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Amoxicillin
Overview
Active ingredients
Source: NDC DirectoryForms, strengths and routes
Source: NDC DirectoryPharmacologic classes are listed in the class section below.
Pharmacologic class
Source: NDC Directory| Class | Type | Browse |
|---|---|---|
| Penicillin-class Antibacterial [EPC] | EPC | All 38 members |
| Penicillins [CS] | CS | All 38 members |
Regulatory status
Source: Drugs@FDANDC Directory| Product | Trade name | Form | Strength | Ingredient | Status | TE | Flags |
|---|---|---|---|---|---|---|---|
| 064013-001 | AMOXICILLIN | TABLET, CHEWABLE | AMOXICILLIN | Prescription | — | RS | |
| 064013-002 | AMOXICILLIN | TABLET, CHEWABLE | AMOXICILLIN | Prescription | — |
Therapeutic equivalence
Source: Orange BookCodes beginning with “A” indicate products the FDA considers therapeutically equivalent. Codes beginning with “B” indicate bioequivalence has not been established. See methodology.
Approval history
Source: Drugs@FDA| Type | No. | Action | Status | Date | Review |
|---|---|---|---|---|---|
| Supplement | 64 | Labeling | Approved | May 1, 2024 | Standard |
| Supplement | 61 | Labeling | Approved | January 3, 2024 | Standard |
| Supplement | 57 | Labeling | Approved | December 4, 2019 | Standard |
| Supplement | 56 | Labeling | Approved | May 18, 2017 | Standard |
| Supplement | 55 | Labeling | Approved | May 18, 2017 | Standard |
| Supplement | 49 | Labeling | Approved | September 10, 2015 | — |
| Supplement | 45 | Labeling | Approved | February 2, 2009 | — |
| Supplement | 44 | Labeling | Approved | July 17, 2008 | — |
| Supplement | 41 | Labeling | Approved | May 31, 2007 | — |
| Supplement | 36 | Labeling | Approved | August 29, 2003 | — |
| Supplement | 32 | Manufacturing (CMC) | Approved | December 9, 2002 | — |
| Supplement | 31 | Manufacturing (CMC) | Approved | September 10, 2002 | — |
| Supplement | 28 | Manufacturing (CMC) | Approved | March 20, 2002 | — |
| Supplement | 27 | Manufacturing (CMC) | Approved | March 20, 2002 | — |
| Supplement | 29 | Manufacturing (CMC) | Approved | March 14, 2002 | — |
| Supplement | 25 | Manufacturing (CMC) | Approved | September 10, 2001 | — |
| Supplement | 24 | Manufacturing (CMC) | Approved | September 10, 2001 | — |
| Supplement | 23 | Manufacturing (CMC) | Approved | September 10, 2001 | — |
| Supplement | 22 | Manufacturing (CMC) | Approved | July 27, 2001 | — |
| Supplement | 26 | Labeling | Approved | July 13, 2001 | — |
| Supplement | 20 | Manufacturing (CMC) | Approved | May 15, 2001 | — |
| Supplement | 21 | Labeling | Approved | March 23, 2001 | — |
| Supplement | 19 | Manufacturing (CMC) | Approved | January 4, 2001 | — |
| Supplement | 18 | Manufacturing (CMC) | Approved | July 7, 2000 | — |
| Supplement | 17 | Manufacturing (CMC) | Approved | June 12, 2000 | — |
| Supplement | 16 | Labeling | Approved | April 6, 1999 | — |
| Supplement | 15 | Manufacturing (CMC) | Approved | August 28, 1996 | — |
| Supplement | 12 | Manufacturing (CMC) | Approved | July 3, 1996 | — |
| Supplement | 14 | Manufacturing (CMC) | Approved | June 5, 1996 | — |
| Supplement | 13 | Manufacturing (CMC) | Approved | June 5, 1996 | — |
| Supplement | 11 | Manufacturing (CMC) | Approved | June 5, 1996 | — |
| Supplement | 10 | Manufacturing (CMC) | Approved | April 1, 1996 | — |
| Supplement | 9 | Manufacturing (CMC) | Approved | February 28, 1996 | — |
| Supplement | 3 | Manufacturing (CMC) | Approved | September 11, 1995 | — |
| Supplement | 2 | Manufacturing (CMC) | Approved | September 11, 1995 | — |
| Supplement | 1 | Labeling | Approved | September 11, 1995 | — |
| Supplement | 6 | Manufacturing (CMC) | Approved | August 26, 1993 | — |
| Supplement | 7 | Labeling | Approved | July 12, 1993 | — |
| Supplement | 4 | Manufacturing (CMC) | Approved | May 13, 1993 | — |
| Supplement | 5 | Manufacturing (CMC) | Approved | May 12, 1993 | — |
| Original application | 1 | Approved | December 22, 1992 | — |
Prescribing information
Source: openFDA Drug LabelingReproduced verbatim from the Structured Product Labeling submitted to the FDA (effective 20260904). This is the manufacturer's labelling text, not a summary and not advice.
Recent Major Changes
openFDA Drug LabelingIndications and Usage, Gonorrhea ( 1.5 ) Removed 9/2015 Dosage and Administration, Gonorrhea ( 2.1 ) Removed 9/2015
Indications and Usage
openFDA Drug Labeling1 INDICATIONS AND USAGE Adults and Pediatric Patients Upper Respiratory Tract Infections of the Ear, Nose, and Throat: Amoxicillin tablets, amoxicillin for oral suspension, amoxicillin tablets (chewable), and amoxicillin capsules are indicated in the treatment of infections due to susceptible (ONLY β-lactamase-negative) isolates of Streptococcus species. (α- and β-hemolytic isolates only), Streptococcus pneumoniae , Staphylococcus spp., or Haemophilus influenzae . Infections of the Genitourinary Tract: Amoxicillin tablets, amoxicillin for oral suspension, amoxicillin tablets (chewable), and amoxicillin capsules are indicated in the treatment of infections due to susceptible (ONLY β-lactamase-negative) isolates of Escherichia coli , Proteus mirabilis , or Enterococcus faecalis . Infections of the Skin and Skin Structure: Amoxicillin tablets, amoxicillin for oral suspension, amoxicillin tablets (chewable), and amoxicillin capsules are indicated in the treatment of infections due to susceptible (ONLY β-lactamase-negative) isolates of Streptococcus spp. (α- and β-hemolytic isolates only), Staphylococcus spp., or E. coli . Infections of the Lower Respiratory Tract: Amoxicillin tablets, amoxicillin for oral suspension, amoxicillin tablets (chewable), and amoxicillin capsules are indicated in the treatment of infections due to susceptible (ONLY β-lactamase-negative) isolates of Streptococcus spp. (α- and β-hemolytic isolates only), S. pneumoniae , Staphylococcus spp., or H. influenzae . Adult Patients only Helicobacter pylori Infection and Duodenal Ulcer Disease: Triple therapy for Helicobacter pylori (H. pylori) with clarithromycin and lansoprazole: Amoxicillin, in combination with clarithromycin plus lansoprazole as triple therapy, is indicated for the treatment of patients with H. pylori infection and duodenal ulcer disease (active or 1-year history of a duodenal ulcer) to eradicate H. pylori . Eradication of H. pylori has been shown to reduce the risk of duodenal ulcer recurrence. Dual therapy for H. pylori with lansoprazole: Amoxicillin, in combination with lansoprazole delayed-release capsules as dual therapy, is indicated for the treatment of patients with H. pylori infection and duodenal ulcer disease (active or 1-year history of a duodenal ulcer) who are either allergic or intolerant to clarithromycin or in whom resistance to clarithromycin is known or suspected. (See the clarithromycin package insert, MICROBIOLOGY.) Eradication of H. pylori has been shown to reduce the risk of duodenal ulcer recurrence. Usage To reduce the development of drug-resistant bacteria and maintain the effectiveness of amoxicillin and other antibacterial drugs, amoxicillin should be used only to treat infections that are proven or strongly suspected to be caused by 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. Amoxicillin is a penicillin-class antibacterial indicated for treatment of infections due to susceptible strains of designated microorganisms. ( 1 ) Adults and Pediatric Patients ( 1 ) Upper Respiratory Tract Infections of the Ear, Nose, and Throat Infections of the Genitourinary Tract Infections of the Skin and Skin Structure Infections of the Lower Respiratory Tract Adult Patients only ( 1 ) Helicobacter pylori Infection and Duodenal Ulcer Disease Usage To reduce the development of drug-resistant bacteria and maintain the effectiveness of amoxicillin tablets, amoxicillin for oral suspension, amoxicillin tablets (chewable), and amoxicillin capsules and other antibacterial drugs, amoxicillin tablets, amoxicillin for oral suspension, amoxicillin tablets (chewable), and amoxicillin capsules should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria. ( 1 )
Dosage and Administration
openFDA Drug Labeling2 DOSAGE AND ADMINISTRATION In Adults, 750 to 1750 mg/day in divided doses every 8 to 12 hours. In Pediatric Patients over 3 Months of Age, 20 to 45 mg/kg/day in divided doses every 8 to 12 hours. Refer to full prescribing information for specific dosing regimens. ( 2.2 , 2.3 ) The upper dose for neonates and infants aged 3 months or younger is 30 mg/kg/day divided every 12 hours. ( 2.3 ) Dosing for H. pylori Infection (in Adults): Triple therapy: 1 gram amoxicillin, 500 mg clarithromycin, and 30 mg lansoprazole, all given twice daily (every 12 hours) for 14 days. Dual therapy: 1 gram amoxicillin and 30 mg lansoprazole, each given three times daily (every 8 hours) for 14 days. ( 2.4 ) Reduce the dose in patients with severe renal impairment (GFR greater than 30 mL/min). ( 2.5 ) 2.1 Important Administration Instructions To minimize the potential for gastrointestinal intolerance, amoxicillin should be taken at the start of a meal. 2.2 Dosage for Adults and Pediatric Patients Aged 3 Months (12 weeks) and Older Treatment should be continued for a minimum of 48 to 72 hours beyond the time that the patient becomes asymptomatic, or evidence of bacterial eradication has been obtained. It is recommended that there be at least 10 days’ treatment for any infection caused by Streptococcus pyogenes to prevent the occurrence of acute rheumatic fever. In some infections, therapy may be required for several weeks. It may be necessary to continue clinical and/or bacteriological follow-up for several months after cessation of therapy. Table 1. Dosage Recommendations for Adult and Pediatric Patients Aged 3 Months (12 weeks) and Older Infection Severity a Recommended Dosage for Adults and Pediatric Patients Aged 3 Months and Older and Weight Greater than 40 kg Recommended Dosage for Pediatric Patients Aged 3 Months and Older and Weight Less than 40 kg Ear/Nose/Throat Skin/Skin Structure Genitourinary Tract Mild/Moderate 500 mg every 12 hours or 250 mg every 8 hours 25 mg/kg/day in divided doses every 12 hours or 20 mg/kg/day in divided doses every 8 hours Severe 875 mg every 12 hours or 500 mg every 8 hours 45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours Lower Respiratory Tract Mild/Moderate or Severe 875 mg every 12 hours or 500 mg every 8 hours 45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours a Dosage for infections caused by bacteria that are intermediate in their susceptibility to amoxicillin should follow the recommendations for severe infections. 2.3 Dosage in Pediatric Patients Aged Less than 12 Weeks (3 months) It is recommended that there be at least 10 days’ treatment for any infection caused by Streptococcus pyogenes to prevent the occurrence of acute rheumatic fever. Due to incompletely developed renal function affecting elimination of amoxicillin in this age group, the recommended upper dose of amoxicillin is 30 mg/kg/day divided every 12 hours. There are currently no dosing recommendations for pediatric patients with impaired renal function. Treatment should be continued for a minimum of 48 to 72 hours beyond the time that the patient becomes asymptomatic, or evidence of bacterial eradication has been obtained. 2.4 Dosage for H. pylori Infection in Adults Triple therapy: The recommended adult oral dose is 1 gram amoxicillin, 500 mg clarithromycin, and 30 mg lansoprazole, all given twice daily (every 12 hours) for 14 days. Dual therapy: The recommended adult oral dose is 1 gram amoxicillin and 30 mg lansoprazole, each given three times daily (every 8 hours) for 14 days. Please refer to clarithromycin and lansoprazole full prescribing information. 2.5 Dosage in Renal Impairment for Adults and Pediatric Patients Aged 3 Months and Older and Weight Greater than 40 kg 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 le …
Dosage Forms and Strengths
openFDA Drug Labeling3 DOSAGE FORMS AND STRENGTHS Amoxicillin: Tablets: 500 mg: Each tablet contains 500 mg of amoxicillin, USP as the trihydrate. Each film-coated, capsule-shaped, off-white, tablet is debossed with “93” on one side and “2263” on the other side. 875 mg: Each tablet contains 875 mg of amoxicillin, USP as the trihydrate. Each film-coated, capsule-shaped, off-white tablet is scored on one side, debossed with “93” on one side of the score and “2264” on the other side of the score. For Oral Suspension: 125 mg/5 mL: Each 5 mL of reconstituted mixed berry flavored suspension contains 125 mg amoxicillin, USP as the trihydrate. 200 mg/5 mL: Each 5 mL of reconstituted pink, fruit gum flavored suspension contains 200 mg amoxicillin, USP as the trihydrate. 250 mg/5 mL: Each 5 mL of reconstituted mixed berry flavored suspension contains 250 mg amoxicillin, USP as the trihydrate. 400 mg/5 mL: Each 5 mL of reconstituted pink, fruit gum flavored suspension contains 400 mg amoxicillin, USP as the trihydrate. Tablets (Chewable): 125 mg: Each white to off-white, capsule-shaped tablet, debossed 93 on one side and 2267 on the other side and contains 125 mg of amoxicillin, USP as the trihydrate. 250 mg: Each white to off-white, capsule-shaped tablet, debossed 93 (partial bisect between 9 and 3) on one side and 2268 on the other side and contains 250 mg of amoxicillin, USP as the trihydrate. Capsules: 250 mg: Opaque caramel cap and opaque buff body, hard gelatin capsule. Printed black “TEVA” on cap and “3107” on body portions of the capsule and contain 250 mg amoxicillin, USP as the trihydrate. 500 mg: Opaque buff cap and opaque buff body, hard gelatin capsules. Printed black “TEVA” on cap and “3109” on body portions of the capsules and contain 500 mg amoxicillin, USP as the trihydrate. Tablets: 500 mg, 875 mg ( 3 ) For Oral Suspension: 125 mg/5 mL, 200 mg/5 mL, 250 mg/5 mL, 400 mg/5 mL ( 3 ) Tablets (Chewable): 125 mg, 250 mg ( 3 ) Capsules: 250 mg, 500 mg ( 3 )
Contraindications
openFDA Drug Labeling4 CONTRAINDICATIONS Amoxicillin is contraindicated in patients who have experienced a serious hypersensitivity reaction (e.g., anaphylaxis or Stevens-Johnson syndrome) to amoxicillin or to other β-lactam antibacterial drugs (e.g., penicillins and cephalosporins). History of a serious hypersensitivity reaction (e.g., anaphylaxis or Stevens-Johnson syndrome) to amoxicillin or to other beta-lactams (e.g., penicillins or cephalosporins). ( 4 )
Warnings and Cautions
openFDA Drug Labeling5 WARNINGS AND PRECAUTIONS Anaphylactic reactions: Serious and occasionally fatal anaphylactic reactions have been reported in patients on penicillin therapy, including amoxicillin. Discontinue amoxicillin if a reaction occurs ( 5.1 ). Severe cutaneous adverse reactions (SCAR): Monitor closely. Discontinue if rash progresses. ( 5.2 ) Drug-induced enterocolitis syndrome (DIES) has been reported with amoxicillin use. If this occurs, discontinue amoxicillin and institute appropriate therapy. ( 5.3 ) Clostridioides difficile -associated diarrhea (CDAD) (ranging from mild diarrhea to fatal colitis): Evaluate if diarrhea occurs. ( 5.4 ) 5.1 Anaphylactic Reactions Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients on penicillin therapy including amoxicillin. Although anaphylaxis is more frequent following parenteral therapy, it has occurred in patients on oral penicillins. These reactions are more likely to occur in individuals with a history of penicillin hypersensitivity and/or a history of sensitivity to multiple allergens. There have been reports of individuals with a history of penicillin hypersensitivity who have experienced severe reactions when treated with cephalosporins. Before initiating therapy with amoxicillin, careful inquiry should be made regarding previous hypersensitivity reactions to penicillins, cephalosporins, or other allergens. If an allergic reaction occurs, amoxicillin should be discontinued, and appropriate therapy instituted. 5.2 Severe Cutaneous Adverse Reactions Amoxicillin may cause severe cutaneous adverse reactions (SCAR), such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms (DRESS), and acute generalized exanthematous pustulosis (AGEP). If patients develop skin rash they should be monitored closely, and amoxicillin discontinued if lesions progress. 5.3 Drug-Induced Enterocolitis Syndrome (DIES) Drug-induced enterocolitis syndrome (DIES) has been reported with amoxicillin use [see Adverse Reactions ( 6.2 )] , with most cases occurring in pediatric patients ≤18 years of age. DIES is a non-IgE mediated hypersensitivity reaction characterized by protracted vomiting occurring 1 to 4 hours after drug ingestion in the absence of skin or respiratory symptoms. DIES may be associated with pallor, lethargy, hypotension, shock, diarrhea within 24 hours after ingesting amoxicillin, and leukocytosis with neutrophilia. If DIES occurs, discontinue amoxicillin and institute appropriate therapy. 5.4 Clostridioides difficile -Associated Diarrhea (CDAD) Clostridioides difficile -associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including amoxicillin, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile . C. difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin-producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibacterial use. Careful medical history is necessary since CDAD has been reported to occur over 2 months after the administration of antibacterial agents. If CDAD is suspected or confirmed, ongoing antibacterial use not directed against C. difficile may need to be discontinued. Appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C. difficile , and surgical evaluation should be instituted as clinically indicated. 5.5 Development of Drug-Resistant Bacteria Prescribing amoxicillin in the absence of a proven or strongly suspected bacterial infection or prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of …
Adverse Reactions
openFDA Drug Labeling6 ADVERSE REACTIONS The following are discussed in more detail in other sections of the labeling: Anaphylactic reactions [see Warnings and Precautions (5.1) ] Severe Cutaneous Adverse Reactions [see Warnings and Precautions (5.2) ] Drug-Induced Enterocolitis Syndrome (DIES) [see Warnings and Precautions (5.3) ] Clostridioides difficile -Associated Diarrhea (CDAD) [see Warnings and Precautions (5.4) ] The most common adverse reactions (greater than 1%) observed in clinical trials of amoxicillin capsules, amoxicillin tablets or for oral suspension were diarrhea, rash, vomiting, and nausea. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Chartwell RX, LLC. at 1-845-232-1683 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. 6.1 Clinical Trials 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 common adverse reactions (greater than 1%) observed in clinical trials of amoxicillin capsules, amoxicillin tablets or for oral suspension were diarrhea, rash, vomiting, and nausea. Triple therapy: The most frequently reported adverse events for patients who received triple therapy (amoxicillin/clarithromycin/ lansoprazole) were diarrhea (7%), headache (6%), and taste perversion (5%). Dual therapy: The most frequently reported adverse events for patients who received double therapy amoxicillin/lansoprazole were diarrhea (8%) and headache (7%). For more information on adverse reactions with clarithromycin or lansoprazole, refer to the Adverse Reactions section of their package inserts. 6.2 Postmarketing Experience In addition to adverse events reported from clinical trials, the following events have been identified during postmarketing use of penicillins. 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. Infections and Infestations: Mucocutaneous candidiasis. Gastrointestinal: Drug-induced enterocolitis syndrome (DIES), black hairy tongue, and hemorrhagic/pseudomembranous colitis. Onset of pseudomembranous colitis symptoms may occur during or after antibacterial treatment [see Warnings and Precautions (5.4) ] . 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 (5.1) ] . Skin and Appendages: Rashes, pruritus, urticaria, erythema multiforme, SJS, TEN, DRESS, AGEP, exfoliative dermatitis, and linear IgA bullous dermatosis. Liver: A moderate rise in AST and/or ALT has been noted, but the significance of this finding is unknown. Hepatic dysfunction including cholestatic jaundice, hepatic cholestasis and acute cytolytic hepatitis have been reported. Renal: Crystalluria has been reported [see Overdosage (10) ] . Hemic and Lymphatic Systems: Anemia, including hemolytic anemia, thrombocytopenia, thrombocytopenic purpura, eosinophilia, leukopenia, and agranulocytosis have been reported. These reactions are usually reversible on discontinuation of therapy and are believed to be hypersensitivity phenomena. Central Nervous System: Reversible hyperactivity, agitation, anxiety, insomnia, confusion, convulsions, behavioral changes, aseptic meningitis, and/or dizziness have been reported. Miscellaneous: Tooth discoloration (brown, yellow, or gray staining) has been reported. Most reports occurred in pediatric patients. Discoloration was reduced or eliminated with brushing or dental cleaning in most cases.
Drug Interactions
openFDA Drug Labeling7 DRUG INTERACTIONS • Probenicid decreases renal tubular secretion of amoxicillin which may result in increased blood levels of amoxicillin. ( 7.1 ) • Concomitant use of amoxicillin and oral anticoagulants may increase the prolongation of prothrombin time. ( 7.2 ) • Coadministration with allopurinol increases the risk of rash. ( 7.3 ) • Amoxicillin may reduce the efficacy of oral contraceptives. ( 7.4 ) 7.1 Probenecid Probenecid decreases the renal tubular secretion of amoxicillin. Concurrent use of amoxicillin and probenecid may result in increased and prolonged blood levels of amoxicillin. 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. 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 may affect the gut flora, leading to lower estrogen reabsorption and reduced efficacy of combined oral estrogen/progesterone contraceptives. 7.5 Other Antibacterials Chloramphenicol, macrolides, sulfonamides, and tetracyclines may interfere with the bactericidal effects of penicillin. This has been demonstrated in vitro ; however, the clinical significance of this interaction is not well documented. 7.6 Drug/Laboratory Interactions High urine concentrations of ampicillin 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, it is recommended that glucose tests based on enzymatic glucose oxidase reactions (such as CLINISTIX ® ) be used. Following administration of ampicillin or amoxicillin to pregnant women, a transient decrease in plasma concentration of total conjugated estriol, estriol-glucuronide, conjugated estrone, and estradiol has been noted.
Use in Specific Populations
openFDA Drug Labeling8 USE IN SPECIFIC POPULATIONS 8.1 Pregnancy Teratogenic Effects : Pregnancy Category B. Reproduction studies have been performed in mice and rats at doses up to 2000 mg/kg (3 and 6 times the 3 g human dose, based on body surface area). There was no evidence of harm to the fetus due to amoxicillin. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, amoxicillin should be used during pregnancy only if clearly needed. 8.2 Labor and Delivery Oral ampicillin is poorly absorbed during labor. It is not known whether use of amoxicillin 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 Penicillins have been shown to be excreted in human milk. Amoxicillin use by nursing mothers may lead to sensitization of infants. Caution should be exercised when amoxicillin is administered to a nursing woman. 8.4 Pediatric Use The safety and effectiveness of amoxicillin for the treatment of upper respiratory tract infections, and infections of the genitourinary tract, skin and skin structure and lower respiratory tract have been established in pediatric patients. The safety and effectiveness of amoxicillin for the treatment of H. Pylori infection have not been established in pediatric patients. Because of incompletely developed renal function in neonates and young infants, the elimination of amoxicillin may be delayed. Dosing of amoxicillin should be modified in pediatric patients 12 weeks or younger (3 months or younger) [see Dosage and Administration ( 2.3 )] . 8.5 Geriatric Use An analysis of clinical studies of amoxicillin was conducted to determine whether subjects aged 65 and over respond differently from younger subjects. These analyses have not identified differences in responses between the elderly and younger patients, but a 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 toxic 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 Dosing in 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 Dosing in Renal Impairment ( 2.5 ) for specific recommendations in patients with renal impairment.
Mechanism of Action
openFDA Drug Labeling12.1 Mechanism of Action Amoxicillin is an antibacterial drug [ see Microbiology ( 12.4 ) ].
Description
openFDA Drug Labeling11 DESCRIPTION Amoxicillin, USP is a semisynthetic antibacterial (amoxicillin), an analog of ampicillin, with a broad spectrum of bactericidal activity against many Gram-positive and Gram-negative microorganisms. Chemically, it 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. It may be represented structurally as: The amoxicillin, USP molecular formula is C 16 H 19 N3O 5 S•3H 2 O, and the molecular weight is 419.45. Tablets: Each tablet contains 500 mg or 875 mg of amoxicillin, USP as the trihydrate. Each film-coated tablet contains: colloidal silicon dioxide, crospovidone, D&C Yellow No. 10 aluminum lake, hypromellose, magnesium stearate, microcrystalline cellulose, lactose monohydrate, sodium starch glycolate, titanium dioxide and triacetin. For Oral Suspension: Each 5 mL of reconstituted suspension contains 125 mg, 200 mg, 250 mg or 400 mg of amoxicillin, USP as the trihydrate. Each 5 mL of the 125 mg reconstituted suspension contains 0.10 mEq (2.29 mg) of sodium. Each 5 mL of the 200 mg reconstituted suspension contains 0.09 mEq (2.11 mg) of sodium. Each 5 mL of the 250 mg reconstituted suspension contains 0.14 mEq (3.24 mg) of sodium. Each 5 mL of the 400 mg reconstituted suspension contains 0.12 mEq (2.69 mg) of sodium. Inactive ingredients for 200 mg and 400 mg : Colloidal silicon dioxide, FD&C Red No. 40, natural and artificial fruit gum flavor, sodium benzoate, sodium citrate, spray dried mask flavor, sucrose, and xanthan gum. Inactive ingredients for 125 mg and 250 mg : FD&C Red No. 40, mixed berry flavoring, silicon dioxide, sodium benzoate, sodium citrate, sucrose, and xanthan gum. Tablets (Chewable): Each tablet contains 125 mg or 250 mg of amoxicillin, USP as the trihydrate. Inactive ingredients in each 125 mg or 250 mg chewable tablet: cherry flavor, lactose anhydrous, magnesium stearate, mannitol, microcrystalline cellulose, sodium citrate, and sucrose. Capsules: Each capsule, for oral administration, contains 250 mg or 500 mg amoxicillin, USP as the trihydrate. The capsules contain the following inactive ingredients: magnesium stearate and talc. The capsule shell contains D&C Yellow No. 10, FD&C Red No. 40, gelatin, and titanium dioxide. In addition, the 250 mg contains D&C Red No. 28 and FD&C Blue No. 1. The 500 mg may also contain methylparaben, propylparaben, and sodium lauryl sulfate. The printing ink contains black iron oxide, propylene glycol, shellac, and strong ammonia solution. In addition, the 250 mg may contain D&C Yellow No. 10 Aluminum Lake, FD&C Blue No. 1 Aluminum Lake, FD&C Blue No. 2 Aluminum Lake, and FD&C Red No. 40 Aluminum Lake. The 500 mg may also contain potassium hydroxide "Image Description"
Overdosage
openFDA Drug Labeling10 OVERDOSAGE In case of overdosage, discontinue amoxicillin, 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. Interstitial nephritis resulting in oliguric renal failure has been reported in a small number of patients after overdosage with amoxicillin 1 . Crystalluria, in some cases leading to renal failure, has also been reported after amoxicillin overdosage in adult and pediatric patients. In case of overdosage, adequate fluid intake and diuresis should be maintained to reduce the risk of amoxicillin 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. Amoxicillin may be removed from circulation by hemodialysis.
How Supplied / Storage and Handling
openFDA Drug Labeling16 HOW SUPPLIED/STORAGE AND HANDLING Amoxicillin tablets, USP: 500 mg : Each tablet contains 500 mg of amoxicillin, USP as the trihydrate. Each film-coated, capsule-shaped, off-white, tablet is debossed with “93” on one side and “2263” on the other side. They are available in bottles of 60 (NDC 62135-084-60) and 100 (NDC 62135-084-01) tablets. 875 mg : Each tablet contains 875 mg of amoxicillin, USP as the trihydrate. Each film-coated, capsule-shaped, off-white tablet is scored on one side, debossed with “93” on one side of the score and “2264” on the other side of the score. They are available in bottles of 20 (NDC 62135-085-20), 60 (NDC 62135-085-60) and 100 (NDC 62135-085-01) tablets. Amoxicillin for oral suspension, USP: 125 mg/5 mL : Each 5 mL of reconstituted mixed berry flavored suspension contains 125 mg amoxicillin, USP as the trihydrate. It is available in bottles of 80 mL (NDC 62135-109-80), 100 mL (NDC 62135-109-01), and 150 mL (NDC 62135-109-51). 200 mg/5 mL : Each 5 mL of reconstituted pink, fruit gum flavored suspension contains 200 mg amoxicillin, USP as the trihydrate. It is available in bottles of 50 mL (NDC 62135-088-50), 75 mL (NDC 62135-088-75), and 100 mL (NDC 62135-088-01). 250 mg/5 mL : Each 5 mL of reconstituted mixed berry flavored suspension contains 250 mg amoxicillin, USP as the trihydrate. It is available in bottles of 80 mL (NDC 62135-089-80), 100 mL (NDC 62135-089-01), and 150 mL (NDC 62135-089-51). 400 mg/5 mL : Each 5 mL of reconstituted pink, fruit gum flavored suspension contains 400 mg amoxicillin, USP as the trihydrate. It is available in bottles of 50 mL (NDC 62135-090-50), 75 mL (NDC 62135-090-75), and 100 mL (NDC 62135-090-01). Amoxicillin tablets (Chewable), USP: 125 mg : Each white to off-white, capsule-shaped tablet, debossed 93 on one side and 2267 on the other side and contain 125 mg amoxicillin, USP as the trihydrate. They are available in bottles of 60 tablets (NDC 62135-086-60) and 100 tablets (NDC 62135-086-01). 250 mg : Each white to off-white, capsule-shaped tablet, debossed 93 (partial bisect between 9 and 3) on one side and 2268 on the other side and contain 250 mg amoxicillin, USP as the trihydrate. They are available in bottles of 60 tablets (NDC 62135-087-60) and 100 tablets (NDC 62135-087-01). Amoxicillin capsules, USP 250 mg : Opaque caramel cap and opaque buff body, hard gelatin capsule. Printed black “TEVA” on cap and “3107” on body portions of the capsule and contain 250 mg amoxicillin, USP as the trihydrate. They are available in bottles of 30 (NDC 62135-082-30), 100 (NDC 62135-082-01) and 300 (NDC 62135-082-31) capsules. 500 mg : Opaque buff cap and opaque buff body, hard gelatin capsules. Printed black “TEVA” on cap and “3109” on body portions of the capsules and contain 500 mg amoxicillin, USP as the trihydrate. They are available in bottles of 20 (NDC 62135-083-20), 60 (NDC 62135-083-60), 100 (NDC 62135-083-01) and 500 (NDC 62135-083-05) capsules. Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature]. Dispense in a tight, light-resistant container as defined in the USP, with a child-resistant closure (as required). Keep this and all medications out of the reach of children.
Adverse event reports
Source: openFDA FAERSAttributed to this product's most-reported active ingredient: AMOXICILLIN. Combination products with more than six active ingredients are not attributed, because a report count summed across a long ingredient list measures the list, not the medicine.
Packaging and NDCs
Source: NDC Directory| Package NDC | Product NDC | Labeler | Description | Marketing start |
|---|---|---|---|---|
| 50090-0454-0 | 50090-0454 | A-S Medication Solutions | 30 TABLET, CHEWABLE in 1 BOTTLE (50090-0454-0) | June 29, 2016 |
| 50090-0454-1 | 50090-0454 | A-S Medication Solutions | 21 TABLET, CHEWABLE in 1 BOTTLE (50090-0454-1) | June 29, 2016 |
| 50090-0454-5 | 50090-0454 | A-S Medication Solutions | 40 TABLET, CHEWABLE in 1 BOTTLE (50090-0454-5) | June 29, 2016 |
| 50090-0455-0 | 50090-0455 | A-S Medication Solutions | 30 TABLET, CHEWABLE in 1 BOTTLE (50090-0455-0) | November 28, 2014 |
| 62135-086-01 | 62135-086 | Chartwell RX, LLC | 100 TABLET, CHEWABLE in 1 BOTTLE (62135-086-01) | July 16, 2026 |
| 62135-086-60 | 62135-086 | Chartwell RX, LLC | 60 TABLET, CHEWABLE in 1 BOTTLE (62135-086-60) | July 16, 2026 |
| 62135-087-01 | 62135-087 | Chartwell RX, LLC | 100 TABLET, CHEWABLE in 1 BOTTLE (62135-087-01) | July 16, 2026 |
| 62135-087-60 | 62135-087 | Chartwell RX, LLC | 60 TABLET, CHEWABLE in 1 BOTTLE (62135-087-60) | July 16, 2026 |
| 82868-063-30 | 82868-063 | Northwind Health Company, LLC | 30 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (82868-063-30) | July 18, 2024 |
| 66267-022-30 | 66267-022 | NuCare Pharmaceuticals, Inc. | 30 TABLET, CHEWABLE in 1 BOTTLE (66267-022-30) | September 26, 2016 |
| 66267-871-03 | 66267-871 | NuCare Pharmaceuticals,Inc. | 3 TABLET, CHEWABLE in 1 BOTTLE (66267-871-03) | June 26, 2019 |
| 43063-341-04 | 43063-341 | PD-Rx Pharmaceuticals, Inc. | 4 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (43063-341-04) | November 26, 2011 |
| 55289-182-06 | 55289-182 | PD-Rx Pharmaceuticals, Inc. | 6 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (55289-182-06) | October 12, 2015 |
| 55289-182-09 | 55289-182 | PD-Rx Pharmaceuticals, Inc. | 9 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (55289-182-09) | October 12, 2015 |
| 55289-182-14 | 55289-182 | PD-Rx Pharmaceuticals, Inc. | 14 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (55289-182-14) | October 12, 2015 |
| 55289-182-20 | 55289-182 | PD-Rx Pharmaceuticals, Inc. | 20 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (55289-182-20) | October 10, 2025 |
| 55289-182-30 | 55289-182 | PD-Rx Pharmaceuticals, Inc. | 30 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (55289-182-30) | October 12, 2015 |
| 55289-182-40 | 55289-182 | PD-Rx Pharmaceuticals, Inc. | 40 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (55289-182-40) | October 12, 2015 |
| 55289-182-90 | 55289-182 | PD-Rx Pharmaceuticals, Inc. | 90 TABLET, CHEWABLE in 1 BOTTLE, PLASTIC (55289-182-90) | August 8, 2016 |
| 63187-343-30 | 63187-343 | Proficient Rx LP | 30 TABLET, CHEWABLE in 1 BOTTLE (63187-343-30) | January 1, 1993 |
| 0093-2267-01 | 0093-2267 | Teva Pharmaceuticals USA, Inc. | 100 TABLET, CHEWABLE in 1 BOTTLE (0093-2267-01) | October 1, 1995 |
| 0093-2268-01 | 0093-2268 | Teva Pharmaceuticals USA, Inc. | 100 TABLET, CHEWABLE in 1 BOTTLE (0093-2268-01) | January 1, 1993 |
| 50090-0454 | 50090-0454 | A-S Medication Solutions | — | January 1, 1993 |
| 50090-0455 | 50090-0455 | A-S Medication Solutions | — | January 1, 1993 |
| 62135-086 | 62135-086 | Chartwell RX, LLC | — | October 1, 1995 |
| 62135-087 | 62135-087 | Chartwell RX, LLC | — | January 1, 1993 |
| 82868-063 | 82868-063 | Northwind Health Company, LLC | — | July 18, 2024 |
| 66267-022 | 66267-022 | NuCare Pharmaceuticals, Inc. | — | January 1, 1993 |
| 66267-871 | 66267-871 | NuCare Pharmaceuticals,Inc. | — | January 1, 1993 |
| 43063-341 | 43063-341 | PD-Rx Pharmaceuticals, Inc. | — | January 1, 1993 |
| 55289-182 | 55289-182 | PD-Rx Pharmaceuticals, Inc. | — | January 1, 1993 |
| 63187-343 | 63187-343 | Proficient Rx LP | — | January 1, 1993 |
| 0093-2267 | 0093-2267 | Teva Pharmaceuticals USA, Inc. | — | October 1, 1995 |
| 0093-2268 | 0093-2268 | Teva Pharmaceuticals USA, Inc. | — | January 1, 1993 |
Sources for this page
| Dataset | Agency | Used for |
|---|---|---|
| NDC Directory | FDA | Identity, ingredients, strengths, forms, routes, labelers, packages |
| Drugs@FDA | FDA | Application, sponsor, submissions, review documents, marketing status |
| Drug Labeling | FDA / NLM | Prescribing information reproduced above |
| FAERS | FDA | Adverse event report counts |
Generated September 25, 2026 · 12 sections on this page.