Also known as AMOX, AMPC, AX, Amoxicilina, Amoxicillin (anhydrous), Amoxicillin Trihydrate, Amoxicillin anhydrous, Amoxicilline, Amoxicillinum, Amoxil, Amoxycillin, Polymox, Trimox, Utimox, Wymox, p-Hydroxyampicillin
A broad-spectrum, semisynthetic aminopenicillin antibiotic with bactericidal activity. Amoxicillin binds to and inactivates penicillin-binding protein (PBP) 1A located on the inner membrane of the bacterial cell wall. Inactivation of PBPs interferes with the cross-linkage of peptidoglycan chains necessary for bacterial cell wall strength and rigidity. This interrupts bacterial cell wall synthesis and results in the weakening of the bacterial cell wall and causes cell lysis.
Originator: NCI Thesaurus | Source: The website of the National Cancer Institute (http://www.cancer.gov)
Can I take Amoxicillin while breastfeeding?
Amoxicillin is acceptable to use during breastfeeding. Limited information indicates that single maternal doses of amoxicillin 1 gram produce low levels in milk that are not expected to cause adverse effects in breastfed infants. Occasionally, rash and disruption of the infant’s gastrointestinal flora, resulting in diarrhea or thrush, have been reported, but these effects have not been adequately evaluated. Amoxicillin powder for suspension reconstituted with breastmilk is absorbed as well as the powder reconstituted with water.[1]
Drug levels
Maternal Levels. After a single 1 g oral dose of amoxicillin in 6 women, peak milk amoxicillin levels occurred 4 to 5 hours after the dose. Average milk levels were 0.69 mg/L (range 0.46 to 0.88 mg/L) at 4 hours and 0.81 mg/L (range 0.39 to 1.3 mg/L) at 5 hours after the dose.[2] Using these data, an exclusively breastfed infant would be expected to receive a maximum of about 0.1 mg/kg/day of amoxicillin with a maternal dose of 500 mg three times daily. This amounts to 0.25 to 0.5% of a typical infant amoxicillin dosage.
Infant Levels. Relevant published information was not found as of the revision date.
Effects in breastfed infants
Maternal Levels. After a single 1 g oral dose of amoxicillin in 6 women, peak milk amoxicillin levels occurred 4 to 5 hours after the dose. Average milk levels were 0.69 mg/L (range 0.46 to 0.88 mg/L) at 4 hours and 0.81 mg/L (range 0.39 to 1.3 mg/L) at 5 hours after the dose.[2] Using these data, an exclusively breastfed infant would be expected to receive a maximum of about 0.1 mg/kg/day of amoxicillin with a maternal dose of 500 mg three times daily. This amounts to 0.25 to 0.5% of a typical infant amoxicillin dosage.
Infant Levels. Relevant published information was not found as of the revision date.
Possible effects on lactation
Relevant published information was not found as of the revision date.
References
1. Yazdani-Brojeni P, Garcia-Bournissen F, Fujii H et al. Relative bioequivalence of amoxicillin dissolved in breast milk. Arch Dis Child. 2014;99:258-61. PMID: 24363363
2. Kafetzis DA, Siafas CA, Georgakopoulos PA et al. Passage of cephalosporins and amoxicillin into the breast milk. Acta Paediatr Scand. 1981;70:285-8. PMID: 7246123
3. Ito S, Blajchman A, Stephenson M et al. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993;168:1393-9. PMID: 8498418
4. Campbell AC, McElnay JC, Passmore CM. The excretion of ampicillin in breast milk and its effect on the suckling infant. Br J Clin Pharmacol. 1991;31:230p. Abstract.
5. Benyamini L, Merlob P, Stahl B et al. The safety of amoxicillin/clavulanic acid and cefuroxime during lactation. Ther Drug Monit. 2005;27:499-502. PMID: 16044108
6. Goldstein LH, Berlin M, Tsur L et al. The safety of macrolides during lactation. Breastfeed Med. 2009;4:197-200. PMID: 19366316
7. Cherif F, El Aidli S, Kastalli S, Zaiem A, Moula HD, Lakhal M et al. Drug induced urticaria via breastfeeding. Fundam Clin Pharmacol. 2009;23 (Suppl 1):37. Abstract 203.
Last Revision Date
20140708
Disclaimer:Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.
Source: LactMed – National Library of Medicine (NLM)