Allergic skin reactions: urticaria, erythematous rash, rarely – exudative erythema multiforme, rarely – exfoliative dermatitis, malignant exudative erythema , in some cases, there is the so-called “fifth day rash” . The reactions depend on the dose of the drug and the patient’s condition. The reactions of the digestive system: nausea, vomiting, diarrhea, abnormal liver function, increased activity of “liver” transaminases, in rare cases – cholestatic jaundice, hepatitis, pseudomembranous colitis. The increase in transaminases oxandrin, bilirubin and alkaline phosphatase is usually seen in males, and in elderly patients, especially those older than 65 years. To prevent adverse events is recommended to take the drug at the beginning of the meal. The risk of such changes is increased while taking the drug for more than 14 days. These phenomena are rarely observed in children. The above changes usually occur during or shortly after treatment. Sometimes it may appear several weeks after discontinuation of the drug. In general, the reaction on the part of the digestive system are transitory and minor character, but sometimes severe. Other: candidiasis, superinfection development, reversible increase of prothrombin time.
The following list shows, in descending order are the possible side effects: Most Gastrointestinal tract: nausea, vomiting, diarrhea, abdominal pain Immune reactions: urticaria Skin and soft tissue: rash RareBlood and lymphatic system: in the composition of the blood changes (leucopenia, thrombocytopenia, hemolytic anemia) Hepato-biliary system: cholestatic jaundice, hepatitis, immune system: angioedema, vasculitis, blood coagulation system: prolonged prothrombin time Mochevydelitelnaya system: interstitial nephritis Isolated cases of anaphylactic shock, angioedema, pseudomembranous colitis, erythema multiforme, exfoliative dermatitis
Overdose can lead to gastrointestinal symptoms such as nausea, vomiting and diarrhea with the possible violation of water and electrolyte balance. Treatment Assign activated carbon. It is necessary to maintain the water and electrolyte balance. In convulsions diazepam prescribed. Other symptoms are treated symptomatically. In the case of severe renal insufficiency should be conducted hemodialysis.
Interaction with other drugs
Antacids, glucosamine, laxatives, drugs oxandrin, aminoglycosides slow down and reduce absorption; . ascorbic acid increases the absorption of
bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, vancomycin, rifampicin) have a synergistic effect; bacteriostatic drugs (macrolides, chloramphenicol, lincosamides, tetracyclines, sulfonamides) -. antagonistic
Improves the effectiveness of indirect anticoagulants (suppressing the intestinal microflora, reduces the synthesis of vitamin K and prothrombin index). At the same time taking anticoagulants need to monitor the performance of blood clotting.
It reduces the effectiveness of oral contraceptives, medicines, in the process of metabolism that produce para-aminobenzoic acid, ethinyl estradiol – the risk of bleeding “breakthrough”.
Diuretics, allopurinol, phenylbutazone, nonsteroidal anti-inflammatory agents and other drugs, block tubular secretion, increase the concentration of amoxicillin (clavulanic acid is derived mainly by glomerular filtration).
Allopurinol increases the risk of skin rash.
amoxicillin should not be administered with disulfiram.
The simultaneous use of amoxicillin and digoxin may lead to increased digoxin plasma levels.
In the treatment of penicillin in patients with hypersensitivity to it may experience an anaphylactic reaction. Treatment in such cases should be immediately discontinued and replaced by other appropriate therapy. For the treatment of anaphylactic shock may require an emergency epinephrine, corticosteroids, and elimination of respiratory failure.
There is a possibility of cross-resistance and hypersensitivity to penicillins or other cephalosporins. As in the case of the other broad-spectrum penicillins may occur superinfections of fungal or bacterial origin (in particular – candidiasis), especially in patients with chronic diseases and / or disorders of the immune system function. In case of superinfection taking the drug overturned and / or pick up a suitable therapy.
In patients with impaired renal function the dose should be selected based on the severity of the condition.
Patients with impaired hepatic function of the combination of amoxicillin / clavulanic acid should be administered with caution and under constant medical supervision. Should oxandrin not be used more than 14 days without the evaluation of liver function.
Occasionally there is an increase in prothrombin time. Amoxicillin / clavulanic acid should be administered with caution to patients receiving anticoagulant therapy.
Non-enzymatic methods for determining urinary sugar, as well as on the urobilinogen test can give false positive results.
In exchange treatment is necessary to monitor the state functions of blood, liver and kidneys.