Transplant: Amoxicillin for dental appointment

Posted by hello1234 @hello1234, Nov 17, 2021

Hi all,
I have an 8am morning dentist appointment next week. The dentist would like me to take 2,000mg amoxicillin one hour before the appointment to prevent infection. Normally at 7am I take my Cellcept and Envarsus XR. What do you do in this instance? Has anyone taken amoxicillin with Cellcept and Envarsus XR? Do you take amoxicillin when you visit your dentist or go for a dental cleaning? Thanks everyone!!

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My dentist said he would do whatever my transplant team advised. And they did not require it for me. The dentist said that it was not standard practice anymore to use it except in specific situations. I don’t know what situations would apply, maybe which organ? Or underlying conditions?
So, I’m taking Cellcept and Tacrolimus and do not take an antibiotic prior to dental work – except once when I had a root canal. And for that I took it for 7-10 days 2 weeks before the procedure.

@hello, this is definitely a question for your kidney transplant team. You can easily ask your on your Mayo Patient Portal. (Note that they are saying to give 4 days to respond)

Let you us know what you find out.

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Thanks so much for the good information @rosemarya 😊 I just sent a message to transplant. When you had your root canal, did you take amoxicillin as your antibiotic?

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@hello1234

Thanks so much for the good information @rosemarya 😊 I just sent a message to transplant. When you had your root canal, did you take amoxicillin as your antibiotic?

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Yes. The endodontist wanted to be sure that I didn’t have an infection because I was experiencing some Jaw pain.
In my own experience, I have been prescribed amoxicillin on several occasions. It seems to be the ‘go to’ antibiotic for general use.

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Thank you very much @rosemarya 😊 I really appreciate your information (and how fast you got back to me!) It's comforting to know that amoxicillin is used on a regular basis with transplant patients on Cellcept and Tacronlimis (Envarsus VR). My transplant nurse also just responded in the portal. She just messaged me that it's fine to take my Cellcept, Envarsus XR and the 2,000mg amoxicillin together.
Thank you again for jumping in to help me…you are awesome!!

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I’m messaging while my husband is driving! It is a good distraction from the crazy traffic today.

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Per my transplant team, I take 2,000 mgs amoxicillin, 1 hour prior to my dental appointment. For me, if I’m supposed to take it at or close to my regular meds, I adjust both by 15 minutes, taking my meds 15 minutes earlier and the amoxicillin 45 minutes before my scheduled appointment. I’m concerned about stomach upset. I figure I sit there getting waiting and getting numb at least 15 minutes.

Did you have your appointment with your ultrasound yet, @hello1234?

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@athenalee

Per my transplant team, I take 2,000 mgs amoxicillin, 1 hour prior to my dental appointment. For me, if I’m supposed to take it at or close to my regular meds, I adjust both by 15 minutes, taking my meds 15 minutes earlier and the amoxicillin 45 minutes before my scheduled appointment. I’m concerned about stomach upset. I figure I sit there getting waiting and getting numb at least 15 minutes.

Did you have your appointment with your ultrasound yet, @hello1234?

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😊 Hi @athenalee 💃 Thank you for your idea regarding separating the time you take the immune suppression drugs and the time you take the amoxicillin. I think I will do the same. I think I will take my Cellcept and Envarsus XR a little earlier than normal and then take the amoxicillin right before I leave for the dentist. That's a good idea!

Regarding my upcoming liver ultrasound and fibroscan, the hospital called and rescheduled my appointment for next Friday morning. They asked me to fast and not drink after midnight. I have five pills that I need to take that morning at 7am. My tests are 8am. The directions say I can take my morning pills with a "sip" of water, but FIVE pills are more like a glass of water, than a sip of water. What do you do in this situation? Should I take my pills after the ultrasound and fibroscan which may be an hour or more likely two hours later than normal or risk drinking too much water for the tests… What are your thoughts? Also, I normally eat with my pills which will probably mean that my med levels will be too high with no food. I am having a dilemma regarding the prep for this test and I would love your advice!

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@hello1234

😊 Hi @athenalee 💃 Thank you for your idea regarding separating the time you take the immune suppression drugs and the time you take the amoxicillin. I think I will do the same. I think I will take my Cellcept and Envarsus XR a little earlier than normal and then take the amoxicillin right before I leave for the dentist. That's a good idea!

Regarding my upcoming liver ultrasound and fibroscan, the hospital called and rescheduled my appointment for next Friday morning. They asked me to fast and not drink after midnight. I have five pills that I need to take that morning at 7am. My tests are 8am. The directions say I can take my morning pills with a "sip" of water, but FIVE pills are more like a glass of water, than a sip of water. What do you do in this situation? Should I take my pills after the ultrasound and fibroscan which may be an hour or more likely two hours later than normal or risk drinking too much water for the tests… What are your thoughts? Also, I normally eat with my pills which will probably mean that my med levels will be too high with no food. I am having a dilemma regarding the prep for this test and I would love your advice!

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I would definitely ask your transplant nurse. When I’ve had to fast like that, they’ve said it’s important to do the tests correctly for the best results. They said, in those instances it’s ok to take the pills 1-3 hours later. So, I always bring my pills with me and a bottle of water, so I can take the pills immediately after I’m done with the test.

Otherwise, talk with the ultrasound people about taking your pills with as little water as possible.

Best wishes and think positive!

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@hello1234, I’m curious since I’m up for regular checkup. Is your dental appointment for cleaning and routine checkup only or for a major procedure?

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@leahdrose

@hello1234, I’m curious since I’m up for regular checkup. Is your dental appointment for cleaning and routine checkup only or for a major procedure?

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Hi @leahdrose 😊 It's always great to hear from you!! This dental appointment is for a deep cleaning with the hygienist. How are things going with you and your appointments, labs and is your biopsy scheduled?

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I had a pancreas transplant in 2005. Part of the aftercare was an antibiotic prescription to take as a prophylactic before dental appointments. It was explained to me that this was necessary to prevent/treat infections I might encounter with dental procedures since I’m immune suppressed. It wasn’t amoxicillin since I have an amoxicillin allergy but I don’t remember what it was. This went on for several years before routine dental cleanings/exams. At some point I broke a crown, had to find a new dentist (insurance change) to repair it. Antibiotic prophylaxis was no longer a consideration. This past summer I found out I needed a root canal in a different area. The endodontist (another new provider due to insurance change) prescribed an antibiotic for pain I was having not for a prophy. I got the root canal and followed up with a permanent filling. I’ve had 3 new providers this past year and no more antibiotic prophylaxis. Maybe this is because I am so far past the original transplant and I am still here, thank God!

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@hello1234

Hi @leahdrose 😊 It's always great to hear from you!! This dental appointment is for a deep cleaning with the hygienist. How are things going with you and your appointments, labs and is your biopsy scheduled?

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@hello1234, thank you for your reply.
BK virus <34.50, CMV <500, Creatinine 1.12 slightly elevated from last time. My regular nephrologist referred me to another nephrologist in the group plan to further analyze my case. No schedule for biopsy yet. I’m reluctant to have biopsy due to risks involved, and it might further damage the new kidney. But if it’s extremely necessary, then I have no choice. I have an appointment with transplant nephrologist at UCLA tomorrow. Will keep you updated.

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