Can I take naproxen with Augmentin (amoxicillin/clavulanate)?

Naproxen and Augmentin Can Be Taken Together with Caution

Yes, naproxen can be taken with Augmentin (amoxicillin/clavulanate), but caution is advised due to potential gastrointestinal risks.

Safety of the Combination

Naproxen (an NSAID) and Augmentin (an antibiotic) do not have a direct pharmacological interaction that would prevent their concurrent use. However, both medications have independent risks that should be considered:

• Augmentin is an antibiotic combination of amoxicillin and clavulanic acid used to treat bacterial infections 1
• Naproxen is a non-selective NSAID that carries gastrointestinal and cardiovascular risks 2

Risk Assessment Before Taking This Combination

Gastrointestinal Risk Factors

Before taking naproxen with Augmentin, consider these risk factors for GI complications:

• Age: Risk increases 2-3.5 fold in patients over 65 years 2
• Previous GI events: 2.5-4 times higher risk in patients with history of ulcers or bleeding 2
• Concomitant medications:
  • Anticoagulants increase GI bleeding risk approximately 3-fold 2
  • Corticosteroids increase risk approximately 2-fold 2

Cardiovascular Considerations

• Non-selective NSAIDs like naproxen may affect cardiovascular risk 2
• If you have cardiovascular disease, discuss with your healthcare provider before using naproxen

Recommendations for Safe Use

If you need to take both medications:

1. Use the lowest effective dose of naproxen for the shortest duration possible 2
2. Consider gastroprotection:
   • For high-risk patients, a proton pump inhibitor (PPI) should be added when taking naproxen 2
   • PPIs can reduce the risk of bleeding ulcers by 75-85% in high-risk NSAID users 2
3. Timing of administration:
   • Take naproxen with food to reduce direct gastric irritation
   • Follow the specific instructions for Augmentin (typically taken at the start of a meal)
4. Monitor for warning signs:
   • Abdominal pain
   • Black/tarry stools
   • Vomiting blood

Special Populations

Patients on Anticoagulants

• Avoid NSAIDs if possible in patients taking anticoagulants 2
• If concurrent use is necessary, monitor closely and use GI prophylaxis 2

Breastfeeding Women

• Naproxen is considered safe during breastfeeding 2
• Discuss Augmentin use during breastfeeding with your healthcare provider

Alternative Options

If you're concerned about the combination:

• Consider acetaminophen (paracetamol) as an alternative pain reliever, which has no increased risk of GI complications 3
• For inflammation, discuss with your healthcare provider about temporarily delaying either medication if possible

Remember to always inform all healthcare providers about all medications you are taking, including over-the-counter drugs and supplements.