ADVERSE REACTIONS
Amoxicillin and clavulanate potassium is generally well tolerated. The majority of side effects observed in clinical trials were of a mild and transient nature and less than 3% of patients discontinued therapy because of drug-related side effects. From the original premarketing studies, where both pediatric and adult patients were enrolled, the most frequently reported adverse effects were diarrhea/loose stools (9%), nausea (3%), skin rashes and urticaria (3%), vomiting (1%) and vaginitis (1%). The overall incidence of side effects, and in particular diarrhea, increased with the higher recommended dose. Other less frequently reported reactions include: Abdominal discomfort, flatulence, and headache.
In pediatric patients (aged 2 months to 12 years), 1 U.S./Canadian clinical trial was conducted which compared amoxicillin and clavulanate potassium 45 mg/6.4 mg/kg/day (divided q12h) for 10 days versus amoxicillin and clavulanate potassium 40 mg/10 mg/kg/day (divided q8h) for 10 days in the treatment of acute otitis media. A total of 575 patients were enrolled, and only the suspension formulations were used in this trial. Overall, the adverse event profile seen was comparable to that noted above; however, there were differences in the rates of diarrhea, skin rashes/urticaria, and diaper area rashes (see CLINICAL STUDIES).
The following adverse reactions have been reported for ampicillin-class antibiotics:
Gastrointestinal: Diarrhea, nausea, vomiting, indigestion, gastritis, stomatitis, glossitis, black “hairy” tongue, mucocutaneous candidiasis, enterocolitis, and hemorrhagic/pseudomembranous colitis. Onset of pseudomembranous colitis symptoms may occur during or after antibiotic treatment (see WARNINGS).
Hypersensitivity Reactions: Skin rashes, pruritus, urticaria, angioedema, serum sickness–like reactions (urticaria or skin rash accompanied by arthritis, arthralgia, myalgia, and frequently fever), erythema multiforme (rarely Stevens-Johnson syndrome), acute generalized exanthematous pustulosis, hypersensitivity vasculitis, and an occasional case of exfoliative dermatitis (including toxic epidermal necrolysis) have been reported. These reactions may be controlled with antihistamines and, if necessary, systemic corticosteroids. Whenever such reactions occur, the drug should be discontinued, unless the opinion of the physician dictates otherwise. Serious and occasional fatal hypersensitivity (anaphylactic) reactions can occur with oral penicillin (see WARNINGS).
Liver: A moderate rise in AST (SGOT) and/or ALT (SGPT) has been noted in patients treated with ampicillin-class antibiotics, but the significance of these findings is unknown. Hepatic dysfunction, including hepatitis and cholestatic jaundice, (see CONTRAINDICATIONS), increases in serum transaminases (AST and/or ALT), serum bilirubin and/or alkaline phosphatase, has been infrequently reported with amoxicillin and clavulanate potassium. It has been reported more commonly in the elderly, in males, or in patients on prolonged treatment. The histologic findings on liver biopsy have consisted of predominantly cholestatic, hepatocellular, or mixed cholestatic-hepatocellular changes. The onset of signs/symptoms of hepatic dysfunction may occur during or several weeks after therapy has been discontinued. The hepatic dysfunction, which may be severe, is usually reversible. On rare occasions, deaths have been reported (less than 1 death reported per estimated 4 million prescriptions worldwide). These have generally been cases associated with serious underlying diseases or concomitant medications.
Renal: Interstitial nephritis and hematuria have been reported rarely. Crystalluria has also been reported (see OVERDOSAGE).
Hemic and Lymphatic Systems: Anemia, including hemolytic anemia, thrombocytopenia, thrombocytopenic purpura, eosinophilia, leukopenia, and agranulocytosis have been reported during therapy with penicillins. These reactions are usually reversible on discontinuation of therapy and are believed to be hypersensitivity phenomena. A slight thrombocytosis was noted in less than 1% of the patients treated with amoxicillin and clavulanate potassium. There have been reports of increased prothrombin time in patients receiving amoxicillin and clavulanate potassium and anticoagulant therapy concomitantly.
Central Nervous System: Agitation, anxiety, behavioral changes, confusion, convulsions, dizziness, insomnia, and reversible hyperactivity have been reported rarely.
Miscellaneous: Tooth discoloration (brown, yellow, or gray staining) has been rarely reported. Most reports occurred in pediatric patients. Discoloration was reduced or eliminated with brushing or dental cleaning in most cases.
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REPORTS OF SIDE EFFECTS / ADVERSE REACTIONS RELATED TO HYDROXYZINE
Below is a sample of reports where side effects / adverse reactions may be related to Hydroxyzine. The information is not vetted and should not be cosidered as verified clinical evidence.
Possible Hydroxyzine side effects / adverse reactions in 30 year old male
Reported by a consumer/non-health professional from United States on 2007-02-06
Patient: 30 year old male
Reactions: Intentional Overdose, Personality Disorder, Histrionic Personality Disorder, Bipolar I Disorder, Completed Suicide, Suicide Attempt, Narcissistic Personality Disorder, Sinus Tachycardia
Adverse event resulted in: death, hospitalization
Suspect drug(s):
Paxil
Dosage: 30mg per day
Administration route: Oral
Indication: Depression
Start date: 2001-06-18
End date: 2003-10-22
Paroxetine HCL
Dosage: 30mg per day
Administration route: Oral
Indication: Depression
Start date: 2003-10-22
Paxil
Dosage: 20mg in the morning
Administration route: Oral
Indication: Depressive Symptom
Start date: 1996-07-01
End date: 1998-05-01
Hydroxyzine
Dosage: 600mg single dose
Administration route: Oral
Start date: 2001-12-20
End date: 2001-12-20
Alcohol
Administration route: Oral
Other drugs received by patient: Marijuana; Toprol-XL
Possible Hydroxyzine side effects / adverse reactions in 37 year old male
Reported by a physician from Japan on 2007-03-02
Patient: 37 year old male
Reactions: Jaundice, Diarrhoea, Anaemia, Gastric Ulcer Haemorrhage, Liver Disorder
Adverse event resulted in: hospitalization
Suspect drug(s):
Pepcid RPD
Administration route: Oral
Indication: Gastroenteritis
Start date: 2006-11-21
End date: 2006-11-26
Hydroxyzine
Administration route: Oral
Indication: Gastroenteritis
Start date: 2006-11-21
End date: 2006-11-26
Zopiclone
Administration route: Oral
Indication: Gastroenteritis
Start date: 2006-11-21
End date: 2006-11-26
Domperidone
Administration route: Oral
Indication: Gastroenteritis
Start date: 2006-11-21
End date: 2006-11-26
Possible Hydroxyzine side effects / adverse reactions in 30 year old male
Reported by a consumer/non-health professional from United States on 2007-03-12
Patient: 30 year old male
Reactions: Intentional Overdose, Personality Disorder, Histrionic Personality Disorder, Bipolar I Disorder, Completed Suicide, Suicide Attempt, Narcissistic Personality Disorder, Sinus Tachycardia
Adverse event resulted in: death, hospitalization
Suspect drug(s):
Paxil
Dosage: 30mg per day
Administration route: Oral
Indication: Depression
Start date: 2001-06-18
End date: 2003-10-22
Paroxetine HCL
Dosage: 30mg per day
Administration route: Oral
Indication: Depression
Start date: 2003-10-22
Paxil
Dosage: 20mg in the morning
Administration route: Oral
Indication: Depressive Symptom
Start date: 1996-07-01
End date: 1998-05-01
Hydroxyzine
Dosage: 600mg single dose
Administration route: Oral
Start date: 2001-12-20
End date: 2001-12-20
Alcohol
Administration route: Oral
Other drugs received by patient: Marijuana; Toprol-XL
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