Gastrointestinal side effects may include abdominal pain, black hairy tongue, colitis, diarrhea, generalized abdominal cramps, hemorrhagic colitis, nausea, pseudomembranous colitis (Clostridium difficile associated diarrhea), and vomiting. Renal side effects may include acute interstitial nephritis and crystalluria, which is frequently associated with eosinophilia, fever, and rash. Nervous system side effects are rare but may include agitation, anxiety, behavioral changes, confusion, convulsions, dizziness, headache, insomnia, reversible hyperactivity, and somnolence. Hematologic side effects related to penicillins may include agranulocytosis, anemia, eosinophilia, granulocytopenia, hemolytic anemia, leukopenia, and thrombocytopenia. Hematologic effects are typically reversible and are thought to be due to hypersensitivity reactions. Immunologic side effects may include mucocutaneous candidiasis and vulvovaginal mycotic infection. Moderate elevations of liver enzymes, AST (SGOT) and/or ALT (SGPT) may be elevated. Other hepatic effects may include acute cytolytic hepatitis, cholestatic jaundice, and hepatic cholestasis. Respiratory side effects may include cough and rhinorrhea. Rare side effects may include tooth discoloration, mainly in pediatric patients. Discoloration may be eliminated or reduced in most cases by brushing or dental cleaning (Lexi-Comp,
Gastrointestinal side effects may include abdominal pain, black hairy tongue, colitis, diarrhea, generalized abdominal cramps, hemorrhagic colitis, nausea, pseudomembranous colitis (Clostridium difficile associated diarrhea), and vomiting. Renal side effects may include acute interstitial nephritis and crystalluria, which is frequently associated with eosinophilia, fever, and rash. Nervous system side effects are rare but may include agitation, anxiety, behavioral changes, confusion, convulsions, dizziness, headache, insomnia, reversible hyperactivity, and somnolence. Hematologic side effects related to penicillins may include agranulocytosis, anemia, eosinophilia, granulocytopenia, hemolytic anemia, leukopenia, and thrombocytopenia. Hematologic effects are typically reversible and are thought to be due to hypersensitivity reactions. Immunologic side effects may include mucocutaneous candidiasis and vulvovaginal mycotic infection. Moderate elevations of liver enzymes, AST (SGOT) and/or ALT (SGPT) may be elevated. Other hepatic effects may include acute cytolytic hepatitis, cholestatic jaundice, and hepatic cholestasis. Respiratory side effects may include cough and rhinorrhea. Rare side effects may include tooth discoloration, mainly in pediatric patients. Discoloration may be eliminated or reduced in most cases by brushing or dental cleaning (Lexi-Comp,