AMOXICILLIN/CLAVULANIC ACID NORMON 875 mg/125 mg ORAL SUSPENSION POWDER IN SACHETS

2. What you need to know before you take Amoxicillin/Clavulanic Acid Normon

Do not take Amoxicillin/Clavulanic Acid Normon:

• if you are allergic to amoxicillin, clavulanic acid, to penicillins or to any of the other ingredients of this medicine (listed in section 6);
• if you have ever had a severe allergic reaction to any other antibiotic. This could include a skin rash or swelling of the face or throat;
• if you have ever had liver problems or jaundice (yellowing of the skin) when taking an antibiotic.

Do not take Amoxicillin/Clavulanic Acid Normon if you are included in any of the above points. Before starting treatment with Amoxicillin/Clavulanic Acid Normon, if you are not sure, consult your doctor or pharmacist.

Warnings and precautions

Consult your doctor or pharmacist before taking this medicine if:

• you have infectious mononucleosis;
• you are receiving treatment for liver or kidney problems;
• you do not urinate regularly.

If you are not sure if any of the above symptoms affect you, inform your doctor or pharmacist before taking Amoxicillin/Clavulanic Acid Normon.

In some cases, your doctor may investigate the type of bacteria that is causing your infection. Depending on the results, you may be prescribed a different formulation of Amoxicillin/Clavulanic Acid or another medicine.

Symptoms to which you must pay attention

Amoxicillin/Clavulanic Acid Normon can worsen certain existing conditions or cause serious side effects. These include allergic reactions, seizures, and inflammation of the large intestine. You should be aware of certain symptoms while taking Amoxicillin/Clavulanic Acid Normon to reduce the risk of problems. See "Symptoms to which you must pay attention" in section 4.

Blood and urine tests

If you are having blood tests (such as red blood cell status studies or liver function studies) or urine tests (to check glucose levels), inform your doctor or nurse that you are taking Amoxicillin/Clavulanic Acid Normon. This is because Amoxicillin/Clavulanic Acid Normon can alter the results of these types of tests.

Other medicines and Amoxicillin/Clavulanic Acid Normon

Tell your doctor or pharmacist if you are taking or have recently taken or may need to take any other medicines.

If you are taking allopurinol (used for gout) with Amoxicillin/Clavulanic Acid Normon, you may be more likely to suffer a skin allergic reaction.

If you are taking probenecid (used for gout), your doctor may adjust the dose of Amoxicillin/Clavulanic Acid Normon. Concomitant use of probenecid can reduce the excretion of amoxicillin and is not recommended.

If you are taking anticoagulants (such as warfarin) with Amoxicillin/Clavulanic Acid Normon, more blood tests will be needed.

Amoxicillin/Clavulanic Acid Normon may affect the action of methotrexate (a medicine used to treat cancer and severe psoriasis). Penicillins can reduce the excretion of methotrexate and cause a potential increase in side effects.

Amoxicillin/Clavulanic Acid Normon may affect how mycophenolate mofetil (a medicine used to prevent organ rejection in transplanted patients) works.

Pregnancy and breastfeeding

If you are pregnant, breastfeeding, think you may be pregnant, or plan to become pregnant, consult your doctor or pharmacist before using this medicine.

Driving and using machines

Amoxicillin/Clavulanic Acid Normon may have side effects and the symptoms can make you unfit to drive.

Do not drive or operate machinery unless you are feeling well.

Important informationabout someof the ingredients of Amoxicillin/Clavulanic Acid Normon875 mg/125 mg powder for oral suspension in sachets EFG

Amoxicillin/Clavulanic Acid Normon contains sucrose

If your doctor has told you that you have an intolerance to some sugars, consult with them before taking this medicine.

Amoxicillin/Clavulanic Acid Normon contains sodium benzoate

This medicine contains 8 mg of sodium benzoate in each sachet. Sodium benzoate may increase the risk of jaundice (yellowing of the skin and eyes) in newborns (up to 4 weeks of age).

Amoxicillin/Clavulanic Acid Normon contains sodium

This medicine contains less than 23 mg of sodium (1 mmol) per dose; this is, essentially "sodium-free".

3. How to take Amoxicillin/Clavulanic Acid Normon

Follow exactly the administration instructions of this medicine indicated by your doctor or pharmacist. In case of doubt, consult your doctor or pharmacist.

Adults and children over40 kg

• Recommended dose - 1 sachet administered twice a day
• Higher dose - 1 sachet administered three times a day

Children under40 kgin weight

Amoxicillin/Clavulanic Acid Normon 875 mg/125 mg powder for oral suspension in sachets EFG is not recommended.

Patient with kidney and liver problems

• If you have kidney problems, your dose may be changed. Your doctor may choose a different formulation or another medicine.
• If you have liver problems, you will have more frequent blood tests to check how your liver is working.

How to take Amoxicillin/Clavulanic Acid Normon

• Just before taking Amoxicillin/Clavulanic Acid Normon, open the sachet and mix the contents in half a glass of water.
• Take it at the start of meals or a while before.
• Space out the doses during the day, at least 4 hours. Do not take 2 doses in 1 hour.
• Do not take this medicine for more than 2 weeks. If you are still feeling unwell, consult your doctor.

If you take more Amoxicillin/Clavulanic Acid Normon than you should

If you take too much Amoxicillin/Clavulanic Acid Normon, symptoms such as stomach upset (nausea, vomiting, or diarrhea) or seizures may appear. Consult your doctor as soon as possible. Bring the package with you to show the doctor.

In case of overdose or accidental ingestion, consult your doctor or pharmacist immediately or call the Toxicology Information Service, telephone 91 562 04 20, indicating the medicine and the amount ingested.

If you forget to take Amoxicillin/Clavulanic Acid Normon

If you forget to take a dose, take it as soon as you remember. Do not take the next dose too soon, wait at least 4 hours before taking the next dose. Do not take a double dose to make up for forgotten doses.

If you stop taking Amoxicillin/Clavulanic Acid Normon

Continue taking this medicine until you finish the treatment, even if you feel better. You need to take the complete treatment to cure the infection. If you do not, the surviving bacteria may cause you to have the infection again.

If you have any other questions about the use of this medicine, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, Amoxicillin/Clavulanic Acid Normon can cause side effects, although not everybody gets them. The side effects described below can occur when taking this medicine.

Symptoms to which you must pay attention

Allergic reactions:

• skin rash;

• inflammation of blood vessels (vasculitis) that can appear as red or purple spots on the skin, but can affect other parts of the body;
• fever, joint pain, swollen glands in the neck, armpits, or groin;
• swelling, sometimes of the face or throat (angioedema), which can cause difficulty breathing;
• collapse;
• chest pain in the context of allergic reactions, which can be a symptom of allergy-induced heart attack (Kounis syndrome).
• • Contact your doctor immediatelyif you experience any of these symptoms. Stop taking Amoxicillin/Clavulanic Acid Normon.

Inflammation of the large intestine

Inflammation of the large intestine, which causes watery diarrhea, usually with blood and mucus, stomach pain, and/or fever.

Acute pancreatitis

If you have intense and persistent stomach pain, this could be a sign of acute pancreatitis.

Drug-induced enterocolitis syndrome (DIES):

DIES has been reported mainly in children who receive amoxicillin. It is a certain type of allergic reaction with the main symptom of repeated vomiting (1-4 hours after taking the medicine). Other symptoms may include abdominal pain, lethargy, diarrhea, and low blood pressure.

• Contact your doctor immediately if you experience any of these symptoms.

Very common side effects

May affect more than 1 in 10 patients

• diarrhea (in adults).

Common side effects

May affect up to 1 in 10 patients

• thrush (Candida– fungal infection in the vagina, mouth, or mucous membranes);
• nausea, especially when taking high doses;
• • if this happens to you, take Amoxicillin/Clavulanic Acid Normon before meals.
• vomiting;
• diarrhea (in children).

Uncommon side effects

May affect up to 1 in 100 patients

• skin rash, itching;
• increased itchy rash (urticarial rash);
• indigestion;
• dizziness;
• headache.

Uncommon side effects that may appear in blood tests:

• Increased levels of some substances (enzymes) produced by the liver.

Rare side effects

May affect up to 1 in 1,000 patients

• skin rash, which can form blisters that look like small targets (dark center surrounded by a paler area, with a dark ring around the edge – erythema multiforme).

• If you have anyof these symptoms, consult your doctor urgently

Rare side effects that may appear in blood tests:

• low count of cells involved in blood clotting;
• low count of white blood cells.

Frequency not known

Frequency cannot be estimated from the available data.

• Allergic reactions (see above).
• Inflammation of the large intestine (see above).
• Inflammation of the membrane that surrounds the brain and spinal cord (aseptic meningitis).
• Severe skin reactions:

• Widespread rash with blisters and peeling of the skin, particularly around the mouth, nose, eyes, and genitals (Stevens-Johnson syndrome), and in its most severe form, causing widespread peeling of the skin (more than 30% of the body surface – toxic epidermal necrolysis).

• Generalized red rash with small blisters containing pus (exfoliative dermatitis).

• Red exfoliative rash, with bumps under the skin and hives (pustular exanthematous).
• Flu-like symptoms with skin rash, fever, gland inflammation, and abnormal blood test results (such as increased white blood cells (eosinophilia) and elevated liver enzymes) (Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)).

• Contact a doctor immediately if you have any of these symptoms.

• Inflammation of the liver (hepatitis);
• jaundice, caused by an increase in bilirubin in the blood (a substance produced by the liver) that can make the skin and the whites of the eyes turn yellow;
• delayed blood clotting;
• hyperactivity;
• seizures (in patients taking high doses of Amoxicillin/Clavulanic Acid or with kidney problems);
• black hairy tongue;
• stained teeth (in children), which usually disappears with brushing;
• rash with blisters arranged in a circle with a central crust or like a string of pearls (linear IgA disease)
aseptic meningitis).

Side effects that may appear in blood or urine tests:

• significant reduction in the number of white blood cells;
• low red blood cell count (hemolytic anemia);
• crystals in the urine that cause acute kidney injury.

Reporting of side effects:

If you experience any side effects, consult your doctor or pharmacist, even if it is a possible side effect not listed in this leaflet. You can also report them directly through the Spanish Pharmacovigilance System for Human Use Medicines: www.notificaRAM.es. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storage of Amoxicillin/Clavulanic Acid Normon

Do not store above 25°C.

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date that appears on the packaging after EXP. The expiry date is the last day of the month indicated.

Do not use Amoxicillin/Clavulanic Acid Normon if the sachets are broken or damaged.

Medicines should not be disposed of via wastewater or household waste. Place the packaging and medicines you no longer need in the SIGRE collection point at the pharmacy. If in doubt, ask your pharmacist how to dispose of the packaging and medicines you no longer need. This will help protect the environment.

6. Contents of the pack and other information

Composition of Amoxicillin/Clavulanic Acid Normon875 mg/125 mg powder for oral suspension in sachets EFG

The active ingredients are amoxicillin and clavulanic acid. Each sachet contains 875 mg of amoxicillin (as amoxicillin trihydrate) and 125 mg of clavulanic acid (as potassium clavulanate).

The other ingredients (excipients) are: anhydrous citric acid (E-330), anhydrous sodium citrate (E-331), colloidal silica, microcrystalline cellulose (E-460i), and sodium carboxymethylcellulose (E-466), xanthan gum (E-415), sodium benzoate (E-211), sucrose, orange flavor.

Appearance of the product and pack contents

Amoxicillin/Clavulanic Acid Normon 875 mg/125 mg is presented in sachets containing powder for oral suspension. The sachets contain a white or slightly creamy powder with a characteristic odor.

Each pack contains 20, 30, and 500 sachets.

Marketing authorization holder and manufacturer

LABORATORIOS NORMON, S.A.

Ronda de Valdecarrizo, 6 – 28760 Tres Cantos – Madrid (Spain)

Date of the last revision of this leaflet:April 2023

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Instructions for reconstitution

Pour the contents of the sachet into a glass.

Add a small amount of water and mix well.

Take immediately.

Detailed and updated information on this medicine is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es