What are the potential interactions of Augmentin with other drugs. How does Augmentin affect alcohol consumption. What are the contraindications for Augmentin use. How does Augmentin interact with specific medications like allopurinol and oral contraceptives. What are the side effects and proper dosage guidelines for Augmentin.

Understanding Augmentin: An Overview of Its Uses and Mechanism

Augmentin is a brand-name prescription medication that combines two active ingredients: amoxicillin and clavulanate potassium. This powerful antibiotic is widely used to treat various bacterial infections, including ear infections, urinary tract infections (UTIs), and pneumonia. Its effectiveness stems from the synergistic action of its components, where amoxicillin attacks bacterial cell walls while clavulanate potassium prevents bacteria from developing resistance.

How does Augmentin work to combat bacterial infections? The amoxicillin component belongs to the penicillin family of antibiotics. It interferes with the bacterial cell wall synthesis, causing the bacteria to become unstable and eventually die. Clavulanate potassium, on the other hand, inhibits beta-lactamase enzymes produced by some bacteria that would otherwise inactivate amoxicillin. This combination allows Augmentin to be effective against a broader spectrum of bacteria compared to amoxicillin alone.

Common Conditions Treated with Augmentin

• Respiratory tract infections (bronchitis, pneumonia)
• Skin and soft tissue infections
• Urinary tract infections
• Dental infections
• Sinus infections
• Ear infections

Augmentin Interactions: What You Need to Know

Drug interactions can significantly impact the effectiveness and safety of medications. In the case of Augmentin, several important interactions should be considered. These interactions can alter the drug’s effectiveness or increase the risk of side effects.

Are there any foods or supplements that interact with Augmentin? Unlike some medications, Augmentin is not known to have significant interactions with foods or supplements. However, it’s always best to consult with your healthcare provider about your diet and supplement regimen while taking any medication.

Key Drug Interactions with Augmentin

1. Probenecid: Can increase the risk of Augmentin side effects
2. Allopurinol: May increase the likelihood of skin rashes
3. Oral blood thinners: Augmentin can enhance their effects
4. Oral contraceptives: Augmentin may decrease their effectiveness

Augmentin and Alcohol: Separating Fact from Fiction

One common concern among patients is the interaction between medications and alcohol. Can you drink alcohol while taking Augmentin? Unlike some antibiotics that have severe interactions with alcohol, such as metronidazole (Flagyl), there is no known direct interaction between Augmentin and alcohol.

However, this doesn’t mean that drinking alcohol while on Augmentin is without risks. Alcohol consumption can exacerbate certain side effects of Augmentin, particularly gastrointestinal issues like nausea and vomiting. Moreover, both alcohol and Augmentin can strain the liver, potentially increasing the risk of liver-related side effects.

What precautions should you take regarding alcohol consumption while on Augmentin? It’s advisable to limit or avoid alcohol during your course of treatment. This approach can help minimize potential side effects and ensure the medication works as effectively as possible. Always consult your healthcare provider for personalized advice on alcohol consumption while taking Augmentin.

Contraindications: When Augmentin Should Be Avoided

Certain medical conditions or previous experiences may contraindicate the use of Augmentin. Understanding these contraindications is crucial for patient safety and treatment effectiveness.

History of Allergic Reactions

Have you ever experienced an allergic reaction to antibiotics? If you’ve had an allergic reaction to Augmentin, its ingredients, or other similar antibiotics in the past, it’s crucial to inform your doctor. This includes reactions to:

• Amoxicillin or clavulanate potassium (the active ingredients in Augmentin)
• Other penicillin antibiotics
• Cephalosporin antibiotics

Why is a history of allergic reactions so important? Allergic reactions to antibiotics can be severe and potentially life-threatening. Your doctor needs this information to assess whether Augmentin is safe for you or if an alternative antibiotic should be considered.

Liver Problems

Augmentin has been associated with rare cases of liver problems, including hepatitis and jaundice. If you have a history of liver issues, particularly if they occurred while taking Augmentin in the past, your risk of experiencing these side effects may be higher.

How does a history of liver problems affect Augmentin use? Your doctor will carefully weigh the potential benefits of Augmentin against the risks based on your medical history. They may choose to prescribe an alternative antibiotic or monitor your liver function closely if Augmentin is deemed necessary.

Delving Deeper: Specific Drug Interactions with Augmentin

While Augmentin is generally well-tolerated, its interactions with certain medications can lead to significant effects. Understanding these interactions is crucial for both healthcare providers and patients to ensure safe and effective treatment.

Augmentin and Allopurinol

Allopurinol, commonly used to treat gout and kidney stones, can interact with Augmentin. This interaction increases the risk of developing a skin rash as a side effect of Augmentin.

Why does this interaction occur? The exact mechanism isn’t fully understood, but it’s believed that both medications independently carry a risk of causing skin rashes. When taken together, this risk may be amplified. If you’re prescribed both medications, your doctor will carefully monitor you for any skin reactions.

Augmentin and Oral Contraceptives

One of the most significant interactions to be aware of is between Augmentin and oral contraceptives. Augmentin can potentially decrease the effectiveness of birth control pills, increasing the risk of unintended pregnancy.

How does Augmentin affect oral contraceptives? Augmentin may alter the balance of bacteria in the gut, which can interfere with the absorption and metabolism of estrogen in birth control pills. This can lead to lower levels of the contraceptive hormones in the body, potentially compromising their effectiveness.

What precautions should be taken when using Augmentin with oral contraceptives? If you’re taking oral contraceptives, it’s crucial to use additional forms of contraception while on Augmentin and for at least 7 days after completing the antibiotic course. Always consult with your healthcare provider for personalized advice.

Side Effects of Augmentin: What to Expect and When to Seek Help

Like all medications, Augmentin can cause side effects. While many people tolerate the medication well, it’s important to be aware of potential adverse reactions.

Common Side Effects

• Diarrhea
• Nausea
• Vomiting
• Skin rash
• Headache

These side effects are usually mild and resolve on their own. However, if they persist or worsen, it’s important to consult your healthcare provider.

Serious Side Effects

While rare, serious side effects can occur with Augmentin use. These include:

• Severe allergic reactions (anaphylaxis)
• Liver problems (hepatitis, jaundice)
• Clostridium difficile-associated diarrhea
• Stevens-Johnson syndrome or toxic epidermal necrolysis (severe skin reactions)

When should you seek immediate medical attention while taking Augmentin? If you experience symptoms such as severe skin rash, yellowing of the skin or eyes, persistent severe diarrhea, or signs of an allergic reaction (like difficulty breathing or swelling of the face, lips, tongue, or throat), seek emergency medical care immediately.

Dosage Guidelines: Ensuring Proper Use of Augmentin

Proper dosing of Augmentin is crucial for its effectiveness and safety. The dosage can vary depending on several factors, including the type and severity of the infection, the patient’s age, weight, and kidney function.

Adult Dosage

For most infections in adults, the typical dosage of Augmentin is:

• 875 mg/125 mg tablet twice daily, or
• 500 mg/125 mg tablet three times daily

How long should you take Augmentin? The duration of treatment usually ranges from 7 to 14 days, depending on the type and severity of the infection. It’s crucial to complete the entire course of antibiotics as prescribed, even if you start feeling better before it’s finished.

Pediatric Dosage

For children, the dosage is typically based on body weight. The usual recommended dose is:

• 25-45 mg/kg/day divided into two doses for mild to moderate infections
• 45-90 mg/kg/day divided into two doses for severe infections

What factors influence the dosing of Augmentin in children? Age, weight, and the severity of the infection all play a role in determining the appropriate dose. Your pediatrician will calculate the correct dosage based on these factors.

Cost Considerations: Making Augmentin Treatment Accessible

The cost of Augmentin can vary widely depending on factors such as insurance coverage, pharmacy pricing, and whether a generic version is used. Understanding these factors can help patients manage the financial aspects of their treatment.

Brand-name vs. Generic Augmentin

Generic versions of Augmentin (amoxicillin/clavulanate potassium) are available and are typically much less expensive than the brand-name version. Generic medications contain the same active ingredients and are required to meet the same quality standards as brand-name drugs.

Is generic Augmentin as effective as the brand-name version? Yes, generic Augmentin is considered to be just as safe and effective as the brand-name version. The FDA requires generic drugs to have the same quality, strength, purity, and stability as brand-name drugs.

Insurance Coverage and Assistance Programs

Many insurance plans cover Augmentin, but coverage can vary. Some plans may require a higher copay for brand-name Augmentin compared to the generic version. For those without insurance or with high out-of-pocket costs, there are several options to consider:

• Pharmacy discount cards
• Manufacturer assistance programs
• Comparison shopping among different pharmacies
• Asking your doctor about less expensive antibiotic alternatives if appropriate for your condition

How can you find the most cost-effective option for Augmentin? Start by checking with your insurance provider about coverage and copay amounts. If costs are still high, discuss with your healthcare provider or pharmacist about generic options or assistance programs that might be available.

Maximizing Augmentin’s Effectiveness: Tips for Patients

To get the most benefit from Augmentin treatment while minimizing risks, patients should follow certain guidelines. These tips can help ensure the medication works effectively and reduces the likelihood of side effects or complications.

Proper Administration

• Take Augmentin exactly as prescribed by your healthcare provider
• Complete the entire course of antibiotics, even if you start feeling better
• Take Augmentin with food to reduce the risk of gastrointestinal side effects
• Space doses evenly throughout the day to maintain consistent levels of the medication in your body

Why is it crucial to complete the entire course of Augmentin? Stopping the medication early, even if you feel better, can lead to antibiotic resistance and potentially allow the infection to return.

Monitoring and Follow-up

While taking Augmentin, it’s important to:

• Monitor for side effects and report any concerns to your healthcare provider
• Attend any follow-up appointments scheduled by your doctor
• Inform your doctor if your symptoms don’t improve or if they worsen

How can you tell if Augmentin is working effectively? You should start to feel improvement in your symptoms within a few days of starting the medication. If you don’t notice any improvement after 3-4 days, or if your symptoms worsen, contact your healthcare provider.

The Future of Antibiotic Treatment: Augmentin and Beyond

As antibiotic resistance continues to be a global health concern, the role of combination antibiotics like Augmentin becomes increasingly important. Understanding the current landscape and future directions of antibiotic treatment can help patients and healthcare providers make informed decisions.

Combating Antibiotic Resistance

Augmentin’s combination of amoxicillin and clavulanate potassium represents an important strategy in the fight against antibiotic resistance. By inhibiting beta-lactamase enzymes, clavulanate potassium helps prevent bacteria from developing resistance to amoxicillin.

How does responsible use of Augmentin contribute to combating antibiotic resistance? By using Augmentin only when necessary, completing the full course of treatment, and following proper administration guidelines, patients can help slow the development of antibiotic-resistant bacteria.

Emerging Alternatives and Research

While Augmentin remains an important tool in treating bacterial infections, research continues on new antibiotics and alternative approaches to combat infection. Some areas of ongoing research include:

• Development of new combination antibiotics
• Exploration of bacteriophage therapy
• Investigation of novel drug delivery methods
• Research into antibiotic-enhancing compounds

What potential alternatives to Augmentin are on the horizon? While specific alternatives are still in development, researchers are exploring various approaches, including new antibiotic combinations, novel mechanisms of action, and even non-antibiotic therapies to treat bacterial infections.

Other drugs, supplements, and more

Augmentin (amoxicillin/clavulanate potassium) is a brand-name prescription drug used to treat bacterial infections. Examples include ear infections, urinary tract infections (UTIs), and pneumonia.

As with other medications, Augmentin can interact with certain other drugs. However, the drug is not known to interact with alcohol, supplements, or foods.

For details about Augmentin’s interactions, keep reading. For additional information about Augmentin, including details about its uses, see this article.

What’s an interaction?

An interaction occurs when one substance causes another substance to have a different effect than expected. For example, sometimes alcohol, a supplement, or another drug can affect how a drug acts in your body. Other times, a drug may change the way these substances act in your system. Interactions with a drug can also occur if you have certain conditions.

To help prevent interactions with Augmentin or any drug, talk with your doctor and pharmacist. Tell them whether you drink alcohol and which medications and supplements you take.

In some cases, a factor or condition could prevent your doctor from prescribing Augmentin due to the risk of harm. This is known as a contraindication. The contraindications of Augmentin include:

If you’ve had an allergic reaction

Before taking Augmentin, tell your doctor if you’ve had an allergic reaction to Augmentin or its ingredients in the past. Also tell them if you’ve had an allergic reaction to any of the following:

• amoxicillin or clavulanate potassium, which are the active drugs in Augmentin
• certain other antibiotics, such as penicillins or cephalosporins

Your risk of an allergic reaction with Augmentin may be higher if you’ve already had an allergic reaction to any of the above drugs. Be sure to tell your doctor if you’ve experienced this, and they’ll determine whether Augmentin is safe for you to take.

If you’ve had liver problems

Augmentin can rarely cause certain liver problems as side effects. Examples include:

• hepatitis (inflammation of the liver)
• jaundice

Your risk of liver problems with Augmentin may be higher if you’ve had liver problems in the past.

Before you start treatment with Augmentin, it’s important to tell your doctor if you’ve had liver problems, particularly with Augmentin in the past. They can determine whether to prescribe this drug for your condition.

There’s no known interaction between Augmentin and alcohol.

Some antibiotics do interact with alcohol, such as Flagyl (metronidazole). Augmentin is a type of antibiotic, but it’s not known to have this interaction.

However, keep in mind that drinking alcohol while taking Augmentin could worsen some of the drug’s side effects. Examples include nausea and vomiting or liver problems. (For details about possible side effects of Augmentin, see this article.)

If you drink alcohol, talk with your doctor before taking Augmentin. They can recommend whether you should limit the amount of alcohol you drink while taking the drug.

Before you start treatment with Augmentin, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you or what not to take with Augmentin, ask your doctor or pharmacist.

Here’s a chart of drugs that can interact with Augmentin. Doctors typically won’t prescribe the below medications with Augmentin. Keep in mind that this chart does not include all drugs that may interact with Augmentin. Some of these interactions are described in detail just below in “Drug interactions in depth.”

Here’s a closer look at certain drug interactions of Augmentin.

Allopurinol

Allopurinol (Lopurin, Zyloprim) is a medication used to treat conditions such as gout and kidney stones.

Interaction result. Taking Augmentin with allopurinol can increase the risk of rash as a side effect of Augmentin.

Interaction explained. It’s not known for certain how allopurinol may increase the risk of rash with Augmentin. It’s thought that both medications have a risk for rash when taken individually. Therefore, taking Augmentin and allopurinol together may increase the risk of rash even more.

Steps you or your doctor may take. Before taking Augmentin, be sure your doctor knows if you’re taking allopurinol. They can advise whether it’s safe for you to take these medications together.

If you do take Augmentin while taking allopurinol, watch for skin warmth, redness, or discoloration. These are possible symptoms of a skin rash. If you have these symptoms, tell your doctor right away. They’ll recommend whether you should keep taking Augmentin or allopurinol.

Oral blood thinners

Blood thinners are also known as anticoagulants. They’re used to treat or help prevent blot clots in certain situations.

Interaction result. Taking Augmentin with blood thinners that you take by mouth can increase your risk of bleeding.

Interaction explained. Oral blood thinners work by blocking certain clotting factors in your body. Clotting factors are substances that help your blood clot. By blocking these factors, oral anticoagulants make your blood less likely to clot. These drugs can also help prevent a blood clot you currently have from getting larger.

One theory for why this interaction occurs is that Augmentin may affect bacteria in the gut that help produce clotting factors. This can lead to your body producing fewer clotting factors, which makes your blood less likely to clot. And this increases your risk of bleeding.

As a result, your risk of bleeding with oral blood thinners is greater if you take these drugs with Augmentin.

Examples of oral blood thinners. Below are examples of oral anticoagulants that may interact with Augmentin:

• warfarin (Jantoven)
• rivaroxaban (Xarelto)
• apixaban (Eliquis)
• dabigatran (Pradaxa)
• edoxaban (Savaysa)

Steps you or your doctor may take. If you take Augmentin with an oral blood thinner, tell your doctor if you have any symptoms of bleeding. Examples include:

• unexplained bruising
• bleeding from your nose or gums that takes a long time to stop
• bloody stool or urine
• coughing up blood

Your doctor may also recommend certain blood tests to check the time it takes your blood to form a clot. This will help them determine if your risk of bleeding may be higher while taking Augmentin with an oral blood thinner.

Oral birth control

Oral birth control refers to medication taken by mouth to help prevent pregnancy.

Interaction result. Augmentin can make birth control that’s taken by mouth less effective.

Interaction explained. Augmentin can affect your body’s ability to absorb oral birth control. As a result, your body may not absorb enough of the birth control to be effective for preventing pregnancy.

Examples of oral birth control drugs. Below are examples of oral birth control drugs that may interact with Augmentin:

• drospirenone/estetrol (Nextstellis)
• ethinyl estradiol/norgestimate (Estarylla, Sprintec, others)
• ethinyl estradiol/norethindrone (Aranelle, Gildagia, others)

Steps you or your doctor may take. If you take Augmentin with oral birth control, you can keep taking your birth control as your doctor has instructed. In addition, your doctor may recommend that you use a backup method of birth control while you’re taking Augmentin. Examples include using a condom or diaphragm.

Your doctor may suggest you keep using a backup method of birth control for at least 7 days after your last dose of Augmentin. This helps make sure your body has had time to clear Augmentin from your system so that your birth control can be fully effective again.

Augmentin may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below.

Augmentin interactions with supplements

It’s possible for drugs to interact with supplements such as vitamins and herbs.

Augmentin interactions with herbs

There were no reports of herbs interacting with Augmentin or Augmentin ES-600. Before taking any herbal products during Augmentin treatment, talk with your doctor or pharmacist. They’ll advise whether there are any potential interactions between Augmentin and these herbs.

Augmentin interactions with vitamins

There were no reports of vitamins interacting with Augmentin or Augmentin ES-600. However, it’s still important to check with your doctor or pharmacist before taking any of these products during Augmentin treatment.

Augmentin interactions with food

There were no reports of food interactions with Augmentin or Augmentin ES-600. If you’d like to learn more about eating certain foods during treatment with Augmentin, talk with your doctor.

Augmentin and vaccines

There were no reports of vaccine interactions with Augmentin or Augmentin ES-600. If you’d like to learn more about getting certain vaccinations during treatment with Augmentin, talk with your doctor.

Augmentin interactions with lab tests

Amoxicillin (one of the active drugs in Augmentin) may interact with certain urine tests for glucose.

Specifically, amoxicillin may cause a false-positive result for glucose in the urine. A false-positive result happens when a test shows a positive result for a substance that isn’t actually present. In this case, the test shows glucose is present in the urine even though glucose may not actually be there.

Before having a urine glucose test, be sure your doctor knows if you’re taking Augmentin. They may give you a different type of glucose test that isn’t affected by the drug.

Augmentin and cannabis or CBD

Cannabis (marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Augmentin or Augmentin ES-600. However, as with any drug or supplement, talk with your doctor before taking cannabis in combination with Augmentin. The impact of cannabis may affect how well you stick to your Augmentin treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Augmentin. Before you take Augmentin, be sure to talk with your doctor about your health history. Augmentin may not be the right treatment option for you if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Augmentin include:

• Phenylketonuria (PKU). The liquid forms of Augmentin contain an ingredient called phenylalanine. For this reason, your doctor may not prescribe a liquid form of Augmentin for you if you have PKU. Your doctor may prescribe the tablet form of Augmentin for you instead. This form of Augmentin doesn’t contain phenylalanine.
• Mononucleosis (commonly called “mono”). Your doctor may not prescribe Augmentin for you if you have mono. This condition can increase the risk of rash as a side effect of Augmentin. Your doctor can recommend the best treatment for mono.
• Kidney problems. If you have kidney problems, be sure to tell your doctor before taking Augmentin. An example is kidney failure with or without the use of dialysis. Your doctor may give you a different dosage of Augmentin than usual if you have kidney problems.
• Liver problems. Before you start treatment with Augmentin, it’s important to tell your doctor if you have liver problems. In some cases, Augmentin may cause certain liver problems as a side effect. Your risk of liver problems as a side effect may be higher if you’ve experienced this in the past. Your doctor will determine whether to prescribe Augmentin for your condition. You can see details in the “When to avoid Augmentin” section above.
• Pregnancy. It’s not known whether Augmentin is safe to take during pregnancy. If you’re pregnant, talk with your doctor before taking Augmentin. They’ll advise on the risks and benefits of taking the drug while pregnant.
• Breastfeeding. Augmentin may pass into the breast milk during breastfeeding, which could cause side effects in a breastfed child. If you’re breastfeeding, talk with your doctor before taking Augmentin. They’ll advise whether Augmentin is safe to take while breastfeeding.
• Allergic reaction. If you’ve had an allergic reaction to Augmentin or any of its ingredients, your doctor will likely not prescribe Augmentin. Ask them about other treatments that may be better choices for you. You can see the “When to avoid Augmentin” section above for details.

Here are some frequently asked questions about Augmentin and possible interactions.

Does Augmentin interact with methotrexate?

There isn’t a known interaction between Augmentin and methotrexate (Otrexup, Trexall, others).

However, taking Augmentin with methotrexate may increase the level of methotrexate in your body. And this could increase your risk of certain side effects with methotrexate. Examples include nausea, vomiting, diarrhea, and other serious side effects.

If you have questions about taking Augmentin with methotrexate, talk with your doctor or pharmacist. They can advise whether it’s safe for you to take these medications together.

Does Augmentin interact with Lexapro?

There isn’t a known interaction between Augmentin and escitalopram (Lexapro).

However, some antibiotics do interact with Lexapro, such as levofloxacin. (Augmentin is a type of antibiotic.) Levofloxacin and Lexapro can each cause an abnormal heart rhythm as a side effect. Taking these drugs together could increase the risk of abnormal heart rhythm even more. But Augmentin isn’t known to increase this risk.

If you have questions about taking Augmentin with Lexapro, talk with your doctor or pharmacist. They can determine if there are any risks of taking these medications together.

You can take certain steps to help prevent interactions with Augmentin. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan the following:

• Tell them about any other medications you take, as well as lab tests you may have planned.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the label of Augmentin and other paperwork that comes with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the prescribing information, may contain details about interactions. If this information is difficult to understand, ask your doctor or pharmacist to help explain it.

You can also help prevent interactions with Augmentin by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Augmentin. These resources might help:

• Overview of Augmentin. For a general overview of Augmentin, you can see this article.
• Drug comparison. For information about how Augmentin compares with amoxicillin, see this article.
• Facts about infections. To learn more about infections that Augmentin may treat, see this list of articles related to infectious diseases.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Other drugs, supplements, and more

Augmentin (amoxicillin/clavulanate potassium) is a brand-name prescription drug used to treat bacterial infections. Examples include ear infections, urinary tract infections (UTIs), and pneumonia.

As with other medications, Augmentin can interact with certain other drugs. However, the drug is not known to interact with alcohol, supplements, or foods.

For details about Augmentin’s interactions, keep reading. For additional information about Augmentin, including details about its uses, see this article.

What’s an interaction?

An interaction occurs when one substance causes another substance to have a different effect than expected. For example, sometimes alcohol, a supplement, or another drug can affect how a drug acts in your body. Other times, a drug may change the way these substances act in your system. Interactions with a drug can also occur if you have certain conditions.

To help prevent interactions with Augmentin or any drug, talk with your doctor and pharmacist. Tell them whether you drink alcohol and which medications and supplements you take.

In some cases, a factor or condition could prevent your doctor from prescribing Augmentin due to the risk of harm. This is known as a contraindication. The contraindications of Augmentin include:

If you’ve had an allergic reaction

Before taking Augmentin, tell your doctor if you’ve had an allergic reaction to Augmentin or its ingredients in the past. Also tell them if you’ve had an allergic reaction to any of the following:

• amoxicillin or clavulanate potassium, which are the active drugs in Augmentin
• certain other antibiotics, such as penicillins or cephalosporins

Your risk of an allergic reaction with Augmentin may be higher if you’ve already had an allergic reaction to any of the above drugs. Be sure to tell your doctor if you’ve experienced this, and they’ll determine whether Augmentin is safe for you to take.

If you’ve had liver problems

Augmentin can rarely cause certain liver problems as side effects. Examples include:

• hepatitis (inflammation of the liver)
• jaundice

Your risk of liver problems with Augmentin may be higher if you’ve had liver problems in the past.

Before you start treatment with Augmentin, it’s important to tell your doctor if you’ve had liver problems, particularly with Augmentin in the past. They can determine whether to prescribe this drug for your condition.

There’s no known interaction between Augmentin and alcohol.

Some antibiotics do interact with alcohol, such as Flagyl (metronidazole). Augmentin is a type of antibiotic, but it’s not known to have this interaction.

However, keep in mind that drinking alcohol while taking Augmentin could worsen some of the drug’s side effects. Examples include nausea and vomiting or liver problems. (For details about possible side effects of Augmentin, see this article.)

If you drink alcohol, talk with your doctor before taking Augmentin. They can recommend whether you should limit the amount of alcohol you drink while taking the drug.

Before you start treatment with Augmentin, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you or what not to take with Augmentin, ask your doctor or pharmacist.

Here’s a chart of drugs that can interact with Augmentin. Doctors typically won’t prescribe the below medications with Augmentin. Keep in mind that this chart does not include all drugs that may interact with Augmentin. Some of these interactions are described in detail just below in “Drug interactions in depth.”

Here’s a closer look at certain drug interactions of Augmentin.

Allopurinol

Allopurinol (Lopurin, Zyloprim) is a medication used to treat conditions such as gout and kidney stones.

Interaction result. Taking Augmentin with allopurinol can increase the risk of rash as a side effect of Augmentin.

Interaction explained. It’s not known for certain how allopurinol may increase the risk of rash with Augmentin. It’s thought that both medications have a risk for rash when taken individually. Therefore, taking Augmentin and allopurinol together may increase the risk of rash even more.

Steps you or your doctor may take. Before taking Augmentin, be sure your doctor knows if you’re taking allopurinol. They can advise whether it’s safe for you to take these medications together.

If you do take Augmentin while taking allopurinol, watch for skin warmth, redness, or discoloration. These are possible symptoms of a skin rash. If you have these symptoms, tell your doctor right away. They’ll recommend whether you should keep taking Augmentin or allopurinol.

Oral blood thinners

Blood thinners are also known as anticoagulants. They’re used to treat or help prevent blot clots in certain situations.

Interaction result. Taking Augmentin with blood thinners that you take by mouth can increase your risk of bleeding.

Interaction explained. Oral blood thinners work by blocking certain clotting factors in your body. Clotting factors are substances that help your blood clot. By blocking these factors, oral anticoagulants make your blood less likely to clot. These drugs can also help prevent a blood clot you currently have from getting larger.

One theory for why this interaction occurs is that Augmentin may affect bacteria in the gut that help produce clotting factors. This can lead to your body producing fewer clotting factors, which makes your blood less likely to clot. And this increases your risk of bleeding.

As a result, your risk of bleeding with oral blood thinners is greater if you take these drugs with Augmentin.

Examples of oral blood thinners. Below are examples of oral anticoagulants that may interact with Augmentin:

• warfarin (Jantoven)
• rivaroxaban (Xarelto)
• apixaban (Eliquis)
• dabigatran (Pradaxa)
• edoxaban (Savaysa)

Steps you or your doctor may take. If you take Augmentin with an oral blood thinner, tell your doctor if you have any symptoms of bleeding. Examples include:

• unexplained bruising
• bleeding from your nose or gums that takes a long time to stop
• bloody stool or urine
• coughing up blood

Your doctor may also recommend certain blood tests to check the time it takes your blood to form a clot. This will help them determine if your risk of bleeding may be higher while taking Augmentin with an oral blood thinner.

Oral birth control

Oral birth control refers to medication taken by mouth to help prevent pregnancy.

Interaction result. Augmentin can make birth control that’s taken by mouth less effective.

Interaction explained. Augmentin can affect your body’s ability to absorb oral birth control. As a result, your body may not absorb enough of the birth control to be effective for preventing pregnancy.

Examples of oral birth control drugs. Below are examples of oral birth control drugs that may interact with Augmentin:

• drospirenone/estetrol (Nextstellis)
• ethinyl estradiol/norgestimate (Estarylla, Sprintec, others)
• ethinyl estradiol/norethindrone (Aranelle, Gildagia, others)

Steps you or your doctor may take. If you take Augmentin with oral birth control, you can keep taking your birth control as your doctor has instructed. In addition, your doctor may recommend that you use a backup method of birth control while you’re taking Augmentin. Examples include using a condom or diaphragm.

Your doctor may suggest you keep using a backup method of birth control for at least 7 days after your last dose of Augmentin. This helps make sure your body has had time to clear Augmentin from your system so that your birth control can be fully effective again.

Augmentin may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below.

Augmentin interactions with supplements

It’s possible for drugs to interact with supplements such as vitamins and herbs.

Augmentin interactions with herbs

There were no reports of herbs interacting with Augmentin or Augmentin ES-600. Before taking any herbal products during Augmentin treatment, talk with your doctor or pharmacist. They’ll advise whether there are any potential interactions between Augmentin and these herbs.

Augmentin interactions with vitamins

There were no reports of vitamins interacting with Augmentin or Augmentin ES-600. However, it’s still important to check with your doctor or pharmacist before taking any of these products during Augmentin treatment.

Augmentin interactions with food

There were no reports of food interactions with Augmentin or Augmentin ES-600. If you’d like to learn more about eating certain foods during treatment with Augmentin, talk with your doctor.

Augmentin and vaccines

There were no reports of vaccine interactions with Augmentin or Augmentin ES-600. If you’d like to learn more about getting certain vaccinations during treatment with Augmentin, talk with your doctor.

Augmentin interactions with lab tests

Amoxicillin (one of the active drugs in Augmentin) may interact with certain urine tests for glucose.

Specifically, amoxicillin may cause a false-positive result for glucose in the urine. A false-positive result happens when a test shows a positive result for a substance that isn’t actually present. In this case, the test shows glucose is present in the urine even though glucose may not actually be there.

Before having a urine glucose test, be sure your doctor knows if you’re taking Augmentin. They may give you a different type of glucose test that isn’t affected by the drug.

Augmentin and cannabis or CBD

Cannabis (marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Augmentin or Augmentin ES-600. However, as with any drug or supplement, talk with your doctor before taking cannabis in combination with Augmentin. The impact of cannabis may affect how well you stick to your Augmentin treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Augmentin. Before you take Augmentin, be sure to talk with your doctor about your health history. Augmentin may not be the right treatment option for you if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Augmentin include:

• Phenylketonuria (PKU). The liquid forms of Augmentin contain an ingredient called phenylalanine. For this reason, your doctor may not prescribe a liquid form of Augmentin for you if you have PKU. Your doctor may prescribe the tablet form of Augmentin for you instead. This form of Augmentin doesn’t contain phenylalanine.
• Mononucleosis (commonly called “mono”). Your doctor may not prescribe Augmentin for you if you have mono. This condition can increase the risk of rash as a side effect of Augmentin. Your doctor can recommend the best treatment for mono.
• Kidney problems. If you have kidney problems, be sure to tell your doctor before taking Augmentin. An example is kidney failure with or without the use of dialysis. Your doctor may give you a different dosage of Augmentin than usual if you have kidney problems.
• Liver problems. Before you start treatment with Augmentin, it’s important to tell your doctor if you have liver problems. In some cases, Augmentin may cause certain liver problems as a side effect. Your risk of liver problems as a side effect may be higher if you’ve experienced this in the past. Your doctor will determine whether to prescribe Augmentin for your condition. You can see details in the “When to avoid Augmentin” section above.
• Pregnancy. It’s not known whether Augmentin is safe to take during pregnancy. If you’re pregnant, talk with your doctor before taking Augmentin. They’ll advise on the risks and benefits of taking the drug while pregnant.
• Breastfeeding. Augmentin may pass into the breast milk during breastfeeding, which could cause side effects in a breastfed child. If you’re breastfeeding, talk with your doctor before taking Augmentin. They’ll advise whether Augmentin is safe to take while breastfeeding.
• Allergic reaction. If you’ve had an allergic reaction to Augmentin or any of its ingredients, your doctor will likely not prescribe Augmentin. Ask them about other treatments that may be better choices for you. You can see the “When to avoid Augmentin” section above for details.

Here are some frequently asked questions about Augmentin and possible interactions.

Does Augmentin interact with methotrexate?

There isn’t a known interaction between Augmentin and methotrexate (Otrexup, Trexall, others).

However, taking Augmentin with methotrexate may increase the level of methotrexate in your body. And this could increase your risk of certain side effects with methotrexate. Examples include nausea, vomiting, diarrhea, and other serious side effects.

If you have questions about taking Augmentin with methotrexate, talk with your doctor or pharmacist. They can advise whether it’s safe for you to take these medications together.

Does Augmentin interact with Lexapro?

There isn’t a known interaction between Augmentin and escitalopram (Lexapro).

However, some antibiotics do interact with Lexapro, such as levofloxacin. (Augmentin is a type of antibiotic.) Levofloxacin and Lexapro can each cause an abnormal heart rhythm as a side effect. Taking these drugs together could increase the risk of abnormal heart rhythm even more. But Augmentin isn’t known to increase this risk.

If you have questions about taking Augmentin with Lexapro, talk with your doctor or pharmacist. They can determine if there are any risks of taking these medications together.

You can take certain steps to help prevent interactions with Augmentin. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan the following:

• Tell them about any other medications you take, as well as lab tests you may have planned.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the label of Augmentin and other paperwork that comes with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the prescribing information, may contain details about interactions. If this information is difficult to understand, ask your doctor or pharmacist to help explain it.

You can also help prevent interactions with Augmentin by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Augmentin. These resources might help:

• Overview of Augmentin. For a general overview of Augmentin, you can see this article.
• Drug comparison. For information about how Augmentin compares with amoxicillin, see this article.
• Facts about infections. To learn more about infections that Augmentin may treat, see this list of articles related to infectious diseases.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Interaction Augmentin – what it is combined with, the effect of the use with other drugs

Augmentin instructions for use

Augmentin instructions for use

Augmentin, instructions for use

Coated tablets

Powder for suspension for oral administration

Description of dosage form:

Tablets 250mg/125mg and 500mg/125mg oval white to almost white with a film sheath and with the inscription ” AUGMENTIN ” on one side.

875mg/125mg oval white to off-white film coated tablets with a break line on one side.

White or off-white powder for suspension.

Composition:

Tablets.
Active ingredients:
amoxicillin trihydrate equivalent to 250 mg, 500 mg, 875 mg amoxicillin, potassium clavulanate equivalent to 125 mg clavulanic acid.

Other ingredients:
magnesium stearate, sodium starch glycollate, colloidal anhydrous silica, microcrystalline cellulose.

Film composition:
titanium dioxide, hydroxypropyl methylcellulose (5 cps and 15 cps), polyethylene glycol 4000, polyethylene glycol 6000, silicone oil, purified water.

Powder for suspension
Active ingredients:
5 ml suspension contains amoxicillin trihydrate equivalent to 125 mg amoxicillin and potassium clavulanate equivalent to 31.25 mg clavulanic acid.

Other Ingredients:
Xanthan Gum, Aspartame, Succinic Acid, Colloidal Silica, Hydroxypropyl Methylcellulose, Silica, Flavors.

Pharmacological group:

Antibiotic, synthetic penicillin + beta-lactamase inhibitor.

Code J01CR02.

PHARMACOLOGICAL PROPERTIES

Pharmacodynamics

Microbiology:

Amoxicillin is a semi-synthetic antibiotic with a wide spectrum of antibacterial activity against many gram-positive and gram-negative microorganisms. Amoxicillin is destroyed by beta-lactamases and therefore is not active against microorganisms that produce these enzymes.

Clavulanic acid – beta-lactam, has the ability to inactivate a wide range of beta-lactamases, enzymes that usually produce microorganisms resistant to penicillins and cephalosporins

It has particular activity against plasmid beta-lactamases, with which drug resistance is often associated. The drug is less effective against chromosomal type 1 beta-lactamases.

The presence of clavulanic acid in Augmentin protects amoxicillin from destruction by beta-lactamases and expands the spectrum of its antibacterial activity to include microorganisms that are usually resistant to other penicillins and cephalosporins. Thus, Augmentin has the properties of an antibiotic with a wide spectrum of bactericidal action and a beta-lactamase inhibitor. It is effective against the following microorganisms.

Gram-positive

Aerobes
Bacillus anthracis
Corynebacterium species
Enterococcus faecalis
Enterococcus faecium
Listeria monocytogenes
Nocardia asteroides
Staphylococ cus aureus
Coagulase negative staphylococci (including Staphylococcus epidermidis)
Streptococcus agalactiae
Streptococcus pneumonia
Streptococcus pyogenes
Streptococcus species
Streptococcus viridans

Anaerobes
Clostridium species
Peptococcus species
Peptostreptococcus species

Gram-negative
Clostridium genus
Peptococcus genus

Aerobes
Bordetella pertussis
Brucella species
Escherichia coli 9051 1 Gardnerella vaginalis
Haemophilus influenzae
Helicobacter pylori
Klebsiella species
Legionella species
Moraxella catarrhalis ( Branhamella catarrhalis )
Neisseria gonorrhoeae
Neisseria meningitidis
Pasteurella multocida
Proteus mirabilis
Proteus vulgaris
Salmonella species
Shigella species
Vibrio cholerae
Yersinia enterocolitica

Anaerobes
Bacteroides species (including Bacteroides fragilis )
Fusob acterium species

Others
Borrelia burgdorferi
Chlamydiae
Leptospira icterohaemorrhagiae
Treponema pallidum

Pharmacokinetic properties

The pharmacokinetic parameters of Augmentin 250/125 mg and 500/125 mg compared with those of amoxicillin and clavulanic acid monotherapy, obtained in a study on an empty stomach in healthy volunteers, were as follows.

Average peak concentration (mg/ml):

for amoxicillin
500 mg and as part of Augmentin 250/125 mg, 500/125 mg, respectively, was 6.5; 3.7; 6.5.

for clavulanic acid
125 mg and as part of Augmentin 250/125 mg and 500/125 mg, respectively, was 3.4; 2.2; 2.8.

Elimination time (hours):

for amoxicillin

500 mg and as part of Augmentin 250/125 mg and 500/125 mg, respectively, was 1.3; 1.1; 1.5.

for clavulanic acid
125 mg and as part of Augmentin 250/125 mg and 500/125 mg, respectively, was 0.9; 1.2; 1.3.

Half-life (hours):

for amoxicillin
500 mg and as part of Augmentin 250/125 mg and 500/125 mg, respectively, was 1.1; 1.0; 1.3.

for clavulanic acid
125 mg and as part of Augmentin 250/125 mg and 500/125 mg, respectively, was 0.7; 1.2; 0.8.

Area under the concentration-time curve (mg.h/l):

for amoxicillin
500 mg and as part of Augmentin 250/125 mg and 500/125 mg, respectively, was 19. 5; 10.9; 23.2.

for clavulanic acid
125 mg and as part of Augmentin 250/125 mg and 500/125 mg, respectively, amounted to 7.8; 6.2; 7.3.

Serum concentrations of amoxicillin in Augmentin were the same as with oral administration of an equivalent dose of amoxicillin alone.

Comparative studies of the pharmacokinetics of Augmentin for administration 3 times a day and 2 times a day in children have shown that data on the removal of the drug in adults are also applicable to children with unimpaired renal function.

Meal time does not significantly affect the pharmacokinetics of amoxicillin in adults. As for clavulanate, the highest concentration and area under the curve values ​​for it and the smallest individual fluctuations in these indicators are observed when taking Augmentin at the beginning of a meal.

Absorption:

Both components of Augmentin completely dissolve in water at physiological pH values, are quickly and well absorbed when taken orally. Absorption of Augmentin is optimal when taken at the beginning of a meal.

Distribution:

After intravenous administration, amoxicillin and clavulanic acid at therapeutic concentrations can be detected in tissues and interstitial fluid. Therapeutic concentrations of both drugs are also determined in the gallbladder, in the skin, in the tissues of the abdominal cavity, in adipose and muscle tissues, in synovial and peritoneal fluids, in bile and purulent discharge.

Amoxicillin and clavulanic acid are not highly bound to plasma proteins. Only about 25% of clavulanic acid and about 18% of amoxicillin from the total content of drugs in plasma is associated with proteins.

Trace amounts of clavulanate and amoxicillin are found in breast milk. However, in breastfed babies, there is only a risk of sensitization without other negative effects.

Amoxicillin and clavulanic acid cross the placenta. However, there is no evidence of a negative effect on reproductive function and harm to the fetus.

Elimination:

As with all penicillins, amoxicillin has a major renal route of elimination, while clavulanate has a renal and extrarenal route of elimination. After a single oral administration of one tablet of 250/125 mg or 500/125 mg, approximately 60% -70% of amoxicillin and about 40% -65% of clavulanic acid are excreted in the urine unchanged during the first 6 hours.

Amoxicillin is partially excreted in the urine as inactive penicillic acid in an amount equivalent to 10%-25% of the original dose. Clavulanic acid is extensively metabolized in the body to 2,5-dihydro-4-(2-hydroethyl)-5-oxo-1 H-pyrol-3-carboxylic acid and 1-amino-4hydroxy-butane-2-one and is excreted in the urine and faeces, as well as in the form of carbon dioxide through exhaled air.

Augmentin is used to treat bacterial infections caused by susceptible microorganisms, including:

• Upper respiratory tract infections (including infections of the ear, throat, nose), eg recurrent tonsillitis, sinusitis, otitis media. These infections are most commonly caused by Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pyogenes.
• Infections of the lower respiratory tract, such as acute bronchitis and exacerbation of chronic bronchitis, lobar pneumonia and bronchopneumonia, which are usually caused by Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis.
• Infections of the urogenital tract, eg, cystitis (especially recurrent and complicated), urethritis, pyelonephritis, gynecological infections, usually caused by Enterobacteriaceae (mainly Escherichia coli), Staphylococcus saprophyticus, Enterococcus species, and gonorrhea, which is caused by Neisseria gonorrhoeae.
• Skin and soft tissue infections usually caused by Staphylococcus aureus, Streptococcus pyogenes and Bacteroides species.
• Bone and joint infections such as osteomyelitis, which is usually caused by Staphylococcus aureus and requires longer therapy.
• Other infectious diseases, eg septic abortion, puerperal sepsis, intra-abdominal sepsis.
• Infections caused by amoxicillin-susceptible organisms are treatable with Augmentin because it contains amoxicillin.
• Augmentin is also effective in mixed infections caused by microorganisms sensitive to amoxicillin and microorganisms producing beta-lactamase, which are insensitive to amoxicillin.

CONTRAINDICATIONS

• History of hypersensitivity to beta-lactam antibiotics (eg penicillins and cephalosporins).
• Jaundice / liver dysfunction associated with the use of Augmentin or penicillin in the anamnesis of patients.
• Infectious mononucleosis
• Phenylketonuria (for suspension containing aspartame)

Use with caution during pregnancy, lactation, diseases of the gastrointestinal tract (including colitis associated with the use of penicillins), chronic renal failure.

Dose route

Doses

Depend on the age, body weight, kidney function of the patients and the severity of the infection.
Doses are expressed as the ratio of amoxicillin to clavulanate (amoxicillin/clavulanate) in Augmentin.

*Esherichia coli
*Proteus mirabilis
*Proteus vulgaris
*Genus Klebsiella
*Genus Salmonella
*Genus Shigella
Bordetella pertussis
*Yersinia enterocolitica
Gard nerella vaginalis
Helicobacter pylori
Genus Brucella
Neisseria meningitidis
*Niesseria gonorrhoeae
*Branhamella catarrhalis
*Haemophilus influenzae
*Haemophilus ducreyi
Pasteurella multocida
Campy lobacter jejuni
Vibrio cholerae

Adults and children over 12 years old

Mild to moderate infections	Tablets 250/125 (2:1) mg 3 times daily Tablets 500/125 mg (4:1) 2 or 3 times daily Tablets 875/125 (7:1) mg bid
Severe infections (including chronic and recurrent urinary tract infections and lower respiratory tract infections).	Tablets 2 doses 250/125 mg 3 times daily Tablets 1-2 doses 500/125 mg 3 times daily Tablets 875/125 mg 3 times daily

Two doses of Augmentin 250/125 mg cannot be replaced by one dose of Augmentin 500/125 mg as they are not equivalent.

Children under 12

Doses should be expressed either in mg/kg/day or in ml of suspension containing 1 dose.
Children weighing 40 kg or more are given doses of the drug as in adults.

Low doses are recommended for skin and soft tissue infections, recurrent tonsillitis.
High doses are recommended for otitis media, sinusitis, upper and lower respiratory tract infections.

Age up to 1 year
2 ml suspension 3 times a day

Age 1 to 6 years (10-18 kg)
5 ml suspension 3 times a day
No clinical data on the use of doses exceeding 40/10 mg/kg /day 3 times a day, in children under 2 years

Age over 6 years (body weight 18-40 kg)
10 ml suspension 3 times a day

Premature
No dosage recommendations.

Elderly
No dose adjustment required, same dose as in adults. In case of impaired renal function, doses are selected as in adults.

Impaired renal function
Dose selection is based on the maximum possible level of amoxicillin with a certain degree of reduction in creatinine clearance.

Recommended doses for adults.

Recommended doses for children

Creatinine clearance > 30 ml/min	No dose adjustment required
Creatinine clearance 10-30 ml/min	15/3. 75 mg/kg twice daily
Creatinine clearance < 10 ml/min	15/3.75 mg/kg once daily

In most cases parenteral therapy with Augmentin is preferred.

Hemodialysis
Dosage titration is based on the maximum possible level of amoxicillin for a given degree of renal impairment.

Adults
1 tablet 500/125 mg or 2 tablets 250/125 mg every 24 hours

In combination with 1 dose during hemodialysis and 1 dose after hemodialysis, since the concentration of amoxicillin and clavulanic acid decreases.

The dose of Augmentin 875/125 mg can only be used in patients with creatinine clearance greater than 30 ml/min.

Children
15/3.75 mg/kg/day once daily.

An additional dose of 15 / 3.75 mg/kg should be given prior to hemodialysis. To restore the concentration of Augmentin in the blood, the second dose of the drug 15 / 3.75 mg / kg should be administered after hemodialysis.

Impaired liver function

• Dose with caution and monitor liver function regularly.
• Insufficient data to recommend doses.

Directions for use

Oral

• Augmentin is given at the start of a meal to reduce gastrointestinal side effects.
• Absorption of Augmentin is optimal when taken at the beginning of a meal.
• Do not treat with Augmentin for more than 14 days without evaluating the feasibility of continuing it. Therapy can be started with parenteral administration of Augmentin, and then continue taking the drug orally.

Suspension preparation

Dry powder should be diluted to obtain an oral suspension in the following proportions:

Dose	Water volume for powder dilution	Bottle size	Finished suspension volume
125 /31. 25	92ml	150 ml	100 ml

SIDE EFFECTS

Side effects are not typical for Augmentin and are usually mild and transient.

Gastrointestinal symptoms:

Diarrhea, indigestion, nausea, vomiting and candidiasis of the skin and mucous membranes have been reported.

Antibiotic-associated colitis (including pseudomembranous and hemorrhagic colitis is rare. Nausea, although not typical, occurs when high doses of Augmentin are taken orally. The severity of gastrointestinal symptoms decreases when Augmentin is taken at the beginning of a meal.

Occasionally superficial discoloration of the teeth appears, mainly when taking the suspension.It can be removed with a toothbrush.

Liver:

Moderate asymptomatic elevations of AST and/or ALT and alkaline phosphatase are occasionally observed. Hepatitis and cholestatic jaundice are rare.

Liver symptoms are more common with Augmentin than with other penicillins and are more common in men and elderly patients over 65 years of age. The risk increases with the duration of treatment for more than 14 days. Very rarely, these complications occur in children.

Symptoms of liver involvement usually develop during or shortly after treatment, but sometimes only a few weeks after drug withdrawal. They are usually reversible, although they are significantly pronounced, very rarely end in death.

Blood:

As with other penicillins, transient leukopenia (including neutropenia and agranulocytosis), thrombocytopenia and hemolytic anemia, prolongation of bleeding time and prothrombin time are rare.

Hypersensitivity reactions:

Sometimes urticaria or erythematous skin rash, skin itching, multiforme erythema, Stevens-Johnson, toxic epidermal necrolysis, bullous exfoliative dermatitis, acute exanthematous pustuleosis, whey, and a hypers-sensitive vasskit. Treatment should be discontinued if one of these symptoms occurs.

Angioedema and anaphylaxis have been reported. Rarely, interstitial nephritis may develop.

CNS:

CNS symptoms develop very rarely. These include reversible hyperactivity, dizziness, headache, convulsions. Seizures may occur with impaired renal function or in patients receiving high doses of Augmentin.

OVERDOSE

Gastrointestinal symptoms and fluid and electrolyte imbalance may occur.

Symptomatic therapy is carried out for symptoms of impaired water and electrolyte balance. Augmentin can be removed from the blood by hemodialysis.

While taking high doses of amoxicillin, patients should be maintained with adequate fluid intake and urine output to reduce the chance of developing amoxicillin crystalluria.

Overdose of amoxicillin up to 250 mg/kg has been reported in children without significant clinical symptoms and without requiring gastric lavage.

INTERACTION WITH OTHER DRUGS

In patients receiving Augmentin, there was an increase in bleeding time and prothrombin time. Augmentin should be used with caution in patients receiving anticoagulants. Augmentin increases the effectiveness of indirect anticoagulants, since, by suppressing the intestinal flora, it reduces the synthesis of vitamin K and prothrombin.

It may reduce the effectiveness of oral contraceptives, ethinyl estradiol with a risk of breakthrough bleeding. Simultaneous use with allopurinol may cause allergic skin reactions.

Diuretics, allopurinol, phenylbutazone, NSAIDs and other drugs that block tubular secretion increase the concentration of amoxicillin.

Antacids, glucosamine, laxatives, aminoglycosides slow down and reduce the absorption of Augmentin, ascorbic acid increases it. Bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, vancomycin, rifampicin) have a synergistic effect, bacteriostatic drugs (macrolides, chloramphenicol, lincosamides, tetracyclines, sulfonamides) have an antagonistic effect.

SPECIAL INSTRUCTIONS

Before prescribing Augmentin therapy, a patient’s history should be carefully collected to determine cases of hypersensitivity to penicillins, cephalosporins or other allergens.

In general, Augmentin is well tolerated and has low toxicity of antibiotics of the penicillin group. It is recommended during therapy to monitor the function of the liver, kidneys and hematological parameters.

When using Augmentin, changes in liver function tests may be observed. Although the clinical significance of these changes is not clear, Augmentin should be used with caution in patients with impaired liver function.

Occasionally, cholestatic jaundice has been reported, which may be severe but reversible.

An erythematous rash with glandular fever has been reported in children receiving amoxicillin.

Prolonged use of the drug may cause overgrowth of non-susceptible organisms.

The patient’s history of hypersensitivity reactions to penicillins and cephalosporins should be carefully assessed before initiating therapy. Serious, often fatal reactions (anaphylactic) have been noted with penicillin, especially in patients with hypersensitivity to penicillin. If such reactions develop, Augmentin should be discontinued and appropriate therapy instituted. Severe anaphylactic reactions require emergency treatment with adrenaline and may also require oxygen, intravenous corticosteroids, and intubation.

Amoxicillin should not be given if infectious mononucleosis is suspected, as a mononucleosis-like rash may develop with amoxicillin.

Dose adjustments should be made in adult patients with impaired renal function.

Due to the content of aspartame in Augmentin suspension, which is a source of phenylalanine, the drug should be used with caution in patients with phenylketonuria.

PREGNANCY AND LACTATION

Animal studies have not shown teratogenic effects in Augmentin.

The appointment of Augmentin should be avoided during pregnancy, especially in the first trimester, unless the doctor deems it necessary.

Amoxicillin may be given during lactation. With the exception of the risk of sensitization, Augmentin does not cause any other undesirable symptoms in children who are breastfed.