Dicloxacillin

Oral
Staphylococcal infections resistant to benzylpenicillin

Should be taken on an empty stomach. Take at least 1 hr before or 2 hr after meals.

Hypersensitivity to dicloxacillin and other penicillins.

Patient w/ history of allergy esp β-lactam allergy, asthma. Pregnancy and lactation.

Hypersensitivity reactions (e.g. urticaria, fever, joint pains, rashes, angioedema, serum sickness-like reactions), nausea, vomiting, diarrhoea, stomatitis, black/hairy tongue, neurotoxic reactions, renal tubular damage, interstitial nephritis, eosinophilia, haemolytic anaemia, agranulocytosis, neutropenia, leucopenia, granulocytopenia, bone marrow depression, hepatotoxicity, cholestatic hepatitis.
Potentially Fatal: Anaphylaxis, Clostridium difficile-associated diarrhoea (CDAD).

PO: B

Monitor renal, hepatic and haematologic functions; urinalysis, BUN, serum creatinine, AST and ALT.

Probenecid prolongs serum levels of dicloxacillin. Bacteriostatic drugs (e.g. chloramphenicol, tetracyclines) may antagonise the bactericidal effect of dicloxacillin. May reduce anticoagulant response to dicumarol and warfarin. May increase risk of methotrexate toxicity. May diminish the effect of live vaccines (e.g. typhoid vaccine).

Food reduces the absorption of dicloxacillin.

Description: Dicloxacillin inhibits bacterial cell wall synthesis by binding to 1 or more of the penicillin-binding proteins (PBPs) which in turn inhibit the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested.
Pharmacokinetics:
Absorption: Rapidly but incompletely absorbed from the GI tract. Absorption may be reduced by the presence of food. Time to peak plasma concentration: 1 hr.
Distribution: Crosses the placenta and enters breast milk. Plasma protein binding: Approx 97%.
Metabolism: Limited metabolism.
Excretion: Via urine (as unchanged drug and metabolites) and bile (small amounts). Plasma half-life: 0.5-1 hr.

Source: National Center for Biotechnology Information. PubChem Database. Dicloxacillin, CID=18381, https://pubchem.ncbi.nlm.nih.gov/compound/Dicloxacillin (accessed on Jan. 21, 2020)

Store between 20-25°C.

Penicillins

Anon. Dicloxacillin. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 26/06/2014.

Buckingham R (ed). Dicloxacillin. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com . Accessed 26/06/2014.

Dicloxacillin Sodium Capsule (Sandoz Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 26/06/2014.

McEvoy GK, Snow EK, Miller J et al (eds). Dicloxacillin Sodium. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 26/06/2014.

Wickersham RM. Dicloxacillin Sodium. Facts and Comparisons [online]. St. Louis, MO. Wolters Kluwer Clinical Drug Information, Inc. https://www.wolterskluwercdi.com/facts-comparisons-online/. Accessed 26/06/2014.