Although reactions have been reported much less frequently after oral than after parenteral penicillin therapy, it should be remembered that all degrees of hypersensitivity, including fatal anaphylaxis, have been observed with oral penicillin.

The most common reactions to oral penicillin are nausea, vomiting, epigastric distress, diarrhea, and black, hairy tongue. The hypersensitivity reactions noted are skin eruptions (ranging from maculopapular to exfoliative dermatitis); urticaria; reactions resembling serum sickness, including chills, fever, edema, arthralgia, and prostration; laryngeal edema; and anaphylaxis. Fever and eosinophilia may frequently be the only reactions observed. Hemolytic anemia, leukopenia, thrombocytopenia, neuropathy, and nephropathy are infrequent reactions and are usually associated with high doses of parenteral penicillin.

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