The initial phase of such a reaction often starts with a change in mental state, skin rash with intense itching often beginning in fingertips and around groin area and rapidly spreading , and sensations of fever, nausea, and vomiting.
Any other symptoms that seem even remotely suspicious must be taken very seriously. However, more mild allergy symptoms, such as a rash, can occur at any time during treatment, even up to a week after treatment has ceased.
For some people allergic to amoxicillin, the side effects can be fatal due to anaphylaxis. Young children having ingested acute overdoses of amoxicillin manifested lethargy , vomiting, and renal dysfunction.
Anti-peristaltic medicinal products are contra-indicated in this situation. Prolonged therapy Periodic assessment of organ system functions; including renal, hepatic and haematopoietic function is advisable during prolonged therapy.
Elevated liver enzymes and changes in blood counts have been reported see section 4. Anticoagulants Prolongation of prothrombin time has been reported rarely in patients receiving amoxicillin.
Appropriate monitoring should be undertaken when anticoagulants are prescribed concomitantly. Adjustments in the dose of oral anticoagulants may be necessary to maintain the desired level of anticoagulation see section 4. Crystalluria In patients with reduced urine output, crystalluria has been observed very rarely, predominantly with parenteral therapy.
During the administration of high doses of amoxicillin, it is advisable to maintain adequate fluid intake and urinary output in order to reduce the possibility of amoxicillin crystalluria. In patients with bladder catheters, a regular check of patency should be maintained see section 4.
Interference with diagnostic tests Elevated serum and urinary levels of amoxicillin are likely to affect certain laboratory tests. Due to the high urinary concentrations of amoxicillin, false positive readings are common with chemical methods. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.
If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist. It is sensible to limit use of medication during breastfeeding whenever possible.
Tell your prescriber if you are taking vitamins or complementary remedies such as herbal products, as these can also interact with medicines. If you are taking more than one medicine, these may interact with each other. Your prescriber may decide to use medicines which interact with each other if the benefit outweighs the risks. In these cases, the dose of your medicines may need to be adjusted or you may be monitored more closely. Oral anticoagulants Oral anticoagulants and penicillin antibiotics have been widely used in practice without reports of interaction.
However, in the literature there are cases of increased international normalised ratio in patients maintained on acenocoumarol or warfarin and prescribed a course of amoxicillin. If co-administration is necessary, the prothrombin time or international normalised ratio should be carefully monitored with the addition or withdrawal of amoxicillin. Moreover, adjustments in the dose of oral anticoagulants may be necessary see sections 4. Methotrexate Penicillins may reduce the excretion of methotrexate causing a potential increase in toxicity.
Limited data on the use of amoxicillin during pregnancy in humans do not indicate an increased risk of congenital malformations. Amoxicillin may be used in pregnancy when the potential benefits outweigh the potential risks associated with treatment. Breastfeeding Amoxicillin is excreted into breast milk in small quantities with the possible risk of sensitisation. Consequently, diarrhoea and fungus infection of the mucous membranes are possible in the breast-fed infant, so that breast-feeding might have to be discontinued.
Fertility There are no data on the effects of amoxicillin on fertility in humans. Reproductive studies in animals have shown no effects on fertility. However, undesirable effects may occur e. The following terminologies have been used in order to classify the occurrence of undesirable effects.
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