AMOXIL SYRUP 100ml Original

Amoxil Syrup contains amoxicillin, a broad-spectrum aminopenicillin antibiotic that kills bacteria by inhibiting cell wall synthesis. It binds to penicillin-binding proteins (PBPs), disrupting peptidoglycan cross-linking and causing bacterial cell lysis. Amoxicillin is active against a wide range of Gram-positive and some Gram-negative organisms.

In Kenya, Amoxil Syrup is one of the most commonly dispensed paediatric antibiotics at community pharmacies and is included in the Kenya Essential Medicines List (KEML). 

Amoxil Syrup is prescribed for childhood infections including ear, throat, chest, urinary tract, and skin infections. It is suitable for children who cannot swallow tablets.

Approved Indications

•       Acute otitis media (middle ear infection) in children

•       Pharyngitis and tonsillitis (Group A Streptococcus)

•       Community-acquired pneumonia (mild to moderate)

•       Acute sinusitis

•       Urinary tract infections (UTIs) caused by susceptible organisms

•       Skin and soft tissue infections

•       H. pylori eradication (as part of triple therapy)

•       Lyme disease prophylaxis / treatment (where applicable)

General Instructions

Amoxil Syrup must be reconstituted with clean, cooled boiled water before use. Shake the bottle well before each dose. Measure each dose carefully using the graduated oral syringe or measuring spoon provided. Give at regular intervals (every 8 or 12 hours) to maintain steady antibiotic levels.

Dosage, Adults

Adults: 250–500 mg every 8 hours or 500–875 mg every 12 hours depending on infection severity.

Dosage, Children

Children (mild-moderate infections): 25 mg/kg/day in divided doses every 8–12 hours (max 40–90 mg/kg/day for severe infections such as AOM). Each 5 mL of reconstituted Amoxil Syrup contains 125 mg amoxicillin.

Missed Dose

Give the missed dose as soon as you remember. If it is nearly time for the next dose, skip the missed one. Never double dose.

Duration of Treatment

Complete the full prescribed course (typically 5–10 days) even if symptoms improve. Stopping early promotes antibiotic resistance.

Common Side Effects

•       Diarrhoea (most common, give with food to reduce)

•       Nausea and vomiting

•       Skin rash (including maculopapular rash, distinct from allergic rash)

•       Stomach cramps and indigestion

Less Common Side Effects

•       Oral or vaginal candidiasis (thrush) due to disruption of normal flora

•       Headache and dizziness

•       Raised liver enzymes (transient)

Serious / Seek Immediate Medical Attention

•       Anaphylaxis, severe allergic reaction with throat swelling, difficulty breathing, collapse. Seek emergency care immediately

•       Stevens-Johnson syndrome / toxic epidermal necrolysis (rare but life-threatening skin reactions)

•       Clostridium difficile-associated diarrhoea (CDAD), watery or bloody stool with fever; stop amoxicillin and seek care

•       Drug-induced hepatitis (rare)

•       Before prescribing, always ask about history of penicillin allergy. Cross-reactivity with cephalosporins exists (~1–2%).

•       In Kenya, check local antimicrobial susceptibility patterns; amoxicillin resistance is increasing in E. coli and H. influenzae.

•       Reconstituted suspension must be stored in the refrigerator and discarded after 7 days; counsel caregivers on this.

•       Use with caution in patients with renal impairment; dose adjustment required if eGFR < 30 mL/min.

•       Amoxicillin can cause false-positive urine glucose results with copper-reduction methods (e.g., Clinitest). Use glucose oxidase methods (e.g., Diastix) instead.

•       Prolonged use may result in superinfection with non-susceptible organisms including fungi.

•       Pregnancy: Category B, adequate human studies show no increased risk; considered safe when clinically needed.

Always inform your pharmacist and prescriber about all medicines, supplements, and herbal remedies you are currently taking.

Warfarin / other anticoagulants: Amoxicillin may potentiate anticoagulant effect, monitor INR

Methotrexate: Penicillins reduce renal tubular secretion of methotrexate, increasing toxicity risk

Oral contraceptives: Theoretical reduction in contraceptive efficacy (clinical significance debated, advise barrier methods during course)

Probenecid: Blocks renal excretion of amoxicillin, raising plasma levels, occasionally used therapeutically

Allopurinol: Combined use increases risk of skin rash

Chloramphenicol/tetracyclines: May antagonise the bactericidal effect of amoxicillin

Unreconstituted powder: store below 25°C in a cool, dry place away from sunlight. After reconstitution: refrigerate at 2–8°C and discard after 7 days. Do not freeze. Label the bottle with the date of reconstitution. Keep out of reach of children.

Amoxil Syrup is a Prescription Only Medicine (POM) in Kenya under the Pharmacy and Poisons Act (Cap 244). Despite being widely available, dispensing without a valid prescription is illegal and contributes to antibiotic resistance. Pharmily dispenses only on presentation of a valid prescription.

Amoxil Syrup is among the highest-volume paediatric dispensing items at Kenyan community pharmacies. Key counselling priorities: reconstitution technique (room-temperature-cooled boiled water to the mark on the bottle), refrigeration requirement, and a strict 7-day discard policy after reconstitution.

Caregiver education on antibiotic stewardship is essential at every dispensing. Ask whether the child has been on amoxicillin recently; recurrent prescriptions within 90 days may indicate treatment failure and possible resistance; consider referring for culture and sensitivity. Note that a maculopapular (non-itchy, flat) rash appearing 5–10 days into therapy is often a non-allergic drug reaction, not a true penicillin allergy; document accurately to avoid lifelong inappropriate allergy labelling.

Q1: How do I prepare Amoxil Syrup at home?

A: Add cooled boiled water to the powder in the bottle up to the line marked on the label. Shake well until all powder dissolves. Store in the refrigerator. The syrup is ready for use immediately after reconstitution.

Q2: How long can I keep Amoxil Syrup after mixing?

A: Refrigerate reconstituted Amoxil Syrup and use within 7 days. After 7 days, discard any unused portion even if it looks fine; the antibiotic degrades and becomes ineffective.

Q3: My child has developed a rash. What should I do?

A: A mild flat rash appearing 5–10 days into the course is sometimes a non-allergic reaction to amoxicillin, not necessarily a penicillin allergy. However, any rash accompanied by swelling, difficulty breathing, or hives requires immediate medical attention. Stop the medicine and go to the nearest hospital.

Q4: Is it OK to give Amoxil with milk or food?

A: Yes. Food does not significantly affect amoxicillin absorption and can help reduce stomach upset. It is safe to give with meals, milk, or formula.

Q5: Will Amoxil Syrup treat a viral infection like a cold or flu?

A: No. Amoxicillin is an antibiotic that kills only bacteria. It does not affect viruses. Taking antibiotics for viral infections promotes antibiotic resistance without providing any benefit.