Description
Calamox 62.5mg/ml Oral Drops combine co-amoxiclav (amoxicillin and clavulanic acid) to treat bacterial infections in children and adults in Pakistan. Effective against resistant bacteria causing ear, respiratory, or urinary tract infections, it’s commonly used in pediatric clinics in cities like Lahore and Karachi, where pollution-related infections are prevalent. Produced by Bosch Pharmaceuticals, it’s available in 20ml bottles, priced around Rs. 187-197, prescription-only, and widely stocked in DRAP-registered pharmacies.
How It Functions
Amoxicillin, a penicillin antibiotic, binds to penicillin-binding proteins, disrupting bacterial cell wall synthesis and causing cell lysis. Clavulanic acid inhibits beta-lactamase enzymes, preventing bacterial resistance and broadening amoxicillin’s spectrum against gram-positive (e.g., Streptococcus) and gram-negative (e.g., E. coli) bacteria. Chemically, amoxicillin is (2S,5R,6R)-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; clavulanic acid is potassium (Z)-(2R,5R)-3-(2-hydroxyethylidene)-7-oxo-4-oxa-1-azabicyclo[3.2.0]heptane-2-carboxylate. Peak effect occurs within 1-2 hours, lasting 6-8 hours.
Dosage Information
Administered orally via dropper:
- Children (3 months-12 years): 25-45 mg/kg/day (amoxicillin component) in 2 divided doses, typically 0.4-0.7 ml/kg/day of 62.5mg/ml drops, every 12 hours.
- Infants (<3 months): 30 mg/kg/day in 2 doses, adjusted for weight.
- Adults: Rarely used; tablets preferred. Shake bottle well, use dropper to measure, and give with or without food. Treatment duration is 5-10 days, based on infection severity. Consult physician for kidney/liver adjustments; complete full course to prevent resistance.
Side Effects
- Very Common (>1 in 10): Diarrhea, nausea, vomiting.
- Common (up to 1 in 10): Skin rash, itching, dizziness, fatigue, vaginal yeast infections.
- Rare: Allergic reactions (hives, swelling, breathing difficulty), liver function changes, severe diarrhea (Clostridium difficile-associated), blood disorders (e.g., low platelets).
Drug Interactions
Co-amoxiclav may interact with:
- Probenecid: Increases amoxicillin levels, risking toxicity.
- Allopurinol: Heightens rash risk.
- Oral contraceptives: Reduces efficacy; use additional contraception.
- Warfarin: Enhances bleeding risk; monitor INR.
- Oral typhoid vaccine: Decreases vaccine response.
- Methotrexate: Increases toxicity.
- Nephrotoxic drugs (e.g., cyclosporine): Raises kidney damage risk.
Indications
Approved for treating:
- Severe/recurrent ear infections (e.g., otitis media).
- Respiratory tract infections (e.g., pneumonia, sinusitis, bronchitis).
- Skin and soft tissue infections (e.g., cellulitis, abscesses).
- Urinary tract infections (e.g., caused by resistant E. coli).
- Dental infections (e.g., abscesses).
- Bone and joint infections.
When Not to Use
Avoid in:
- Hypersensitivity to amoxicillin, clavulanic acid, penicillin, or beta-lactam antibiotics.
- History of severe allergic reactions (e.g., anaphylaxis) to beta-lactams.
- Liver dysfunction or jaundice linked to co-amoxiclav.
- Infectious mononucleosis (increases rash risk).
- Severe kidney disease requiring dialysis.
- History of severe diarrhea or colitis.
Precautions
- Monitor for allergic reactions; stop if rash, swelling, or breathing issues occur.
- Use cautiously in kidney/liver disease; adjust dose based on creatinine clearance.
- Watch for severe diarrhea; may indicate Clostridium difficile infection—stop and seek care.
- Complete full course to prevent antibiotic resistance, common in Pakistan’s overmedicated settings.
- Ensure hydration, especially in hot weather or fasting, to support kidney function.
- Buy from DRAP-registered pharmacies; check holograms to avoid counterfeits.
- Shake bottle before use; discard reconstituted drops after 7 days.
Warnings
- Allergic reactions: Risk of anaphylaxis; immediate medical attention needed for swelling or breathing issues.
- Liver toxicity: Rare but serious; monitor liver enzymes in prolonged use.
- Antibiotic resistance: Avoid use without confirmed bacterial infection.
- Gastrointestinal: Severe diarrhea or bloody stools require stopping and evaluation.
- Pregnancy/breastfeeding: Use only if benefits outweigh risks; monitor infant for side effects.
Additional Notes
- Pregnancy Category: Consult physician; category B, limited risk but use only if needed.
- Breastfeeding: Small amounts in milk; monitor infant for diarrhea or thrush.
- Availability: Common in urban and rural pharmacies; generics like Augmentin drops available.
- Stability: Reconstituted suspension stable for 7 days refrigerated; do not freeze.
- Reporting: Log batch for side effects; report to DRAP for quality control.
Doctor Review
Dr. Sana Iqbal, a pediatrician in Islamabad, notes Calamox drops’ effectiveness for children’s ear and respiratory infections, especially in pollution-heavy areas like Rawalpindi. DRAP data supports its broad-spectrum action, but Dr. Iqbal emphasizes completing the course and monitoring for diarrhea to avoid resistance or complications.
Disclaimer
This is general product information, not a prescription or medical advice. Consult your doctor or pharmacist for personal guidance.
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