Ampicillin is bactericidal at low concentrations and is clinically effective not only against the grampositive organisms usually susceptible to penicillin G but also against a variety of gram-negative organisms. It is stable in the presence of gastric acid and is well absorbed from the gastrointestinal tract. It diffuses readily into most body tissues and fluids, however, penetration into the cerebrospinal fluid and brain occurs only with meningeol inflammation. Ampicillin is excreted largely delayed by concurrent administration of probenecid which inhibits the trend renal tubulor secretion of ampicillin. In blood serum, ampicillin is the least bound of all the penicillins; on overage of about 20% of the drug is bound to plasma proteins as compared to 60 to 90 percent of the other penicillins. The administration of 500mg dose of ampicillin capsules results in an average peak blood serum level of approximately 3.0 mcg/mL.

Adult and children weight over 2okg: Genitourinary or gastrointestinal tract infections in men and women, the usual dose is 500 mg q.i.d. in equally spaced doses; severe or chronic infections may require large doses.
Gonorrhea in both men and women, a single oral dose of 3.5 grams of ampicillin administration.
Respiratory track infections, the usual dose is 250mg q.i.d. in equally spaced doses.
Children weighing 20 kg or less: Genitourinary or gastrointestinal trad infections, the usual dose is 100 mg/kg/clay total, q.i.d. in equally divided doses.
Respiratory infections, the usual doses is 50 mg/kg/day total, in equally divided doses three to four times daily. Doses for children should not exceed doses recommended for adult.

Gastrointestinal: glositis, stomatitis, nausea, vomiting enterocolitis, pseudomembranous colitis, and dianhec. These reactions are usually associated with oral dosage forms of the drugs.
Hypersensitivity Reactions: An erythematous, mildly pruritic maculopapular skin rash has been reported fairly frequently. Other hypersensitivity reactions that have been reported are: skin rash, pruritus, urticaria erythema multiforme, and an occasional case of exfoliative dermaatitis.
Live: Moderate elevation in serum glutarr oxalaocetic transaminase (SCOT) has been noted but significance of this findings is unknown.
Hemic and Lymphatic Systems: Anemia, thromboqpnia, thrombocytopenic purpura, easinophil leukopenia, and agranulocytosis have been reported during therapy with penicillins.

General-Proloned use of antibiotics may promote the overgrowth of nonsusceptible organisms, including fungi. Should superinfections occur, appropriate measures should be taken. Patients with gonorrhea who also have syphilis should be given appropriate parenteral penicillin treatment. Card nogenesis, Mutagenesis, Impairment of fertility, long-term studies in animals have not been performed to evaluate card nogenesis, mutagenesis, or impairment of fertility in males or females. Pregnancy – Reproduction studies in animals have revealed no evidence of impaired fertility or harm to the fetus due to penicillin. There are, however, no adequate and well-controlled studies in pregnant women, Because animal reproduction studies are not always predictive of human response, penicillin should be used during pregnancy only if clearly needed.
Nursing Mothers-Ampicillin-class antibiotics are excreted in milk. Ampicillin used by nursing mothers may lead to sensitization of infants; therefore, a decision should be made whether to discontinue a nursing or to discontinue ampicillin, taking into account the importance of the drug to the mother.
Pediatric Use – Penicillins are excreted primarily unchanged by the kidney, therefore, the incompletely developed renal functioning neonates and young infants will delay the excretion of penicillin. Administration to neonates and young infants should be limited to the lowest dosage compatible with on effective therapeutic regimen.

Serious and occasional fatal hypersensitivity (anaphylactoid) reactions have been reported in patients on penicillin therapy. Although anaphylaxis is more frequent following parenteral administration, it has frequent following parenteral administration. it has occurred in patients on oral penicillins. These reactions are more apt to occur in individuals with a history at penicillin hypersensitivity and/or a history of sensitivity to multiple allergens. There have been well documented reports individuals with no history of penicillin hypersensitivity reactions when treated with cephalosporins. Before initiating therapy with any penicillin, careful inquiry should be made concerning previous hypersensitivity reactions to penicillin, cephalosporins, and other allergens. If an allergic reaction occurs, this drug should be discontinued and appropriated therapy instituted. Serious anaphylactic reactions require immediate emergency treatment with epinephrine. Oxygen, intravenous steroids, and airway management; including incubation, shouldalso be administered as indicated. Pseudo membranous colitis has been reported with nearly all antibacterial agents, including ampicillin, and may range in severity from mild to life threatening. Therefore, it is important to consider thus diagnosis in patients who present with diarrhea subsequent to the administration of antibacterial agents. Treatment with antibacterial agents alters the normal flora of the colon and may permit overgrowth of clostridium. Studies indicate that a toxin produced by clostridium difficile, is one primary cause of ‘antibioticassociated colitis. After the diagnosis of pseudomembrance colitis has been established, therapeutic measures should be initiated. Mild cases of pseudomembrance colitis usually respond to drug discontinuation alone. In moderate to severe cases, consideration should be given to management with fluids and electrolytes, protein supplementation and treatment with an antibacterial drug clinically effective against C difficile colitis.

Store in cool dry place. Protect from light. Keep all medicines away from reach of children.

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