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Pivya
pivmecillinam
Adult Dosing .
Dosage forms: TAB: 185 mg
UTI, uncomplicated
- [female pts]
- Dose: 185 mg PO tid x3-7 days
renal dosing
- [see below]
- renal impairment: no adjustment
- HD/PD: not defined
hepatic dosing
- [no adjustment]
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- carnitine deficiency
- porphyria
- caution: hypersensitivity to beta-lactams
- caution: abx-associated colitis hx, recent
Drug Interactions .
Overview
pivmecillinam
penicillin
- affected by altered gastrointestinal motility
- alters GI flora
- bactericidal activity requires bacterial growth
- impairs immunomodulatory bacterial infective agent
- pivmecillinam (prodrug) converted to mecillinam
Avoid/Use Alternative
- BCG live intravesical
- bremelanotide
- cholera vaccine, live
- fecal microbiota, live
- methotrexate
- typhoid vaccine, live
- valproic acid
Monitor/Modify Tx
- exenatide
- mycophenolate mofetil
- mycophenolic acid
- pramlintide
- warfarin
Caution Advised
- demeclocycline
- doxycycline
- dulaglutide
- eravacycline
- lactulose
- liraglutide
- minocycline
- sarecycline
- sodium picosulfate
- tetracycline
- tirzepatide
Adverse Reactions .
Serious Reactions
- hypersensitivity rxn
- anaphylaxis
- skin rxn, severe
- acute generalized exanthematous pustulosis
- drug rxn w/ eosinophilia and systemic sx
- Stevens-Johnson syndrome
- toxic epidermal necrolysis
- porphyria
- C. difficile-assoc. diarrhea
Common Reactions
- nausea
- diarrhea
Safety/Monitoring .
Monitoring Parameters
no routine tests recommended
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; no known risk of fetal harm based on limited human data and animal data at 3.4x, 5.1x, and 7.9x MRHD
Lactation
Clinical Summary
weigh risk/benefit while breastfeeding; inadequate human data available to assess risk of infant harm; no human data available to assess effects on milk production
Pharmacology .
Metabolism: minimal; CYP450: none; Info: prodrug converted to mecillinam
Excretion: urine 80%; Half-life: 1h
Subclass: Antiseptics, Urinary ; Beta-Lactams ; Penicillins, Amidinopenicillins
Mechanism of Action
binds to peptidoglycan, inhibiting cell wall synthesis
Formulary .
No Formulary Selected
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