E-MOX (Amoxicillin): Uses, Formulations, and Side Effects

1. Disclaimer

The information provided in this report is intended solely for educational and professional reference purposes and is not a substitute for medical advice, diagnosis, or treatment. Clinical decisions must always be based on officially approved prescribing information, local antimicrobial guidelines, and the judgment of qualified healthcare professionals.

We do not guarantee the accuracy, currency or completeness of information regarding medications or medical products, and official sources should be verified before making any decisions. By using this blog, you agree to assume personal responsibility for relying on the information provided.

2. Summary

E-MOX® is a branded formulation of amoxicillin, a broad-spectrum, bactericidal β-lactam antibiotic belonging to the aminopenicillin subclass. It is widely used for the treatment of infections caused by susceptible Gram-positive and selected Gram-negative organisms. Compared with ampicillin, amoxicillin has superior oral bioavailability and more reliable systemic exposure. E-MOX® is available in oral and parenteral dosage forms, allowing use in both outpatient and inpatient settings.

3. Brand Name

E-MOX®

4. Category

• Therapeutic class: Antibacterial
• Pharmacological class: β-Lactam antibiotic
• Subclass: Aminopenicillin (monocomponent penicillin)

5. Active Ingredient

Amoxicillin

• Oral forms: Amoxicillin trihydrate
• Parenteral forms: Amoxicillin sodium

6. Pharmaceutical Form & Strength

Oral forms

• Capsules: 500 mg
• Powder for oral suspension:
  • 125 mg/5 mL
  • 250 mg/5 mL (80 mL bottle after reconstitution)

Parenteral forms

• Powder for IM/IV injection:
  • 250 mg
  • 500 mg
  • 1 g

7. Manufacturer & Marketing Authorization Holder

EIPICO – Egyptian International Pharmaceutical Industries Co.
10th of Ramadan City, Arab Republic of Egypt
(Marketing authorization details should be verified with the current national regulatory authority.)

8. Mechanism of Action

Amoxicillin is a bactericidal antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs). This blocks the final transpeptidation step of peptidoglycan synthesis, resulting in a weakened cell wall, osmotic instability, and bacterial cell lysis. Activity is greatest against actively dividing organisms.

9. Spectrum of Activity

Active against susceptible strains of:

Gram-positive bacteria

• Streptococcus pneumoniae (penicillin-susceptible strains)
• Streptococcus pyogenes
• Enterococcus faecalis
• Non-penicillinase-producing Staphylococcus aureus
• Bacillus anthracis
• Clostridium spp. (non-resistant strains)

Gram-negative bacteria

• Haemophilus influenzae (non-β-lactamase producing)
• Escherichia coli (selected strains)
• Proteus mirabilis
• Neisseria gonorrhoeae (non-PPNG)
• Neisseria meningitidis
• Salmonella spp.
• Bordetella pertussis
• Brucella spp.

Limitations:
Not effective against β-lactamase-producing organisms, MRSA, or ESBL-producing Enterobacteriaceae unless combined with a β-lactamase inhibitor.

10. Pharmacokinetics

• Absorption: Rapid and well absorbed orally; bioavailability ~75–90%; food has minimal effect
• Peak plasma concentration: 1–2 hours after oral dosing
• Distribution: Wide tissue distribution (lungs, middle ear fluid, sputum, bile, urine); crosses placenta; low CSF penetration unless meninges are inflamed
• Protein binding: ~18–20%
• Metabolism: Minimal hepatic metabolism
• Elimination: Primarily renal (60–80% excreted unchanged in urine)
• Half-life: ~1 hour (significantly prolonged in renal impairment)

11. Indications

• ENT infections: Otitis media, sinusitis, tonsillitis, pharyngitis
• Respiratory tract infections: Acute/chronic bronchitis, community-acquired pneumonia
• Genitourinary infections: Cystitis, pyelonephritis, urethritis
• Skin and soft-tissue infections: Cellulitis, wound infections, erysipelas
• Gastrointestinal indications: H. pylori eradication (as part of combination therapy)
• Other susceptible infections guided by culture and sensitivity testing

12. Administration

• Oral: Capsules swallowed whole; suspension shaken well before use
• IM: Deep injection into a large muscle
• IV:
  • Slow injection over 3–4 minutes
  • Infusion over 30–60 minutes

13. Method of Preparation

• Reconstitute injectable vials with sterile Water for Injection as directed
• Use immediately after reconstitution
• A transient pink coloration or slight opalescence may occur and is acceptable
• Do not mix with blood products or protein-containing solutions

14. Contraindications

• Known hypersensitivity to amoxicillin, penicillins, or other β-lactam antibiotics
• History of immediate severe allergic reactions (e.g., anaphylaxis) to β-lactams

15. Warnings & Precautions

• Risk of serious hypersensitivity reactions, including anaphylaxis
• High incidence of rash in infectious mononucleosis (avoid use)
• Possible Clostridioides difficile-associated diarrhea
• Dose adjustment required in renal impairment
• Prolonged use may cause superinfection (e.g., candidiasis)

16. Drug Interactions

• Probenecid: Increases amoxicillin plasma levels
• Allopurinol: Increased risk of skin rash
• Warfarin: Possible increased anticoagulant effect (monitor INR)
• Methotrexate: Reduced clearance and increased toxicity
• Oral contraceptives: Possible reduction in efficacy

17. Side Effects

Common

• Nausea, vomiting, diarrhea
• Skin rash

Uncommon

• Urticaria, pruritus
• Mild elevation of liver enzymes

Rare but serious

• Anaphylaxis
• Stevens–Johnson syndrome
• Antibiotic-associated colitis

18. Use in Special Populations

• Pregnancy: Generally considered safe (formerly FDA Category B); use when clearly indicated
• Lactation: Excreted in breast milk in small amounts; usually compatible with breastfeeding
• Pediatrics: Safe with weight-based dosing
• Elderly: Monitor renal function; dose adjustment may be required
• Renal impairment: Dose adjustment mandatory in severe cases

19. Storage Conditions

• Store below 25°C in a dry place
• Protect from moisture
• Reconstituted oral suspension: stable up to 14 days under refrigeration (check label)
• Keep out of reach of children

20. Additional Sections

Pharmacodynamics:

Time-dependent killing; efficacy correlates with time above MIC

Overdose:

Mainly gastrointestinal symptoms; supportive treatment recommended

21. Frequently Asked Questions (FAQ)

Q: Is E-MOX effective against viral infections?
A: No. It is active only against susceptible bacterial infections.

Q: Can I stop treatment once symptoms improve?
A: No. The full prescribed course must be completed.

Q: Is E-MOX safe in penicillin-allergic patients?
A: No. It should be avoided in patients with known penicillin allergy.

22. References

1. British National Formulary (BNF), latest edition
2. Martindale: The Complete Drug Reference
3. Lexicomp Drug Information – Amoxicillin
4. WHO Model Formulary
5. FDA Prescribing Information: Amoxicillin (updated labeling)
6. Goodman & Gilman’s The Pharmacological Basis of Therapeutics