Listeria endocarditis: 200 mg/kg/day IV divided q6hr; administer concomitantly with aminoglycoside for at least 4-6 wk
Genitourinary Tract Infections (Excluding Gonorrhea)
<40 kg: 50 mg/kg/day IV/IM divided q6-8hr
≥40 kg: 500 mg PO/IV/IM q6hr
Gastrointestinal Tract Infections
<40 kg: 50 mg/kg/day IV/IM divided q6-8hr
≥40 kg: 500 mg IV/IM q6hr; larger doses may be necessary in severe or chronic infection
Urinary Tract Infection (ampicillin-susceptible Enterococcus; Off-label)
1-2 g IV q4-6hr with or without an aminoglycoside
Gonorrhea
3.5 g IV administered once simultaneously with 1 g of probenecid
Respiratory Tract Infections
≥40 kg
- 250 mg PO q6hr
- 250-500 mg IV/IM q6hr
<40 kg
- 25 to 50 mg/kg/day IV or IM divided q6-8hr
Bacterial Meningitis/Septicemia
150-200 mg/kg/day IV divided q6-8hr; initiate with IV infusion; may continue with IM injections if preferred; range 6-12 g/day
Group B Streptococcus (Off-label)
Maternal dose for neonatal prophylaxis
2 g IV initially, followed by 1 g q4hr until delivery
Listeria Infection (Off-label)
2 g IV q4hr
Administration
Take oral dosage form on empty stomach
Dosing Modifications
Renal impairment
- CrCl <10 mL/min: Administer q12-24hr
- CrCl 10-50 mL/min: Administer q6-12hr
- CrCl >50 mL/min: Administer q6hr
Hepatic impairment
- Not studied
Dosage Forms & Strengths
capsules
- 250mg
- 500mg
oral suspension
- 125mg/5mL
- 250mg/5mL
powder for injection
- 125mg
- 250mg
- 500mg
- 1g
- 2g
General Dosing Guidelines
25-200 mg/kg/day IV/IM divided q6-8hr; not to exceed 12 g/day
50-100 mg/kg/day PO divided q6hr; not to exceed 2-4 g/day
Severe infection: 200-400 mg/kg/day IV/IM divided q6hr
Potential toxic dose <6 years: 300 mg/kg
Neonates (<28 Days)
<7 days
- <2 kg: 50-100 mg/kg/day IV/IM divided q12hr
- >2 kg: 75-150 mg/kg/day IV/IM divided q8hr
>7 days
- <1.2 kg: 50-100 mg/kg/day IV/IM divided q12hr
- 1.2-2 kg: 75-150 mg/kg/day IV/IM divided q8hr
- >2 kg: 100-200 mg/kg/day IV/IM divided q6hr
Endocarditis Prophylaxis (Off-label)
50 mg/kg IV/IM (+/- gentamicin 1.5 mg/kg for GI/GU) within 30-60 minutes before procedure
Dosing considerations
- AHA Guidelines recommend only for high risk patients
Endocarditis Treatment
300 mg/kg/day IV divided q4-6hr in combination with other antibiotics; not to exceed 12 g/day
Genitourinary Tract Infections
<40 kg: 50-100 mg/kg/day IV/IM divided q6hr
≥40 kg: 500 mg IV/IM q6hr
Gastrointestinal Tract Infections
<20 kg: 50-100 mg/kg/day PO divided q6hr
>20 kg: 500 mg PO q6hr
<40 kg: 50 mg/kg/day IV/IM divided q6-8hr
>40 kg: 500 mg IV/IM q6hr
Gonorrhea
<20 kg: Safety and efficacy not established
>20 kg: 3.5 g PO administered once simultaneously with 1 g of probenecid
Respiratory Tract Infections
<20 kg: 50 mg/kg/day PO divided q6-8hr
>20 kg: 250 mg PO q6hr
<40 kg: 25-50 mg/kg/day IV/IM divided q6-8hr
>40 kg: 250-500 mg IV/IM q6hr
Bacterial Meningitis/Septicemia
150-200 mg/kg/day IV/IM divided q3-4hr; should initiate with IV infusion therapy and continued with IM injections if preferred
Soft Tissue Infections
<40 kg: 25-50 mg/kg/day IV/IM divided q6-8hr
≥40 kg: 250-500 mg IV/IM q6hr
Community Acquired Pneumonia
< 3 months: Safety and efficacy not established
> 3 months:
Empiric treatment or S. pneumoniae
- MICs to penicillin ≤ 2 mcg/mL or H. influenzae (beta-lactamase negative, preferred: 150-200 mg/kg/day IV/IM divided q6hr
- MICs to penicillin ≥ 4 mg/mL; alternative to ceftriaxone: 300-400 mg/kg/day IV/IM divided q6hr
Group A Streptococcus
- Moderate to severe (preferred): 200 mg/kg/day IVIM divided q6hr
Administration
Take oral dosage form on empty stomach
Next:
Interactions
Interaction Checker
Enter a drug nameand ampicillin
No Results
No Interactions Found
Interactions Found
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
All Interactions Sort By:
Contraindicated (0)
Serious - Use Alternative (12)
- BCG vaccine live
ampicillin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.
- cholera vaccine
ampicillin, cholera vaccine. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid coadministration of cholera vaccine with systemic antibiotics since these agents may be active against the vaccine strain. Do not administer cholera vaccine to patients who have received oral or parenteral antibiotics within 14 days prior to vaccination.
- demeclocycline
demeclocycline decreases effects of ampicillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Tetracyclines may interfere with the bactericidal action of penicillins. Monitor for decreased therapeutic effects of penicillins if concomitantly used with a tetracycline.
- doxycycline
doxycycline decreases effects of ampicillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Tetracyclines may interfere with the bactericidal action of penicillins. Monitor for decreased therapeutic effects of penicillins if concomitantly used with a tetracycline.
- eravacycline
eravacycline decreases effects of ampicillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Tetracyclines may interfere with the bactericidal action of penicillins. Monitor for decreased therapeutic effects of penicillins if concomitantly used with a tetracycline.
- minocycline
minocycline decreases effects of ampicillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Tetracyclines may interfere with the bactericidal action of penicillins. Monitor for decreased therapeutic effects of penicillins if concomitantly used with a tetracycline.
- mycophenolate
ampicillin, mycophenolate. Either increases levels of the other by decreasing renal clearance. Avoid or Use Alternate Drug.
- omadacycline
omadacycline decreases effects of ampicillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Tetracyclines may interfere with the bactericidal action of penicillins. Monitor for decreased therapeutic effects of penicillins if concomitantly used with a tetracycline.
- oxytetracycline
oxytetracycline decreases effects of ampicillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug.
- sarecycline
sarecycline decreases effects of ampicillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Tetracyclines may interfere with the bactericidal action of penicillins. Monitor for decreased therapeutic effects of penicillins if concomitantly used with a tetracycline.
- tetracycline
tetracycline decreases effects of ampicillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Tetracyclines may interfere with the bactericidal action of penicillins. Monitor for decreased therapeutic effects of penicillins if concomitantly used with a tetracycline.
- typhoid vaccine live
ampicillin decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.
Monitor Closely (29)
- aspirin
ampicillin, aspirin. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.
- aspirin rectal
ampicillin, aspirin rectal. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.
- aspirin/citric acid/sodium bicarbonate
ampicillin, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.
- bazedoxifene/conjugated estrogens
ampicillin will decrease the level or effect of bazedoxifene/conjugated estrogens by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.
- chloroquine
chloroquine decreases levels of ampicillin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate doses by at least 2 hr.
- choline magnesium trisalicylate
ampicillin, choline magnesium trisalicylate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
ampicillin, choline magnesium trisalicylate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor. - deflazacort
ampicillin and deflazacort both decrease serum potassium. Use Caution/Monitor.
- dexlansoprazole
dexlansoprazole will decrease the level or effect of ampicillin by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- dienogest/estradiol valerate
ampicillin will decrease the level or effect of dienogest/estradiol valerate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. An alternate or additional form of birth control may be advisable during concomitant use.
- esomeprazole
esomeprazole will decrease the level or effect of ampicillin by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- ethinylestradiol
ampicillin will decrease the level or effect of ethinylestradiol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.
- ibuprofen/famotidine
ibuprofen/famotidine will decrease the level or effect of ampicillin by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- lansoprazole
lansoprazole will decrease the level or effect of ampicillin by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- lanthanum carbonate
lanthanum carbonate decreases levels of ampicillin by cation binding in GI tract. Use Caution/Monitor. Administer ampicillin at least 2 hr before or after lanthanum. Interaction applies to oral ampicillin.
- levonorgestrel oral/ethinylestradiol/ferrous bisglycinate
ampicillin will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. Antibiotics may decrease hormonal contraceptive efficacy.
- mestranol
ampicillin will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.
- methotrexate
ampicillin increases levels of methotrexate by decreasing renal clearance. Use Caution/Monitor. Increased serum concentrations of methotrexate with concomitant hematologic and gastrointestinal toxicity have been observed with concurrent administration of high or low doses of methotrexate and penicillins.
- omeprazole
omeprazole will decrease the level or effect of ampicillin by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- pantoprazole
pantoprazole will decrease the level or effect of ampicillin by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- rabeprazole
rabeprazole will decrease the level or effect of ampicillin by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- rose hips
ampicillin, rose hips. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
- sodium bicarbonate
sodium bicarbonate will decrease the level or effect of ampicillin by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- sodium citrate/citric acid
sodium citrate/citric acid will decrease the level or effect of ampicillin by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- sodium phenylacetate
ampicillin, sodium phenylacetate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
- sodium picosulfate/magnesium oxide/anhydrous citric acid
ampicillin decreases effects of sodium picosulfate/magnesium oxide/anhydrous citric acid by altering metabolism. Use Caution/Monitor. Coadministration with antibiotics decreases efficacy by altering colonic bacterial flora needed to convert sodium picosulfate to active drug.
- sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol
ampicillin and sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol both decrease serum potassium. Modify Therapy/Monitor Closely.
- spironolactone
ampicillin increases effects of spironolactone by unspecified interaction mechanism. Use Caution/Monitor. Hyperkalemia.
- sulfasalazine
ampicillin, sulfasalazine. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.
ampicillin, sulfasalazine. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor. - willow bark
ampicillin, willow bark. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
Minor (18)
- allopurinol
ampicillin, allopurinol. Mechanism: unknown. Minor/Significance Unknown. Increased incidence of rash.
- atenolol
ampicillin decreases levels of atenolol by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- azithromycin
azithromycin decreases effects of ampicillin by pharmacodynamic antagonism. Minor/Significance Unknown.
- bendroflumethiazide
bendroflumethiazide increases effects of ampicillin by decreasing renal clearance. Minor/Significance Unknown. May increase side effects.
- chloramphenicol
chloramphenicol decreases effects of ampicillin by pharmacodynamic antagonism. Minor/Significance Unknown.
- chlorothiazide
chlorothiazide increases levels of ampicillin by decreasing renal clearance. Minor/Significance Unknown.
- clarithromycin
clarithromycin decreases effects of ampicillin by pharmacodynamic antagonism. Minor/Significance Unknown.
- colestipol
colestipol decreases levels of ampicillin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- didanosine
didanosine will decrease the level or effect of ampicillin by increasing gastric pH. Applies only to oral form of both agents. Minor/Significance Unknown.
- erythromycin base
erythromycin base decreases effects of ampicillin by pharmacodynamic antagonism. Minor/Significance Unknown.
- erythromycin ethylsuccinate
erythromycin ethylsuccinate decreases effects of ampicillin by pharmacodynamic antagonism. Minor/Significance Unknown.
- erythromycin lactobionate
erythromycin lactobionate decreases effects of ampicillin by pharmacodynamic antagonism. Minor/Significance Unknown.
- erythromycin stearate
erythromycin stearate decreases effects of ampicillin by pharmacodynamic antagonism. Minor/Significance Unknown.
- hydrochlorothiazide
hydrochlorothiazide increases levels of ampicillin by decreasing renal clearance. Minor/Significance Unknown.
- methyclothiazide
methyclothiazide increases levels of ampicillin by decreasing renal clearance. Minor/Significance Unknown.
- metolazone
metolazone increases levels of ampicillin by decreasing renal clearance. Minor/Significance Unknown.
- rifampin
rifampin decreases levels of ampicillin by increasing metabolism. Minor/Significance Unknown.
- roxithromycin
roxithromycin decreases effects of ampicillin by pharmacodynamic antagonism. Minor/Significance Unknown.
- allopurinol
Minor (1)ampicillin, allopurinol. Mechanism: unknown. Minor/Significance Unknown. Increased incidence of rash.
- aspirin
Monitor Closely (1)ampicillin, aspirin. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.
- aspirin rectal
Monitor Closely (1)ampicillin, aspirin rectal. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.
- aspirin/citric acid/sodium bicarbonate
Monitor Closely (1)ampicillin, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.
- atenolol
Minor (1)ampicillin decreases levels of atenolol by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- azithromycin
Minor (1)azithromycin decreases effects of ampicillin by pharmacodynamic antagonism. Minor/Significance Unknown.
- bazedoxifene/conjugated estrogens
Monitor Closely (1)ampicillin will decrease the level or effect of bazedoxifene/conjugated estrogens by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.
- BCG vaccine live
Serious - Use Alternative (1)ampicillin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.
- bendroflumethiazide
Minor (1)bendroflumethiazide increases effects of ampicillin by decreasing renal clearance. Minor/Significance Unknown. May increase side effects.
- chloramphenicol
Minor (1)chloramphenicol decreases effects of ampicillin by pharmacodynamic antagonism. Minor/Significance Unknown.
- chloroquine
Monitor Closely (1)chloroquine decreases levels of ampicillin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate doses by at least 2 hr.
- chlorothiazide
Minor (1)chlorothiazide increases levels of ampicillin by decreasing renal clearance. Minor/Significance Unknown.
- cholera vaccine
Serious - Use Alternative (1)ampicillin, cholera vaccine. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid coadministration of cholera vaccine with systemic antibiotics since these agents may be active against the vaccine strain. Do not administer cholera vaccine to patients who have received oral or parenteral antibiotics within 14 days prior to vaccination.
- choline magnesium trisalicylate
Monitor Closely (2)ampicillin, choline magnesium trisalicylate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
ampicillin, choline magnesium trisalicylate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor. - clarithromycin
Minor (1)clarithromycin decreases effects of ampicillin by pharmacodynamic antagonism. Minor/Significance Unknown.
- colestipol
Minor (1)colestipol decreases levels of ampicillin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- deflazacort
Monitor Closely (1)ampicillin and deflazacort both decrease serum potassium. Use Caution/Monitor.
- demeclocycline
Serious - Use Alternative (1)demeclocycline decreases effects of ampicillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Tetracyclines may interfere with the bactericidal action of penicillins. Monitor for decreased therapeutic effects of penicillins if concomitantly used with a tetracycline.
- dexlansoprazole
Monitor Closely (1)dexlansoprazole will decrease the level or effect of ampicillin by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- didanosine
Minor (1)didanosine will decrease the level or effect of ampicillin by increasing gastric pH. Applies only to oral form of both agents. Minor/Significance Unknown.
- dienogest/estradiol valerate
Monitor Closely (1)ampicillin will decrease the level or effect of dienogest/estradiol valerate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. An alternate or additional form of birth control may be advisable during concomitant use.
- doxycycline
Serious - Use Alternative (1)doxycycline decreases effects of ampicillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Tetracyclines may interfere with the bactericidal action of penicillins. Monitor for decreased therapeutic effects of penicillins if concomitantly used with a tetracycline.
- eravacycline
Serious - Use Alternative (1)eravacycline decreases effects of ampicillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Tetracyclines may interfere with the bactericidal action of penicillins. Monitor for decreased therapeutic effects of penicillins if concomitantly used with a tetracycline.
- erythromycin base
Minor (1)erythromycin base decreases effects of ampicillin by pharmacodynamic antagonism. Minor/Significance Unknown.
- erythromycin ethylsuccinate
Minor (1)erythromycin ethylsuccinate decreases effects of ampicillin by pharmacodynamic antagonism. Minor/Significance Unknown.
- erythromycin lactobionate
Minor (1)erythromycin lactobionate decreases effects of ampicillin by pharmacodynamic antagonism. Minor/Significance Unknown.
- erythromycin stearate
Minor (1)erythromycin stearate decreases effects of ampicillin by pharmacodynamic antagonism. Minor/Significance Unknown.
- esomeprazole
Monitor Closely (1)esomeprazole will decrease the level or effect of ampicillin by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- ethinylestradiol
Monitor Closely (1)ampicillin will decrease the level or effect of ethinylestradiol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.
- hydrochlorothiazide
Minor (1)hydrochlorothiazide increases levels of ampicillin by decreasing renal clearance. Minor/Significance Unknown.
- ibuprofen/famotidine
Monitor Closely (1)ibuprofen/famotidine will decrease the level or effect of ampicillin by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- lansoprazole
Monitor Closely (1)lansoprazole will decrease the level or effect of ampicillin by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- lanthanum carbonate
Monitor Closely (1)lanthanum carbonate decreases levels of ampicillin by cation binding in GI tract. Use Caution/Monitor. Administer ampicillin at least 2 hr before or after lanthanum. Interaction applies to oral ampicillin.
- levonorgestrel oral/ethinylestradiol/ferrous bisglycinate
Monitor Closely (1)ampicillin will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. Antibiotics may decrease hormonal contraceptive efficacy.
- mestranol
Monitor Closely (1)ampicillin will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.
- methotrexate
Monitor Closely (1)ampicillin increases levels of methotrexate by decreasing renal clearance. Use Caution/Monitor. Increased serum concentrations of methotrexate with concomitant hematologic and gastrointestinal toxicity have been observed with concurrent administration of high or low doses of methotrexate and penicillins.
- methyclothiazide
Minor (1)methyclothiazide increases levels of ampicillin by decreasing renal clearance. Minor/Significance Unknown.
- metolazone
Minor (1)metolazone increases levels of ampicillin by decreasing renal clearance. Minor/Significance Unknown.
- minocycline
Serious - Use Alternative (1)minocycline decreases effects of ampicillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Tetracyclines may interfere with the bactericidal action of penicillins. Monitor for decreased therapeutic effects of penicillins if concomitantly used with a tetracycline.
- mycophenolate
Serious - Use Alternative (1)ampicillin, mycophenolate. Either increases levels of the other by decreasing renal clearance. Avoid or Use Alternate Drug.
- omadacycline
Serious - Use Alternative (1)omadacycline decreases effects of ampicillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Tetracyclines may interfere with the bactericidal action of penicillins. Monitor for decreased therapeutic effects of penicillins if concomitantly used with a tetracycline.
- omeprazole
Monitor Closely (1)omeprazole will decrease the level or effect of ampicillin by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- oxytetracycline
Serious - Use Alternative (1)oxytetracycline decreases effects of ampicillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug.
- pantoprazole
Monitor Closely (1)pantoprazole will decrease the level or effect of ampicillin by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- rabeprazole
Monitor Closely (1)rabeprazole will decrease the level or effect of ampicillin by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- rifampin
Minor (1)rifampin decreases levels of ampicillin by increasing metabolism. Minor/Significance Unknown.
- rose hips
Monitor Closely (1)ampicillin, rose hips. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
- roxithromycin
Minor (1)roxithromycin decreases effects of ampicillin by pharmacodynamic antagonism. Minor/Significance Unknown.
- sarecycline
Serious - Use Alternative (1)sarecycline decreases effects of ampicillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Tetracyclines may interfere with the bactericidal action of penicillins. Monitor for decreased therapeutic effects of penicillins if concomitantly used with a tetracycline.
- sodium bicarbonate
Monitor Closely (1)sodium bicarbonate will decrease the level or effect of ampicillin by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- sodium citrate/citric acid
Monitor Closely (1)sodium citrate/citric acid will decrease the level or effect of ampicillin by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- sodium phenylacetate
Monitor Closely (1)ampicillin, sodium phenylacetate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
- sodium picosulfate/magnesium oxide/anhydrous citric acid
Monitor Closely (1)ampicillin decreases effects of sodium picosulfate/magnesium oxide/anhydrous citric acid by altering metabolism. Use Caution/Monitor. Coadministration with antibiotics decreases efficacy by altering colonic bacterial flora needed to convert sodium picosulfate to active drug.
- sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol
Monitor Closely (1)ampicillin and sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol both decrease serum potassium. Modify Therapy/Monitor Closely.
- spironolactone
Monitor Closely (1)ampicillin increases effects of spironolactone by unspecified interaction mechanism. Use Caution/Monitor. Hyperkalemia.
- sulfasalazine
Monitor Closely (2)ampicillin, sulfasalazine. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.
ampicillin, sulfasalazine. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor. - tetracycline
Serious - Use Alternative (1)tetracycline decreases effects of ampicillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Tetracyclines may interfere with the bactericidal action of penicillins. Monitor for decreased therapeutic effects of penicillins if concomitantly used with a tetracycline.
- typhoid vaccine live
Serious - Use Alternative (1)ampicillin decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.
- willow bark
Monitor Closely (1)ampicillin, willow bark. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
Previous
Next:
Adverse Effects
Frequency Not Defined
Erythema multiforme
Exfoliative dermatitis
Rash
Urticaria
Fever
Seizure
Black hairy tongue
Diarrhea
Enterocolitis
Glossitis
Nausea
Oral candidiasis
Pseudomembranous colitis
Stomatitis
Vomiting
Agranulocytosis
Anemia
Hemolytic anemia
Eosinophilia
Leukopenia
Thrombocytopenia purpura
Anaphylaxis
Aspartate aminotransferase increased
Interstitial nephritis
Laryngeal stridor
Serum sickness-like reaction
Previous
Next:
Warnings
Contraindications
Hypersensitivity
Cautions
Use caution in allergy to cephalosporins, carbapenems
Adjust dose in renal failure; evaluate rash and differentiate from hypersensitivity reaction
Endocarditis prophylaxis: Use only for high-risk patients, per AHA Guidelines
Prolonged use associated with fungal or bacterial superinfection
Rash has developed during therapy in high percentage of patients with infectious mononucleosis receiving ampicillin class antibiotics; avoid therapy in these patients
Previous
Next:
Pregnancy & Lactation
Pregnancy category: B
Lactation: Excreted in breast milk; use caution
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.NA: Information not available.Previous
Next:
Pharmacology
Mechanism of Action
Broad-spectrum penicillin; interferes with bacterial cell wall synthesis during active replication, causing bactericidal activity against susceptible organisms; alternative to amoxicillin when unable to take medication orally
Absorption
Peak plasma time: 1-2 hr (oral)
Bioavailability: 30-40%
Distribution
Protein bound: 15-25%
Blister and tissue fluids, bile, and CSF with inflamed meninges
Metabolism
Liver
Elimination
Half-life: 1-1.8 hr (normal renal function); 7-20 hr (anuria/end-stage renal disease)
Excretion: Urine (90% within 24 hr)
Previous
Next:
Administration
IV Incompatibilities
Solution: Dextran and dextrose solutions, LR, Ringer's, Na-bicarb, Na-lactate 1/6 M, IV fat emulsions, invert sugar solutions
Additive: Amikacin, aztreonam(?), cefepime(?), chlorpromazine, dopamine, gentamicin, heparin(?), hydralazine, hydrocortisone, prochlorperazine,
Syringe: Erythromycin, gentamicin, hydromorphone, kanamycin, lincomycin, metoclopramide, polymyxin B SO4, streptomycin
Y-site: Amphotericin B cholesteryl SO4, Ca gluconate, cisatracurium (at high cisatracurium concentration; may be compatible at low concentrations), diltiazem, epinephrine, fenoldopam, fluconazole, hydralazine, midazolam, nicardipine, ondansetron, sargramostim, verapamil, vinorelbine
IV Compatibilities
Solution: NS (some contrary reports)
Additive: Clindamycin, erythromycin, floxacillin, furosemide, metronidazole, verapamil
Syringe: Chloramphenicol, colistimethate, heparin, lidocaine
Y-site (partial list): Acyclovir, aztreonam, clarithromycin, cyclophosphamide, esmolol, famotidine, heparin, labetalol, linezolid, KCl, MgSO4, meperidine, propofol, vancomycin, vitamins B/C
IV Preparation
Reconstitute with sterile water for injection or bacteriostatic water for injection
Use 5 mL for 125 mg, 250 mg, or 500 mg vials; 7.4 mL for 1 g vials; or 14.8 mL for 2 g vials
IV Administration
Use initial dilution within 1 hr
Give direct IV over 3-5 min for (125-500 mg) and over 10-15 minutes for larger doses (1-2 g)
Do not exceed a rate of 100 mg/min
For intermittent infusion, dilute in 50-100 mL of NS and give over 15-30 min
Give IV intermittently to prevent vein irritation (change site q48hr)
Previous
Next:
Images
BRANDFORM.UNIT PRICEPILL IMAGEampicillin oral
-
500 mg capsule-
250 mg capsuleCopyright © 2010 First DataBank, Inc.
Previous
Next:
Patient Handout
Patient Education
ampicillin oral
AMPICILLIN - ORAL
(AM-pi-SIL-in)
COMMON BRAND NAME(S): Principen
USES: Ampicillin is used to treat a wide variety of bacterial infections. It is a penicillin-type antibiotic. It works by stopping the growth of bacteria.This antibiotic treats only bacterial infections. It will not work for viral infections (such as common cold, flu). Using any antibiotic when it is not needed can cause it to not work for future infections.
HOW TO USE: Take this medication by mouth as directed by your doctor, usually 4 times a day (every 6 hours). Take ampicillin on an empty stomach (1 hour before or 2 hours after a meal) with a full glass of water. Drink plenty of fluids while using this medication unless your doctor tells you otherwise.The dosage is based on your medical condition and response to therapy.For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same time(s) every day.Continue to take this medication until the full-prescribed amount is finished even if symptoms disappear after a few days. Stopping the medication too early may allow bacteria to continue to grow, which may result in a relapse of the infection.Tell your doctor if your condition lasts or gets worse.
SIDE EFFECTS: Nausea, vomiting, diarrhea, or mouth/tongue sores may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: nausea or vomiting that doesn't stop, sore throat or fever that doesn't go away, dark urine, stomach/abdominal pain, yellowing eyes or skin, easy bruising or bleeding.This medication may rarely cause a severe intestinal condition due to a bacteria called C. difficile. This condition may occur during treatment or weeks to months after treatment has stopped. Tell your doctor right away if you develop: diarrhea that doesn't stop, abdominal or stomach pain/cramping, blood/mucus in your stool.If you have these symptoms, do not use anti-diarrhea or opioid products because they may make symptoms worse.Use of this medication for prolonged or repeated periods may result in oral thrush or a new vaginal yeast infection (oral or vaginal fungal infection). Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge or other new symptoms.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.Ampicillin can commonly cause a mild rash that is usually not serious. However, you may not be able to tell it apart from a rare rash that could be a sign of a severe allergic reaction. Get medical help right away if you develop any rash.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking ampicillin, tell your doctor or pharmacist if you are allergic to it; or to penicillin or cephalosporin antibiotics; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, a certain type of viral infection (infectious mononucleosis).Ampicillin may cause live bacterial vaccines (such as typhoid vaccine) to not work well. Tell your health care professional that you are using ampicillin before having any immunizations/vaccinations.Older adults may be at greater risk for side effects while using this drug.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.Ampicillin passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: methotrexate, tetracyclines.Ampicillin may cause false positive results with certain diabetic urine testing products (cupric sulfate-type). This drug may also affect the results of certain lab tests. Make sure laboratory personnel and your doctors know you use this drug.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: diarrhea that doesn't stop, severe vomiting, unusual change in the amount of urine, or seizures.
NOTES: Do not share this medication with others.This medication has been prescribed for your current condition only. Do not use it later for another infection unless your doctor tells you to.With prolonged treatment, laboratory and/or medical tests (such as kidney and liver function, complete blood counts) should be performed periodically to monitor your progress or check for side effects. Consult the doctor for more details.
MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised September 2022. Copyright(c) 2022 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Previous
Next:
Formulary
FormularyPatient Discounts
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Create Your List of Plans
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.
View explanations for tiers and restrictions
TierDescription1This drug is available at the lowest co-pay. Most commonly, these are generic drugs.2This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.3This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.4This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.5This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.6This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.NCNOT COVERED – Drugs that are not covered by the plan.CodeDefinitionPAPrior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.QLQuantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.STStep Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.OROther Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
Plans
Select State:
Done
Non-Medicare Plans Medicare Plans
Done
CLOSE
Additional Offers
CLOSE
Email to Patient
From:
To:
The recipient will receive more details and instructions to access this offer.
By clicking send, you acknowledge that you have permission to email the recipient with this information.
CLOSE
Email Forms to Patient
From:
To:
The recipient will receive more details and instructions to access this offer.
By clicking send, you acknowledge that you have permission to email the recipient with this information.
Previous
Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.