英文药名: Amoxil(Amoxicillin Trihydrate Capsules)

中文药名: 阿莫西林三水酸胶囊

品牌药生产厂家: Glaxo Smith Kline

药品名称

【别名】阿莫西林、阿莫灵、阿莫仙、阿莫新、新达贝宁、阿摩西林、安福喜、奥纳欣、弗莱莫星、酚塔西林、广林、奈他美、羟氨苄青霉素、强必林、强力阿莫仙、特力士、益萨林、氧他西林、再林、再灵。
【外文名】Amoxicillin、Amolin、Amolin Bristamox、Amoxa、Amoxicilline、Amoxicillinum、Amoxicllin、Amoxil、Amoxipen、Amoxycillin、BRL-2333、Bristamox、Clamoxil、Clamoxyl、Daxipen、Flemoxin、Larocin、Natamox、Oxetacillin
规 格

阿莫西林三水酸胶囊 250mg, 500mg; 阿莫西林三水悬浮液 125mg/5ml, 250mg/5ml。
药理作用

阿莫西林为半合成广谱青霉素类药，抗菌谱及抗菌活性与氨苄西林基本相同，但其耐酸性较氨苄西林强，其杀菌作用优于氨苄西林，但不能用于脑膜炎的治疗。半衰期约为61.3分钟。
阿莫西林杀菌作用强，穿透细胞壁的能力也强。口服后药物分子中的内酰胺基立即水解生成肽键，迅速和菌体内的转肽酶结合使之失活，切断了菌体依靠转肽酶合成糖肽用来建造细胞壁的唯一途径，使细菌细胞迅速成为球形体而破裂溶解，菌体终于因细胞壁损水份不断渗透而胀裂死亡。对大多数致病的G+菌和G-菌(包括球菌和杆菌)均有强大的抑菌和杀菌作用。其中对溶血性链球菌，布氏杆菌，沙门氏菌和肠球菌等中度或轻度敏感。血液透析能清除部分药物，但腹膜透析无清除本品的作用。
敏感菌：链球菌A、B、C、F、G和非分组型、单核细胞增多性李斯特菌、白喉杆菌、奈瑟脑膜炎双球菌、百日咳杆菌、产气荚膜杆菌属、丙酸杆菌、消化链球菌、牛链球菌、沙门菌、真细菌属、放线菌、钩端螺旋体、梅毒螺旋体。
不稳定性敏感菌：青霉素敏感性或耐药性肺炎球菌、肠粪链球菌、大肠杆菌、奇异变形杆菌、志贺菌、霍乱弧菌、流感嗜血菌、淋病奈瑟球菌、梭状杆菌。
耐药菌：葡萄球菌、卡他菌属、产酸克雷白杆菌、肺炎克雷白杆菌、普通变形杆菌、假单孢菌属、不动杆菌、弯曲杆菌、韦荣球菌、支原体、立克次体、军团菌属、分歧杆菌、脆弱杆菌。
适应症

用以治疗伤寒、其他沙门菌感染和伤寒带菌者，敏感细菌所致的尿路感染及肺炎球菌、不产青霉素酶金葡菌、溶血性链球菌和流感杆菌所致的耳、鼻、喉感染和软组织感染等。
禁忌

青霉素过敏及青霉素皮肤试验阳性患者禁用。
不良反应

临床应用阿莫西林的不良反应发生率约为5-6%，因反应而停药者约2%。其主要不良反应有：
1.过敏反应症状
可出现药物热、荨麻疹、皮疹等，尤易发生于传染性单核细胞增多症者。少见过敏性休克。
2.消化系统症状
多见腹泻、恶心、呕吐等症状，偶见假膜性结肠炎。
3.血液系统症状
偶见嗜酸粒细胞增多、白细胞减少、血小板减少、贫血等。
4.皮肤粘膜反应
偶见斑丘疹、渗出性多形性红斑、Lyell综合征、剥脱性皮炎。
5.肝、肾功能紊乱
少数患者用药后偶见血清转氨酶升高、急性间质性肾炎。
6.其它
长期使用本药可出现由念珠菌或耐药菌引起的二重感染。
7.静脉注射量大时可见惊厥、嗜酸性粒细胞增多。
注意事项

1.对一种青霉素过敏者可能对其它青霉素过敏，也可能对青霉胺或头孢菌素过敏，用药前必须做青霉素皮肤试验，阳性者禁用。
2.对此药或其它青霉素类药物过敏的患者；传染性单核细胞增多症、淋巴细胞性白血病、巨细胞病毒感染、淋巴瘤等患者禁用。
3.对头孢菌素类药过敏者；本品可经乳汁排出，乳母使用本品后可使婴儿致敏，哺乳期妇女；哮喘、湿疹、枯草热、荨麻疹等过敏性疾病史者；疱疹病毒感染者，尤其是传染性单核细胞增多症患者(可增强皮肤不良反应的危险性)；应慎用。晚期妊娠孕妇应用后，可使血浆中结合的雌激素浓度减少，但对游离的雌激素和孕激素无影响。
4.用含硫酸铜的片状试剂(R)、费林溶液测定尿糖时可能会导致假阳性反应 ；少数患者用药后可出现血清转氨酶升高、嗜酸粒细胞增多和白细胞减少。
药物相互作用

1.丙磺舒可延缓阿莫西林经肾排泄，延长其血清半衰期，因而使本品的血药浓度升高。
2.阿莫西林与氨基糖苷类药合用时，在亚抑菌浓度时可增强阿莫西林对粪链球菌体外杀菌作用。
3.阿莫西林与β-内酰胺酶抑制剂如克拉维酸合用时，抗菌作用明显增强。克拉维酸不仅可以不同程度地增强产β-内酰胺酶菌株对阿莫西林的敏感性，还可增强阿莫西林对某些非敏感菌株的作用，这些菌株包括拟杆菌、军团菌、诺卡菌和假鼻疽杆菌。
4.阿莫西林与避孕药合用时，可干扰避孕药的肠肝循环，从而降低其药效。
5.别嘌呤类尿酸合成抑制剂可增加阿莫西林发生皮肤不良反应的危险性。
6.阿莫西林与氨甲蝶呤合用时，本品可使氨甲蝶呤肾廓清率降低，从而增加氨甲蝶呤毒性。
7.食物可延迟阿莫西林的吸收，但食物并不明显降低药物吸收的总量。

Amoxil
Generic name: Amoxicillin

Why is Amoxil prescribed?

Amoxil, an antibiotic, is used to treat a wide variety of infections, including: gonorrhea, middle ear infections, skin infections, upper and lower respiratory tract infections, and infections of the genital and urinary tract. In combination with other drugs, it is also used to treat duodenal ulcers caused by H. pylori bacteria (ulcers in the wall of the small intestine near the exit from the stomach).

Most important fact about Amoxil

If you are allergic to either penicillin or cephalosporin antibiotics in any form, consult your doctor before taking Amoxil. There is a possibility that you are allergic to both types of medication; and if a reaction occurs, it could be extremely severe. If you take the drug and feel signs of a reaction, seek medical attention immediately.

How should you take Amoxil?

Amoxil can be taken with or without food. If you are using Amoxil suspension, shake it well before using.

Your doctor will only prescribe Amoxil to treat a bacterial infection. Amoxil will not cure a viral infection such as the common cold. It's important to take all of your medication as instructed by your doctor, even if you're feeling better in a few days. Not finishing the complete dosage of Amoxil may decrease the drug's effectiveness and increase the chances for bacterial resistance to Amoxil and similar antibiotics.

If you miss a dose...
Take it as soon as you remember. If it is almost time for the next dose, and you take 2 doses a day, take the one you missed and the next dose 5 to 6 hours later. If you take 3 or more doses a day, take the one you missed and the next dose 2 to 4 hours later. Then go back to your regular schedule.
Storage instructions...
Amoxil suspension and pediatric drops should be stored in a tightly closed bottle. Discard any unused medication after 14 days. Refrigeration is preferable.
Store capsules at or below 68 degrees Fahrenheit. Store chewable tablets and tablets at or below 77 degrees Fahrenheit in a tightly closed container.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Amoxil.

Side effects may include:
Agitation, anemia, anxiety, changes in behavior, colitis, confusion, convulsions, diarrhea, dizziness, hives, hyperactivity, insomnia, liver problems and jaundice, nausea, peeling skin, rash, tooth discoloration in children, vomiting.
When Amoxil is used in combination with other drugs for the treatment of ulcers, the most common side effects are changes in taste sensation, diarrhea, and headache.

Why should Amoxil not be prescribed?

You should not use Amoxil if you are allergic to penicillin or cephalosporin antibiotics.

Special warnings about Amoxil

If you have ever had asthma, hives, hay fever, or other allergies, consult with your doctor before taking Amoxil.

You should stop using Amoxil if you experience reactions such as bruising, fever, skin rash, itching, joint pain, swollen lymph nodes, and/or sores on the genitals. If these reactions occur, stop taking Amoxil unless your doctor advises you to continue.

For infections such as strep throat, it is important to take Amoxil for the entire amount of time your doctor has prescribed. Even if you feel better, you need to continue taking Amoxil. If you stop taking Amoxil before your treatment time is complete, you may get other infections, such as glomerulonephritis (a kidney infection) or rheumatic fever.

If you are diabetic, be aware that Amoxil may cause a false positive Clinitest (urine glucose test) result to occur. You should consult with your doctor about using different tests while taking Amoxil.

Before taking Amoxil, tell your doctor if you have ever had asthma, colitis (inflammatory bowel disease), diabetes, or kidney or liver disease.

The chewable tablet form of Amoxil contains phenylalanine. If you or your child has the hereditary disease phenylketonuria, this form of Amoxil should not be used.

Possible food and drug interactions when taking Amoxil

If Amoxil is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Amoxil with the following:

Chloramphenicol Erythromycin Estrogen Oral contraceptives Other antibiotics, including tetracycline Probenecid

Special information if you are pregnant or breastfeeding

Amoxil should be used during pregnancy only when clearly needed. If you are pregnant or plan to become pregnant, inform your doctor immediately. Since Amoxil may appear in breast milk, you should consult your doctor if you plan to breastfeed your baby.

Recommended dosage for Amoxil

Dosages will be determined by the type of infection being treated.

ADULTS

Ear, Nose, Throat, Skin, Genital, and Urinary Tract Infections

For mild or moderate infections, the usual dose is 250 milligrams every 8 hours, or 500 milligrams every 12 hours. For severe infections, the usual dose is 500 milligrams every 8 hours, or 875 milligrams every 12 hours.

Lower Respiratory Tract Infections

For mild, moderate, or severe infections, the usual dose is 500 milligrams every 8 hours, or 875 milligrams every 12 hours.

Gonorrhea, Acute, Uncomplicated Anogenita,l and Urethral Infections

The usual dosage is 3 grams in a single oral dose.

Ulcers

For ulcer treatment, Amoxil is combined with other medications. There are several dosage regimens available, and your doctor will choose the best one for you.

If your kidneys are severely impaired or you are undergoing hemodialysis, the doctor may have to adjust your dosage accordingly.

CHILDREN OLDER THAN 3 MONTHS

Children weighing 88 pounds and over should follow the recommended adult dose schedule.

Children weighing under 88 pounds will have their dosage determined by their weight.

Ear, Nose, Throat, Genital, and Urinary Tract Infections

For mild or moderate infections, the usual dose is 25 milligrams per 2.2 pounds of body weight, divided into two daily doses and taken every 12 hours; or 20 milligrams per 2.2 pounds of body weight, divided into three daily doses and taken every 8 hours.

For severe infections, the usual dose is 45 milligrams per 2.2 pounds of body weight, divided into two daily doses and taken every 12 hours; or 40 milligrams per 2.2 pounds of body weight, divided into three daily doses and taken every 8 hours.

Lower Respiratory Tract Infections

For mild, moderate, or severe infections, the usual dose is 45 milligrams per 2.2 pounds of body weight, divided into two daily doses and taken every 12 hours; or 40 milligrams per 2.2 pounds of body weight, divided into three daily doses and taken every 8 hours.

For infants 3 months or younger the maximum daily dose is 30 milligrams per 2.2 pounds of body weight, divided into two daily doses and taken every 12 hours.

The required amount of liquid medication should be placed directly on the child's tongue for swallowing. It can also be added to formula, milk, fruit juice, water, ginger ale, or cold drinks. The preparation should be taken immediately. To be certain the child is getting the full dose of medication, make sure he or she drinks the entire preparation.

If your child is taking the pediatric drops, use the dropper provided to measure the dosage.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

Symptoms of Amoxil overdose may include:
Diarrhea, nausea, stomach cramps, vomiting