Ampirex500 mg/vial

Respiratory Tract Infections

Ampirex is an established treatment for upper and lower respiratory tract infections (such as bronchitis, sinusitis, otitis media, and community-acquired pneumonia) caused by susceptible strains of organisms including non-penicillinase-producing Streptococcus pneumoniae, other streptococci, non-penicillinase-producing Staphylococcus aureus, and Haemophilus influenzae.

Genitourinary Tract Infections

Ampirex is indicated for urinary tract infections caused by susceptible strains of Escherichia coli, Proteus mirabilis, and enterococci. Ampirex is also FDA-labeled for uncomplicated gonorrhea (non-penicillinase-producing Neisseria gonorrhoeae) as a single large oral dose combined with probenecid, although current gonorrhea treatment guidelines now favor ceftriaxone-based regimens because of widespread penicillin resistance.

Gastrointestinal Infections

Ampirex is established therapy for gastrointestinal infections caused by susceptible strains of Shigella, Salmonella typhi and other Salmonella species, Escherichia coli, and enterococci, where local susceptibility testing supports its use; resistance among Shigella and Salmonella isolates is common in many regions, so culture and sensitivity results should guide therapy where possible.

Meningitis

Ampirex is indicated for bacterial meningitis caused by susceptible strains of Neisseria meningitidis and Haemophilus influenzae. Because empiric meningitis therapy must cover organisms that may not be susceptible to Ampirex alone, Ampirex is typically given as part of a combination regimen with another antibacterial agent (such as a third-generation cephalosporin) until the causative organism and its susceptibility are confirmed.

Septicemia and Endocarditis

Ampirex is indicated for septicemia and endocarditis caused by susceptible strains of streptococci, enterococci, and non-penicillinase-producing staphylococci. For enterococcal endocarditis and other serious enterococcal infections, guideline-supported therapy requires combining Ampirex with a synergistic agent (an aminoglycoside, or in specific regimens a second cell-wall-active agent such as ceftriaxone) rather than using Ampirex alone.

Listeria monocytogenes Infection

Ampirex is a guideline-preferred drug of choice for infections caused by susceptible strains of Listeria monocytogenes, including listerial meningitis and sepsis; for severe or central nervous system infection, Ampirex is usually combined with an aminoglycoside (such as gentamicin) for synergy, rather than used as monotherapy.

Endocarditis Prophylaxis (Adjunct Use)

In patients at high risk of infective endocarditis who require antibiotic prophylaxis before certain dental or surgical procedures and who cannot take oral medication, intravenous or intramuscular Ampirex is a guideline-supported alternative to oral amoxicillin, given as a single dose shortly before the procedure.

Ampicillin is available as Ampicillin (as trihydrate) capsules of 250 mg and 500 mg, Ampicillin (as trihydrate) powder for oral suspension (commonly 125 mg/5 mL and 250 mg/5 mL after reconstitution), and Ampicillin sodium powder for injection (commonly 250 mg, 500 mg, and 1 g vials) for intramuscular or intravenous use, depending on the marketed strength and formulation.

Ampirex is a broad-spectrum, semi-synthetic aminopenicillin antibiotic used to treat a range of bacterial infections. Ampirex works by interfering with the ability of susceptible bacteria to build their cell walls, causing the bacteria to rupture and die. Ampirex is commonly used for respiratory tract infections, urinary tract infections, certain gastrointestinal infections, and, particularly as part of combination regimens, for more serious infections such as meningitis, endocarditis, and infections caused by Listeria monocytogenes. Ampirex does not treat viral infections such as the common cold or flu, and Ampirex should be taken exactly as prescribed by a qualified healthcare professional.

Antibiotic (Aminopenicillin / Beta-lactam class)

Ampicillin is a bactericidal beta-lactam antibiotic. After oral administration, Ampicillin is reasonably well absorbed from the gastrointestinal tract, although absorption of Ampicillin is reduced when taken with food, so oral Ampicillin is generally taken on an empty stomach. Ampicillin is widely distributed into most body tissues and fluids, and therapeutic concentrations can be achieved in cerebrospinal fluid when the meninges are inflamed. Ampicillin is only modestly protein-bound in plasma. Ampicillin undergoes minimal hepatic metabolism and is eliminated primarily unchanged by the kidneys through glomerular filtration and tubular secretion, with a smaller portion excreted in bile; the elimination half-life of Ampicillin is prolonged in patients with renal impairment, requiring dose adjustment.

• Take oral Ampirex capsules or suspension on an empty stomach, at least 1 hour before or 2 hours after meals, for best absorption, unless your doctor advises otherwise.
• Shake the reconstituted Ampirex oral suspension well before each use and measure the dose with an accurate oral dosing syringe or spoon, not a household spoon.
• Space doses of Ampirex evenly throughout the day (as prescribed) to maintain consistent drug levels.
• Injectable Ampirex is administered by a healthcare professional via intramuscular or intravenous injection/infusion, generally in a hospital or clinic setting.
• Take Ampirex exactly as prescribed by your physician; do not stop, extend, skip doses, or share this medicine with others without medical advice, and complete the full course even if you feel better before it is finished.

• Allopurinol: concurrent use of allopurinol with Ampirex is associated with a substantially increased incidence of skin rash, independent of a true drug allergy; monitor closely if this combination is necessary.
• Probenecid: probenecid blocks renal tubular secretion of Ampirex, resulting in increased and prolonged blood levels of Ampirex; this interaction is occasionally used intentionally (for example, in single-dose gonorrhea regimens) but can otherwise increase the risk of Ampirex-related side effects.
• Hormonal (oral) contraceptives: Ampirex may reduce the enterohepatic recirculation of estrogens, theoretically reducing contraceptive efficacy; patients should be advised to consider an additional or backup contraceptive method while taking Ampirex.
• Warfarin and other oral anticoagulants: Ampirex may enhance the effect of anticoagulants by reducing vitamin K-producing gut flora, increasing bleeding risk; closer INR monitoring is advised when Ampirex is started or stopped in patients on anticoagulant therapy.
• Bacteriostatic antibiotics (e.g., tetracyclines, chloramphenicol, macrolides): these may antagonize the bactericidal action of Ampirex when used concurrently; such combinations are generally avoided unless specifically directed.
• Methotrexate: penicillins including Ampirex may reduce renal clearance of methotrexate, increasing the risk of methotrexate toxicity; concurrent use requires caution and monitoring.

Common Side Effects

• Nausea, vomiting, and diarrhea
• Skin rash (including a distinctive non-allergic maculopapular rash that occurs much more frequently when Ampirex is given to patients with acute infectious mononucleosis/Epstein-Barr virus infection or certain leukemias — see Precautions and Warnings)
• Sore mouth or tongue, or oral thrush

Serious Side Effects (Seek Medical Attention)

• Signs of a severe allergic reaction to Ampirex, such as hives, swelling of the face/lips/throat, wheezing, or difficulty breathing (anaphylaxis)
• Severe or persistent watery or bloody diarrhea, which may indicate Clostridioides difficile-associated diarrhea or colitis, and can occur even weeks after stopping Ampirex
• Severe skin reactions such as blistering, peeling skin, or widespread rash (rare, possible Stevens-Johnson syndrome or toxic epidermal necrolysis)
• Yellowing of the skin or eyes, dark urine, or unusual tiredness, which may indicate liver injury
• Unusual bruising, bleeding, sore throat, fever, or pallor, which may rarely indicate a blood disorder
• Seizures, especially in patients with renal impairment or those receiving high intravenous doses

Pregnancy

Ampirex crosses the placenta. Penicillin-class antibiotics, including Ampirex, are among the antibiotic classes most extensively used in pregnancy and have not been associated with an established increased risk of major birth defects in available data. Nonetheless, Ampirex should be used in pregnancy only if clearly needed and if the potential benefit justifies the potential risk to the fetus; use of Ampirex during pregnancy should always be under the direct guidance of a qualified healthcare professional.

Breastfeeding

Ampirex is excreted into breast milk in low concentrations. Ampirex is generally considered compatible with breastfeeding, but the nursing infant should be monitored for possible effects on gut flora, such as diarrhea, candidiasis (thrush), or rash, and for rare sensitization. Consult a physician before using Ampirex while breastfeeding.

• Hypersensitivity reactions: serious and occasionally fatal anaphylactic reactions have been reported with penicillin-class antibiotics including Ampirex, particularly in patients with a history of penicillin or cephalosporin allergy; before starting Ampirex, inform your doctor of any prior allergic reaction to a penicillin, cephalosporin, or other beta-lactam antibiotic.
• Ampirex rash with viral infection: a non-allergic, morbilliform (measles-like) skin rash occurs in a large proportion of patients with acute infectious mononucleosis (Epstein-Barr virus), cytomegalovirus infection, or certain lymphoproliferative disorders who are given Ampirex; this rash does not necessarily indicate true penicillin allergy but Ampirex is generally avoided in patients with suspected mononucleosis.
• Clostridioides difficile-associated diarrhea (CDAD): as with almost any antibiotic, Ampirex can disturb normal gut bacteria and allow overgrowth of C. difficile, causing diarrhea or colitis ranging from mild to severe; seek medical advice for persistent or severe diarrhea, even weeks after stopping Ampirex.
• Seizures: high doses of Ampirex, particularly given intravenously to patients with renal impairment, have been associated with seizures; dose adjustment in renal impairment is important to reduce this risk.
• Superinfection: prolonged use of Ampirex may lead to overgrowth of non-susceptible organisms, including fungal infections; report new symptoms to your healthcare professional.
• Antibiotic stewardship: take Ampirex exactly as prescribed by your physician; do not stop, extend, skip doses, or share this medicine with others without medical advice. Using Ampirex unnecessarily, or not completing the full prescribed course, contributes to antibiotic resistance and reduces the future effectiveness of Ampirex and related antibiotics.
• Not effective against viral infections: Ampirex treats bacterial infections only and has no effect on viruses such as those causing the common cold or influenza.

Reported effects of Ampirex overdose are generally an extension of its common side effects, particularly nausea, vomiting, diarrhea, and abdominal discomfort; high intravenous doses of Ampirex, especially in patients with renal impairment, may increase the risk of neuromuscular hyperexcitability or seizures. No specific antidote for Ampirex overdose exists. If an overdose of Ampirex is suspected, contact a doctor, emergency medical services, or a poison control center immediately for guidance; do not attempt specific home treatment. Management is generally supportive and symptomatic, and hemodialysis can help remove Ampirex from the blood in cases of significant renal impairment or severe overdose.

Store Ampirex capsules and unreconstituted powder at room temperature (below 30°C), away from light and moisture, and out of reach of children. Once the oral suspension of Ampirex has been reconstituted with water, it should be refrigerated (2–8°C), shaken well before each use, and any unused portion discarded after 7 days (or as directed on the product label); do not freeze the reconstituted suspension. Reconstituted Ampirex injection solutions have limited stability and should generally be used promptly, per the manufacturer's instructions, and unused portions discarded appropriately.

Children

Ampirex is approved for use in infants and children, including neonates, with weight-based dosing that varies by indication and severity; dosing in neonates and young infants must account for immature renal function and is generally directed by a pediatric specialist. Safety and efficacy of specific regimens in premature infants should be individually assessed.

Elderly

No specific dose adjustment of Ampirex is established for older adults on the basis of age alone, but because renal function commonly declines with age, elderly patients should have renal function assessed, and the dose or interval of Ampirex adjusted accordingly.

Renal Impairment

Ampirex is eliminated primarily by the kidneys, and its half-life is prolonged in renal impairment; the dose or dosing interval of Ampirex should be reduced according to creatinine clearance, and Ampirex is partially removed by hemodialysis, which may require supplemental dosing after a dialysis session, as directed by the treating physician.

Hepatic Impairment

Specific dose-adjustment guidance for Ampirex in hepatic impairment alone is not well established, as Ampirex is eliminated mainly by the kidneys rather than the liver; Ampirex should still be used with routine clinical monitoring in patients with significant liver disease.

Pregnant and Breastfeeding Women

See the Pregnancy and Lactation section above for detailed guidance on the use of Ampirex in this population.

The duration of treatment with Ampirex is set by the prescriber and depends on the indication, its severity, and the patient's clinical response: typically 7–10 days for most respiratory, urinary, and gastrointestinal infections; a single dose for endocarditis prophylaxis or for uncomplicated gonorrhea (when used); and considerably longer courses (often 2–3 weeks or more, guided by a specialist) for meningitis, endocarditis, or Listeria monocytogenes infections. Patients should take Ampirex for exactly as long as prescribed and should not stop, extend, or repeat a course of Ampirex without medical advice, even if symptoms improve early.

Ampirex powder for oral suspension must be reconstituted with the specified amount of clean drinking water before use, as directed on the product label, and shaken well until the powder is fully dispersed; the reconstituted suspension should then be refrigerated and used within the period stated on the label (commonly 7 days), with unused suspension discarded after this time. Ampirex sodium powder for injection must be reconstituted with an appropriate diluent (such as sterile water for injection, or a compatible intravenous fluid) by a healthcare professional immediately or shortly before administration, following the manufacturer's instructions for the specific concentration and route (intramuscular or intravenous); reconstituted injectable solutions of Ampirex have limited stability and should generally be used promptly and not stored for later use.

Aminopenicillin antibiotic (Beta-lactam class)

Ampicillin is a bactericidal beta-lactam antibiotic that inhibits the third and final stage of bacterial cell wall synthesis. Ampicillin binds to penicillin-binding proteins (PBPs) located on the inner membrane of the bacterial cell wall, inhibiting the transpeptidation reaction that cross-links peptidoglycan strands. This weakens the bacterial cell wall, activates autolytic enzymes, and ultimately causes lysis and death of the susceptible bacterial cell. Compared with earlier penicillins, Ampicillin has an extended spectrum that includes activity against many Gram-negative organisms in addition to Gram-positive organisms, although Ampicillin remains susceptible to breakdown by beta-lactamase enzymes produced by many resistant bacteria.

Category B (FDA legacy pregnancy category)

Ampirex is approved for use in pediatric patients, including neonates and infants, for indications such as respiratory tract infections, urinary tract infections, gastrointestinal infections, meningitis, and septicemia, with dosing based on body weight and adjusted for age-related differences in renal function and drug clearance. In neonates and young infants, dosing intervals of Ampirex are typically longer (to account for immature kidney function) and should be determined by a pediatric or neonatal specialist. For serious infections such as neonatal or childhood bacterial meningitis and susceptible Listeria monocytogenes infections, Ampirex is usually given intravenously as part of a combination regimen with another antibacterial agent. As with adults, the full prescribed course of Ampirex should be completed in children, and Ampirex should never be given to a child based on leftover medicine or another person's prescription.