Asparaginase is a bacterial enzyme used in the pharmaceutical industry to treat Acute Lymphoblastic Leukemia (ALL).
This chemotherapy drug prevents the cancer cells from growing and reproducing.
There are three kinds of asparaginase available in the market:
Pegylation is a process that helps improve drug stability and solubility. It also helps the drug stay in the body for a longer period of time.
This drug is available as intramuscular or intravenous injections.
Asparaginase is used in treating a type of cancer called Acute Lymphoblastic Leukemia (ALL).
ALL is cancer in the bones and bone marrow, and the disease progresses very quickly and needs targeted drug therapy and chemotherapy from the early stages.
This type of cancer majorly affects children.
Since the introduction of asparaginase for treating ALL, the survival rates in children have increased by 90%.
Asparaginase is an antineoplastic chemotherapy drug classified under the category ‘enzyme.’
Asparaginase works primarily by breaking down a non-essential amino acid called asparagine.
This substance is needed for making new cells in the body.
Normal cells in the body make their asparagine, while cancer cells cannot.
Asparaginase breaks down asparagine in the body and prevents the cancer cells from using them to grow and multiply.
L-asparaginase is a fast-acting drug.
The half-life of asparaginase with intramuscular injection is between 0.65-5.73 days, depending on the type of asparaginase chosen.
Similarly, the half-life of intravenous injections can be between 0.27 and 0.76 days.
The common side effects of asparaginase:
The severe side effects of asparaginase:
Asparaginase may interact with other drugs and lead to changes in drug efficacy or cause severe side effects. So talk to your doctor if you are prescribed any of the following drugs along with asparaginase.
The allergic reaction to asparaginase may vary depending on the specific formulation of the drug.
According to a 2021 article, the allergic reaction rate could be anywhere from 3% to 45% in patients.
Many baked foods contain heat-stable asparaginase to bring down the levels of acrylamide in them.
Acrylamide is a natural substance found in many plant-based foods, and high levels of acrylamide have been proven to cause cancer in animals and may affect human health.
Heat-stable asparaginase is found in
The HLA-DRB1 gene (histocompatibility complex, class II, DR beta 1 gene) plays a major role in controlling the immune system.
This gene makes the HLA complex, which the body uses to differentiate between the body’s proteins and foreign substances.
rs17885382 is a Single Nucleotide Polymorphism (SNP) in this gene.
The risk allele, T, is associated with a higher risk of developing asparaginase hypersensitivity when compared to the major allele, C.
| Allele | Implications |
| T | Higher risk of developing asparaginase hypersensitivity |
| C | Regular risk of developing asparaginase hypersensitivity |
The GRIA1 gene (Glutamate receptor 1 gene) helps produce the GRIA1 protein.
This protein plays a role in inflammation of the Central Nervous System (CNS).
rs4958351 is an SNP in the GRIA1 gene.
According to a study, people with the AA and AG genotypes had a higher chance of developing asparaginase hypersensitivity (74% and 44%) than those with the GG genotype (32%).
| Genotype | Implications |
| AA | 74% higher chance of developing asparaginase hypersensitivity |
| AG | 44% higher chance of developing asparaginase hypersensitivity |
| GG | 32% higher chance of developing asparaginase hypersensitivity |
The CNOT3 gene (CCR4-NOT transcription complex subunit 3 gene) helps produce the CNOT3 protein.
This protein may be involved in metabolism regulation.
rs73062673 is an SNP in this gene, and the minor C allele of this SNP is associated with a higher risk of PEG-asparaginase allergy.
PEG-asparaginase is used to treat acute lymphoblastic leukemia in adults and children.
| Allele | Implication |
| C | Higher risk of developing PEG-asparaginase allergy |
| T | Normal risk of developing PEG-asparaginase allergy |
Analyze Your Genetic Response to Asparaginase
One of the most common risks of using asparaginase is developing allergic reactions to it.
Symptoms include swelling, tenderness, skin rashes, high sugar levels, hypotension (low blood pressure), and angioedema (swelling under the skin).
It is recommended to stay aware of hypersensitivity symptoms and contact your doctor right away if you experience anything unpleasant after using the drug.
Another common complication of asparaginase is thrombosis.
Thrombosis is the development of blood clots in the vessels.
Upper central venous thrombosis is the most common type of thrombosis in people using asparaginase.
In a study that analyzed the risk of thrombosis in people using asparaginase, experts concluded that adults were more at risk than pediatric patients.
It is recommended to check antithrombin and fibrinogen levels before treating with asparaginase and supplement these if they are low.
Apart from developing hypersensitivity to the drug and thrombosis, patients may develop other toxicity symptoms, which may cause severe side effects when left unidentified. Some of the conditions that can develop because of asparaginase toxicity are:
Even without developing hypersensitivity or toxic symptoms, up to one-third of the individuals may develop asparaginase-inactivating antibodies upon using the drug.
These inactivating antibodies cause a decrease in the concentration of asparaginase in the body and may lead to drug resistance.
Such individuals may have to be treated with appropriately high doses upon the suggestion of a qualified medical practitioner.
The goal of asparaginase is to reduce serum levels of asparagine.
The drug's half-life varies depending on the type of bacteria or enzyme used in preparing it.
According to experts, an asparaginase activity level of 0.1 IU/mL should be the target to reduce serum asparagine levels effectively.
Doctors will need to identify optimal drug doses for each patient to ensure the drug performs effectively.
https://en.wikipedia.org/wiki/Asparaginase
https://chemocare.com/chemotherapy/drug-info/Lasparaginase.aspx
https://www.rxlist.com/elspar-drug.htm#warnings
https://www.drugs.com/drug-interactions/asparaginase-escherichia-coli.html
https://chemocare.com/chemotherapy/drug-info/Lasparaginase.aspx
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4936081/
https://www.uniprot.org/uniprot/O75175
https://cdrjournal.com/article/view/3055
https://www.genecards.org/cgi-bin/carddisp.pl?gene=GRIA1
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Co-trimoxazole is a sulfonamide drug that is a combination of sulfamethoxazole and trimethoprim.
This drug is used to treat bacterial infections like pneumonia, bronchitis, urinary tract infections, and infection of the ears and intestines. Co-trimoxazole is also used to treat ‘traveler’s diarrhea.
Co-trimoxazole is also used to treat some fungal and parasitic infections.
This drug may be given orally or via intravenous (IV) infusion.
Co-trimoxazole is used for a variety of bacterial, fungal, and parasitic infections, including:
Co-trimoxazole works by inhibiting the growth of bacteria, fungi, and parasites, thereby preventing the spread of the infection.
This drug is not effective against viruses and diseases caused by them.
The co-trimoxazle dose usually prescribed for adults is two tablets, twice a day.
Depending upon the infection, you may need to take co-trimoxazole for three to seven days.
The dosage and duration of co-trimoxazole in children depend upon their age, body weight, and the nature of the condition.
Despite its efficacy in treating several bacterial infections, co-trimoxazole is often preceded by simpler antibiotics due to its side effects in some people.
Common side effects observed with co-trimoxazole include
If you experience any side effects after taking co-trimoxazole, inform your doctor immediately.
Some severe side effects of co-trimoxazole that require immediate medical attention include:
Trimethoprim in co-trimoxazole does not cause hepatic damage, but sulphamethoxazole is known to cause liver injury.
So, co-trimoxazole increases the risk of liver damage in some individuals.
Co-trimoxazole interacts with several drugs, so you must always inform your doctor about all medications you are currently taking.
Some interactions of co-trimoxazole with other drugs include
Cyclic antidepressants
These are a class of drugs used to treat and manage major depressive disorder.
When co-trimoxazole is taken with cyclic antidepressants, there is a possible decrease in the latter's efficacy.
Cyclosporin
This drug is a calcineurin inhibitor and is used as an immunosuppressant drug to treat various diseases like rheumatoid arthritis and nephrotic syndrome and prevent rejection in transplant cases.
When cyclosporin is taken with co-trimoxazole, reversible nephrotoxicity has been reported in renal transplant patients.
Digoxin
This drug is used to treat cardiac conditions like irregular heart rhythm and heart failure.
Taking digoxin concomitantly with co-trimoxazole increases the concentration of digoxin in geriatric patients.
This may increase the side effects of the drug.
Diuretics
Diuretics or water pills are commonly used antihypertensive medications that increase urine production and enable sodium excretion.
Taking co-trimoxazole with diuretics (especially thiazides) raises the possibility of thrombocytopenia (a severe decrease in platelet count) and purpura.
This is usually observed in the geriatric population.
Oral hypoglycemics
These drugs are used in individuals with diabetes.
When oral hypoglycemics are taken with co-trimoxazole, the combination increases the risk for hypoglycemic complications in these individuals.
Indomethacin
This is an NSAID drug used to relieve moderate pain, tenderness, and swelling in joints caused by osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and other similar joint pains.
Taking indomethacin with co-trimoxazole may increase the sulfamethoxazole concentration and its side effects.
Methotrexate
This drug is a chemotherapeutic agent and an immunosuppressant used to treat many autoimmune diseases and cancer.
Co-trimoxazole must be avoided in people with methotrexate as it increases the concentration of free methotrexate.
As a result, the efficacy of methotrexate is reduced.
Phenytoin
This drug is used in the treatment of epilepsy.
When phenytoin is taken with co-trimoxazole, the latter may inhibit the metabolism of phenytoin and increase its half-life, increasing the risk of its side effects.
Warfarin
Warfarin is a commonly used blood thinner.
Possible inhibition of warfarin metabolism and clearance may be seen when consumed with co-trimoxazole.
Warfarin dosage may need to be adjusted if it is taken with co-trimoxazole.
Individuals who are allergic to sulphonamides or trimethoprim can be allergic to co-trimoxazole.
rs761142 is a single nucleotide polymorphism or SNP in the glutamate-cysteine ligase catalytic subunit (GCLC) gene.
This SNP is associated with sulfamethoxazole-associated hypersensitivity in HIV/AIDS patients.
Individuals having the CC genotype have a greater risk of developing drug hypersensitivity when treated with sulphamethoxazole than those with the AA genotype.
In another study conducted, individuals having the minor G allele of rs761142 ad a greater risk of developing sulfamethoxazole hypersensitivity than those with the T allele.
Each minor G allele copy increased the risk of hypersensitivity by 1.9 fold.
rs41554616 is an SNP located between HLA-B and MICA genes.
This SNP is associated with co-trimoxazole-induced severe cutaneous adverse reaction (SCAR).
HLA-B∗13:01 allele in the rs41554616 has been strongly linked to the development of SCAR in Asians.
Analyze Your Genetic Response to Co-Trimoxazole
If you are allergic to co-trimoxazole, sulfonamides, or trimethoprim, you must inform your doctor before taking the drug.
Some common symptoms of allergy to co-trimoxazole include cough, shortness of breath, sore throat, fever, and other respiratory symptoms.
Co-trimoxazole is not recommended in individuals with megaloblastic anemia due to folate deficiency.
People with G6PD deficiency may experience hemolysis when they take co-trimoxazole and must avoid the drug.
Co-trimoxazole’s safety and efficacy have not been established in the pediatric population below two years of age.
So, it is not advisable to prescribe this drug to this age group.
Sulfonamides are known to cause kernicterus in newborns, and so co-trimoxazole is contraindicated in pregnant women.
Since sulfamethoxazole and trimethoprim can pass into breast milk, co-trimoxazole is contraindicated in lactating and nursing women.
Co-trimoxazole is contraindicated in older adults, especially those with impaired hepatic or renal function.
These individuals may be at an increased risk for adverse reactions.
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Allopurinol is a drug that prevents the build-up of uric acid in the blood, which is a primary cause of conditions like gout and kidney stones.
Gout is characterized by the deposition of monosodium urate (uric acid) crystals in body tissues like the joints.
Allopurinol is metabolized (broken down into smaller molecules) in the liver, and around 80% of orally ingested Allopurinol is excreted via urine.
The most commonly used form of Allopurinol is orally ingestible tablets. However, Allopurinol is also available in the IV form.
Gout treatment using Allopurinol is usually a long-term one, and patients can expect their condition to improve after taking the drug for a few months.
Though there may be an increase in hypoxanthine and xanthine levels after taking Allopurinol, the risk of their deposition in kidney tissues and joints is less than that of uric acid because they are more soluble and more quickly eliminated by the kidneys.
Allopurinol and its metabolites (intermediaries or end-products of metabolism) are mainly eliminated via the kidneys.
Therefore, any accumulation of Allopurinol in patients with kidney conditions can be a cause of concern.
For this reason, people with kidney conditions must always inform their doctor of their condition before taking Allopurinol.
If you experience any side effects from taking Allopurinol, you must stop the medication immediately and report it to your healthcare provider.
Allopurinol may cause drowsiness, so you must not operate any heavy machinery, drive or perform tasks that require you to be alert.
Other common side effects of Allopurinol include
Though many mild side effects caused by Allopurinol may subside within a few days to weeks, you must report to your doctor if you experience any of the following severe side effects:
Allopurinol oral tablets may interact with other medications, nutritional supplements, and herbs that you may be taking.
Therefore, it is always recommended that you inform your doctor about all medications and supplements you are taking before taking Allopurinol.
Some common medications that Allopurinol interacts with and causes adverse effects are:
Ampicillin or amoxicillin
Ampicillin and amoxicillin are antibiotics used in treating bacterial infections.
If you take either of these medications along with Allopurinol, you may have an increased risk of developing a skin rash.
Thiazide diuretics (like hydrochlorothiazide)
Thiazide diuretics are commonly used in treating hypertension (high blood pressure).
However, taking thiazide diuretics with Allopurinol may cause an increased risk of side effects like skin rash, diarrhea, nausea, or a flare-up of gout symptoms.
Mercaptopurine
Mercaptopurine is a drug used in the treatment of cancer and some autoimmune diseases.
Taking Allopurinol while taking mercaptopurine can increase the levels of mercaptopurine in the blood.
This rise in mercaptopurine levels in the blood can trigger side effects of the drug such as black tarry or clay-colored stools, decreased appetite, fever, chills, nausea, vomiting, rash, or itchy skin among others.
To prevent this from happening, your doctor may reduce your dosage of mercaptopurine.
Azathioprine
Azathioprine is an immunosuppressive drug (used to suppress the immune system reaction) used in treating conditions like rheumatoid arthritis, ulcerative colitis, kidney transplants, etc.
If you are taking azathioprine, taking Allopurinol can increase the blood levels of this drug by blocking the enzymes that help break down azathioprine.
Unfortunately, this results in side effects of azathioprine such as abdominal pain, nausea, vomiting, loss of appetite, unusual bruising, fatigue, etc.
So, before your doctor prescribes Allopurinol, they may reduce your azathioprine dosage.
Cyclosporine
Cyclosporine is an immunosuppressant medication, and taking Allopurinol with it can increase cyclosporine levels in the blood.
Therefore, your doctor may need to alter your cyclosporine dosage if they prescribe Allopurinol to you.
Other drugs that may interact with Allopurinol are blood thinners like warfarin, capecitabine (an anti-cancer drug used to treat breast cancer, gastric cancer, and colorectal cancer), and didanosine (used in treating HIV).
The HLA-B gene is a part of the Human Leukocyte Antigen or HLA complex.
The HLA complex helps the immune system differentiate between the body’s proteins and those of foreign origin, like viruses and bacteria.
Due to this property of HLA genes, they are responsible for drug hypersensitivity reactions.
A type of the HLA gene called the HLA-B*58:01 is strongly associated with severe Cutaneous Adverse Drug Reactions with Allopurinol treatment.
This type is more common in the Asian population, particularly in people of Korean, Han-Chinese, or Thai descent.
In addition, people of Thai descent with the HLA-B*58:01 type were also found to be at an increased risk of Allopurinol-induced Steven Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN).
To avoid these skin conditions, people who have the HLA-B*58:01 gene must be prescribed an alternative drug to Allopurinol, or the drug dosage must be reduced.
HLA-B*58:01, therefore, acts as a genetic marker for screening Thai people who may be at risk for Steven Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN).
ATP-Binding Cassette subfamily G member 2 or the ABCG2 gene is a part of the ATP-Binding Cassette family.
This gene provides instructions for making transport proteins that help in the movement of molecules across cell membranes.
In the intestine, the ABCG2 protein is responsible for releasing a substance called urate into the urine.
This protein also helps eliminate chemotherapeutic drugs from organs and tissues.
Changes (or mutations) in the ABCG2 gene have been associated with gout.
These changes reduce the body’s ability to remove urate from blood, which causes a rise in blood urate levels.
This excess urate begins to accumulate in the joints as uric acid crystals, resulting in gout.
rs2231142 is a single nucleotide polymorphism (SNP) in the ABCG2 gene. It is also called Q141 or C421A.
The A allele of this SNP is the risk allele and makes one susceptible to gout.
| Genotype | Effect |
| CC | Normal |
| AC | 1.74x increased risk of gout |
| AA | Causes Gout |
If you have a kidney condition, you may not efficiently clear Allopurinol and its metabolites.
This increases the levels of the drug in the body, making you susceptible to its side effects.
Allopurinol may also decrease kidney function in such individuals.
Depending on some factors, an alternate drug or altered dosage may be suggested.
Allopurinol should not be used in pregnant women without consulting a doctor.
It is known to be a category C pregnancy drug which means that animal studies have shown adverse effects on the fetus or that there aren’t enough studies to show Allopurinol is safe for pregnant women.
In emergency cases, Allopurinol may be given to pregnant women but only after a thorough evaluation by a doctor.
It has been found that Allopurinol passes into breast milk and may cause side effects in the baby.
So, if you are breastfeeding, you must inform your doctor about the same before taking Allopurinol.
There aren’t enough studies that show the effects of Allopurinol in children below 18 years of age.
Therefore, Allopurinol must be avoided for treating gout in children below 18 years.
The kidneys in older adults do not function as efficiently as they do in younger adults.
This impaired kidney function in seniors impacts Allopurinol clearance from the body and increases the risk of side effects of the drug in this age group.
If you have any of the following pre-existing medical conditions, you must inform your doctor before taking Allopurinol:
This information also helps your doctor determine the appropriate dosage of Allopurinol for you.
While taking Allopurinol, you must consume at least eight glasses of water every day or as directed by your doctor.
This is because drinking plenty of water or fluids helps your body get rid of the excess urate (uric acid).
Allopurinol may make you drowsy.
If you take alcohol with Allopurinol, it can increase drowsiness.
Additionally, alcohol may reduce the effectiveness of Allopurinol.
So, it is recommended that you reduce or avoid alcohol intake while taking this drug.
Genetic testing gives a deeper insight into how your body may react to a specific drug and your risk of developing side effects.
It also helps your doctor determine the appropriate dosage of a particular drug for you.
Allopurinol is not indicated in carriers of the HLA-B*58:01 as they are at risk of developing skin-related adverse reactions to the drug.
Analyze Your Genetic Response to Allopurinol
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Meperidine is a synthetic opioid pain killer (analgesic) used to treat moderate to severe pain.
It is similar to morphine and is commonly used to relieve post-operative pain.
Since this drug can cause dependence and withdrawal symptoms, it requires a prescription.
Meperidine is available as a syrup, tablet, and injection and is used as a second line of treatment for acute pain.
This drug has a chemical structure similar to anesthetics, and so it has been used for regional anesthesia, peripheral nerve blocks, intraarticular, epidural, and spinal anesthesia.
Meperidine is metabolized in the liver and excreted in the urine.
Is Meperidine An Opioid?
Meperidine is a synthetic drug belonging to the class of opioid analgesics.
It is not recommended for long-term use or for treating chronic ongoing pain.
Is Demerol The Same As Meperidine?
Demerol is the brand name for meperidine hydrochloride.
It is a prescription drug and may be used alone or with other medications.
Meperidine is used to treat sudden or acute episodes of moderate to severe pain.
The dosage and form of meperidine prescribed for you will depend on the cause and intensity of your pain, risk of addiction, and medical history.
Some uses of this drug are:
Meperidine is not used in the geriatric population (elderly patients) as it may have central nervous system effects due to the drug by-products like normeperidine.
Meperidine binds to kappa-opiate receptors and brings about anesthetic effects.
When meperidine binds to the kappa-opiate receptors, it prevents the production of neurotransmitters like substance P, GABA, dopamine, acetylcholine, and noradrenaline, which cause pain sensation.
Meperidine is also known to prevent the release of vasopressin, somatostatin, insulin, and glucagon, which further reduce neuron excitability and reduce pain.
The onset of meperidine effects is more rapid than with morphine, and the duration of action of this drug is shorter.
Though meperidine is safe to consume, it may cause side effects in some individuals.
Common side effects of meperidine are:
Some severe side effects of meperidine that require immediate medical attention include
When two or more drugs are taken together, they can interact with each other, resulting in a change in the mechanism of action of one or all the drugs and an increased risk for side effects.
You must, therefore, inform your doctor about any medications or supplements you are taking before consuming meperidine.
Some drugs that may interact with meperidine are:
Other opioid medications
Taking other opioid medications or morphine derivatives may lead to nervous system depression, respiratory distress, coma, or other side effects.
MAO inhibitors
Taking MAO inhibitors like isocarboxazid, linezolid, metaxalone, etc., may result in serious drug interaction.
For this reason, you must not take MAO inhibitors for at least two weeks before treatment with meperidine.
Discuss with your doctor when you can stop these drugs.
Drugs that increase serotonin
When meperidine is taken with other drugs that increase serotonin, the risk of developing serotonin syndrome or toxicity increases.
Drugs that affect the elimination of meperidine
Drugs like azole antifungals (ketoconazole), macrolide antibiotics (erythromycin), mifepristone, and antiseizure drugs (carbamazepine, phenytoin) reduce the elimination of meperidine, increasing the risk of side effects.
Avoid taking these drugs with meperidine.
Opioid allergy is common, and some people may be allergic to meperidine.
However, less than 2% of opioid allergies are true allergies?
Pseudo allergy is a side effect of opioid drugs like meperidine that resemble true allergies but is caused by histamine release from a specific type of cells called mast cells in the skin.
True allergic reactions to opioids like meperidine may include symptoms like
If you have a known allergy to other opioids, inform your doctor about the same before taking meperidine.
rs11049274 is a single nucleotide polymorphism or SNP located at LOC7292 on the PTHLH gene.
People with the A allele are at an increased risk of developing adverse drug reactions on taking meperidine than those with the G allele.
rs113100019 is an SNP in the FIP1L1 gene.
People with the G allele are at an increased risk of developing adverse drug reactions on taking meperidine than those with the T allele.
rs185462714 is an SNP located on the SERINC5 gene on chromosome 5.
People with the C allele are at a greater risk of developing adverse drug reactions on taking meperidine than those with the A allele.
| Gene | SNP | Risk Allele | Effect |
| PTHLH | rs11049274 | A | Increased risk for adverse drug reactions |
| FIP1L1 | rs113100019 | G | Increased risk for adverse drug reactions |
| SERINC5 | rs185462714 | C | Increased risk for adverse drug reactions |
Analyze Your Genetic Response to Meperidine
Meperidine has not been adequately assessed and evaluated in pregnant women.
However, it is advised to avoid it during pregnancy as it is known to cross the placenta.
Meperidine gets distributed into breast milk, and its effects on infants are unknown.
Hence, it must be avoided by lactating and breastfeeding women.
This drug is also habit-forming and must be avoided by pregnant women or who are planning to conceive in the near future.
Meperidine is known to cause constipation, so you must eat plenty of dietary fiber, drink lots of water, and exercise regularly while taking the drug.
If you are experiencing chronic constipation due to the medication, your doctor may prescribe a laxative to help clear your bowels.
For people experiencing dizziness or lightheadedness on taking the medication, getting up slowly when changing posture is advisable.
Meperidine may interact with alcohol and cause adverse reactions.
So, avoid alcohol consumption if you are taking this drug.
Meperidine interacts with a wide range of drugs, including pain-relieving medicines, sedatives, muscle relaxants, pentazocine, phenytoin, and other drugs that make you drowsy or slow down your breathing.
To avoid adverse reactions due to the interactions of meperidine with other drugs, you must inform your doctor about all medications you are currently taking.
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Amoxicillin-Clavulanate is a combination drug prescribed for bacterial infections in the body. It is commonly used to treat conditions like
It is available in the form of oral capsules, suspension liquids, and injections.
It has been added to WHO’s List of Essential Medicines.
In 2019 alone, about 25,702,634 prescriptions of amoxicillin were given out to treat different bacterial infections in adults and children.
Amoxicillin is sold under different brand names, including Amoxil, Moxatag, Clavulin, Talicia, and Prevpac.
Yes, amoxicillin is prescribed to treat tooth infections and tooth pain.
Usually, a combination of amoxicillin and clavulanic acid is used to improve the effectiveness of the drug.
Amoxicillin belongs to the penicillin class of antibiotics.
It works by stopping the growth of bacteria.
It interferes with the integrity of the bacteria's cell wall, ultimately killing them.
Clavulanic acid is in a class of medications called beta-lactamase inhibitors.
It protects amoxicillin from any attacks by the bacteria.
Usually, the dosage of antibacterial medications recommended depends on the type of bacteria.
Some bacteria have thicker outer walls and may need a higher drug dosage to kill them.
The body quickly absorbs amoxicillin, and peak levels may be reached between 1-2 hours.
However, it may take 2 days for the infection symptoms to reduce after taking amoxicillin-clavulanate.
It is important to not discontinue the course immediately after this.
Completing the full course is important for effective treatment.
The half-life of amoxicillin is about 61.3 minutes, and 60% of the drug is eliminated through urine in 8 hours.
Half-life is the time taken for the drug’s active component to reduce by half in the body.
Half-life determines how slowly or quickly a drug is metabolized and eliminated from the system.
Some of the common side effects are:
Some of the severe side effects are:
Please notify your doctor if you experience any discomfort after using the medicine.
Yes, you can take amoxicillin on an empty stomach.
If you experience gastrointestinal problems like an upset stomach, nausea, or bloating, then consume it after a meal.
Most antibiotics can make you slightly tired and sleepy because of their mechanism of action. It is normal to feel tired and sleepy while on amoxicillin.
However, if you feel excessively tired, sleepy, and experience a lack of energy, get medical attention right away.
Amoxicillin-clavulanate may interact with other drugs and lead to changes in drug efficacy or severe side effects. Notify your doctor if you use any of the below medicines along with amoxicillin.
The HLA-DQB1 gene (major histocompatibility complex, class II, DQ beta 1 gene) provides instructions to produce a protein that plays an important role in the functioning of the immune system.
This gene helps the immune system differentiate between its proteins and the proteins of foreign substances like bacteria and viruses.
There are hundreds of HLA-DQB1 gene changes identified in the human body.
rs9274407 is a Single Nucleotide Polymorphism (SNP) in the HLA-DQB1 gene.
People with the A allele of this SNP have an increased chance of developing Drug-Induced Liver Injury (DILI) when treated with amoxicillin when compared to people with the T allele.
DILI is a condition that causes liver injuries due to the administration of certain drugs.
| Allele | Implications |
| A | Increased risk of developing DILI when amoxicillin-clavulanate is administered |
| T | Reduced risk of developing DILI when amoxicillin-clavulanate is administered |
Some people may be allergic to amoxicillin-clavulanate and develop allergy symptoms, including the following.
Very few people may be extremely sensitive to amoxicillin and develop anaphylaxis (severe allergic reactions that may be life-threatening).
Look out for allergic reactions that may develop immediately or up to 24 hours after administering the drug.
Amoxicillin overdose may lead to the below conditions.
An extreme overdose may lead to kidney failure, which may be reversed with immediate treatment.
People with existing renal conditions have to be monitored carefully while on antibiotics like amoxicillin-clavulanate.
In most cases, the doctors will alter the drug dosage to prevent the risk of renal damage.
In rare cases, amoxicillin-clavulanate may induce liver injuries in healthy individuals. In most cases, the symptoms of liver injury improve once the drug is discontinued. Studies show that the risk of liver injury due to amoxicillin is 0.3 in 10,000 prescriptions.
Check for symptoms like tender abdomen, abdominal pain, and nausea after using amoxicillin, and consult a doctor to rule out DILI.
According to the Food and Drug Administration (FDA), pregnant and lactating women may use amoxicillin-clavulanate to treat bacterial infections when the benefits outweigh the risks.
As of date, there are no clinical studies that relate the drug to abortions, congenital defects, or fetal harm.
While a small percentage of the drug is expressed in breastmilk, it may not cause adverse side effects to the baby.
However, if you are pregnant or breastfeeding, discuss the possible effects with your doctor before using it.
Genetic testing will help understand a person’s risk of developing Drug-Induced Liver Injury because of amoxicillin. If the risk is high, doctors may consider reducing the drug dosage or using an alternate drug to treat infections.
Analyze Your Genetic Response to Amoxicillin_Clavulanate
https://www.rxlist.com/amoxicillin-drug.htm#overdosage
https://go.drugbank.com/drugs/DB01060
https://en.wikipedia.org/wiki/Amoxicillin#Interactions
https://medlineplus.gov/druginfo/meds/a685001.html
https://www.drugs.com/amoxicillin.html#dosage
https://www.news-medical.net/health/Penicillin-Mechanism.aspx
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Penicillins are a class of antibacterial drugs used in treating diseases caused by a wide range of bacteria.
Penicillins were the first group of antibacterials ever used, and their discovery is said to have changed the course of medicine, saving millions of lives to date.
Penicillin is obtained from the Penicillium fungi, and this drug is given both orally and in an injection.
Today, there are several different types of penicillins, and their primary mechanism of action is killing the bacteria by disrupting their cell walls.
Amoxicillin is a semi-synthetic form of penicillin launched in 1972.
While both amoxicillin and penicillin treat bacterial infections, penicillin may be preferred for streptococcal throat infection, bacterial pneumonia, bacterial meningitis, and syphilis.
On the other hand, amoxicillin is more effective against syphilis, dental infections, ear infections, and lung infections like bronchitis.
Antibiotics like penicillin cannot be purchased over-the-counter without a valid prescription from a certified medical practitioner.
However, some topical antibiotics comprising Neosporin and other generics for application on acne, minor scrapes, and wounds are available as OTC products.
Natural penicillins and their synthetic derivatives are the most widely used antibacterials globally.
Penicillins are effective against the following types of bacteria:
Penicillin-based antibiotics are commonly used to treat infections like
This class of drugs is also used to treat some serious conditions such as
Penicillins, along with B-lactam antibiotics, are the first line of treatment for sexually transmitted diseases (STDs).
Penicillins are effective in treating all stages of syphilis and gonorrhea.
Penicillin is an antibiotic that treats bacterial infections and diseases. It works to kill bacteria and does not cause pain relief.
Penicillin and other drugs in its class work by preventing bacterial cell wall synthesis by attacking peptidoglycans.
Peptidogylancs are a mesh-like structure and an integral part of the bacterial cell wall.
The cell wall protects bacteria from the environment and prevents external fluids and other particles from entering the cell.
The lack of a cell wall results in surrounding fluids gushing into the bacterial cell, leading to the bursting of the cell and eventual death.
Like most drugs, penicillin may cause side effects in some individuals.
Commonly encountered side effects of penicillin are:
A few rare side effects that may occur on taking penicillin include:
When the antibiotic is working to fight the infection, it can make you tired and fatigued.
If your doctor has prescribed penicillin to treat your bacterial infection, inform them about the drugs and supplements you are currently taking.
Some penicillin-drug interactions
An allergy to penicillin is an abnormal reaction of your immune system to the drug.
Around 10% of people, less than 1% of people are dangerously allergic to the drug.
Common signs and symptoms of penicillin allergy are
Some delayed signs of a penicillin allergy that occur after a few days or weeks of exposure to the drug are:
People allergic to penicillins are usually allergic to other antibiotics having a beta-lactam ring.
In these individuals, broad-spectrum antibiotics are preferred, but they may cause more severe side effects.
For this reason, your doctor may confirm your penicillin allergy with tests and determine the best possible antibiotic depending on your test results.
The human Leucocyte Antigen (HLA) system is a complex set of genes present on chromosome 6.
These genes are associated with allergic reactions, including penicillin allergy.
rs114892859 is a single nucleotide polymorphism (SNP) in the HLA-B gene.
Tagged as HLA-B*55:01, people of European ancestry with the T allele of rs114892859 SNP are at a greater risk of developing penicillin allergy.
rs7192 is an SNP in the HLA-DRA gene on chromosome 6 and has been associated with food allergies and allergy to penicillin and amoxicillin.
People with the G allele of this SNP had a lower risk of developing penicillin allergy than those with the T allele.
This SNP has been associated with penicillin and amoxicillin allergies.
Individuals with the G allele of SNP rs11740584 have a greater risk for penicillin allergy than those with the T allele.
Analyze Your Genetic Response to Penicillin
The best way to take penicillin tablets is with a glass of water, preferably on an empty stomach, unless directed by your physician.
Avoid consuming acidic juices or other beverages within one hour of taking penicillin, as it may prevent the drug from acting effectively.
Always take penicillin in the dosage prescribed by your doctor for the required number of days.
If you miss a dose, do not compensate for the same by taking an extra dose later on in the day.
Before taking penicillin or its derivatives, inform your doctor about other medications and supplements that you are currently taking to avoid interactions and adverse effects.
Inform your doctor if you are on a low-sodium diet, as some penicillin derivatives may require adequate sodium for their effect.
If you have a history of side effects of penicillin or any other beta-lactam ring-containing antibiotic, inform your doctor about the same.
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