Oxacillin Side Effects

Please note - some side effects for Oxacillin may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA at http://www.fda.gov/medwatch/ or 1-800-FDA-1088 (1-800-332-1088).

Side Effects of Oxacillin - for the Consumer

Oxacillin

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Oxacillin:

Mild diarrhea, nausea, or vomiting; swelling or redness at the injection site.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black tongue; blood in the urine; bloody stools; chest pain; dark urine; fever, chills, or sore throat; joint or muscle pain; mouth irritation; red, swollen, or blistered skin; seizures; severe diarrhea; severe or persistent nausea or vomiting; severe stomach pain/cramps; swelling in the mouth; swollen joints; unusual bruising or bleeding; vaginal irritation or discharge; vein swelling or tenderness; yellowing of the eyes or skin.

Oxacillin Solution

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Oxacillin Solution:

Mild diarrhea, nausea, or vomiting.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black tongue; blood in the urine; bloody stools; chest pain; dark urine; fever, chills, or sore throat; joint or muscle pain; mouth irritation; red, swollen, or blistered skin; seizures; severe diarrhea; severe or persistent nausea or vomiting; severe stomach pain/cramps; swelling in the mouth; swollen joints; unusual bruising or bleeding; vaginal irritation or discharge; vein swelling or tenderness; yellowing of the eyes or skin.

Oxacillin Side Effects - for the Professional

Oxacillin

Body as a Whole

The reported incidence of allergic reactions to penicillin ranges from 0.7 to 10 percent. Sensitization is usually the result of treatment but some individuals have had immediate reactions when first treated. In such cases, it is thought that the patients may have had prior exposure to the drug via trace amounts present in milk and vaccines.

Two types of allergic reactions to penicillins are noted clinically, immediate and delayed.

Immediate reactions usually occur within 20 minutes of administration and range in severity from urticaria and pruritus to angioneurotic edema, laryngospasm, bronchospasm, hypotension, vascular collapse and death. Such immediate anaphylactic reactions are very rare and usually occur after parenteral therapy but have occurred in patients receiving oral therapy. Another type of immediate reaction, an accelerated reaction, may occur between 20 minutes and 48 hours after administration and may include urticaria, pruritus, and fever. Although laryngeal edema, laryngospasm, and hypotension occasionally occur, fatality is uncommon. Delayed allergic reactions to penicillin therapy usually occur after 48 hours and sometimes as late as 2 to 4 weeks after initiation of therapy. Manifestations of this type of reaction include serum sickness-like symptoms (i.e., fever, malaise, urticaria, myalgia, arthralgia, abdominal pain) and various skin rashes. Nausea, vomiting, diarrhea, stomatitis, black or hairy tongue, and other symptoms of gastrointestinal irritation may occur, especially during oral penicillin therapy.

Nervous System Reactions

Neurotoxic reactions similar to those observed with penicillin G may occur with large intravenous doses of Oxacillin, especially with patients with renal insufficiency.

Urogenital Reactions

Renal tubular damage and interstitial nephritis have been associated infrequently with the administration of Oxacillin. Manifestations of this reaction may include rash, fever, eosinophilia, hematuria, proteinuria, and renal insufficiency.

Gastrointestinal Reactions

Pseudomembranous colitis has been reported with the use of Oxacillin. The onset of pseudomembranous colitis symptoms may occur during or after antibiotic treatment.

Metabolic Reactions

Hepatotoxicity, characterized by fever, nausea, and vomiting associated with abnormal liver function tests, mainly elevated SGOT levels, has been associated with the use of Oxacillin.

Oxacillin Injection

Body as a Whole

The reported incidence of allergic reactions to penicillin ranges from 0.7 to 10 percent. Sensitization is usually the result of treatment but some individuals have had immediate reactions to penicillin when first treated. In such cases, it is thought that the patients may have had prior exposure to the drug via trace amounts present in milk and vaccines.

Two types of allergic reactions to penicillin are noted clinically, immediate and delayed.

Immediate reactions usually occur within 20 minutes of administration and range in severity from urticaria and pruritus to angioneurotic edema, laryngospasm, bronchospasm, hypotension, vascular collapse, and death. Such immediate anaphylactic reactions are very rare and usually occur after parenteral therapy but have occurred in patients receiving oral therapy. Another type of immediate reaction, an accelerated reaction, may occur between 20 minutes and 48 hours after administration and may include urticaria, pruritus, and fever. Although laryngeal edema, laryngospasm, and hypotension occasionally occur, fatality is uncommon.

Delayed allergic reactions to penicillin therapy usually occur after 48 hours and sometimes as late as 2 to 4 weeks after initiation of therapy. Manifestations of this type of reaction include serum sickness-like symptoms (ie, fever, malaise, urticaria, myalgia, arthralgia, abdominal pain) and various skin rashes. Nausea, vomiting, diarrhea, stomatitis, black or hairy tongue, and other symptoms of gastrointestinal irritation may occur, especially during oral penicillin therapy.

Nervous System Reactions

Neurotoxic reactions similar to those observed with penicillin G may occur with large intravenous doses of the penicillinase-resistant penicillins especially in patients with renal insufficiency.

Urogenital Reactions

Renal tubular damage and interstitial nephritis have been associated with the administration of methicillin sodium and infrequently with the administration of nafcillin and Oxacillin. Manifestations of this reaction may include rash, fever, eosinophilia, hematuria, proteinuria, and renal insufficiency. Methicillin-induced nephropathy does not appear to be dose-related and is generally reversible upon prompt discontinuation of therapy.

Gastrointestinal Reactions

Pseudomembranous colitis has been reported with the use of Oxacillin Sodium (and other broad spectrum antibiotics); therefore, it is important to consider its diagnosis in patients who develop diarrhea in association with antibiotic use.

Treatment with broad spectrum antibiotics alters normal flora of the colon and may permit overgrowth of clostridia. Studies indicate a toxin produced by Clostridium difficile is one primary cause of antibiotic-associated colitis. Cholestyramine and colestipol resins have been shown to bind the toxin in vitro.

Mild cases of colitis may respond to drug discontinuance alone.

Moderate to severe cases should be managed with fluid, electrolyte and protein supplementation as indicated.

When the colitis is not relieved by drug discontinuance or when it is severe, oral vancomycin is the treatment of choice for antibiotic-associated pseudomembranous colitis produced by C. difficile. Other causes of colitis should also be considered.

Metabolic Reactions

Agranulocytosis, neutropenia, and bone marrow depression have been associated with the use of methicillin sodium, nafcillin, Oxacillin, and clOxacillin. Hepatotoxicity, characterized by fever, nausea, and vomiting associated with abnormal liver function tests, mainly elevated SGOT levels, has been associated with the use of Oxacillin and clOxacillin.

Side Effects by Body System

Gastrointestinal

Gastrointestinal side effects have included nausea, vomiting, diarrhea, stomatitis, black or hairy tongue, gastrointestinal irritation, and pseudomembranous colitis.

Hematologic

Hematologic adverse effects have included neutropenia, leukopenia, thrombocytopenia, bone marrow depression, and agranulocytosis.

Hematologic effects of oxacillin are uncommon and appear to be associated with higher doses given for prolonged periods. Oxacillin may exert a reversible toxic effect on the maturation of granulocytes. Some investigators have also suggested a possible hypersensitivity or immunologic component. Recovery generally occurs within several days to 2 weeks following discontinuation of therapy. Penicillin and some of its other semisynthetic derivatives are also associated with hematologic toxicities.

Hepatic

Hepatic side effects have included cholestatic jaundice associated with the use of high parenteral doses. A case of severe hepatitis has also been reported. Alkaline phosphatase and GGT serum levels may take several weeks to return to normal following discontinuation of therapy.

Serum liver enzyme levels have typically returned to normal soon after stopping therapy or changing to another antibiotic such as nafcillin, which is chemically related to oxacillin. Patients may be asymptomatic or have hepatic tenderness or enlargement and/or pronounced fever, nausea, and vomiting. Hepatotoxicity may also occur on a hypersensitivity basis and accompany some allergic manifestations such as pruritus, eosinophilia, and serum sickness.

Intravenous oxacillin has been associated with a higher incidence of hepatotoxicity than nafcillin, clindamycin, or other intravenous antimicrobials in children. The onset of hepatitis occurred after 6 to 43 days of oxacillin treatment (n=9).

Hypersensitivity

Hypersensitivity reactions have included urticaria, pruritus, angioneurotic edema, laryngospasm, bronchospasm, hypotension, vascular collapse, anaphylaxis, death, serum sickness-like reactions, fever, and rash.

Local

Local side effects of parenteral administration have included thrombophlebitis and tissue necrosis following extravasation.

Renal

Renal side effects have included acute renal failure and interstitial nephritis.

Nervous system

Nervous system side effects including seizures have occurred when large parenteral doses of oxacillin were administered to patients with renal failure.

Metabolic

Metabolic side effects including severe hypokalemia, have been rarely associated with the use of high dose oxacillin (12 grams per day for 10 days).

Dermatologic

Intravenous oxacillin has been associated with a higher incidence of rash than nafcillin or other intravenous antimicrobials in children. The onset of rash occurred after a mean of 19.5 days of oxacillin treatment.

Dermatologic side effects included hypersensitivity-related urticaria, pruritus, and rash.

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