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Amoxicillin and metronidazole at the same time

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  • Amoxicillin and metronidazole at the same time

    I have read that it is safe to take amoxicillin and metronidazole while breastfeeding but I haven't seen anything that says whether you can take both at the same time while breastfeeding. I am currently exclusively breastfeeding my 5 month old and have been prescribed both antibiotics at 500mg capsules to be taken 3 times daily for 7 days. I would like to know if it is okay to do so.

  • #2
    There should be no problem with taking them at the same time. There's nothing about these drugs that makes them more dangerous when taken together.

    -James Abbey, MD


    • #3
      I was given amoxicillin and metronidazole and I am 18 weeks pregnant . Is it safe for me to take them together ?


      • #4

        These medications are relatively safe when used in pregnancy especially if they are used short term. They are both rated P2's-benefits likely to exceed the risk. The combination should not be a problem for the fetus in the second trimester, but may increase your risk of GI upset or thrush. Always check with your OB/GYN before starting any medication.

        "Pregnancy: Amoxicillin has been used during pregnancy for many years and does not appear to increase the incidence of congenital malformations. Amoxicillin is a penicillin antibiotic used to treat respiratory tract and urinary tract infections, H pylori, and skin infections.[1] Amoxicillin is not recommended for the treatment of gonorrhea.[2] Amoxicillin has been used prophylactically after premature rupture of membranes.[3] Amoxicillin has been used during pregnancy for many years and does not appear to increase the incidence of congenital malformations.[4-8] As with any medication during pregnancy, amoxicillin should only be used when absolutely necessary."
        (Medications and Mothers' Milk database, Dr Thomas Hale PhD).

        1.##Kastrup E. Drug Facts and Comparisons 2010: Wolters Kluwer Health; 2010.
        2.##Cavenee MR, Farris JR, Spalding TR, Barnes DL, Castaneda YS, Wendel GD, Jr. Treatment of gonorrhea in pregnancy. Obstet Gynecol. Jan 1993;81(1):33-38.
        3.##Muller AE, DeJongh J, Oostvogel PM, et al. Amoxicillin pharmacokinetics in pregnant women with preterm premature rupture of the membranes. Am J Obstet Gynecol. Jan 2008;198(1):108 e101-106.4.Lee M, Bozzo, P., Einarson, A., and Koren, G. Urinary tract infections in pregnancy. June 2008 ed; 2008.
        5.##Jepsen P, Skriver MV, Floyd A, Lipworth L, Schonheyder HC, Sorensen HT. A population-based study of maternal use of amoxicillin and pregnancy outcome in Denmark. Br J Clin Pharmacol. Feb 2003;55(2):216-221.
        6.##Silverman NS, Sullivan M, Hochman M, Womack M, Jungkind DL. A randomized, prospective trial comparing amoxicillin and erythromycin for the treatment of Chlamydia trachomatis in pregnancy. Am J Obstet Gynecol. Mar 1994;170(3):829-832.
        7.##Masterton RG, Evans DC, Strike PW. Single-dose amoxycillin in the treatment of bacteriuria in pregnancy and the puerperium--a controlled clinical trial. Br J Obstet Gynaecol. May 1985;92(5):498-505.
        8.##Briggs G, Freeman, R., and Yaffe, S. Drugs in Pregancy and Lactation. Vol Seventh Ed. Philadelphia PA: Lippincott, Williams, and Wilkins; 2005.

        "Pregnancy: Metronidazole does not increase the risk of congenital malformations in the newborn if taken in proper recommended dosages. [1,2,3] Metronidazole is an antibiotic that is commonly used in the treatment of anaerobic bacteria or protozoa. It can be prescribed orally or as a topical preparation. A prospective controlled cohort study looking at the pregnancy outcomes of women who took metronidazole during gestation concluded that metronidazole , if taken in proper recommended dosages, does not increase the risk of congenital malformations in the newborn." (Medications and Mothers' Milk database, Dr Thomas Hale PhD).

        1.##Diav-Citrin O, Shechtman S, Gotteiner T, Arnon J, Ornoy A. Pregnancy outcome after gestational exposure to metronidazole: a prospective controlled cohort study. Teratology. May 2001;63(5):186-192.
        2.##Burtin P, Taddio A, Ariburnu O, Einarson TR, Koren G. Safety of metronidazole in pregnancy: a meta-analysis. Am J Obstet Gynecol. Feb 1995;172(2 Pt 1):525-529.
        3.##Kazy Z, Puho E, Czeizel AE. Teratogenic potential of vaginal metronidazole treatment during pregnancy. Eur J Obstet Gynecol Reprod Biol. Dec 1 2005;123(2):174-178.

        Sandra Lovato R.N.
        InfantRisk Center