Acute uncomplicated cystitis: 400 mg initially, then 200 mg 3 times a dayChronic or recurrent bacteriuria: 400 mg every 6–8 hoursEnteric fever (typhoid): 1.2–2.4 g daily for 14 days
20 to 50     : Dose as in normal renal function
10 to 20     : Dose as in normal renal function
<10           : Dose as in normal renal function. See ‘Other Information’
DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD                :Likely dialysability. Dose as in GFR <10 mL/min
HD                     :Likely dialysability. Dose as in GFR <10 mL/min
HDF/high flux   :Likely dialysability. Dose as in GFR <10 mL/min
CAV/VVHD      :Likely dialysability. Dose as in normal renal function
IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugsMethotrexate: penicillins can reduce the excretion of methotrexate (increased risk of toxicity)Probenecid: reduces excretion of penicillins
ADMINISTRATION
Reconstition
–
Route
Oral
Rate of Administration
–
Comments
Take with food
OTHER INFORMATION
Hydrolysed to mecillinam which is the active drug
Contraindicated in carnitine deficiency as it can cause carnitine deficiencyCan cause oesophageal injury, take with water and food while standing upCan cause porphyria Accumulation may occur in patients with severe renal impairment, so use the lower dose if using for extended periods of timeUnlikely to work in people with little residual kidney function as works by renal excretion into the bladder, where its site of action