Pencla Special Precautions

Two of the Pencla tablets should not be taken at 1 time since the double dose of clavulanate is more likely to cause GIT adverse effect.
It should be administered carefully to the following patients: Patients with severe hepatic dysfunction.
Patients with moderate or severe renal dysfunction. (Dose interval should be adjusted for the patients because blood concentration of the drug can be prolonged.)
Patients with a previous history of hypersensitivity to penicillins or cephems.
Patients who or whose family have a tendency to show allergic symptoms such as bronchial asthma, rashes, urticaria, etc.
Patients who are malnutritioned orally or who are parenterally administered nutritioned, the elderly patients, and patients with bad systemic circulation. (Vitamin K deficiency may occur).
General: Severe and occasionally fatal hypersensitivity (anaphylactic) reactions and vasculoneural edema may occur in patients treated with penicillin. Such reactions may easily occur in patients who have previous sensitivity to multiple allergen or previous penicillin hypersensitivity. Also these reactions may easily occur in both oral and parenteral therapy, but more frequently in parenteral therapy.
The long-term treatment with Co-Amoxiclav may result in overgrowth of non-susceptible organisms, thus careful observation is required for more than 14 days treatment.
Changes in liver function test have been observed in some patients receiving Co-Amoxiclav. The clinical significance of these changes is uncertain, but Co-Amoxiclav should be used with caution in patient with evidence of hepatic failure. Serious and usually reversible cholestatic jaundice have been reported rarely. Signs and symptoms may not occur in appearance until 6 weeks after treatment has ended.
In patients with moderate and severe renal dysfunction, dose of Co-Amoxiclav should be adjusted following dosage and administration.
Erythematous rashes have been associated with glandular fever in patients receiving amoxicillin, thus use of Co-Amoxiclav should be avoided in case that glandular fever is suspected.