This information is intended for use by health professionals
Penbritin 250mg Capsules
Ampicillin 250mg Capsules
(Ampicillin Capsules): 250mg ampicillin as Ampicillin Trihydrate
Black and red capsules overprinted Penbritin 250
Ampicillin is a broad-spectrum penicillin, indicated for the treatment of a wide range of bacterial infections caused by ampicillin-sensitive organisms. Typical indications include: ear, nose and throat infections, bronchitis, pneumonia, urinary tract infections, gonorrhoea, gynaecological infections, septicaemia, peritonitis, endocarditis, meningitis, enteric fever, gastro-intestinal infections.
Parenteral usage is indicated where oral dosage is inappropriate.
Usual adult dosage (including elderly patients):
Usual children's dosage (under 10 years)
| Ear, nose and throat infections:
|| 250mg four times a day.
|| Routine therapy: 250mg four times a day.
High-dosage therapy: 1 g four times a day.
|| 500 mg four times a day.
| Urinary tract infections:
|| 500 mg three times a day.
|| 2 g orally with 1 g probenecid as a single dose. Repeated doses are recommended for the treatment of females.
| Gastro-intestinal infections:
|| 500-750 mg three to four times daily.
|| Acute: 1-2 g four times a day for two weeks.
Carriers: 1-2 g four times a day for four to twelve weeks
Half adult routine dosage.
All recommended dosages are a guide only. In severe infections the above dosages may be increased, or ampicillin given by injection. Oral doses of ampicillin should be taken half to one hour before meals.
In the presence of severe renal impairment (creatinine clearance <10ml/min) a reduction in dose or extension of dose interval should be considered. In cases of dialysis, an additional dose should be administered after the procedure.
Ampicillin is a penicillin and should not be given to patients with a history of hypersensitivity to beta-lactam antibiotics (e.g. ampicillin, penicillins, cephalosporins) or excipients.
Before initiating therapy with ampicillin, careful enquiry should be made concerning previous hypersensitivity reactions to beta-lactam antibiotics.
Serious and occasionally fatal hypersensitivity reactions (anaphylaxis) have been reported in patients receiving beta-lactam antibiotics. 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 beta-lactam hypersensitivity.
Ampicillin should be avoided if infectious mononucleosis and/or acute or chronic leukaemia of lymphoid origin are suspected. The occurrence of a skin rash has been associated with these conditions following the administration of ampicillin.
Prolonged use may occasionally result in overgrowth of non-susceptible organisms.
Dosage should be adjusted in patients with renal impairment (see section 4.2).
Bacteriostatic drugs may interfere with the bactericidal action of ampicillin.
In common with other oral broad-spectrum antibiotics, ampicillin may reduce the efficacy of oral contraceptives and patients should be warned accordingly.
Probenecid decreases the renal tubular secretion of ampicillin. Concurrent use with ampicillin may result in increased and prolonged blood levels of ampicillin.
Concurrent administration of allopurinol during treatment with ampicillin can increase the likelihood of allergic skin reactions.
It is recommended that when testing for the presence of glucose in urine during ampicillin treatment, enzymatic glucose oxidase methods should be used. Due to the high urinary concentrations of ampicillin, false positive readings are common with chemical methods.
Animal studies with Ampicillin have shown no teratogenic effects. The product has been in extensive clinical use since 1961 and its use in human pregnancy has been well documented in clinical studies. When antibiotic therapy is required during pregnancy, Ampicillin may be considered appropriate.
During lactation, trace quantities of penicillins can be detected in breast milk.
Adequate human and animal data on use of Ampicillin during lactation are not available.
Adverse effects on the ability to drive or operate machinery have not been observed.
If any hypersensitivity reaction occurs, the treatment should be discontinued.
Skin rash, pruritis and urticaria have been reported occasionally. The incidence is higher in patients suffering from infectious mononucleosis and acute or chronic leukaemia of lymphoid origin. Purpura has also been reported. Rarely, skin reactions such as erythema multiforme and Stevens-Johnson syndrome, and toxic epidermal necrolysis have been reported.
As with other antibiotics, anaphylaxis (see Item 4.4 Warnings) has been reported rarely.
Interstitial nephritis can occur rarely.
Effects include nausea, vomiting and diarrhoea. Pseudomembraneous colitis and haemorrhagic colitis have been reported rarely.
As with other beta-lactam antibiotics, hepatitis and cholestatic jaundice have been reported rarely. As with most other antibiotics, a moderate and transient increase in transaminases has been reported.
As with other beta-lactams, haematological effects including transient leucopenia, transient thrombocytopenia and haemolytic anaemia have been reported rarely. Prolongation of bleeding time and prothrombin have also been reported rarely.
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard.
Gastrointestinal effects such as nausea, vomiting and diarrhoea may be evident and should be treated symptomatically.
Ampicillin may be removed from the circulation by haemodialysis.
Ampicillin is a broad spectrum penicillin, indicated for the treatment of a wide range of bacterial infections caused by ampicillin sensitive organisms.
Ampicillin is excreted mainly in the bile and urine with a plasma half life of 1-2 hours.
No further information of relevance to add.
Magnesium stearate, gelatin, black and red iron oxides (E172), titanium dioxide (E171) and erythrosine (E127).
| Blister packs:
|| five years
|| three years
Containers: Do not store above 25°C. Keep the container tightly closed.
Blisters: Do not store above 25°C. Store in the original package.
Glass bottle fitted with a screw cap
Polypropylene tube with a polyethylene closure
Aluminium foil pack - 4, 16, 50, 100, 500
Aluminium/PVC tray foil blister pack - 28
Aluminium/PVC/PVdC blister pack - 28
Chemidex Pharma Ltd
T/A Essential Generics or Chemidex Pharma
Egham Business Village