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Pivya
pivmecillinam
Adult Dosing .
Dosage forms: TAB: 185 mg
UTI, uncomplicated
- [female patients]
- 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: antibiotic-associated colitis history, 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
Monitor/Modify Tx
Caution Advised
Adverse Reactions .
Serious Reactions
- hypersensitivity reaction
- anaphylaxis
- skin reaction, severe
- acute generalized exanthematous pustulosis
- drug reaction with eosinophilia and systemic symptoms
- Stevens-Johnson syndrome
- toxic epidermal necrolysis
- porphyria
- C. difficile-associated 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: for pivmecillinam: minimal; CYP450: none
Excretion: for pivmecillinam: urine 80%; Half-life: 1h
Subclass: Antiseptics, Urinary ; Beta-Lactams ; Penicillins, Amidinopenicillins
Mechanism of Action
for pivmecillinam: binds to peptidoglycan, inhibiting cell wall synthesis
Formulary .
No Formulary Selected
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