Clamoxyl - take with food
 

I'm on Clamoxyl at the moment, and I was wondering if the SSSF Brains Trust could answer a couple of questions of vague curiosity about the drug for me, please.

1. The tablets came in their usual blister pack, but the blister pack was itself inside a sealed foil container inside the cardboard box. Why the sealed foil container? Do I need to keep the tablets inside the foil container? (I have been.) How similar is the drug to Amoxycillin? (I don't remember seeing this sort of foil wrapper for Amoxycillin.)

2. The box says the tablets are to be taken "immediately before or with the first mountful of food". Why such precise proximity to food? How much time is acceptable if I'm prevented from eating? Is the effectiveness of the drug reduced if I take the tablet some time during the meal or immediately afterwards? (The pharmacy instructions say "with food", which is a lot less precise.)

Thank you!

I'll take a stab while you wait for the real brains to come along http://www.discussworldissues.com/fo...lies/smile.png

re question 2.

"Absorption: Amoxycillin and clavulanic acid are stable in the presence of gastric acid. These two components are rapidly absorbed if administered before or with a meal, but if given after meals, the serum levels of clavulanic acid are significantly reduced. To optimise absorption of clavulanic acid amoxycillin and clavulanic acid tablets should be administered at the start of a meal. The pharmacokinetics of amoxycillin are not affected by food."

so the effectiveness of the medication is reduced significantly if it is not taken with food.

question 1. the foil could be to help with keeping the storage temperature stable as well as moisture control ?? just thoughts.

as to how similar is the drug to amoxycillin .. it is amoxycillin with added clavulonic acid.

Hmm, Clamoxyl = Augmentin? Had it once and it nearly choked me.

That packaging is exactly the way my Perindopril comes to me now. I just hoik the foil pack and drying agent after I've opened the box.

yep same drug. those augmentin tablets are huge.

a penicillin allergy has put paid to me having to try to swallow them ever again.

The clavanulic acid doesn't like me - my throat closes after a couple of doses. Don't mind the amoxycillin on its own.

1. Clavulanic acid is hygroscopic, foil helps prevent moisture entering. No. It's amoxycillin with an ingredient that blocks bacterial enzymes that break down penicillins.

2. Stupidity. Causes nausea when taken on an empty stomach in some people. In practice, it doesn't matter when you take it with regards to food, effectiveness isn't reduced.

hi poikilotherm

regarding point 2.

from http://www.pbs.gov.au/meds%2Fpi%2Fafpcladt10412.pdf

Absorption: Amoxycillin and clavulanic acid are stable in the presence of gastric acid. These two components are rapidly absorbed if administered before or with a meal, but if given after meals, the serum levels of clavulanic acid are significantly reduced. To optimise absorption of clavulanic acid amoxycillin and clavulanic acid tablets should be administered at the start of a meal. The pharmacokinetics of amoxycillin are not affected by food."

there is more at that link ...

I generally go with what the manufacturers say and dont try to second guess them. It can be awkward to juggle the dont eat before and some that rely on the full stomach. One method I have found works well is the early morning piss I take the pill that requires an empty stomach then, (this is usually about 5 in the morning) I then usually go back to bed for a snooze so plenty of time on an empty stomach (they usually want at least half an hour) and then have the ones with food at brekky. Another advantage is if it is the twice a day one, you can have the second at 5 in the arvo which is lots of time after lunch and (for me) about an hour before dinner so plenty of time again on the empty stomach and also gives the optimal 12 hour spread.

I think it easier to sort things that way than try and work against what the manufacturer says based on what web sites or what people on forums say.

After a while it becomes routine and not a biggie.

"Clinical studies to demonstrate the efficacy and safety of amoxicillin/potassium clavulanate were performed without regard to meals" - I'd post the ref, but it's behind a pay wall.

So, it's a curious thing it lowers blood levels, but in practice makes little real difference.

Found one - http://dailymed.nlm.nih.gov/dailymed...archiveid=3024

thx for that !

from your link.

"CLINICAL PHARMACOLOGY
Amoxicillin and clavulanate potassium are well absorbed from the gastrointestinal tract after oral administration of amoxicillin and clavulanate potassium. Dosing in the fasted or fed state has minimal effect on the pharmacokinetics of amoxicillin. While amoxicillin and clavulanate potassium can be given without regard to meals, absorption of clavulanate potassium when taken with food is greater relative to the fasted state. In 1 study, the relative bioavailability of clavulanate was reduced when amoxicillin and clavulanate potassium was dosed at 30 and 150 minutes after the start of a high-fat breakfast. The safety and efficacy of amoxicillin and clavulanate potassium have been established in clinical trials where amoxicillin and clavulanate potassium was taken without regard to meals."

so in practice it does make little difference but....
the pbs document talks about 'optimising absorption' by following the instructions in the leaflets that come with the drug.

nausea is an issue with it on an empty stomach.

so stupidity and playing safe ?

Mostly just stupid. http://www.discussworldissues.com/fo...ilies/wink.png

Another form of second guessing is the not taking the whole course because you feel better. I am very aware of resistance issues and do the full lot and will go back to the doc if still not cleared up. I cannot afford to collect a bank of resistant greebles.

yep. I've got so used to my routine drugs that a glance into the container tells me whether i have them all and also whether i have the right ones.
I'm an aspie (aspergers) so i see patterns and notice differences in them so it is an easy thing for me to do.
puts nurses off a bit when i glance in and say somethings missing , there when it shouldn't be or not the right amount of some .. when there are 9 -12 tablets in a small pill pot. http://www.discussworldissues.com/fo...lies/smile.png

yes...

Jokes on you lot, just having one course of antibiotics increases risk of resistance by two fold. Regardless of 'finishing the full course' or not...

Butler CC, Kelly MJ, Hood K, et al. Antibiotic prescribing for discoloured sputum in acute cough/lower respiratory tract infection. Eur Resp J 2011;38:119–25.
Nasrin D, Collignon PJ, Roberts L, et al. Effect of beta lactam antibiotic use in children on pneumococcal resistance to penicillin: prospective cohort study. BMJ 2002;324:28–30.
Chung A, Perera R, Brueggemann AB, et al. Effect of antibiotic prescribing on antibiotic resistance in individual children in primary care: prospective cohort study. BMJ 2007;335:429.
Costelloe C, Metcalfe C, Lovering A, et al. Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis. BMJ 2010;340:c2096.

*I'm not saying don't finish the course as recommended by the doctor - just in case it seemed like I was to some...

.... so that is why my gp insists i have a repeat ? i don't recall having just one lot for quite a few years now.
or would it be another reason ?

i do have a lung condition.

Respiratory infections tend to be treated anywhere from 5-10 days in primary care, the longer treatment if there are other 'factors' involved, hence your repeat.

thx... haematomas must too. he gave me a repeat of bactrim just the other day.

Yeah I dont get that, you would think the lungs well supplied with blood would be easy to treat, compared to say bone infections.

sorry.
wrong thread