Phenoxymethyl Penicillin 250mg

Indications

For the treatment of mild to moderately severe bacterial infections, if these are due to penicillin-susceptible pathogens and respond to therapy with oral penicillin, such as:
 

• infections of the ear, nose, and throat regions, e.g., tonsillitis, pharyngitis, laryngitis, otitis media, and sinusitis.
• infections of the lower respiratory tract, e.g., bronchitis and pneumonia, bronchopneumonia.
• infections due to beta-hemolytic streptococci of group A, e.g., scarlet fever, erysipelas, and rheumatic fever.
• skin infections, e.g., pyoderma, furunculosis, phlegmon, erysipeloid, erythema migrans, insofar as the micro-organisms are penicillin-susceptible.
• lymphadenitis and lymphangitis of bacterial origin.
• infections of the buccal cavity, gums, or jaws, e.g., inflammatory infiltrates, delayed dentition stages II and III, antral fistulae, secondary bacterial infection with Gram-positive pathogens following virus-induced gingivitis or stomatitis.
• For prophylaxis of scarlet fever; also to prevent recurrences of rheumatic fever. For prophylaxis of infection after dental and oral surgical procedures or dental extractions in certain high-risk patients (e.g. with congenital cardiac defects, artificial heart valves, rheumatic endocarditis). In some cases, combined with another appropriate antibiotic may be indicated.

Pharmacology

Penicillin V (phenoxymethylpenicillin) is an acid-stable antibiotic that is absorbed from the top section of the small intestine. The potassium salt of Phenoxymethyl penicillin is the most absorbable of the several forms of Phenoxymethyl penicillin. This can be taken with or without food, however, the best absorption occurs when the medicine is taken orally at least 1 hour before or 2 hours after the meal. Gram-positive infections can be treated with phenoxymethyl penicillin, which is a highly convenient antibiotic. In terms of resistance to inactivation by stomach acid, phenoxymethyl penicillin has a considerable advantage over penicillin G.

Dosage & Administration

The dosage of Phenoxymethylpenicillin should be determined according to the sensitivity of the causative micro-organism and the severity of the infection and adjusted to the clinical response of the patient.

• Adults: 250-500 mg 6 hourly
• Children (above 1 year):

125-250 mg 6 hourly

• 125 mg/5 ml powder for suspension: 1-2 teaspoonfuls (5-10 ml) 6 hourly
• 250 mg/5 ml powder for suspension: ½-1 teaspoonful (2.5-5 ml) 6 hourly

Infants (below 1 year):

62.5-125 mg 6 hourly.

• 125 mg/5 ml powder for suspension: ½-1 teaspoonful (2.5-5 ml) 6 hourly, or as prescribed by the physician.

Phenoxymethyl penicillin is best taken with an empty stomach, preferably at least 1 hour before or 2 hours after a meal.

Phenoxymethyl Penicillin is best taken on an empty stomach, preferably one hour before meals. The tablets are swallowed without chewing with sufficient amounts of liquid. Before each use of this syrup, the bottle has to be shaken vigorously.

Interaction

Food: The simultaneous intake of food will cause a decrease in the rate of absorption. Therefore, phenoxymethyl penicillin is best taken on an empty stomach, preferably one hour before meals, in order to achieve the highest possible absorption rate.

Drug Interactions: Taking penicillin at the same time can increase the level of serum methotrexate and enhance its toxic effects. Therefore, it is necessary to monitor the serum level of methotrexate.

If phenoxymethyl penicillin is used to treat diarrhea, the absorption of other oral drugs may be disturbed, which may affect their effectiveness. If penicillin is combined with antibacterial chemotherapeutic agents or antibiotics (such as tetracycline, chloramphenicol), the activity of the penicillin may be weakened or disappear. Concurrent administration of probenecid inhibits renal excretion of penicillin. Simultaneous use of indomethacin, phenylbutazone, salicylate, or sulpiridone can cause the serum level of phenoxymethylpenicillin to rise and be prolonged.

The administration of penicillins may cause a temporary decrease in plasma concentrations of estrogen and progesterone. Therefore, the effectiveness of oral contraceptives is uncertain.

In the case of intestinal sterilization with aminoglycosides (such as neomycin), the absorption of phenoxymethylpenicillin may be reduced. The combination of penicillin and oral anticoagulants (such as warfarin) can prolong the prothrombin time / INR.

Interference with Laboratory and Diagnostic Tests: Non-enzymatic urine glucose determination and urobilinogen test can produce false positive results.

Contraindications

Patients who are hypersensitive to penicillin or any of the excipients should not be given phenoxy methyl Penicillin. Patients with severe gastrointestinal issues, including vomiting and diarrhea, should not be treated with phenoxymethylpenicillin.

Side Effects

Occasionally, hypersensitivity reactions that affect the skin (such as urticaria, measles or scarlet rash, itching), eosinophilia, or more severe allergic reactions, such as, for example, drug fever, vasculitis, serum sickness, or interstitial Nephritis. Allergic or allergic reactions can occur with, for example, angioedema, laryngeal edema, bronchospasm, and shock.

If signs of an allergic/anaphylactic reaction appear, treatment should be stopped immediately. Occasionally, a rash or mucosal inflammation may occur, especially in the oral cavity (stomatitis); in rare cases, dry mouth and taste disorders may occur.

In individual cases, severe skin blistering reactions have been reported, usually involving mucous membranes (Stevens-Johnson syndrome, Lyell syndrome). Disorders of the gastrointestinal tract may occur, such as nausea, vomiting, abdominal pain, loose stools, or diarrhea.

Diarrhea may sometimes be a symptom of enterocolitis, and in some cases it may be hemorrhagic. A special form of enterocolitis that can occur with antibiotics is pseudomembranous colitis (in most cases caused by Clostridium difficile). This should be taken into consideration for patients who develop severe and persistent diarrhea during treatment or in the first few weeks after treatment. Even if pseudomembranous colitis is only suspected, phenoxymethyl penicillin should be stopped immediately. This type of colitis requires proper treatment by a doctor immediately. In this case, do not take drugs that inhibit intestinal peristalsis. In individual cases, especially after administration of high and long-term doses, the blood picture changes, such as leukopenia (for example, leukopenia, agranulocytopenia, agranulocytosis), red blood cells (for example, due to hemolytic anemia), thrombocytopenia or May occur pancytopenia and bone marrow suppression. In the process of treating spirochete infection, a Herxian reaction may occur characterized by the appearance or deterioration of systemic symptoms such as fever, chills, headache, and joint pain. In individual cases, drug-induced aseptic meningitis can occur.

In rare cases, you may notice temporary tooth discoloration during treatment with phenoxymethylpenicillin. The use of antibiotics, especially if used for a long time, can lead to the growth of resistant microorganisms.

Beta-lactams puts patients at risk for encephalopathy (which may include seizures, confusion, impaired consciousness, movement disorders), especially in the case of overdose or kidney failure.

Pregnancy & Lactation

The antibiotic phenoxymethylpenicillin passes through the placenta. This can be utilized at any point during pregnancy if the conditions are met. In modest levels, phenoxymethylpenicillin gets into breast milk. This can be used during nursing, however the infant may experience diarrhoea and yeast colonization of the mucous membranes.

Precautions & Warnings

Occasionally, hypersensitivity reactions that affect the skin (such as urticaria, measles or scarlet rash, itching), eosinophilia, or more severe allergic reactions, such as, for example, drug fever, vasculitis, serum sickness, or interstitial Nephritis. Allergic or allergic reactions can occur with, for example, angioedema, laryngeal edema, bronchospasm, and shock.

If signs of an allergic/anaphylactic reaction appear, treatment should be stopped immediately. Occasionally, a rash or mucosal inflammation may occur, especially in the oral cavity (stomatitis); in rare cases, dry mouth and taste disorders may occur.

In individual cases, severe skin blistering reactions have been reported, usually involving mucous membranes (Stevens-Johnson syndrome, Lyell syndrome). Disorders of the gastrointestinal tract may occur, such as nausea, vomiting, abdominal pain, loose stools, or diarrhea.

Diarrhea may sometimes be a symptom of enterocolitis, and in some cases it may be hemorrhagic. A special form of enterocolitis that can occur with antibiotics is pseudomembranous colitis (in most cases caused by Clostridium difficile). This should be taken into consideration for patients who develop severe and persistent diarrhea during treatment or in the first few weeks after treatment. Even if pseudomembranous colitis is only suspected, phenoxymethyl penicillin should be stopped immediately. This type of colitis requires proper treatment by a doctor immediately. In this case, do not take drugs that inhibit intestinal peristalsis. In individual cases, especially after administration of high and long-term doses, the blood picture changes, such as leukopenia (for example, leukopenia, agranulocytopenia, agranulocytosis), red blood cells (for example, due to hemolytic anemia), thrombocytopenia or May occur pancytopenia and bone marrow suppression. In the process of treating spirochete infection, a Herxian reaction may occur characterized by the appearance or deterioration of systemic symptoms such as fever, chills, headache, and joint pain. In individual cases, drug-induced aseptic meningitis can occur.

In rare cases, you may notice temporary tooth discoloration during treatment with phenoxymethylpenicillin. The use of antibiotics, especially if used for a long time, can lead to the growth of resistant microorganisms.

Beta-lactams puts patients at risk for encephalopathy (which may include seizures, confusion, impaired consciousness, and movement disorders), especially in the case of overdose or kidney failure.

There is no indication of impaired ability to drive or operate machinery. Beta-lactams predispose the patient to encephalopathy risk. In the case of adverse reactions such as encephalopathy (which may include convulsions, confusion, impairment of consciousness, and movement disorders), the patient should not operate machines or drive a vehicle.

Storage Conditions

Store in a cool and dry place, and protect from light.