Amoxicillin (drug interactions)
Amoxicillin is a modified version of the antibiotic penicillin, designed to have a broader range of effectiveness against bacterial infections. While it is commonly prescribed, potential drug interactions should be considered to ensure safe and effective treatment. Notably, the supplement bromelain, derived from pineapple stems, may enhance the absorption of amoxicillin, potentially improving its efficacy. Conversely, antibiotic treatment may slightly reduce vitamin K levels, which could be a concern for individuals already deficient in this nutrient.
Patients on anticoagulants, such as Warfarin, need to be cautious when taking amoxicillin, as the combination increases the risk of bleeding, particularly in older adults or those with liver or kidney issues. Additionally, individuals taking allopurinol or probenecid for gout may experience a higher incidence of skin rashes or hives when these medications are combined with amoxicillin. Understanding these interactions is essential for patients and healthcare providers to optimize treatment outcomes while minimizing risks.
Subject Terms
Amoxicillin (drug interactions)
DEFINITION: Relative of the antibiotic penicillin but modified to have a broader spectrum of effect.
INTERACTIONS: Bromelain, vitamin K, anticoagulants, allopurinol, and probenecid
TRADE NAMES: Amoxil, Trimox, Wymox
Bromelain
Effect: Possible helpful interaction
According to two studies, the supplement bromelain (from pineapple stems) may increase the absorption of amoxicillin. This effect might help the antibiotic work better.
Vitamin K
Effect: Possible nutritional depletion
There are concerns that antibiotic treatment might reduce levels of vitamin K in the body. However, this effect seems to be slight and only significant in persons who are already considerably deficient in vitamin K.
Anticoagulants
Effect: Increased risk of bleeding
Patients taking anticoagulants, or blood thinners, such as Warfarin may be at risk for bleeding if taken with amoxicillin. This is especially true in older patients or patients with liver or kidney diseases. Monitoring of international normalized ratios (INR) via blood work and dosage adjustment may be necessary.
Allopurinol and Probenecid
Effect: Increased risk of skin rash or hives
Patients with gout taking allopurinol or probenecid, both of which decrease uric acid in the body, may have an increased incidence of rash or hives when combining with amoxicillin than patients taking amoxicillin alone.
Bibliography
Apa, Nicole. "7 Amoxicillin Interactions You Should Know About." Good Rx Health, 7 Oct. 2022, www.goodrx.com/amoxicillin/interactions. Accessed 8 Dec. 2022.
Akhavan, Bobak J., et al. “Amoxicillin.” National Library of Medicine, StatPearls, 17 Nov. 2023, www.ncbi.nlm.nih.gov/books/NBK482250/. Accessed 12 Sept. 2024.
Cohen, H., et al. “The Development of Hypoprothrombinaemia Following Antibiotic Therapy in Malnourished Patients with Low Serum Vitamin K1 Levels.”British Journal of Haematology68 (1988): 63-66.
Conly, J., and K. Stein. “Reduction of Vitamin K2 Concentrations in Human Liver Associated with the Use of Broad Spectrum Antimicrobials.” Clinical and Investigative Medicine 17 (1994): 531-539.
Goss, T. F., et al. “Prospective Evaluation of Risk Factors for Antibiotic-Associated Bleeding in Critically Ill Patients.” Pharmacotherapy 12 (1992): 283-291.
Shearer, M. J., et al. “Mechanism of Cephalosporin-Induced Hypoprothrombinemia: Relation to Cephalosporin Side Chain, Vitamin K Metabolism, and Vitamin K Status.” Journal of Clinical Pharmacology 28 (1988): 88-95.