergic to ampicillin or to any other penicillin antibiotic, such as:

  • amoxicillin (Amoxil, Amoxicot, Biomox, Dispermox, Trimox);




  • carbenicillin (Geocillin);




  • dicloxacillin (Dycill, Dynapen);




  • oxacillin (Bactocill); or




  • penicillin (Beepen-VK, Ledercillin VK, Pen-V, Pen-Vee K, Pfizerpen, V-Cillin K, Veetids, and others).



To make sure you can safely take ampicillin, tell your doctor if you are allergic to any drugs (especially cephalosporins such as Omnicef, Cefzil, Ceftin, Keflex, and others), or if you have:



  • asthma;




  • kidney disease;




  • a bleeding or blood clotting disorder;




  • mononucleosis (also called "mono");




  • a history of diarrhea caused by taking antibiotics; or




  • a history of any type of allergy.




FDA pregnancy category B. Ampicillin is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Ampicillin can make birth control pills less effective, which may result in pregnancy. Before taking ampicillin, tell your doctor if you use birth control pills. Ampicillin can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are taking ampicillin.

How should I take ampicillin?


Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.


Take the medicine with a full glass of water. Ampicillin should be taken on an empty stomach, at least 1 hour before or 2 hours after eating a meal.

To be sure this medicine is helping your condition, your blood will need to be tested often. Your liver and kidney function may also need to be tested. Visit your doctor regularly.


If you are being treated for gonorrhea, your doctor may also have you tested for syphilis, another sexually transmitted disease.


Take this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Ampicillin will not treat a viral infection such as the common cold or flu. Do not share this medication with another person, even if they have the same symptoms you have.

This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using ampicillin.


Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?


Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.


What happens if I overdose?


Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include confusion, behavior changes, a severe skin rash, urinating less than usual, or seizure (black-out or convulsions).


What should I avoid while taking ampicillin?


Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking ampicillin and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.


Ampicillin side effects


Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:

  • fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;




  • diarrhea that is watery or bloody;




  • fever, chills, body aches, flu symptoms;




  • easy bruising or bleeding, unusual weakness;




  • urinating less than usual or not at all;




  • agitation, confusion, unusual thoughts or behavior; or




  • seizure (black-out or convulsions).



Less serious side effects may include



  • nausea, vomiting, stomach pain;




  • vaginal itching or discharge;




  • headache;




  • swollen, black, or "hairy" tongue; or




  • thrush (white patches or inside your mouth or throat).



This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.


Ampicillin Dosing Information


Usual Adult Dose for Bacterial Endocarditis Prophylaxis:

Low to moderate risk: 2 g IV or IM 30 minutes before procedure.

High risk: Ampicillin 2 g plus gentamicin 1.5 mg/kg IV or IM 30 minutes before procedure. Follow with ampicillin 1 g IV or IM, or amoxicillin 1 g orally, 6 hours after initial dose.

Usual Adult Dose for Bronchitis:

Bacterial exacerbations of chronic bronchitis:
250 to 500 mg orally every 6 hours for 5 to 10 days, depending on the nature and severity of the infection.

Usual Adult Dose for Endocarditis:

Enterococcal:
Ampicillin 2 g IV every 4 hours plus gentamicin 1 mg/kg IV every 8 hours for 4 to 6 weeks.

Usual Adult Dose for Gastroenteritis:

250 to 500 mg orally every 6 hours.

Usual Adult Dose for Intraabdominal Infection:

1 to 2 g IV every 4 to 6 hours in combination with other antibiotics, depending on the nature and severity of the infection.

Duration: 10-14 days.

Usual Adult Dose for Leptospirosis:

Moderate to severe: 0.5 to 1 g intravenously every 6 hours.
Mild: 500 to 750 mg orally every 6 hours.

Usual Adult Dose for Meningitis:

IV:
200 mg/kg/day (up to 12 g/day) IV in equally divided doses every 4 hours, in combination with other parenteral antibiotics.

Intrathecal or intraventricular:
10 to 50 mg/day in addition to IV antibiotics.

Usual Adult Dose for Peritonitis:

CAPD-associated peritonitis: 250 to 500 mg orally twice daily and/or 100 to 125 mg/L exchange intraperitoneally, with or without other antibiotics depending on the nature and severity of the infection.

Secondary: 1 to 2 g IV every 4 to 6 hours in combination with other antibiotics, depending on the nature and severity of the infection.

Duration: 10 to 14 days.

Usual Adult Dose for Pneumonia:

Beta-lactamase negative, penicillin-susceptible: 1 to 2 g IV every 4 to 6 hours, in combination with other antibiotic(s) depending on the nature and severity of the infection.

Usual Adult Dose for Prevention of Perinatal Group B Streptococcal Disease:

As an alternative to penicillin G: 2 g IV as a loading dose, followed by 1 g every 4 hours until delivery.

Usual Adult Dose for Pyelonephritis:

500 mg to 2 g IV or IM every 4 to 6 hours with or without other antibiotics, depending on the nature and severity of the infection.
Duration: 2 to 3 weeks.

Usual Adult Dose for Septicemia:

1 to 2 g IV every 3 to 4 hours, in combination with other antibiotics.

Usual Adult Dose for Shigellosis:

500 mg orally every 6 hours for 5 days

Usual Adult Dose for Skin or Soft Tissue Infection:

250 to 500 mg orally every 6 hours or 1 to 2 g IV every 4 to 6 hours, depending on the nature and severity of the infection.

Usual Adult Dose for Surgical Prophylaxis:

Liver transplant: Ampicillin 1 g plus cefotaxime 1 g IV at induction, then every 6 hours for 48 hours after closure.

Usual Adult Dose for Typhoid Fever:

Severe, fully susceptible: 25 mg/kg IV or IM every 6 hours for 10 to 14 days.
Carrier state: 1.5 g orally or IV with probenecid 500 mg every 6 hours for 6 weeks.
Fluoroquinolones or amoxicillin are considered the drugs of choice.

Usual Adult Dose for Otitis Media:

500 mg orally or 1 to 2 g IV or IM every 6 hours, depending on the nature and severity of the infection.

Usual Adult Dose for Pharyngitis:

500 mg orally or 1 to 2 g IV or IM every 6 hours, depending on the nature and severity of the infection.

Usual Adult Dose for Sinusitis:

500 mg orally or 1 to 2 g IV or IM every 6 hours, depending on the nature and severity of the infection.

Usual Adult Dose for Upper Respiratory Tract Infection:

500 mg orally or 1 to 2 g IV or IM every 6 hours, depending on the nature and severity of the infection.

Usual Adult Dose for Urinary Tract Infection:

Mild, uncomplicated: 250 to 500 mg orally every 6 hours
Severe, complicated: 500 mg to 2 g IV every 4 to 6 hours with or without other antibiotics, depending on the nature and severity of the infection.

Usual Pediatric Dose for Bacterial Endocarditis Prophylaxis:

Low to moderate risk: 50 mg/kg IV or IM 30 minutes before procedure.

High risk: 50 mg/kg plus gentamicin 1.5 mg/kg, both intramuscularly or IV 30 minutes before procedure. Follow with ampicillin 25 mg/kg IV or IM, or amoxicillin 25 mg/kg orally, 6 hours after initial dose.

Usual Pediatric Dose for Meningitis:

Neonates:
2000 g: 50 mg/kg IV every 8 hours.
> 7 days, birthweight > 7 days, birthweight 1200 to 2000 g: 50 mg/kg IV every 8 hours.
> 7 days, birthweight > 2000 g: 50 mg/kg IV every 6 hours.

Infants and children:
50 to 100 mg/kg IV every 6 hours. Maximum dose 12 g/day.

Ampicillin should be given in combination with another antibiotic, depending on the nature of the infection.

Usual Pediatric Dose for Skin or Soft Tissue Infection:

IV: 6.25 to 12.5 mg/kg every 6 hours (maximum 12 g/day).

Oral: 6.25 to 12.5 mg/kg every 6 hours (maximum 2 to 3 g/day).

Usual Pediatric Dose for Upper Respiratory Tract Infection:

IV: 6.25 to 12.5 mg/kg every 6 hours (maximum 12 g/day).

Oral: 6.25 to 12.5 mg/kg every 6 hours (maximum 2 to 3 g/day).

Usual Pediatric Dose for Surgical Prophylaxis:

Liver transplant: Ampicillin 50 mg/kg plus cefotaxime 50 mg/kg at induction and every 6 hours for 48 hours after closure.


What other drugs will affect ampicillin?


Tell your doctor about all other medicines you use, especially:



  • allopurinol (Zyloprim);




  • methotrexate (Rheumatrex, Trexall);




  • probenecid (Benemid);




  • a sulfa drug (such as Bactrim or Septra); or




  • a tetracycline antibiotic such as demeclocycline (Declomycin), doxycycline (Adoxa, Doryx, Oracea, Vibramycin), minocycline (Dynacin, Minocin, Solodyn, Vectrin), or tetracycline (Brodspec, Panmycin, Sumycin, Tetracap).



This list is not complete and there may be other drugs that can interact with ampicillin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.



More ampicillin resources


  • Ampicillin Side Effects (in more detail)
  • Ampicillin Use in Pregnancy & Breastfeeding
  • Drug Images
  • Ampicillin Drug Interactions
  • Ampicillin Support Group
  • 3 Reviews for Ampicillin - Add your own review/rating


  • Ampicillin Prescribing Information (FDA)

  • Ampicillin Professional Patient Advice (Wolters Kluwer)

  • Ampicillin Monograph (AHFS DI)

  • Ampicillin MedFacts Consumer Leaflet (Wolters Kluwer)

  • Ampicillin Sodium and Sulbactam Sodium Monograph (AHFS DI)

  • Principen Advanced Consumer (Micromedex) - Includes Dosage Information



Compare ampicillin with other medications


  • Bacterial Endocarditis Prevention
  • Bronchitis
  • Endocarditis
  • Gastroenteritis
  • Intraabdominal Infection
  • Kidney Infections
  • Leptospirosis
  • Meningitis
  • Otitis Media
  • Peritonitis
  • Pharyngitis
  • Pneumonia
  • Prevention of Perinatal Group B Streptococcal Disease
  • Septicemia
  • Shigellosis
  • Sinusitis
  • Skin Infection
  • Surgical Prophylaxis
  • Typhoid Fever
  • Upper Respiratory Tract Infection
  • Urinary Tract Infection


Where can I get more information?


  • Your pharmacist can provide more information about ampicillin.

See also: ampicillin side effects (in more detail)


Amphotec


Pronunciation: am-foe-TER-ih-sin B
Generic Name: Amphotericin B Cholesteryl Sulfate Complex
Brand Name: Amphotec

Amphotec should be used to treat only serious fungal infections. Do not use Amphotec for less severe infections such as oral thrush (white spots in the mouth), vaginal yeast infections, or throat (esophageal) infections, or for localized (not spread throughout the body) fungal infections in people with normal white blood cell levels.





Amphotec is used for:

Treating a severe and potentially life-threatening fungal infection (aspergillosis) in certain patients. It may also be used for other conditions as determined by your doctor.


Amphotec is an antifungal antibiotic. It works by killing the fungus and preventing its reproduction.


Do NOT use Amphotec if:


  • you are allergic to any ingredient in Amphotec

Contact your doctor or health care provider right away if any of these apply to you.



Before using Amphotec:


Some medical conditions may interact with Amphotec. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:


  • if you are pregnant, planning to become pregnant, or are breast-feeding

  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement

  • if you have allergies to medicines, foods, or other substances

  • if you have kidney problems

Some MEDICINES MAY INTERACT with Amphotec. Tell your health care provider if you are taking any other medicines, especially any of the following:


  • Azole antifungals (eg, ketoconazole) because the effectiveness of Amphotec may be decreased

  • Aminoglycoside antibiotics (eg, gentamicin), antineoplastic medicines (eg, nitrogen mustard), cyclosporine, or pentamidine because side effects, such as kidney problems, may occur

  • Leukocyte transfusions because side effects, such as lung problems, may occur

  • Corticosteroids (eg, prednisone) or corticotropin (ACTH) because side effects, such as heart problems, may occur

  • Digoxin, flucytosine, or skeletal muscle relaxants (eg, tubocurarine) because side effects and toxic effects may be increased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Amphotec may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.


How to use Amphotec:


Use Amphotec as directed by your doctor. Check the label on the medicine for exact dosing instructions.


  • Amphotec is usually administered as an injection at your doctor's office, hospital, or clinic. If you are using Amphotec at home, carefully follow the injection procedures taught to you by your health care provider.

  • If the medicine contains particles or is discolored, or if the vial/container is cracked or damaged in any way, do not use it.

  • Amphotec works best if it is taken at the same time each day.

  • To clear up your infection completely, continue using Amphotec for the full course of treatment even if you feel better in a few days. Do not miss any doses.

  • Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor, nurse, or pharmacist to explain local regulations for selecting an appropriate container and properly disposing of the container when full.

  • If you miss a dose of Amphotec, contact your doctor for advice on when to schedule the next dose.

Ask your health care provider any questions you may have about how to use Amphotec.



Important safety information:


  • Amphotec may cause dizziness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Amphotec. Using Amphotec alone, with certain other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks.

  • To reduce side effects, your doctor may prescribe other medicines before administration of Amphotec. Take these other medicines as directed.

  • It is important to use Amphotec for the full course of treatment. Failure to do so may decrease the effectiveness of Amphotec and may increase the risk that the fungus will no longer be sensitive to Amphotec and will not be able to be treated by this or certain other antifungals in the future.

  • LAB TESTS, including kidney function, liver function, blood cell counts, and blood electrolytes, may be performed to monitor your progress or to check for side effects. Be sure to keep all doctor and lab appointments.

  • Amphotec is not recommended for use in NEWBORNS. Safety and effectiveness in this age group have not been confirmed.

  • Use Amphotec with extreme caution in CHILDREN. Safety and effectiveness have not been confirmed.

  • PREGNANCY and BREAST-FEEDING: If you become pregnant, discuss with your doctor the benefits and risks of using Amphotec during pregnancy. It is unknown if Amphotec is excreted in breast milk. Do not breast-feed while taking Amphotec.


Possible side effects of Amphotec:


All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:



Chills; fever; headache; loss of appetite; muscle or joint pain; nausea; stomach pain; weight loss.



Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; convulsions; dark, bloody stools; decreased urination; diarrhea; dizziness; fast breathing; hearing loss; irregular heartbeat; pain or redness at the injection site; unusual tiredness or weakness; vomiting; yellowing of the skin or eyes.



This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.


See also: Amphotec side effects (in more detail)


If OVERDOSE is suspected:


Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.


Proper storage of Amphotec:

Store Amphotec as directed on the prescription label. Store away from heat and light. Do not store in the bathroom. Keep Amphotec, as well as needles and syringes, out of the reach of children and away from pets.


General information:


  • If you have any questions about Amphotec, please talk with your doctor, pharmacist, or other health care provider.

  • Amphotec is to be used only by the patient for whom it is prescribed. Do not share it with other people.

  • If your symptoms do not improve or if they become worse, check with your doctor.

  • Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Amphotec. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.



Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Amphotec resources


  • Amphotec Side Effects (in more detail)
  • Amphotec Use in Pregnancy & Breastfeeding
  • Amphotec Drug Interactions
  • Amphotec Support Group
  • 0 Reviews for Amphotec - Add your own review/rating


  • Amphotec Prescribing Information (FDA)

  • Amphotec Advanced Consumer (Micromedex) - Includes Dosage Information



Compare Amphotec with other medications


  • Aspergillosis, Invasive
  • Candida Infections, Systemic
  • Febrile Neutropenia
  • Histoplasmosis
  • Leishmaniasis

Amoxil Pediatric



Generic Name: penicillin (Oral route, Injection route, Intravenous route, Intramuscular route)


Commonly used brand name(s)

In the U.S.


  • Amoxil

  • Bactocill

  • Bicillin L-A

  • Cloxapen

  • Crysticillin

  • Dynapen

  • Geocillin

  • Nafcil

  • Pfizerpen

  • Pipracil

  • Principen

  • Staphcillin

  • Ticar

  • Veetids

In Canada


  • Amoxil Pediatric

  • Ampicillin Sodium

  • Apo-Amoxi

  • Apo-Amoxi Sugar-Free

  • Apo-Cloxi

  • Apo-Pen-Vk

  • Gen-Amoxicillin

  • Med Amoxicillin

  • Nadopen V 200

  • Nadopen V 400

  • Novamoxin

Available Dosage Forms:


  • Powder for Suspension

  • Tablet

  • Tablet, Chewable

  • Tablet for Suspension

  • Tablet, Extended Release

  • Capsule

  • Powder for Solution

  • Suspension

  • Solution

  • Syrup

Uses For Amoxil Pediatric


Penicillins are used to treat infections caused by bacteria. They work by killing the bacteria or preventing their growth.


There are several different kinds of penicillins. Each is used to treat different kinds of infections. One kind of penicillin usually may not be used in place of another. In addition, penicillins are used to treat bacterial infections in many different parts of the body. They are sometimes given with other antibacterial medicines (antibiotics). Some of the penicillins may also be used for other problems as determined by your doctor. However, none of the penicillins will work for colds, flu, or other virus infections.


Penicillins are available only with your doctor's prescription.


Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, penicillins are used in certain patients with the following medical conditions:


  • Chlamydia infections in pregnant women—Amoxicillin and ampicillin

  • Gas gangrene—Penicillin G

  • Helicobacter pylori-associated gastritis or peptic ulcer disease—Amoxicillin

  • Leptospirosis—Ampicillin and penicillin G

  • Lyme disease—Amoxicillin and penicillin V

  • Typhoid fever—Amoxicillin and ampicillin

Before Using Amoxil Pediatric


Allergies


Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.


Pediatric


Many penicillins have been used in children and, in effective doses, are not expected to cause different side effects or problems in children than they do in adults.


Some strengths of the chewable tablets of amoxicillin contain aspartame, which is changed by the body to phenylalanine, a substance that is harmful to patients with phenylketonuria.


Geriatric


Penicillins have been used in the elderly and have not been shown to cause different side effects or problems in older people than they do in younger adults.


Pregnancy


Penicillins have not been studied in pregnant women. However, penicillins have been widely used in pregnant women and have not been shown to cause birth defects or other problems in animal studies.


Breast Feeding


Penicillins pass into the breast milk. Even though only small amounts may pass into breast milk, allergic reactions, diarrhea, fungus infections, and skin rash may occur in nursing babies.


Interactions with Medicines


Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking any of these medicines, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.


Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.


  • Cyclosporine

  • Methotrexate

  • Vecuronium

  • Venlafaxine

Interactions with Food/Tobacco/Alcohol


Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.


Other Medical Problems


The presence of other medical problems may affect the use of medicines in this class. Make sure you tell your doctor if you have any other medical problems, especially:


  • Allergy, general (such as asthma, eczema, hay fever, hives), history of—Patients with a history of general allergies may be more likely to have a severe reaction to penicillins

  • Bleeding problems, history of—Patients with a history of bleeding problems may be more likely to have bleeding when receiving carbenicillin, piperacillin, or ticarcillin

  • Congestive heart failure (CHF) or

  • High blood pressure—Large doses of carbenicillin or ticarcillin may make these conditions worse, because these medicines contain a large amount of salt

  • Cystic fibrosis—Patients with cystic fibrosis may have an increased chance of fever and skin rash when receiving piperacillin

  • Kidney disease—Patients with kidney disease may have an increased chance of side effects

  • Mononucleosis (”mono”)—Patients with mononucleosis may have an increased chance of skin rash when receiving ampicillin, bacampicillin, or pivampicillin

  • Phenylketonuria—Some strengths of the amoxicillin chewable tablets contain aspartame, which is changed by the body to phenylalanine, a substance that is harmful to patients with phenylketonuria.

  • Stomach or intestinal disease, history of (especially colitis, including colitis caused by antibiotics)—Patients with a history of stomach or intestinal disease may be more likely to develop colitis while taking penicillins

Proper Use of penicillin

This section provides information on the proper use of a number of products that contain penicillin. It may not be specific to Amoxil Pediatric. Please read with care.


Penicillins (except bacampicillin tablets, amoxicillin, penicillin V, pivampicillin, and pivmecillinam) are best taken with a full glass (8 ounces) of water on an empty stomach (either 1 hour before or 2 hours after meals) unless otherwise directed by your doctor.


For patients taking amoxicillin, penicillin V, pivampicillin, and pivmecillinam:


  • Amoxicillin, penicillin V, pivampicillin, and pivmecillinam may be taken on a full or empty stomach.

  • The liquid form of amoxicillin may also be taken by itself or mixed with formulas, milk, fruit juice, water, ginger ale, or other cold drinks. If mixed with other liquids, take immediately after mixing. Be sure to drink all the liquid to get the full dose of medicine.

For patients taking bacampicillin:


  • The liquid form of this medicine is best taken with a full glass (8 ounces) of water on an empty stomach (either 1 hour before or 2 hours after meals) unless otherwise directed by your doctor.

  • The tablet form of this medicine may be taken on a full or empty stomach.

For patients taking penicillin G by mouth:


  • Do not drink acidic fruit juices (for example, orange or grapefruit juice) or other acidic beverages within 1 hour of taking penicillin G since this may keep the medicine from working properly.

For patients taking the oral liquid form of penicillins:


  • This medicine is to be taken by mouth even if it comes in a dropper bottle. If this medicine does not come in a dropper bottle, use a specially marked measuring spoon or other device to measure each dose accurately. The average household teaspoon may not hold the right amount of liquid.

  • Do not use after the expiration date on the label. The medicine may not work properly after that date. If you have any questions about this, check with your pharmacist.

For patients taking the chewable tablet form of amoxicillin:


  • Tablets should be chewed or crushed before they are swallowed.

To help clear up your infection completely, keep taking this medicine for the full time of treatment, even if you begin to feel better after a few days. If you have a ”strep” infection, you should keep taking this medicine for at least 10 days. This is especially important in ”strep” infections. Serious heart problems could develop later if your infection is not cleared up completely. Also, if you stop taking this medicine too soon, your symptoms may return.


This medicine works best when there is a constant amount in the blood or urine. To help keep the amount constant, do not miss any doses. Also, it is best to take the doses at evenly spaced times, day and night . For example, if you are to take four doses a day, the doses should be spaced about 6 hours apart. If this interferes with your sleep or other daily activities, or if you need help in planning the best times to take your medicine, check with your health care professional.


Make certain your health care professional knows if you are on a low-sodium (low-salt) diet. Some of these medicines contain enough sodium to cause problems in some people.


Dosing


The dose medicines in this class will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.


The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.


The number of tablets or teaspoonfuls of suspension that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking a penicillin.


  • For amoxicillin:
    • For bacterial infections:
      • For oral dosage forms (capsules, oral suspension, tablets, and chewable tablets):
        • Adults, teenagers, and children weighing more than 40 kilograms (kg) (88 pounds)—250 to 500 milligrams (mg) every eight hours or 500 to 875 mg every twelve hours, depending on the type and severity of the infection.

        • Neonates and infants up to 3 months of age—Dose is based on body weight and must be determined by your doctor. The usual dose is 15 mg per kg (6.8 mg per pound) of body weight or less every twelve hours.

        • Infants 3 months of age and older and children weighing up to 40 kg (88 lbs.)—Dose is based on body weight and must be determined by your doctor. The usual dose is 6.7 to 13.3 mg per kg (3 to 6 mg per pound) of body weight every eight hours or 12.5 to 22.5 mg per kg (5.7 to 10.2 mg per pound) of body weight every twelve hours.
          • For duodenal ulcers (associated with Helicobacter pylori bacterial infection):
            • For oral dosage forms (capsules, oral suspension, tablets, and chewable tablets):
              • Adults: 1000 mg twice a day every twelve hours for fourteen days, along with the two other medicines, clarithromycin and lansoprazole, as directed by your doctor.

              • Teenagers and children: Use and dose must be determined by your doctor.
                • For dual medicine therapy—
                  • Adults: 1000 mg three times a day every eight hours for fourteen days, along with the other medicine, lansoprazole, as directed by your doctor.

                  • Teenagers and children: Use and dose must be determined by your doctor.









  • For ampicillin:
    • For bacterial infections:
      • For oral dosage forms (capsules and oral suspension):
        • Adults, teenagers, and children weighing more than 20 kilograms (kg) (44 pounds)—250 to 500 milligrams (mg) every six hours.

        • Infants and children weighing up to 20 kg (44 pounds)—Dose is based on body weight and must be determined by your doctor. The usual dose is 12.5 to 25 mg per kg (5.7 to 11.4 mg per pound) of body weight every six hours; or 16.7 to 33.3 mg per kg (7.6 to 15 mg per pound) of body weight every eight hours.
          • For injection dosage form:
            • Adults, teenagers, and children weighing more than 20 kg (44 pounds)—250 to 500 mg, injected into a vein or muscle every three to six hours.

            • Infants and children weighing up to 20 kg (44 pounds)—Dose is based on body weight and must be determined by your doctor. The usual dose is 12.5 mg per kg (5.7 mg per pound) of body weight, injected into a vein or muscle every six hours.






  • For bacampicillin:
    • For bacterial infections:
      • For oral dosage forms (oral suspension and tablets):
        • Adults, teenagers, and children weighing more than 25 kilograms (kg) (55 pounds)—400 to 800 milligrams (mg) every twelve hours.

        • Children weighing up to 25 kg (55 pounds)—Bacampicillin tablets are not recommended for use in children weighing up to 25 kg (55 pounds). The dose of the oral suspension is based on body weight and must be determined by your doctor. The usual dose is 12.5 to 25 mg per kg (5.7 to 11.4 mg per pound) of body weight every twelve hours.




  • For carbenicillin:
    • For bacterial infections:
      • For oral dosage form (tablets):
        • Adults and teenagers—500 milligrams (mg) to 1 gram every six hours.

        • Children—Dose must be determined by your doctor.
          • For injection dosage form:
            • Adults and teenagers—Dose is based on body weight and must be determined by your doctor. The usual dose is 50 to 83.3 mg per kilogram (kg) (22.8 to 37.9 mg per pound) of body weight, injected into a vein or muscle every four hours.

            • Older infants and children—Dose is based on body weight and must be determined by your doctor. The usual dose is 16.7 to 75 mg per kg (7.6 to 34 mg per pound) of body weight, injected into a vein or muscle every four to six hours.






  • For cloxacillin:
    • For bacterial infections:
      • For oral dosage form (capsules and oral solution):
        • Adults, teenagers, and children weighing more than 20 kilograms (kg) (44 pounds)—250 to 500 milligrams (mg) every six hours.

        • Infants and children weighing up to 20 kg (44 pounds)—Dose is based on body weight and must be determined by your doctor. The usual dose is 6.25 to 12.5 mg per kg (2.8 to 5.7 mg per pound) of body weight every six hours.
          • For injection dosage form:
            • Adults, teenagers, and children weighing more than 20 kg—250 to 500 mg, injected into a vein every six hours.

            • Infants and children weighing up to 20 kg (44 pounds)—Dose is based on body weight and must be determined by your doctor. The usual dose is 6.25 to 12.5 mg per kg (2.8 to 5.7 mg per pound) of body weight, injected into a vein every six hours.






  • For dicloxacillin:
    • For bacterial infections:
      • For oral dosage form (capsules and oral suspension):
        • Adults, teenagers, and children weighing more than 40 kilograms (kg) (88 pounds)—125 to 250 milligrams (mg) every six hours.

        • Infants and children weighing up to 40 kg (88 pounds)—Dose is based on body weight and must be determined by your doctor. The usual dose is 3.1 to 6.2 mg per kg (1.4 to 2.8 mg per pound) of body weight every six hours.




  • For flucloxacillin:
    • For bacterial infections:
      • For oral dosage form (capsules and oral suspension):
        • Adults, teenagers, and children more than 12 years of age and weighing more than 40 kilograms (kg) (88 pounds)—250 to 500 milligrams (mg) every six hours.

        • Children less than 12 years of age and weighing up to 40 kg (88 pounds)—125 to 250 mg every six hours; or 6.25 to 12.5 mg per kg (2.8 to 5.7 mg per pound) of body weight every six hours.

        • Infants up to 6 months of age—Dose is based on body weight and must be determined by your doctor. The usual dose is 6.25 mg per kg (2.8 mg per pound) of body weight every six hours.




  • For methicillin:
    • For bacterial infections:
      • For injection dosage form:
        • Adults, teenagers, and children weighing more than 40 kilograms (kg) (88 pounds)—1 gram injected into a muscle every four to six hours; or 1 gram injected into a vein every six hours.

        • Children weighing up to 40 kg (88 pounds)—Dose is based on body weight and must be determined by your doctor. The usual dose is 25 milligrams (mg) per kg (11.4 mg per pound) of body weight, injected into a vein or muscle every six hours.




  • For mezlocillin:
    • For bacterial infections:
      • For injection dosage form:
        • Adults and teenagers—Dose is based on body weight and must be determined by your doctor. The usual dose is 33.3 to 87.5 milligrams (mg) per kilogram (kg) (15.1 to 39.8 mg per pound) of body weight, injected into a vein or muscle every four to six hours; or 3 to 4 grams every four to six hours.

        • Infants over 1 month of age and children up to 12 years of age—Dose is based on body weight and must be determined by your doctor. The usual dose is 50 mg per kg (22.7 mg per pound) of body weight, injected into a vein or muscle every four hours.




  • For nafcillin:
    • For bacterial infections:
      • For oral dosage form (capsules and tablets):
        • Adults and teenagers—250 milligrams (mg) to 1 gram every four to six hours.

        • Older infants and children—Dose is based on body weight and must be determined by your doctor. The usual dose is 6.25 to 12.5 mg per kilogram (kg) (2.8 to 5.7 mg per pound) of body weight every six hours.

        • Newborns—Dose is based on body weight and must be determined by your doctor. The usual dose is 10 mg per kg (4.5 mg per pound) of body weight every six to eight hours.
          • For injection dosage form:
            • Adults and teenagers—500 mg to 2 grams injected into a vein or muscle every four to six hours.

            • Infants and children—Dose is based on body weight and must be determined by your doctor. The usual dose is 10 to 25 mg per kg (4.5 to 11.4 mg per pound) of body weight, injected into a muscle every twelve hours; or 10 to 40 mg per kg (4.5 to 18.2 mg per pound) of body weight, injected into a vein every four to eight hours.






  • For oxacillin:
    • For bacterial infections:
      • For oral dosage form (capsules and oral solution):
        • Adults, teenagers, and children weighing more than 40 kilograms (kg) (88 pounds)—500 milligrams (mg) to 1 gram every four to six hours.

        • Children weighing up to 40 kg (88 pounds)—Dose is based on body weight and must be determined by your doctor. The usual dose is 12.5 to 25 mg per kg (5.7 to 11.4 mg per pound) of body weight every six hours.
          • For injection dosage form:
            • Adults, teenagers, and children weighing more than 40 kg (88 pounds)—250 mg to 1 gram injected into a vein or muscle every four to six hours.

            • Children weighing up to 40 kg (88 pounds)—Dose is based on body weight and must be determined by your doctor. The usual dose is 12.5 to 25 mg per kg (5.7 to 11.4 mg per pound) of body weight, injected into a vein or muscle every four to six hours.

            • Premature infants and newborns—Dose is based on body weight and must be determined by your doctor. The usual dose is 6.25 mg per kg (2.8 mg per pound) of body weight, injected into a vein or muscle every six hours.






  • For penicillin G:
    • For bacterial infections:
      • For oral dosage form (oral solution, oral suspension, and tablets):
        • Adults and teenagers—200,000 to 500,000 Units (125 to 312 milligrams [mg]) every four to six hours.

        • Infants and children less than 12 years of age—Dose is based on body weight and must be determined by your doctor. The usual dose is 4167 to 30,000 Units per kilogram (kg) (189 to 13,636 Units per pound) of body weight every four to eight hours.
          • For benzathine injection dosage form:
            • Adults and teenagers—1,200,000 to 2,400,000 Units injected into a muscle as a single dose.

            • Infants and children—300,000 to 1,200,000 Units injected into a muscle as a single dose; or 50,000 Units per kg (22,727 Units per pound) of body weight injected into a muscle as a single dose.
              • For injection dosage forms (potassium and sodium salts):
                • Adults and teenagers—1,000,000 to 5,000,000 Units, injected into a vein or muscle every four to six hours.

                • Older infants and children—Dose is based on body weight and must be determined by your doctor. The usual dose is 8333 to 25,000 Units per kg (3788 to 11,363 Units per pound) of body weight, injected into a vein or muscle every four to six hours.

                • Premature infants and newborns—Dose is based on body weight and must be determined by your doctor. The usual dose is 30,000 Units per kg (13,636 Units per pound) of body weight, injected into a vein or muscle every twelve hours.
                  • For procaine injection dosage form:
                    • Adults and teenagers—600,000 to 1,200,000 Units injected into a muscle once a day.

                    • Children—Dose is based on body weight and must be determined by your doctor. The usual dose is 50,000 Units per kg (22,727 Units per pound) of body weight, injected into a muscle once a day.










  • For penicillin V:
    • For bacterial infections:
      • For the benzathine salt oral dosage form (oral solution):
        • Adults and teenagers—200,000 to 500,000 Units every six to eight hours.

        • Children—100,000 to 250,000 Units every six to eight hours.
          • For the potassium salt oral dosage forms (oral solution, oral suspension, and tablets):
            • Adults and teenagers—125 to 500 milligrams (mg) every six to eight hours.

            • Children—Dose is based on body weight and must be determined by your doctor. The usual dose is 2.5 to 16.7 mg per kilogram (kg) (1.1 to 7.6 mg per pound) of body weight every four to eight hours.






  • For piperacillin:
    • For bacterial infections:
      • For injection dosage form:
        • Adults and teenagers—3 to 4 grams, injected into a vein or muscle every four to six hours.

        • Infants and children—Dose must be determined by your doctor.




  • For pivampicillin:
    • For bacterial infections:
      • For oral dosage form (oral suspension):
        • Adults, teenagers, and children 10 years of age and older—525 to 1050 milligrams (mg) two times a day.

        • Children 7 to 10 years of age—350 mg two times a day.

        • Children 4 to 6 years of age—262.5 mg two times a day.

        • Children 1 to 3 years of age—175 mg two times a day.

        • Infants 3 to 12 months of age—Dose is based on body weight and must be determined by your doctor. The usual dose is 20 to 30 mg per kilogram (kg) (9.1 to 13.6 mg per pound) of body weight two times a day.
          • For oral dosage form (tablets):
            • Adults, teenagers, and children 10 years of age and older—500 mg to 1 gram two times a day.

            • Children up to 10 years of age—Dose must be determined by your doctor.






  • For pivmecillinam:
    • For bacterial infections:
      • For oral dosage form (tablets):
        • Adults, teenagers, and children weighing more than 40 kilograms (kg) (88 pounds)—200 milligrams (mg) two to four times a day for three days.

        • Children up to 40 kg (88 pounds)—Dose must be determined by your doctor.




  • For ticarcillin:
    • For bacterial infections:
      • For injection dosage form:
        • Adults, teenagers, and children weighing more than 40 kilograms (kg) (88 pounds)—3 grams injected into a vein every four hours; or 4 grams injected into a vein every six hours.

        • Children up to 40 kg (88 pounds)—Dose is based on body weight and must be determined by your doctor. The usual dose is 33.3 to 75 milligrams (mg) per kg (15 to 34 mg per pound) of body weight, injected into a vein every four to six hours.




Missed Dose


If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.


Storage


Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.


Keep out of the reach of children.


Do not keep outdated medicine or medicine no longer needed.


Precautions While Using Amoxil Pediatric


If your symptoms do not improve within a few days, or if they become worse, check with your doctor.


Penicillins may cause diarrhea in some patients.


  • Check with your doctor if severe diarrhea occurs. Severe diarrhea may be a sign of a serious side effect. Do not take any diarrhea medicine without first checking with your doctor. Diarrhea medicines may make your diarrhea worse or make it last longer.

  • For mild diarrhea, diarrhea medicine containing kaolin or attapulgite (e.g., Kaopectate tablets, Diasorb) may be taken. However, other kinds of diarrhea medicine should not be taken. They may make your diarrhea worse or make it last longer.

  • If you have any questions about this or if mild diarrhea continues or gets worse, check with your health care professional.

Oral contraceptives (birth control pills) containing estrogen may not work properly if you take them while you are taking ampicillin, amoxicillin, or penicillin V. Unplanned pregnancies may occur. You should use a different or additional means of birth control while you are taking any of these penicillins. If you have any questions about this, check with your health care professional.


For diabetic patients:


  • Penicillins may cause false test results with some urine sugar tests. Check with your doctor before changing your diet or the dosage of your diabetes medicine.

Before you have any medical tests, tell the doctor in charge that you are taking this medicine. The results of some tests may be affected by this medicine.


Amoxil Pediatric Side Effects


Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.


Stop taking this medicine and get emergency help immediately if any of the following effects occur:


Less common
  • Fast or irregular breathing

  • fever

  • joint pain

  • lightheadedness or fainting (sudden)

  • puffiness or swelling around the face

  • red, scaly skin

  • shortness of breath

  • skin rash, hives, itching

Check with your doctor immediately if any of the following side effects occur:


Rare
  • Abdominal or stomach cramps and pain (severe)

  • abdominal tenderness

  • convulsions (seizures)

  • decreased amount of urine

  • diarrhea (watery and severe), which may also be bloody

  • mental depression

  • nausea and vomiting

  • pain at place of injection

  • sore throat and fever

  • unusual bleeding or bruising

  • yellow eyes or skin

Rare - For penicillin G procaine only
  • Agitation or combativeness

  • anxiety

  • confusion

  • fear of impending death

  • feeling, hearing, or seeing things that are not real

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:


More common
  • Diarrhea (mild)

  • headache

  • sore mouth or tongue

  • vaginal itching and discharge

  • white patches in the mouth and/or on the tongue

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.


Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Amoxil Pediatric side effects (in more detail)



The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.


The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.


More Amoxil Pediatric resources


  • Amoxil Pediatric Side Effects (in more detail)
  • Amoxil Pediatric Use in Pregnancy & Breastfeeding
  • Drug Images
  • Amoxil Pediatric Drug Interactions
  • Amoxil Pediatric Support Group
  • 11 Reviews for Amoxil Pediatric - Add your own review/rating


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Amphadase



hyaluronidase

Dosage Form: injection
Amphadase®

(hyaluronidase injection, USP)

Description


Amphadase is a preparation of purified bovine testicular hyaluronidase, a protein enzyme. The exact chemical structure of this enzyme is unknown. However, the amino acid sequence for the primary structure of the enzyme has been deduced from the sequence of purified peptides.


Amphadase (hyaluronidase injection) is supplied as a sterile, colorless, ready for use solution. Each vial contains 150 USP units of hyaluronidase per mL with 8.5 mg sodium chloride, 1 mg edetate disodium, 0.4 mg calcium chloride, monobasic sodium phosphate buffer, and not more than 0.1 mg thimerosal (mercury derivative).


The ready for use solution is clear and colorless with an approximate pH of 6.8 and an osmolality of 295 to 355 mOsm.



Clinical Pharmacology


Hyaluronidase is a spreading or diffusing substance which modifies the permeability of connective tissue through the hydrolysis of hyaluronic acid, a polysaccharide found in the intercellular ground substance of connective tissue, and of certain specialized tissues, such as the umbilical cord and vitreous humor. Hyaluronic acid is also present in the capsules of type A and C hemolytic streptococci. Hyaluronidase hydrolyzes hyaluronic acid by splitting the glucosaminidic bond between C1 of the glucosamine moiety and C4 of glucuronic acid. This temporarily decreases the viscosity of the cellular cement and promotes diffusion of injected fluids or of localized transudates or exudates, thus facilitating their absorption.


Hyaluronidase cleaves glycosidic bonds of hyaluronic acid and, to a variable degree, some other acid mucopolysaccharides of the connective tissue. The activity is measured in vitro by monitoring the decrease in the amount of an insoluble serum albumen-hyaluronic acid complex as the enzyme cleaves the hyaluronic acid component.


When no spreading factor is present, material injected subcutaneously spreads very slowly, but hyaluronidase causes rapid spreading, provided local interstitial pressure is adequate to furnish the necessary mechanical impulse. Such an impulse is normally initiated by injected solutions. The rate of diffusion is proportionate to the amount of enzyme, and the extent is proportionate to the volume of solution.


Knowledge of the mechanisms involved in the disappearance of injected hyaluronidase is limited. It is known, however, that the blood of a number of mammalian species brings about the inactivation of hyaluronidase. Studies have demonstrated that hyaluronidase is antigenic: repeated injections of relatively large amounts of this enzyme may result in the formation of neutralizing antibodies. The reconstitution of the dermal barrier removed by intradermal injection of hyaluronidase (20, 2, 0.2, 0.02, and 0.002 U/mL) to adult humans indicated that at 24 hours the restoration of the barrier is incomplete and inversely related to the dosage of enzyme: at 48 hours the barrier is completely restored in all treated areas.


Results from an experimental study, in humans, on the influence of hyaluronidase in bone repair support the conclusion that this enzyme alone, in the usual clinical dosage, does not deter bone healing.



Indications and Usage


Amphadase is indicated as an adjuvant to increase the absorption and dispersion of other injected drugs; for hypodermoclysis; and as an adjunct in subcutaneous urography for improving resorption of radiopaque agents.



Contraindications


Hypersensitivity to hyaluronidase or any other ingredient in the formulation is a contraindication to the use of this product.



Warnings


Discontinue Amphadase (hyaluronidase injection) if sensitization occurs.


Hyaluronidase should not be used to enhance the absorption and dispersion of dopamine and/or alpha agonist drugs.


Hyaluronidase should not be injected into or around an infected or acutely inflamed area because of the danger of spreading a localized infection.


Hyaluronidase should not be used to reduce the swelling of bites or stings.


Hyaluronidase should not be applied directly to the cornea.


Hyaluronidase should not be used for intravenous injections because the enzyme is rapidly inactivated.



Precautions



GENERAL


Furosemide, the benzodiazepines and phenytoin have been found to be incompatible with hyaluronidase.


When considering the administration of any other drug with hyaluronidase, it is recommended that appropriate references first be consulted to determine the usual precautions for the use of the other drug; e.g., when epinephrine is injected along with hyaluronidase, the precautions for the use of epinephrine in cardiovascular disease, thyroid disease, diabetes, digital nerve block, ischemia of the fingers and toes etc., should be observed.



LABORATORY TESTS


A preliminary skin test for hypersensitivity to Amphadase can be performed. The skin test is made by an intradermal injection of approximately 0.02 mL (3 Units) of a 150 Unit/mL solution. (See "Dosage and Administration.") A positive reaction consists of a wheal with pseudopods appearing within 5 minutes and persisting for 20 to 30 minutes and accompanied by localized itching. Transient vasodilation at the site of the test, i.e., erythema, is not a positive reaction.



DRUG INTERACTIONS


When hyaluronidase is added to a local anesthetic agent, it hastens the onset of analgesia and tends to reduce the swelling caused by local infiltration, but the wider spread of the local anesthetic solution increases its absorption; this shortens its duration of action and tends to increase the incidence of systemic reaction.


Patients receiving large doses of salicylates, cortisone, ACTH, estrogens or antihistamines may require larger amounts of hyaluronidase for equivalent dispersing effect, since these drugs apparently render tissues partly resistant to the action of hyaluronidase.



CARCINOGENESIS, MUTAGENESIS, IMPAIRMENT OF FERTILITY


Long-term animal studies have not been performed to assess the carcinogenic or mutagenic potential of hyaluronidase. Hyaluronidase is found in most tissues of the body.


Long-term animal studies have not been performed to assess whether hyaluronidase impaired fertility; however, it has been reported that testicular degeneration may occur with the production of organ-specific antibodies against this enzyme following repeated injections. Human studies on the effect of intravaginal hyaluronidase in sterility due to oligospermia indicated that hyaluronidase may have aided conception. Thus, it appears that hyaluronidase may not adversely affect fertility in females.



PREGNANCY


Teratogenic Effects

Pregnancy Category C


No adequate and well controlled animal studies have been conducted with Amphadase to determine reproductive effects. No adequate and well controlled studies have been conducted with Amphadase in pregnant women. Amphadase should be used during pregnancy only if clearly needed.



LABOR AND DELIVERY


Administration of hyaluronidase during labor was reported to cause no complications: no increase in blood loss or differences in cervical trauma were observed. It is not known whether Amphadase has an effect on the fetus if used during labor; the effect of hyaluronidase on the later growth, development, and functional maturation of the infant is unknown.



NURSING MOTHERS


It is not known whether hyaluronidase is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when hyaluronidase is administered to a nursing woman.



PEDIATRIC USE


Hyaluronidase may be added to small volumes of solution (up to 200 mL), such as small clysis for infants or solutions of drugs for subcutaneous injection. The potential for chemical or physical incompatibilities should be kept in mind. (See "Dosage and Administration")


For infants and children less than 3 years old, the volume of a single clysis should be limited to 200 mL; and in premature infants or during the neonatal period, the daily dosage should not exceed 25 mL/kg of body weight; the rate of administration should not be greater than 2 mL per minute. For older patients, the rate and volume of administration should not exceed those employed for intravenous infusion.


During hypodermoclysis, special care must be taken in pediatric patients to avoid overhydration by controlling the rate and total volume of the clysis. (See "Dosage and Administration, HYPODERMOCLYSIS.")



Geriatric Use


No overall differences in safety or effectiveness have been observed between elderly and younger adult patients.



Adverse Reactions


The most frequently reported adverse experiences have been local injection site reactions. Hyaluronidase has been reported to enhance the adverse events associated with co-administered drug products. Edema has been reported most frequently in association with hypodermoclysis. Allergic reactions (urticaria, angioedema) have been reported in less than 0.1% of patients receiving hyaluronidase. Anaphylactic-like reactions following retrobulbar block or intravenous injections have occurred, rarely.



Overdosage


Symptoms of toxicity consist of local edema or urticaria, erythema, chills, nausea, vomiting, dizziness, tachycardia, and hypotension. The enzyme should be discontinued and supportive measures initiated immediately.



Dosage and Administration


Amphadase (hyaluronidase, Injection) should be administered only as discussed below since its effects relative to absorption and dispersion of other drugs are not produced when it is administered intravenously.



ABSORPTION AND DISPERSION OF INJECTED DRUGS


Absorption and dispersion of other injected drugs may be enhanced by adding 50–300 Units, most typically 150 U hyaluronidase, to the injection solution.


It is recommended that appropriate references be consulted regarding physical or chemical incompatibilities before adding Amphadase to a solution containing another drug.



HYPODERMOCLYSIS


Insert needle with aseptic precautions. With tip lying free and movable between skin and muscle, begin clysis; fluid should start in readily without pain or lump. Then inject Amphadase (hyaluronidase injection) into rubber tubing close to needle.


An alternate method is to inject Amphadase under skin prior to clysis. 150 U will facilitate absorption of 1,000 mL or more of solution. As with all parenteral fluid therapy, observe effect closely, with same precautions for restoring fluid and electrolyte balance as in intravenous injections. The dose, the rate of injection, and the type of solution (saline, glucose, Ringer's, etc.) must be adjusted carefully to the individual patient. When solutions devoid of inorganic electrolytes are given by hypodermoclysis, hypovolemia may occur. This may be prevented by using solutions containing adequate amounts of inorganic electrolytes and/or controlling the volume and speed of administration.


Amphadase may be added to small volumes of solution (up to 200 mL), such as small clysis for infants or solutions of drugs for subcutaneous injection. For infants and children less than 3 years old, the volume of a single clysis should be limited to 200 mL; and in premature infants or during the neonatal period, the daily dosage should not exceed 25 mL/kg of body weight; the rate of administration should not be greater than 2 mL per minute. For older patients, the rate and volume of administration should not exceed those employed for intravenous infusion.



SUBCUTANEOUS UROGRAPHY


The subcutaneous route of administration of urographic contrast media is indicated when intravenous administration cannot be successfully accomplished, particularly in infants and small children. With the patient prone, 75 U of Amphadase (hyaluronidase) is injected subcutaneously over each scapula, followed by injection of the contrast medium at the same sites.


Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.



How Supplied


Amphadase (hyaluronidase injection) is supplied sterile as 150 USP units of hyaluronidase per mL in a 2 mL glass vial with a gray rubber stopper and aluminum flip-off seal.


NDC 0548-9090-10, 1 mL vial, 10 vials/carton.

NDC 0548-9090-00, 1 mL vial, 25 vials/carton.


Not Recommended for IV Use.



Store in a refrigerator at 2° to 8°C (36° to 46°F).



Rx Only


Amphastar Pharmaceuticals, Inc.

Rancho Cucamonga, CA 91730, U.S.A.


6990906H


5/06



PRINCIPAL DISPLAY PANEL - 25 x 1 mL Single Dose Vial Carton


NDC 0548-9090-00


See Insert for Dosage.

Not for IV use.

Store in Refrigerator.


Amphadase®

HYALURONIDASE

INJECTION, USP


25 x 1 mL Single Dose Vials


Rx Only


5290906G/5-06


AMPHASTAR PHARMACEUTICALS, INC.

Rancho Cucamonga, CA 91730 U.S.A.










Amphadase 
hyaluronidase  injection










Product Information
Product TypeHUMAN PRESCRIPTION DRUGNDC Product Code (Source)0548-9090
Route of AdministrationPARENTERALDEA Schedule    








Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
Hyaluronidase (Hyaluronidase)Hyaluronidase150 [USP'U]  in 1 mL





Inactive Ingredients
Ingredient NameStrength
No Inactive Ingredients Found


















Product Characteristics
Color    Score    
ShapeSize
FlavorImprint Code
Contains      






















Packaging
#NDCPackage DescriptionMultilevel Packaging
10548-9090-1010 VIAL In 1 CARTONcontains a VIAL, SINGLE-DOSE
11 mL In 1 VIAL, SINGLE-DOSEThis package is contained within the CARTON (0548-9090-10)
20548-9090-0025 VIAL In 1 CARTONcontains a VIAL, SINGLE-DOSE
21 mL In 1 VIAL, SINGLE-DOSEThis package is contained within the CARTON (0548-9090-00)










Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
NDANDA02166510/26/2004


Labeler - Amphastar Pharmaceuticals, Inc. (024736733)
Revised: 12/2009Amphastar Pharmaceuticals, Inc.

More Amphadase resources


  • Amphadase Side Effects (in more detail)
  • Amphadase Use in Pregnancy & Breastfeeding
  • Amphadase Drug Interactions
  • Amphadase Support Group
  • 0 Reviews for Amphadase - Add your own review/rating


  • Amphadase Advanced Consumer (Micromedex) - Includes Dosage Information

  • Amphadase Consumer Overview

  • Amphadase MedFacts Consumer Leaflet (Wolters Kluwer)

  • Hyaluronidase Professional Patient Advice (Wolters Kluwer)

  • Hylenex Consumer Overview

  • Hylenex MedFacts Consumer Leaflet (Wolters Kluwer)

  • Vitrase Consumer Overview



Compare Amphadase with other medications


  • Extravasation
  • Hypodermoclysis
  • Subcutaneous Urography

Amrix



Generic Name: cyclobenzaprine (sye kloe BEN za preen)

Brand Names: Amrix, Comfort Pac with Cyclobenzaprine, Fexmid, Flexeril


What is Amrix (cyclobenzaprine)?

Cyclobenzaprine is a muscle relaxant. It works by blocking nerve impulses (or pain sensations) that are sent to your brain.


Cyclobenzaprine is used together with rest and physical therapy to treat skeletal muscle conditions such as pain or injury.


Cyclobenzaprine may also be used for other purposes not listed in this medication guide.


What is the most important information I should know about Amrix (cyclobenzaprine)?


Do not take cyclobenzaprine if you have used an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam) within the past 14 days. Serious, life-threatening side effects can occur if you take cyclobenzaprine before the MAO inhibitor has cleared from your body.

You should not take cyclobenzaprine if you have recently had a heart attack, or if you have a heart rhythm disorder, congestive heart failure, heart block, or an overactive thyroid.


Cyclobenzaprine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol, which can increase some of the side effects of cyclobenzaprine.

What should I discuss with my doctor before taking Amrix (cyclobenzaprine)?


Do not take cyclobenzaprine if you have used an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam) within the past 14 days. Serious, life-threatening side effects can occur if you take cyclobenzaprine before the MAO inhibitor has cleared from your body. Do not use cyclobenzaprine if you have recently had a heart attack, or if you have:

  • a heart rhythm disorder;




  • congestive heart failure;




  • heart block; or




  • an overactive thyroid.



Before using cyclobenzaprine, tell your doctor if you are allergic to any drugs, or if you have:



  • problems with urination;




  • enlarged prostate;




  • glaucoma; or




  • liver disease.



If you have any of these conditions, you may need a dose adjustment or special tests to safely take cyclobenzaprine.


FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether cyclobenzaprine passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Older adults may be more sensitive to the side effects of this medication.


How should I take Amrix (cyclobenzaprine)?


Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.


Take this medicine with a full glass of water. Do not crush, chew, break, or open an extended-release capsule. Swallow the pill whole. Breaking or opening the pill may cause too much of the drug to be released at one time.

Cyclobenzaprine is only part of a complete program of treatment that may also include rest, physical therapy, or other pain relief measures. Follow your doctor's instructions.


Store cyclobenzaprine at room temperature away from moisture, heat, and light.

What happens if I miss a dose?


Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?


Seek emergency medical attention if you think you have used too much of this medicine. An overdose of cyclobenzaprine can be fatal.

Overdose symptoms may include drowsiness, fast heartbeat, tremors or shaking, slurred speech, confusion, nausea, vomiting, hallucinations (seeing things), chest pain, or seizure (convulsions).


What should I avoid while taking Amrix (cyclobenzaprine)?


Cyclobenzaprine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol, which can increase some of the side effects of cyclobenzaprine. Cold or allergy medicine, narcotic pain medicine, sleeping pills, and medicine for seizures, depression or anxiety can add to sleepiness caused by cyclobenzaprine. Tell your doctor if you regularly use any of these medicines, or any other muscle relaxer.

Amrix (cyclobenzaprine) side effects


Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using cyclobenzaprine and call your doctor at once if you have any of these serious side effects:

  • fast, pounding, or uneven heartbeats;




  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;




  • sudden numbness or weakness, especially on one side of the body;




  • sudden headache, confusion, problems with vision, speech, or balance;




  • feeling light-headed, fainting;




  • confusion, weakness, lack of coordination;




  • nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);




  • seizure (convulsions);




  • unusual thoughts or behavior, hallucinations (seeing things); or




  • easy bruising or bleeding, unusual weakness.



Less serious side effects may include:



  • dry mouth or throat;




  • blurred vision;




  • drowsiness, dizziness, tired feeling;




  • loss of appetite, stomach pain, nausea;




  • diarrhea, constipation, gas; or




  • muscle weakness.



This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.


What other drugs will affect Amrix (cyclobenzaprine)?


Many drugs can interact with cyclobenzaprine. Below is just a partial list. Tell your doctor if you are using:



  • atropine (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm-Scop);




  • a bronchodilator such as ipratroprium (Atrovent) or tiotropium (Spiriva);




  • glycopyrrolate (Robinul);




  • guanethidine (Ismelin);




  • mepenzolate (Cantil);




  • tramadol (Ultram);




  • bladder or urinary medications such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare); or




  • irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Anaspaz, Cystospaz, Levsin, and others), or propantheline (Pro-Banthine).



This list is not complete and there may be other drugs that can interact with cyclobenzaprine. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.



More Amrix resources


  • Amrix Side Effects (in more detail)
  • Amrix Use in Pregnancy & Breastfeeding
  • Drug Images
  • Amrix Drug Interactions
  • Amrix Support Group
  • 33 Reviews for Amrix - Add your own review/rating


  • Amrix Advanced Consumer (Micromedex) - Includes Dosage Information

  • Amrix Extended-Release Capsules MedFacts Consumer Leaflet (Wolters Kluwer)

  • Amrix Prescribing Information (FDA)

  • Cyclobenzaprine Prescribing Information (FDA)

  • Cyclobenzaprine Monograph (AHFS DI)

  • Cyclobenzaprine MedFacts Consumer Leaflet (Wolters Kluwer)

  • Fexmid Prescribing Information (FDA)

  • Flexeril Prescribing Information (FDA)

  • Flexeril Consumer Overview



Compare Amrix with other medications


  • Fibromyalgia
  • Migraine
  • Muscle Spasm
  • Sciatica
  • Temporomandibular Joint Disorder


Where can I get more information?


  • Your pharmacist can provide more information about cyclobenzaprine.

See also: Amrix side effects (in more detail)


amphotericin b liposome Intravenous


am-foe-TER-i-sin B LYE-poh-some


Commonly used brand name(s)

In the U.S.


  • Ambisome

Available Dosage Forms:


  • Powder for Solution

Therapeutic Class: Antifungal


Chemical Class: Polyene


Uses For amphotericin b liposome


Amphotericin B liposomal complex is an antifungal and an antiprotozoal medicine. It is used to help the body overcome serious infections caused by fungus or protozoa.


amphotericin b liposome is available only with your doctor's prescription.


Before Using amphotericin b liposome


In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For amphotericin b liposome, the following should be considered:


Allergies


Tell your doctor if you have ever had any unusual or allergic reaction to amphotericin b liposome or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.


Pediatric


Appropriate studies performed to date have not demonstrated pediatrics-specific problems that would limit the usefulness of amphotericin B liposomal complex in children.


Geriatric


Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of amphotericin B liposomal complex in the elderly with use in other age groups, amphotericin b liposome is not expected to cause different side effects or problems in older people than it does in younger adults.


Pregnancy








Pregnancy CategoryExplanation
All TrimestersBAnimal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast Feeding


There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.


Interactions with Medicines


Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking amphotericin b liposome, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.


Using amphotericin b liposome with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.


  • Cyclosporine

Interactions with Food/Tobacco/Alcohol


Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.


Other Medical Problems


The presence of other medical problems may affect the use of amphotericin b liposome. Make sure you tell your doctor if you have any other medical problems, especially:


  • Blood transfusion—Amphotericin B liposomal complex may cause side effects affecting the lungs

  • Kidney disease—Amphotericin B liposomal complex may make your kidney problems worse

Proper Use of amphotericin b liposome


Dosing


The dose of amphotericin b liposome will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of amphotericin b liposome. If your dose is different, do not change it unless your doctor tells you to do so.


The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.


  • For the treatment of infection caused by fungus or protozoa
    • For injection dosage form:
      • Adults and children: 3 to 6 milligrams (mg) per kilogram (1.36 to 2.73 mg per pound) of body weight once a day, injected slowly into a vein. The number of days that you receive this treatment depends on the medical problem for which you are receiving amphotericin B liposomal complex.



amphotericin b liposome Side Effects


Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.


Check with your doctor as soon as possible if any of the following side effects occur:


More common
  • Chills

  • fever

  • irregular heartbeat

  • muscle cramps or pain

  • unusual tiredness or weakness

Less common
  • Back pain

  • chest pain

  • dark urine

  • difficulty in breathing

  • headache

  • yellowing of eyes or skin

Rare
  • Difficulty in swallowing

  • hives

  • itching, especially of feet or hands

  • reddening of skin, especially around ears

  • swelling of eyes, face, or inside of nose

  • unusual tiredness or weakness (sudden and severe)

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:


More common
  • Abdominal pain

  • cough

  • diarrhea

  • dizziness

  • nausea

  • vomiting

Less common
  • Skin rash

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.


Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: amphotericin b liposome Intravenous side effects (in more detail)



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More amphotericin b liposome Intravenous resources


  • Amphotericin b liposome Intravenous Side Effects (in more detail)
  • Amphotericin b liposome Intravenous Use in Pregnancy & Breastfeeding
  • Amphotericin b liposome Intravenous Drug Interactions
  • Amphotericin b liposome Intravenous Support Group
  • 0 Reviews for Amphotericin b liposome Intravenous - Add your own review/rating


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  • Aspergillosis, Invasive
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