AUGMENTINE 875 mg/125 mg ORAL SUSPENSION POWDER IN SACHETS

2. What you need to know before you take Augmentine

Do not take Augmentine

• if you are allergic to amoxicillin, clavulanic acid, or 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 Augmentine if you are included in any of the above points. Before starting treatment with Augmentine, if you are not sure, consult your doctor or pharmacist.

Warnings and precautions

Consult your doctor or pharmacist before starting Augmentine 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 Augmentine.

In some cases, your doctor may investigate the type of bacteria causing your infection.

Depending on the results, you may be prescribed a different presentation of Augmentine or another medication.

Symptoms to be aware of

Augmentine may worsen certain existing conditions or cause serious side effects. These include allergic reactions, convulsions, and inflammation of the large intestine. You should be aware of certain symptoms while taking Augmentine to reduce the risk of problems. See "Symptoms to be aware of"in section 4.

Blood and urine tests

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

Other medications and Augmentine

Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medications.

If you are taking allopurinol (used for gout) with Augmentine, 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 Augmentine.

If you are taking anticoagulants (such as warfarin) with Augmentine, more blood tests will be needed.

Augmentine may affect the action of methotrexate (a medication used to treat cancer or rheumatic diseases).

Augmentine may affect how mycophenolate mofetil (a medication used to prevent organ rejection in transplanted patients) works.

Pregnancy, breastfeeding, and fertility

If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

Driving and using machines

Augmentine may have side effects, and the symptoms may make you unfit to drive.

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

Augmentine contains aspartame and maltodextrin

• This medicine contains 24 mg of aspartame in each sachet. Aspartame is a source of phenylalanine, which may be harmful in people with phenylketonuria (a rare genetic disorder in which phenylalanine accumulates because the body cannot eliminate it properly).

• This medicine contains maltodextrin (glucose). If your doctor has told you that you have an intolerance to some sugars, consult them before taking this medicine.

3. How to take Augmentine

Always take this medicine exactly as your doctor or pharmacist has told you. If you are not sure, check with your doctor or pharmacist.

Adults and children over 40 kg

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

Children under 40 kg

Augmentine 875 mg/125 mg powder for oral suspension in sachets is not recommended.

Patients with kidney and liver problems

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

How to take Augmentine

• Just before taking Augmentine, open the sachet and mix the contents with 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 apart. Do not take 2 doses in 1 hour.
• Do not take Augmentine for more than 2 weeks. If you are still feeling unwell, consult your doctor.

If you take more Augmentine than you should

If you take too much Augmentine, you may experience symptoms such as stomach upset (nausea, vomiting, or diarrhea) or convulsions. Consult your doctor as soon as possible. Take 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 medication and the amount ingested.

If you forget to take Augmentine

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 Augmentine

Continue taking Augmentine until you finish the treatment, even if you feel better. You need to take the full treatment to cure the infection. If you do not, the bacteria that survive may cause you to become infected again.

If you have any further questions on the use of this product, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them. The following side effects may happen with this medicine.

Symptoms to be aware of

Allergic reactions:

• skin rash
• inflammation of blood vessels (vasculitis) which 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 an allergic myocardial infarction (Kounis syndrome).

Contact your doctor immediatelyif you experience any of these symptoms. Stop taking Augmentine.

Inflammation of the large intestine

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

Drug-induced enterocolitis syndrome (DIES)

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

Acute pancreatitis (inflammation of the pancreas)

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

Contact your doctor immediatelyif you experience any of these symptoms.

Very common side effects

May affect more than 1 in 10 people

• diarrhea (in adults).

Common side effects

May affect up to 1 in 10 people

• thrush (Candida - fungal infection in the vagina, mouth, or mucous membranes)
• nausea, especially when taking high doses

→ if this happens, take Augmentine before meals

• vomiting
• diarrhea (in children).

Uncommon side effects

May affect up to 1 in 100 people

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

Uncommon side effects that may appear in blood tests:

• increase in some substances (enzymes) produced by the liver.

Rare side effects

May affect up to 1 in 1,000 people

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

If you have any of 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)
• 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)

• widespread rash with small blisters containing pus (bullous exfoliative dermatitis)
• red rash with bumps under the skin and blisters (pustular exanthematous rash)
• flu-like symptoms with skin rash, fever, gland inflammation, and abnormal blood test results (such as elevated white blood cell count (eosinophilia) and elevated liver enzymes) (Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS))
• red rash usually observed on both sides of the buttocks, in the upper inner thighs, in the armpits, on the neck (Symmetrical Drug-Related Intertriginous and Flexural Exanthema (SDRIFE)).

Contact a doctor immediatelyif you have any of these symptoms.

• rash with blisters arranged in a circle with a central crust or like a string of pearls (linear IgA disease)
  • liver inflammation (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
• inflammation of the kidney ducts
• delayed blood clotting
• hyperactivity
• convulsions (in patients taking high doses of Augmentine or with kidney problems)
• black hairy tongue
• stained teeth (in children), which usually disappears with brushing.

Side effects that may appear in blood or urine tests:

• significant decrease 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, talk to your doctor, pharmacist, or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly through the Spanish Medicines Monitoring System for Human Use: www.notificaRAM.es.

By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storage of Augmentine

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

Do not use this medicine after the expiry date which is stated on the carton after EXP. The expiry date refers to the last day of that month.

Do not store above 25°C.

Store in the original package to protect from moisture.

Do not use if the sachets are broken or damaged.

Medicines should not be disposed of via wastewater or household waste. Return the packages and any unused medicines to the pharmacy's SIGRE Point. If in doubt, ask your pharmacist how to dispose of packages and unused medicines. This will help protect the environment.

6. Contents of the pack and other information

Composition of Augmentine 875 mg/125 mg powder for oral suspension in sachets

• The active substances are amoxicillin and clavulanic acid. Each sachet contains amoxicillin trihydrate equivalent to 875 mg of amoxicillin and potassium clavulanate equivalent to 125 mg of clavulanic acid.
• The other ingredients (excipients) are: magnesium stearate, crospovidone, colloidal anhydrous silica, aspartame (E951), peach-lemon-strawberry flavoring (contains maltodextrin).
• See section 2 for more important information about some of the ingredients of Augmentine.

Appearance of the product and pack contents

Augmentine 875 mg/125 mg powder for oral suspension in sachets contains a white powder for oral suspension.

The sachets come in a box. Each pack contains 12, 20, or 30 sachets.

Not all pack sizes may be marketed.

Marketing authorization holder and manufacturer

Marketing authorization holder:

GlaxoSmithKline, S.A.

P.T.M. C/ Severo Ochoa, 2

28760 Tres Cantos (Madrid)

Tel: +34 900 202 700

[email protected]

Manufacturer:

Glaxo Wellcome Production

Z.I. de la Peyennière

53100 Mayenne

France

This medicine is authorized in the Member States of the European Economic Area under the following names:

Italy - Augmentin, Clavulin

Spain - Augmentine

Date of last revision of this leaflet:May 2024.

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

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Instructions for reconstitution

Pour the contents of the sachet into half a glass of water, shake until a suspension is obtained, and take immediately.