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AUGMENTIN® (amoxicillin/clavulanate potassium)
2016-04-21 11:14:56 来源: 作者: 【 】 浏览:357次 评论:0
  • HIGHLIGHTS OF PRESCRIBING INFORMATION
    These highlights do not include all the information needed to use AUGMENTIN safely and effectively. See full prescribing information for AUGMENTIN.
    AUGMENTIN® (amoxicillin/clavulanate potassium) Tablets, Powder for Oral Suspension, and Chewable Tablets
    Initial U.S. Approval: 1984

    To reduce the development of drug-resistant bacteria and maintain the effectiveness of AUGMENTIN and other antibacterial drugs, AUGMENTIN should be used only to treat infections that are proven or strongly suspected to be caused by bacteria.
    INDICATIONS AND USAGE

    AUGMENTIN is a combination penicillin-class antibacterial and beta‑lactamase inhibitor indicated for treatment of the following:

    Lower respiratory tract infections (1.1)

    Acute bacterial otitis media (1.2)

    Sinusitis (1.3)

    Skin and skin structure infections (1.4)

    Urinary tract infections (1.5)

    DOSAGE AND ADMINISTRATION
    • Adults and Pediatric Patients > 40 kg: 500 or 875 mg every 12 hours or 250 or 500 mg every 8 hours. (2.1, 2.2)
    • Pediatric patients aged 12 weeks (3 months) and older: 25 to 45 mg/kg/day every 12 hours or 20 to 40 mg/kg/day every 8 hours, up to the adult dose. (2.2)
    • Neonates and infants < 12 weeks of age: 30 mg/kg/day divided every 12 hours, based on the amoxicillin component. Use of the 125 mg/5 mL oral suspension is recommended. (2.2)

    DOSAGE FORMS AND STRENGTHS

    Formulations and amoxicillin/clavulanate content are:

    Tablets: 250 mg/125 mg, 500 mg/125 mg, 875 mg/125 mg; 875 mg/125 mg tablets are scored. (3)

    Powder for Oral Suspension:  125 mg/31.25 mg per 5 mL, 200 mg/28.5 mg per 5 mL, 250 mg/62.5 mg per 5 mL, 400 mg/57 mg per 5 mL (3)

    Chewable Tablets: 125 mg/31.25 mg, 200 mg/28.5 mg, 250 mg/62.5 mg, 400 mg/57 mg (3)
    CONTRAINDICATIONS

    • History of a serious hypersensitivity reaction (e.g., anaphylaxis or Stevens-Johnson syndrome) to AUGMENTIN or to other beta‑lactams (e.g., penicillins or cephalosporins) (4)
    • History of cholestatic jaundice/hepatic dysfunction associated with AUGMENTIN. (4)

    WARNINGS AND PRECAUTIONS

    • Serious (including fatal) hypersensitivity reactions: Discontinue AUGMENTIN if a reaction occurs. (5.1)
    • Hepatic dysfunction and cholestatic jaundice: Discontinue if signs/symptoms of hepatitis occur.  Monitor liver function tests in patients with hepatic impairment. (5.2)
    • Clostridium difficile-associated diarrhea (CDAD): eva luate patients if diarrhea occurs. (5.3)
    • Patients with mononucleosis who receive AUGMENTIN develop skin rash. Avoid AUGMENTIN use in these patients. (5.4)
    • Overgrowth: The possibility of superinfections with fungal or bacterial pathogens should be considered during therapy. (5.5)
    ADVERSE REACTIONS

    The most frequently reported adverse effects were diarrhea/loose stools (9%), nausea (3%), skin rashes and urticaria (3%),vomiting (1%) and vaginitis (1%) (6.1)

    To report SUSPECTED ADVERSE REACTIONS, contact Dr. Reddy’s Laboratories Inc., at 1-888-375-3784 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

    DRUG INTERACTIONS
    • Co‑administration with probenecid is not recommended. (7.1)
    • Concomitant use of AUGMENTIN and oral anticoagulants may increase the prolongation of prothrombin time. (7.2)
    • Coadministration with allopurinol increases the risk of rash. (7.3)
    • AUGMENTIN may reduce efficacy of oral contraceptives. (7.4)
    USE IN SPECIFIC POPULATIONS
    • Pediatric Use: Modify dose in patients 12 weeks or younger. (8.4)
    • Renal impairment; Dosage adjustment is recommended for severe renal impairment (GFR< 30mL/min). (2.3, 8.6)
    See 17 for PATIENT COUNSELING INFORMATION.

    Revised: 2/2013

  • FULL PRESCRIBING INFORMATION: CONTENTS*

    1 INDICATIONS AND USAGE

    1.1  Lower Respiratory Tract Infections

    1.2 Acute Bacterial Otitis Media

    1.3 Sinusitis

    1.4 Skin and Skin Structure Infections

    1.5 Urinary Tract Infections

    1.6 Limitations of Use

    2 DOSAGE AND ADMINISTRATION

    2.1 Adults

    2.2 Pediatric Patients

    2.3 Patients with Renal Impairment

    2.4 Directions for Mixing Oral Suspension

    3 DOSAGE FORMS AND STRENGTHS

    4 CONTRAINDICATIONS

    4.1 Serious Hypersensitivity Reactions

    4.2 Cholestatic Jaundice/Hepatic Dysfunction

    5 WARNINGS AND PRECAUTIONS

    5.1 Hypersensitivity Reactions

    5.2 Hepatic Dysfunction

    5.3 Clostridium difficile Associated Diarrhea (CDAD)

    5.4 Skin Rash in Patients with Mononucleosis

    5.5 Potential for Microbial Overgrowth

    5.6 Phenylketonurics

    5.7 Development of Drug-Resistant Bacteria

    6 ADVERSE REACTIONS

    6.1 Clinical Trial Experience

    6.2 Postmarketing Experience

    7 DRUG INTERACTIONS

    7.1 Probenecid

    7.2 Oral Anticoagulants

    7.3 Allopurinol

    7.4 Oral Contraceptives

    7.5 Effects on Laboratory Tests

    8 USE IN SPECIFIC POPULATIONS

    8.1 Pregnancy

    8.2 Labor and Delivery

    8.3 Nursing Mothers

    8.4 Pediatric Use

    8.5 Geriatric Use

    8.6 Dosing in Renal Impairment

    10 OVERDOSAGE

    11 DESCRIPTION

    12 CLINICAL PHARMACOLOGY

    12.1 Mechanism of Action

    12.3 Pharmacokinetics

    12.4 Microbiology

    13 NONCLINICAL TOXICOLOGY

    13.1 Carcinogenesis, Mutagenesis, Impairment Of Fertility

    14 CLINICAL STUDIES

    14.1 Lower Respiratory Tract and Complicated Urinary Tract Infections

    14.2 Acute Bacterial Otitis Media and Diarrhea in Pediatric Patients

    15 REFERENCES

    16 HOW SUPPLIED/STORAGE AND HANDLING

    17 PATIENT COUNSELING INFORMATION

    17.1 Information for Patients

    *
    Sections or subsections omitted from the full prescribing information are not listed.
  • 1 INDICATIONS AND USAGE

    To reduce the development of drug‑resistant bacteria and maintain the effectiveness of AUGMENTIN (amoxicillin/clavulanate potassium) and other antibacterial drugs, AUGMENTIN should be used only to treat infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

    AUGMENTIN® is a combination penicillin-class antibacterial and beta-lactamase inhibitor indicated in the treatment of infections due to susceptible isolates of the designated bacteria in the conditions listed below*:

    1.1  Lower Respiratory Tract Infections

    caused by beta‑lactamase–producing isolates of Haemophilus influenzae and Moraxella catarrhalis.

    1.2 Acute Bacterial Otitis Media

    caused by beta‑lactamase–producing isolates of H. influenzae and M. catarrhalis.

    1.3 Sinusitis

    caused by beta‑lactamase–producing isolates of H. influenzae and M. catarrhalis.

    1.4 Skin and Skin Structure Infections

    caused by beta‑lactamase–producing isolates of Staphylococcus aureus, Escherichia coli, and Klebsiella species.

    1.5 Urinary Tract Infections

    caused by beta‑lactamase–producing isolates of E. coli, Klebsiella species, and Enterobacter species.

    1.6 Limitations of Use

    When susceptibility test results show susceptibility to amoxicillin, indicating no beta-lactamase production, AUGMENTIN should not be used.

  • 2 DOSAGE AND ADMINISTRATION

    AUGMENTIN may be taken without regard to meals; however, absorption of clavulanate potassium is enhanced when AUGMENTIN is administered at the start of a meal. To minimize the potential for gastrointestinal intolerance, AUGMENTIN should be taken at the start of a meal.

    2.1 Adults

    The usual adult dose is one 500-mg tablet of AUGMENTIN every 12 hours or one 250-mg tablet of AUGMENTIN every 8 hours. For more severe infections and infections of the respiratory tract, the dose should be one 875-mg tablet of AUGMENTIN every 12 hours or one 500-mg tablet of AUGMENTIN every 8 hours. Adults who have difficulty swallowing may be given the 125 mg/5 mL or 250 mg/5 mL suspension in place of the 500-mg tablet. The 200 mg/5 mL suspension or the 400 mg/5 mL suspension may be used in place of the 875-mg tablet.

    Two 250-mg tablets of AUGMENTIN should not be substituted for one 500-mg tablet of AUGMENTIN. Since both the 250-mg and 500-mg tablets of AUGMENTIN contain the same amount of clavulanic acid (125 mg, as the potassium salt), two 250-mg tablets are not equivalent to one 500-mg tablet of AUGMENTIN.

    The 250-mg tablet of AUGMENTIN and the 250-mg chewable tablet should not be substituted for each other, as they are not interchangeable. The 250-mg tablet of AUGMENTIN and the 250-mg chewable tablet do not contain the same amount of clavulanic acid (as the potassium salt). The 250-mg tablet of AUGMENTIN contains 125 mg of clavulanic acid, whereas the 250-mg chewable tablet contains 62.5 mg of clavulanic acid.

    2.2 Pediatric Patients

    Based on the amoxicillin component, AUGMENTIN should be dosed as follows:

    Neonates and Infants Aged <12 weeks (<3 months): The recommended dose of AUGMENTIN is 30 mg/kg/day divided every 12 hours, based on the amoxicillin component. Experience with the 200 mg/5 mL formulation in this age group is limited, and thus, use of the 125 mg/5 mL oral suspension is recommended.

    Patients Aged 12 weeks (3 months) and Older: See dosing regimens provided in Table 1. The every 12 hour regimen is recommended as it is associated with significantly less diarrhea [see Clinical Studies (14.2)]. However, the every 12 hour suspension (200 mg/5 mL and 400 mg/5 mL) and chewable tablets (200 mg and 400 mg) contain aspartame and should not be used by phenylketonurics. [see Warnings and Precautions (5.6)]

    Table 1: Dosing in Patients Aged 12 weeks (3 months) and Older

    INFECTION DOSING REGIMEN
    Every 12 hours Every 8 hours
    200 mg/5 mL or 400 mg/5 mL oral suspensiona 125 mg/5 mL or 250 mg/5 mL oral suspensiona
    Otitis mediab, sinusitis, lower respiratory tract infections, and more severe infections 45 mg/kg/day every 12 hours 40 mg/kg/day every 8 hours
    Less severe infections 25 mg/kg/day every 12 hours 20 mg/kg/day every 8 hours

    a Each strength of suspension of AUGMENTIN is available as a chewable tablet for use by older children.

    b Duration of therapy studied and recommended for acute otitis media is 10 days.

    Patients Weighing 40 kg or More: Pediatric patients weighing 40 kg or more should be dosed according to adult recommendations.

    The 250-mg tablet of AUGMENTIN should not be used until the child weighs at least 40 kg,due to the different amoxicillin to clavulanic acid ratios in the 250-mg tablet of AUGMENTIN (250/125) versus the 250-mg chewable tablet of AUGMENTIN (250/62.5).

    2.3 Patients with Renal Impairment

    Patients with impaired renal function do not generally require a reduction in dose unless the impairment is severe. Renal impairment patients with a glomerular filtration rate of <30 mL/min should not receive the 875‑mg dose. Patients with a glomerular filtration rate of 10 to 30 mL/min should receive 500 mg or 250 mg every 12 hours, depending on the severity of the infection. Patients with a glomerular filtration rate less than 10 mL/min should receive 500 mg or 250 mg every 24 hours, depending on severity of the infection.

    Hemodialysis patients should receive 500 mg or 250 mg every 24 hours,depending on severity of the infection. They should receive an additional dose both during and at the end of dialysis.

    2.4 Directions for Mixing Oral Suspension

    Prepare a suspension at time of dispensing as follows: Tap bottle until all the powder flows freely. Add approximately 2/3 of the total amount of water for reconstitution (see Table 2 below) and shake vigorously to suspend powder. Add remainder of the water and again shake vigorously.

    Table 2: Amount of Water for Mixing Oral Suspension

    以下是“全球医药”详细资料
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