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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Dizzy And Nauseous After Taking Amoxicillin For Dental Infection. Allergic Reaction?

Hello, my husband had a strange thing happen at the dentist a few weeks ago. He went in for an implant on a Wed. He got 2 shots of local anesthetic because the first one didn t seem to be working/ strong enough. The dentist also found he had an infection under the crown next to the implant although he did not give my husband Amoxicillin until Friday. On Friday my husband went back to dentist for more local anesthetic and root canal . He came home around noon, ate lunch, and started Amoxicillin. From that evening he started feeling really dizzy and nauseous. On Sat he almost could not function; he was eating but almost vomited and he had to take a very long nap in the afternoon because he was just too dizzy. Slowly, over the weekend, he began to feel better and was able to drive and go to work on Mon. He kept taking Amoxicillin for 10 days. Does this seem like an allergic reaction or a toxicity from too much anesthetic? Reaction to PABA or some other chemical in anesthetic? Dentist seems to think it is an allergy to Amoxicillin .... but my husband has taken antibiotics before w/o such a reaction. Also, he began to feel strange on Thurs even BEFORE starting Amoxicillin.
Sat, 3 Aug 2013
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Allergist and Immunologist 's  Response
Hello,
Thank you for the detailed query. However, the timeline of starting amoxicillin is a bit confusing when you say 'from that evening (i.e., Friday) he started amoxicillin' while the last sentence contradicts this.
Anyway, you are right that this is unlikely a reaction to amoxicillin as he had CONTINUED to take this and was all right. If the 'dizziness' was part of a reaction to penicillin, then he would have been far worse after that!
Local anaesthetic (LA) allergy or an intolerance reaction is more likely. Why I say intolerance is because occasionally adrenaline is mixed with the LA and if the injection accidentally goes into the blood stream you feel the adrenaline effects. Your husband definitely needs a full workup to ensure he is not allergic to LAs and there are several of them. Skin prick testing, followed by intradermal testing and if he does not react a subcutaneous challenge is then indicated. If he passes all these tests, he is NOT allergic. If he is alergic to the LA he was given then a series of other LA needs to be done at the same time so that cross reactivity is excluded.
I hope this was useful.
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  User's Response
HI
Allergic reaction to tablest of Amoxycillin are something vaery rarely encountered, especially in patients who have earlier recieved other antibiotics. Also, allergy is not manifested as Dizzyness or being nauseous, instead, it is more likely presented as skin rashes/ itching/ swelling like. Side effects from Amoxycillin that are commonly reported are, generally in the form of LOOSE MOTIONS (Diarrhoea).

The dizyness or Nauseous feeling may be more akin to Local Anesthetic solution, which contains Adrenaline, which can slightly rise Blood Pressure. But Adrenaline causes such reaction in patients having some heart related problems. As amount of adrenaline in LA solutions is in very minute amount, generally, unable to evoke such reaction.

Lastly such feeling are some times felt by many patients after dental treatment, as part of anxiety and stress. If it happens agian, seek an advice from physician regarding Blood Pressure and Blood Glucose levels.
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Dizzy And Nauseous After Taking Amoxicillin For Dental Infection. Allergic Reaction?

Hello, Thank you for the detailed query. However, the timeline of starting amoxicillin is a bit confusing when you say from that evening (i.e., Friday) he started amoxicillin while the last sentence contradicts this. Anyway, you are right that this is unlikely a reaction to amoxicillin as he had CONTINUED to take this and was all right. If the dizziness was part of a reaction to penicillin, then he would have been far worse after that! Local anaesthetic (LA) allergy or an intolerance reaction is more likely. Why I say intolerance is because occasionally adrenaline is mixed with the LA and if the injection accidentally goes into the blood stream you feel the adrenaline effects. Your husband definitely needs a full workup to ensure he is not allergic to LAs and there are several of them. Skin prick testing, followed by intradermal testing and if he does not react a subcutaneous challenge is then indicated. If he passes all these tests, he is NOT allergic. If he is alergic to the LA he was given then a series of other LA needs to be done at the same time so that cross reactivity is excluded. I hope this was useful.