Amoxicillin and alcohol – is that compatible?

Amoxicillin belongs to the large group of antibiotics. An antibiotic is a substance or drug that has an antimicrobial effect and is therefore used in the treatment of infections. However, an antibiotic is only effective against infectious diseases caused by bacterial pathogens.

You can find general information about this antibiotic at AmoxicillinIf an infectious disease is caused by a viral pathogen, for example, antibiotic therapy is therefore ineffective. Amoxicillin is an antibiotic that belongs to the large group of so-called penicillins. Penicillins have an antibiotic effect by inhibiting the formation of the bacterial cell wall.

Penicillins are particularly effective against so-called gram-positive bacteria. Such gram-positive bacteria are, for example, streptococci, which can trigger tonsillitis or erysipelas. In contrast to classical penicillin, amoxicillin has a broader spectrum of action with an additional effect against so-called gram negative bacteria such as E. coli, so that it can also be used against urinary tract infections.

Amoxicillin is mainly excreted via the kidneys. Alcohol in the narrower sense of the word means drinking alcohol, which contains the chemical alcohol ethanol. Drinking alcohol is mainly metabolized in the liver via the enzyme alcohol dehydrogenase.

As there are also some antibiotics that are metabolised in the liver, in contrast to amoxicillin, one should avoid drinking alcohol while taking them. Amoxicillin is an antibiotic which is not only subject to pharmacy obligation but also to prescription. This prevents in particular the improper use of antibiotics.

Amoxicillin can therefore only be obtained with a doctor’s prescription. The tablets are white in colour and have a breaking notch to make it easier for the patient to divide them up according to the dose. The tablet should be taken unchewed and with a sip of water.

The simultaneous intake of food with amoxicillin is possible without hesitation and does not hinder its effect. As far as the dosage is concerned, the duration of use and the amount of dosage must always be adjusted individually by the doctor to the patient concerned. The dosage depends on the patient’s age, weight and kidney function, the type of pathogen and the location and severity of the infection.

For adults and children weighing more than 40 kilograms, the standard dose is 1500-3000mg divided into 3 doses per day. By distributing the dose over 3 individual doses, a continuous effect level is achieved. In the case of particularly severe infectious diseases, the daily amoxicillin dose can be increased up to 4000-6000mg per day.

Dose determination in children weighing less than 40 kilograms is based on body weight. Children receive a dose of 50-100 mg of amoxicillin per kilogram of body weight per day. Here too, the dose is divided into 3 individual doses per day.

In addition, there are some special features to be considered regarding the dosage of amoxicillin. In case of a restriction of renal function, i.e. a restriction of the so-called glomerular filtration rate (GFR), which is basically a measure of the kidney‘s performance, the dose of Amoxicillin must be adjusted. Normal kidney function results in a glomerular filtration rate of around 100-120 ml/min.

In case of limited renal function with a glomerular filtration rate below 30 ml/min, a reduction of the Amoxicillin dose is recommended. In this case the kidney is no longer able to excrete the drug Amoxicillin properly, which leads to an accumulation of the drug in the body. If the kidney function is even worse with a glomerular filtration rate of 20-30 ml/min or even below 20 ml/min, a reduction of the dose to 2/3 or 1/3 of the normal dose should be aimed for.

Not only the kidney function determines the dose of amoxicillin, but also the pathogen and the site of infection. If amoxicillin is used as part of a so-called triple therapy together with clarithromycin, a macrolide antibiotic, and pantoprazole, a proton pump inhibitor, to treat a Helicobacter pylori infection, the dose in this therapy regimen is 2 times 1000 mg amoxicillin per day for 7 days. Helicobacter pylori is a bacterium that colonises the stomach and very often causes gastritis and ulcers.

Another possible indication for amoxicillin therapy is the so-called endocarditis prophylaxis. Endocarditis is a highly acute disease of the heart valves, usually caused by bacteria, which mainly affects the mitral valve and aortic valve and can lead to their destruction. In patients at particular risk, for example patients with a heart valve replacement or congenital heart defects, a single oral amoxicillin administration of 2000-3000 mg is administered 1 hour before the procedure for interventions with a high risk of endocarditis.

Interventions with such a high risk for the above-mentioned high-risk patients include dental procedures. In general, not only the dose of amoxicillin therapy should be chosen individually, but also the duration of therapy. In principle, the attending physician should also decide on the duration of the amoxicillin therapy.

Amoxicillin should be taken for about 7-10 days, with a minimum therapy duration of about 2-3 days after the end of the disease symptoms. However, the therapy of certain pathogens such as the so-called beta-haemolytic streptococci requires a longer therapy duration in order to prevent complications such as rheumatic fever. Regular consumption of alcohol should be avoided, especially when taking amoxicillin for a longer period of time.