Kara asked
My child was prescribed amoxicillin for a ear infection. Should I be giving that with food or does it not matter?
At a glance
- Food does not alter the effectiveness of immediate release amoxicillin products. However, Moxatag (extended release amoxicillin) is recommended to be given with food or within one hour of finishing a meal.
Answer
Immediate release amoxicillin products (e.g. capsules, suspension) can safely be taken with or without food. There are no interactions known that could potentially decrease effectiveness.
Per the prescribing information for amoxicillin capsules:
"Capsules, chewable tablets, and oral suspensions of AMOXIL may be given without regard to meals. The 400-mg suspension, 400-mg chewable tablet, and the 875-mg tablet have been studied only when administered at the start of a light meal. However, food effect studies have not been performed with the 200-mg and 500-mg formulations."
However, the extended release amoxicillin product, Moxatag, does have a specific recommendation when it comes to food. It is recommended to take either with food or within one hour of eating food:
"Patients should be informed that the recommended dose of MOXATAG is 775 mg once daily taken with food for 10 days. MOXATAG should be taken within 1 hour of finishing a meal and at approximately the same time every day."
It is true that certain antibiotics have significant interactions with food. One example is with tetracycline antibiotics. If taken with food high in calcium or magnesium, the total absorption of these antibiotics can be significantly decreased, which may alter effectiveness.
The prescribing information for doxycycline states:
"All patients taking doxycycline should be advised: that the absorption of tetracyclines is reduced when taken with foods, especially those that contain calcium. However, the absorption of doxycycline is not markedly influenced by simultaneous ingestion of food or milk."
So, overall:
- Immediate release amoxicillin tablets, capsules and liquids can be taken with or without food.
- Moxatag (amoxicillin extended release) should be taken with food or within one hour of food.
It is important to note that the most prevalent side effects of amoxicillin are nausea and general gastrointestinal discomfort.
Even though immediate release amoxicillin products don't have to be taken with food, doing so can help to reduce nausea and make them better tolerated. Several studies suggest giving it with food, especially in children and adolescents, to improve tolerability.
About Amoxicillin
Amoxicillin is an "aminopenicillin" similar to ampicillin and penicillin. It is better absorbed than ampicillin, allowing for fewer daily doses and has a broader spectrum of activity compared to penicillin.
It is used to treat a variety of bacterial infections, including:
- Ear infections
- Sinus infections
- Bronchitis
- Cystitis
It is available in many different dosage forms, including capsules, tablets and liquid suspensions. The liquid suspensions are stable for 14 days at room or refrigeration, so refrigeration isn't required. Nevertheless, refrigeration is the recommended storage condition as it improves tolerability.
