didoxacillin sodium
Wednesday, January 6th, 2010HOW SUPPLIED
Capsules: 125 mg, 250 mg, 500 mg
Oral suspension: 62.5 mg/5 mg(after reconstitution)
ACTION
A penicillinase resistant penicillin that inhibits cell-wall synthesis during microor ganism multiplication. Bacteria resist penicillins by producing penicillinases en ymes that convert penicillins to inactive penicillic acid. Dicloxacillin resists these enzymes.
INDICATIONS & DOSAGE
Systemic infections due to penicillinase producing staphylococci -
Adults and children weighing over 40 kg (88Ib): 125 to 250 mg P.O. q 6 hours.
Children weighing 40 kg or less: 12.5 to 25 mg/kg P.O. daily, in divided doses q 6 hours depending on severity.
ADVERSE REACTIONS
CNS: neuromuscular irritability, seizures, lethargy, hallucinations, anxiety, confusion, agitation, depression, dizziness, fatigue.
GI: nausea, vomiting, epigastric distress, flatulence, diarrhea, enterocolitis, pseudomembranous colitis, black “hairy” tongue, abdominal pain.
GU: interstitial nephritis, nephropathy.
Hematologic: anemia, thrombocytopenia, eosinophilia, leukopenia, hemolytic anemia, agranulocytosis.
Hepatic: transient elevations in liver function test results.
Other: hypersensitivity reactions (pruritus, urticaria, rash, anaphylaxis), over growth of nonsusceptible organisms.
INTERACTIONS
Drug-drug. Oral contraceptives: efficacy of oral contraceptives may be decreased. An additional form of contraception should be recommended during penicillin therapy.
Probenecid: increased blood levels of dicloxacillin and other penicillins. Probenecid may be used for this purpose.
EFFECTS ON DIAGNOSTIC TESTS
Drug produces false positive or elevated results in turbidimetric urine and serum protein tests using sulfosalicylic acid or I richloroacetic acid; it also reportedly produces false results on the Bradshaw screening test for Bence Jones protein.
CONTRAINDICATIONS
Contraindicated in patients with hypersensitivity to drug or other penicillins. It is not recommended for use in newborns
SPECIAL CONSIDERATIONS
Use cautiously in patients with other drug allergies, especially to cephalosporins (possible cross sensitivity), and in those with mononucleosis (high incidence of maculopapular rash).
Before the drug is given, the patient must he asked about previous allergic reactions 10 penicillin. However, a negative history of penicillin allergy is no guarantee against a future allergic reaction.
A specimen for culture and sensitivity lesls should be obtained before giving first dose. Therapy may begin pending results.
The drug is given I to 2 hours before or ) 103 hours after meals. Drug may cause GI disturbances. Food may interfere with absorption.
Dicloxacillin is given at least 1 hour berore a bacteriostatic antibiotic.
Renal, hepatic, and hematopoietic function must periodically be assessed in patients receiving long term therapy.
Elevated liver function test results may indicate drug-induced cholestasis or hepatitis.
Patient must be observed closely. With large doses and prolonged therapy, bacterial or fungal superinfection may occur, especially in elderly, debilitated, or immunosuppressed patients.
Patient teathing
• Take entire quantity of drug exactly as prescribed, even after feeling better.
• Take drug on an empty stomach.
• Notify health care provider if rash, fever, or chills develop. Rash is the most common allergic reaction