Amoxicillin and alcohol - are they compatible?

introduction

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

General information about this antibiotic can be found at: Amoxicillin

If an infectious disease is caused by a viral pathogen, for example, antibiotic therapy is ineffective. Amoxicillin is an antibiotic that belongs to the large group of so-called Penicillins heard. Penicillins have an antibiotic effect by inhibiting the build-up of the bacterial cell wall.
Penicillins are mainly against so-called gram positive bacteria effective. Such gram-positive bacteria are, for example Streptococciwho have favourited one Tonsillitis or one Sore rose could be.

In contrast to the classic penicillin, amoxicillin has one broader spectrum of activity with an additional effect against so-called gram-negative bacteria such as E. coliso it also against Urinary tract infections can be used. Amoxicillin is predominantly made through that kidney eliminated.
Under alcohol is meant in the narrower sense of the drinking alcohol, which contains the chemical alcohol ethanol. The drinking alcohol is mainly used in the liver about the enzyme Alcohol dehydrogenase metabolized. Since, in contrast to amoxicillin, there are also some antibiotics that are metabolized via the liver, one should rather avoid consuming alcohol while taking them.

General

Amoxicillin is an antibiotic that's not just that Compulsory pharmacy subject, but also the Prescription requirement. This particularly prevents the improper use of antibiotics. So you can only get amoxicillin with a doctor's prescription.

The Tablets are white in color and have a score line to make it easier for the patient to divide them, depending on the dose. The tablet should be swallowed whole and with a sip of water. The simultaneous consumption of food with amoxicillin is possible without hesitation and does not hinder its effectiveness.

Regarding the dosage, the duration of use and the amount of dosage must always be individually adapted by the doctor to the patient concerned. The dosage is namely dependent from Age, Weight as well as the Kidney function a patient and the type of pathogen as well as the location and severity of one infection. For adults and children weighing more than 40 kilograms, a dose of 1500-3000mg divided into 3 doses per day is the standard. By distributing the dose over 3 individual doses, a continuous effective level is achieved.
In the case of particularly severe infectious diseases, the daily amoxicillin dose can be increased to up to 4000-6000 mg per day. The dose setting for children with a weight below 40 kilograms is based on their body weight. Children receive a dose of 50-100 mg 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 consider with regard to the dosage of amoxicillin. If the kidney function is restricted, i.e. if the so-called glomerular filtration rate (GFR) is restricted, which is basically a measure of the kidney's performance, the dose of amoxicillin must be adjusted. A normal one Kidney function gives a glomerular filtration rate around 100-120 ml / min. In the case of impaired kidney function with a glomerular filtration rate below 30 ml / min, a reduction in the amoxicillin dose is advisable. The kidney is no longer able to do this Eliminate drug amoxicillin properlycausing the drug to build up 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, the dose should be reduced to 2/3 or 1/3 of the normal dose.

Not only kidney function determines the dose of amoxicillin, but also the pathogen and the location of the infection. Amoxicillin is used in what is called a Triple Therapy along with Clarithromycin, one Macrolide antibiotic, and Pantoprazole, a proton pump inhibitor, used to treat a Helicobacter pylori infection, the dose in this therapy regimen is 2 x 1000 mg amoxicillin per day for a period of 7 days. At Helicobacter pylori it is a bacteriumthat colonizes the stomach and is very common Inflammation of the gastric mucosa and causes ulcers.

Another possible indication of amoxicillin therapy is the so-called Endocarditis prophylaxis represent. A 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 who are particularly at risk, for example patients with a heart valve replacement or congenital heart defects, a single oral amoxicillin dose of 2000-3000 mg 1 hour before the operation is carried out in interventions with a high risk of endocarditis. Interventions with such a high risk for the above risk patients are among others dental interventions.

In general, not only the dose for amoxicillin therapy should be selected individually, but also the duration of the 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 symptoms of the disease have ceased. However, the therapy of certain pathogens such as the so-called beta-hemolytic streptococci requires a longer duration of therapy, with complications such as a rheumatic fever can be prevented.
Regular consumption of alcohol should be avoided, especially when taking amoxicillin for a longer period of time.

Mode of action and areas of application

Amoxicillin is a drug that belongs to the group of antibiotics. Antibiotics are antimicrobial effective and therefore become Infection treatment used. However, an antibiotic is only effective against such infectious diseases that are caused by bacteria. A use against virally caused infections is therefore ineffective.

Amoxicillin belongs to the group of so-called Penicillins on. Penicillins have an antibiotic effect by inhibiting the build-up of the bacterial cell wall in the growth phase. In doing so, they block the so-called penicillin-binding proteins. Penicillins are particularly effective against so-called gram-positive bacteria. Gram-positive or gram-negative only describes how the bacteria can be stained with a certain dye. Such gram positive bacteria are for example Streptococci, for example a Tonsillitis or one Sore rose can trigger.

In contrast to the classic penicillin, amoxicillin has a broader spectrum of activity with an additional effect against so-called gram negative bacteria how E. coliso it is also used in the treatment of Urinary tract infections can be used. Amoxicillin can therefore be used against both acute and chronic bacterial infections that are within the spectrum of activity of amoxicillin and can be achieved by administering oral medication. Classic areas of application are therefore ear, nose and throat infections such as tonsillitis, Otitis media or Sinus infections. But amoxicillin is also very suitable as part of triple therapy against Helicobacter pylori in the case of gastric mucosal inflammation or for endocarditis prophylaxis.

Contraindication

For the application of Amoxicillin There are some special warnings that must be observed. When known Hypersensitivity compared to the active ingredient amoxicillin or any other penicillin, it is strictly forbidden to take amoxicillin, as the ingestion is too severe and life threatening allergic reactions can lead. It is particularly important to inquire about previous treatments with penicillins, cephalosporins, other beta-lactam antibiotics and their tolerance. This can lead to so-called cross-allergies with other beta-lactam antibiotics such as cephalosporins. Also, patients with known allergies or have allergic asthma a higher risk of having an allergic reaction from treatment with amoxicillin.

Side effects

As with all drugs, there are numerous Side effects and interactions known as amoxicillin therapy. The need for increased vigilance Amoxicillin Therapy with a simultaneous viral infection. Especially with simultaneous infectious mononucleosis (Pfeiffer's glandular fever) or a lymphatic leukemia Amoxicillin should not be used at all or only with great caution for antibacterial therapy, as the risk of a skin reaction from the administration of amoxicillin increases significantly.

Likewise does one impaired kidney function dose adjustment of amoxicillin is necessary. This can lead to an accumulation of amoxicillin in the body due to a reduction in kidney function. This can be too Seizures, an impairment of the Blood clotting as well as one decreased Uric acid excretion to lead.
Alcohol in particular can critically intensify these side effects.
But even the treatment with amoxicillin itself can damage a previously healthy kidney to such an extent that a Kidney failure arises.

The gastrointestinal tract is very often a place where the side effects of amoxicillin therapy become noticeable. As with almost all antibiotics, ingestion can increase nausea, Vomit and Diarrhea to lead. Occasionally it can be a so-called pseudomembranous colitis act that requires immediate discontinuation of antibiotic administration and simultaneous treatment of this side effect. Colitis is inflammation of the large intestine.

Please also read our article on this Antibiotic side effects

Interactions with alcohol

There are numerous known interactions with other drugs during amoxicillin therapy. In particular, drugs that are excreted via the kidneys interact with amoxicillin. In principle, simultaneous therapy with bacteriostatic antibiotics, i.e. antibiotics that inhibit the growth of bacteria but do not kill it, should be avoided, as an opposite effect was observed. This applies, among other things, to antibiotics from the group of so-called tetracyclines and macrolides.

It is also known that amoxicillin reduces the excretion of methotrexate and thus can increase the effects and side effects of methotrexate. This is a common immunosuppressant that is used, among other things, to treat rheumatoid arthritis, i.e. an inflammatory joint disease.
Please also read our topic: Alcohol and methotrexate

Caution should also be exercised if diuretics are administered at the same time. Diuretics are drugs that are designed to increase the amount of water excreted by the body through the kidney. This also leads to an acceleration of the amoxicillin excretion, which ultimately leads to a lower concentration of amoxicillin in the body. The combination of amoxicillin and digoxin can lead to increased absorption of digoxin, which can lead to dangerous side effects such as irregular heartbeat. Mindfulness should also be exercised during the simultaneous therapy of amoxicillin and oral anticoagulants, as increased coagulation values ​​have been observed in isolated cases.

Finally, it must be taken into account that the effect of hormonal contraceptives is weakened by the simultaneous use of amoxicillin and therefore safe contraception cannot be guaranteed.

In general, all side effects and interactions can be aggravated by the consumption of alcohol.

Metabolism of amoxicillin

Amoxicillin is mostly about that kidney excreted from the body. For this reason, good kidney function is primarily important when giving amoxicillin. Impaired kidney function, which is based on the so-called glomerular filtration rate (GFR) dose adjustment of amoxicillin is necessary. This can lead to a reduction in kidney function Accumulation of amoxicillin come in the body. This can be too Seizures, impaired blood clotting and reduced uric acid excretion. However, treatment with amoxicillin itself can damage a previously healthy kidney to such an extent that kidney failure occurs.

Interaction in the liver

Alcohol is broken down in the liver. Many antibiotics are also metabolized in this organ. Amoxicillin is largely excreted through the kidneys, but the liver also does some of it. So it can get through Amoxicillin and alcohol to a Interaction in the liver come. If you take amoxicillin and alcohol at the same time, the liver takes over primarily the breakdown of amoxicillinso that the Alcohol longer and may also have a stronger effect.
People who consumed both would consequently be drunk faster and longer. Although this effect is less than with other antibiotics, it is still measurable.
This interaction in the liver also ensures that taking amoxicillin and alcohol too major damage comes to the liver.
If you do this regularly, you are Complications as a Fatty liver and cirrhosis more likely. So in the case of Taking amoxicillin refrain from consuming alcohol.

Metabolism of alcohol

A completely different one Metabolism is subject to alcohol. Alcohol, in the narrower sense, means drinking alcohol, which contains the chemical alcohol ethanol. Ethanol is mainly used in the liver about the enzyme Alcohol dehydrogenase metabolized. Due to this different metabolism of alcohol and amoxicillin, alcohol and amoxicillin can be taken at the same time and are compatible. However, this tolerance does not apply in any case to all antibiotics. This varies from antibiotic to antibiotic. It should be noted with all antibiotics that the reason for therapy with an antibiotic such as amoxicillin is bacterial inflammation of the body.
In principle, the body is weakened and needed Protection. Alcohol also weakens and damages the body in principle, so that in a phase in which physical rest and relaxation are the order of the day, alcohol consumption is more harmful from this point of view.

Consumption with non-alcoholic beer

When taking amoxicillin, there is no need to go without alcohol-free beer. This is because, as the name suggests, alcohol-free beer does not contain any alcohol that can lead to undesirable side effects or interactions. So is alcohol-free beer in spite of Amoxicillin problem-free to drink.

Amoxicillin and clavulanic acid with alcohol

In some cases, not just amoxicillin is prescribed, but a combination drug. This is the combination of amoxicillin and clavulanic acid. It is better known under the trade name Augmentan®.
Clavulanic acid is an active ingredient that inhibits additional enzymes from bacteria. These enzymes are responsible for breaking down amoxicillin. This makes some bacteria resistant to amoxicillin. Due to the simultaneous administration of amoxicillin and clavulanic acid, however, these pathogens are again vulnerable to amoxicillin.
Here, too, there are interactions with alcohol. It is also important to refrain from taking amoxicillin and clavulanic acid with alcohol at the same time. Clavulanic acid is to a significant extent broken down by the liver. So here the potential for an interaction with alcohol is even higher. The liver gives the antibiotic priority over alcohol. Amoxicillin and clavulanic acid with alcohol lead to a heavy burden on the liver. When consumed at the same time, the alcohol is broken down and converted to a lesser extent. The alcohol can cause unforeseen effects.
In addition, the body, which is already burdened by a bacterial infection, should not be exposed to additional stress from alcohol. For these reasons, the simultaneous consumption of amoxicillin and clavulanic acid with alcohol is strongly discouraged.