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Augmentin XR or Augmentin ?

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Folks just a warning. The maximum daily dosage for clavulanic acid is 600 mg for adults and 10 mg/kg body weight for children.


Typical Augmentin is 500/125 (meaning 500 of amoxicillin and 125 mg of Clavulanic Acid). If this was taken twice a day (i.e., 250 mg of Clavulanic Acid) then you need to weigh at least 55 lbs. If you are prescribed a higher amount then you need the XR formulation which is typically of the form 1000/62.5 which is 1000 mg of Augmentin and 62.5 mg clavulanic acid.

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I was wondering exactly what too much clavulanic acid might do to someone, so I decided to "Google" it. I see references to gastrointestinal distress (which my son has experienced), but a reference to liver toxicity and drug-induced hepatits was alarming:


clavulanic acid hepatits

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This is so interesting about the dosing guidelines, Alex. Thanks for sharing this!


I also thought that the 2000 mg daily dose was very high, because the highest treatment dose we could ever get prior to this was 1000 mg for a short period (10-14 days), then 500 mg daily prophylaxis after that. And every local doc we've spoken to reacts the same way: they act like that's an insanely high dose and ask about intestinal problems / risk of liver damage / etc. And our son is indeed 13 years old and > 100 pounds. It's reassuring to find out that the dose isn't "mega" after all, because it seems to be working for us, and we want to continue it until PANDAS is a distant memory (or at least as long as Sammy M did).


And - after your info - I'm very glad that Dr. K agreed to prescribe XR for our son. Thanks again!



Just one quick thoughut. On this forum I think the 'Saving Sammy' dose has been perceived as some really high dose. Turns out it is not. For anyone with a child/teen over say 100lbs then you would probably be a go for the full 4000mg daily (recommended in fact) dose of XR. Maybe better would be three pills spaced 8 hours apart to enhance the extended coverage aspect. The dosing guidlines that I read did allow for 8 hour spacing. The hard part about that would be that the XR is supposed to be taken immediately before a regular meal which would be tough to do on an 8 hour schedule.



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In reference to this thread, I belatedly recalled that my uncle is a pharmacist with the National Health Service and has been for over 40 years. So I asked him what he thought on the subject. His reply follows:


The AugmentXR 1000mg of Amoxicillin/ 62.5mg of Clavuanate Acid per tablet has less Clavuanate; however the daily dose is two tablet every 12 hours (daily dose of 4000mg/250mg) which is greater than the Augmentin formulation which is generically available and cheaper. It is interesting that the generic brands are made by the original drug company.Daily dose of Augmentin 875/250mg is every 8 hours. The daily dose is 2625mg/375mg. There is some evidence the higher amount od Clavuanate could cause some jaundice which is reversible. There are several web sites that can give you good data. Also you can google augmentxr and get several sites to read. The one I use is relist.com.


If Lucas is not responding as well as you think he should, then the AugmentXR would be the logical choice. But that decision should be basde on blood lab work that give concentration levels and liver function tests.

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Our best results were with the XR, but our son was taking that 1,000 mg. dose not once each day but twice, so he was actually getting 2,000 mg. XR while on the dosage.


Not only were his symptoms improved on the XR versus twice daily dosing of regular Augmentin at 875 mg., but the XR did not seem to upset his stomach or gut nearly as much.

I am so excited to hear this! We just came back from Dr. Latimer with a prescription for XR! We had seen progress with regular Augmentin + Steroids, but he was exposed again and we are almost back to square 1. So maybe he'll do better on the XR...

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  • 7 years later...

Hi . We see Dr. T in New Jersey and just switched to him recently and Best Alison Malhoney was our advocate and wanted our son on Augmentium XR but we could barely get our doctor to do the augmetium at all so after begging and pleading and thank go d we did it was the only antibiotic that got our song strep titers down from 800 to currently 236 ( Dr. T said  ) not the Reflex the other doctor was treating all his  " PANDAS" patients with. Out son needed up having PANS tats why we went to Dr T . Our son wasn't getting better he ended up having 2 infections strep and Sinusitis  ( Panusitis I think it's called ) so when he took over all PANDAS treatment ( now PANS) I asked him if he could increase the Augmentum of 875 2 times a day to 1000mg XR with the other doctor wouldn't and I he said sure why not it's better because of the following :

Extended release 

there is a component to it that kills off the antibodies that attack the brain ( during fares ) that the regular Agumentium doesn't 

And we only have to take it once a day and it's 1000 MG and he was taking 875 2 times a days before so lesser dose but more powerful because it's extend release ( I am not sure as to why) 

And the reason I believe doctors won't prescribe it is not cost related ( at least this is what my pharmacist told me when I ask way back) it's due to the weight and age of the child. So now that my son weighs more he can take the XR version and insurance has nothing to do with covering one or the other. it's prescribed by weight / age. At least that is what I was told and my insurance covers it ether way. Hope that helps. I worked with Both Beth Malhoney that wrote Saving Sammy and we see Dr. T so they are the ones that gave me the information on the Aumentium regular VS Augmetium XR.  Good luck. And Hapy New Year. And you can cut the pill in half we but the 1000 mg pill in half for our son and it doesn't make it any less effective , it's so he cantata it since it's so big. 


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