about Cloxacillin class, uses, side effects contraindications
Cloxacillin
Short Description
Cloxacillin is a semi-?synthetic penicillin?antibiotic that is particularly effective against Staphylococcus aureus.
In addition to its effectiveness against infections caused by Streptococcus and Pneumococcus.
It is used to treat some types of bacterial infections, including the following:
endocarditis;
Pneumonia.
Bone and joint infections Skin infections.
Septicemia caused by susceptible strains of penicillinase-producing staphylococci.
Because this antibiotic belongs to the penicillin family, people who are allergic to penicillin are also allergic to cloxacillin.
It is worth noting that this drug is not approved in many countries, including the United States.
Category
Chemical class: Penicillinase-resistant isoxazolyl penicillin derivative
Therapeutic class: Antibiotic
Pregnancy category: B
Indications
To treat mild to moderate upper respiratory tract infections or localized skin and soft-tissue infections caused by penicillinase-producing staphylococci ,,
IV
, I.V. OR
IM
Adults and children weighing 20 kg (44 lb) or more. 250 mg every 6 hr. Maximum: 6 g daily. Children and infants weighing less than 20 kg.50 mg/kg daily in equally divided doses every 6 hr. To treat severe lower respiratory tract infections or disseminated infections caused by penicillinase-producing staphylococci ,,
IV
, I.V. OR
IM
Adults and children weighing 20 kg or more.500 mg every 6 hr. Maximum: 6 g daily. Infants and children weighing less than 20 kg.100 mg/kg daily in divided doses every 6 hr.
Mechanism of Action
Inhibits cell wall synthesis and causes cell lysis and death in bacteria that make rigid, cross-linked cell walls in several steps. Cloxacillin affects the final stage of crosslinking by binding with and inactivating penicillin-binding protein, the enzyme that causes linkage in cell wall strands. cloxacillin sodium 259 C
Incompatibilities
Don’t mix cloxacillin with aminoglycosides because of risk of mutual inactivation.
Contraindications
Hypersensitivity to cloxacillin, penicillin, or their components
Interactions
chloramphenicol, erythromycins, sulfonamides, tetracyclines: Decreased cloxacillin effects hepatotoxic , such as fluconazole: Increased risk of hepatotoxicity methotrexate: Increased blood methotrexate level and risk of toxicity probenecid: Increased and prolonged blood cloxacillin level
Side Efect
CNS: Headache
EENT: Glossitis, oral candidiasis
GI: Abdominal pain, diarrhea, elevated liver function test results, nausea, pseudomembranous colitis, vomiting
GU: Hematuria, vaginal candidiasis
MS: Muscle twitching
SKIN: Pruritus, rash, urticaria
Other: Anaphylaxis
Cautions
Use cloxacillin cautiously in patients hypersensitive to cephalosporins (allergic reaction may be delayed) and those with hypertension (drug is relatively high in sodium). For I.V. injection, reconstitute 250-mg vial with 4.9 ml of sterile water for injection, 500-mg vial with 4.8 ml, and 2,000-mg vial with 6.8 ml. Shake to dissolve. For direct I.V. injection, give over 2 to 4 minutes through tubing of a compatible infusing I.V. solution. If giving by intermittent I.V. infusion, further dilute with a suitable diluent (see package insert) and administer over 30 to 40 minutes. For I.M. injection, reconstitute 250-mg vial with 1.9 ml of sterile water for injection and 500-mg vial with 1.7 ml of sterile water. Shake to dissolve. Be aware that parenteral solutions are stable 24 hours at room temperature and 72 hours if refrigerated. PATIENT SAFTY
Tell patient to finish full course of therapy, even if he feels better before drug is gone. Instruct patient to take oral cloxacillin 1 to 2 hours before meals. Tell patient to take oral form of cloxacillin with a full glass of water (not fruit juice or soda). Instruct patient taking oral solution to refrigerate container and to discard unused portion after 14 days. Also instruct him to use a calibrated measuring device to ensure accurate doses. Advise patient to report signs or symptoms of allergic reaction.
Category
Chemical class: Isoxazolyl penicillin derivative
Therapeutic class: Antibiotic Pregnancy category: B
Indications
To treat mild to moderate upper respiratory tract and localized skin and softtissue infections caused by penicillinaseproducing staphylococci , Adults and children weighing 40 kg (88 lb) or more. 125 mg every 6 hr. Children weighing less than 40 kg. 12.5 mg/kg daily divided into four equal doses and given every 6 hr. To treat severe infections, such as lower respiratory tract or disseminated infections, caused by penicillinase-producing staphylococci , Adults and children weighing 40 kg or more.250 mg every 6 hr, or higher doses, if needed. Maximum: 6 g daily. Children over age 1 month weighing less than 40 kg. 25 mg/kg daily divided into 4 equal doses and given every 6 hr, or higher doses if needed. Mechanism of Action
Inhibits cell wall synthesis in susceptible bacteria, which assemble rigid, cross-linked cell walls in several steps. Dicloxacillin affects final cross-linking by inactivating penicillin-binding protein (the enzyme needed to link cell wall strands). This action inhibits cell wall synthesis and causes cell lysis and death. Contraindications
Hypersensitivity to dicloxacillin, other penicillins, beta-lactamase inhibitors (such as piperacillin/tazobactam), cephalosporins, imipenem, or their components Interactions
hepatotoxic : Increased risk of hepatotoxicity methotrexate: Decreased methotrexate clearance and increased risk of toxicity oral contraceptives: Decreased contraceptive action probenecid: Increased and prolonged blood dicloxacillin level tetracyclines: Decreased dicloxacillin effectiveness all : Possibly delayed absorption Side Efect
CNS: Dizziness, fatigue, fever, insomnia
EENT: Black “hairy”tongue, dry mouth, glossitis, laryngeal edema, laryngospasm, stomatitis, taste perversion
GI: Abdominal pain, anorexia, diarrhea, flatulence, nausea, pseudomembranous dicloxacillin sodium 314 colitis, transient hepatitis, vomiting
GU: Nephropathy, vaginitis
MS: Prolonged muscle relaxation
SKIN: Dermatitis, erythema multiforme, pruritus, rash, urticaria, vesicular eruptions
Other: Anaphylaxis, serum sicknesslike reaction, superinfection Cautions
Before dicloxacillin therapy begins, expect to obtain body fluid and tissue samples for culture and sensitivity tests, as ordered, and review the results, if possible. Also check for history of sensitivity to cephalosporins, penicillins, and other substances. If diarrhea develops, notify prescriber; it could be the development of pseudomembranous colitis. PATIENT SAFTY
Instruct patient to take drug 1 hour before or 2 hours after meals. Instruct patient to take drug around the clock, not to miss a dose, and to complete the entire prescription unless directed otherwise by prescriber. Advise patient to take oral solution with a cold beverage but not acidic juice, such as orange juice. Explain that solution is effective for 7 days at room temperature and for 14 days if refrigerated. Caution patient not to open capsules and mix contents with food or liquids because an unpleasant taste and decreased drug absorption will result. Instruct parent to shake oral solution thoroughly and measure doses with a calibrated device for accuracy. Advise patient to notify prescriber if she experiences adverse GI reactions or signs of hypersensitivity or superinfection. If patient takes an oral contraceptive, advise her to use an additional form of contraception during therapy. Instruct patient to store drug away from heat, moisture, and direct light and to refrigerate—but not freeze—oral solution.
Trade Name & Company Name
effect of Cloxacillin in Pregnancy, Fetal Health
and Breast feeding
Pregnancy
. There are no adequate reports or well-controlled studies of dicloxacillin in pregnant women. Dicloxacillin is a penicillinase- resistant, acid-resistant semisynthetic broad-spectrum penicillin. It is an excellent drug for the treatment of postpartum mastitis. Fetal Health
There are no adequate reports or well-controlled studies in human fetuses. Dicloxacillin crosses the human placenta but the fetal concentrations are relatively low, perhaps because of the high degree of maternal protein binding. Rodent studies are reassuring, revealing no evidence of teratogenicity or IUGR despite the use of doses higher than those used clinically. Breastfeeding
There is no published experience in nursing women. It is unknown whether dicloxacillin enters human breast milk. The extensive clinical experience with its use for mastitis is reassuring. Other penicillin agents are excreted into human breast milk, but are generally considered safe. Pregnancy
. Cloxacillin sodium is a broad-spectrum antibiotic effective against penicillinase-producing Staphylococcus and is usually combined with ampicillin. There are no adequate reports or well- controlled studies in pregnant women. Before its withdrawal in 229 the US, cloxacillin was used for the treatment of mastitis. There is a significant increase in the free plasma fraction of cloxacillin during pregnancy, beginning in the 2nd trimester and peaking at delivery. A similarly increased free-of-fraction cloxacillin is found in cord blood, which increases further during the 1st postnatal week. Cloxacillin is highly concentrated in the kidneys. Fetal Health
There are no adequate reports or well-controlled studies in human fetuses. Cloxacillin crosses the human placenta. Fetal drug levels rise slowly to equilibrium within the maternal circulation 1-3h after drug administration. Thereafter, fetal drug levels exceed maternal values. AF levels are low during early gestation, rising progressively near term until they exceed maternal values 6-8h after drug administration. Rodent studies are reassuring, revealing no evidence of teratogenicity or IUGR despite the use of doses higher than those used clinically. Breastfeeding
There is no published experience in nursing mothers. Cloxacillin is excreted in the breast milk of both humans and cows.
the follwing drugs will increse Cloxacillin by inhepiting cyp450
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the follwing drugs will decrease Cloxacillin by inhancing cyp450
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trad drugs based on Cloxacillin
| Gen name | Trade name | Catagory name |
| dicloxacillin | Dycill | Penicillinase resistant penicillins |
| dicloxacillin | Dynapen | Penicillinase resistant penicillins |
| Cloxacillin | CLOXA 1000MG VIAL | |
| Cloxacillin | FLOXAPEN 250MG-5ML POWD.FOR SUSP | |
| Cloxacillin | FLOXAPEN 500MG CAPS | |
| Cloxacillin | FLOXAPEN CAPS 250MG | |
| Cloxacillin | FLOXAPEN SYP 125MG-5ML | |
| Cloxacillin | FLOXAPEN VIAL 250MG | |
| Cloxacillin | ORBENIN 500MG VIAL | |
other drugs from same cataogory
| Gen name | trade name | catogry |
| dicloxacillin | Dynapen | Penicillinase resistant penicillins |
| dicloxacillin | Dycill | Penicillinase resistant penicillins |