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Can I take Co-amoxiclav and Ramipril together?

Drug interaction guide

Taking co-amoxiclav and ramipril together can occasionally increase the risk of a rare but serious allergic reaction called angioedema (swelling under the skin). It may also increase the risk of high potassium levels in the blood or affect your kidney function, especially if you are already unwell with an infection.

Why this happens

Both drugs can affect how the kidneys work and how the body handles potassium. Additionally, certain types of antibiotics (like co-amoxiclav) may rarely increase the risk of swelling reactions when taken with ACE inhibitors like ramipril.

It is generally safe to take these together, but you should be aware of the signs of an allergic reaction. Seek immediate medical help if you experience swelling of the face, lips, or tongue, or have difficulty breathing. Your doctor may want to check your kidney function or potassium levels with a blood test if you are taking these for a long period or if you are feeling very unwell.

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Pregnancy

You must not take ramipril if you are pregnant. It can cause serious harm to your unborn baby, particularly affecting their kidney development.

Penicillin allergy

Do not take co-amoxiclav if you have ever had a severe allergic reaction (such as a skin rash, swelling of the face or neck, or difficulty breathing) to penicillin or any other antibiotic.

Angioedema (swelling)

Seek immediate medical help if you experience swelling of the face, lips, tongue, or throat. Ramipril can cause a rare but life-threatening allergic reaction called angioedema.

Liver problems

Seek immediate medical advice if you develop yellowing of the eyes or skin (jaundice) or pale stools, as co-amoxiclav can cause serious liver inflammation, sometimes weeks after finishing the course.

Alcohol

While alcohol does not directly interact with co-amoxiclav, it is generally advised to avoid alcohol while you are unwell with an infection, as it can make you feel more tired and may contribute to dehydration. Drinking alcohol while taking ramipril can increase the blood pressure-lowering effect of the medicine, which may make you feel dizzy, lightheaded, or faint. It is best to keep alcohol intake to a minimum, especially when you first start taking ramipril or when your dose is increased.

Salt substitutes (Potassium-rich)

Ramipril can increase the levels of potassium in your blood. You should avoid using salt substitutes that contain potassium (such as Lo-Salt) while taking this medicine, as this could lead to dangerously high potassium levels.

Food (General)

To reduce the risk of stomach upset or indigestion, it is best to take co-amoxiclav at the start of a meal or with a snack.

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Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.

Article history

The information on this page is written and peer reviewed by qualified clinicians.

  • 25 Jan 2026 | Originally published
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