Drug/Small Molecule:
amoxicillin

PharmGKB contains no dosing guidelines for this drug/small molecule. To report known genotype-based dosing guidelines, or if you are interested in developing guidelines, click here.

PharmGKB gathers information regarding PGx on FDA drug labels from the FDA's "Table of Pharmacogenomic Biomarkers in Drug Labels", and from FDA-approved FDA and EMA-approved (European Medicines Agency) EMA labels brought to our attention. Excerpts from the label and downloadable highlighted label PDFs are manually curated by PharmGKB.

Please note that some drugs may have been removed from or added to the FDA's "Table of Pharmacogenomic Biomarkers in Drug Labels" without our knowledge. We periodically check the table for additions to this table and update PharmGKB accordingly.

There is currently no such list for European drug labels - we are working with the EMA to establish a list of European Public Assessment Reports (EPAR)s that contain PGx information. We are constructing this list by initially searching for drugs for which we have PGx-containing FDA drug labels - of these 44 EMA EPARs were identified and are being curated for pgx information.

We welcome any information regarding drug labels containing PGx information approved by the FDA, EMA or other Medicine Agencies around the world - please contact feedback.



PharmGKB contains no Clinical Variants that meet the highest level of criteria.

To see more Clinical Variants with lower levels of criteria, click the button at the bottom of the page.

Disclaimer: The PharmGKB's clinical annotations reflect expert consensus based on clinical evidence and peer-reviewed literature available at the time they are written and are intended only to assist clinicians in decision-making and to identify questions for further research. New evidence may have emerged since the time an annotation was submitted to the PharmGKB. The annotations are limited in scope and are not applicable to interventions or diseases that are not specifically identified.

The annotations do not account for individual variations among patients, and cannot be considered inclusive of all proper methods of care or exclusive of other treatments. It remains the responsibility of the health-care provider to determine the best course of treatment for a patient. Adherence to any guideline is voluntary, with the ultimate determination regarding its application to be made solely by the clinician and the patient. PharmGKB assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of the PharmGKB clinical annotations, or for any errors or omissions.

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This is a non-comprehensive list of genetic tests with pharmacogenetics relevance, typically submitted by the manufacturer and manually curated by PharmGKB. The information listed is provided for educational purposes only and does not constitute an endorsement of any listed test or manufacturer.

A more complete listing of genetic tests is found at the Genetic Testing Registry (GTR).

PGx Test Variants Assayed Gene?

The table below contains information about pharmacogenomic variants on PharmGKB. Please follow the link in the "Variant" column for more information about a particular variant. Each link in the "Variant" column leads to the corresponding PharmGKB Variant Page. The Variant Page contains summary data, including PharmGKB manually curated information about variant-drug pairs based on individual PubMed publications. The PMIDs for these PubMed publications can be found on the Variant Page.

The tags in the first column of the table indicate what type of information can be found on the corresponding Variant Page.

Links in the "Gene" column lead to PharmGKB Gene Pages.

Gene ? Variant?
(138)
Alternate Names / Tag SNPs ? Drugs ? Alleles ?
(+ chr strand)
Function ? Amino Acid?
Translation
No VIP available CA VA
rs9274407 122A>A, 122T>A, 32572832A>T, 32632832A>T, 3864927T>T, 3967118T>T, 4078473T>T, 4088493T>T, 6639A>A, Phe41Tyr, Tyr41=
T > A
Missense
Tyr41Phe
Alleles, Functions, and Amino Acid Translations are all sourced from dbSNP 138
2D structure from PubChem
provided by PubChem

Overview

Generic Names
  • AMC
  • Amoxicilina [INN-Spanish]
  • Amoxicillin Trihydrate
  • Amoxicillin anhydrous
  • Amoxicilline [INN-French]
  • Amoxicillinum [INN-Latin]
  • Amoxycillin
  • Amoxycillin Trihydrate
  • D-Amoxicillin
  • p-Hydroxyampicillin
Trade Names
  • AMPC
  • Actimoxi
  • Amoclen
  • Amolin
  • Amopen
  • Amopenixin
  • Amoxi
  • Amoxi-Mast
  • Amoxibiotic
  • Amoxiden
  • Amoxil
  • Amoxivet
  • Anemolin
  • Aspenil
  • Biomox
  • Bristamox
  • Cemoxin
  • Clamoxyl
  • Delacillin
  • Dispermox
  • Efpenix
  • Flemoxin
  • Hiconcil
  • Histocillin
  • Ibiamox
  • Imacillin
  • Lamoxy
  • Metafarma capsules
  • Metifarma capsules
  • Moxacin
  • Moxal
  • Ospamox
  • Pamoxicillin
  • Piramox
  • Polymox
  • Robamox
  • Sawamox PM
  • Sumox
  • Tolodina
  • Trimox
  • Unicillin
  • Utimox
  • Vetramox
  • Wymox
  • Zimox
Brand Mixture Names
  • Augmentin (amoxicillin + clavulanic acid)
  • Co-amoxiclav (amoxicillin + clavulanic acid)
  • Prevpac (amoxicillin + clarithromycin + lansoprazole)

PharmGKB Accession Id:
PA448406

Description

A broad-spectrum semisynthetic antibiotic similar to ampicillin except that its resistance to gastric acid permits higher serum levels with oral administration. Amoxicillin is commonly prescribed with clauvanic acid (a beta lactamase inhibitor) as it is susceptible to beta-lacatamase degradation.

Source: Drug Bank

Indication

For the treatment of infections of the ear, nose, and throat, the genitourinary tract, the skin and skin structure, and the lower respiratory tract due to susceptible (only b-lactamase-negative) strains of Streptococcus spp. (a- and b-hemolytic strains only), S. pneumoniae, Staphylococcus spp., H. influenzae, E. coli, P. mirabilis, or E. faecalis. Also for the treatment of acute, uncomplicated gonorrhea (ano-genital and urethral infections) due to N. gonorrhoeae (males and females).

Source: Drug Bank

Other Vocabularies

Information pulled from DrugBank has not been reviewed by PharmGKB.

Pharmacology, Interactions, and Contraindications

Mechanism of Action

Amoxicillin binds to penicillin-binding protein 1A (PBP-1A) located inside the bacterial cell well. Penicillins acylate the penicillin-sensitive transpeptidase C-terminal domain by opening the lactam ring. This inactivation of the enzyme prevents the formation of a cross-link of two linear peptidoglycan strands, inhibiting the third and last stage of bacterial cell wall synthesis. Cell lysis is then mediated by bacterial cell wall autolytic enzymes such as autolysins; it is possible that amoxicllin interferes with an autolysin inhibitor.

Source: Drug Bank

Pharmacology

Amoxicillin is a moderate-spectrum antibiotic active against a wide range of Gram-positive, and a limited range of Gram-negative organisms. It is usually the drug of choice within the class because it is better absorbed, following oral administration, than other beta-lactam antibiotics. Amoxicillin is susceptible to degradation by beta-lactamase-producing bacteria, and so may be given with clavulanic acid to increase its susceptability. The incidence of beta-lactamase-producing resistant organisms, including E. coli, appears to be increasing. Amoxicillin is sometimes combined with clavulanic acid, a beta-lactamase inhibitor, to increase the spectrum of action against Gram-negative organisms, and to overcome bacterial antibiotic resistance mediated through beta-lactamase production.

Source: Drug Bank

Food Interaction

Take without regard to meals.

Source: Drug Bank

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Hepatic metabolism accounts for less than 30% of the biotransformation of most penicillins

Source: Drug Bank

Protein Binding

In blood serum, amoxicillin is approximately 20% protein-bound

Source: Drug Bank

Absorption

Rapidly absorbed after oral administration.

Source: Drug Bank

Half-Life

61.3 minutes

Source: Drug Bank

Toxicity

Serious toxicity is unlikely following large doses of amoxicillin. Acute ingestion of large doses of amoxicillin may cause nausea, vomiting, diarrhea and abdominal pain. Acute oliguric renal failure and hematuria may occur following large doses.

Source: Drug Bank

Route of Elimination

Most of the amoxicillin is excreted unchanged in the urine; its excretion can be delayed by concurrent administration of probenecid.

Source: Drug Bank

Chemical Properties

Chemical Formula

C16H19N3O5S

Source: Drug Bank

Isomeric SMILES

CC1([C@@H](N2[C@H](S1)[C@@H](C2=O)NC(=O)[C@@H](c3ccc(cc3)O)N)C(=O)O)C

Source: OpenEye

Canonical SMILES

CC1(C)S[C@@H]2[C@H]

Source: Drug Bank

Average Molecular Weight

365.404

Source: Drug Bank

Monoisotopic Molecular Weight

365.104541423

Source: Drug Bank

Genes that are associated with this drug in PharmGKB's database based on (1) variant annotations, (2) literature review, (3) pathways or (4) information automatically retrieved from DrugBank, depending on the "evidence" and "source" listed below.

Curated Information ?

EvidenceGene
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
GSTT1
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
HLA-DQB1
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
NR1I2

Drug Interactions

Drug Description
demeclocycline Possible antagonism of action (source: Drug Bank)
doxycycline Possible antagonism of action (source: Drug Bank)
doxycycline Possible antagonism of action (source: Drug Bank)
ethinyl estradiol This anti-infectious agent could decrease the effect of the oral contraceptive (source: Drug Bank)
mestranol This anti-infectious agent could decrease the effect of the oral contraceptive (source: Drug Bank)
mestranol This anti-infectious agent could decrease the effect of the oral contraceptive (source: Drug Bank)
methacycline Possible antagonism of action (source: Drug Bank)
methotrexate The penicillin increases the effect and toxicity of methotrexate (source: Drug Bank)
methotrexate The penicillin increases the effect and toxicity of methotrexate (source: Drug Bank)
minocycline Possible antagonism of action (source: Drug Bank)
minocycline Possible antagonism of action (source: Drug Bank)
oxytetracycline Possible antagonism of action (source: Drug Bank)
oxytetracycline Possible antagonism of action (source: Drug Bank)
rolitetracycline Possible antagonism of action (source: Drug Bank)
tetracycline Possible antagonism of action (source: Drug Bank)
tetracycline Possible antagonism of action (source: Drug Bank)
amoxicillin Possible antagonism of action (source: Drug Bank)
amoxicillin Possible antagonism of action (source: Drug Bank)
amoxicillin Possible antagonism of action (source: Drug Bank)
amoxicillin This anti-infectious agent could decrease the effect of the oral contraceptive (source: Drug Bank)
amoxicillin This anti-infectious agent could decrease the effect of the oral contraceptive (source: Drug Bank)
amoxicillin The penicillin increases the effect and toxicity of methotrexate (source: Drug Bank)
amoxicillin The penicillin increases the effect and toxicity of methotrexate (source: Drug Bank)
amoxicillin Possible antagonism of action (source: Drug Bank)
amoxicillin Possible antagonism of action (source: Drug Bank)
amoxicillin Possible antagonism of action (source: Drug Bank)
amoxicillin Possible antagonism of action (source: Drug Bank)

Curated Information ?

EvidenceDisease
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Drug Toxicity

Relationships from National Drug File - Reference Terminology (NDF-RT)

May Treat
May Prevent
Contraindicated With

Publications related to amoxicillin: 10

No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
PharmGKB summary: very important pharmacogene information for GSTT1. Pharmacogenetics and genomics. 2012. Thorn Caroline F, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Susceptibility to amoxicillin-clavulanate-induced liver injury is influenced by multiple HLA class I and II alleles. Gastroenterology. 2011. Lucena M Isabel, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Genome-wide association study of serious blistering skin rash caused by drugs. The pharmacogenomics journal. 2011. Shen Y, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
A comprehensive in vitro and in silico analysis of antibiotics that activate pregnane X receptor and induce CYP3A4 in liver and intestine. Drug metabolism and disposition: the biological fate of chemicals. 2008. Yasuda Kazuto, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Glutathione S-transferase m1 and t1 null genotypes increase susceptibility to idiosyncratic drug-induced liver injury. Hepatology (Baltimore, Md.). 2008. Lucena M Isabel, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Amoxicillin pharmacokinetics in pregnant women: modeling and simulations of dosage strategies. Clinical pharmacology and therapeutics. 2007. Andrew M A, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Pharmacogenomics-based tailored versus standard therapeutic regimen for eradication of H. pylori. Clinical pharmacology and therapeutics. 2007. Furuta T, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Clinical impact of CYP2C19 polymorphism on the action of proton pump inhibitors: a review of a special problem. International journal of clinical pharmacology and therapeutics. 2006. Klotz U. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Interaction of 31 beta-lactam antibiotics with the H+/peptide symporter PEPT2: analysis of affinity constants and comparison with PEPT1. European journal of pharmaceutics and biopharmaceutics : official journal of Arbeitsgemeinschaft für Pharmazeutische Verfahrenstechnik e.V. 2005. Luckner Petra, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Glutathione S-transferase polymorphisms in patients with drug eruption. Archives of dermatological research. 2004. Ate¿ Nurcan Aras, et al. PubMed

LinkOuts

Web Resource:
Wikipedia
National Drug Code Directory:
0781-6039-58
DrugBank:
DB01060
ChEBI:
2676
KEGG Compound:
C06827
PubChem Compound:
33613
PubChem Substance:
175459
46507578
Drugs Product Database (DPD):
2262886
ChemSpider:
31006
Therapeutic Targets Database:
DAP000443
FDA Drug Label at DailyMed:
13bd4214-9b7f-425b-af5f-fc1ddc678230

Clinical Trials

These are trials that mention amoxicillin and are related to either pharmacogenetics or pharmacogenomics.

Common Searches

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Sources for PharmGKB drug information: DrugBank, Open Eye Scientific Software.