What happens if I overdose Penmox?
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include decreased urination.
Proper storage of Penmox suspension:
Store Penmox suspension in the refrigerator, between 36 and 46 degrees F (2 and 8 degrees C). Do not freeze. If necessary, it may be stored at room temperature. Store away from heat, moisture, and light. Do not store in the bathroom. Throw away any unused medicine after 14 days. Keep Penmox suspension out of reach of children and away from pets.
Overdose of Penmox in details
In case of overdose, discontinue medication, treat symptomatically, and institute supportive measures as required. If the overdose is very recent and there is no contraindication, an attempt at emesis or other means of removal of drug from the stomach may be performed. A prospective study of 51 pediatric patients at a poison-control center suggested that overdosages of less than 250 mg/kg of Penmox are not associated with significant clinical symptoms and do not require gastric emptying.
Interstitial nephritis resulting in oliguric renal failure has been reported in a small number of patients after overdosage with Penmox.
Crystalluria, in some cases leading to renal failure, has also been reported after Penmox overdosage in adult and pediatric patients. In case of overdosage, adequate fluid intake and diuresis should be maintained to reduce the risk of Penmox crystalluria.
Renal impairment appears to be reversible with cessation of drug administration. High blood levels may occur more readily in patients with impaired renal function because of decreased renal clearance of Penmox. Penmox may be removed from circulation by hemodialysis.
For additional information about overdose treatment, call a poison control center (1-800-222-1222).
What should I avoid while taking Penmox?
Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking Penmox and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.
Penmox warnings
Anaphylactic Reactions
Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients on penicillin therapy including Penmox. Although anaphylaxis is more frequent following parenteral therapy, it has occurred in patients on oral penicillins. These reactions are more likely to occur in individuals with a history of penicillin hypersensitivity and/or a history of sensitivity to multiple allergens. There have been reports of individuals with a history of penicillin hypersensitivity who have experienced severe reactions when treated with cephalosporins. Before initiating therapy with Penmox, careful inquiry should be made regarding previous hypersensitivity reactions to penicillins, cephalosporins, or other allergens. If an allergic reaction occurs, Penmox should be discontinued and appropriate therapy instituted.
Clostridium difficile Associated Diarrhea
Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including Penmox, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile.
C. difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin-producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibacterial use. Careful medical history is necessary since CDAD has been reported to occur over 2 months after the administration of antibacterial agents.
If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated.
Development of Drug-Resistant Bacteria
Prescribing Penmox in the absence of a proven or strongly suspected bacterial infection is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.
Use in Patients With Mononucleosis
A high percentage of patients with mononucleosis who receive Penmox develop an erythematous skin rash. Thus Penmox should not be administered to patients with mononucleosis.
Phenylketonurics
The oral suspension of Penmox do not contain phenylalanine and can be used by phenylketonurics.
What should I discuss with my healthcare provider before taking Penmox?
Some medical conditions may interact with Penmox drops. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have a history of asthma, hay fever, or hives
- if you have had a severe allergic reaction (eg, severe rash, hives, breathing difficulties, dizziness) to a cephalosporin (eg, cephalexin) or another beta-lactam antibiotic (eg, imipenem)
- if you have kidney problems or gonorrhea
Some MEDICINES MAY INTERACT with Penmox drops. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Anticoagulants (eg, warfarin) because the risk of bleeding may be increased
- Probenecid because it may increase the risk of Penmox drops's side effects
- Chloramphenicol, macrolide antibiotics (eg, erythromycin), sulfonamides (eg, sulfamethoxazole), or tetracycline antibiotics (eg, doxycycline) because they may decrease Penmox drops's effectiveness
- Methotrexate because the risk of its side effects may be increased by Penmox drops
- Hormonal birth control (eg, birth control pills) because their effectiveness may be decreased by Penmox drops
This may not be a complete list of all interactions that may occur. Ask your health care provider if Penmox drops may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
Penmox precautions
Before initiating therapy with Penmox, careful inquiry should be made concerning previous hypersensitivity reactions to penicillins, cephalosporins.
Serious and occasionally fatal hypersensitivity (anaphylactoid) reactions have been reported in patients on penicillin therapy. These reactions are more likely to occur in individuals with a history of hypersensitivity to β-lactam antibiotics.
Erythematous (morbilliform) rashes have been associated with glandular fever in patients receiving Penmox.
Prolonged use may also occasionally result in overgrowth of non-susceptible organisms.
In patients with reduced urine output, crystalluria has been observed very rarely, predominantly with parenteral therapy. During the administration of high doses of Penmox, it is advisable to maintain adequate fluid intake and urinary output in order to reduce the possibility of Penmox crystalluria.
In patients with renal impairment, the rate of excretion of Penmox will be reduced depending on the degree of impairment and it may be necessary to reduce the total daily unit Penmox dosage accordingly.
Effects on the Ability to Drive or Operate Machinery: Penmox has no effect on ability to drive or use machines.
Use in pregnancy & lactation: The safety of Penmox for use in human pregnancy has not been established by well controlled studies in pregnant women. Reproduction studies have been performed in mice and rats at doses of up to 10 times the human dose; and these studies have revealed no evidence of impaired fertility or harm to the foetus due to Penmox.
Penmox may be used in pregnancy when the potential benefits outweigh the potential risks associated with treatment.
Penmox may be given during lactation. With the exception of the risk of sensitisation associated with the excretion of trace quantities of Penmox in breast milk, there are no known detrimental effects for the breastfed infant.
What happens if I miss a dose of Penmox?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
References
- DailyMed. "AMOXICILLIN; CLAVULANATE POTASSIUM: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- DrugBank. "amoxicillin". http://www.drugbank.ca/drugs/DB01060 (accessed September 17, 2018).
- MeSH. "Anti-Bacterial Agents". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology
