Augmentin (Amoxicillin + Clavulanic Acid)
Also sold as: Moxikind-CV, Clavam, Megaclav, Bactoclav
Pregnancy
Cat B
Lactation
Safe
Schedule
H
Forms
Tablet 375/625/1000mg +2
Indications
- Acute otitis media
- Sinusitis
- CAP
- UTI
- Skin/soft tissue infections
- Animal bite prophylaxis
- Dental abscess
Adult Dosing
Mild-moderate infections
625 mg PO every 8 hours
5-7 days
Severe infections / sinusitis
1g PO every 12 hours
7-10 days
IV (hospital)
1.2g IV every 8 hours
Switch to oral when stable
Pediatric Dosing
Use high-dose 80-90 mg/kg/day for AOM, sinusitis, CAP per IAP guidelines
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| CrCl > 30 mL/min | No adjustment needed |
| CrCl 10-30 mL/min | 500 mg every 12 hours; do not use 875 mg or 1g tablets |
| CrCl < 10 mL/min | 500 mg every 24 hours |
| Hemodialysis | 500 mg every 24 hours; supplemental dose during and after dialysis |
Hepatic Adjustment
Use with caution. Discontinue if cholestatic jaundice develops (1-2 per 10,000 patients).
Pregnancy & Lactation
Pregnancy: Category B
Generally considered safe in pregnancy. Used widely for UTI and respiratory infections.
Lactation: Safe
Excreted in breast milk in small amounts; monitor infant for diarrhea, rash, candidiasis.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Warfarin | Increased anticoagulant effect — monitor INR | Moderate |
| Methotrexate | Decreased MTX clearance — toxicity risk | Major |
| Probenecid | Increases amoxicillin levels (avoid combination) | Moderate |
| Allopurinol | Increased risk of skin rash | Moderate |
| Oral contraceptives | May reduce efficacy — use barrier method | Minor |
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Side Effects
Common
- Diarrhea (15-20%, mainly clavulanate-related)
- Nausea/vomiting
- Vaginal/oral candidiasis
- Skin rash
Serious / Discontinue If
- Anaphylaxis
- Stevens-Johnson syndrome
- Cholestatic jaundice/hepatitis
- Clostridioides difficile colitis
Contraindications
- Penicillin or beta-lactam allergy
- Previous augmentin-induced cholestatic jaundice
- Severe infectious mononucleosis (rash risk)
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Augmentin 625 Duo | GSK | 10 tab strip ₹245 |
| Moxikind-CV 625 | Mankind | 10 tab ₹130 |
| Clavam 625 | Alkem | 10 tab ₹165 |
| Megaclav 625 | Sun Pharma | 10 tab ₹125 |
Monitoring Required
- LFT for prolonged use (>14 days)
- Renal function in elderly/CKD
- Watch for diarrhea (C. diff)
Patient Counseling Points
- Take with food to reduce GI upset
- Complete the full course even if you feel better
- Report severe diarrhea immediately
- Use additional contraception if on OCPs
Stop Googling drug references mid-consultation
EasyClinic auto-flags Augmentin interactions, renal cutoffs, and pregnancy warnings the moment you write the prescription. Built-in safety net for every Indian doctor.
References
- BNF — Co-amoxiclav
- IAP Standard Treatment Guidelines 2024
- KDIGO 2024 Drug Dosing in CKD
- GSK Augmentin Prescribing Information India