Augmentin interactions: Alcohol, medications, and other factors

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.