E-MOXCLAV

Composition
1 Tablet Dry Mix (5 ml)
375 mg625 mg 156 mg 312 mg
Amoxycillin (as trihydrate)
Clavulanic acid (as potassium salt)
250 mg
125 mg
500 mg
125 mg
125 mg
31.25 mg
250 mg
62.5 mg

Properties and Mode of Action
E-MOXCLAV is a combination of amoxycillin, the broad spectrum bactericidal penicillinase - sensitive penicillin and clavulanic acid, the " suicidal " inhibitor of a wide variety of bacterial beta - lactamase enzymes which irreversibly inactivates the latter. Due to this combination, amoxycillin is protected from enzymatic degradation and its spectrum is therefore extended to include bacteria normally resistant to amoxycillin and other beta - lactam antibiotics.
E-MOXCLAV is effective against many G+ve and G-ve aerobic bacteria and some anaerobes e.g. Staphylococci (including penicillinase-resistant S.aureus), b-haemolytric Streptococci, Streptococcus pneumoniae, faecalis and viridans, Nocardia, E.coli, H.influenzae and ducreyi, Klebsiella, N.gonorrhoeae and meningitidis, Salmonella, Shigella, Proteus mirabilis, Enterobacter, Pseudomonas pseudomallei, Moraxella (Branhamella) catarrhalis, Legionella, Clostridia, Peptococci, Peptostreptococci, and Bacteroides fragilis.

Indications
Treatment of infections due to susceptible micro-organisms: Upper respiratory tract infections.
Lower respiratory tract infections.
Genitourinary tract infections.
Skin and soft tissue infections including burn wound infections.
Biliary tract infections.
Bone and joint infections.
Chancroid.
Mixed infections caused by ampicillin-susceptible and beta-lactamase producing organisms.

Dosage and Administration
E-MOXCLAV may be taken without regard to meals.
Usual Adult and Adolescent Dose:
One E-MOXCLAV 375 mg Tablet every 8 hours, or
One E-MOXCLAV 625 mg Tablet every 8 hours in severe infections.
Usual Children Dose:
Chidren's dose is based on amoxycillin content.
< 3 months old: 30 mg/kg/day divided every 12 hours based on amoxycillin component.
Use of the 125 mg / 5 ml oral suspension is recommended.
>= 3 months old: 20 - 40 mg/kg/day divided every 8 hours based on amoxycillin content.
Use of the 125 mg / 5 ml or 250 mg / 5 ml is recommended.
>= 40 kg body weight: Dose according to adult recommendations. Dosage in Renal Impairment E-MOXCLAV does not generally require a reduction in dose in patients with impaired renal function, unless the impairment is severe: If Creatinine clearance is 50 - 10 ml/min., the usual adult dose is given 12 hourly. If Creatinine clearance is < 10 ml/min.(anuric), the usual adult dose is given 12 - 24 hourly.

Precautions
As with other antibiotics, prolonged or repeated use may result in superinfection, in which case, appropriate measures should be taken.
Positive direct Coomb's tests, elevated ALT (SGPT) and AST (SGOT) concentrations; transient decrease in total conjugated estriol, estriol glucuronide, conjugated estrone and estradiol concentrations following administration to pregnant women may occur.
Risk - benefit should be considered with intolerance to penicillins, cephalosporins, cephamycins, or penicillamine, infectious mononucleosis, history of general allergy, ulcerative colitis, regional enteritis, or antibiotic-associated colitis.
Pregnancy:
Well-controlled studies in humans have not been done. However, studies in animals given doses higher than the usual human dose have not shown that the combination causes adverse effects in the fetus. Use when clearly indicated.

Drug Interactions
Probenecid decreases renal tubular secretion of amoxycillin and prolongs its blood level but it does not interact with clavulanic acid.

Contra_indications
Hypersensitivity to penicillins or cephalosporins.

Side effects
Nausea, vomiting, mild diarrhoea, hypersensitivity reactions including skin rash in infectious mononucleosis patients, erythema multiforme including the Stevens-Johnson syndrome , darkened or discoloured tongue, may occasionally occur. Hepatitis and cholestatic jaundice have been reported rarely.

Presentation
E-MOXCLAV 375 mg Tablets : Box of 2 blisters of 5 tablets each.
E-MOXCLAV 625 mg Tablets : Box of 2 blisters of 5 tablets each.
E-MOXCLAV 156 mg Dry Mix : Bottle of 60 ml suspension after reconstitution with "EIPICO" solvent.
E-MOXCLAV 312 mg Dry Mix : Bottle of 60 ml suspension after reconstitution with "EIPICO" solvent.