- Stock: In Stock
- Brand: Beximco Pharmaceutical
- Product ID: Amoxicillin + Clavulanic Acid
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Tyclav BID Suspension 228.5mg/5ml — Twice-Daily Co-Amoxiclav Oral Suspension | Beximco Pharmaceuticals
| Generic Names | Amoxicillin Trihydrate 200 mg + Potassium Clavulanate 28.5 mg per 5 ml |
| Concentration | 228.5 mg total co-amoxiclav per 5 ml |
| Dosage Form | Powder for Oral Suspension (BID / twice-daily formulation) |
| Dosing Schedule | Twice daily (BD / q12h) — key advantage over standard TDS suspension |
| Manufacturer | Beximco Pharmaceuticals Ltd. |
| Therapeutic Class | Beta-Lactamase Protected Aminopenicillin (Co-amoxiclav) — BD Oral Suspension |
| Brand Equivalent | Augmentin Duo Suspension / Augmentin ES 228.5 (GSK) — same formulation |
Overview
Tyclav BID Suspension is Beximco's twice-daily co-amoxiclav suspension — Amoxicillin 200mg + Clavulanic Acid 28.5mg per 5ml. The BID formulation was specifically developed to overcome the compliance challenge of three-times-daily suspensions in young children. By giving a larger amoxicillin dose per 5ml (200mg vs 125mg), twice-daily administration achieves equivalent 24-hour amoxicillin exposure to the standard TDS suspension. The clavulanate ratio is intentionally kept lower (28.5mg vs 31.25mg per 5ml) to minimise diarrhoea, which is a common reason parents discontinue antibiotic courses early. Equivalent to Augmentin Duo suspension internationally.
BID vs TDS Suspension — Key Differences
| Feature | Tyclav Suspension (TDS) | Tyclav BID Suspension (this) |
|---|---|---|
| Strength per 5ml | Amoxicillin 125mg + Clav 31.25mg (156.25mg) | Amoxicillin 200mg + Clav 28.5mg (228.5mg) |
| Dosing frequency | 3× daily (every 8 hours) | 2× daily (every 12 hours) |
| Total daily clavulanate | 93.75mg (3× 31.25mg) | 57mg (2× 28.5mg) |
| GI side effects | More (higher daily clavulanate) | Less (lower daily clavulanate) |
| Compliance | Harder (school-age: midday dose issue) | Better (morning + evening only) |
| Best for | Standard first-line use | School-age children, compliance issues, reduced diarrhoea |
Indications
- Acute Otitis Media (AOM) — particularly treatment-failure after standard amoxicillin; first-choice in areas with high resistant H. influenzae rates
- Acute Sinusitis — persistent bacterial sinusitis; severe or treatment-failure cases
- Lower Respiratory Tract Infections — community-acquired pneumonia, bronchitis, LRTI with resistant organisms
- Tonsillitis / Pharyngitis — beta-lactamase-producing Streptococci, S. aureus
- Skin & Soft Tissue Infections — impetigo, wound infections, infected eczema
- Urinary Tract Infections — amoxicillin-resistant organisms
- Animal Bite Wounds
Paediatric Dosage Guide
| Weight | Dose (Amoxicillin component) | Volume (228.5mg/5ml) | Frequency |
|---|---|---|---|
| 3–6 kg (0–3 months) | Neonates — consult physician | — | Use plain amoxicillin; co-amoxiclav generally not used <3 months |
| 6–10 kg (~3–12 months) | 125 mg per dose | 3.1 ml BD | Twice daily |
| 10–15 kg (1–3 years) | 187.5 mg per dose | 4.7 ml BD | Twice daily |
| 15–20 kg (3–6 years) | 250 mg per dose | 6.25 ml BD | Twice daily |
| 20–30 kg (6–10 years) | 375 mg per dose | 9.4 ml BD | Twice daily |
| 30–40 kg (10–12 years) | 500 mg per dose | 12.5 ml BD | Twice daily |
| Over 40 kg / Adults | Use tablets (Tyclav 625mg BD or 1gm BD) | — | Switch to tablets |
Important: Doses are approximate guides. Physician must confirm exact dose based on current weight, indication, and severity. Do not exceed adult dose.
Reconstitution & Storage
- Tap bottle to loosen powder; add cooled boiled water in two portions to the calibration mark
- Shake well after each addition; shake vigorously before every dose
- Store in refrigerator (2–8°C) after reconstitution
- Discard after 7 days of reconstitution
- Do not freeze. Write reconstitution date on label.
Special Note for Diabetic Patients / Parents of Diabetic Children
Tyclav BID suspension contains sucrose as a suspending agent. Diabetic parents managing a diabetic child should note the sugar content per dose and factor it into carbohydrate counting. The antibiotic components (amoxicillin, clavulanate) have no glucose-raising pharmacological action. For adult diabetic patients, Tyclav 1gm tablet BD (sugar-free) is preferred over suspension where possible. The twice-daily regimen of Tyclav BID suspension aligns well with morning and evening medication schedules common in diabetes management.
Side Effects
- GI: Diarrhoea, nausea — less frequent than TDS suspension due to lower daily clavulanate; still give with food
- Skin: Rash, urticaria; amoxicillin rash in EBV mononucleosis
- Hypersensitivity: Anaphylaxis (rare; avoid in penicillin allergy)
- Superinfection: Oral thrush in infants — especially with prolonged courses
FAQ
Q1: Why is clavulanate lower in BID suspension (28.5mg) vs TDS suspension (31.25mg per 5ml)?
The total daily clavulanate is what matters for safety — BID suspension gives 57mg/day (2 × 28.5mg) vs 93.75mg/day for TDS suspension. Lower daily clavulanate significantly reduces diarrhoea and GI upset, which is one of the main reasons parents stop antibiotic courses early. The 28.5mg per dose is still more than adequate for beta-lactamase inhibition, so spectrum is maintained with better tolerability.
Q2: Is there an age restriction for Tyclav BID Suspension?
Generally not recommended for neonates under 3 months (limited data and different pharmacokinetics in this age group). For children 3 months and older, Tyclav BID Suspension is safe at weight-appropriate doses. Always confirm with the prescribing physician.
Q3: My child missed a BID dose. What should I do?
If the missed dose is remembered within 4–5 hours of when it was due, give it immediately. If it is closer to the time of the next dose (within 2–3 hours), skip the missed dose and continue normally. Never double a dose. Maintain the every-12-hour schedule as consistently as possible.
Q4: Can Tyclav BID Suspension be mixed with milk or juice?
You can mix the measured dose with a small amount of cold milk, formula, or fruit juice immediately before administration. Do not mix the full bottle with liquid, and do not pre-mix doses in advance. Ensure the child takes the full mixed volume to receive the complete dose.
Medical Disclaimer: Paediatric antibiotic dosing must be confirmed by a qualified physician based on the child's current weight and clinical condition. Prescription required. Complete the full antibiotic course even if the child improves.
