Augmentin (amoxicillin / clavulanate) Disease Interactions
There are 6 disease interactions with Augmentin (amoxicillin / clavulanate):
Patients with mononucleosis treated with an aminopenicillin antibiotic, particularly ampicillin, quite frequently develop a pruritic erythematous maculopapular skin rash that generally occurs 5 to 10 days after therapy is initiated. The rash is usually self-limiting and resolves within days of discontinuing the offending agent. An altered drug metabolism or an immune-mediated process unrelated to drug hypersensitivity has been proposed as the underlying mechanism. Clinicians should recognize that a skin eruption under this circumstance does not necessarily indicate a life-long allergy to these agents or other penicillin derivatives. Therapy with aminopenicillin antibiotics may not be appropriate in patients with mononucleosis.
- "Product Information. Polycillin (ampicillin)." Apothecon Inc, Plainsboro, NJ.
- Adcock BB, Rodman DP "Ampicillin-specific rashes." Arch Fam Med 5 (1996): 301-4
- Chan HL "Fixed drug eruption to bacampicillin (ampicillin)." Arch Dermatol 120 (1984): 542
The administration of amoxicillin-clavulanate has infrequently been associated with hepatotoxicity such as elevations in serum transaminases, bilirubin, and/or alkaline phosphatase. The histologic findings on liver biopsy have consisted of predominantly cholestatic and/or hepatocellular changes. Symptoms may occur during or several weeks after therapy. The hepatotoxicity is generally reversible, although deaths have been reported on rare occasions, mostly in patients with serious underlying diseases or concomitant use of other medications. Liver enzyme abnormalities have also been observed with the use of amoxicillin or ampicillin alone. According to the manufacturer, therapy with amoxicillin-clavulanate should be administered cautiously in patients with evidence of hepatic dysfunction. Periodic monitoring of liver function is recommended during prolonged therapy. The use of amoxicillin-clavulanate is contraindicated in patients with a history of cholestatic jaundice or hepatic dysfunction associated with the drug.
- Ryley NG, Fleming KA, Chapman RWG "Focal destructive cholangiopathy associated with amoxycillin/clavulanic acid (augmentin)." J Hepatol 23 (1995): 278-82
- Verhamme M, Ramboer C, Van De Bruaene P, Inderadjaja N "Cholestatic hepatitis due to an amoxycillin/clavulanic acid preparation." J Hepatol 9 (1989): 260-4
- Larrey D, Vial T, Micaleff A, et al. "Hepatitis associated with amoxycillin-clavulanic acid combination report of 15 cases." Gut 33 (1992): 368-71
Augmentin (brand of amoxicillin-clavulanate) chewable tablets contain 2.1 mg of phenylalanine per each 200 mg tablet and 4.2 mg of phenylalanine per each 400 mg tablet. Augmentin oral suspension contains 7 mg of phenylalanine per each 5 mL of reconstituted suspension for both the 200 mg/5 mL and 400 mg/5 mL strengths. The phenylalanine content should be considered when these products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).
- "Product Information. Augmentin (amoxicillin-clavulanate)." SmithKline Beecham, Philadelphia, PA.
Pseudomembranous colitis has been reported with most antibacterial agents and may range in severity from mild to life-threatening, with an onset of up to two months following cessation of therapy. Antibiotic therapy can alter the normal flora of the colon and permit overgrowth of Clostridium difficile, whose toxin is believed to be a primary cause of antibiotic-associated colitis. The colitis is usually characterized by severe, persistent diarrhea and severe abdominal cramps, and may be associated with the passage of blood and mucus. The most common culprits are clindamycin, lincomycin, the aminopenicillins (amoxicillin, ampicillin), and the cephalosporins. Therapy with broad-spectrum antibiotics and other agents with significant antibacterial activity should be administered cautiously in patients with a history of gastrointestinal diseases, particularly colitis. There is some evidence that pseudomembranous colitis, if it occurs, may run a more severe course in these patients and that it may be associated with flares in their underlying disease activity. The offending antibiotic(s) should be discontinued if significant diarrhea occurs during therapy. Stool cultures for Clostridium difficile and stool assay for C. difficile toxin may be helpful diagnostically. A large bowel endoscopy may be considered to establish a definitive diagnosis in cases of severe diarrhea.
- Moriarty HJ, Scobie BA "Pseudomembranous colitis in a patient on rifampicin and ethambutol." N Z Med J 04/23/80 (1980): 294-5
- Thomas E, Mehta JB "Pseudomembranous colitis due to oxacillin therapy." South Med J 77 (1984): 532-3
- Meadowcroft AM, Diaz PR, Latham GS "Clostridium difficile toxin-induced colitis after use of clindmycin phosphate vaginal cream." Ann Pharmacother 32 (1998): 309-11
Most beta-lactam antibiotics are eliminated by the kidney as unchanged drug and, in some cases, also as metabolites. The serum concentrations of beta-lactam antibiotics and their metabolites may be increased and the half-lives prolonged in patients with impaired renal function. Dosage adjustments may be necessary and modifications should be based on the degree of renal impairment as well as severity of infection in accordance with the individual product package labeling. Renal function tests should be performed periodically during prolonged and/or high-dose therapy, since nephrotoxicity and alterations in renal function have occasionally been associated with the use of these drugs.
- "Product Information. Geocillin (carbenicillin)." Roerig Division, New York, NY.
- DeSante KA, Zeckel ML "Pharmacokinetic profile of loracarbef." Am J Med 92 (1992): s16-9
- "Product Information. Suprax (cefixime)." Lupin Pharmaceuticals Inc, Baltimore, MD.
Penicillin antibiotics (except for agents in the penicillinase-resistant class) are removed by hemodialysis. Doses should either be scheduled for administration after dialysis or supplemental doses be given after dialysis.
- Francke EL, Appel GB, Neu HC "Kinetics of intravenous amoxicillin in patients on long-term dialysis." Clin Pharmacol Ther 26 (1979): 31-5
- Davies BE, Boon R, Horton R, Reubi FC, Descoeudres CE "Pharmacokinetics of amoxycillin and clavulanic acid in haemodialysis patients following intravenous administration of augmentin." Br J Clin Pharmacol 26 (1988): 385-90
- Reitberg DP, Marble DA, Schultz RW, Whall TJ, Schentag JJ "Pharmacokinetics of cefoperazone (2.0 g) and sulbactam (1.0 g) coadministered to subjects with normal renal function, patients with decreased renal function, and patients with end-stage renal disease on hemodialysis." Antimicrob Agents Chemother 32 (1988): 503-9
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Augmentin (amoxicillin / clavulanate) drug Interactions
There are 74 drug interactions with Augmentin (amoxicillin / clavulanate)
Drug Interaction Classification
The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
|Major||Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.|
|Moderate||Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.|
|Minor||Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.|
Do not stop taking any medications without consulting your healthcare provider.
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