Drug information of dicloxacillin

Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs) which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested.

Absorption

Rapid and incomplete; reduced by food

Time to reach the peak

Serum: 1 to 1.5 hours

Distribution

Vd: 5.99 L; increased in patients with ESRD on IHD (Nauta 1976); CSF penetration is low

Half life

~0.7 hours; prolonged with renal impairment.

Excretion

Feces; urine (as unchanged drug)

Neonates: Prolonged

CF patients: More rapid excretion than healthy patients

Staphylococcal infections: Treatment of infections caused by penicillinase-producing staphylococci.

Usual Adult Dose for Bronchitis:

250 to 500 mg orally every 6 hours for 10 days, depending on the nature and severity of the infection.

Usual Adult Dose for Pharyngitis:

250 mg orally every 6 hours for 10 days, depending on the nature and severity of the infection.

Usual Adult Dose for Pneumonia:

500 mg orally every 6 hours for up to 21 days, depending on the nature and severity of the infection.

Usual Adult Dose for Skin or Soft Tissue Infection:

500 mg orally every 6 hours for 7 days, or for 3 days after acute inflammation resolves, depending on the nature and severity of the infection.

Usual Adult Dose for Upper Respiratory Tract Infection:

250 mg orally every 6 hours for 7 to 21 days, depending on the nature and severity of the infection.

Usual Pediatric Dose for Skin or Soft Tissue Infection:

<40 kg: 3.125 to 6.25 mg/kg orally every 6 hours.

>40 kg: 125 to 250 mg orally every 6 hours.

Usual Pediatric Dose for Upper Respiratory Tract Infection:

<40 kg: 3.125 to 6.25 mg/kg orally every 6 hours.

>40 kg: 125 to 250 mg orally every 6 hours.

Usual Pediatric Dose for Osteomyelitis:

Following initial intravenous therapy:

>= 1 year:

<40 kg: 12.5 to 25 mg/kg orally every 6 hours, not to exceed 2000 mg/24 hours.

>40 kg: 250 mg orally every 6 hours, not to exceed 2000 mg/24 hours.

Usual Pediatric Dose for Pneumonia:

<40 kg: 6.25 mg/kg orally every 6 hours.

>40 kg: 250 mg orally every 6 hours.

1-Hypersensitivity to dicloxacillin, other penicillins, or any component of the formulation.

2-Initial treatment of severe infections.

3-Concomitant live bacterial vaccines.

Frequency not defined. 

1% to 10%: Gastrointestinal: Abdominal pain diarrhea, nausea

Acemetacin, BCG (Intravesical), BCG Vaccine (Immunization), Cholera Vaccine, CloZAPine, CYP2C19 Substrates (High risk with Inducers), Lactobacillus and Estriol, Methotrexate, Mycophenolate, NiMODipine, Probenecid, Sodium Picosulfate, Tetracyclines, Typhoid Vaccine, Vitamin K Antagonists (eg, warfarin).

1-Test Interactions

False-positive urine and serum proteins; false-positive in uric acid, urinary steroids; may interfere with urinary glucose tests using cupric sulfate (Benedict's solution, Clinitest®); may inactivate aminoglycosides in vitro

2-Serious and occasionally fatal hypersensitivity (anaphylactic shock with collapse) reactions have been reported in patients on penicillin therapy. Initiate therapy only after a comprehensive drug and allergy history; use with caution in patients with a history of significant allergies and/or asthma. Discontinue use and institute appropriate therapy if a hypersensitivity reaction occurs.

3- Prolonged use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea (CDAD) and pseudomembranous colitis; CDAD has been observed >2 months postantibiotic treatment.

4-Use with caution in neonates; elimination of drug is slow.

1-You should not use dicloxacillin if you are allergic to dicloxacillin or to any other penicillin antibiotic, such as:

amoxicillin , ampicillin , carbenicillin ,oxacillin , penicillin

2-To make sure dicloxacillin is safe for you, tell your doctor if you have:

asthma

a stomach illness (nausea, vomiting, digestive problems)

liver disease

kidney disease

a bleeding or blood clotting disorder

a history of diarrhea caused by taking antibiotics

a history of any type of allergy (especially cephalosporins such as Ceclor, Ceftin, Duricef, Keflex, and others)

3-Dicloxacillin can make birth control pills less effective. Ask your doctor about using a non hormonal birth control (condom, diaphragm with spermicide) to prevent pregnancy.

4-Take dicloxacillin on an empty stomach, at least 1 hour before or 2 hours after a meal.

5-Take this medicine with a full glass of water. To avoid heartburn or stomach irritation, do not take dicloxacillin while you are lying down or getting ready for bed.

6-Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Dicloxacillin will not treat a viral infection such as the flu or a common cold.

7-Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

8-Tell your doctor about all your current medicines and any you start or stop using, especially:

probenecid

tetracycline

a blood thinner (warfarin, Coumadin, Jantoven)

any other antibiotic

9-Oral: Administer 1 hour before or 2 hours after meals with at least 120 mL of water. Administer around-the-clock to promote less variation in peak and trough serum levels. Should not be administered in the supine position or immediately before going to bed.

Storage

Store at 20°C to 25°C (68°F to 77°F).

Adverse events have not been observed in animal reproduction studies. Dicloxacillin crosses the placenta . Maternal use of penicillins has generally not resulted in an increased risk of birth defects.