Nepenic
Nepenic Uses, Dosage, Side Effects, Food Interaction and all others data.
Nepenic inhibits the 3rd and last step of bacterial cell wall synthesis by binding to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall. It is active against penicillinase-producing and non-penicillinase-producing staphylococci.
Nepenic is isoxazolyl penicillin which combined the properties of resistance to hydrolysis by penicillinase, gastric acid stability and activity against gram-positive bacteria. Nepenic is a bactericidal antibiotic that is particularly useful against penicillinase-producing staphylococci. Nepenic kills bacterial cellwall, thus interfering with peptidoglycan synthesis. Peptidoglycan is a heteropolymeric structure that provides the cell wall with its mechanical stability. The final stage of peptidoglycan synthesis involves the completion of the cross-linking with the terminal glycine residue of the pentaglycin bridge linking to the fourth residue of the pentapeptide (D-alanine). The transpeptidase enzyme that performs this step is inhibited by Nepenic. As a result the bacterial cellwall is weakened, the cell swells and then ruptures. Nepenic resists the action of bacterial penicillinase probably because of the steric hindrance induced by the acyl side chain which prevents the opening of the β- lactam ring.
Nepenic is a penicillin beta-lactam antibiotic used in the treatment of bacterial infections caused by susceptible, usually gram-positive, organisms. The name "penicillin" can either refer to several variants of penicillin available, or to the group of antibiotics derived from the penicillins. Nepenic has in vitro activity against gram-positive and gram-negative aerobic and anaerobic bacteria. The bactericidal activity of Nepenic results from the inhibition of cell wall synthesis and is mediated through flucloxacillin binding to penicillin binding proteins (PBPs). Nepenic is stable against hydrolysis by a variety of beta-lactamases, including penicillinases, and cephalosporinases and extended spectrum beta-lactamases.
| Trade Name | Nepenic |
| Generic | Flucloxacillin |
| Flucloxacillin Other Names | Floxacillin, Flucloxacilina, Flucloxacillin, Flucloxacilline, Flucloxacillinum |
| Type | |
| Formula | C19H17ClFN3O5S |
| Weight | Average: 453.872 Monoisotopic: 453.056147271 |
| Groups | Approved, Investigational |
| Therapeutic Class | Penicillinase-resistant penicillins |
| Manufacturer | |
| Available Country | Italy |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Nepenic is used for the treatment of infections due to Gram-positive organisms, including infections caused by β-lactamase producing staphylococci.
Skin and Soft Tissue Infections: Boils, abscesses, carbuncles, furunculosis,infected wounds, infected burns, protection of skin grafts, otitis media and externa, impetigo.
Infected Skin Conditions: Ulcer, eczema and acne.
Respiratory Tract Infections: Pneumonia, lung abscess, empyema, sinusitis,pharyngitis, tonsillitis, quinsy.
Other infections caused by Nepenic-sensitive organisms such as osteomyelitis, enteritis, endocarditis, urinary tract infection, meningitis, septicaemia.
Nepenic is also used for use as a prophylactic agent during major surgical procedures where appropriate, for example, cardiothoracic and orthopaedic surgery
Nepenic is also used to associated treatment for these conditions: Susceptible infections
How Nepenic works
By binding to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall, flucloxacillin inhibits the third and last stage of bacterial cell wall synthesis. Cell lysis is then mediated by bacterial cell wall autolytic enzymes such as autolysins; it is possible that flucloxacillin interferes with an autolysin inhibitor.
Dosage
Nepenic dosage
Oral administration:
Adult or Elderly:
- Usual dosage: 250 mg four times daily. In severe infections, dosage should be doubled.
- In osteomyelitis and endocarditis: up to 8 gm daily, in divided doses 6 to 8 hourly.
- In case of secondary bacterial infection in chicken pox: Nepenic 500 mg six hourly should be prescribed.
Children:
- Usual dosage: 2-10 years: half of the adult dose. Under 2 years: quarter of the adult dose.
Parenteral administration:
Adult or Elderly:
- Intramuscular Injection: 250 mg four times daily.
- Intravenous Injection: 250 mg-1 g four times daily by slow injection over 3 to 4 minutes or by intravenous infusion.
- All systemic doses may be doubled in severe infections: doses up to 8 g daily have been suggested for endocarditis or osteomyelitis.
Children:
- Usual dosage: 2-10 years : half of the adult dose. Under 2 years : quarter of the adult dose.
Doses should be administered half an hour before meals.
Nepenic has been used in other routes in conjunction with systemic therapy. It has been administered in a dose of 250 mg to 500 mg daily by intraarticular injection, dissolved if necessary in a 0.5% solution of lignocaine hydrochloride, and by intrapleural injection in a dose of 250 mg daily. Using powder for injection, 125 mg-250 mg has been dissolved in 3 ml of sterile water and inhaled by nebuliser four times daily.
Side Effects
There have been some common side effects of GIT such as nausea, vomiting, diarrhoea, dyspepsia and other minor gastrointestinal disturbances. Besides these rashes, urticaria, purpura, fever, interstitial nephritis, hepatitis and cholestatic jaundice have been reported
Precaution
Patient with spirochaete infections (e.g. syphilis, leptospirosis), history of hypersensitivity to β-lactam antibiotics. Newborn infants. Hepatic or renal impairment. Pregnancy and lactation.
Interaction
The administration of probenecid with Nepenic results in higher serum peak concentrations and prolongs the time that therapeutic concentrations of Nepenic are achieved in serum. Physical incompatibility and/or loss of activity of Nepenic in solution has been reported when given with gentamycin sulphate, streptomycin sulphate, vitamin mixtures. Nepenic should not be added to intravenous lipids, blood products and protein hydrolysates or other proteinaceous fluids.
Food Interaction
- Take on an empty stomach.
Elimination Route
Bioavailability is 50–70% following oral administration.
Half Life
0.75–1 hour
Pregnancy & Breastfeeding use
The use of Nepenic in pregnancy should be reserved for cases considered essential by the clinician. Use of the drug in the second and third trimesters may result in the sensitisation of the fetus. During lactation, trace quantities of penicillins can be detected in breast milk.
Contraindication
Nepenic is contraindicated for those who have hypersensitivity to penicillins.
Special Warning
Dose adjustment in renal impairment : As common with other penicillins, Nepenic usage in patients with renal impairment does not usually require dosage reduction. However, in the presence of severe renal failure (creatinine clearance < 10 ml/min) a reduction in dose or an extension of dose interval should be considered. Nepenic is not significantly removed by dialysis and hence no supplementary dosages need to be administered either during or at the end of the dialysis period.
Acute Overdose
Symptoms: Neurotoxicity (e.g. convulsions, encephalopathy), GI effects (e.g. nausea, vomiting, diarrhoea), blood disorders (e.g. neutropenia, haemolytic anaemia, prolongation of bleeding time, defective platelet function), electrolyte disturbances.
Management: Symptomatic treatment.
Storage Condition
Store below 25° C. Reconstituted solution: Store between 2-8°C.
Innovators Monograph
You find simplified version here Nepenic
Nepenic contains Flucloxacillin see full prescribing information from innovator Nepenic Monograph, Nepenic MSDS, Nepenic FDA label
FAQ
What is Nepenic used for?
Nepenic is an antibiotic used to treat skin infections, external ear infections, infections of leg ulcers, diabetic foot infections, and infection of bone. It may be used together with other medications to treat pneumonia, and endocarditis.
How safe is Nepenic?
It is normally very well tolerated but can be more likely than other antibiotics to cause heartburn.
How does Nepenic work?
Nepenic works by interfering with the formation of the bacterial cell walls.
What are the common side effects of Nepenic?
The most common side effects are feeling sick (nausea) and diarrhoea. You can drink alcohol while taking Nepenic. You can take Nepenic during pregnancy or while you're breastfeeding.
Is Nepenic safe during pregnancy?
It is safe to take Nepenic during pregnancy.
Is Nepenic safe during breastfeeding?
It is safe to take Nepenic while breastfeeding. Information shows that only tiny amounts of Nepenic get into breast milk, which would not be expected to cause any side effects in your baby.
Can I drink alcohol with Nepenic?
Yes, you can drink alcohol while taking Nepenic.
How quickly does Nepenic take to work?
This means at least 30 to 60 minutes before a meal or snack, or at least 2 hours after. For most infections, you should start to feel better within a few days.
Can I take Nepenic on an empty stomach?
Nepenic is best taken on an empty stomach, one hour before eating food. This is because your body may absorb less Nepenic after a meal, making it less effective.
What is the half life of Nepenic?
The elimination half-life of Nepenic is in the order of 53 minutes.
How often can I take Nepenic?
The usual dose of Nepenic is 250mg to 500mg, taken 4 times a day.
Can I take Nepenic long term?
Keep taking Nepenic until you finish the pack, or for as long as your doctor recommends. Do not stop taking Nepenic, even if you feel better after a few days, unless advised by your doctor. Your infection may not clear completely if you stop taking your medicine too soon.
What happen If I stop taking Nepenic?
Do not stop taking Nepenic, even if you feel better after a few days, unless advised by your doctor. If you do not complete the full course prescribed by your doctor, the infection may not clear completely or your symptoms may return.
What happens if I miss a dose?
If you miss a dose, take it as soon as you remember. However, if it's almost time for your next dose, plan to skip the missed dose and take your next dose as scheduled. Never double up on a dose. If you'd like more information about an antibiotic you've been prescribed, talk with your doctor or pharmacist.
What happens if I overdose?
Symptoms of an overdose may include nausea, vomiting and diarrhoea. If you take too much (overdose) Immediately telephone your doctor or the Poisons Information Centre for advice, or go to Accident and Emergency at the nearest hospital, if you think that you or anyone else may have taken too much FLOPEN. Do this even if there are no signs of discomfort or poisoning.
Who should not take Nepenic?
You have pale poo with dark pee, and the whites of your eyes or skin turn yellow (this may be less obvious on black or brown skin) – this can be a sign of liver problems. you get bruising or discoloured skin. you have joint or muscle pain that starts happening after 2 days of taking the medicine.
Can Nepenic affect my kidneys?
Nepenic can injure the kidneys as well as the liver. Both interstitial nephritis and hepatitis are listed as very rare undesirable effects in the Nepenic data sheets.
Can Nepenic affects my liver?
Nepenic is now established as an important cause of cholestatic liver disease.
