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Methicillin Disease Interactions

There are 5 disease interactions with methicillin:

Major

Beta-Lactams (Parenteral) (Includes Methicillin) ↔ 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.

References

  1. Jackson EA, McLeod DC "Pharmacokinetics and dosing of antimicrobial agents in renal impairment, part I." Am J Hosp Pharm 31 (1974): 36-52
  2. Aronoff GR, Sloan RS, Stanish RA, Fineberg NS "Mezlocillin dose dependent elimination kinetics in renal impairment." Eur J Clin Pharmacol 21 (1982): 505-9
  3. Kampf D, Schurig R, Korsukewitz I, Bruckner O "Cefoxitin pharmacokinetics: relation to three different renal clearance studies in patients with variuos degrees of renal insufficiency." Antimicrob Agents Chemother 20 (1981): 741-6
View all 153 references
Major

Penicillinase-Resistant Pcns (Includes Methicillin) ↔ Marrow Toxicity

Severe Potential Hazard, Moderate plausibility

Applies to: 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.

References

  1. "Product Information. Staphcillin (methicillin)." Apothecon Inc, Plainsboro, NJ.
  2. "Product Information. Dynapen (dicloxacillin)." Apothecon Inc, Plainsboro, NJ.
  3. Leventhal JM, Silken AB "Oxacillin-induced neutropenia in children." J Pediatr 89 (1976): 769-71
View all 29 references
Moderate

Antibiotics (Includes Methicillin) ↔ Colitis

Moderate 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 two months 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.

References

  1. Moriarty HJ, Scobie BA "Pseudomembranous colitis in a patient on rifampicin and ethambutol." N Z Med J 04/23/80 (1980): 294-5
  2. Thomas E, Mehta JB "Pseudomembranous colitis due to oxacillin therapy." South Med J 77 (1984): 532-3
  3. Harmon T, Burkhart G, Applebaum H "Perforated pseudomembranous colitis in the breast-fed infant." J Pediatr Surg 27 (1992): 744-6
View all 47 references
Moderate

Diclox-Methacillin (Includes Methicillin) ↔ Cystic Fibrosis

Moderate Potential Hazard, High plausibility

Applies to: Cystic Fibrosis

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.

References

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

Methicillin (Includes Methicillin) ↔ Sodium/Potassium

Moderate Potential Hazard, High plausibility

Applies to: Congestive Heart Failure, Fluid Retention, Hypernatremia, Hypertension, Hypokalemia

Each gram of parenteral methicillin sodium contains approximately 60 to 71 mg (2.6 to 3.1 mEq) of sodium and is buffered with 50 mg of sodium citrate. The sodium content should be considered in patients with conditions that may require sodium restriction, such as congestive heart failure, hypertension, and fluid retention. In addition, hypokalemia has been reported rarely during therapy with the penicillinase-resistant penicillins, which may be particularly important to bear in mind when treating patients with low potassium reserves or fluid and electrolyte imbalance. Clinical monitoring of electrolytes is recommended if these agents are used for prolonged periods.

References

  1. "Product Information. Staphcillin (methicillin)." Apothecon Inc, Plainsboro, NJ.
  2. Andreoli SP, Kleiman MB, Glick MR, Bergstein JM "Nafcillin, pseudoproteinuria, and hypokalemic alkalosis." J Pediatr 97 (1980): 841-2
  3. Schlaeffer F "Oxacillin-associated hypokalemia." Drug Intell Clin Pharm 22 (1988): 695-6

methicillin drug Interactions

There are 53 drug interactions with methicillin

methicillin alcohol/food Interactions

There is 1 alcohol/food interaction with methicillin

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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