Quick Answer
Yes, it is generally safe to take 500mg of amoxicillin 4 times per day, resulting in a total daily dose of 2000mg. This dosage is commonly prescribed for bacterial infections like bronchitis, pneumonia, ear infections, sinus infections, urinary tract infections, and skin infections. The most common side effects are diarrhea, nausea, and vomiting. Taking amoxicillin with food can help minimize side effects. Do not take more than 4000mg per day without consulting your doctor. Completing the full course as prescribed is important to fully treat the infection.
What is Amoxicillin?
Amoxicillin is a penicillin-based antibiotic used to treat a wide variety of bacterial infections. It works by stopping the growth and killing susceptible bacteria by preventing them from forming cell walls. Amoxicillin was discovered in 1958 and first came into medical use in 1972. It is on the World Health Organization’s List of Essential Medicines.
Some key facts about amoxicillin:
- Drug class: Penicillin antibiotic
- Common brand names: Amoxil, Trimox, Wymox
- Available as capsules, tablets, chewable tablets, powder for suspension
- Usually taken every 8 or 12 hours
- Well-absorbed orally, widely distributed in the body
- Primarily eliminated through urine
Amoxicillin is used to treat infections caused by susceptible bacteria, including:
- Ear infections
- Sinus infections
- Skin infections
- Urinary tract infections
- Lower respiratory tract infections like bronchitis and pneumonia
- Bacterial throat infections like strep throat
It can be used alone or combined with other antibiotics to treat more severe infections. Amoxicillin is not effective against viral infections like the common cold or flu.
Typical Prescribed Dosage
A common dosage for amoxicillin is 500mg taken 3 times per day, which provides a total daily dose of 1500mg. However, depending on the type and severity of infection, doses can range from 250mg to 500mg taken from 2 to 4 times daily.
Some typical prescribed dosages of amoxicillin include:
- 250mg 3 times per day = 750mg total daily dose
- 500mg 2 times per day = 1000mg total daily dose
- 500mg 3 times per day = 1500mg total daily dose
- 875mg 2 times per day = 1750mg total daily dose
- 500mg 4 times per day = 2000mg total daily dose
Doses are often increased for more severe infections. However, doses above 4000mg per day are not recommended without medical supervision due to increased side effects.
In children, the dosage is based on weight, usually ranging from 20-50mg/kg/day divided into 2-4 doses.
Duration of Treatment
It is important to complete the full course of amoxicillin therapy as prescribed by your doctor, even if you start feeling better. Not finishing all doses can increase the risk that the infection will recur or that antibiotic resistance will develop.
Typical treatment length is:
- Ear infections: 5-7 days
- Sinus infections: 5-7 days
- Skin infections: 7-10 days
- Urinary tract infections: 5-7 days
- Bronchitis: 5-7 days
- Pneumonia: 7-14 days
- Strep throat: 10 days
Treatment should not be extended beyond 14 days without reevaluation.
Is 500mg 4 Times Daily Safe?
Yes, taking 500mg of amoxicillin 4 times a day, resulting in a total daily dose of 2000mg, is generally considered safe when prescribed by a doctor and taken correctly.
Higher doses may be prescribed for severe bacterial infections, recurrent infections, or those resistant to standard doses. Doses up to 4000mg per day are approved for medical use.
There are a few precautions to keep in mind with a 2000mg daily amoxicillin dose:
- Take with food – This can help minimize potential side effects like upset stomach.
- Space doses evenly – Take the 500mg dose every 6 hours for steady coverage.
- Finish full course – Take all doses as directed, even if feeling better.
- Stay hydrated – Drink plenty of fluids to help clear the drug and prevent kidney issues.
- Monitor side effects – Report severe diarrhea, rash, swelling or shortness of breath.
- Avoid other penicillins – Don’t take related antibiotics at the same time.
- Check for allergies – Make sure you are not allergic before starting.
Those with kidney disease may require dose adjustments based on kidney function tests. Very high doses above 4000mg per day can increase the risk of more severe side effects.
If taking 500mg amoxicillin 4 times per day, it’s recommended to follow up with your doctor after a few days to ensure the infection is improving.
Maximum Daily Dose
The maximum recommended daily dose of amoxicillin is 4000mg, divided into 4 or 6 doses of 500mg to 875mg every 8 hours.
Higher doses may be used in hospital settings or to treat very severe infections under close supervision. But routine use of more than 4000mg per day is not advised due to increased side effects:
- Nausea, vomiting, diarrhea
- Abdominal pain
- C. diff infection
- Allergic reaction (rash, swelling)
- Kidney injury
Talk to your doctor before increasing your amoxicillin dose above the typical recommendations. Make sure to monitor for signs of overdose like severe diarrhea or vomiting.
Side Effects
Amoxicillin is generally well tolerated, but some people may experience side effects, especially at higher doses. Common side effects include:
- Diarrhea – Most common side effect.
- Nausea and vomiting
- Abdominal discomfort
- Fungal infections like oral thrush
- Allergic reaction – rash, hives, itching, swelling.
Less common but serious side effects include:
- C. diff infection leading to severe diarrhea
- Liver toxicity – yellowing eyes or skin, dark urine
- Kidney injury – little or no urination.
- Anaphylaxis – life-threatening allergic reaction
Side effects are usually more common at higher doses. Taking amoxicillin with food and plenty of fluids can help reduce digestive upset. Contact your doctor if you experience severe diarrhea, rash, yellowing skin or eyes, or shortness of breath while taking amoxicillin.
Interactions
Amoxicillin can interact with other medications. Important interactions to discuss with your doctor include:
- Blood thinners like warfarin – Amoxicillin may increase bleeding risk
- Methotrexate – Increased methotrexate levels
- Probenecid – Decreased excretion of amoxicillin
- Birth control pills – May reduce contraceptive effectiveness
- Other penicillins or cephalosporins – Increased risk of side effects
Amoxicillin may reduce the effectiveness of live bacterial vaccines like typhoid vaccine. Probiotics can help restore good bacteria in the gut and prevent C. diff infection.
Special Considerations
There are a few important factors to consider when taking high-dose amoxicillin:
Kidney Function
Amoxicillin is eliminated through the kidneys, so kidney impairment can lead to build-up of the drug in the body. Severe kidney dysfunction may require dosage reductions to prevent drug accumulation and toxicity. Kidney function should be monitored in those on high doses.
Allergies
Amoxicillin can cause severe allergic reactions in those with penicillin hypersensitivity. Signs of an allergic reaction include rash, hives, swelling, and anaphylaxis. Use caution if you have any drug allergies.
Antibiotic Resistance
Overuse and misuse of amoxicillin can lead to antibiotic resistant bacteria. It should only be used for diagnosed bacterial infections and taken exactly as prescribed. Completing the full course is important to prevent resistance.
C. difficile Infection
Like other antibiotics, amoxicillin can increase the risk of C. diff infection leading to severe diarrhea. The highest risk is with prolonged use of high doses. Preventive measures include probiotics, proper hydration, and stopping treatment if severe diarrhea develops.
Pregnancy and Breastfeeding
Amoxicillin has been safely used in pregnant and breastfeeding women. It’s considered a preferred penicillin antibiotic in pregnancy due to its good safety profile. As with any drug, the benefits should be weighed against potential risks.
| Prescribed Dose | 500mg 4 times per day = 2000mg total daily dose |
| Maximum Daily Dose | 4000mg per day, divided into 4-6 doses |
| Common Uses | Bronchitis, pneumonia, strep throat, UTIs, ear/sinus infections |
| Duration of Treatment | Usually 5-14 days depending on infection type |
| Side Effects | Diarrhea, nausea, vomiting, allergic reaction |
| Precautions | Take with food, monitor kidney function, check for allergies, watch for C. diff infection |
Conclusion
In conclusion, taking 500mg of amoxicillin 4 times daily, resulting in a 2000mg total daily dose, is generally considered safe and effective when prescribed by a doctor for bacterial infections like pneumonia, bronchitis, or skin infections.
Completing the full course is important to fully clear the infection. The most common side effects are digestive upset and diarrhea. To reduce side effects, take with food and avoid other penicillin antibiotics. Very high doses above 4000mg per day are not recommended. Kidney function and allergy risk should be assessed when using high doses.
With proper precautions, a 2000mg total daily amoxicillin dose can safely and effectively treat a variety of moderate to severe bacterial infections. But it’s important to always take medication as directed by your doctor. Contact your doctor if you have any concerns about dosage or experience any troublesome side effects while taking amoxicillin.