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What Are the Interactions between Amoxicillin and Acetaminophen?

Dorothy Bland
Dorothy Bland

As the liver metabolizes amoxicillin and acetaminophen, there is the possibility that taking both could damage liver health. This interaction exists despite the fact that from a pharmacological perspective, there is no direct interaction between the drugs. The main concern is possible acetaminophen interactions that may occur if the drug is taken in significant doses for a long amount of time. Additionally, both drugs can have negative reactions with some other drugs, like warfarin.

Amoxicillin and acetaminophen are not available in a combined dose. Amoxicillin is a popular prescription antibiotic used to treat bacterial infections such as ear infections and gonorrhea. Doctors will often recommend over-the-counter acetaminophen to those taking amoxicillin to reduce the pain or fever associated with the infection. For most people, taking both drugs at the same time is not a cause for concern.

Both amoxicillin and acetaminophen can cause liver damage.
Both amoxicillin and acetaminophen can cause liver damage.

Both substances are among the hundreds of drugs that are believed to be capable of causing liver damage. By taking these drugs during the same period, there is a possibility of an increased risk of hepatotoxicity, chemically caused liver damage, occurring. Weakness, nausea, and abdominal pain are all likely symptoms of hepatotoxicity. In fact, acetaminophen single-handedly accounts for more cases of liver damage than any other drug. Other symptoms of toxicity can include diarrhea, nausea, and fatigue, all of which can easily be dismissed or associated with a range of other conditions.

Amoxicillin is an antibiotic used to treat bacterial infections.
Amoxicillin is an antibiotic used to treat bacterial infections.

It appears that hepatotoxicity associated with amoxicillin and acetaminophen is an uncommon occurrence. When both drugs are indicated with hepatotoxicity, it is usually because the patient has other risk factors that make the liver more susceptible to damage. Heavy alcohol use, for instance, can also damage the liver.

Cases of liver toxicity involving this combination of drugs seem mainly related to excessively surpassing therapeutic acetaminophen dosage recommendations. The pain relief drug is found in various dosages, strengths, and brands of over-the-counter and prescription medication. Consuming the drug from multiple sources, such as extra strength pain relievers and liquid flu remedies, can lead to an overdose high enough to affect normal liver functioning.

Doctors should carefully look at a patient's other medications before prescribing drugs that commonly interact.
Doctors should carefully look at a patient's other medications before prescribing drugs that commonly interact.

Adverse interactions involving these medications are also more likely when they are taken with additional drugs known to cause interactions, like warfarin. Warfarin is a blood thinner that is used to prevent blood clots; the drug's ability to control bleeding, however, can be affected by the pain reliever or antibiotic. While on these medications with warfarin, patients may need to have International Normalized Ratio (INR) tests periodically to measure how the blood is clotting and adjust dosages if needed.

Both amoxicillin and acetaminophen may cause liver damage if taken in large doses.
Both amoxicillin and acetaminophen may cause liver damage if taken in large doses.

Although it appears that most individuals can take amoxicillin and acetaminophen together over the short term without issue, the risk of possible interaction should be taken seriously. To avoid injury, health professionals caution patients to stick to dosage recommendations. With the risk of encountering acetaminophen from multiple sources, patients are also encouraged to carefully monitor all sources of the pain reliever, remain within the appropriate daily dosage guidelines, and avoid long-term reliance.

Frequently Asked Questions

Is it okay to combine acetaminophen with amoxicillin?

Acetaminophen, more commonly known by the brand name "Tylenol", is an over-the-counter painkiller.
Acetaminophen, more commonly known by the brand name "Tylenol", is an over-the-counter painkiller.

The combination of acetaminophen and amoxicillin is usually regarded as safe. To minimize liver damage, it is crucial to take both drugs precisely as directed and to refrain from taking acetaminophen in high amounts. Also, it is advised to use the least amount of any drug that works.

What negative consequences could amoxicillin and acetaminophen have when used together?

When these drugs are used together, possible adverse effects include nausea, vomiting, diarrhea, headaches, and allergic reactions. Contact your doctor if you suffer any of these negative effects.

Can taking amoxicillin and acetaminophen together cause liver damage?

Amoxicillin is a popular prescription antibiotic used to treat bacterial infections such as ear infections and gonorrhea.
Amoxicillin is a popular prescription antibiotic used to treat bacterial infections such as ear infections and gonorrhea.

While excessive dosages of acetaminophen may affect the liver, taking amoxicillin and acetaminophen together is often not harmful to the liver. Before using acetaminophen, anyone with pre-existing liver issues or those taking other drugs that may have an impact on the liver should talk to their doctor.

Do acetaminophen and amoxicillin interact with one another?

While there is no known direct interaction between acetaminophen and amoxicillin, using them together may result in unwanted side effects. Ask your doctor if there might be any interactions if you are taking other drugs.

What are some alternatives to acetaminophen and amoxicillin?

Depending on the kind of illness, other antibiotics like penicillin or erythromycin may be recommended. Acetaminophen may be substituted with ibuprofen or naproxen to alleviate fever and discomfort. To find out which alternative therapies are best for your particular ailment, it is essential to discuss them with your doctor.

Discussion Comments

turquoise

If I have to take a pain reliever like acetaminophen while I'm on antibiotics, I don't take them at the same time. I know that I will have negative side effects like nausea and upset stomach. So I leave at least 6-8 hours in between.

I think this gives the first medication enough time to be absorbed and metabolized, so it should not interact with the second medication too much.

bluedolphin

@donasmrs-- I'm not a doctor but I think that acetaminophen is more harmful for liver health than amoxicillin. Acetaminophen is an NSAID (non-steroidal anti-inflammatory drug). This group of pain relievers is known for causing stomach ulcers and damaging the liver with long-term use.

The problem with taking amoxicillin and acetaminophen together is that there is more pressure placed on the liver. Both drugs are metabolized in the liver, which means that the liver has to work harder.

For healthy people, this is usually not a problem. But for someone who already has liver damage or poor liver function, it can be detrimental. I'm sure that your doctor prescribed/recommended these medications knowing that you have no liver problems. But people should not take them together on whim, without checking with a doctor first. Combining medications in general is a bad idea without doctor approval.

donasmrs

I have taken amoxicillin and acetaminophen together in the past. I didn't experience any problems. I did take them on a full stomach, along with a glass of milk however. My doctor told me to take them, so it never even occurred to me that the combination could be harmful.

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    • Both amoxicillin and acetaminophen can cause liver damage.
      By: 7activestudio
      Both amoxicillin and acetaminophen can cause liver damage.
    • Amoxicillin is an antibiotic used to treat bacterial infections.
      By: Oleksii Nykonchuk
      Amoxicillin is an antibiotic used to treat bacterial infections.
    • Doctors should carefully look at a patient's other medications before prescribing drugs that commonly interact.
      By: emiliau
      Doctors should carefully look at a patient's other medications before prescribing drugs that commonly interact.
    • Both amoxicillin and acetaminophen may cause liver damage if taken in large doses.
      By: acherst
      Both amoxicillin and acetaminophen may cause liver damage if taken in large doses.
    • Acetaminophen, more commonly known by the brand name "Tylenol", is an over-the-counter painkiller.
      By: Radosław Brzozo
      Acetaminophen, more commonly known by the brand name "Tylenol", is an over-the-counter painkiller.
    • Amoxicillin is a popular prescription antibiotic used to treat bacterial infections such as ear infections and gonorrhea.
      By: ognianmed
      Amoxicillin is a popular prescription antibiotic used to treat bacterial infections such as ear infections and gonorrhea.