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penicillin V

Pronunciation

Generic Name: penicillin V (pen i SILL in)
Brand Name: PC Pen VK, Pen-V

What is penicillin V?

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.

What is the most important information I should know about penicillin V?

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.

Slideshow: The Shocking Truth About Antibiotic Resistance

Penicillin V can make birth control pills less effective, which may result in pregnancy. Before taking penicillin V, tell your doctor if you use birth control pills.

Take this medication 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.

What should I discuss with my healthcare provider before taking penicillin V?

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. This medication 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 penicillin V, 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 V?

Take this medication 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 this medication 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 this medication 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 penicillin V to another person, even if they have the same symptoms you do.

This medication 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 penicillin that has not been used within 14 days after it was mixed at the pharmacy.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include confusion, behavior changes, a severe skin rash, urinating less than usual, or seizure (black-out or convulsions).

What should I avoid while taking penicillin V?

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.

Penicillin V side effects

Get emergency medical help if you have any of these signs of an allergic reaction: 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 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.

See also: Side effects (in more detail)

Penicillin V dosing information

Usual Adult Dose for Actinomycosis:

Cervicofacial: Aqueous penicillin G 1 to 6 million units IV per day
Thoracic and abdominal: Aqueous penicillin G 10 to 20 million units IV per day

Duration: 4 to 6 weeks, followed by oral therapy for 6 to 12 months depending on the nature and severity of the infection

Usual Adult Dose for Inhalation Bacillus anthracis:

If penicillin-susceptible: Aqueous penicillin G 4 million units IV every 4 hours plus 1 or 2 additional antibiotics with activity against the causative organism

The additional drugs may include ciprofloxacin, doxycycline, rifampin, vancomycin, chloramphenicol, imipenem, clindamycin, and macrolides.

Usual Adult Dose for Cutaneous Bacillus anthracis:

If penicillin-susceptible: Aqueous penicillin G 4 million units IV every 4 to 6 hours

Usual Adult Dose for Aspiration Pneumonia:

Aqueous penicillin G 2 to 3 million units IV every 4 to 6 hours plus metronidazole 500 mg IV every 8 hours for 7 to 14 days, depending on the nature and severity of the infection

Usual Adult Dose for Clostridial Infection:

Wound botulism: Aqueous penicillin G 3 to 4 million units IV every 4 hours for 7 to 14 days, as an adjunct to debridement; once the patient improves, penicillin V potassium 250 to 500 mg orally every 6 hours

Usual Adult Dose for Deep Neck Infection:

Penicillin G 2 to 4 million units IV or IM every 4 to 6 hours for 2 to 3 weeks, depending on the nature and severity of the infection

The addition of metronidazole to high-dose penicillin therapy is recommended by many experts to treat parapharyngeal infections because of the increasing frequency of penicillin-resistant anaerobes. Removal of abscessed material is also necessary for successful treatment.

Usual Adult Dose for Diphtheria:

As an adjunct to antitoxin to prevent carrier state: Aqueous penicillin G 2 to 3 million units IV per day in divided doses every 4 to 6 hours for 10 to 12 days

Usual Adult Dose for Endocarditis:

Patients with normal renal function:
Native valve infections due to highly penicillin-susceptible Streptococcus viridans and S bovis (MIC less than or equal to 0.12 mcg/mL): Aqueous penicillin G 12 to 18 million units/day IV continuously or in 4 or 6 divided doses for 4 weeks; may add gentamicin 3 mg/kg IV every 24 hours for 2 weeks

Native valve infections due to relatively resistant strains of S viridans and S bovis (MIC greater than 0.12 mcg/mL and less than 0.5 mcg/mL): Aqueous penicillin G 24 million units/day IV continuously or in 4 to 6 divided doses for 4 weeks plus gentamicin 3 mg/kg IV every 24 hours for 2 weeks

Prosthetic valve infections due to penicillin-susceptible S viridans and S bovis (less than or equal to 0.12 mcg/mL): Aqueous penicillin G 24 million units/day IV continuously or in 4 to 6 divided doses for 6 weeks with or without gentamicin 3 mg/kg IV every 24 hours for 2 weeks

Prosthetic valve infections due to relatively or fully resistant S viridans and S bovis (MIC greater than 0.12 mcg/mL): Aqueous penicillin G 24 million units/day IV continuously or in 4 to 6 divided doses for 6 weeks plus gentamicin 3 mg/kg IV every 24 hours for 6 weeks

Native valve or prosthetic valve infections due to susceptible enterococci: Aqueous penicillin G sodium 18 to 30 million units/day IV continuously or in 6 divided doses, plus gentamicin 3 mg/kg IM or IV every 24 hours or streptomycin 7.5 mg/kg IV or IM (if gentamicin resistant) every 12 hours for 4 to 6 weeks

Erysipelothrix rhusiopathiae: Aqueous penicillin G 12 to 20 million units/day IV continuously or in divided doses every 4 to 6 hours for 4 to 6 weeks

Listeria monocytogenes: Aqueous penicillin G 15 to 20 million units/day IV in divided doses every 4 to 6 hours for 4 weeks

Refer to current published guidelines for detailed recommendations.

Usual Adult Dose for Fusospirochetosis:

Aqueous penicillin G 5 to 10 million units IV per day in 4 to 6 divided doses

Usual Adult Dose for Joint Infection:

Aqueous penicillin G 2 to 3 million units IV every 4 hours for 2 weeks, depending on the nature and severity of the infection

Usual Adult Dose for Leptospirosis:

Aqueous penicillin G 1.5 million units IV every 6 hours for 7 days

Usual Adult Dose for Lyme Disease -- Arthritis:

Recurrent arthritis after oral treatment: Aqueous penicillin G 3 to 4 million units IV every 4 hours (18 to 24 million units/day)
Duration: 14 to 28 days

Ceftriaxone is considered the parenteral drug of choice.

Usual Adult Dose for Lyme Disease -- Carditis:

Third-degree heart block: Aqueous penicillin G 3 to 4 million units IV every 4 hours (18 to 24 million units/day), with cardiac monitoring and a temporary pacemaker for complete heart block
Duration: 14 to 21 days

Ceftriaxone is considered the parenteral drug of choice.

Usual Adult Dose for Lyme Disease -- Erythema Chronicum Migrans:

250 to 500 mg orally every 6 hours for 14 to 21 days

Amoxicillin and doxycycline are considered the oral drugs of choice.

Usual Adult Dose for Lyme Disease -- Neurologic:

Meningitis, radiculopathy, or late-Lyme CNS or peripheral nerve disease: Aqueous penicillin G 3 to 4 million units IV every 4 hours (18 to 24 million units/day)
Duration: 14 to 28 days

Ceftriaxone is considered the parenteral drug of choice.

Usual Adult Dose for Meningitis:

Listerial meningitis: Aqueous penicillin G 15 to 20 million units/day IV administered in equally divided doses every 4 to 6 hours for 2 weeks
Pasteurella meningitis: Aqueous penicillin G 1 million units IV every 4 to 6 hours for 2 weeks

Usual Adult Dose for Meningitis -- Meningococcal:

Aqueous penicillin G 6 million units IV every 4 hours or 24 million units/day continuous IV infusion for 14 days or until afebrile for 7 days

If meningococcal meningitis is suspected, immediate treatment with penicillin is required, and should be started before lumbar puncture confirmation of the diagnosis. The mortality of this disease is 50% within the first 24 hours.

Usual Adult Dose for Meningitis -- Pneumococcal:

Penicillin-sensitive (MIC less than 0.1 mcg/mL): Aqueous penicillin G 4 million units IV every 4 hours for 14 days

Usual Adult Dose for Otitis Media:

Streptococcal: Penicillin V potassium 250 to 500 mg orally every 6 hours for 2 weeks

Usual Adult Dose for Pneumonia:

Penicillin-susceptible pneumococci: Aqueous penicillin G 1 to 2 million units IV every 4 hours for 7 to 14 days, depending on the nature and severity of the infection

Mild to moderate infection: Penicillin V potassium 250 to 500 mg orally every 6 hours

Usual Adult Dose for Prevention of Perinatal Group B Streptococcal Disease:

Aqueous penicillin G 5 million units IV as a loading dose, followed by 2.5 million units every 4 hours until delivery

Usual Adult Dose for Rat-bite Fever:

Mild infection: Penicillin V potassium 500 mg orally every 6 hours
Moderate to severe infection: Aqueous penicillin G 3 to 5 million units IV every 6 hours (12 to 20 million units/day)

Duration: 10 to 14 days

Usual Adult Dose for Rheumatic Fever Prophylaxis:

Penicillin G benzathine: 1.2 million units IM every 3 to 4 weeks
Penicillin V potassium: 250 mg orally twice daily

For high-risk patients, penicillin G benzathine given every 3 weeks may be more effective and is recommended. Oral penicillin can be used for prevention in lower risk patients whose compliance can be ensured.

Usual Adult Dose for Skin or Soft Tissue Infection:

Streptococcal cellulitis: Aqueous penicillin G 1 to 2 million units IV every 6 hours for 7 to 10 days
Prevention of recurrent erysipelas (Milroy disease): Penicillin G benzathine 1.2 million units IM every 4 weeks

Usual Adult Dose for Syphilis -- Early:

Primary, secondary: Penicillin G benzathine 2.4 million units IM once

All patients should undergo clinical and serological testing every 6 months for 2 to 3 years.

Usual Adult Dose for Syphilis -- Latent:

Early latent: Penicillin G benzathine 2.4 million units IM once
Late latent or unknown duration: Penicillin G benzathine 2.4 million units IM once a week for 3 weeks (total dose 7.2 million units)

All patients should undergo clinical and serological testing every 6 months for 2 to 3 years.

Usual Adult Dose for Neurosyphilis:

Aqueous penicillin G 3 to 4 million units IV every 4 hours or 18 to 24 million units per day as a continuous infusion for 10 to 14 days; may follow with penicillin G benzathine 2.4 million units IM once a week for up to 3 weeks

All patients should undergo clinical and serological testing every 6 months for 2 to 3 years.

Usual Adult Dose for Tertiary Syphilis:

Penicillin G benzathine 2.4 million units IM once a week for 3 weeks

All patients should undergo clinical and serological testing every 6 months for 2 to 3 years.

Usual Adult Dose for Tonsillitis/Pharyngitis:

Streptococcal pharyngitis: Penicillin V potassium 500 mg orally every 6 hours for 10 days

Usual Adult Dose for Upper Respiratory Tract Infection:

Mild streptococcal infection: Penicillin V potassium 250 to 500 mg orally every 6 to 8 hours for 10 days
Pneumococcal empyema: Penicillin G 5 to 24 million units/day IV in divided doses every 4 to 6 hours

Usual Pediatric Dose for Bacterial Infection:

Aqueous penicillin G:
Neonates:
0 to 4 weeks, birthweight less than 1200 g: 25,000 to 50,000 units/kg IV or IM every 12 hours
Less than 1 week, birthweight 1200 to 2000 g: 25,000 to 50,000 units/kg IV or IM every 12 hours
Less than 1 week, birthweight greater than 2000 g: 25,000 to 50,000 units/kg IV or IM every 8 hours
1 to 4 weeks, birthweight 1200 to 2000 g: 25,000 to 50,000 units/kg IV or IM every 8 hours
1 to 4 weeks, birthweight greater than 2000 g: 25,000 to 50,000 units/kg IV or IM every 6 hours

Greater than 1 month:
Mild to moderate infections: 6250 to 12,500 units/kg IV or IM every 6 hours
Severe infections: 250,000 to 400,000 units/kg per day IV or IM in 4 to 6 divided doses

Maximum dose: 24 million units

Penicillin G benzathine:
Mild to moderate infections:
1 month or older, less than 27 kg: 300,000 to 600,000 units IM once
1 month or older, 27 kg or more: 900,000 to 1,200,000 units IM once

Penicillin V potassium:
Mild to moderate infections:
Greater than 1 month to less than 12 years: 25 to 50 mg/kg per day orally in divided doses every 6 to 8 hours
Maximum dose: 3 g/day

12 years or older: 125 to 500 mg orally every 6 to 8 hours

Usual Pediatric Dose for Endocarditis:

Patients with normal renal function (dosage should not exceed adult dose):
Native valve infections due to highly penicillin-susceptible Streptococcus viridans and S bovis (MIC less than or equal to 0.12 mcg/mL): Aqueous penicillin G 200,000 units/kg/day IV in 4 or 6 divided doses for 4 weeks; may add gentamicin 1 mg/kg IM or IV every 8 hours or 3 mg/kg IV every 24 hours for 2 weeks

Native valve infections due to relatively resistant strains of S viridans and S bovis (MIC greater than 0.12 mcg/mL and less than 0.5 mcg/mL): Aqueous penicillin G 300,000 units/day IV in 4 to 6 divided doses for 4 weeks plus gentamicin 1 mg/kg IM or IV every 8 hours or 3 mg/kg IV every 24 hours for 2 weeks

Prosthetic valve infections due to penicillin-susceptible S viridans and S bovis (less than or equal to 0.12 mcg/mL): Aqueous penicillin G 300,000 units/day IV in 4 to 6 divided doses for 6 weeks with or without gentamicin 1 mg/kg IM or IV every 8 hours or 3 mg/kg IV every 24 hours for 2 weeks

Prosthetic valve infections due to relatively or fully resistant S viridans and S bovis (MIC greater than 0.12 mcg/mL): Aqueous penicillin G 300,000 units/day IV in 4 to 6 divided doses for 6 weeks plus gentamicin 1 mg/kg IM or IV every 8 hours for 6 weeks

Native valve or prosthetic valve infections due to susceptible enterococci: Aqueous penicillin G 300,000 units/day IV in 4 to 6 divided doses, plus gentamicin 1 mg/kg IM or IV every 8 hours or streptomycin 10 to 15 mg/kg IV or IM (if gentamicin resistant) every 12 hours for 4 to 6 weeks

Erysipelothrix rhusiopathiae: Aqueous penicillin G 12 to 20 million units/day IV continuously or in divided doses every 4 to 6 hours for 4 to 6 weeks

Listeria monocytogenes: Aqueous penicillin G 15 to 20 million units/day IV in divided doses every 4 to 6 hours for 4 weeks

Refer to current published guidelines for detailed recommendations.

Usual Pediatric Dose for Lyme Disease -- Arthritis:

Recurrent arthritis after oral treatment: Aqueous penicillin G 50,000 to 100,000 units/kg IV every 4 hours
Maximum dose: 24 million units/day

Duration: 14 to 28 days

Usual Pediatric Dose for Lyme Disease -- Carditis:

Third-degree heart block: Aqueous penicillin G 50,000 to 100,000 units/kg IV every 4 hours, with cardiac monitoring and a temporary pacemaker for complete heart block
Maximum dose: 24 million units/day

Duration: 14 to 21 days

Usual Pediatric Dose for Lyme Disease -- Neurologic:

Meningitis, radiculopathy, or late-Lyme CNS or peripheral nerve disease: Aqueous penicillin G 50,000 to 100,000 units/kg IV every 4 hours
Maximum dose: 24 million units/day

Duration: 14 to 28 days

Usual Pediatric Dose for Rheumatic Fever Prophylaxis:

Penicillin G benzathine 25,000 to 50,000 units/kg IM once every 3 to 4 weeks
Maximum dose: 1.2 million units/dose

Usual Pediatric Dose for Congenital Syphilis:

Aqueous penicillin G:
Less than 1 month (symptomatic infants and asymptomatic infants with abnormal CSF): 50,000 units/kg IV every 12 hours during the first 7 days of life and every 8 hours thereafter for 10 days

Greater than 1 month: 50,000 units/kg IV every 4 to 6 hours for 10 days

Penicillin G benzathine:
Asymptomatic neonates weighing greater than 1200 g: 50,000 units/kg IM one time

Infants and children: 50,000 units/kg IM once a week for 3 weeks
Maximum dose: 2.4 million units/dose

Usual Pediatric Dose for Syphilis -- Early:

Greater than 1 month: Penicillin G benzathine 50,000 units/kg IM once
Maximum dose: 2.4 million units/dose

Usual Pediatric Dose for Syphilis -- Latent:

Penicillin G benzathine:
Early latent: 50,000 units/kg IM once
Late latent or unknown duration: 50,000 units/kg IM once a week for 3 weeks

Maximum dose: 2.4 million units/dose

What other drugs will affect penicillin V?

Before taking penicillin V, tell your doctor if you are using any of the following drugs:

  • methotrexate (Rheumatrex, Trexall); or

  • probenecid (Benemid).

This list is not complete and there may be other drugs that can interact with penicillin V. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about penicillin V.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 6.02. Revision Date: 2010-12-15, 5:01:39 PM.

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