What is Bang Lin?
Amoxicillin (Bang Lin) is an antibiotic in a group of drugs called penicillins. Amoxicillin (Bang Lin) fights bacteria in the body.
Clavulanate potassium is a form of Clavulanic Acid (Bang Lin), which is similar to penicillin. Clavulanate potassium fights bacteria that is often resistant to penicillins and other antibiotics.
The combination of Amoxicillin (Bang Lin) and clavulanate potassium is used to treat many different infections caused by bacteria, such as sinusitis, pneumonia, ear infections, bronchitis, urinary tract infections, and infections of the skin.
Amoxicillin (Bang Lin) and clavulanate potassium may also be used for purposes not listed in this medication guide.
Bang Lin indications
Bang Lin-600 is indicated for the treatment of pediatric patients with recurrent or persistent acute otitis media due to S. pneumoniae (penicillin MICs ≤ 2 mcg/mL), H. influenzae (including β-lactamase–producing strains), or M. catarrhalis (including β-lactamase–producing strains) characterized by the following risk factors:
- antibiotic exposure for acute otitis media within the preceding 3 months, and either of the following:
- age ≤ 2 years
- daycare attendance
NOTE: Acute otitis media due to S. pneumoniae alone can be treated with Amoxicillin (Bang Lin). Bang Lin-600 is not indicated for the treatment of acute otitis media due to S. pneumoniae with penicillin MIC ≥ 4 mcg/mL.
Therapy may be instituted prior to obtaining the results from bacteriological studies when there is reason to believe the infection may involve both S. pneumoniae (penicillin MIC ≤ 2 mcg/mL) and the β-lactamase–producing organisms listed above.
To reduce the development of drug-resistant bacteria and maintain the effectiveness of Bang Lin-600 and other antibacterial drugs, Bang Lin-600 should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
Bang Lin description
Each film-coated tablet contains Amoxicillin (Bang Lin) trihydrate equivalent to Amoxicillin (Bang Lin) 500 mg, and potassium clavulanate equivalent to Clavulanic Acid (Bang Lin) 125 mg, respectively.
Each vial contains Amoxicillin (Bang Lin) sodium equivalent to Amoxicillin (Bang Lin) 1000 mg and clavulanate potassium equivalent to Clavulanic Acid (Bang Lin) 200 mg, respectively.
Bang Lin tablets also contains the following excipients: Microcrystalline cellulose, sodium starch glycolate, anhydrous colloidal silica, povidone (K30), eudragit E 100, isopropyl alcohol, magnesium stearate, white opadryl 03B58965, PEG400, methylene chloride.
Bang Lin is an antibacterial combination consisting of the semi-synthetic antibiotic Amoxicillin (Bang Lin) and the β-lactamase inhibitor, clavulanate potassium (the potassium salt of Clavulanic Acid (Bang Lin)). Amoxicillin (Bang Lin) is an analog of ampicillin, derived from the basic penicillin nucleus, 6-aminopenicillanic acid. Its molecular formula is C16H19N305S3H20 and the molecular weight is 419.46. Chemically, Amoxicillin (Bang Lin) is (2S, 5R, 6R)-6-[(R)-(-)-2-Amino-2-(p-hydroxyphenyl) acetamido]-3, 3-dimethyl-7-oxo-4-1-azabicyclo[3.2.1] heptane-2-carboxylic acid trihydrate.
Amoxicillin (Bang Lin): Clavulanic Acid (Bang Lin) is produced by the fermentation of Streptomyces clavuligerus. It is a β-lactam structurally related to the penicillins and possesses the ability to inactivate a wide variety of β-lactamases by blocking the active sites of these enzymes. Clavulanic Acid (Bang Lin) is particularly active against the clinically important plasmid-mediated β-lactamases frequently responsible for transferred drug resistance to penicillins and cephalosporins. The clavulanate potassium molecular formula is C8H8KN05 and the molecular weight is 237.25. Chemically, clavulanate potassium is potassium (Z)-(2R, 5R)-3-(2-hydroxyethylidene)-7-oxo-4-oxa-1-azabicyclo[3.2.0]-heptane-2-carboxylate.
Bang Lin dosage
Tablet: Tablets should be taken immediately before a meal.
General Information: For infections caused by Amoxicillin (Bang Lin)-sensitive organisms, the dosage is that approved for Amoxicillin (Bang Lin) as the Clavulanic Acid (Bang Lin) component does not contribute to the therapeutic effect.
Adults: 1 or 2 Bang Lin 375 mg tab 8 hourly or 1 Bang Lin 625 mg tab 8 hourly for more severe infections and infections of the respiratory tract.
For Amoxicillin (Bang Lin)-resistant organisms, the dosage of Bang Lin tablets are as follows:
Since both Bang Lin 375 mg and 625 mg contain the same amount of Clavulanic Acid (Bang Lin) (125 mg, as the potassium salt), 2 Bang Lin 375 mg are not equivalent to 1 Bang Lin 625 mg. Therefore, 2 Bang Lin 375 mg should not be substituted for 1 Bang Lin 625 mg for treatment of more severe infections.
Renal Failure: Both Amoxicillin (Bang Lin) and Clavulanic Acid (Bang Lin) are excreted by the kidneys and the serum t½ of each increases in patients with renal failure. Therefore, the dose may need to be reduced or the interval extended. The following schedule in the dosage is proposed:
Haemodialysis decreases serum concentrations of both Amoxicillin (Bang Lin) and Clavulanic Acid (Bang Lin) and an additional dose should be administered at the end of dialysis.
Oral Suspension:
Suspensions should be taken immediately before a meal.Reconstitution: For reconstitution to 30 mL, add water till the mark, invert the bottle and shake well until all the powder is dispersed.
Children: 25-50 mg/kg/day of the 4 parts Amoxicillin (Bang Lin), 1 part Clavulanic Acid (Bang Lin) preparations (which corresponds to a daily dosage of the equivalent of Amoxicillin (Bang Lin) 20-40 mg/kg and Clavulanic Acid (Bang Lin) 5-10 mg/kg) to be taken in divided doses every 8 hrs at the start of a meal.
Dosage Guide:
To correspond to a dosage of 25-50 mg/kg/day.
To correspond to a dosage of 50 mg/kg/day.
IV/IM: Bang Lin may be administered by the IV routes.
Bang Lin is administered by IM or slow IV injection in doses of 500 mg every 8 hrs.
Severe Infections: 1 g every 6 hrs by slow IV injection over 3-4 min or by infusion over 30-60 min.
Children ≤10 years: 50-100 mg/kg body weight daily by injection in divided doses.
Bang Lin interactions
See also:
What other drugs will affect Bang Lin?
Probenecid decreases the renal excretion of Amoxicillin (Bang Lin). Concurrent use with Bang Lin may result in increased and prolonged blood levels of Amoxicillin (Bang Lin).
The concurrent administration of allopurinol and ampicillin increases the incidence of rashes in patients receiving both drugs as compared to patients receiving ampicillin alone. But it is not known whether this potentiation of ampicillin rash is due to allopurinol or the hyperuricemia present in these patients.
Bang Lin should not be co-administrated with disulfiram.
Prolongation of bleeding time and prothrombin time have been reported in some patients receiving Bang Lin. Thus, Bang Lin should be used with care in patients on anticoagulation therapy.
Bang Lin may reduce the effect of oral contraceptives and the caution should be given to patients.
Laboratory Test Interactions: Bang Lin results in high urine concentration. High urine concentration of ampicillin may result in false-positive reactions when testing for the presence of glucose in urine using Clinitest, Benedict or Fehling's solution.
Bang Lin side effects
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What are the possible side effects of Bang Lin?
The most frequently reported adverse effects were diarrhoea, nausea, vomiting, abdominal pain, skin rashes, urticaria and erythema multiforme, vaginitis, abnormal taste, headache, dizziness, tiredness and hot flushes. The incidence and severity of adverse effects, particularly nausea and diarrhoea, increased with the higher recommended dose and can be minimised by administering the agent at the start of a meal. In addition, as these symptoms are especially related to the potassium clavulanate component, where these GI symptoms occur and a higher concentration of Amoxicillin (Bang Lin) is required, consideration should be given to administering the additional Amoxicillin (Bang Lin) separately.
Hepatitis and cholestatic jaundice have been reported with the combination of Amoxicillin (Bang Lin) and Clavulanic Acid (Bang Lin); the Clavulanic Acid (Bang Lin) component has been implicated. The events associated with Bang Lin may be severe and occur predominantly in adult or elderly patients. Signs and symptoms usually occur during or shortly after treatment, but in some cases may not become apparent until several weeks after treatment has ceased. The hepatic events are usually reversible. However, in extremely rare circumstances, death has been reported. These have almost always been cases associated with serious underlying disease or concomitant medication.
A moderate rise in aspartate transaminase and/or alanine transaminase has been noted in patients treated with Bang Lin, the significance of these findings is unknown.
The following adverse reactions have been reported for ampicillin class antibiotics and may occur with Bang Lin.
Gastrointestinal: Gastritis, stomatitis, glossitis, black hairy tongue, enterocolitis and pseudomembranous colitis. If GI reactions are evident, they may be reduced by taking Bang Lin at the start of a meal.
Amoxicillin (Bang Lin) causes hypersensitivity reactions similar to those induced by penicillin G and ampicillin, including rashes and fever. The incidence of these reaction is probably no higher than with other penicillins. Sensitivity reactions are more likely to occur in individuals who have previously demonstrated hypersensitivity to penicillins and in those with a history of allergy, asthma, hay fever or uticaria. Hypersensitivity reactions include skin rashes, urticaria, erythema multiforme, rare cases of Stevens-Johnson syndrome and less frequently exfoliative dermatitis and toxic epidermal necrolysis have been reported. Whenever such reactions occur, Bang Lin should be discontinued. Serious and occasional fatal hypersensitivity (anaphylactic) reactions and angioneurotic oedema can occur with oral penicillin.
Haematopoietic and Lymphatic: Anaemia, thrombocytopenia, thrombocytopenic purpura, eosinophilia, leucopenia and agranulocytosis have been reported during therapy with penicillins. These reactions are usually reversible on discontinuation of therapy and are believed to be hypersensitivity phenomena. A slight thrombocytosis was noted in patients treated with Bang Lin. Prolongation of bleeding time and prothrombin time have also been reported less frequently.
Amoxicillin (Bang Lin) alone or in combination with Clavulanic Acid (Bang Lin) has been associated with acute hepatic dysfunction. The incidence rate (95% confidence intervals) were 1.7 (1.1-2.7) (Amoxicillin (Bang Lin)-Clavulanic Acid (Bang Lin)) and 0.3 (0.2-0.5)/10,000 prescriptions (Amoxicillin (Bang Lin) alone). Risks were increased in patients receiving >1 course and in older recipients.
Central Nervous System: Reversible hyperactivity, agitation, anxiety, insomnia, confusion, behavioural changes and/or dizziness have also been reported. Depression, seizures or hallucinations.
Bang Lin contraindications
Hypersensitivity to the Amoxicillin (Bang Lin)/clavulanate potassium to any of the penicillins or to any of the excipients of Bang Lin.
History of a severe immediate hypersensitivity reaction (eg, anaphylaxis) to another β-lactam agent (eg, a cephalosporin, carbapenem or monobactam).
History of cholestatic jaundice/hepatic dysfunction due to Bang Lin.
Active ingredient matches for Bang Lin:
Amoxicillin/Clavulanic Acid in China.
List of Bang Lin substitutes (brand and generic names) | Sort by popularity |
| Unit description / dosage (Manufacturer) | Price, USD |
| BACTOVAN | |
| Bactovan 1000 mg/200 mg Injection (Bharat Serums & Vaccines Ltd) | $ 1.81 |
| BARCLAV | |
| BARCLAV 1000MG/200MG INJECTION 1 vial / 1 injection each (Bharti Life Sciences) | $ 2.31 |
| BARCLAV 250MG/125MG TABLET 1 strip / 10 tablets each (Bharti Life Sciences) | $ 1.38 |
| BARCLAV 500MG/125MG TABLET 1 strip / 6 tablets each (Bharti Life Sciences) | $ 1.72 |
| Barclav 1000 mg/200 mg Injection (Bharti Life Sciences) | $ 2.31 |
| Barclav 250 mg/125 mg Tablet (Bharti Life Sciences) | $ 0.14 |
| Barclav 500 mg/125 mg Tablet (Bharti Life Sciences) | $ 0.29 |
| BARCLAV PD | |
| BARCLAV PD 200MG/28.5MG SUSPENSION 1 bottle / 30 ML suspension each (Bharti Life Sciences) | $ 0.80 |
| Barclav PD 200 mg/28.5 mg Suspension (Bharti Life Sciences) | $ 0.80 |
| BARRISTER | |
| BARRISTER 200MG/28.5MG DRY SYRUP 1 bottle / 30 ML dry syrup each (Abaris Healthcare) | $ 0.67 |
| BARRISTER 250MG/125MG TABLET 1 strip / 6 tablets each (Abaris Healthcare) | $ 1.78 |
| BARRISTER 500MG/125MG TABLET 1 strip / 6 tablets each (Abaris Healthcare) | $ 2.18 |
| Barrister 250 mg/125 mg Tablet (Abaris Healthcare) | $ 0.30 |
| Barrister 500 mg/125 mg Tablet (Abaris Healthcare) | $ 0.36 |
| BARRISTER KID | |
| BARRISTER KID 200MG/28.5MG TABLET 1 strip / 6 tablets each (Abaris Healthcare) | $ 0.65 |
| Barrister Kid 200 mg/28.5 mg Tablet (Abaris Healthcare) | $ 0.11 |
| BAX CV | |
| BAX CV 1000MG/200MG INJECTION 1 vial / 1 ML injection each (Bio Warriors Pharmaceuticals Pvt Ltd) | $ 1.53 |
| BAX CV 200MG/28.5MG DRY SYRUP 1 bottle / 30 ML dry syrup each (Bio Warriors Pharmaceuticals Pvt Ltd) | $ 0.72 |
| BAX CV 400MG/57MG DRY SYRUP 1 bottle / 30 ML dry syrup each (Bio Warriors Pharmaceuticals Pvt Ltd) | $ 1.19 |
| BAX CV 500MG/125MG TABLET 1 strip / 6 tablets each (Bio Warriors Pharmaceuticals Pvt Ltd) | $ 1.50 |
| BAX CV 300MG INJECTION 1 vial / 1 injection each (Bio Warriors Pharmaceuticals Pvt Ltd) | $ 0.62 |
| Bax CV 1000 mg/200 mg Injection (Bio Warriors Pharmaceuticals Pvt Ltd) | $ 1.53 |
| Bax CV 200 mg/28.5 mg Dry Syrup (Bio Warriors Pharmaceuticals Pvt Ltd) | $ 0.72 |
| Bax CV 300mg Injection (Bio Warriors Pharmaceuticals Pvt Ltd) | $ 0.62 |
| Bax CV 400 mg/57 mg Dry Syrup (Bio Warriors Pharmaceuticals Pvt Ltd) | $ 1.19 |
| Bax CV 500 mg/125 mg Tablet (Bio Warriors Pharmaceuticals Pvt Ltd) | $ 0.25 |
| BAX CV 300 MG INJECTION | |
| BAX CV 300 MG INJECTION 1 vial / 1 injection each (Bio Warriors Pharmaceuticals Pvt Ltd) | $ 0.62 |
| BAX CV KID TABLET DT | |
| BAX CV KID TABLET DT 1 strip / 10 tablet dts each (Bio Warriors Pharmaceuticals Pvt Ltd) | $ 0.97 |
| Beeclav (India) | |
| Beeclav Amoxicillin trihydrate 500 mg, clavulanic acid 125 mg. CAP / 10 (Biocin) | |
| Beeclav Amoxicillin trihydrate 1 g, clavulanic acid 0.2 g. POWD / 1 (Biocin) | $ 2.33 |
| Beeclav Amoxycillin trihydrate 200 mg, clavulanic acid 28.5 mg. DRY-SYR / 30ml (Biocin) | $ 0.95 |
| BEECLAV cap 10's (Biocin) | |
| BEECLAV dry syr 30ml (Biocin) | $ 0.95 |
| Bellamox (Indonesia) | |
| Bellamox 15's (Soho) | $ 17.67 |
| Bellamox 60 mL x 1's (Soho) | $ 5.95 |
| Bellamox Forte 60 mL x 1's (Soho) | $ 8.68 |
| Bellamox Forte (Indonesia) | |
| Benzoclav (India) | |
| Benzoclav Amoxicillin Trihydrate 250mg, Clavulante 125mg TAB / 10 (Medreich Saimirra Ltd) | $ 3.31 |
| Benzoclav Amoxicillin Trihydrate 500mg, K Clavulante 125mg TAB / 7 (Medreich Saimirra Ltd) | $ 2.99 |
| Benzoclav Amoxicillin Trihydrate 875mg, K Clavulante 125mg TAB / 7 (Medreich Saimirra Ltd) | $ 4.16 |
| Benzoclav Amoxicillin Trihydrate 80mg, KClavulante 11.4mg DPS / 30ml (Medreich Saimirra Ltd) | $ 1.99 |
| 10's (Medreich Saimirra Ltd) | $ 3.31 |
See 7042 substitutes for Bang Lin | |
References
- DailyMed. "AMOXICILLIN; CLAVULANATE POTASSIUM: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- PubChem. "CLAVULANIC ACID". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
- PubChem. "amoxicillin". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology
