Penicillins - Anibiotics

What is penicillin?

Penicillin V is an antibiotic in the penicillin group of drugs. It fights bacteria in your body.

Penicillin V is used to treat many different types of infections caused by bacteria, such as ear infections,.

Penicillin V may also be used for other purposes not listed in this medication guide.

Important information

Do not use this medication if you are allergic to penicillin V or to any other penicillin antibiotic, such as amoxicillin (Amoxil), ampicillin (Omnipen, Principen), carbenicillin (Geocillin), dicloxacillin (Dycill, Dynapen), or oxacillin (Bactocill).

Before using penicillin V, tell your doctor if you are allergic to cephalosporins such as Ceclor, Ceftin, Duricef, Keflex, and others, or if you have asthma, kidney disease, a bleeding or blood clotting disorder, a history of diarrhea caused by taking antibiotics, or a history of any type of allergy.

Penicillin V can make birth control pills less effective, which may result in pregnancy. Before taking this medicine, tell your doctor if you use birth control pills. Take penicillin V for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated. Penicillin V will not treat a viral infection such as the common cold or flu. Do not give this medication to another person, even if they have the same symptoms you do.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

Before taking this Medicine

Do not use this medication if you are allergic to penicillin V or to any other penicillin antibiotic, such as:

• Amoxicillin (Amoxil, Amoxicot, Biomox, Dispermox, Trimox);

• Ampicillin (Omnipen, Principen);

• Carbenicillin (Geocillin);

• Dicloxacillin (Dycill, Dynapen); or

• Oxacillin (Bactocill).

Before using penicillin V, tell your doctor if you are allergic to any drugs (especially cephalosporins such as Ceclor, Ceftin, Duricef, Keflex, and others), or if you have:

• asthma;
• kidney disease;
• a bleeding or blood clotting disorder;
• a history of diarrhea caused by taking antibiotics; or
• a history of any type of allergy.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take penicillin V.

FDA pregnancy category B. Penicillin V is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Penicillin V can make birth control pills less effective, which may result in pregnancy. Before taking this medicine, tell your doctor if you use birth control pills. Penicillin V can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take Penicillin?

Take penicillin V exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

You may take penicillin V with or without food.

To be sure penicillin V is helping your condition, your blood will need to be tested on a regular basis. Your kidney or liver function may also need to be tested. Do not miss any scheduled visits to your doctor.

Shake the oral suspension (liquid) well just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Take penicillin V for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated. Penicillin V will not treat a viral infection such as the common cold or flu. Do not give this medicine to another person, even if they have the same symptoms you do.

Penicillin V can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are using penicillin V.

Store penicillin V tablets at room temperature away from moisture, heat, and light. Store liquid penicillin V in a refrigerator but do not allow it to freeze. Throw away any liquid that has not been used within 14 days after it was mixed at the pharmacy.

Penicillin side effects

Get emergency medical help if you have any of these signs of an allergic reaction to penicillin V: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

• Diarrhea that is watery or bloody;
• Fever, chills, body aches, flu symptoms;
• Easy bruising or bleeding, unusual weakness;
• Urinating less than usual or not at all;
• Severe skin rash, itching, or peeling;
• Agitation, confusion, unusual thoughts or behavior; or
• Seizure (black-out or convulsions).

Less serious penicillin V side effects are more likely to occur, such as:

• Nausea, vomiting, stomach pain;
• Vaginal itching or discharge;
• Headache;
• Swollen, black, or "hairy" tongue; or
• Thrush (white patches or inside your mouth or throat).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Side Effects

Applies to penicillin v potassium: capsule, powder for solution, powder for suspension, solution, suspension, syrup, tablet, tablet for suspension, tablet chewable, tablet extended release

As well as its needed effects, penicillin v potassium may cause unwanted side effects that require medical attention.

Stop taking penicillin v potassium and get emergency help immediately if any of the following effects occur:

Less common:

• Fast or irregular breathing
• fever
• joint pain
• lightheadedness or fainting (sudden)
• puffiness or swelling around the face
• red, scaly skin
• shortness of breath
• skin rash, hives, itching

Major Side Effects

• Abdominal or stomach cramps and pain (severe)
• abdominal tenderness
• convulsions (seizures)
• decreased amount of urine
• diarrhea (watery and severe), which may also be bloody
• mental depression
• nausea and vomiting
• pain at place of injection
• sore throat and fever
• unusual bleeding or bruising
• yellow eyes or skin

Rare - For penicillin G procaine only

• Agitation or combativeness
• anxiety
• confusion
• fear of impending death
• feeling, hearing, or seeing things that are not real

Minor Side Effects

Some penicillin v potassium side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common:

• Diarrhea (mild)
• headache
• sore mouth or tongue
• vaginal itching and discharge
• white patches in the mouth and/or on the tongue.

For Healthcare Professionals

Applies to penicillin v potassium: oral powder for reconstitution, oral tablet

General

In general, side effects associated with oral penicillin therapy have been reported much less frequently than with parenteral penicillin therapy. However, all degrees of hypersensitivity, including fatal anaphylaxis, have been reported with oral penicillin.

Gastrointestinal

Gastrointestinal side effects have included nausea, vomiting, epigastric distress, diarrhea, and black hairy tongue. Clostridium difficile associated diarrhea has been reported and may occur during or after therapy. Pancreatitis, intestinal necrosis, and blood in the stool have also been reported.

Hypersensitivity

Hypersensitivity reactions with penicillin are more common and more serious with intravenous therapy, but have also been reported with oral therapy. An initial sensitizing exposure is required to stimulate the production of antigen-specific IgE before clinical manifestations of hypersensitivity are seen on the second exposure. There are numerous "hidden" environmental or occupational exposures to penicillin including in utero exposure, breast milk exposure, and occupational exposure.

Hypersensitivity side effects have included skin eruptions (maculopapular to exfoliative dermatitis), pruritus, urticaria, laryngeal edema, fever, eosinophilia, hypersensitivity myocarditis, serum sickness-like reactions (chills, fever, edema, arthralgia, and prostration), severe or fatal anaphylaxis, shock, and death.

Dermatologic

Dermatologic side effects have included rash, peeling, mucosal ulceration, and urticaria.

Hematologic

Hematologic side effects have included hemolytic anemia, anemia, leukopenia, thrombocytopenia, and lymphadenopathy.

Hepatic

Hepatic side effects have included increased SGOT, reversible hepatotoxicity, jaundice, and prolonged cholestasis.

Nervous system

Nervous system side effects have included severe reactions with high dose penicillin therapy or in patients with renal dysfunction. These reactions have included myoclonus, seizures, auditory and visual hallucinations, and decreased mentation. Neurologic reactions occurred frequently in patients with renal dysfunction. Aseptic meningitis has been reported.

Severe neurologic reactions were most often seen with penicillin doses of 18 million to 80 million units daily. These reactions frequently abated after discontinuation of penicillin. In several cases, penicillin was restarted at a lower dose with no further sequelae. In one review, the authors found that cerebral spinal fluid (CSF) penicillin levels were higher in patients with seizures than in those without. CSF penicillin levels ranged from 12 to 61 units/mL in the seizure group with the highest CSF concentrations, compared to 7.8 units/mL in the group without seizures.

Other

Other side effects have included fatigue, asthenia, pain, abnormal taste perception, tinnitus, and aggravation of existing disorders.

Respiratory

Respiratory side effects have included hypoxia, apnea, and dyspnea.