Himox (Amoxicillin trihydrate, antibiotic)

Himox is a brand name of amoxicillin. Amoxicillin is penicillin-type antibiotic. Amoxicillin binds to penicillin-binding proteins (PBPs) that certain bacterial cell walls. This binding prevents normal crosslinking and results in a weakened cell wall that ruptures and kills the bacteria.

However, antibiotics have no effect on viral infections.

Uses

What is Himox used for?

Amoxicillin is a broad-spectrum antibiotic mainly indicated to treat the following bacterial infections:

• Upper and lower respiratory tract infections, including ear, nose and throat infections (e.g. acute otitis media)
• Gastrointestinal tract infections
• Genitourinary tract infections
• Skin and skin structure infections
• Bone infections (e.g. osteomyelitis)
• Gall bladder / Biliary tract infections
• Helicobacter pylori infections (in combination with other drugs)
• Lyme Disease
• Dental abscess (as an adjunct to surgical management)

How should I take Himox?

Himox is available as an oral drop, suspension, and capsule. The oral capsule should be taken by mouth without chewing or crushing it. The oral drops and suspension require reconstitution (mixing) with clean drinking water. It can be taken with or without food, followed by a glass of water.

How do I store Himox?

This drug should be stored at room temperature (<30°C) and be protected from light and moisture. Do not freeze this product. Always check the label before using this product. For safety, keep out of the reach of children and pets.

Do not use if the printed expiration date has passed, the product seal has been broken, or the product has changed in color, odor, or consistency. Keep reconstituted suspensions in the refrigerator for up to 14 days, or at room temperature for up to 7 days only.

Do not dispose of this product by pouring it down the drain, toilet, or into the environment. Ask your pharmacist regarding the proper way and location of disposal.

Precautions & warnings

What should I know before using Himox?

Before using this medication, inform your doctor if you are/have:

• Had an allergic reaction to amoxicillin
• A history of allergy to other medications, food, or other substances
• Taking other medications
• Underlying health conditions

Is it safe during pregnancy or breastfeeding?

This drug is a pregnancy category B drug. There are no adequate and well-controlled studies using amoxicillin in pregnant women, however, animal studies show no risk to the fetus. So, this drug should be used during pregnancy only if your doctor prescribes it.

Amoxicillin is excreted in breast milk. Therefore, this drug should be used while breastfeeding only if your doctor approves.

Side effects

What side effects can occur when using Himox?

All drugs have the potential to elicit side effects even with normal use. Many side effects are dose-related and will resolve when it is adjusted or at the end of therapy.

Potential side effects while using this drug include:

• Nausea, vomiting
• Diarrhea
• Black “hairy” tongue
• Colitis
• Mild allergic reaction
• Tooth discoloration

Rare, serious adverse reactions:

• Hepatitis
• Nephrotoxicity
• Blood abnormalities
• Anaphylactic reaction
• Convulsions

You may experience some, none, or other side effects not mentioned above. If you experience serious adverse reactions, you must stop taking the drug immediately. If you have any concerns about a side effect or it becomes bothersome, consult your doctor or pharmacist.

Interactions

What drugs may interact with Himox?

This drug may interact with other medications. To avoid any potential drug interactions, keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist.

Known drugs and their interactions with medication include:

• Allopurinol
  • Increased risk of rash
• Anticoagulants
  • Slight prolongation of prothrombin time
• Bacteriostatic agents
  • May make amoxicillin less effective

• May decrease renal clearance of methotrexate

If you experience an adverse drug interaction, stop taking this drug and continue taking your other medication. Inform your doctor immediately to reevaluate your treatment plan. Your dose may need to be adjusted, substituted with another drug, or discontinue using the drug.

Does food or alcohol interact with Himox?

This drug can be taken with or without meals, as there is no notable interaction. There are no notable interactions with alcohol with this drug.

Inform your doctor or pharmacist if you have any concerns regarding food-drug interactions.

What health conditions may interact with Himox?

This drug should be taken with caution if you have any of the following conditions or risk factors:

• Renal impairment
• Clostridium difficile-associated diarrhea

Inform your doctor or pharmacist if you have any concerns regarding specific health conditions.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using Himox.

What is the dose of Himox for an adult?

• Take 250 mg to 500 mg every 8 hours or 500 mg every 12 hours, depending on the type and severity of the infection.
• Maximum dose: 6 g/day in divided doses.

What is the dose of Himox for a child?

• Neonates and infants <3 months: give 20 to 30 mg/kg of body weight per day in divided doses, every 12 hours.
• Infants >3 months and children <40 kg: 25 to 50 mg/kg of body weight per day in divided doses every 8 or 12 hours.

How is Himox available?

This drug is available in the following dosage forms and strengths:

• Powder for oral drops 100 mg/mL in 10 mL bottle
• Powder for oral suspension 125 mg/5 mL, 250 mg/ 5 mL in 60 mL and 105 mL bottles
• Oral capsule 250 mg, 500 mg in a box of 100

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room. Symptoms of overdose may include:

• Allergic reaction
• GI distress
• Crystalluria
• Renal impairment
• Convulsions
• Myoclonia
• Loss of consciousness

What should I do if I miss a dose?

If you miss a dose of this drug, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose. Avoid missing doses to prevent bacterial resistance and treatment failure.