Pivmecillinam Dosage

Medically reviewed by Drugs.com. Last updated on May 20, 2025.

Usual Adult Dose for Urinary Tract Infection

Females aged 18 years and older: 185 mg (1 tablet) orally 3 times a day for 3 to 7 days, as clinically indicated

Comments:

• This drug should only be used to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria.
• When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy.
• In the absence of culture and susceptibility data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

Use: For the treatment of uncomplicated urinary tract infections caused by susceptible isolates of Escherichia coli, Proteus mirabilis, and Staphylococcus saprophyticus

Renal Dose Adjustments

Renal dysfunction: No adjustment recommended based on available safety data

Comments:

• Decreased renal function is anticipated to reduce both systemic elimination and urinary excretion of the active component of this drug; the clinical significance of these changes on efficacy is unknown.

Liver Dose Adjustments

Liver dysfunction: No adjustment recommended

Precautions

CONTRAINDICATIONS:

• Known history of serious hypersensitivity reaction (e.g., anaphylaxis or Stevens-Johnson syndrome) to this drug or other beta-lactam antibacterial drugs (e.g., penicillins and cephalosporins)
• In patients with primary or secondary carnitine deficiency resulting from inherited disorders of mitochondrial fatty acid oxidation and carnitine metabolism, and other inborn errors of metabolism (e.g., methylmalonic aciduria, or propionic acidemia)
• In patients suffering from porphyria (this drug has been associated with acute attacks of porphyria)

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• For oral use
• This drug may be administered with or without food.
• Missed dose: Take the dose as soon as possible; do NOT double the dose to make up for a missed dose.

Storage requirements:

• Store at 20C to 25C (68F to 77F); excursions permitted between 15C to 30C (59F to 86F).
• Store and dispense tablets in the unit dose blisters.

General:

• This drug is a prodrug of mecillinam (the active antibacterial agent).

Monitoring:

• Dermatologic: For severe cutaneous adverse reactions/hypersensitivity (during treatment)
• Gastrointestinal: For diarrhea (during and after treatment)
• General: For history of hypersensitivity to beta-lactam antibiotics (prior to therapy)

Patient advice:

• Read the US FDA-approved patient labeling.
• Seek immediate medical attention if signs/symptoms of serious allergic or cutaneous reaction such as new rash, urticaria, drug eruptions, swelling of the face, and/or difficulty in breathing.
• Tell your healthcare provider about all of the medicines you take.
• Understand that diarrhea is a common problem associated with this drug and should end after treatment is discontinued; seek medical attention if watery and/or bloody stools occur.
• Do not skip doses of this drug; missed doses may decrease effectiveness and bacterial resistance.
• Pregnant patients: Treatment prior to delivery may result in a false positive test for isovaleric acidemia in the newborn.

See also:

Further information

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

Medical Disclaimer