Can Augmentin Cause Heartburn?
Yes, Augmentin (amoxicillin/clavulanate) can cause gastrointestinal side effects including indigestion, which may manifest as heartburn, though this is not among the most commonly reported adverse reactions. 1
Evidence from FDA Drug Label
The FDA-approved prescribing information for Augmentin provides clear documentation of gastrointestinal adverse effects:
Most frequent adverse reactions in clinical trials were diarrhea/loose stools (9%), nausea (3%), skin rashes and urticaria (3%), vomiting (1%), and vaginitis (1%). 1
Postmarketing surveillance has identified additional gastrointestinal effects including indigestion, gastritis, stomatitis, and glossitis. 1
The overall incidence of adverse reactions, particularly diarrhea, increases with higher recommended doses. 1
Less than 3% of patients discontinued therapy due to drug-related adverse reactions. 1
Clinical Context and Mechanism
While heartburn is not explicitly listed among the most common side effects, the documented occurrence of indigestion and gastritis in postmarketing reports suggests that reflux-type symptoms can occur. 1
Important distinction: The gastrointestinal side effects from Augmentin differ mechanically from gastroesophageal reflux disease (GERD). Patients experiencing heartburn-like symptoms while on Augmentin should be evaluated to determine whether this represents:
- Drug-induced gastritis or indigestion 1
- Coincidental GERD (which affects a substantial portion of the general population) 2
- Other gastrointestinal pathology requiring investigation 2
Management Considerations
If a patient develops heartburn while taking Augmentin:
Consider antacid therapy with H2 blockers or proton pump inhibitors if symptoms are bothersome, as these are commonly used for drug-induced dyspepsia. 2
Avoid NSAIDs concurrently, as these can exacerbate gastrointestinal symptoms. 2
Monitor for more serious gastrointestinal complications such as pseudomembranous colitis if diarrhea develops, though this is distinct from heartburn. 1
Complete the antibiotic course unless symptoms are severe or intolerable, as the gastrointestinal effects are typically mild and self-limited. 1
The tolerability profile of Augmentin has been well-established over more than 20 years of clinical use, with gastrointestinal disturbances being generally mild and manageable. 3, 4