Description

Simple

A type of penicillin antibiotic that is used to prevent and treat various skin, respiratory and other infections in the body caused by bacteria.

Clinical

A penicillin antibiotic used to prevent and treat mild to moderately severe infections in the respiratory tract, skin, and soft tissues.

Overview

Phenoxymethylpenicillin is a narrow spectrum antibiotic also commonly referred to as Penicillin V or Penicillin VK.[3] It is a phenoxymethyl analog of Penicillin G, or [benzylpenicillin]. An orally active naturally penicillin, phenoxymethylpenicillin is used to treat mild to moderate infections in the respiratory tract, skin, and soft tissues caused by penicillin G­-sensitive microorganisms. Phenoxymethylpenicillin has also be used in some cases as prophylaxis against susceptible organisms. While there have been no controlled clinical efficacy studies that were conducted, phenoxymethylpenicillin has been suggested by the American Heart Association and the American Dental Association for use as an oral regimen for prophylaxis against bacterial endocarditis in patients with congenital heart disease or rheumatic or other acquired valvular heart disease when they undergo dental procedures and surgical procedures of the upper respiratory tract, except for those who are at an elevated risk for endocarditis.[label]

Pharmacology

Indication

Indicated for the treatment of mild to moderately severe infections due to penicillin G­-sensitive microorganisms, with the use of bacteriological studies (including sensitivity tests) and clinical response.[label]

Phenoxymethylpenicillin may be used for the treatment of:

- mild to moderate... Read more

Pharmacodynamic

Phenoxymethylpenicillin works against penicillin-sensitive microorganisms with bactericidal effects. It targets the bacteria during its active multiplication stage by interfering with bacterial cell wall peptidoglycan synthesis. _In vitro_, phenoxymethylpenicillin was shown to be active against stap... Read more

Mechanism of action

Phenoxymethylpenicillin inhibits the biosynthesis of cell wall mucopeptide [label] by binding to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall, which are critical in the cell wall synthesis and maintenance, as well as cell division.[ Read more

Absorption

Upon oral administration, phenoxymethylpenicillin is rapidly but incompletely absorbed.[4] The bioa... Read more

Protein binding

Upon oral administration, about 50-80% of the drug is bound to plasma proteins.[8,label]

Volume of distribution

Following intravenous administration, the volume of distribution at steady state was 35.4 L.[ Read more

Clearance

Information currently not available.

Half life

Upon oral administration, the half-life is about 30 minutes. It can last up to 4 hours in patients with renal impairment.[8]

Route of elimination

While the drug is rapidly excreted, only 25% of the total dose is detected in the urine. Renal excretion may be delayed in neonates, young infants, and patients with renal impairment.[label]

Toxicity

The oral LD50 is >1040 mg/kg in rats. Nausea, vomiting, black hairy tongue, and epigastric distress are common reactions to oral penicillins.[label] In rare cases, neuromuscular sensitivity and seizures may be seen with antibiotics and supportive treatments are advised and further drug ab... Read more

Adverse Effects

Contraindications

Information currently not available.

Food Interactions

  • Absorption is increased when taken on an empty stomach (one hour before or two hours after meals).

Interactions

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  • Paracetamol(acetaminophen)
  • Paxil(paroxetine)
  • Pamelor(nortriptyline)
  • Panadol(acetaminophen)
  • Patanol(olopatadine ophthalmic)
  • Pataday(olopatadine ophthalmic)
  • Parnate(tranylcypromine)
  • Pazeo(olopatadine ophthalmic)
(R)-warfarin
Phenoxymethylpenicillin may increase the anticoagulant activities of (R)-warfarin.
(S)-Warfarin
Phenoxymethylpenicillin may increase the anticoagulant activities of (S)-Warfarin.
4-hydroxycoumarin
Phenoxymethylpenicillin may increase the anticoagulant activities of 4-hydroxycoumarin.
Acemetacin
Acemetacin may decrease the excretion rate of Phenoxymethylpenicillin which could result in a higher serum level.
Acenocoumarol
Phenoxymethylpenicillin may increase the anticoagulant activities of Acenocoumarol.
Alcuronium
The therapeutic efficacy of Alcuronium can be increased when used in combination with Phenoxymethylpenicillin.
Amikacin
The serum concentration of Amikacin can be decreased when it is combined with Phenoxymethylpenicillin.
Apramycin
The serum concentration of Apramycin can be decreased when it is combined with Phenoxymethylpenicillin.
Arbekacin
The serum concentration of Arbekacin can be decreased when it is combined with Phenoxymethylpenicillin.
Atenolol
The bioavailability of Atenolol can be decreased when combined with Phenoxymethylpenicillin.
Atracurium
The therapeutic efficacy of Atracurium can be increased when used in combination with Phenoxymethylpenicillin.
Atracurium besylate
The therapeutic efficacy of Atracurium besylate can be increased when used in combination with Phenoxymethylpenicillin.
BCG vaccine
The therapeutic efficacy of BCG vaccine can be decreased when used in combination with Phenoxymethylpenicillin.
Bekanamycin
The serum concentration of Bekanamycin can be decreased when it is combined with Phenoxymethylpenicillin.
Capreomycin
The serum concentration of Capreomycin can be decreased when it is combined with Phenoxymethylpenicillin.
Chlormadinone
The therapeutic efficacy of Chlormadinone can be decreased when used in combination with Phenoxymethylpenicillin.
Cinoxacin
The serum concentration of Cinoxacin can be increased when it is combined with Phenoxymethylpenicillin.
Ciprofloxacin
The serum concentration of Ciprofloxacin can be increased when it is combined with Phenoxymethylpenicillin.
Cisatracurium
The therapeutic efficacy of Cisatracurium can be increased when used in combination with Phenoxymethylpenicillin.
Clomocycline
The therapeutic efficacy of Phenoxymethylpenicillin can be decreased when used in combination with Clomocycline.
10 References
  1. 1 . Authors unspecified: Inadvertent use of Bicillin C-R to treat syphilis infection--Los Angeles, California, 1999-2004. MMWR Morb Mortal Wkly Rep. 2005 Mar 11;54(9):217-9.PubMed: 15758893
  2. 2 . Gruchalla RS, Pirmohamed M: Clinical practice. Antibiotic allergy. N Engl J Med. 2006 Feb 9;354(6):601-9.PubMed: 16467547
  3. 3 . Skarpeid PL, Hoye S: Phenoxymethylpenicillin Versus Amoxicillin for Infections in Ambulatory Care: A Systematic Review. Antibiotics (Basel). 2018 Sep 4;7(3). pii: antibiotics7030081. doi: 10.3390/antibiotics7030081.PubMed: 30181520
  4. 4 . Josefsson K, Bergan T: Pharmacokinetics of phenoxymethylpenicillin in volunteers. Chemotherapy. 1982;28(4):241-6. doi: 10.1159/000238084.PubMed: 6811219
  5. 5 . Overbosch D, Mattie H, van Furth R: Comparative pharmacodynamics and clinical pharmacokinetics of phenoxymethylpenicillin and pheneticillin. Br J Clin Pharmacol. 1985 May;19(5):657-68. doi: 10.1111/j.1365-2125.1985.tb02693.x.PubMed: 3924086
  6. 6 . Llor C, Arranz J, Morros R, Garcia-Sangenis A, Pera H, Llobera J, Guillen-Sola M, Carandell E, Ortega J, Hernandez S, Miravitlles M: Efficacy of high doses of oral penicillin versus amoxicillin in the treatment of adults with non-severe pneumonia attended in the community: study protocol for a randomised controlled trial. BMC Fam Pract. 2013 Apr 17;14:50. doi: 10.1186/1471-2296-14-50.PubMed: 23594463
  7. 7 . Phenoxymethylpenicillin (Penicillin V) Monograph - Government of Western Australia Child and Adolescents Health Service Link
  8. 8 . Phenoxymethyl Penicillin 250mg/5ml Oral Solution Sugar Free (syringe) - eMC Link
  9. 9 . phenoxymethylpenicillin (penicillin v) - King Edward Memorial Hospital Link
  10. 10 . Penicillin V potassium - GLOWM Link