Maximum Dosage of Augmentin for Adults
The maximum daily dose of Augmentin (amoxicillin-clavulanate) for adults is 2,000 mg of amoxicillin component per day, typically administered as 875 mg/125 mg tablets twice daily or 500 mg/125 mg tablets every 8 hours. 1
Dosage Forms and Administration
- For standard infections, the usual adult dose is one 500 mg/125 mg tablet every 12 hours or one 250 mg/125 mg tablet every 8 hours 1
- For more severe infections and respiratory tract infections, the recommended dose is one 875 mg/125 mg tablet every 12 hours or one 500 mg/125 mg tablet every 8 hours 1
- Augmentin may be taken without regard to meals, but absorption of clavulanate potassium is enhanced when taken at the start of a meal 1
- Taking Augmentin at the start of a meal can help minimize potential gastrointestinal intolerance 1
Special Population Considerations
Renal Impairment
- Patients with normal to moderate renal function do not generally require dose adjustment 1
- Patients with severe renal impairment (glomerular filtration rate <30 mL/min) should not receive the 875 mg/125 mg formulation 1
- For patients with GFR 10-30 mL/min: Use 500 mg/125 mg or 250 mg/125 mg every 12 hours, depending on infection severity 1
- For patients with GFR <10 mL/min: Use 500 mg/125 mg or 250 mg/125 mg every 24 hours, depending on infection severity 1
Hemodialysis Patients
- Should receive 500 mg/125 mg or 250 mg/125 mg every 24 hours based on infection severity 1
- An additional dose should be administered both during and at the end of dialysis 1
Hepatic Impairment
- Patients with hepatic impairment should be dosed with caution and hepatic function monitored regularly 1
Specific Clinical Applications
- For chronic carriers of Group A Streptococcus, the recommended dosage is 40 mg amoxicillin per kg per day in three doses, with a maximum of 2,000 mg amoxicillin per day for a duration of 10 days 2
- When used for skin and soft tissue infections, the standard adult dosing applies with the maximum daily dose remaining at 2,000 mg of amoxicillin component 3
Important Considerations
- Note that two 250 mg/125 mg tablets are not equivalent to one 500 mg/125 mg tablet because they contain different amounts of clavulanic acid 1
- The different formulations have different amoxicillin to clavulanic acid ratios, which affects their clinical application 1
- For pediatric patients weighing 40 kg or more, adult dosing recommendations should be followed 1
Formulation Differences
- Standard formulations: 250 mg/125 mg, 500 mg/125 mg, and 875 mg/125 mg 1
- Extended-release formulation (Augmentin XR): 2000 mg/125 mg twice daily (available in the USA for adult respiratory tract infections caused by drug-resistant pathogens) 4
- Pediatric formulation (Augmentin ES-600): 90/6.4 mg/kg/day in two divided doses 4