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dicloxacillin (Dynapen, Pathocil)

Tradenames: Dynapen, Pathocil. 2nd generation penicillin. Indications: - treatment of non-life-threatening bacterial infections - infectious arthritis, osteomyelitis - skin or soft tissue infection - urinary tract infection - respiratory tract infection - treatment of penicillinase-producing Staphylococci - empiric treatment for fever of unknown oritin Contraindications: - Streptococcus - less active than other penicillins against Streptococci Dosage: 1) should be taken on an empty stomach 2) 125-500 mg PO QID 3) pediatrics: 12-25 mg/kg/day divided QID Tabs: (Capsule) 125, 250, 500 mg. Elixir: 62.5 mg/5 mL (80, 100, 200 mL). Pharmacokinetics: 1) oral bioavailability 50-70%, decreased when taken with food 2) elimination 1/2life is 1 hour with normal or moderately impaired renal function 3) docloxacillin & its metabolites are eliminated in the urine 4) dosage adjustment not necessary with renal insufficiency 5) well distributed to most body tissues 6) minimal CSF penetration Adverse effects: 1) most common (1-10%) - diarrhea 2) uncommon (< 1%) - fever, rash, nausea/vomiting, eosinophilia, neutropenia, leukopenia, thrombocytopenia, serum sickness-like reaction, elevation in serum transaminases Drug interactions: 1) codaministration with warfarin decreases PT & INR [6] 2) probenecid increases serum concentrations & prolongs the 1/2life of dicloxacillin Mechanism of action: 1) inhibition of bacterial cell wall synthesis 2) active against penicillinase-resistant organisms

Interactions

drug interactions

General

2nd generation penicillin (penicillinase-resistant)

Properties

MISC-INFO: elimination route KIDNEY 1/2life 1 HOUR pregnancy-category B safety in lactation ?

Database Correlations

PUBCHEM correlations

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
  3. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  4. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  5. Deprecated Reference
  6. Pottegard A, Henriksen DP, Madsen KG et al Change in International Normalized Ratio Among Patients Treated With Dicloxacillin and Vitamin K Antagonists. JAMA. 2015;314(3):296-297. PMID: 26197191 http://jama.jamanetwork.com/article.aspx?articleid=2397825