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Amoxicillin / clavulanate Pregnancy and Breastfeeding Warnings

Brand names: Amoclan, Augmentin, Augmentin ES-600, Augmentin XR

Medically reviewed by Drugs.com. Last updated on Sep 27, 2024.

Amoxicillin / clavulanate Pregnancy Warnings

Amoxicillin-clavulanate has been assigned to pregnancy category B by the FDA. Animal studies failed to reveal any evidence of teratogenicity. There are no controlled data in human pregnancies. The results of a study suggest an increased risk of necrotizing enterocolitis in neonates if amoxicillin-clavulanate is given prophylactically to women with premature rupture of membranes. Amoxicillin-clavulanate should only be given during pregnancy when need has been clearly established.

In the Collaborative Perinatal Project involving 50,282 mother-child pairs, there were 3,546 mother-child pairs exposed to penicillin derivatives in the first trimester. As a group, there was no significant increase in the risk of malformations.

In the Michigan Medicaid Birth Defects Study involving 229,101 pregnancies from 1985 to 1992, there were 8,538 first trimester exposures to amoxicillin. Overall, 317 cases of birth defects were observed (363 expected). There was no evidence of an association between first trimester use of amoxicillin and major groups of malformations.

In the Michigan Medicaid Birth Defects Study, there were 556 first trimester exposures to clavulanate. Overall, 24 cases of birth defects were observed (24 expected). Two cases of spina bifida occurred compared with only 0.3 cases expected, representing a statistically significant increase in the incidence of this anomaly.

See references

Amoxicillin / clavulanate Breastfeeding Warnings

Amoxicillin is excreted into human milk in small amounts and is considered compatible with breast-feeding by the American Academy of Pediatrics. Clavulanate has not been detected in human milk. Adverse effects in the nursing infant are unlikely. The manufacturer recommends caution when amoxicillin-clavulanate is administered to a nursing woman.

In one study, six women were administered a single 1000 mg dose of amoxicillin on the third postpartum day. Amoxicillin milk concentrations ranged from 0.10 to 0.81 mcg/mL, with a peak concentration measured at 5 hours post-dose. The milk to maternal serum concentration ratio ranged from 0.013 to 0.043.

See references

References for pregnancy information

  1. Heinonen O, Shapiro S; Kaufman DW ed., Slone D (1977) "Birth Defects and Drugs in Pregnancy." Littleton, MA: Publishing Sciences Group, Inc., p. 297
  2. (2002) "Product Information. Augmentin (amoxicillin-clavulanate)." SmithKline Beecham
  3. Briggs GG, Freeman RK, Yaffe SJ.. (1998) "Drugs in Pregnancy and Lactation." Baltimore, MD: Williams & Wilkins
  4. (2003) "Product Information. Augmentin XR (amoxicillin-clavulanate)." GlaxoSmithKline

References for breastfeeding information

  1. Roberts RJ, Blumer JL, Gorman RL, et al. (1989) "American Academy of Pediatrics Committee on Drugs: Transfer of drugs and other chemicals into human milk." Pediatrics, 84, p. 924-36
  2. (2002) "Product Information. Augmentin (amoxicillin-clavulanate)." SmithKline Beecham
  3. Committee on Drugs, 1992 to 1993 (1994) "The transfer of drugs and other chemicals into human milk." Pediatrics, 93, p. 137-50
  4. Kafetzi D, Siafas C, Georgakopoulos P, Papdatos C (1981) "Passage of cephalosporins and amoxicillin into the breast milk." Acta Paediatr Scand, 70, p. 285-8
  5. Briggs GG, Freeman RK, Yaffe SJ.. (1998) "Drugs in Pregnancy and Lactation." Baltimore, MD: Williams & Wilkins
  6. (2003) "Product Information. Augmentin XR (amoxicillin-clavulanate)." GlaxoSmithKline
  7. Benyamini L, Merlob P, Stahl B, et al. (2005) "The Safety of Amoxicillin/Clavulanic Acid and Cefuroxime During Lactation." Ther Drug Monit, 27, p. 499-502

Further information

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