Does amoxicillin cause acid reflux? (+3 tips)
By
Ivan Kahwa
Author bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
In this article, we will explore whether amoxicillin causes acid reflux, how amoxicillin causes acid reflux, what factors influence amoxicillin-induced acid reflux and what to do if amoxicillin causes acid reflux. In addition to this, the available pharmacological treatment options will also be discussed.
Does amoxicillin cause acid reflux?
Yes, amoxicillin can cause acid reflux. It is not a commonly reported side effect of amoxicillin. However, some individuals who are prone to gastrointestinal side effects may experience acid reflux after taking amoxicillin. Amoxicillin does show its adverse effects on the gastrointestinal tract.
Amoxicillin is an antibiotic medication commonly used to treat certain bacterial infections (1). Amoxicillin can cause nausea, diarrhoea and some other effects on the gastrointestinal tract. In some cases, an upset stomach or indigestion may contribute to this effect in the patients taking amoxicillin.
If you are taking amoxicillin and experience acid reflux then you may consult your healthcare provider to help you manage the effect and to diagnose the exact cause of this effect.
How does amoxicillin cause acid reflux?
Amoxicillin is a well-tolerated medication but it can cause acid reflux in some individuals. Research studies have shown the potential link between amoxicillin and acid reflux.
Amoxicillin can irritate the lining of the stomach and oesophagus which may lead to gastric distress, acid reflux or heartburn. Amoxicillin can trigger this action in the stomach (2).
Amoxicillin is an antibiotic and antibiotics are found to have an effect on acid secretion in the stomach (3). Amoxicillin can potentiate the acid secretion in the stomach leading to gastric distress which may cause acid reflux as well. It can be dangerous in patients having pre-existing GERD.
Amoxicillin, being an antibiotic disrupts the balance of the gut bacteria that helps with the health of the gastrointestinal tract (4). These are a natural defence of the body against acid reflux. These bacteria help neutralize the effects of acid in the stomach. Due to the disruption of this delicate balance, you may experience aid reflux after taking amoxicillin.
What factors influence amoxicillin-induced acid reflux?
Here are some factors that may influence amoxicillin-induced acid reflux.
Individual factors
If you have pre-existing health conditions such as gastroesophageal reflux disease (GERD), gastric sensitivity or gastric ulcer etc, then you are more susceptible to getting acid reflux after taking amoxicillin.
Certain other conditions including disrupted gut microbiome or gastric sensitivity can increase the risk of a patient experiencing acid reflux after taking amoxicillin.
Some individuals might be more sensitive to the effects of amoxicillin on the gastrointestinal tract due to genetic predisposition, age and gender or physiological condition of the body.
Medication factors
Higher doses are more commonly associated with an increased risk of acid reflux or any other side effect experienced by the patient after taking amoxicillin. In addition to higher doses, prolonged use can also play an essential role in the incidence of side effects like acid reflux.
Concomitant medications such as aspirin or ibuprofen alongside amoxicillin can also cause the patient to experience side effects related to the gastrointestinal tract such as acid reflux (5).
Lifestyle factors
Spicy food, soft drinks, coffee, smoking and alcohol consumption can prove to be essential factors in the lifestyle that increase the risk of a patient experiencing acid reflux (6). These substances relax the oesophageal sphincter which makes it easier for the stomach acid to reflux back.
Stress plays a crucial role in making a patient susceptible to experiencing acid reflux.
What to do if amoxicillin causes acid reflux?
If you are taking amoxicillin and experience acid reflux then you need to consult your healthcare provider.
Consulting healthcare provider
Your healthcare provider, after a thorough analysis and examination, will help you determine the exact cause of acid reflux and will tailor your treatment plan according to the requirements of your body.
Your doctor might suggest lowering your dose and modifying the duration of use of amoxicillin. The dose and duration of medication play an important role in the incidence of side effects. Your doctor may also suggest some over-the-counter medication to help manage your condition.
If by altering the dosage plan, acid reflux does not subside then your doctor may suggest an alternative treatment option to lower the incidence of side effects.
Alternative to amoxicillin
Your doctor may recommend one of the following to provide the therapeutic effect and to lower the adverse effects.
- Penicillin such as Omnicef or Vantin
- Cephalosporin such as Keflex or Cefzil
- Macrolides such as Zithromax or Biaxin
- Cleocin
- Vibramycin
The specific choice of antibiotic will depend upon the specific type of bacterial infection you have or the intensity of the infection.
What are pharmacological treatment options to treat amoxicillin-induced acid reflux?
Several medications can help manage the acid reflux caused by amoxicillin. The treatment options may include:
Proton-pump inhibitors PPIs
PPIs are the most potent medications available to treat acid reflux. They can treat even the most severe cases of acid reflux. They are acid suppressants and offer relief to the patients. These include (7):
- Omeprazole
- Lansoprazole
- Esomeprazole
- Pantoprazole
- Rabeprazole
H2 receptor antagonist
H2 receptor antagonists reduce the production of acid in the stomach thereby helping with acid reflux. They are good for mild symptoms. The medications in this class may include (8):
- Ranitidine
- Famotidine
- Cimetidine
- Nizatidine
Antacids
Antacids neutralize the acidic effects on the stomach and provide immediate relief but they do not heal the damage caused by acid in the stomach. Some commonly used antacids include:
- Tums
- Rolaids
- Alka-seltzer
- Maalox
How to manage amoxicillin-induced acid reflux?
Here are a few tips to help manage the condition of amoxicillin-induced acid reflux:
- Take amoxicillin with food or milk
- Elevate your head while sleeping
- Avoid trigger foods such as spicy food or smoking.
- Don’t keep your stomach empty. Take smaller, more frequent meals.
- Do not lie down immediately after eating.
- Use antacids to help with the acidity.
In my opinion, amoxicilin can cause acid reflux although it is not a common report. The incidence and risk largely depend upon certain other factors such as individual sensitivity, patient’s medical condition and certain concurrent medications.
However, the acid reflux might not be observed in every patient taking amoxicillin. Some might not even expereince it. If you experience this side effect after taking amoxicillin and it interferes with your normal routine then you need to consult your healthcre provider.
Was this helpful?
References
1.-
Akhavan, B. J. (2023, November 17). Amoxicillin. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK482250/#:~:text=primary%20care%20setting.,Amoxicillin%20is%20an%20aminopenicillin%20created%20by%20adding%20an%20extra%20amino,negative%20organisms%20compared%20to%20penicillin.
2.-
Sherwood, P. V., Wibawa, J. I., Atherton, J. C., Jordan, N., Jenkins, D., Barrett, D. A., Shaw, P. N., & Spiller, R. C. (2002). Impact of acid secretion, gastritis, and mucus thickness on gastric transfer of antibiotics in rats. Gut, 51(4), 490–495. https://doi.org/10.1136/gut.51.4.490
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Abdi, S., Masbough, F., Nazari, M., & Abbasinazari, M. (2022). Drug-induced esophagitis and helpful management for healthcare providers. Gastroenterology and hepatology from bed to bench, 15(3), 219–224. https://doi.org/10.22037/ghfbb.v15i3.2591
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Yang, L., Bajinka, O., Jarju, P. O., Tan, Y., Taal, A. M., & Ozdemir, G. (2021). The varying effects of antibiotics on gut microbiota. AMB Express, 11(1), 116. https://doi.org/10.1186/s13568-021-01274-w
5.-
Ruszniewski P, Soufflet C, Barthélémy P. Nonsteroidal anti-inflammatory drug use as a risk factor for gastro-oesophageal reflux disease: an observational study. Aliment Pharmacol Ther. 2008 Nov 1;28(9):1134-9. doi: 10.1111/j.1365-2036.2008.03821.x. Epub 2008 Jul 30. PMID: 18671778
6.-
Choe, J. W., Joo, M. K., Kim, H. J., Lee, B. J., Kim, J. H., Yeon, J. E., Park, J. J., Kim, J. S., Byun, K. S., & Bak, Y. T. (2017). Foods Inducing Typical Gastroesophageal Reflux Disease Symptoms in Korea. Journal of neurogastroenterology and motility, 23(3), 363–369. https://doi.org/10.5056/jnm16122
7.-
Kinoshita, Y., Ishimura, N., & Ishihara, S. (2018). Advantages and Disadvantages of Long-term Proton Pump Inhibitor Use. Journal of neurogastroenterology and motility, 24(2), 182–196. https://doi.org/10.5056/jnm18001
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Histamine Type-2 Receptor Antagonists (H2 Blockers). (2018, January 25). LiverTox – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK547929/
