Severe and sometimes fatal cases of hypersensitivity (anaphylactic reaction) were noted in patients who were on penicillin therapy. Such reactions occur more often in patients with known severe allergic reactions in the anamnesis. Treatment with the preparation must be discontinued and replaced by another appropriate treatment. It may be necessary to eliminate the symptoms of an anaphylactic reaction, for example, the immediate introduction of epinephrine, steroids (in / in) and emergency therapy of respiratory failure.

In patients with impaired kidney function, the excretion of amoxicillin slows down and, depending on the degree of impairment, treatment with amoxicillin should be stopped or the daily dose of the preparation should be reduced.

Long-term use of the preparation can lead to overgrowth of insensitive microorganisms or yeast. A superinfection may occur, which requires careful monitoring of such patients.

When using high doses of the preparation, it is necessary to consume a sufficient amount of liquid to prevent crystalluria, which can be caused by amoxicillin. The presence of a high concentration of amoxicillin in the urine can cause precipitation of the preparation in the urinary catheter, so it should be visually checked at certain time intervals.

If severe diarrhea occurs, characteristic of pseudomembranous colitis (in most cases caused by Clostridium difficile), it is recommended to stop using the preparation and take appropriate measures. The use of antiperistaltic agents is contraindicated.

Amoxicillin is not recommended for the treatment of patients with acute lymphoblastic leukemia or infectious mononucleosis due to the increased risk of erythematous rashes on the skin.

Blood counts should be monitored regularly during high-dose therapy.

Therapy with high doses of amoxicillin in patients with renal failure or patients with a history of epilepsy and meningitis can in some cases lead to convulsions.

The occurrence of generalized erythema with fever and pustules at the beginning of treatment may indicate the development of acute generalized eczematous pustulosis, which requires discontinuation of amoxicillin therapy.

Application during pregnancy and lactation. No teratogenic effect of amoxicillin was found. However, if it is necessary to prescribe Augmentin during pregnancy, it is necessary to assess the relationship between the potential risk for the fetus and the expected benefit for the woman in advance. A small amount of amoxicillin is excreted in breast milk. Use during breastfeeding is possible, but to prevent possible sensitization of the child, it is recommended to stop breastfeeding.

Children. The preparation Augmentin is used in children older than 1 year (in this dosage form). Augmentin - other forms of amoxicillin are prescribed to children under the age of 5.

The ability to influence the speed of reaction when driving a motor vehicle or working with other mechanisms. Before finding out the individual reaction to the preparation (there may be dizziness), it is recommended to be careful when driving vehicles or working with mechanisms.

Probenecid, phenylbutazone, oxyphenbutazone, to a lesser extent acetylsalicylic acid and sulfinpyrazone suppress the tubular secretion of preparations of the penicillin series, which leads to an increase in t½ and an increase in the concentration of amoxicillin in the blood plasma.

Preparations that have a bacteriostatic effect (tetracycline antibiotics, macrolides, chloramphenicol) can neutralize the bactericidal effect of amoxicillin. Simultaneous use of aminoglycosides is possible (synergistic effect).

Allopurinol. Simultaneous use with amoxicillin leads to allergic reactions.

Digoxin. The absorption of digoxin increases, so dose adjustment is necessary.

Disulfiram. Simultaneous use with amoxicillin is contraindicated.

Anticoagulants. The simultaneous use of amoxicillin and anticoagulants of the coumarin class can prolong the bleeding time. It is necessary to adjust the dose of anticoagulants. There have been reports of increased activity of oral anticoagulants in patients receiving amoxicillin.

Methotrexate. The use of amoxicillin with methotrexate leads to an increase in the toxic effect of the latter. Amoxicillin reduces the renal clearance of methotrexate, so the level of its concentration in the blood plasma should be monitored.

Amoxicillin should be used with caution together with oral hormonal contraceptives - the plasma level of estrogens and progesterone may temporarily decrease, which may reduce the effectiveness of hormonal contraceptives. Therefore, it is recommended to use additional non-hormonal contraceptives.

Simultaneous use with antacids reduces the absorption of amoxicillin.

Other types of interactions. Forced diuresis leads to a decrease in the concentration of the preparation in the blood by increasing its elimination.

Diarrhea can reduce the absorption of other preparations and adversely affect their effectiveness.