Co-amoxiclav is a combination antibiotic used for bacterial infections.

It contains amoxicillin (an antibiotic from the penicillin group of medicines) mixed with clavulanic acid. The clavulanic acid stops bacteria from breaking down amoxicillin, allowing the antibiotic to work better.

It is used in adults and children to treat:

• middle ear and sinus infections
• throat or lung respiratory tract infections
• urinary tract infections
• skin and soft tissue infections
• dental infections
• joint and bone infections

The medicine is only available on prescription. It comes as tablets or as a liquid that you drink.

It's also given by injection, but this is usually only done in a hospital.

• For most infections, you'll start to feel better within a few days.
• Usually you take co-amoxiclav 3 times a day.
• The most common side effects of co-amoxiclav are diarrhoea, thrush and feeling or being sick.
• Co-amoxiclav liquid can stain teeth. This is not permanent and brushing your teeth will remove any stains.
• Co-amoxiclav is also called by the brand name Augmentin.

Co-amoxiclav can be taken by adults, including pregnant and breastfeeding women.

Co-amoxiclav can be taken by children.

Co-amoxiclav is not suitable for some people. To make sure co-amoxiclav is safe for you, tell your doctor if you:

• have had an allergic reaction to amoxicillin, clavulanic acid, penicillin or any of the other ingredients
• have had a severe allergic reaction to any other antibiotic. This can include a skin rash or swelling of the face and throat
• have ever had liver problems or jaundice (yellowing of the skin) when taking antibiotics
• have (or think you may have) glandular fever
• have liver or kidney problems
• are not peeing regularly

The usual dose of co-amoxiclav is 1 tablet (either 375mg or 625mg) taken 3 times a day.

The dose may be lower for children. The doctor will use your child's weight to work out the right dose for them.

Try to space the doses out evenly throughout the day, at least 4 hours apart.

How to take it

Take co-amoxiclav with a meal or snack. This will make you less likely to feel sick.

Swallow the tablets whole with a glass of water.

If you find tablets hard to swallow, you can break them in half. There is a line down the middle to make them easier to break. Take both pieces at the same time, swallowing one after the other.

If you are taking co-amoxiclav as a liquid, shake the bottle well before using. The medicine will come with a plastic syringe or spoon to help you measure out the right dose. If you do not have one, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not give the right amount.

What if I forget to take it?

If you forget to take a dose, take it as soon as you remember, then wait about 4 hours before taking your next one. However, if it's nearly time for your next dose just leave out the missed one and take your next dose as normal.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you. You could ask your pharmacist for advice on other ways to remember your medicines.

What if I take too much?

Accidently taking 1 extra dose of co-amoxiclav is unlikely to harm you. Signs of taking too much co-amoxiclav might include an upset stomach (feeling or being sick, or diarrhoea) or having a fit (seizure).

Speak to your pharmacist or doctor as soon as possible if you take 2 extra doses or more.

Like all medicines, co-amoxiclav can cause side effects, although not everyone gets them.

Common side effects

These common side effects happen in around 1 in 10 people. Keep taking the medicine but talk to your doctor or pharmacist if these side effects bother you or don't go away:

• diarrhoea
• itching, redness and discomfort in or around your mouth, armpits, vagina, penis or groin area – these are symptoms of thrush (a yeast infection)
• feeling or being sick (nausea or vomiting), especially when taking high doses of co-amoxiclav

Serious side effects

Serious side effects are not common and happen in less than 1 in 100 people.

Tell a doctor straight away if you have:

• a skin rash which may blister, and looks like small targets (central dark spots surrounded by a paler area, with a dark ring around the edge – these are signs of a skin reaction called erythema multiforme)
• watery diarrhoea – usually with blood and mucus
• stomach pain, possibly with a high temperature – these are signs of inflammation of the large intestines
• pale poo with dark pee, yellowing of the skin or the whites of your eyes – these are warning signs of liver or gall bladder problems. This can happen even after you have finished taking this medicine

Serious allergic reaction

In rare cases, co-amoxiclav can cause a serious allergic reaction (anaphylaxis).

These are not all the side effects of co-amoxiclav. For a full list see the leaflet inside your medicines packet.

What to do about:

• diarrhoea – drink plenty of fluids, such as water or squash to avoid dehydration. Signs of dehydration include peeing less than usual or having strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor
• thrush – ask your pharmacist or doctor for advice if this happens to you
• feeling or being sick – stick to simple meals and do not eat rich or spicy food. Take co-amoxiclav with food. Drink lots of fluids, such as water or squash – take small, frequent sips if you feel sick to avoid dehydration. Signs of dehydration include peeing less than usual or having strong-smelling pee. Do not take any other medicines without speaking to a pharmacist or doctor

It's usually safe to take co-amoxiclav during pregnancy and while breastfeeding.

For more information about how co-amoxiclav can affect you and your baby during pregnancy, read this leaflet on the Best Use of Medicines in Pregnancy (BUMPS) website.

There are some medicines that do not mix well with co-amoxiclav.

Tell your doctor if you're taking these medicines before you start taking co-amoxiclav:

• allopurinol or probenecid, which are used to treat gout
• a blood thinner called warfarin
• methotrexate, which is used to treat cancer or rheumatic diseases
• mycophenolate mofetil, which is used to prevent the rejection of transplanted organs

Mixing co-amoxiclav with herbal remedies or supplements

There are no known problems with taking herbal remedies and supplements alongside co-amoxiclav.