Sandoz Co-Amoxyclav is co-amoxiclav — amoxicillin combined with clavulanic acid. It treats bacterial infections that plain amoxicillin cannot, because the second ingredient disables the enzyme resistant bacteria use to destroy penicillins. It is used for chest, sinus, ear, urinary, dental, skin and bite infections.
What is Sandoz Co Amoxyclav?
The South African Medicine Price Registry lists Sandoz Co Amoxyclav as a Schedule 4 injection:
| Product | Form | Contains |
|---|---|---|
| Sandoz Co Amoxyclav vial 20 ml | Injection | Amoxicillin 1 g + clavulanic acid 200 mg |
The numbers people usually search for — 375, 625 and 1000 — are the standard oral tablet strengths of co-amoxiclav, and they refer to the total of both ingredients:
- 375 mg = amoxicillin 250 mg + clavulanic acid 125 mg
- 625 mg = amoxicillin 500 mg + clavulanic acid 125 mg
- 1000 mg (often written 1 g) = amoxicillin 875 mg + clavulanic acid 125 mg
Note that the clavulanic acid stays at 125 mg while the amoxicillin rises. This is why two 625 mg tablets are not the same as one 1000 mg tablet — doubling up doubles the clavulanic acid too, which mostly adds diarrhoea rather than antibacterial effect. Take the strength you were prescribed.
Under this exact brand name, the register lists the injection. Oral co-amoxiclav is widely registered in South Africa under many other names, and the medicine is the same combination whichever brand you receive.
How the combination works. Amoxicillin blocks bacteria from building their cell walls. Many bacteria defend themselves by producing beta-lactamase, an enzyme that breaks amoxicillin apart before it can act. Clavulanic acid has almost no antibacterial activity of its own — its job is to bind that enzyme and disable it, leaving the amoxicillin free to work. It is a chemical bodyguard rather than a second antibiotic.
What is Sandoz Co Amoxyclav commonly used for?
Co-amoxiclav is used where resistance is likely or the infection is more serious:
- Chest infections — bronchitis and pneumonia, especially where amoxicillin has failed.
- Sinusitis that is not settling.
- Middle ear infection, particularly recurrent or unresponsive cases.
- Urinary tract infections, including some kidney infections.
- Dental infections and abscesses, alongside dental treatment.
- Skin and soft tissue infections, including cellulitis and infected wounds.
- Animal and human bites. This is a use where co-amoxiclav is specifically preferred, because bite wounds carry a mix of organisms it covers well.
- Bone and joint infections, and intra-abdominal infections, usually starting intravenously.
- Preventing infection around some surgery — which is where the injection form is most often used.
It will not help colds, flu or most sore throats and coughs, which are viral.
Co-amoxiclav is deliberately a second-line choice in many settings. It is broader than amoxicillin, which means it kills more of your normal bacteria along with the target and puts more pressure on resistance. Being prescribed it means someone judged that breadth necessary — not that your infection is trivial.
How Sandoz Co Amoxyclav fits into this medicine category
| Group | Examples | Typical role |
|---|---|---|
| Penicillin + inhibitor | Co-amoxiclav | Where beta-lactamase defeats plain amoxicillin |
| Aminopenicillins | Amoxicillin | Broad first-line cover |
| Penicillinase-resistant penicillins | Cloxacillin, flucloxacillin | Staphylococcal skin and soft tissue infection |
| Macrolides | Azithromycin (Azrotrin), erythromycin | Alternative in penicillin allergy; atypical pneumonia |
| Nitroimidazoles | Metronidazole | Anaerobic and dental infections |
| Cephalosporins | Cefuroxime, ceftriaxone | Alternative broad cover |
See the antibiotics and antimicrobials hub.
What to check before using Sandoz Co Amoxyclav
Penicillin allergy is the critical check. If you have ever reacted to penicillin, amoxicillin, co-amoxiclav or a cephalosporin, say so before the first dose. A previous mild reaction does not guarantee the next will be mild.
Also tell your doctor or pharmacist if you:
- Have liver disease, or have had jaundice or a liver reaction with co-amoxiclav before. This matters more than with most antibiotics — liver injury is uncommon but is more frequently associated with co-amoxiclav than with plain amoxicillin, is more likely in older people and with longer courses, and can appear weeks after the course ends. A previous liver reaction to it usually rules out ever taking it again.
- Have kidney disease — the dose may need adjusting.
- Have glandular fever (infectious mononucleosis), where a widespread rash is very likely.
- Take warfarin, methotrexate or allopurinol.
- Are pregnant or breastfeeding. Generally considered acceptable, but confirm with your clinician.
- Use the combined oral contraceptive pill and develop vomiting or diarrhoea during the course.
Practical points:
- Take it at the start of a meal. This reduces stomach upset and improves absorption — more important with co-amoxiclav than with plain amoxicillin, because the clavulanic acid is what irritates the gut.
- Space doses evenly as directed.
- Finish the full course.
- Do not substitute strengths. Two smaller tablets do not equal one larger one.
Possible cautions and when to ask a pharmacist or doctor
The most common effects are diarrhoea, nausea, vomiting and rash. Diarrhoea is notably more common with co-amoxiclav than with amoxicillin alone, and is caused by the clavulanic acid.
Get emergency help for:
- Swelling of the face, lips or tongue, difficulty breathing, widespread hives, or a rash with blistering or peeling — signs of a serious allergic reaction. Stop taking it.
- Severe, watery or bloody diarrhoea, especially with fever or cramping, during or in the weeks after the course. This may indicate Clostridioides difficile infection and needs assessment rather than an anti-diarrhoeal from the shelf.
- Yellowing of the skin or eyes, dark urine, pale stools, itching, or persistent right-sided abdominal pain — possible liver injury. Seek advice even if the course finished weeks ago.
Contact your doctor if:
- The infection is not improving after two to three days, or is spreading.
- You develop fever, breathlessness, confusion, or feel markedly worse.
- Thrush develops — oral or vaginal — which is common after broad antibiotics and easily treated.
- You have been bitten, and the wound becomes red, swollen, hot or painful, or you are unsure about tetanus or rabies risk. Bites need proper assessment, not antibiotics alone.
Related medicine guides
Frequently asked questions
What is Sandoz Co-Amoxyclav 625 used for? Bacterial infections of the chest, sinuses, ears, urinary tract, teeth, skin and bite wounds — particularly where plain amoxicillin has failed or resistance is likely. 625 mg is a standard adult oral strength.
What is Sandoz Co-Amoxyclav 1000 used for? The same infections at a higher amoxicillin dose, used for more serious infections or heavier patients.
What is the difference between 375, 625 and 1000? The amoxicillin component rises; the clavulanic acid stays at 125 mg. They are not interchangeable by combining smaller tablets.
How is it different from amoxicillin? Clavulanic acid disables the enzyme many bacteria use to destroy amoxicillin, so the combination works where amoxicillin alone would fail.
Why does it upset my stomach more than amoxicillin? The clavulanic acid is responsible for most of the diarrhoea and nausea. Taking it at the start of a meal helps.
Can I take it if I am allergic to penicillin? No. It contains amoxicillin, a penicillin. Tell your prescriber so an alternative can be used.
Will it treat flu? No. Flu is viral and antibiotics have no effect on it.
Do I need a prescription? Yes. It is Schedule 4 in South Africa.