amoxicillin and clavulanate potassium

Warnings and Precautions, Drug-Induced Enterocolitis Syndrome (DIES) ( 5 .3) 05/2024

1 INDICATIONS AND USAGE Amoxicillin and Clavulanate Potassium is indicated for the treatment of infections in adults and pediatric patients, due to susceptible isolates of the designated bacteria in the conditions listed below: • Lower Respiratory Tract Infections - caused by beta‐lactamase–producing isolates of Haemophilus influenzae and Moraxella catarrhalis . • Acute Bacterial Otitis Media - caused by beta‐lactamase–producing isolates of H. influenzae and M. catarrhalis . • Sinusitis - caused by beta‐lactamase–producing isolates of H. influenzae and M. catarrhalis . • Skin and Skin Structure Infections - caused by beta‐lactamase–producing isolates of Staphylococcus aureus , Escherichia coli , and Klebsiella species. • Urinary Tract Infections - caused by beta‐lactamase–producing isolates of E. coli , Klebsiella species, and Enterobacter species. Amoxicillin and Clavulanate Potassium is a combination of amoxicillin, a penicillin-class antibacterial and clavulanate potassium, a beta‐lactamase inhibitor indicated for treatment of the following infections in adults and pediatric patients: ( Error! Hyperlink reference not valid. ) • Lower respiratory tract infections • Acute bacterial otitis media • Sinusitis • Skin and skin structure infections • Urinary tract infections Limitations of Use When susceptibility test results show susceptibility to amoxicillin, indicating no beta-lactamase production, Amoxicillin and Clavulanate Potassium should not be used. ( Error! Hyperlink reference not valid. ) Usage To reduce the development of drug-resistant bacteria and maintain the effectiveness of Amoxicillin and Clavulanate Potassium and other antibacterial drugs, Amoxicillin and Clavulanate Potassium should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria. ( Error! Hyperlink reference not valid. ) Limitations of Use When susceptibility test results show susceptibility to amoxicillin, indicating no beta-lactamase production, Amoxicillin and Clavulanate Potassium should not be used. Usage To reduce the development of drug‐resistant bacteria and maintain the effectiveness of Amoxicillin and Clavulanate Potassium and other antibacterial drugs, Amoxicillin and Clavulanate Potassium should be used only to treat or prevent 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.

2 DOSAGE AND ADMINISTRATION • Adults and Pediatric Patients greater than 40 kg: 500 or 875 mg every 12 hours or 250 or 500 mg every 8 hours, based on the amoxicillin component. (, ) • 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. () • Neonates and infants less than 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. () 2.1 Important Administration Instructions Amoxicillin and Clavulanate Potassium may be taken without regard to meals; however, absorption of clavulanate potassium is enhanced when Amoxicillin and Clavulanate Potassium is administered at the start of a meal. To minimize the potential for gastrointestinal intolerance, Amoxicillin and Clavulanate Potassium should be taken at the start of a meal. 2.2 Adult Patients See dosing regimens of Amoxicillin and Clavulanate Potassium (based on the amoxicillin component) provided in Table 1 below. Table 1. Dosing Regimens of Amoxicillin and Clavulanate Potassium in Adult Patients TYPE OF INFECTION DOSING REGIMEN OF Amoxicillin and Clavulanate Potassium Severe infections and infections of the respiratory tract one 875 mg tablet a of Amoxicillin and Clavulanate Potassium every 12 hours or one 500 mg tablet b,c of Amoxicillin and Clavulanate Potassium every 8 hours Less severe infections one 500 mg tablet b,c of Amoxicillin and Clavulanate Potassium every 12 hours or one 250 mg tablet d of Amoxicillin and Clavulanate Potassium every 8 hours a Adults who have difficulty swallowing may be given the Amoxicillin and Clavulanate Potassium 200 mg/28.5 mg per 5 mL suspension or the Amoxicillin and Clavulanate Potassium 400 mg/57 mg per 5 mL suspension may be used in place of the 875 mg/125 mg tablet. b Adults who have difficulty swallowing may be given the Amoxicillin and Clavulanate Potassium 125 mg/31.25 mg per 5 mL or Amoxicillin and Clavulanate Potassium 250 mg/62.5 mg per 5 mL suspension in place of the 500 mg/125 mg tablet. c Two Amoxicillin and Clavulanate Potassium 250 mg/125 mg tablets are NOT substitutable with one 500 mg/125 mg Amoxicillin and Clavulanate Potassium tablet [see Dosage and Administration ( )] . d Amoxicillin and Clavulanate Potassium 250 mg/125 mg tablet is NOT substitutable with Amoxicillin and Clavulanate Potassium 250 mg/62.5 mg chewable tablet [see Dosage and Administration ( )] 2.3 Pediatric Patients Based on the amoxicillin component, Amoxicillin and Clavulanate Potassium should be dosed as follows: Neonates and Infants Aged less than 12 weeks (less than 3 months) : See dosing regimens of Amoxicillin and Clavulanate Potassium provided in Table 2 below. Table 2: Dosing Regimens of Amoxicillin and Clavulanate Potassium in Neonates and Infants Aged Less than 12 Weeks (Less than 3 Months) PATIENT POPULATION DOSING REGIMEN Amoxicillin and Clavulanate Potassium 125 mg/31.25 mg per 5 mL for oral suspension a Neonates and Infants aged less than 12 weeks (less than 3 months) 30 mg/kg/day every 12 hours a Experience with the Amoxicillin and Clavulanate Potassium 200 mg/28.5 mg per 5 mL formulation in this age group is limited, and thus, use of the Amoxicillin and Clavulanate Potassium 125 mg/31.25 mg per 5 mL for oral suspension is recommended. Patients Aged 12 weeks (3 months) and Older and Weighing Less than 40 kg : See dosing regimens provided in Table 3 below. • The every 12 hour regimen is recommended as it is associated with significantly less diarrhea [see Clinical Studies ( )] . • The Amoxicillin and Clavulanate Potassium 200 mg/28.5 mg per 5 mL and Amoxicillin and Clavulanate Potassium 400 mg/57 mg per 5 mL) for oral suspension and Amoxicillin and Clavulanate Potassium 200 mg/28.5 mg and Amoxicillin and Clavulanate Potassium 400 mg/57 mg chewable tablets contain aspartame and should not be used by phenylketonurics. [see Warnings and Precautions ( )]. Table 3: Dosi …

3 DOSAGE FORMS AND STRENGTHS Amoxicillin and Clavulanate Potassium Tablets, USP : • 250 mg/125 mg Tablets: Each white oval film-coated tablet, debossed with AUGMENTIN on one side and 250/125 on the other side, contains 250 mg of amoxicillin as the trihydrate and 125 mg of clavulanic acid as the potassium salt. • 500 mg/125 mg Tablets : Each white oval film-coated tablet, debossed with AUGMENTIN on one side and 500/125 on the other side, contains 500 mg of amoxicillin as the trihydrate and 125 mg of clavulanic acid as the potassium salt. • 875 mg/125 mg Tablets : Each scored white capsule‐shaped tablet, debossed with AUGMENTIN 875 on one side and scored on the other side, contains 875 mg of amoxicillin as the trihydrate and 125 mg of clavulanic acid as the potassium salt. Amoxicillin and Clavulanate Potassium for Oral Suspension, USP: • 125 mg/31.25 mg per 5 mL : Banana-flavored powder for oral suspension (each 5 mL of reconstituted suspension contains 125 mg of amoxicillin as the trihydrate and 31.25 mg of clavulanic acid as the potassium salt). • 200 mg/28.5 mg per 5 mL : Orange-flavored powder for oral suspension (each 5 mL of reconstituted suspension contains 200 mg of amoxicillin as the trihydrate and 28.5 mg of clavulanic acid as the potassium salt). • 250 mg/62.5 mg per 5 mL : Orange-flavored powder for oral suspension (each 5 mL of reconstituted suspension contains 250 mg of amoxicillin as the trihydrate and 62.5 mg of clavulanic acid as the potassium salt). • 400 mg/57 mg per 5 mL: Orange-flavored powder for oral suspension (each 5 mL of reconstituted suspension contains 400 mg of amoxicillin as the trihydrate and 57 mg of clavulanic acid as the potassium salt). Amoxicillin and Clavulanate Potassium Chewable Tablets, USP: • 125 mg/31.25 mg Chewable Tablets : Each mottled yellow, round, lemon-lime-flavored tablet, debossed with BMP 189 contains 125 mg of amoxicillin as the trihydrate and 31.25 mg of clavulanic acid as the potassium salt. • 200 mg/28.5 mg Chewable Tablets : Each mottled pink, round, biconvex cherry-banana-flavored tablet, debossed with AUGMENTIN 200 contains 200 mg of amoxicillin as the trihydrate and 28.5 mg of clavulanic acid as the potassium salt. • 250 mg/62.5 mg Chewable Tablets : Each mottled yellow, round, lemon-lime-flavored tablet, debossed with BMP 190 contains 250 mg of amoxicillin as the trihydrate and 62.5 mg of clavulanic acid as the potassium salt. • 400 mg/57 mg Chewable Tablets : Each mottled pink, round, biconvex cherry-banana-flavored tablet, debossed with AUGMENTIN 400 contains 400 mg of amoxicillin as the trihydrate and 57 of clavulanic acid as the potassium salt. • Tablets: 250 mg/125 mg, 500 mg/125 mg, 875 mg/125 mg; 875 mg/125 mg tablets are scored. ( 3 ) • 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 )

4 CONTRAINDICATIONS • History of a serious hypersensitivity reaction (e.g., anaphylaxis or Stevens-Johnson syndrome) to Amoxicillin and Clavulanate Potassium or to other beta‐lactams (e.g., penicillins or cephalosporins). ( Error! Hyperlink reference not valid. ) • History of cholestatic jaundice/hepatic dysfunction associated with Amoxicillin and Clavulanate Potassium. ( Error! Hyperlink reference not valid. ) 4.1 Serious Hypersensitivity Reactions Amoxicillin and Clavulanate Potassium is contraindicated in patients with a history of serious hypersensitivity reactions (e.g., anaphylaxis or Stevens-Johnson syndrome) to amoxicillin, clavulanate or to other beta‐lactam antibacterial drugs (e.g., penicillins and cephalosporins). 4.2 Cholestatic Jaundice/Hepatic Dysfunction Amoxicillin and Clavulanate Potassium is contraindicated in patients with a previous history of cholestatic jaundice/hepatic dysfunction associated with Amoxicillin and Clavulanate Potassium.

6 ADVERSE REACTIONS The following are discussed in more detail in other sections of the labeling: • Anaphylactic reactions [see Warnings and Precautions Error! Hyperlink reference not valid. ] • Severe Cutaneous Adverse Reactions [see Warnings and Precautions ( )] • Drug-Induced Enterocolitis Syndrome (DIES) [see Warning and Precautions ( )] • Hepatic Dysfunction [see Warnings and Precautions Error! Hyperlink reference not valid. ] • Clostridioides difficile Associated Diarrhea (CDAD) [see Warnings and Precautions Error! Hyperlink reference not valid. ] The most frequently reported adverse effects were diarrhea/loose stools (9%), nausea (3%), skin rashes and urticaria (3%), vomiting (1%) and vaginitis (1%). () To report SUSPECTED ADVERSE REACTIONS, contact USAntibiotics, LLC at 1-844-454-5532 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. 6.1 Clinical Trial Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. The most frequently reported adverse reactions were diarrhea/loose stools (9%), nausea (3%), skin rashes and urticaria (3%), vomiting (1%) and vaginitis (1%). Less than 3% of patients discontinued therapy because of drug‐related adverse reactions. The overall incidence of adverse reactions, and in particular diarrhea, increased with the higher recommended dose. Other less frequently reported adverse reactions (less than 1%) include: Abdominal discomfort, flatulence, and headache. In pediatric patients (aged 2 months to 12 years), 1 US/Canadian clinical trial was conducted which compared 45/6.4 mg/kg/day (divided every 12 hours) of Amoxicillin and Clavulanate Potassium for 10 days versus 40/10 mg/kg/day (divided every 8 hours) of Amoxicillin and Clavulanate Potassium for 10 days in the treatment of acute otitis media. A total of 575 patients were enrolled, and only the suspension formulations were used in this trial. Overall, the adverse reactions seen were comparable to that noted above; however, there were differences in the rates of diarrhea, skin rashes/urticaria, and diaper area rashes. [see Clinical Studies ( Error! Hyperlink reference not valid. )] . 6.2 Postmarketing Experience In addition to adverse reactions reported from clinical trials, the following have been identified during postmarketing use of Amoxicillin and Clavulanate Potassium. Because they are reported voluntarily from a population of unknown size, estimates of frequency cannot be made. These events have been chosen for inclusion due to a combination of their seriousness, frequency of reporting, or potential causal connection to Amoxicillin and Clavulanate Potassium. Gastrointestinal: Drug-induced enterocolitis syndrome (DIES), indigestion, gastritis, stomatitis, glossitis, black “hairy” tongue, mucocutaneous candidiasis, enterocolitis, and hemorrhagic/pseudomembranous colitis. Onset of pseudomembranous colitis symptoms may occur during or after antibacterial treatment. [see Warnings and Precautions ( Error! Hyperlink reference not valid. )] . Immune: Hypersensitivity reactions, anaphylactic/anaphylactoid reactions (including shock), angioedema, serum sickness-like reactions (urticaria or skin rash accompanied by arthritis, arthralgia, myalgia, and frequently fever), hypersensitivity vasculitis [see Warnings and Precautions ( )] . Skin and Appendages: Rashes, pruritus, urticaria, erythema multiforme, SJS, TEN, DRESS, AGEP, exfoliative dermatitis, and linear IgA bullous dermatosis. Liver: Hepatic dysfunction, including hepatitis and cholestatic jaundice, increases in serum transaminases (AST and/or ALT), serum bilirubin, and/or alkaline phosphatase, has been reported with Amoxicillin and Clavulanate Potassium. It has been reported more commonly in the elderly, in males, or in patients on prolonged treatment. The histologic findings …

7 DRUG INTERACTIONS • Co‐administration with probenecid is not recommended. ( 7.1 ) • Concomitant use of Amoxicillin and Clavulanate Potassium and oral anticoagulants may increase the prolongation of prothrombin time.( 7.2 ) • Co-administration with allopurinol increases the risk of rash. ( 7.3 ) • Amoxicillin and Clavulanate Potassium may reduce efficacy of oral contraceptives. ( 7.4 ) 7.1 Probenecid Probenecid decreases the renal tubular secretion of amoxicillin but does not delay renal excretion of clavulanic acid. Concurrent use with Amoxicillin and Clavulanate Potassium may result in increased and prolonged blood concentrations of amoxicillin. Co-administration of probenecid is not recommended. 7.2 Oral Anticoagulants Abnormal prolongation of prothrombin time (increased international normalized ratio [INR]) has been reported in patients receiving amoxicillin and oral anticoagulants. Appropriate monitoring should be undertaken when anticoagulants are prescribed concurrently with Amoxicillin and Clavulanate Potassium. Adjustments in the dose of oral anticoagulants may be necessary to maintain the desired level of anticoagulation. 7.3 Allopurinol The concurrent administration of allopurinol and amoxicillin increases the incidence of rashes in patients receiving both drugs as compared to patients receiving amoxicillin alone. It is not known whether this potentiation of amoxicillin rashes is due to allopurinol or the hyperuricemia present in these patients. 7.4 Oral Contraceptives Amoxicillin and Clavulanate Potassium may affect intestinal flora, leading to lower estrogen reabsorption and reduced efficacy of combined oral estrogen/progesterone contraceptives. 7.5 Effects on Laboratory Tests High urine concentrations of amoxicillin may result in false-positive reactions when testing for the presence of glucose in urine using CLINITEST ® , Benedict's Solution, or Fehling's Solution. Since this effect may also occur with Amoxicillin and Clavulanate Potassium, it is recommended that glucose tests based on enzymatic glucose oxidase reactions be used. Following administration of amoxicillin to pregnant women, a transient decrease in plasma concentration of total conjugated estriol, estriol-glucuronide, conjugated estrone, and estradiol has been noted.

8 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 less than 30mL/min). ( 2.4 , Error! Hyperlink reference not valid. ) 8.1 Pregnancy Teratogenic Effects : Pregnancy Category B. Reproduction studies performed in pregnant rats and mice given Amoxicillin and Clavulanate Potassium (2:1 ratio formulation of amoxicillin:clavulanate) at oral doses up to 1200 mg/kg/day revealed no evidence of harm to the fetus due to Amoxicillin and Clavulanate Potassium. The amoxicillin doses in rats and mice (based on body surface area) were approximately 4 and 2 times the maximum recommended adult human oral dose (875 mg every 12 hours). For clavulanate, these dose multiples were approximately 9 and 4 times the maximum recommended adult human oral dose (125 mg every 8 hours). There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. 8.2 Labor and Delivery Oral ampicillin‐class antibacterials are poorly absorbed during labor. It is not known whether use of amoxicillin and clavulanate potassium in humans during labor or delivery has immediate or delayed adverse effects on the fetus, prolongs the duration of labor, or increases the likelihood of the necessity for an obstetrical intervention. 8.3 Nursing Mothers Amoxicillin has been shown to be excreted in human milk. Amoxicillin and clavulanate potassium use by nursing mothers may lead to sensitization of infants. Caution should be exercised when amoxicillin and clavulanate potassium is administered to a nursing woman. 8.4 Pediatric Use The safety and effectiveness of Amoxicillin and Clavulanate Potassium for Oral Suspension and Chewable Tablets have been established in pediatric patients. Use of Amoxicillin and Clavulanate Potassium in pediatric patients is supported by evidence from studies of Amoxicillin and Clavulanate Potassium Tablets in adults with additional data from a study of Amoxicillin and Clavulanate Potassium for Oral Suspension in pediatric patients aged 2 months to 12 years with acute otitis media [see Clinical Studies ( Error! Hyperlink reference not valid. )] . Because of incompletely developed renal function in neonates and young infants, the elimination of amoxicillin may be delayed; clavulanate elimination is unaltered in this age group. Dosing of Amoxicillin and Clavulanate Potassium should be modified in pediatric patients aged less than 12 weeks (less than 3 months) [see Dosage and Administration ( 2.3 )]. 8.5 Geriatric Use Of the 3,119 patients in an analysis of clinical studies of Amoxicillin and Clavulanate Potassium, 32% were greater than or equal to 65 years old, and 14% were greater than or equal to 75 years old. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. This drug is known to be substantially excreted by the kidney, and the risk of adverse reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function. 8.6 Renal Impairment Amoxicillin is primarily eliminated by the kidney and dosage adjustment is usually required in patients with severe renal impairment (GFR less than 30 mL/min). See Patients with Renal Impairment [see Dosage and Administration ( 2.4 )] for specific recommendations in patients with renal impairment.

12.1 Mechanism of Action Amoxicillin and Clavulanate Potassium is an antibacterial drug [see Microbiology ( Error! Hyperlink reference not valid. )] .

11 DESCRIPTION Amoxicillin and Clavulanate Potassium is an oral antibacterial combination consisting of amoxicillin and the beta‐lactamase inhibitor, clavulanate potassium (the potassium salt of clavulanic acid). Amoxicillin is an analog of ampicillin, derived from the basic penicillin nucleus, 6‐aminopenicillanic acid. The amoxicillin molecular formula is C 16 H 19 N 3 O 5 S•3H 2 O, and the molecular weight is 419.46. Chemically, amoxicillin is (2 S ,5 R ,6 R )-6-[( R )-(-)-2-Amino-2-( p -hydroxyphenyl)acetamido]-3,3-dimethyl-7-oxo-4-thia-1-azabicyclo[3.2.0]heptane-2-carboxylic acid trihydrate and may be represented structurally as: Clavulanic acid is produced by the fermentation of Streptomyces clavuligerus . It is a beta-lactam structurally related to the penicillins and possesses the ability to inactivate some beta‐lactamases by blocking the active sites of these enzymes. The clavulanate potassium molecular formula is C 8 H 8 KNO 5 , and the molecular weight is 237.25. Chemically, clavulanate potassium is potassium ( Z )(2 R ,5 R )-3-(2-hydroxyethylidene)-7-oxo-4-oxa-1-azabicyclo[3.2.0]-heptane-2-carboxylate and may be represented structurally as: Amoxicillin and Clavulanate Potassium Tablets: • 250 mg/125 mg: Each tablet contains 250 mg of amoxicillin as the trihydrate, and 125 mg of clavulanic acid (equivalent to 149 mg of clavulanate potassium). • 500 mg/125 mg: Each tablet contains 500 mg of amoxicillin as the trihydrate, and 125 mg of clavulanic acid (equivalent to 149 mg of clavulanate potassium). • 875 mg/125 mg: Each tablet contains 875 mg of amoxicillin as the trihydrate, and 125 mg of clavulanic acid (equivalent to 149 mg of clavulanate potassium). Amoxicillin and Clavulanate Potassium for Oral Suspension: • 125 mg/31.25 mg : Following constitution, each 5 mL of oral suspension contains 125 mg of amoxicillin as the trihydrate, and 31.25 mg of clavulanic acid (equivalent to 37.23 mg of clavulanate potassium). • 200 mg/28.5 mg : Following constitution, each 5 mL of oral suspension contains 200 mg of amoxicillin as the trihydrate, and 28.5 mg of clavulanic acid (equivalent to 34 mg of clavulanate potassium). • 250 mg/62.5 mg : Following constitution, each 5 mL of oral suspension contains 250 mg of amoxicillin as the trihydrate, and 62.5 mg of clavulanic acid (equivalent to 74.5 mg of clavulanate potassium). • 400 mg/57 mg : Following constitution, each 5 mL of oral suspension contains 400 mg of amoxicillin as the trihydrate, and 57 mg of clavulanic acid (equivalent to 68 mg of clavulanate potassium). Amoxicillin and Clavulanate Potassium Chewable Tablets: • 125 mg/31.25 mg: Each chewable tablet contains 125 mg of amoxicillin as the trihydrate, and 31.25 mg of clavulanic acid (equivalent to 37.23 mg of clavulanate potassium). • 200 mg/28.5 mg: Each chewable tablet contains 200 mg of amoxicillin as the trihydrate, and 28.5 mg of clavulanic acid (equivalent to 34 mg of clavulanate potassium). • 250 mg/62.5 mg: Each chewable tablet contains 250 mg of amoxicillin as the trihydrate, and 62.5 mg of clavulanic acid (equivalent to 74.5 mg of clavulanate potassium). • 400 mg/57 mg: Each chewable tablet contains 400 mg of amoxicillin as the trihydrate, and 57 mg of clavulanic acid (equivalent to 68 mg of clavulanate potassium). Inactive Ingredients: • Amoxicillin and Clavulanate Potassium Tablets - Colloidal silicon dioxide, hypromellose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, sodium starch glycolate, and titanium dioxide. • Each tablet of Amoxicillin and Clavulanate Potassium contains 0.63 mEq potassium. • Amoxicillin and Clavulanate Potassium for Oral Suspension, 125 mg/31.5 mg per 5mL and 250 mg/62.5 mg per 5mL - Colloidal silicon dioxide, flavorings, xanthan gum, mannitol, succinic acid, silica gel and sodium saccharin. • Each 5 mL of reconstituted 125 mg/31.5 mg oral suspension of Amoxicillin and Clavulanate Potassium contains 0.16 mEq potassium • Each 5 mL of reconstituted 250 mg/62.5 mg ora …

10 OVERDOSAGE In case of overdosage, discontinue medication, treat symptomatically, and institute supportive measures as required. A prospective study of 51 pediatric patients at a poison-control center suggested that overdosages of less than 250 mg/kg of amoxicillin are not associated with significant clinical symptoms 1 . Interstitial nephritis resulting in oliguric renal failure has been reported in patients after overdosage with amoxicillin and clavulanate potassium. Crystalluria, in some cases leading to renal failure, has also been reported after amoxicillin and clavulanate potassium overdosage in adult and pediatric patients. In case of overdosage, adequate fluid intake and diuresis should be maintained to reduce the risk of amoxicillin and clavulanate potassium crystalluria. Renal impairment appears to be reversible with cessation of drug administration. High blood levels may occur more readily in patients with impaired renal function because of decreased renal clearance of amoxicillin and clavulanate potassium. Amoxicillin and clavulanate potassium may be removed from circulation by hemodialysis [see Dosage and Administration ( 2.4 )] .

16 HOW SUPPLIED/STORAGE AND HANDLING Amoxicillin and Clavulanate Potassium Tablets, USP: 875 mg/125 mg Tablets : Each scored white capsule‐shaped tablet, debossed with AUGMENTIN 875 on one side and scored on the other side, contains 875 mg of amoxicillin as the trihydrate and 125 mg of clavulanic acid as the potassium salt (equivalent to 149 mg of clavulanate potassium). NDC Bottles o 20 Tablets Dispense in tight container [See USP]. Store tablets and dry powder at or below 25°C (77°F). Store reconstituted suspension under refrigeration. Discard unused suspension after 10 days. Keep out of the reach of children.