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Before initiating therapy with KOACT, careful enquiry should be made concerning previous hypersensitivity reactions to penicillins, cephalosporins, or other allergens. Because serious and occasionally fatal hypersensitivity (anaphylactoid) reactions have been reported in patients with a history of hypersensitivity to penicillin.
This drug may cause cholestatic jaundice or rise of hepatic enzyme (cause hepatic dysfunction), which may be severe, but is usually reversible. Symptoms may not become apparent for up to 6 weeks after treatment has ceased.
Prolonged use of this drug may also occasionally result in overgrowth of non-susceptible organisms.
KOACT should be used carefully when anticoagulants are prescribed concomitantly because this drug increases the effect of warfarin in prolongation of prothrombin time.
Patients with evidence of hepatic dysfunction, KOACT should not be used in patients unless considered essential by the physician, and hepatic function should be monitored at regular intervals.
Patients with renal impairment, KOACT dosage should be adjusted according to creatinine clearance.
Patients with reduced urine output, crystalluria has been observed very rarely, predominately with parenteral therapy. During the administration of high doses of amoxicillin, it is advisable to maintain adequate fluid intake in order to reduce the possibility of amoxicillin crystalluria.
Effects on ability to drive and use machines: Adverse effects on ability to drive and operate machinery have not been observed.
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