What volume of Co-amoxiclav (amoxicillin/clavulanic acid) drops should be given every 8 hours?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: November 10, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Co-amoxiclav Dosing Calculation

Give 3.2 mL of Co-amoxiclav drops (62.5mg/mL) every 8 hours for 7 days.

Calculation Breakdown

Total daily dose needed:

  • Weight: 10 kg
  • Prescribed dose: 40 mg/kg/day
  • Total daily dose: 10 kg × 40 mg/kg = 400 mg/day 1

Dose per administration:

  • The prescription states "BID" (twice daily), but the formulation specifies "every 8 hours" (three times daily)
  • Important caveat: There is a discrepancy in your prescription. BID means twice daily (every 12 hours), but you've written "every 8 hours" which is three times daily (TID). Every 8 hours dosing is the standard for this formulation 1.

Using every 8 hours (TID) dosing:

  • 400 mg/day ÷ 3 doses = 133.3 mg per dose
  • Available concentration: 62.5 mg/mL
  • Volume needed: 133.3 mg ÷ 62.5 mg/mL = 2.13 mL per dose

However, if following standard pediatric dosing from FDA labeling:

  • For a 10 kg child with moderate infections, the recommended dose is 20 mg/kg/day every 8 hours = 200 mg/day total 1
  • This equals: 200 mg/day ÷ 3 = 66.7 mg per dose
  • Volume: 66.7 mg ÷ 62.5 mg/mL = 1.07 mL per dose

For more severe infections (40 mg/kg/day every 8 hours):

  • 40 mg/kg/day × 10 kg = 400 mg/day 1
  • 400 mg/day ÷ 3 doses = 133.3 mg per dose
  • Volume: 133.3 mg ÷ 62.5 mg/mL = 2.13 mL per dose

Critical Clarification Needed

The prescription contains conflicting instructions: "BID" (twice daily) versus "every 8 hours" (three times daily). The 62.5 mg/mL suspension formulation is typically dosed every 8 hours, not twice daily 1.

If the intent is 40 mg/kg/day divided every 8 hours (standard for severe infections): Give 2.1 mL every 8 hours 1.

If the intent is truly BID dosing: The FDA recommends using higher concentration formulations (200 mg/28.5 mg per 5 mL or 400 mg/57 mg per 5 mL) for twice-daily dosing, as the q12h regimen is associated with significantly less diarrhea 1, 2, 3. For 40 mg/kg/day BID with current formulation: give 3.2 mL every 12 hours.

Recommendation

Clarify the intended dosing frequency with the prescriber. The most common error is mixing BID notation with "every 8 hours" instructions, which are incompatible 1.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.