Emcil 200 Tablet – (200mg)

Square Pharmaceuticals PLC.

Generic: Pivmecillinam

Weight

0.015 kg

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Indication

Acute uncomplicated cystitis, Chronic or recurrent bacteriuria

Adult Dose

Oral Acute uncomplicated cystitis Adult: Initially 400 mg followed by 200 mg tid for 8 doses. Chronic or recurrent bacteriuria Adult: 400 mg 3-4 times daily.

Child Dose

Oral Acute uncomplicated cystitis Child: <40 kg with UTI: 20-40 mg/kg/day in 3-4 divided doses. Chronic or recurrent bacteriuria Child: <40 kg with UTI: 20-40 mg/kg/day in 3-4 divided doses.

Contraindication

Hypersensitivity, porphyria.

Mode of Action

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 beta-lactamases, but is more stable than ampicillin.

Precaution

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.

Side Effect

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.

Interaction

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.

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