
My Wife Has Had 3 TKRs On Her Left Knee,

Question: My wife has had 3 TKRs on her left knee, last one resulted in strep equine infection. For that she has been taking Keflex, 500 mg, twice a day, for a couple of years. She continually suffers stomach distress, of late, so the Infectious Disease DR prescribed a new medicine Amox-Clay, 500 MG, twice a day. The warnings include it may cause kidney damage. She has a low GFR, in low 20s and is wary of any damage.. Does the new medicine endanger her kidneys?

My wife has had 3 TKRs on her left knee, last one resulted in strep equine infection. For that she has been taking Keflex, 500 mg, twice a day, for a couple of years. She continually suffers stomach distress, of late, so the Infectious Disease DR prescribed a new medicine Amox-Clay, 500 MG, twice a day. The warnings include it may cause kidney damage. She has a low GFR, in low 20s and is wary of any damage.. Does the new medicine endanger her kidneys?
Brief Answer:
Amox-Clavulanate at 500 mg is an appropriate dose
Detailed Answer:
Hello, I'm Dr. Branch, thanks for using Ask a Doctor. You are right to be careful with medications given your wife's kidney disease, as medication doses often need to be adjusted, and toxicity is more common. Fortunately, it appears your infectious disease doctor took that into consideration, as the dose of Amox-Clavulanate with someone with a low GFR like your wife's would be decreased to 250-500 mg every 12 hours, so it looks like she is on an appropriate dose.
It is also true that penicillin antibiotics such as amox-clavulanate can sometimes cause kidney damage. Unfortunately almost all antibiotics and medications can do this, so the benefit of the medication has to be determined to be greater than this risk, which it sounds like is the case for your wife. I wouldn't be too concerned about this, especially since your infectious disease doctor (and probably kidney doctor) will be monitoring for this, but if she does notice any decreased urine output, dark or red urine, or an itchy rash, you should contact your doctor immediately.
I hope that helps, please let me know if you have any questions about any of that, and I would be glad to discuss it with you further.
Amox-Clavulanate at 500 mg is an appropriate dose
Detailed Answer:
Hello, I'm Dr. Branch, thanks for using Ask a Doctor. You are right to be careful with medications given your wife's kidney disease, as medication doses often need to be adjusted, and toxicity is more common. Fortunately, it appears your infectious disease doctor took that into consideration, as the dose of Amox-Clavulanate with someone with a low GFR like your wife's would be decreased to 250-500 mg every 12 hours, so it looks like she is on an appropriate dose.
It is also true that penicillin antibiotics such as amox-clavulanate can sometimes cause kidney damage. Unfortunately almost all antibiotics and medications can do this, so the benefit of the medication has to be determined to be greater than this risk, which it sounds like is the case for your wife. I wouldn't be too concerned about this, especially since your infectious disease doctor (and probably kidney doctor) will be monitoring for this, but if she does notice any decreased urine output, dark or red urine, or an itchy rash, you should contact your doctor immediately.
I hope that helps, please let me know if you have any questions about any of that, and I would be glad to discuss it with you further.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj

Brief Answer:
Amox-Clavulanate at 500 mg is an appropriate dose
Detailed Answer:
Hello, I'm Dr. Branch, thanks for using Ask a Doctor. You are right to be careful with medications given your wife's kidney disease, as medication doses often need to be adjusted, and toxicity is more common. Fortunately, it appears your infectious disease doctor took that into consideration, as the dose of Amox-Clavulanate with someone with a low GFR like your wife's would be decreased to 250-500 mg every 12 hours, so it looks like she is on an appropriate dose.
It is also true that penicillin antibiotics such as amox-clavulanate can sometimes cause kidney damage. Unfortunately almost all antibiotics and medications can do this, so the benefit of the medication has to be determined to be greater than this risk, which it sounds like is the case for your wife. I wouldn't be too concerned about this, especially since your infectious disease doctor (and probably kidney doctor) will be monitoring for this, but if she does notice any decreased urine output, dark or red urine, or an itchy rash, you should contact your doctor immediately.
I hope that helps, please let me know if you have any questions about any of that, and I would be glad to discuss it with you further.
Amox-Clavulanate at 500 mg is an appropriate dose
Detailed Answer:
Hello, I'm Dr. Branch, thanks for using Ask a Doctor. You are right to be careful with medications given your wife's kidney disease, as medication doses often need to be adjusted, and toxicity is more common. Fortunately, it appears your infectious disease doctor took that into consideration, as the dose of Amox-Clavulanate with someone with a low GFR like your wife's would be decreased to 250-500 mg every 12 hours, so it looks like she is on an appropriate dose.
It is also true that penicillin antibiotics such as amox-clavulanate can sometimes cause kidney damage. Unfortunately almost all antibiotics and medications can do this, so the benefit of the medication has to be determined to be greater than this risk, which it sounds like is the case for your wife. I wouldn't be too concerned about this, especially since your infectious disease doctor (and probably kidney doctor) will be monitoring for this, but if she does notice any decreased urine output, dark or red urine, or an itchy rash, you should contact your doctor immediately.
I hope that helps, please let me know if you have any questions about any of that, and I would be glad to discuss it with you further.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj


Thanks for a good, complete answer, but I have a related question. She is constantly fighting pain in her knee. She tried CBD salve, 2000 mg, but it had no noticeable benefit. She tried CBD oil, 100mg but no effect on pain. Do you think CBD with THC could help but of course obtaining it is problematic in NM. But it is possible. XXXXXXX

Thanks for a good, complete answer, but I have a related question. She is constantly fighting pain in her knee. She tried CBD salve, 2000 mg, but it had no noticeable benefit. She tried CBD oil, 100mg but no effect on pain. Do you think CBD with THC could help but of course obtaining it is problematic in NM. But it is possible. XXXXXXX
Brief Answer:
THC could help
Detailed Answer:
I don't have a lot of experience with these products, as they are relatively new, but from my research, it appears that THC could help with pain where CBD does not, as they work differently on the brain, and THC seems to be used more for chronic pain. So I would say it is possible, and if you can get it, it would be worth trying to see if it helps with your wife's pain. Other treatments, which you may already be aware of, would including Tylenol/Ibuprofen, opioids such as tramadol or hydrocodone (not typically recommended for chronic pain but sometimes are used), topical treatments such as topical diclofenac (which can work well for the knee joint) or capsaicin, and antidepressants that also work to decrease pain such as Cymbalta or amitriptyline. If she is having significant pain, it might be beneficial to get a referral to a pain management doctor who specializes in these and other treatments.
Please let me know if you have any other questions, I'd be glad to help any way I can.
THC could help
Detailed Answer:
I don't have a lot of experience with these products, as they are relatively new, but from my research, it appears that THC could help with pain where CBD does not, as they work differently on the brain, and THC seems to be used more for chronic pain. So I would say it is possible, and if you can get it, it would be worth trying to see if it helps with your wife's pain. Other treatments, which you may already be aware of, would including Tylenol/Ibuprofen, opioids such as tramadol or hydrocodone (not typically recommended for chronic pain but sometimes are used), topical treatments such as topical diclofenac (which can work well for the knee joint) or capsaicin, and antidepressants that also work to decrease pain such as Cymbalta or amitriptyline. If she is having significant pain, it might be beneficial to get a referral to a pain management doctor who specializes in these and other treatments.
Please let me know if you have any other questions, I'd be glad to help any way I can.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj

Brief Answer:
THC could help
Detailed Answer:
I don't have a lot of experience with these products, as they are relatively new, but from my research, it appears that THC could help with pain where CBD does not, as they work differently on the brain, and THC seems to be used more for chronic pain. So I would say it is possible, and if you can get it, it would be worth trying to see if it helps with your wife's pain. Other treatments, which you may already be aware of, would including Tylenol/Ibuprofen, opioids such as tramadol or hydrocodone (not typically recommended for chronic pain but sometimes are used), topical treatments such as topical diclofenac (which can work well for the knee joint) or capsaicin, and antidepressants that also work to decrease pain such as Cymbalta or amitriptyline. If she is having significant pain, it might be beneficial to get a referral to a pain management doctor who specializes in these and other treatments.
Please let me know if you have any other questions, I'd be glad to help any way I can.
THC could help
Detailed Answer:
I don't have a lot of experience with these products, as they are relatively new, but from my research, it appears that THC could help with pain where CBD does not, as they work differently on the brain, and THC seems to be used more for chronic pain. So I would say it is possible, and if you can get it, it would be worth trying to see if it helps with your wife's pain. Other treatments, which you may already be aware of, would including Tylenol/Ibuprofen, opioids such as tramadol or hydrocodone (not typically recommended for chronic pain but sometimes are used), topical treatments such as topical diclofenac (which can work well for the knee joint) or capsaicin, and antidepressants that also work to decrease pain such as Cymbalta or amitriptyline. If she is having significant pain, it might be beneficial to get a referral to a pain management doctor who specializes in these and other treatments.
Please let me know if you have any other questions, I'd be glad to help any way I can.
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj

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