Like all medicines, this medicine can cause side effects, although not everybody gets them.
Serious side effects: If the patient has any of the following symptoms of a severe allergic reaction, stop taking this medicine and tell the doctor immediately or go to the casualty department at the nearest hospital: Sudden difficulty in breathing, speaking and swallowing; Swelling of the eyelids, lips, tongue, face and neck; Extreme dizziness or collapse; Severe or itchy skin rash, especially if this shows blistering and there is soreness of the eyes, mouth or genital organs; Skin eruption that is characterised by the rapid appearance of areas of red skin studded with small pustules (small blisters filled with white/yellow fluid).
If the patient experiences any of the following side effects, contact the doctor as soon as possible: Diarrhoea that is serious, lasts a long time or has blood in it, with stomach pain or fever. This can be a sign of a serious bowel inflammation, that can rarely happen after taking antibiotics.
Yellowing of the skin or whites of the eyes caused by liver problems.
Inflammation of the pancreas, which causes severe pain in the abdomen and back.
Increased or reduced urine output, or traces of blood in the urine.
Skin rash caused by sensitivity to sunlight.
Unusual bruising or bleeding.
Irregular heart beat.
These are all serious side effects. The patient may need urgent medical attention. Serious side effects are uncommon (may affect up to 1 in 100 people), rare (may affect up to 1 in 1,000 people), or the frequency cannot be estimated from the available data.
Other possible side effects: Very common side-effects (may affect more than 1 in 10 people): diarrhoea.
Common side-effects (may affect up to 1 in 10 people): headache; nausea, vomiting, abdominal pain; Changes in number of white blood cells (low numbers of lymphocytes, higher number of eosinophils, higher number of basophils, monocytes and neutrophils; decreased blood bicarbonate (what indicates too much acidic substances in blood).
Uncommon side-effects (may affect up to 1 in 100 people): Yeast and bacterial infections especially of the mouth, throat, nose, lung, stomach, bowel and vagina; Changes in number of white blood cells (low numbers of leukocytes, low number of neutrophils, higher number of eosinophils); Swelling, allergic reactions of various severity; Loss of appetite (anorexia); Nervousness, insomnia, drowsiness, sleeplessness, dizziness, taste disturbance, tingling or numbness of the hands and/or feet; Visual disturbances; impaired hearing, spinning sensation (vertigo); Pounding heart beat; Feeling of intense heat with sweating and rapid heartbeat (hot flush); difficulty breathing, nose bleeds; constipation wind, indigestion, inflammation of the stomach, difficulty in swallowing, bloating, dry mouth, eructation, mouth sores, increased formation of saliva; inflammation of the liver (hepatitis); Skin rash, itching, hives, skin inflammation, dry skin, sweating; Bones and joint inflammation, muscle, back and neck pains; difficulty and pain when passing urine, kidney pain; uterine bleeding, testis disorder; skin swelling, weakness, generally feeling unwell, tiredness, swelling of the face, chest pain, fever, pain, swelling of extremities; abnormal laboratory test values (e.g. blood, liver and kidney function test results); post procedural complications.
Rare side-effects (may affect up to 1 in 1,000 people): Agitation; Abnormal liver function; sensitivity to sunlight; skin eruptions that is characterised by the rapid appearance of areas of red skin studded with small pustules (small blisters filled with white/yellow fluid); A delayed allergic reaction (up to several weeks after exposure) with rash and other possible symptoms such as swelling of the face, swollen glands and abnormal test results (e.g. liver tests and raised levels of some white blood cells) (Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)).
Not known (frequency cannot be estimated from the available data): Low level of red blood cells which can make the skin pale yellow and cause weakness or breathlessness; Reduction in blood platelets, which increases risk of bleeding or bruising; Severe allergic reaction; Aggression, anxiety, severe confusion, hallucination; Fainting, fits, decreased skin sensitivity, feeling hyperactive, disturbed sense of smell, loss of sense of smell or taste, muscle weakness (myasthenia); Poor hearing, deafness or ringing in the ears; Arrhythmia, abnormal electrocardiogram (ECG); Low blood pressure; Tongue discoloration; Inflammation of the pancreas; Hepatic failure, serious liver inflammation; Joint pain; Renal failure, renal inflammation; Problems with the eye sight (blurred vision).
Reporting of side effects: If the patient gets any side effects, talk to the doctor or pharmacist. This includes any possible side effects not listed in this monograph. The patient can also report side effects directly via the national reporting system listed in Appendix V*. By reporting side effects the patient can help provide more information on the safety of this medicine.