Pivmecillinam Disease Interactions

Pivmecillinam is contraindicated in patients suffering from porphyria as use of this drug has been associated with acute attacks of porphyria, which may be life-threatening.

Clinical manifestations of carnitine depletion may occur with pivalate-containing compounds, including pivmecillinam. Pivmecillinam is contraindicated in patients with primary or secondary carnitine deficiency due to inherited metabolic disorders known to cause carnitine depletion. In patients at risk for reductions in serum carnitine (e.g., significant renal impairment or decreased muscle mass) consider alternative antibacterial therapies.

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. 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.