The tablets are indicated in the treatment of the following infections caused by ß-lactamase producing strains of bacteria sensitive to amoxicillin in combination with clavulanic acid:
•Skin infections (including superficial and deep pyodermas) caused by susceptible Staphylococci.
•Urinary tract infections caused by susceptible Staphylococci or Escherichia coli.
•Respiratory infections caused by susceptible Staphylococci.
•Enteritis caused by susceptible Escherichia coli. It is recommended to carry out suitable tests for sensitivity testing when initiating the treatment. The treatment should only proceed if sensitivity is proven to the combination.
Dosage and administration
Administration is via the oral route. The dosage rate is 12.5 mg combined actives/kg body weight twice daily. The tablets may be crushed and added to a little food.
The following tables are intended as a guide to dispensing the product at the standard dose rate of 12.5 mg of combined actives per kg twice daily.
Duration of therapy
Acute cases: 5 to 7 days of treatment. If no improvement is observed after 5 to 7 days, the diagnosis should be re-assessed. Chronic or refractory cases: In these cases where there is considerable tissue damage, a longer course of therapy may be required so that it allows sufficient time for damaged tissue to repair. If no improvement is observed after two weeks, the diagnosis should be re-assessed.
|Body weight (kg)||No. of 250 mg tablets twice daily|
|19 - 20||1|
|21 - 30||1½|
|31 - 40||2|
|41 - 50||2½|
|More than 50||3|
|Body Weight (kg)||No. of 500 mg tablets twice daily|
Duration of Therapy
Routine cases involving all indications: The majority of cases respond to between 5 and 7 days therapy. Chronic or refractory cases: In those cases where there is considerable tissue damage, a longer course of therapy may be required so that it allows sufficient time for damaged tissue to repair. If no improvement is observed after two weeks, the diagnosis should be re-assessed.
Use During Pregnancy or Lactation
Studies in laboratory animals have not produced any evidence of teratogenic effects. Use only according to the benefit/risk assessment by the responsible veterinarian.
Contra-indications, warnings, etc
Do not use in animals with known hypersensitivity to penicillin or other substances of the beta-lactam group.
Do not use in rabbits, guinea pigs, hamsters, gerbils, horses or ruminating animals.
Do not use in animals with serious dysfunction of the kidneys accompanied by anuria or oliguria.
Do not use where resistance to this combination is known to occur.
Inappropriate use of the product may increase the prevalence of bacteria resistant to amoxicillin/clavulanic acid.
In animals with hepatic and renal failure, the dosing regimen should be carefully evaluated.
Use of the product should be based on susceptibility testing and take into account official and local antimicrobial policies.
Narrow spectrum antibacterial therapy should be used for first line treatment where susceptibility testing suggests likely efficacy of this approach.
Caution is advised in the use in small herbivores other than those mentioned above.
Dogs and cats diagnosed with Pseudomonas infections should not be treated with this antibiotic combination.
The product is of a low order of toxicity and is well tolerated by the oral route.
In dogs no adverse effects have been reported after the daily administration of 3 times the recommended dose of 12.5mg of the combined actives administered twice daily for 8 days, and after the daily administration of the recommended dose for 21 days.
In cats no adverse effects have been reported after the twice daily administration of 3 times the recommended dose of 12.5mg of the combined actives administered for 15 days.
Hypersensitivity reactions unrelated to dose can occur with these agents.
Gastrointestinal symptoms (diarrhoea, vomiting) may occur after administration of the product.
Allergic reactions (e.g. skin reactions, anaphylaxis) may occasionally occur.
In case of occurrence of allergic reaction, the treatment should be withdrawn.
Chloramphenicol, macrolides, sulfonamides and tetracyclines may inhibit the antibacterial effect of penicillins because of the rapid onset of bacteriostatic action.
The potential for allergic cross-reactivity with other penicillins should be considered. Penicillins may increase the effect of aminoglycosides.
Penicillins and cephalosporins may cause hypersensitivity (allergy) following injection, inhalation, ingestion or skin contact.
Hypersensitivity to penicillins may lead to cross-reactions to cephalosporins and vice versa. Allergic reactions to these substances may occasionally be serious.
Do not handle this product if you know you are sensitised, or if you have been advised not to work with such preparations.
Handle this product with great care to avoid exposure, taking all recommended precautions and wash hands after use.
If you develop symptoms following exposure such as a skin rash, you should seek medical advice and show the doctor this warning. Swelling of the face, lips or eyes or difficulty with breathing are more serious symptoms and require urgent medical attention.
Any unused product or waste material should be disposed of in accordance with national requirements.
Do not store above 25°C.
Nisamox 500 mg Palatable Tablets: Any halved tablets should be returned to the open blister and used within one day.
Store in a dry place in the original package in order to protect from moisture.
Shelf-life of the veterinary medicinal product as packaged for sale: Blister packs: 2 years.
Legal category: POM-V
Nisamox 50 mg tablets – Aluminium blister strips containing 10 50 mg tablets presented in a pack containing 100 or 500 tablets.
Nisamox 250 mg tablets – Aluminium blister strips containing 5 250 mg tablets presented in a pack containing 50 or 250 tablets.
Nisamox 500 mg palatable tablets - Aluminium blister strips containing 5 500 mg tablets presented in a pack containing 100 tablets.
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