Dicloxacillin is a penicillin antibiotic that fights bacteria in your body.
Dicloxacillin (Betaclox) is a penicillin antibiotic of the beta-lactam group. It has a narrow spectrum of activity and is used in the treatment of patients with infections caused by staphylococcus aureus.
Dicloxacillin is used to treat many different types of infections caused by bacteria such as bronchitis, pneumonia, or staphylococcal (also called "staph") infections.
Dicloxacillin may also be used for purposes not listed in this medication guide.
Warnings
Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.
Before taking this medicine
You should not use dicloxacillin if you are allergic to dicloxacillin or to any other penicillin antibiotic, such as:
amoxicillin;
ampicillin;
carbenicillin;
oxacillin; or
penicillin.
To make sure dicloxacillin is safe for you, tell your doctor if you have:
asthma;
a stomach illness (nausea, vomiting, digestive problems);
liver disease;
kidney disease;
a bleeding or blood clotting disorder;
a history of diarrhea caused by taking antibiotics; or
a history of any type of allergy (especially cephalosporins such as Ceclor, Ceftin, Duricef, Keflex, and others).
Dicloxacillin Uses:
Staphylococcal infections:
Treatment of infections caused by penicillinase-producing staphylococci.
Off Label Use of Dicloxacillin in Adults:
Bite wounds caused by animal bites.
Impetigo
Dicloxacillin (Betaclox) Dose in the treatment of Staphylococcal infections:
Oral: 125 to 250 mg every 6 hours
Dicloxacillin (Betaclox) Dose in the treatment of Bite wounds (animal) (off-label):
Oral: 500 mg 4 times a day; with penicillin.
Dicloxacillin (Betaclox) Dose in the treatment of Impetigo (off-label):
Oral: 250 mg 4 times a day for 7 days, reliant on the response of the treatment.
Dicloxacillin (Betaclox) Dose in the treatment of prosthetic joint infection:
Dicloxacillin (Betaclox) Dose in the treatment of Skin and soft tissue infection due to MSSA (off-label dose):
Oral: 500 mg every 6 hours for 1 to 2 weeks.
General dosing in susceptible infection:
Infants, Children, and Adolescents:
Mild to moderate infection:
Oral: 12 to 25 mg/kg/day split every 6 hours;
maximum dose: 250 mg/dose
Severe infection (step-down therapy of bone and joint infection):
Oral: 100 mg/kg/day split every 6 hours;
The maximum dose: 500 mg/dose
Dicloxacillin (Betaclox) Dose in the treatment of Skin and soft tissue infection caused by methicillin-susceptible Staphylococcus aureus (MSSA):
Infants, Children, and Adolescents:
Oral: 25 to 50 mg/kg/day divided every 6 hours;
The maximum dose: 500 mg/dose.
Pregnancy Risk Factor B
Animal reproductive studies have shown unpleasing effects.
Dicloxacillin is introduced to the placenta.
Penicillins given to mothers have not been shown to increase the risk of birth abnormalities.
Use during breastfeeding:
Breast milk contains dicloxacillin.
Breast milk antibiotics can cause non-dose-related changes in the bowel flora.Check for GI disturbances in infants.
The manufacturer warns against giving dicloxacillin breastfeeding women. However, penicillins can be used in the recommended doses and are compatible with breastfeeding.
Dicloxacillin is a treatment for mastitis in lactating mothers.
Dose in Kidney Disease:
There are no defined dosage modifications given in the manufacturer’s labeling; total dosage reduction should be considered in kidney damage.
Hemodialysis:
Not dialyzable;
An additional dose is not needed.
Peritoneal dialysis effects:
An additional dose is not needed.
Dose in Liver disease:
Manufacturer’s labeling provides no dosage modifications.
Side Effects of Dicloxacillin (Betaclox):
Gastrointestinal:
Abdominal pain diarrhea
Nausea
Contraindications to Dicloxacillin (Betaclox):
Hypersensitivity to penicillins and dicloxacillin or any other penicillins or any component of this formulation
Warnings and precautions
Hypersensitivity reactions
Patients receiving penicillin therapy have experienced severe and sometimes fatal allergic reactions (anaphylactic stress with collapse).
Only start treatment after you have done a thorough background check on the drug and allergy.
Patients with severe allergies or asthma should be cautious.
If you experience an allergic reaction, stop using the medication and seek appropriate treatment.
Superinfection
Extended use of antibiotics, including C. difficile-associated diarrhea(CDAD) or pseudomembranous collitis (Pseudomembranous Colitis), has been linked to serious bacterial and fungal infections.
Even after antibiotic treatment, CDAD was still present.
Dicloxacillin: Drug Interaction
Note: Drug Interaction Categories:
Risk Factor C: Monitor When Using Combination
Risk Factor D: Consider Treatment Modification
Risk Factor X: Avoid Concomitant Use
Risk Factor C (Monitor therapy).
Acemetacin
Penicillins may increase serum levels
BCG Vaccine (Immunization)
Antibiotics can decrease the therapeutic effects of BCG Vaccine (Immunization).
CloZAPine
CloZAPine serum concentrations may be decreased by CYP3A4 Inducers (Weak).
CYP2C19 Substrates. High risk with Inducers
Moderate CYP2C19 Inducers may reduce serum concentrations of CYP2C19 Substrates (High Risk with Inducers).
Lactobacillus & Estriol
Antibiotics can reduce the therapeutic effects of Lactobacillus or Estriol.
Methotrexate
Methotrexate serum concentrations could be increased by penicillins
Mycophenolate
Penicillins can decrease serum levels of active metabolites of Mycophenolate.This may be due to impaired enterohepatic circulation.
NiMODipine
CYP3A4 Inducers, (Weak), may reduce the serum NiMODipine concentration.
Vitamin K antagonists (eg warfarin)
Vitamin K Antagonists may have a lower anticoagulant effect due to dicloxacillin.
Risk Factor D (Consider therapy modifications)
Probenecid
Increases the serum level of Penicillins.Management: Penicillins should not be combined with probenecid. However, this combination can be beneficial in certain cases and under careful supervision.If probenecid is given or if the dose is increased, monitor for potential toxic effects.
Sodium Picosulfate
Antibiotics can reduce the therapeutic effects of Sodium Picosulfate.Patients who are currently using or have just finished using antibiotics should consider using an alternative product to cleanse the bowel before undergoing a colonoscopy.
Tetracyclines
Penicillins may have a lower therapeutic efficacy.
Typhoid Vaccine
The therapeutic effects of Typhoid vaccine may be diminished by antibiotics.The only affected strain is the live attenuated Ty21a.Patients being treated with systemic antibiotics should avoid vaccination with live attenuated Typhoid vaccine (Ty21a).This vaccine should not be used until at least three days after the cessation or discontinuation of antibacterial agent treatment.
Risk Factor X (Avoid Combination)
BCG (Intravesical).
The therapeutic effects of BCG (Intravesical) may be diminished by antibiotics
Cholera Vaccine
Cholera Vaccine may be less effective if taken with antibiotics.Treatment: Cholera vaccine should be avoided in patients who have received systemic antibiotics.
Monitoring parameters:
Baseline and periodic CBC with differential;
periodic BUN, serum creatinine,
AST and ALT (especially with prolonged therapy);
Prothrombin time if patient concurrently on warfarin;
Signs of anaphylaxis during the first dose
How to administer Dicloxacillin (Betaclox)?
Oral: Give 1 hour before or 2 hours after meals with at least 120 mL of water. Give full time to promote less variation in peak and trough serum levels. Should not be administered in the supine position or immediately before going to bed.
Mechanism of action of Dicloxacillin (Betaclox):
By binding to one or several penicillin-binding proteins, inhibits bacterial cell wall formation. This in turn inhibes the final step of peptidoglycan synthesis in bacterial cells walls.
Bacteria eventually lyse because of the continuing activity of cell wall hydrolases (autolysins, murein hydrolases), while cell wall assembly becomes stopped.
Absorption:
Rapid and incomplete;
Reduced by food
Distribution:
Increased in patients with ESRD on IHD;
CSF penetration is low
Protein binding:
95% to 99% (primarily albumin)
Bioavailability:
49% to 76%.
Half-life elimination:
~0.7 hours;
prolonged with renal impairment.
Time to peak, serum:
1 to 1.5 hours
Excretion:
Feces;
urine (as unchanged drug);
CF patients: More rapid excretion than healthy patients.
International Brand Names of Dicloxacillin:
Betaclox
Brispen
Butimaxil
Damacir
Diamsalina
Diclex
Diclo
Diclocil
Diclonox
Diclox
Dicloxane
Dicloxane-F
Dicloxin
Dicloxno
Dicloxsig
Diloxin
Distaph
Ditterolina
Dyclobiot
Hilox
Penclox
Posipen
Uniclox
Ziefmycin
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