Amoxicillin interactions: Alcohol, supplements, an
Amoxicillin has interactions with some other drugs. Examples include warfarin, methotrexate, and allopurinol. Talk with your doctor to avoid potentially harmful effects from amoxicillin interactions.
Amoxicillin oral tablet is a generic drug prescribed for a variety of bacterial infections in adults and children. It’s available as the brand-name drug Amoxil.
An interaction occurs when one substance causes another substance to have a different effect than expected.
Amoxicillin comes in different forms, and they have the same interactions. The forms are:
oral tablet
oral capsule
chewable tablet
oral liquid suspension
By learning about possible amoxicillin interactions, you can work with your doctor to ensure amoxicillin is safe and effective for you to take.
»Learn more about amoxicillin, including details about its uses.
Amoxicillin interactions with other drugs
Before you start treatment with amoxicillin, tell your doctor and pharmacist about any prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions.
To learn whether amoxicillin interacts with supplements, herbs, or vitamins, see the “Amoxicillin and other interactions” section.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Here’s a table of drugs that can interact with amoxicillin. Keep in mind this table doesn’t include all drugs that may interact with amoxicillin. Some of these interactions are described in detail in “Drug interactions in depth.”
Drug class or drug nameDrug examplesInteraction result with amoxicillin
certain • warfarin (Coumadin, Jantoven)
• apixaban (Eliquis)
• rivaroxaban (Xarelto) may increase the risk of bleeding
certain birth control pills • ethinyl estradiol/desogestrel (Kariva, Mircette, others)
• ethinyl estradiol/drospirenone (Yaz, Yasmin, Ocella, others)
• ethinyl estradiol/norgestimate (Sprintec, Previfem, others) can make the birth control pill less effective
methotrexate (Trexall, Xatmep) — may increase the risk of side effects of methotrexate
allopurinol — may increase the risk of skin rash
probenecid — may increase the risk of side effects of amoxicillin
When to avoid Amoxicillin
In some cases, factors or conditions could prevent your doctor from prescribing amoxicillin due to the risk of harm. These are known as contraindications. Following are the contraindications of amoxicillin.
Note: Before you start treatment with amoxicillin, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe amoxicillin.
Having had an allergic reaction to amoxicillin or any of its ingredients
If you have had an allergic reaction to amoxicillin or any of its ingredients, your doctor will likely not prescribe the drug.
Your doctor also won’t likely prescribe amoxicillin if you’ve had an allergic reaction to certain other beta-lactam antibiotics, such as penicillins or cephalosporins. (Amoxicillin is a type of beta-lactam antibiotic.) Taking one of these drugs could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
Amoxicillin interaction with alcohol
There are no known interactions between amoxicillin and alcohol. However, if you drink alcohol, your doctor may advise you to avoid or limit it during amoxicillin treatment.
This is because drinking alcohol while taking amoxicillin may worsen some of the drug’s side effects, such as nausea, vomiting, or diarrhea. If you consume alcohol during amoxicillin treatment, these side effects may be more likely to occur.
Alcohol can also weaken your immune system. Drinking alcohol during amoxicillin treatment may make it harder for your body to fight the infection that amoxicillin is prescribed to treat.
If you have questions about drinking alcohol while taking amoxicillin, talk with your doctor.
»MORE:Safety of drinking alcohol with antibiotics
Drug interactions in depth
Here’s a closer look at certain drug interactions of amoxicillin.
Certain blood thinners
Taking certain blood thinners with amoxicillin may increase your risk of bleeding.
With the help of gut bacteria, your body makes clotting factors to form blood clots. (Blood clots are needed to repair blood vessels that may get injured.) Amoxicillin may affect the gut bacteria that produce clotting factors, which can reduce the amount of clotting factors your body produces. This can increase the risk of bleeding. Blood thinners also block these clotting factors. So taking a blood thinner and amoxicillin together may further increase the risk of bleeding.
Here are some blood thinners that may interact with Amoxicillin:
Steps you or your doctor may take
Your doctor will monitor you for any signs of bleeding. If you experience symptoms of bleeding, tell your doctor right away. These symptoms may include:
In some cases, your doctor may recommend the international normalized ratio (INR) test to check how long it takes your blood to form a clot. This test can let them know if you have an increased risk of bleeding. If your doctor determines your risk of bleeding is higher than usual while taking amoxicillin, they may adjust the dose of your blood thinner.
Certain birth control pills
Taking amoxicillin with oral birth control pills may make your birth control pills less effective. Amoxicillin may cause your body to absorb less of the drug in the birth control pills. This leads to lower levels of the drug in your blood and can further make your birth control pills less effective at preventing pregnancy.
Here are some oral birth control pills that may interact with Amoxicillin:
Steps you or your doctor may take
If your doctor prescribes amoxicillin, you should keep taking your birth control pills as you usually would. But your doctor may recommend that you use a backup method of birth control, such as a condom or diaphragm, while you’re taking amoxicillin and for 7 days after your last dose.
Allopurinol
Taking both amoxicillin and allopurinol together can increase the risk of developing a skin rash. It isn’t known why more people develop a skin rash while taking both drugs. However, both drugs can cause a skin rash on their own as a side effect, so taking them together may further increase this risk.
Steps you or your doctor may take
Tell your doctor if you’re taking allopurinol before starting treatment with amoxicillin. They can determine whether taking these medications together is safe for you.
Amoxicillin and other interactions
Amoxicillin may have other interactions, such as with foods, vitamins, vaccines, or lab tests.
Here are some potential interactions with amoxicillin. Keep in mind that the following information does not include all other possible amoxicillin interactions.
Amoxicillin interactions with food
There were no reports of food interactions with amoxicillin. If you’d like to learn more about eating certain foods during treatment with amoxicillin, talk with your doctor.
Amoxicillin interactions with supplements
It’s possible for drugs to interact with supplements such as vitamins and herbs.
Amoxicillin interactions with vitamins
There are no specific reports of vitamins interacting with amoxicillin. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with amoxicillin.
Amoxicillin interactions with herbs
There are no specific reports of herbs interacting with amoxicillin. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during amoxicillin treatment.
Amoxicillin interactions with vaccines
Amoxicillin is known to interact with the live typhoid vaccine. The typhoid vaccine contains live but weakened pieces of the Salmonella bacteria it’s meant to defend against. When your immune system is healthy, live vaccines usually won’t cause infection. However, amoxicillin can make the typhoid vaccine less effective.
Your doctor will typically recommend that you wait 24 hours after your last dose of amoxicillin before getting the typhoid vaccine.
Before starting amoxicillin, talk with your doctor or pharmacist about any vaccines you may need.
Amoxicillin interactions with lab tests
Amoxicillin may interact with certain lab tests. Specifically, it may interact with certain urine glucose tests used to monitor how well your diabetes is being managed.
If you’re prescribed amoxicillin, your doctor may recommend different tests to gather this information.
AMOXICILLIN INTERACTION WITH CANNABIS OR CBD
Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with amoxicillin. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with amoxicillin. The impact of cannabis may affect how well you stick to your amoxicillin treatment plan.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Amoxicillin and health-related interactions
Certain medical conditions and other factors may increase the risk of interactions with amoxicillin. Before you take this drug, be sure to talk with your doctor about your health history. Amoxicillin may not be the right treatment option if you have certain medical conditions or other factors affecting your health.
Health conditions or factors that might interact with amoxicillin include:
»Learn more about amoxicillin and prengnacy and breastfeeding.
FAQ about amoxicillin and interactions
Here are some frequently asked questions about amoxicillin and possible interactions.
Can I take amoxicillin and aspirin together?
Typically, yes. Clinical studies haven’t reported a known interaction between amoxicillin and aspirin, so it’s generally considered safe to take them together.
However, one animal study from 2019 suggests that amoxicillin may affect how aspirin is broken down in the body by changing gut bacteria. In rats, this led to higher levels of aspirin’s active ingredient in the blood. However, it’s not known whether this happens in humans, and more research is needed.
If you have questions about taking amoxicillin with aspirin, talk with your doctor or pharmacist. They can advise whether it’s safe for you to use these medications at the same time. If they recommend taking both medications, let them know if you notice unusual bleeding or bruising.
Can I drink milk while taking amoxicillin?
Yes, you can drink milk when taking amoxicillin. Clinical studies didn’t find any interactions between amoxicillin and dairy. Generally, there are no restrictions on food or drinks while taking amoxicillin. If you experience stomach upset while taking amoxicillin, taking it with food or milk may help reduce this side effect.
Keep in mind that some antibiotics, such as tetracycline or levofloxacin, should not be taken with dairy products. Taking certain antibiotics with milk can affect how the drug is absorbed, so the drug levels in your body will be lower. This may cause the antibiotic to not work as well to treat an infection.
Talk with your doctor or pharmacist if you have questions about taking amoxicillin with milk.
Preventing interactions
You can take certain steps to help prevent interactions with amoxicillin. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:
It’s also important to read the amoxicillin label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. The paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.
If amoxicillin doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.
You can also help prevent interactions with amoxicillin by taking it exactly as your doctor prescribes.
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.