Convulsions2
Not known
Aseptic meningitis
Not known
Gastrointestinal disorders
Diarrhoea
Common
Nausea3
Common
Vomiting
Common
Indigestion
Uncommon
Antibiotic-associated colitis4
Not known
Black hairy tongue
Not known
Tooth discolouration11
Not known
Hepatobiliary disorders
Rises in AST and/or ALT5
Uncommon
Hepatitis6
Not known
Cholestatic jaundice6
Not known
Skin and subcutaneous tissue disorders 7
Skin rash
Uncommon
Pruritus
Uncommon
Urticaria
Uncommon
Erythema multiforme
Rare
Stevens-Johnson syndrome
Not known
Toxic epidermal necrolysis
Not known
Bullous exfoliative-dermatitis
Not known
Acute generalised exanthemous pustulosis (AGEP)9
Not known
Renal and urinary disorders
Interstitial nephritis
Not known
Crystalluria8
Not known
1 See section 4.4
2 See section 4.4
3 Nausea is more often associated with higher oral doses. If gastrointestinal reactions are evident, they may be reduced by taking Augmentin at the start of a meal.
4 Including pseudomembranous colitis and haemorrhagic colitis (see section 4.4)
5 A moderate rise in AST and/or ALT has been noted in patients treated with beta-lactam class antibiotics, but the significance of these findings is unknown.
6 These events have been noted with other penicillins and cephalosporins (see section 4.4).
7 If any hypersensitivity dermatitis reaction occurs, treatment should be discontinued (see section 4.4).
8 See section 4.9
9 See section 4.4
10 See sections 4.3 and 4.4
11 Superficial tooth discolouration has been reported very rarely in children. Good oral hygiene may help to prevent tooth discolouration as it can usually be removed by brushing.
4.9 Overdose
Symptoms and signs of overdose
Gastrointestinal symptoms and disturbance of the fluid and electrolyte balances may be evident. Amoxicillin crystalluria, in some cases leading to renal failure, has been observed (see section 4.4).
Convulsions may occur in patients with impaired renal function or in those receiving high doses.
Amoxicillin has been reported to precipitate in bladder catheters, predominantly after intravenous administration of large doses. A regular check of patency should be maintained (see section 4.4).
Treatment of intoxication
Gastrointestinal symptoms may be treated symptomatically, with attention to the water/electrolyte balance.
Amoxicillin/clavulanic acid can be removed from the circulation by haemodialysis.
5. PHARMACOLOGICAL PROPERTIES
5.1 Pharmacodynamic properties
Pharmacotherapeutic group: Combinations of penicillins, incl. beta-lactamase inhibitors; ATC code: J01CR02.
Mode of action
Amoxicillin is a semisynthetic penicillin (beta-lactam antibiotic) that inhibits one or