Interactions with alcohol
There are numerous interactions with other drugs known under the therapy of amoxicillin. Especially drugs that are excreted via the kidneys interact with amoxicillin. As a matter of principle, simultaneous therapy with bacteriostatic antibiotics, i.e. antibiotics that inhibit the growth of the bacteria but do not kill them, should be avoided as an opposite effect has been observed.
This applies, among others, to antibiotics from the group of the so-called tetracyclines and macrolides. It is also known that amoxicillin reduces the excretion of methotrexate and can therefore increase the effect and side effects of methotrexate. This is a common immunosuppressive agent which is used, among other things, for the treatment of rheumatoid arthritis, i.e. an inflammatory joint disease.
Caution is also required when diuretics are administered at the same time. Diuretics are drugs that are intended to increase the excretion of water from the body via the kidneys. They also accelerate the excretion of amoxicillin, which ultimately leads to a lower concentration of amoxicillin in the body.
The combination of amoxicillin and digoxin can lead to a higher intake of digoxin, which can lead to dangerous side effects such as cardiac arrhythmia. Care should also be taken when taking amoxicillin and oral anticoagulants at the same time, as occasionally increased coagulation levels have been observed. Finally, it must be taken into consideration that the effect of hormonal contraceptives is weakened by the simultaneous intake of amoxicillin and therefore safe contraception cannot be guaranteed. In general, all side effects and interactions can be enhanced by the consumption of alcohol.
Metabolism of amoxicillin
Amoxicillin is mainly excreted from the body via the kidneys. Therefore, good kidney function is of primary importance when administering amoxicillin. Restricted kidney function, which can be measured by the so-called glomerular filtration rate (GFR), makes it necessary to adjust the dose of amoxicillin.
In this case, a restriction of renal function can lead to an accumulation of amoxicillin in the body. This can lead to seizures, impaired blood clotting and reduced uric acid excretion. However, even treatment with amoxicillin itself can damage a previously healthy kidney to such an extent that kidney failure occurs.
Alcohol is broken down by the liver. In the same way, many antibiotics are metabolised in this organ. Amoxicillin is mostly excreted through the kidneys, but some is also metabolized by the liver.
Amoxicillin and alcohol can therefore interact in the liver. If amoxicillin and alcohol are taken at the same time, the liver primarily takes over the breakdown of amoxicillin so that the alcohol has a longer and possibly stronger effect. People who have taken both would therefore be drunk faster and longer.
Although this effect is less than with other antibiotics, it is still measurable. This interaction in the liver also causes greater damage to the liver when taking amoxicillin and alcohol. If this is done regularly, complications such as fatty liver and cirrhosis are more likely. Therefore, if you are taking amoxicillin, you should avoid alcohol.