Penicillin Disease Interactions
There are 4 disease interactions with penicillin:
Antibiotics (Includes Penicillin) ↔ Colitis
Severe Potential Hazard, Moderate plausibility
Applies to: Colitis/Enteritis (Noninfectious)
Pseudomembranous colitis has been reported with most antibacterial agents and may range in severity from mild to life-threatening, with an onset of up to several weeks following cessation of therapy. Antibiotic therapy can alter the normal flora of the colon and permit overgrowth of Clostridium difficile, whose toxin is believed to be a primary cause of antibiotic-associated colitis. The colitis is usually characterized by severe, persistent diarrhea and severe abdominal cramps, and may be associated with the passage of blood and mucus. The most common culprits are clindamycin, lincomycin, the aminopenicillins (amoxicillin, ampicillin), and the cephalosporins. Therapy with broad-spectrum antibiotics and other agents with significant antibacterial activity should be administered cautiously in patients with a history of gastrointestinal diseases, particularly colitis. There is some evidence that pseudomembranous colitis, if it occurs, may run a more severe course in these patients and that it may be associated with flares in their underlying disease activity. The offending antibiotic(s) should be discontinued if significant diarrhea occurs during therapy. Stool cultures for Clostridium difficile and stool assay for C. difficile toxin may be helpful diagnostically. A large bowel endoscopy may be considered to establish a definitive diagnosis in cases of severe diarrhea.
Beta-Lactams (Parenteral) (Includes Penicillin) ↔ Renal Dysfunction
Severe Potential Hazard, High plausibility
Applies to: Renal Dysfunction
Most beta-lactam antibiotics are eliminated by the kidney as unchanged drug and, in some cases, also as metabolites. The serum concentrations of beta-lactam antibiotics and their metabolites may be increased and the half-lives prolonged in patients with impaired renal function. Neurotoxic reactions, including encephalopathy, asterixis, myoclonus, seizures and coma, have been reported in such patients treated parenterally with these agents. Dosage adjustments may be necessary and modifications should be based on the degree of renal impairment as well as severity of infection in accordance with the individual product package labeling. Renal function tests should be performed periodically during prolonged and/or high-dose therapy, since nephrotoxicity and alterations in renal function have occasionally been associated with the use of these drugs.
Penicillin G (Includes Penicillin) ↔ Sodium/Potassium
Moderate Potential Hazard, High plausibility
Applies to: Hyperkalemia, Hypernatremia, Congestive Heart Failure, Fluid Retention, Hypertension, Renal Dysfunction
Penicillin G sodium contains approximately 46 mg (2 mEq) of sodium per each million units of penicillin. Aqueous penicillin G potassium contains approximately 7 mg (0.3 mEq) of sodium per each million units of penicillin. The sodium content should be considered when these products are used in patients with conditions that may require sodium restriction, such as congestive heart failure, hypertension, and fluid retention. Each million units of aqueous penicillin G potassium also contain 65.6 mg (1.68 mEq) of potassium and should be considered in patients who may require potassium restriction, such as those with hyperkalemia and/or impaired renal function. Clinical monitoring of electrolytes is recommended if these agents are used.
Penicillins (Includes Penicillin) ↔ Hemodialysis
Moderate Potential Hazard, High plausibility
Applies to: hemodialysis
Penicillin antibiotics (except for agents in the penicillinase-resistant class) are removed by hemodialysis. Doses should either be scheduled for administration after dialysis or supplemental doses be given after dialysis.
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penicillin drug Interactions
There are 54 drug interactions with penicillin
penicillin alcohol/food Interactions
There are 2 alcohol/food interactions with penicillin
See also...
Drug Interaction Classification
The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
Do not stop taking any medications without consulting your healthcare provider.
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