Moxiclav Special Precautions

Before initiating therapy with MOXICLAV careful enquiry should be made concerning hypersensitivity reactions to penicillins and cephalosporins or other allergens.
Serious and occasionally fatal hypersensitivity reactions (including anaphylactoid and severe cutaneous adverse reactions) have been reported in patients on penicillin therapy. These reactions are more likely to occur in individuals with a history of penicillin hypersensitivity (see Contraindications). If an allergic reaction occurs, MOXICLAV therapy must be discontinued and appropriate alternative therapy instituted. Serious anaphylactic reactions require immediate emergency treatment with adrenaline. Oxygen, intravenous (i.v.) steroids and airway management (including intubation) may also be required.
MOXICLAV should be avoided if infectious mononucleosis is suspected since the occurrence of a morbilliform rash has been associated with this condition following the use of amoxicillin.
Prolonged use may also occasionally result in overgrowth of non-susceptible organisms.
Prolongation of bleeding time and prothrombin time has been reported in some patients receiving MOXICLAV. MOXICLAV should be used with care in patients on anti-coagulation therapy.
Changes in liver function tests have been observed in some patients receiving MOXICLAV. The clinical significance of these changes is uncertain. MOXICLAV should be used with caution in patients with evidence of hepatic dysfunction.
Cholestatic jaundice, which may be severe, but is usually reversible, has been reported rarely. Signs and symptoms may not become apparent for up to six weeks after treatment has ceased.
In patients with renal impairment MOXICLAV dosage should be adjusted as recommended. (See Dosage & Administration.)
In patients with reduced urine output, crystalluria has been observed very rarely , predominantly with parenteral therapy. During the administration of high doses of amoxicillin, it is advisable to maintain adequate fluid intake and urinary output in order to reduce the possibility of amoxicillin crystalluria (see Overdosage).
Effects on Ability to Drive and Use Machines: Adverse effects on the ability to drive or operate machinery have not been observed.