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Applies to penicillin v potassium: capsule, powder for solution, powder for suspension, solution, suspension, tablet, tablet chewable, tablet extended release
Along with its needed effects, penicillin v potassium may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Stop taking penicillin v potassium and get emergency help immediately if any of the following effects occur:
Check with your doctor immediately if any of the following side effects occur while taking penicillin v potassium:
Rare- For penicillin G procaine only
Some side effects of penicillin v potassium may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Applies to penicillin v potassium: oral powder for reconstitution, oral tablet
The most common side effects are gastrointestinal effects and hypersensitivity reactions. In general, hypersensitivity reactions have been reported much less frequently after oral than after parenteral therapy; however, all degrees of hypersensitivity (including fatal anaphylaxis) have been reported with oral penicillin.
Onset of Clostridium difficile-associated diarrhea has been reported during or after antibacterial therapy.
Common (1% to 10%): Nausea, vomiting, abdominal pain, diarrhea
Rare (0.01% to 0.1%): Sore mouth, black hairy tongue (discoloration of tongue), pseudomembranous colitis
Frequency not reported: Epigastric distress, stomatitis, glossitis, soft stools, pancreatitis, intestinal necrosis, blood in the stool
Hypersensitivity reactions with penicillin were more common and more serious with IV therapy, but have also been reported with oral therapy. An initial sensitizing exposure is required to stimulate the production of antigen-specific IgE before clinical manifestations of hypersensitivity were seen on the second exposure. There were numerous "hidden" environmental or occupational exposures to penicillin including in utero exposure, breast milk exposure, and occupational exposure.
Common (1% to 10%): Allergic reactions (usually manifested as skin reactions)
Rare (0.01% to 0.1%): Severe allergic reactions (causing angioedema, laryngeal edema, anaphylaxis [severe or fatal])
Frequency not reported: Serum sickness-like reactions (chills, fever, edema, arthralgia, prostration), hypersensitivity/allergic reactions (including skin eruptions [maculopapular to exfoliative dermatitis], pruritus, urticaria, angioneurotic edema, erythema multiforme, joint pain, fever, eosinophilia, hypersensitivity myocarditis, hemolytic anemia, interstitial nephritis, anaphylactic shock [sometimes fatal] with collapse, anaphylactoid reactions [asthma, purpura, gastrointestinal symptoms])
Common (1% to 10%): Rash (urticarial, erythematous, morbilliform), pruritus
Rare (0.01% to 0.1%): Exfoliative dermatitis
Frequency not reported: Peeling, mucosal ulceration, urticaria
Very rare (less than 0.01%): Changes in blood counts, hemolytic anemia, leukopenia, thrombocytopenia, neutropenia, eosinophilia, agranulocytosis
Frequency not reported: Coagulation disorders (including prolonged bleeding time, platelet dysfunction), anemia, lymphadenopathy
Very rare (less than 0.01%): Hepatitis, cholestatic jaundice
Frequency not reported: Increased AST, reversible hepatotoxicity, jaundice, prolonged cholestasis
Nephropathy has typically been associated with high doses of parenteral penicillin.
Very rare (less than 0.01%): Interstitial nephritis
Frequency not reported: Nephropathy
Frequency not reported: Central nervous system (CNS) toxicity (including convulsions), paresthesia, neuropathy, myoclonus, seizures, decreased mentation, abnormal taste perception, tinnitus, neurologic reactions, aseptic meningitis
CNS toxicity has been reported, especially with high doses or in severe renal dysfunction. Paresthesia has been reported with prolonged use. Neuropathy has typically been associated with high doses of parenteral penicillin.
Severe neurologic reactions were most often seen with penicillin doses of 18 to 80 million units daily. These reactions frequently abated after discontinuation of penicillin. In several cases, penicillin was restarted at a lower dose with no further sequelae. In 1 review, the authors found that cerebral spinal fluid (CSF) penicillin levels were higher in patients with seizures than in those without. CSF penicillin levels ranged from 12 to 61 units/mL in the seizure group with the highest CSF levels, compared to 7.8 units/mL in the group without seizures.
Frequency not reported: Overgrowth of nonsusceptible organisms (e.g., Candida), fatigue, asthenia, pain, aggravation of existing disorders
Frequency not reported: Vulvovaginitis
Frequency not reported: Auditory hallucinations, visual hallucinations
Frequency not reported: Hypoxia, apnea, dyspnea
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