Pivmecillinam


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Acute uncomplicated cystitis Initial: 400 mg, then 200 mg 3 times/day for 8 doses. Chronic or recurrent bacteriuria 400 mg 3-4 times/day.
Dosage Details
Oral
Acute uncomplicated cystitis
Adult: Initially 400 mg followed by 200 mg tid for 8 doses.
Child: <40 kg with UTI: 20-40 mg/kg/day in 3-4 divided doses.

Oral
Chronic or recurrent bacteriuria
Adult: 400 mg 3-4 times daily.
Child: <40 kg with UTI: 20-40 mg/kg/day in 3-4 divided doses.
Contraindications
Hypersensitivity, porphyria.
Special Precautions
Very high doses in poor renal function (risk of neurotoxicity) or heart failure. Avoid contact, skin sensitization may occur. Monitor serum K concentration, renal and haematological status. Spirochete infections particularly syphilis; suprainfection with penicillin-resistant organisms with prolonged use; avoid intrathecal route. May cause oesophageal injury.
Adverse Reactions
Hypersensitivity reactions including uticaria; fever; joint pains; rashes; angioedema; serum sickness-like reactions; haemolytic anaemia; interstitial nephritis; neutropaenia; thrombocytopaenia; CNS toxicity including convulsions; diarrhoea; antibiotic-associated colitis. Induction of carnitine deficiency.
Potentially Fatal: Anaphylaxis.
Drug Interactions
Probenecid prolongs T1/2 of pivmecillinam. May cause prolonged bleeding when taken with anticoagulants. May decrease the efficacy of oral contraceptives. Increased risk of carnitine deficiency when used with valproate.
Lab Interference
May interfere with diagnostic tests for urinary glucose using copper sulfate, direct Coomb's test, and test for urinary or serum proteins. May interfere with diagnostic tests that use bacteria.
Action
Description: Pivmecillinam has the antimicrobial activity of mecillinam to which it is hydrolysed in vivo. It interferes with the synthesis of bacterial cell wall. It is active against many gm-ve bacteria, esp Enterobacteriaceae including Escherichia coli, Enterobacter, Klebsiella, Salmonella and Shigella spp; indole-positive Proteus and Serratia marcescens are resistant. It is inactivated by β-lactamases, but is more stable than ampicillin.
Pharmacokinetics:
Absorption: Well absorbed.
Distribution: Peak plasma concentrations about 1-2 hr after a 400 mg dose.
Metabolism: Hydrolysed to mecillinam, pivalic acid and formaldehyde.
Excretion: About 45% excreted in the urine as mecillinam within the first 6 hr.
MIMS Class
Disclaimer: This information is independently developed by MIMS based on Pivmecillinam from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in