Augmentin/Augmentin ES Drug Interactions

Avoid concomitant use with probenecid (for Augmentin tablet only). Concomitant use of probenecid is not recommended (for Augmentin suspension 228 mg/5 mL and 457 mg/5 mL and Augmentin ES suspension only). Probenecid decreases the renal tubular secretion of amoxicillin. Concomitant use with Augmentin/Augmentin ES may result in increased and prolonged blood levels of amoxicillin but not of clavulanic acid.
Concomitant use of allopurinol during treatment with amoxicillin can increase the likelihood of allergic drug skin reactions. There are no data on the concomitant use of Augmentin/Augmentin ES and allopurinol.
In common with other antibiotics, Augmentin may affect the normal gut flora, leading to lower oestrogen reabsorption and reduced efficacy of combined oral contraceptives and patients should be advised to use barrier methods of contraception.
In patients receiving mycophenolate mofetil, reduction in pre-dose concentration of the active metabolite mycophenolic acid of approximately 50% has been reported following commencement of oral amoxicillin plus clavulanic acid. The change in pre-dose level may not accurately represent changes in overall MPA exposure.
Augmentin tablet: Abnormal prolongation of prothrombin time (increased INR) has been reported rarely in patients receiving amoxicillin-clavulanate and oral anticoagulants. Measuring INR should be undertaken when anticoagulants are prescribed concurrently. Adjustment in decrease dose of oral anticoagulants may be necessary to maintain the desired level of anticoagulation. And increase the dose for adjusting INR after Augmentin have been ceased.
Augmentin suspension 228 mg/5 mL and 457 mg/5 mL and Augmentin ES suspension: In the literature there are rare cases of increased international normalised ratio in patients maintained on acenocoumarol or warfarin and prescribed a course of amoxicillin. If co-administration is necessary, the prothrombin time or international normalised ratio should be carefully monitored with the addition or withdrawal of Augmentin.