V-Penicillin instructions for use
Please note that before buying the drug V-Penicillin Slovofarma, you must carefully read the instructions for use, the methods of application and dosage, as well as other useful information on the drug V-Penicillin Slovakofarma. On the site "Encyclopaedia of Diseases" you will find all the necessary information: instructions for proper use, recommended dosage, contraindications, as well as reviews of patients who have already used this medication.
V-Penicillin - Composition and form of release
Phenoxymethylpenicillinum kalicum 278 mg, corresponding to Phenoxymethylpenicillinum 250 mg (440,000 IU) in 1 tablet, or Phenoxymethylpenicillinum kalicum 556 mg, which corresponds to Phenoxymethylpenicillinum 500 mg (880,000 IU) in 1 tablet.
Excipients: Saccharum lactis, croscarmelosum natricum, talcum, magnesium stearas, cellulosum microcrystallisatum.
V-Penicillin - Pharmacological action
V-Penicillin Slovakopharma is a bactericidal acid - fasting oral penicillin antibiotic. The antimicrobial effect of this drug is due to the inhibition of the synthesis of the cell wall of the microorganism. The following mechanisms are involved in this process: the combination of the beta-lactam drug with penicillin-specific proteins (penicillinbinding proteins PBP-1 and PBP-3), inhibition of the cell wall of transpeptidization of peptidoglucan. This activates autolytic enzymes in the cell wall, which eventually damage the cell wall and kill the cell.
V-Penicillin - Pharmacokinetics
Phenoxymethylpenicillin is resistant to the action of gastric acid, so it can be administered orally. The maximum concentration in the plasma is achieved already after 1 hour after taking an empty stomach, after eating only after 2 hours, and it can be even 50% lower than when taken on an empty stomach. Then the concentration of phenoxymethylpenicillin in the blood rapidly decreases. V-Penicillin is distributed to all tissues and body fluids, including the pleural, pericardial and articular fluids.
The concentration of penicillin in the tissues is equal to the concentration in the serum, only in the eyes, the prostate gland and in the central nervous system the concentrations are lower.
V-Penicillin combines with plasma proteins in 65-80%, antibiotic enters the central nervous system in 5%, in bile concentrates even 200%, in bones up to 10%, in bronchial secretion 45-50%, in extracellular fluid 20-40 %, in the soft tissue of 20-40%.
Phenoxymethylpenicillin is excreted by the kidneys, 10% of the received amount by glomerular filtration and 90% by tubular secretion.
Approximately 30-40% of the orally taken dose is excreted within 6 hours in the urine unchanged. The biological half-cycle varies within 0.5-1 hours, however, it is significantly prolonged for violations of renal functions, for example, in newborns or in elderly patients.
V-Penicillin - Indications for use
V-Penicillin is used in the therapy of bacterial pharyngitis and pneumococcal pneumonia, infections of the skin and soft tissues if they are caused by pneumococci, staphylococci and streptococcus group A, in the therapy of bacterial endocarditis, rheumatic fever, erysipelas, necrotizing ulcerous gingivostomatitis and other infections caused by sensitive microorganisms.
The antibacterial spectrum of the preparation includes pyogenic and other hemolytic streptococci, pneumococci, gonococci and meningococci, listeria, Erysipelothrix insidosa, corynebacterium, anthrax rods, actinomycetes, clostridia tetanus and other anaerobic clostridia, moracella, Treponema pallidum, most strains of leptospira.
Less often, V-Penicillin affects Streptococcus viridans (active against approximately 70-80% of strains) and enterococci (20-40% of strains).
In high concentrations in the serum after taking large doses, in urine and when administering the usual amounts, V-Penicillin has an effect on some gram-negative intestinal sticks, for example. Escherichia coli, creeping forms of Proteus and Salmonella.
In recent years there has been a change in the sensitivity of gonococci, hemolytic streptococci and pneumococci to penicillin.
V-Penicillin - Dosages
• Streptococcal tonsillopharyngitis: Children weighing less than 25 kg are prescribed 250 mg every 8 hours. Children with a body weight of 25-40 kg are prescribed 250-500 mg every 8 hours. Adolescents and adults weighing less than 70 kg are prescribed 500 mg every 8 hours. The drug is taken within 10 days.
• Secondary prevention of rheumatic fever: Children and adults are prescribed 250 mg every 12 hours for a period of 5 years or more.
• Therapy of the first stage of limb Borrelliosis: Assign 30 mg / kg of body weight per day, dividing the dose into three divided doses. Accept for 3-4 weeks.
• Continuation of parenteral therapy of pneumococcal pneumonia: Adults appoint 500-750 mg every 6 or 8 hours.
In other indications, children under the age of 14 are usually prescribed 250-500 mg every 8 hours, individuals over 14 years of age have 500-750 mg every 8 hours. The drug takes at least 5-7 days, with a disease caused by beta-hemolytic streptococci 7-40 days.
According to clinical experience to date, it is recommended to prescribe V-penicillin the first two days at a dose of 750 mg every 8 hours, on subsequent days every 12 hours. It is advisable to combine the appointment of V-penicillin with the intake of vitamin C. In elderly people with renal insufficiency, the biological half-period of phenoxymethylpenicillin is prolonged up to about 4 hours, therefore, less frequent intervals between the intake of individual doses should be observed.
The drug is intended for oral administration. The tablet is taken half an hour before meals or 2 hours after meals, washed down with water or fruit juice.
V-Penicillin - Contraindications
Absolute contraindication of the appointment of V-penicillin is hypersensitivity to penicillin and cephalosporin antibiotics, and all conditions that adversely affect the absorption of the drug from the digestive tract (vomiting, diarrhea).
Relative contraindications are allergic diseases ( bronchial asthma , urticaria ), gastrointestinal diseases (also in anamnesis - ulcerous colitis, regional enteritis, colitis caused by antibiotics). Infectious mononucleosis is also considered a relative contraindication to the appointment of V-penicillin, since patients taking penicillin often develop skin rashes.
Given the fact that V-penicillin, like most penicillins, is excreted by the kidneys, it is necessary in patients with impaired renal function or to reduce the dose, or to extend the dosage interval.
V-Penicillin - Prevention
Most of the undesired actions are due to increased sensitivity. Allergy to phenoxymethylpenicillin, as a rule, is crossed with allergies to other penicillins, and sometimes to cephalosporins.
In extremely rare cases (in 0.05% of patients) allergic reactions may occur in the form of a typical anaphylactic shock . Sometimes, symptoms similar to serum sickness are possible: urticaria, fever, swelling of the joints, angioedema, intense itching and shortness of breath. Usually, these symptoms occur within the first 7-10 days after the initiation of therapy. Of the remaining unwanted actions, various skin rashes develop, mucous membrane damage to the mouth, fever, interstitial nephritis, eosinophilic leukocytosis , hemolytic anemia and other hematologic disorders, vasculitis .
After oral administration of large doses of penicillin, complications may occur in the digestive tract (nausea, vomiting, diarrhea).
Toxic symptoms after taking penicillin practically do not occur. Only in exceptional cases, patients receiving large doses of penicillin (more than 12 g of penicillin per day) showed signs of irritation of the cerebral cortex as a result of penicillin entering the central nervous system.
V-Penicillin - Drug Interactions
Bacteriostatic drugs (chloramphenicol, erythromycin, sulfonamides, tetracyclines) can interact with the bactericidal action of penicillins in the therapy of meningitis and other diseases in which the rapid development of the bactericidal effect is important.
Cholestyramine and Kolestipol reduce the absorption of orally taken penicillin.
Penicillins reduce the effectiveness of contraception by stimulating the metabolism of estrogens or also by weakening their enterohepatic circulation, which leads to irregular menstrual cycles, intermenstrual bleeding, and unwanted pregnancies.
Probenecid reduces the tubular release of penicillins. This increases their plasma concentrations, prolongs their biological half-life and increases the risk of toxicity.
Pregnancy and breastfeeding
Penicillins penetrate the placental barrier and enter the mother's milk, where their concentration reaches 3-15% concentration in the serum.
V-Penicillin is included in a group of antibiotics that do not have an undesirable effect on the mother or child. If you exclude possible allergic reactions, it is a suitable antibiotic used during pregnancy or breastfeeding.
Penicillins belong to the group of safe drugs, the probability of influence of which on concentration of attention is zero.
V-Penicillin - Side Effects
Side effect occurs in approximately 5% of cases, allergic reactions are observed in 2-5%.
Taking large doses of V-Penicillin can cause urticaria, fever, eosinophilia , arthralgia, angioedema, leukopenia, pancytopenia and increased bleeding due to platelet function impairment, as well as thrombocytopenia .
Frequently increased doses can have a damaging effect on the central nervous system, especially in children and elderly patients with impaired renal function.
When treating syphilis in 50% of cases, the Yarisch-Gerxheimer reaction may occur as a result of the release of endotoxin. Symptoms of this reaction - fever, excessive sweating, headache , even collapse. When using large doses due to the intake of a significant amount of potassium, there is a risk of hyperkalemia .
V-Penicillin - Overdose
With an intravenous application, the lethal dose of LD50 is 4,000,000 IU / kg in mice, which corresponds to a recalculation of approximately 300,000,000 IU in humans.
At present, there is no specific antidote, the therapy of intoxication is symptomatic and auxiliary.
Remove phenoxymethyl-penicillin from the blood can be hemodialysis.
Preclinical data with regard to drug safety
The safety of the drug has been tested with a sufficiently long application in clinical practice.
The drug is intended for oral administration, it is produced only in the dosage form of tablets.
Physical or chemical incompatibility when mixing the drug in infusion solutions is not relevant.
Analogues of V-Penicillin
Vepicombin, Cliacil, Megacillin oral, Ospen, Ospen 750, Penicillin Fau potassium salt, Star Pen, Phenoxymethylpenicillin, Phenoxymethylpenicillin (for suspension), Phenoxymethylpenicillin Watham, Phenoxymethylpenicillin potassium.
Store in a dry dark place, at a temperature of 15-25 ° C.
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