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Revision as of 14:31, 30 November 2010 editBeetstra (talk | contribs)Edit filter managers, Administrators172,031 edits Script assisted update of identifiers from ChemSpider, CommonChemistry and FDA for the Chem/Drugbox validation project - Updated: StdInChI StdInChIKey.← Previous edit Latest revision as of 15:27, 21 August 2024 edit undoBoghog (talk | contribs)Autopatrolled, Extended confirmed users, IP block exemptions, New page reviewers, Pending changes reviewers, Rollbackers, Template editors137,758 edits consistent citation formatting 
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{{Short description|Combination drug}}
{{drugbox
{{cs1 config|name-list-style=vanc|display-authors=6}}
| type = combo
{{Drugbox
| component1 = Ampicillin
| verifiedrevid = 399726521
| class1 = Moderate-spectrum ]
| image = Ampicillin 3d structure pdb.png
| component2 = Flucloxacillin
| image2 = Flucloxacillin3d.png
| class2 = ]
<!--Combo data-->
| type = combo
| component1 = Ampicillin
| class1 = ]<ref name=Tidwell>{{Cite book| vauthors = Tidwell TT |chapter-url=https://books.google.com/books?id=VDXbDgAAQBAJ&pg=PA106|title=Beta-Lactams: Novel Synthetic Pathways and Applications|date=2017|publisher=Springer|isbn=978-3-319-55621-5| veditors = Banik BK |location=Edinburg, Texas|pages=106|language=en|chapter=Beta-Lactams from ketene- Imine Cycloadditins: An Update}}</ref>
| component2 = Flucloxacillin
| class2 = ]<ref name=Tidwell/>
<!--Clinical data-->
| tradename =
| pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X -->
| pregnancy_US = <!-- A / B / C / D / X -->
| pregnancy_category =
| legal_AU = <!-- Unscheduled / S2 / S3 / S4 / S5 / S6 / S7 / S8 / S9 -->
| legal_CA = <!-- / Schedule I, II, III, IV, V, VI, VII, VIII -->
| legal_UK = <!-- GSL / P / POM / CD / Class A, B, C -->
| legal_US = <!-- OTC / Rx-only / Schedule I, II, III, IV, V -->
| legal_status =
| routes_of_administration = Oral, ], ]<ref name=BNF80/>
<!--Identifiers-->
| CAS_number = 69-53-4
| CAS_number2 = 5250-39-5
| UNII_Ref = {{fdacite|correct|FDA}}
| UNII = 7C782967RD
| UNII2_Ref = {{fdacite|correct|FDA}}
| UNII2 = 43B2M34G2V
| ATC_prefix = J01
| ATC_suffix = CR50
| PubChem =
| DrugBank =
| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}
| ChemSpiderID = 21106281 | ChemSpiderID = 21106281
<!--Chemical data-->
| InChI = 1/C19H17ClFN3O5S.C16H19N3O4S/c1-7-10(12(23-29-7)11-8(20)5-4-6-9(11)21)15(25)22-13-16(26)24-14(18(27)28)19(2,3)30-17(13)24;1-16(2)11(15(22)23)19-13(21)10(14(19)24-16)18-12(20)9(17)8-6-4-3-5-7-8/h4-6,13-14,17H,1-3H3,(H,22,25)(H,27,28);3-7,9-11,14H,17H2,1-2H3,(H,18,20)(H,22,23)/t13-,14+,17-;9-,10-,11+,14-/m11/s1
| smiles = O=C(O)2N3C(=O)(NC(=O)(N)c1ccccc1)3SC2(C)C.Fc1cccc(Cl)c1c2noc(C)c2C(=O)N3C(=O)N4(C(O)=O)C(C)(C)S34
| InChIKey = MRHKOEQOYWPVKY-TWZKVBNYBV
| StdInChI = 1S/C19H17ClFN3O5S.C16H19N3O4S/c1-7-10(12(23-29-7)11-8(20)5-4-6-9(11)21)15(25)22-13-16(26)24-14(18(27)28)19(2,3)30-17(13)24;1-16(2)11(15(22)23)19-13(21)10(14(19)24-16)18-12(20)9(17)8-6-4-3-5-7-8/h4-6,13-14,17H,1-3H3,(H,22,25)(H,27,28);3-7,9-11,14H,17H2,1-2H3,(H,18,20)(H,22,23)/t13-,14+,17-;9-,10-,11+,14-/m11/s1
| StdInChIKey = MRHKOEQOYWPVKY-TWZKVBNYSA-N
| CAS_number =
| ATC_prefix = J01
| ATC_suffix = CR50
| PubChem =
| DrugBank =
| pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X -->
| pregnancy_US = <!-- A / B / C / D / X -->
| pregnancy_category=
| legal_AU = <!-- Unscheduled / S2 / S3 / S4 / S5 / S6 / S7 / S8 / S9 -->
| legal_CA = <!-- / Schedule I, II, III, IV, V, VI, VII, VIII -->
| legal_UK = <!-- GSL / P / POM / CD / Class A, B, C -->
| legal_US = <!-- OTC / Rx-only / Schedule I, II, III, IV, V -->
| legal_status =
| routes_of_administration = Oral, ]
}} }}
'''Ampicillin/flucloxacillin''' (]) also known as '''co-fluampicil''' (]), and sold under the ] '''Magnapen''', is a combination drug of the two ]s, ] and ], both in equal amounts, available in a capsule and as a liquid, both taken by mouth, and as a formulation which can be given by injection into muscle or vein.<ref name=BNF80>{{cite book | title=]|date=September 2020 – March 2021|publisher=BMJ Group and the Pharmaceutical Press|isbn=978-0-85711-369-6|edition=80|page=582|chapter=5. Infection}}</ref><ref name=MIMS>{{Cite web|title=Magnapen|url=https://www.mims.co.uk/drugs/infections-and-infestations/bacterial-infections/magnapen-|access-date=18 December 2020|website=]|archive-date=16 January 2021|archive-url=https://web.archive.org/web/20210116205235/https://www.mims.co.uk/drugs/infections-and-infestations/bacterial-infections/magnapen-|url-status=dead}}</ref>
'''Co-fluampicil''' is the ], for the combination of ] and ] &beta;-lactam ]s (trade name '''Magnapen''').

It is used to treat infections before the laboratory results confirm the causative organism.<ref name="Drug.com"/> Side effects include stomach or bowel upsets.<ref name=BNF80/> It should not be taken by people allergic to penicillin.<ref name=BNF80/><ref name=PIL>{{Cite web|title=Co-fluampicil for bacterial infections. Side effects and dosage|url=https://patient.info/medicine/co-fluampicil-for-infection|access-date=18 December 2020|website=patient.info|language=en|archive-date=15 January 2021|archive-url=https://web.archive.org/web/20210115175541/https://patient.info/medicine/co-fluampicil-for-infection|url-status=live}}</ref>


==Indication== ==Indication==
The combination of ampicillin/flucloxacillin is typically given before laboratory results are known. Conditions for which it may be used include ], ], throat, skin and soft tissue. It can be given in ], ] and in people receiving immunosuppressive treatments, and to prevent infection after surgery.<ref name="Drug.com">{{cite web |title=Co-fluampicil capsules |url=https://www.drugs.com/uk/co-fluampicil-capsules-leaflet.html |website=Drugs.com |access-date=18 December 2020 |language=en }}{{Dead link|date=February 2022 |bot=InternetArchiveBot |fix-attempted=yes }}</ref>
Ampicillin is a moderate spectrum penicillin antibiotic with good cover against ] whilst Flucloxacillin is a narrow spectrum antibiotic with cover against ]. The combination covers the two most likely bacteria in ] infections in the arm or leg.


==Formulations== ==Formulations==
It is available in a capsule and a liquid, both taken by mouth, and as a formulation which can be given by injection into muscle or vein.<ref name=BNF80/><ref name=Gray>{{Cite book|vauthors=Gray A, Wright J, Goodey V, Bruce L|url=https://books.google.com/books?id=42TEmTJ0ewAC&pg=PA180|title=Injectable Drugs Guide|date=2010|publisher=Pharmaceutical Press|isbn=978-0-85369-787-9|language=en|access-date=2020-12-18|archive-date=2023-01-12|archive-url=https://web.archive.org/web/20230112010938/https://books.google.com/books?id=42TEmTJ0ewAC&pg=PA180|url-status=live}}</ref>
As Co-fluampicil 250/250 capsules containing 250] of each component, Co-fluampicil 125/125 syrup or as Co-fluampicil 250/250 powder for reconstruction for ] injection.

Capsules contain 250&nbsp;mg of each component, the syrup 125/125&nbsp;mg per spoon, and the powder for reconstruction for ] injection 250/250&nbsp;mg.<ref name=BNF80/>
<gallery>

File:Co-fluampicil capsules and container.jpg|Co-fluampicil capsules and container (UK)
File:Co-fluampicil capsules.jpg|Co-fluampicil capsules (UK)
</gallery>


==Dosage== ==Dosage==
The usual dose by mouth is one capsule of 250&nbsp;mg 4 times a day in adults and half the adult dose as a syrup for children under the age of 10 years but over 2.<ref name="Drug.com"/> For children below the age of 2 years, the oral dose is a quarter of the adult oral dose.<ref name=MIMS/> Ampicillin/flucloxacillin is taken orally about half an hour before food.<ref name=PIL/>
Typical oral dosage is Co-fluampicil 250/250 four times a day, doubled in severe infection and half the dose for children under 10 years.

==Side effects and contraindications==
Side effects are the same as per the individual components, with stomach or bowel upset from the flucloxacillin being the most common.<ref name=BNF80/> ] or blood count may occur.<ref name=MIMS/>

Both parts are members of the ] family of antibiotics, so should not be taken by people allergic to penicillin.<ref name=BNF80/> The combination is contraindicated in people with a history of flucloxacillin-associated jaundice/hepatic dysfunction and in people with ].<ref name="Drug.com"/>

It is given cautiously to people with ], ], ] or ]; who may have an increased chance of rashes.<ref name=BNF80/>

==Interactions==
Interactions may occur with ] or ].<ref name=MIMS/> Taking the contraceptive pill with ampicillin/flucloxacillin is safe unless vomiting or diarrhoea occurs and persists for more than one day, when extra contraceptive precautions would then be required.<ref name=PIL/>

==Pregnancy and breastfeeding==
It is generally safe in pregnancy. A trace amount in breast milk does not mean in cannot be used in breastfeeding mothers.<ref name=BNF80/>

==History==
Ampicillin/flucloxacillin is one of at least 63 β-lactam antibiotics developed in the forty years following the discovery of penicillin.<ref name=Tidwell/>


==Side-effects== ==See also==
*]
As per the individual components with stomach or bowel upset from the Flucloxacillin being the most common. Both parts are members of the ] family of antibiotics, and therefore should not be taken by patients allergic to penicillin. See ] for additional contraindications.


==References== == References ==
{{Reflist}}
*] '50' September 2005


{{Cell wall disruptive antibiotics}}
{{treatment-stub}}


{{DEFAULTSORT:Ampicillin flucloxacillin}}
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