Drug Interaction Report

Ampicillin Injection and Khat: Interaction Details

AI-assisted, pharmacist-reviewed · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Ampicillin Injection

Omnipen-N® Penbritin-S® Polycillin-N® Polyflex Totacillin-N®
+

Khat

No brand names on record
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Updated Jul 11, 2026
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Interaction severity
Moderate
Can be significant — usually manageable with monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 57 documented Ampicillin Injection interactions, 10 are rated moderate — including this one.
Onset
rapid
Evidence
probable
Severity
Moderate

What happens

Reduced effectiveness of ampicillin

Interaction Deep Dive

Khat chewing significantly reduced the rate and extent of ampicillin urinary excretion in 8 healthy subjects except when ampicillin was taken 2 hours after the end of the khat chewing session1.

Why it happens (mechanism)

Reduced absorption of ampicillin speculated to result from formation of insoluble, unabsorbable complexes between the tannin content of khat and ampicillin

Literature reports

1 report — tap to read

a) Khat chewing significantly reduced the percentage excreted unchanged and maximum peak excretion in urine, and increased in the maximum time to reach the peak excretion of ampicillin in 8 healthy male subjects in a crossover study. A single dose of ampicillin 500 milligrams was taken orally in 5 conditions with a washout period of 7 days between each condition: (A) alone under fasting conditions, (B) just before khat chewing, (C) just before khat chewing with regular food and drink, (D) 2 hours before khat chewing, (E) midway through the 4 hour khat chewing session, and (F) 2 hours after the end of the khat chewing session. Khat ('Sauty') was obtained from a local market in Yemen. Urine measures of excretion were used to estimate bioavailability; urine was collected at 0, 1, 2, 3, 4, 5, 6, 7, 8, and 12 hours after the ampicillin dose. Percentage excreted unchanged and maximum peak excretion in urine were significantly reduced, and maximum time to reach the peak excretion was significantly increased in conditions B, C, D, and E (p less than 0.05). Ampicillin excretion was not affected when taken 2 hours after the end of the khat chewing session (condition F) 1.

Common questions

Can I take Ampicillin Injection and Khat together?

Reduced effectiveness of ampicillin Always confirm with your pharmacist or prescriber before making any change.

How serious is the Ampicillin Injection and Khat interaction?

It is rated moderate. Can be significant — usually manageable with monitoring.

How quickly could this interaction happen?

The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.

How strong is the evidence for this interaction?

The evidence is graded "probable". Good supporting evidence, though not definitively proven.

Questions for your pharmacist

  • Does my dose of Ampicillin Injection or Khat need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there anything you'd monitor while I'm on both?

References (1)

  1. Attef OA, Ali AA, & Hassan MA: Effect of khat chewing on the bioavailability of ampicillin and amoxycillin. J Antimicrob Chemother 1997; 39)4):523-525. PubMed
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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.