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ampicillin (Rx)Brand and Other Names:Ampi, Omnipen, more...Penglobe, Principen

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

capsules

  • 250mg
  • 500mg

oral suspension

  • 125mg/5mL
  • 250mg/5mL

powder for injection

  • 125 mg
  • 250mg
  • 500mg
  • 1 g
  • 2 g
  • 10 g
more...

General Dosing Guidelines

PO: 250-500 mg q6hr

IV/IM: 1-2 g q4-6hr

Endocarditis Prophylaxis

2 g IV/IM (±gentamicin 1.5 mg/kg for GI/GU) within 30 minutes before procedure

Recent AHA Guidelines recommend only for high risk patients

Genitourinary Tract Infections (Excluding Gonorrhea)

500 - 2000 mg IV q6hr

GI Tract Infections

500 mg IV q6hr

Gonorrhea

3.5 g IV administered once simultaneously with 1 g of probenecid

Respiratory Tract Infections

250 mg IV q6hr

Renal Impairment

CrCl <10 mL/min: use q12-16hr

Other Information

Take on empty stomach

Other Indications & Uses

Shigella, Salmonella, E. coli, H. influenzae, Proteus mirabilis, N. gonorrhoeae, enterococci infections, N. meningitidis meningitis, gram-pos. staph, strep, pneumococci

Dosage Forms & Strengths

capsules

  • 250 mg
  • 500 mg

oral suspension

  • 125 mg/5mL
  • 250 mg/5mL

powder for injection

  • 125 mg
  • 250 mg
  • 500 mg
  • 1 g
  • 2 g
more...

General Dosing Guidelines

100-400 mg/kg/day IV/IM divided q6hr

50-100 mg/kg/day PO divided q6hr

Severe infection: 200-400 mg/kg/day IV/IM divided q6hr

Neonates (<28 Days Old)

<7 days old

  • <2 kg: 50-100 mg/kg/day divided q12hr IV/IM
  • >2 kg: 75-150 mg/kg/day divided q8hr IV/IM

>7 days old

  • <1.2 kg: 50-100 mg/kg/day divided q12hr IV/IM
  • 1.2-2 kg: 75-150 mg/kg/day divided q8hr IV/IM
  • >2 kg: 100-200 mg/kg/day divided q6hr IV/IM

Endocarditis Prophylaxis

50 mg/kg (+/- gentamicin 1.5 mg/kg for GI/GU) IV/IM within 30 minutes before procedure 

Recent AHA Guidelines recommend only for high risk patients

Genitourinary Tract Infections

<20 kg: 50-100 mg/kg/day IV divided q6hr

>20 kg: 500 mg IV q6hr

GI Tract Infections

<20 kg: 50-100 mg/kg/day IV divided q6hr

>20 kg: 500 mg IV q6hr

Gonorrhea

<20 kg: Safety & efficacy not established

>20 kg: 3.5 g IV administered once simultaneously with 1 g of probenecid

Respiratory Tract Infections

<20 kg: 50 mg/kg/day IV divided q6-8hr

>20 kg: 250 mg IV q6hr

Cholera

50 mg/kg/day PO divided q6hr for 3 days; not to exceed 2 g/day

Other Information

Potential toxic dose <6 years old: 300 mg/kg

Take on empty stomach

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Interactions

Interaction Checker

ampicillin and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Erythema multiforme

            Exfoliative dermatitis

            Rash

            Urticaria

            Fever

            Seizure

            Black hairy tongue

            Diarrhea

            Enterocolitis

            Glossitis

            Nausea

            Oral candidiasis

            Pseudomembranous colitis

            Stomatis

            Vomiting

            Agranulocytosis

            Anemia

            Hemolytic anemia

            Eosinophilia

            Leukopenia

            Thrombocytopenia purpura

            Anaphylaxis

            AST increased

            Interstitial nephritis

            Laryngeal stridor

            Serum sickness like reaction

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            Warnings

            Contraindications

            Hypersensitivity

            Infectious mononucleosis

            Cautions

            Allergy to cephalosporins, carbapenems

            Adjust dose in renal failure; evaluate rash and differentiate from hypersensitivity reaction

            Endocarditis prophylaxis: Use only for high risk patients, per recent AHA Guidelines

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            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: Excreted in breast milk, use caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
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            Pharmacology

            Half-Life: 1-1.8 hr

            Protein Bound: 15-25%

            Peak Plasma Time: Oral 1-2 hr

            Absorption: oral 50%

            Distribution: bile, blister & tissue fluids, CSF with inflamed meninges

            Metabolism: liver

            Excretion: urine

            Mechanism of Action

            Broad-spectrum penicillin. Interferes with bacterial cell wall synthesis during active replication, causing bactericidal activity against susceptible organisms. Alternative to amoxicillin when unable to take medication orally.

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            Administration

            IV Compatibilities

            Solution: NS (some contrary reports)

            Additive: clindamycin, erythromycin, floxacillin, furosemide, metronidazole, verapamil

            Syringe: chloramphenicol, colistimethate, heparin, lidocaine

            Y-site (partial list): acyclovir, aztreonam, clarithrmycin, cyclophodsphamide, esmolol, famotidine, heparin, labetalol, linezolid, KCl, MgSO4, meperidine, propofol, vancomycin, vit B/C

            IV Incompatibilities

            Solution: dextran & dextrose solutions, LR, Ringer's, Na-bicarb, Na-lactate 1/6 M, IV fat emuslions, invert sugar solutions

            Additive: amikacin, azrtreonam(?), cefepime(?), chlorpromazine, dopamine, gentamicin, heparin(?), hydralazine, hydrocortisone, prochlorperazine,

            Syringe: erythromycin, gentamicin, hydromorphone, kanamycin, lincomycin, metoclopramide, polymyxin B SO4, streptomycin

            Y-site: ampho B cholesteryl SO4, Ca gluconate, cisatracurium (at high cisatra conc, may be compatible at low concs), diltiazem, epinephrine, fenoldopam, fluconazole, hydralazine, midazolam, nicardipine, ondansetron, sargramostim, verapamil, vinorelbine

            IV Preparation

            Reconstitute w/ SWI or BWI

            Use 5 mL for 125 mg, 250 mg, or 500 mg vials; 7.4 mL for 1 g vials; or 14.8 mL for 2 g vials

            IV Administration

            Use initial dilution w/in 1 hr

            Give direct IV over 3-5 min for (125-500 mg) and over 10-15 minutes for larger doses (1-2 g)

            Don't exceed a rate of 100 mg/min

            For intermittent infusion, dilute in 50-100 mL of NS and give over 15-30 min

            Give IV intermittently to prevent vein irritation

            • Change site q48hr
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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Add or Remove Plans
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            Select a box to add or remove a plan.

            Select a class to view formulary status for similar drugs

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