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Dicloxacillin Disease Interactions

There are 4 disease interactions with dicloxacillin.


Antibiotics (applies to dicloxacillin) colitis

Major Potential Hazard, Moderate plausibility. Applicable conditions: Colitis/Enteritis (Noninfectious)

Clostridioides difficile-associated diarrhea (CDAD), formerly pseudomembranous colitis, has been reported with almost all antibacterial drugs and may range from mild diarrhea to fatal colitis. The most common culprits include clindamycin and lincomycin. Antibacterial therapy alters the normal flora of the colon, leading to overgrowth of C difficile, whose toxins A and B contribute to CDAD development. Morbidity and mortality are increased with hypertoxin-producing strains of C difficile; these infections can be resistant to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea after antibacterial use. Since CDAD has been reported to occur more than 2 months after antibacterial use, careful medical history is necessary. Therapy with broad-spectrum antibacterials and other agents with significant antibacterial activity should be administered cautiously in patients with history of gastrointestinal disease, particularly colitis; pseudomembranous colitis (generally characterized by severe, persistent diarrhea and severe abdominal cramps, and sometimes associated with the passage of blood and mucus), if it occurs, may be more severe in these patients and may be associated with flares in underlying disease activity. Antibacterial drugs not directed against C difficile may need to be stopped if CDAD is suspected or confirmed. Appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C difficile, and surgical evaluation should be started as clinically indicated.


  1. (2002) "Product Information. Omnipen (ampicillin)." Wyeth-Ayerst Laboratories
  2. (2002) "Product Information. Ceftin (cefuroxime)." Glaxo Wellcome
  3. (2002) "Product Information. Zinacef (cefuroxime)." Glaxo Wellcome
  4. (2002) "Product Information. Cleocin (clindamycin)." Pharmacia and Upjohn
  5. (2002) "Product Information. Macrobid (nitrofurantoin)." Procter and Gamble Pharmaceuticals
  6. (2002) "Product Information. Macrodantin (nitrofurantoin)." Procter and Gamble Pharmaceuticals
  7. (2001) "Product Information. Amoxil (amoxicillin)." SmithKline Beecham
  8. (2001) "Product Information. Merrem (meropenem)." Astra-Zeneca Pharmaceuticals
  9. (2001) "Product Information. Coly-Mycin M Parenteral (colistimethate)." Parke-Davis
  10. (2001) "Product Information. Lincocin (lincomycin)." Pharmacia and Upjohn
  11. (2003) "Product Information. Cubicin (daptomycin)." Cubist Pharmaceuticals Inc
  12. (2004) "Product Information. Xifaxan (rifaximin)." Salix Pharmaceuticals
  13. (2007) "Product Information. Doribax (doripenem)." Ortho McNeil Pharmaceutical
  14. (2009) "Product Information. Penicillin G Procaine (procaine penicillin)." Monarch Pharmaceuticals Inc
  15. (2009) "Product Information. Vibativ (telavancin)." Theravance Inc
  16. (2010) "Product Information. Teflaro (ceftaroline)." Forest Pharmaceuticals
  17. (2022) "Product Information. Penicillin G Sodium (penicillin G sodium)." Sandoz Inc
  18. (2014) "Product Information. Dalvance (dalbavancin)." Durata Therapeutics, Inc.
  19. (2014) "Product Information. Orbactiv (oritavancin)." The Medicines Company
  20. (2017) "Product Information. Bicillin C-R (benzathine penicillin-procaine penicillin)." A-S Medication Solutions
  21. (2017) "Product Information. Baxdela (delafloxacin)." Melinta Therapeutics, Inc.
  22. (2022) "Product Information. Polymyxin B Sulfate (polymyxin B sulfate)." AuroMedics Pharma LLC
  23. (2018) "Product Information. Zemdri (plazomicin)." Achaogen
  24. (2018) "Product Information. Seysara (sarecycline)." Allergan Inc
  25. (2018) "Product Information. Nuzyra (omadacycline)." Paratek Pharmaceuticals, Inc.
  26. (2018) "Product Information. Aemcolo (rifamycin)." Aries Pharmaceuticals, Inc.
  27. (2019) "Product Information. Fetroja (cefiderocol)." Shionogi USA Inc
  28. (2019) "Product Information. Biaxin (clarithromycin)." AbbVie US LLC, SUPPL-61
  29. (2021) "Product Information. Zithromax (azithromycin)." Pfizer U.S. Pharmaceuticals Group, LAB-0372-7.0
  30. (2018) "Product Information. E.E.S.-400 Filmtab (erythromycin)." Arbor Pharmaceuticals, SUPPL-74
  31. (2020) "Product Information. Priftin (rifapentine)." sanofi-aventis, SUPPL-18
  32. (2021) "Product Information. Xerava (eravacycline)." Tetraphase Pharmaceuticals, Inc
  33. (2023) "Product Information. Xacduro (durlobactam-sulbactam)." La Jolla Pharmaceutical
  34. (2024) "Product Information. Exblifep (cefepime-enmetazobactam)." Allecra Therapeutics
  35. (2021) "Product Information. Maxipime (cefepime)." Hospira Inc, SUPPL-46
View all 35 references

Penicillinase-resistant PCNs (applies to dicloxacillin) marrow toxicity

Major Potential Hazard, Moderate plausibility. Applicable conditions: Neutropenia, Thrombocytopenia

The use of penicillinase-resistant penicillins has been associated with adverse hematologic effects, including neutropenia, leukopenia, granulocytopenia and thrombocytopenia, particularly when given in high parenteral dosages. Agranulocytosis and prolonged bleeding time have been reported rarely. Therapy with penicillinase-resistant penicillins should be administered cautiously in patients with preexisting blood dyscrasias or bone marrow depression, and hematopoietic function should be monitored. Blood counts with differential should be performed prior to initiation of therapy and 1 to 3 times weekly during therapy. Hematologic abnormalities are generally reversible and resolve within several days to two weeks following discontinuation of therapy.


  1. Godin M, Deshayes P, Ducastelle T, Delpech A, Leloet X, Fillastre JP (1980) "Agranulocytosis, haemorrhagic cystitis and acute interstitial nephritis during methicillin therapy." J Antimicrob Chemother, 6, p. 296-7
  2. Carpenter J (1980) "Neutropenia induced by semisynthetic penicillin." South Med J, 73, p. 745-8
  3. Slovick FT, Bamberger DM, Stark KR (1989) "Spontaneous clostridial myonecrosis in a man with drug-induced agranulocytosis." South Med J, 82, p. 1272-4
  4. Shah I, Kumar KS, Lerner AM (1982) "Agranulocytosis associated with chronic oral administration of cloxacillin for suppression of staphylococcal osteomyelitis." Am J Hematol, 12, p. 203-6
  5. Neftel K, Muller MR, Hauser SP, Walti M, de Weck AL (1983) "More on penicillin-induced leukopenia." N Engl J Med, 308, p. 901-2
  6. Clotet B, Vea AM, Rubies-Prat J, Sala MF (1985) "Cloxacillin-induced leukopenia." Arch Intern Med, 145, p. 1531
  7. Olaison L, Alestig K (1990) "A prospective study of neutropenia induced by high doses of B-lactam antiobiotics." J Antimicrob Chemother, 25, p. 449-53
  8. Klein JO, Finland M (1963) "The new penicillins (concluded)." N Engl J Med, 269, p. 1129-34
  9. Alexander DP, Russo ME, Fohrman DE, Rothstein G (1983) "Nafcillin-induced platelet dysfunction and bleeding." Antimicrob Agents Chemother, 23, p. 59-62
  10. Jeter EK, Scott A, Kizer J, Lazarchick J (1990) "Impaired platelet function associated with parenteral nafcillin." Ann Clin Lab Sci, 20, p. 79-84
  11. Westerman EL, Bradshaw MW, Williams TW (1978) "Agranulocytosis during therapy with orally administered cloxacillin." Am J Clin Pathol, 69, p. 559-60
  12. Kitzing W, Nelson JD, Mohs E (1981) "Comparative toxicities of methicillin and nafcillin." Am J Dis Child, 135, p. 52-5
  13. (2002) "Product Information. Tegopen (cloxacillin)." Apothecon Inc
  14. (2002) "Product Information. Dynapen (dicloxacillin)." Apothecon Inc
  15. (2002) "Product Information. Staphcillin (methicillin)." Apothecon Inc
  16. (2002) "Product Information. Unipen (nafcillin)." Wyeth-Ayerst Laboratories
  17. (2001) "Product Information. Bactocill (oxacillin)." SmithKline Beecham
  18. Walbroehl GS, John PG (1992) "Antibiotic-associated neutropenia." Am Fam Physician, 45, p. 2237-41
  19. Greene GR, Cohen E (1978) "Nafcillin-induced neutropenia in children." Pediatrics, 61, p. 94-7
  20. Couchonnal GJ, Hinthorn DR, Hodges GR, Liu C (1978) "Nafcillin-associated granulocytopenia." South Med J, 71, p. 1356-8
  21. Passoff TL, Sherry HS (1978) "Oxacillin induced neutropenia. A case report." Clin Orthop, 135, p. 69-70
  22. Chu JY, O'Connor DM, Schmidt RR (1977) "The mechanism of oxacillin-induced neutropenia." J Pediatr, 90, p. 668-9
  23. Leventhal JM, Silken AB (1976) "Oxacillin-induced neutropenia in children." J Pediatr, 89, p. 769-71
  24. Kahn JB (1978) "Oxacillin-induced agranulocytosis." JAMA, 240, p. 2632
  25. Brook I (1977) "Leukopenia and granulocytopenia after oxacillin therapy." South Med J, 70, p. 565-6
  26. Fallon JA, Tall AR, Janis MG, Brauer MJ (1978) "Oxacillin-induced granulocytopenia." Acta Haematol, 59, p. 163-70
  27. Ahern MJ, Hicks JE, Andriole VT (1976) "Neutropenia during high dose intravenous oxacillin therapy." Yale J Biol Med, 49, p. 351-60
View all 27 references

Diclox-methacillin (applies to dicloxacillin) cystic fibrosis

Moderate Potential Hazard, High plausibility.

The penicillinase-resistant penicillins, dicloxacillin and methicillin, are both eliminated by the kidney. Renal elimination of these penicillins has been shown to increase in patients with cystic fibrosis, resulting in decreased peak serum drug concentrations and AUCs. Clinicians should be cognizant of these effects when prescribing or administering the antibiotics to patients with cystic fibrosis.


  1. Yaffe SJ, Gerbracht LM, Mosovich LL, Mattar ME, Danish M, Jusko WJ (1977) "Pharmacokinetics of methicillin in patients with cystic fibrosis." J Infect Dis, 135, p. 828-31
  2. (2002) "Product Information. Dynapen (dicloxacillin)." Apothecon Inc
  3. (2002) "Product Information. Staphcillin (methicillin)." Apothecon Inc

Dicloxacillin (applies to dicloxacillin) sodium

Moderate Potential Hazard, High plausibility. Applicable conditions: Congestive Heart Failure, Fluid Retention, Hypernatremia, Hypertension

Each 250 mg capsule of dicloxacillin sodium contains approximately 14 mg (0.6 mEq) of sodium, and each teaspoonful of the 62.5 mg/5 mL oral suspension contains approximately 67 mg (2.9 mEq) of sodium. The sodium content should be considered in patients with conditions that may require sodium restriction, such as congestive heart failure, hypertension, and fluid retention.


  1. (2002) "Product Information. Dynapen (dicloxacillin)." Apothecon Inc

Dicloxacillin drug interactions

There are 38 drug interactions with dicloxacillin.

Dicloxacillin alcohol/food interactions

There are 2 alcohol/food interactions with dicloxacillin.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.