Moxaclav
Generic Name
Amoxicillin Trihydrate + Clavulanic Acid
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| moxaclav 250 mg tablet | ৳ 25.00 | ৳ 150.00 |
Description
Overview of the medicine
Moxaclav 250 mg tablet is a broad-spectrum antibiotic containing amoxicillin and clavulanic acid. Amoxicillin is a penicillin-type antibiotic that fights bacteria, while clavulanic acid helps prevent certain bacteria from inactivating amoxicillin, thereby extending its antibacterial spectrum.
Uses & Indications
Dosage
Adults
Standard dose is 250 mg/62.5 mg three times daily for mild to moderate infections. For more severe infections, 500 mg/125 mg three times daily may be prescribed. Dosing should be continued for 7-10 days, or as directed by a physician.
Elderly
No specific dose adjustment is required unless there is evidence of renal impairment. If renal impairment is present, dosage should be adjusted as for renal impairment.
Renal_impairment
For creatinine clearance (CrCl) >30 ml/min, no adjustment. For CrCl 10-30 ml/min, 250 mg/62.5 mg twice daily. For CrCl <10 ml/min, 250 mg/62.5 mg once daily. Hemodialysis patients: 250 mg/62.5 mg every 24 hours, with an additional dose during and at the end of dialysis.
How to Take
Take orally, preferably at the start of a meal to minimize potential gastrointestinal intolerance and to enhance the absorption of clavulanic acid. Swallow the tablet whole with a glass of water. Do not crush or chew.
Mechanism of Action
Amoxicillin inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), leading to cell lysis and death. Clavulanic acid is a beta-lactamase inhibitor that irreversibly binds to and inactivates beta-lactamase enzymes produced by bacteria, thus protecting amoxicillin from hydrolysis and extending its antibacterial activity against beta-lactamase-producing strains.
Pharmacokinetics
Onset
Antibacterial effect typically observed within 1 hour after administration.
Excretion
Primarily excreted unchanged by the kidneys. Approximately 60-80% of amoxicillin and 25-40% of clavulanic acid are excreted in the urine within the first 6 hours after administration. Renal impairment significantly delays excretion.
Half life
Amoxicillin has an elimination half-life of approximately 1 to 1.5 hours. Clavulanic acid has an elimination half-life of approximately 1 hour. Both are prolonged in patients with impaired renal function.
Absorption
Rapidly and well-absorbed from the gastrointestinal tract following oral administration. Peak plasma concentrations are reached approximately 1-2 hours after dosing. Absorption of clavulanic acid is improved when taken with food.
Metabolism
Both amoxicillin and clavulanic acid are partially metabolized in the liver. Amoxicillin undergoes minor metabolism to inactive metabolites. Clavulanic acid is extensively metabolized.
Side Effects
Contraindications
- Known hypersensitivity to penicillin or any component of Moxaclav (e.g., amoxicillin, clavulanic acid)
- History of severe immediate hypersensitivity reactions (e.g., anaphylaxis) to any other beta-lactam antibiotic (e.g., cephalosporins, carbapenems)
- History of cholestatic jaundice or hepatic dysfunction associated with previous amoxicillin/clavulanic acid therapy
Drug Interactions
Probenecid
Reduces renal tubular secretion of amoxicillin, increasing and prolonging amoxicillin blood levels.
Allopurinol
Concomitant use with amoxicillin may increase the incidence of skin rashes.
Methotrexate
Amoxicillin may reduce renal excretion of methotrexate, increasing its toxicity.
Oral Contraceptives
May reduce the efficacy of oral contraceptives; advise patients to use additional non-hormonal contraception.
Anticoagulants (e.g., Warfarin)
May prolong prothrombin time (INR). Close monitoring is recommended.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include gastrointestinal symptoms (e.g., abdominal pain, vomiting, diarrhea) and disturbances of the fluid and electrolyte balance. Renal impairment leading to crystalluria has been observed in some cases. Treatment should be symptomatic and supportive. Amoxicillin/clavulanic acid can be removed from circulation by hemodialysis.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have not shown harm to the fetus. However, there are no adequate and well-controlled studies in pregnant women. Use during pregnancy only if clearly needed. Both amoxicillin and clavulanic acid are excreted into breast milk. Use with caution in nursing mothers, as it may cause sensitization or gastrointestinal disturbances in the infant.
Side Effects
Contraindications
- Known hypersensitivity to penicillin or any component of Moxaclav (e.g., amoxicillin, clavulanic acid)
- History of severe immediate hypersensitivity reactions (e.g., anaphylaxis) to any other beta-lactam antibiotic (e.g., cephalosporins, carbapenems)
- History of cholestatic jaundice or hepatic dysfunction associated with previous amoxicillin/clavulanic acid therapy
Drug Interactions
Probenecid
Reduces renal tubular secretion of amoxicillin, increasing and prolonging amoxicillin blood levels.
Allopurinol
Concomitant use with amoxicillin may increase the incidence of skin rashes.
Methotrexate
Amoxicillin may reduce renal excretion of methotrexate, increasing its toxicity.
Oral Contraceptives
May reduce the efficacy of oral contraceptives; advise patients to use additional non-hormonal contraception.
Anticoagulants (e.g., Warfarin)
May prolong prothrombin time (INR). Close monitoring is recommended.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include gastrointestinal symptoms (e.g., abdominal pain, vomiting, diarrhea) and disturbances of the fluid and electrolyte balance. Renal impairment leading to crystalluria has been observed in some cases. Treatment should be symptomatic and supportive. Amoxicillin/clavulanic acid can be removed from circulation by hemodialysis.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have not shown harm to the fetus. However, there are no adequate and well-controlled studies in pregnant women. Use during pregnancy only if clearly needed. Both amoxicillin and clavulanic acid are excreted into breast milk. Use with caution in nursing mothers, as it may cause sensitization or gastrointestinal disturbances in the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date, check packaging for exact date.
Availability
Available in pharmacies and hospitals
Approval Status
Approved in many countries including Bangladesh
Patent Status
Patent expired, generic available
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials have established the efficacy and safety of amoxicillin/clavulanic acid for various bacterial infections. Ongoing research focuses on resistance patterns and optimal dosing strategies.
Lab Monitoring
- Liver function tests (ALT, AST, bilirubin) in patients with pre-existing hepatic impairment or during prolonged therapy
- Renal function tests (creatinine, BUN) in patients with renal impairment or during prolonged therapy
- Complete Blood Count (CBC) for prolonged therapy due to potential for hematologic effects
Doctor Notes
- Verify penicillin allergy history before prescribing.
- Advise patients to complete the full course to prevent resistance and recurrence.
- Monitor for signs of hypersensitivity reactions, especially within the first few days of therapy.
- Consider renal function for dose adjustment, particularly in elderly patients.
Patient Guidelines
- Complete the entire prescribed course of medication, even if symptoms improve, to prevent the development of antibiotic resistance.
- Take the tablet at the start of a meal to reduce stomach upset.
- Inform your doctor if you experience severe or persistent diarrhea, skin rash, yellowing of skin/eyes, or unusual bruising/bleeding.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Moxaclav generally does not impair the ability to drive or operate machinery. However, side effects like dizziness can occur, which may affect alertness. If affected, avoid driving or operating heavy machinery.
Lifestyle Advice
- Maintain good hydration by drinking plenty of fluids.
- Consider consuming probiotics (e.g., yogurt, fermented foods) to help restore beneficial gut bacteria, especially if experiencing diarrhea.
- Avoid alcohol consumption during the course of treatment, as it may exacerbate gastrointestinal side effects.
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