Cloxacillin

435.88

435.88

200-514-7

O6X5QGC2VB

DTXSID5022853

C61688

J - Antiinfectives for systemic use

138

3

Solid

1.6±0.1 g/cm3

689.7±55.0 °C at 760 mmHg

370.9±31.5 °C

1.685

5.32e-02 g/L

Commercially available cloxacillin sodium capsules and powder for oral solution should be stored in tight containers at a temperature less than 40 deg C, preferably between 15-30 deg C. Following reconstitution, cloxacillin sodium oral solutions should be stored at 2-8 deg C, and any unused soln should be discarded after 14 days. If stored at room temperature, the oral soln is stable for 3 days. /Cloxacillin sodium/

2.78None

2.78

193.8 Ų [M+H]+ [CCS Type: TW, Method: calibrated with Waters Major Mix]|200.4 Ų [M+Na]+ [CCS Type: TW, Method: calibrated with Waters Major Mix]|200.94 Ų [M-H]-

Microcryst powder, dec 170 °C, specific optical rotation +163 deg @ 20 °C/D; pH 6.0-7.5. Soluble in water, methanol, ethanol, pyridine, ethylene glycol /Sodium monohydrate/

Penicillinase-resistant penicillins are generally stable in the dry state @ room temp for several yr; however, the drugs are stable only for short periods of time in soln unless frozen. Stability of the drugs is pH and temp dependent. Methicillin, nafcillin, and oxacillin are generally stable @ pH 5-8. /Penicillinase-resistant penicillins/

P261, P264, P270, P272, P280, P285, P301+P312, P302+P352, P304+P341, P305+P351+P338, P321, P330, P332+P313, P333+P313, P337+P313, P342+P311, P362, P363, P501

H302

SRP: At the time of review, criteria for land treatment or burial (sanitary landfill) disposal practices are subject to significant revision. Prior to implementing land disposal of waste residue (including waste sludge), consult with environmental regulatory agencies for guidance on acceptable disposal practices.

A tolerance is established for negligible residues of cloxacillin in the uncooked edible tissues of cattle and in milk.|Manufacturers, packers, and distributors of drug and drug products for human use are responsible for complying with the labeling, certification, and usage requirements as prescribed by the Federal Food, Drug, and Cosmetic Act, as amended (secs 201-902, 52 Stat. 1040 et seq., as amended; 21 U.S.C. 321-392).

|Danger|H302 (11.11%): Harmful if swallowed [Warning Acute toxicity, oral]|P261, P264, P270, P272, P280, P285, P301+P312, P302+P352, P304+P341, P305+P351+P338, P321, P330, P332+P313, P333+P313, P337+P313, P342+P311, P362, P363, and P501|Aggregated GHS information provided by 9 companies from 4 notifications to the ECHA C&L Inventory. Each notification may be associated with multiple companies.|H317 (100%): May cause an allergic skin reaction [Warning Sensitization, Skin]|P261, P272, P280, P285, P302+P352, P304+P341, P321, P333+P313, P342+P311, P363, and P501|Aggregated GHS information provided by 35 companies from 1 notifications to the ECHA C&L Inventory. Each notification may be associated with multiple companies.|H315 (85.42%): Causes skin irritation [Warning Skin corrosion/irritation]|P261, P264, P271, P272, P280, P285, P302+P352, P304+P340, P304+P341, P305+P351+P338, P312, P321, P332+P313, P333+P313, P337+P313, P342+P311, P362, P363, P403+P233, P405, and P501|Aggregated GHS information provided by 48 companies from 4 notifications to the ECHA C&L Inventory. Each notification may be associated with multiple companies.

Oral LD50 in rat and mouse is 5000 mg/kg. Intravenous LD50 in rat is 1660 mg/kg. Symptoms of overdose include wheezing, tightness in the chest, fever, itching, bad cough, blue skin color, fits, and swelling of face, lips, tongue, or throat.

Three forms of liver injury have been attributed to the penicillinase-resistant and other penicillins. The first is a transient and usually asymptomatic elevation in serum aminotransferase levels that occurs with high dose intravenous therapy with oxacillin (Case 1, Oxacillin) and rarely with standard penicillins (Case 1, Penicillin G). This reaction has not been described with nafcillin or dicloxacillin and patients can be safety switched to these or other forms of penicillin in the face of oxacillin injury. This form of penicillin-induced liver injury occurs only with high dose therapy that is likely due to direct hepatotoxicity.

PENICILLINS SHOULD NOT BE ROUTINELY ADMIN WITH ERYTHROMYCIN. /PENICILLINS/|OTHER PENICILLIN ANALOGS SHOWN TO INTERACT WITH PROBENECID ARE...CLOXACILLIN...|TETRACYCLINE MAY ANTAGONIZE BACTERICIDAL EFFECT OF PENICILLIN... /PENICILLINS/|Concurrent use of other hepatotoxic medications with cloxacillin ... may increase the potential for hepatotoxicity.|For more Interactions (Complete) data for CLOXACILLIN (9 total), please visit the HSDB record page.

LD50 MOUSE ORAL 5.0 G/KG

95%

Used to treat infections caused by penicillinase-producing staphylococci, including pneumococci, group A beta-hemolytic streptococci, and penicillin G-sensitive and penicillin G-resistant staphylococci.

Penicillins|...ITS USE SHOULD BE LIMITED TO TREATING INFECTIONS CAUSED BY PENICILLINASE-PRODUCING SUSCEPTIBLE MICROORGANISMS WHICH ARE RESISTANT TO PENICILLIN G. ...CAN BE USED IN COMBINATION WITH AMPICILLIN IN TREATMENT OF URINARY TRACT INFECTIONS CAUSED BY GRAM-NEGATIVE BACILLI. /MONOHYDRATE/|METHICILLIN-RESISTANT STAPHYLOCOCCI ARE ALSO SENSITIVE TO CLOXACILLIN, SO THAT DRUG IS USEFUL IN TREATING INFECTIONS WHICH HAVE BECOME RESISTANT TO METHICILLIN. /MONOHYDRATE/|IN FEW INSTANCES, IT IS NECESSARY TO INTERDICT FUTURE USE OF PENICILLIN BECAUSE OF RISK OF DEATH, & PT SHOULD BE SO WARNED. IT MUST AGAIN BE STRESSED THAT FATAL EPISODES OF ANAPHYLAXIS HAVE FOLLOWED INGESTION OF VERY SMALL DOSES OF THIS ANTIBIOTIC. /PENICILLINS/|For more Therapeutic Uses (Complete) data for CLOXACILLIN (19 total), please visit the HSDB record page.

Penicillins are distributed into breast milk, some in low concentrations. Although significant problems in humans have not been documented, the use of penicillins by nursing mothers may lead to sensitization, diarrhea, candidiasis, and skin rash in the infant. /Penicillins/|Many penicillins have been used in pediatric patients and no pediatrics-specific problems have been documented to date. However, the incompletely developed renal function of neonates and young infants may delay the excretion of renally eliminated penicillins. /Penicillins/|Penicillins have been used in geriatric patients and no geriatrics-specific problems have been documented to date. However, elderly patients are more likely to have age-related renal function impairment, which may require an adjustment in dosage in patients receiving penicillins. /Penicillins/|Prolonged use of penicillins may lead to the development of oral candidiasis. /Penicillins/|For more Drug Warnings (Complete) data for CLOXACILLIN (16 total), please visit the HSDB record page.

...PENICILLIN G LIES ON BORDERLINE BETWEEN TOXICITY CLASSES 2 & 3. 2= SLIGHTLY TOXIC: PROBABLE ORAL LETHAL DOSE (HUMAN) 5-15 G/KG, BETWEEN 1 PINT & 1 QUART FOR 70 KG PERSON (150 LB). 3= MODERATELY TOXIC; PROBABLE ORAL LETHAL DOSE (HUMAN) 0.5-5 G/KG, BETWEEN 1 OZ & 1 PINT (OR 1 LB) FOR 70 KG PERSON (150 LB). /PENICILLINS/

Cloxacillin is a semisynthetic antibiotic in the same class as penicillin. Cloxacillin is for use against staphylococci that produce beta-lactamase.

Substances that inhibit the growth or reproduction of BACTERIA. (See all compounds classified as Anti-Bacterial Agents.)

Well absorbed from the gastrointestinal tract.|.../ANTIMICROBIAL AGENTS/ ARE RAPIDLY BUT INCOMPLETELY (30-80%) ABSORBED FROM GI TRACT. ABSORPTION OF DRUGS IS MORE EFFICIENT WHEN THEY ARE TAKEN ON AN EMPTY STOMACH. PEAK PLASMA CONCN ARE ATTAINED BY 1 HR & APPROX 5-10 UG/ML AFTER INGESTION OF 1 G OF OXACILLIN, & SIMILAR VALUES ARE OBTAINED WITH CLOXACILLIN.|SINCE ABSORPTION IS LESS THAN COMPLETE, HIGHER PLASMA CONCN ARE ACHIEVED FOLLOWING IM INJECTION, & LARGER QUANTITIES OF DRUGS ARE RECOVERABLE IN URINE. ...BOUND TO PLASMA ALBUMIN TO GREAT EXTENT (APPROX 90-95%); NONE IS REMOVED FROM CIRCULATION TO SIGNIFICANT DEGREE BY HEMODIALYSIS.|NORMALLY, ABOUT ONE HALF OF.../DRUG/ IS EXCRETED IN URINE IN FIRST 6 HR AFTER CONVENTIONAL ORAL DOSE. THERE IS ALSO SIGNIFICANT HEPATIC ELIMINATION...IN BILE.|ISOXAZOLYL PENICILLINS ARE RAPIDLY EXCRETED BY KIDNEY, & CONCURRENT ADMIN OF PROBENECID RESULTS IN HIGHER & MORE PERSISTENT PLASMA CONCN. /PENICILLINS/|For more Absorption, Distribution and Excretion (Complete) data for CLOXACILLIN (16 total), please visit the HSDB record page.

PENICILLIN CAN UNDERGO SLOW CONVERSION IN VIVO TO INTERMEDIATES, SUCH AS PENICILLENIC ACID, WHICH CAN REACT WITH APPROPRIATE CONSTITUENTS OF TISSUES. /PENICILLINS/|Cloxacillin is partially metabolized to active and inactive metabolites. In one study following administration of a single 500-mg oral cloxacillin dose, 22% of the absorbed dose was hydrolyzed to penicilloic acids which are microbiologically inactive. Cloxacillin is also hydroxylated to a small extent to a microbiologically active metabolite which appears to be as active as cloxacillin.

HALF-LIVES...BETWEEN 30 AND 60 MINUTES.|IN CHILDREN BEING TREATED FOR STAPHYLOCOCCAL INFECTIONS, MEAN ELIMINATION HALF-LIFE WAS 71 MIN.|The serum half-life of cloxacillin in adults with normal renal function is 0.4-0.8 hr.|The serum half-life of cloxacillin is slightly prolonged in patients with impaired renal function and has been reported to range from 0.8-2.3 hr in patients with severe renal impairment.|In one study in children 1 week to 2 years of age, the serum elimination half-life of cloxacillin was 0.8-1.5 hr. Serum concentrations of cloxacillin are generally higher and the serum half-life more prolonged in neonates than in older children.

By binding to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall, cloxacillin inhibits the third and last stage of bacterial cell wall synthesis. Cell lysis is then mediated by bacterial cell wall autolytic enzymes such as autolysins; it is possible that cloxacillin interferes with an autolysin inhibitor.|...ITS ANTIBACTERIAL SPECTRUM AGAINST GRAM-POSITIVE BACTERIA IS LIKE THAT OF PENICILLIN EXCEPT IT IS BROADER BY MARGIN OF THOSE STRAINS OR SPECIES THAT PRODUCE PENICILLINASE. ...IT IS LESS ACTIVE THAN PENICILLIN G AGAINST NON-PENICILLINASE-PRODUCING BACTERIA, ESPECIALLY STREPTOCOCCI. /CLOXACILLIN MONOHYDRATE/|SINCE PENICILLIN HAS NO EFFECT ON EXISTING CELL WALLS, BACTERIA MUST BE MULTIPLYING FOR BACTERIAL ACTION OF PENICILLIN TO BE MANIFEST. /PENICILLINS/|The penicillins and their metabolites are potent immunogens because of their ability to combine with proteins and act as haptens for acute antibody-mediated reactions. The most frequent (about 95 percent) or "major" determinant of penicillin allergy is the penicilloyl determinant produced by opening the beta-lactam ring of the penicillin. This allows linkage of the penicillin to protein at the amide group. "Minor" determinants (less frequent) are the other metabolites formed, including native penicillin and penicilloic acids. /Penicillins/|Bactericidal; inhibit bacterial cell wall synthesis. Action is dependent on the ability of penicillins to reach and bind penicillin-binding proteins (PBPs) located on the inner membrane of the bacterial cell wall. Penicillin-binding proteins (which include transpeptidases, carboxypeptidases, and endopeptidases) are enzymes that are involved in the terminal stages of assembling the bacterial cell wall and in reshaping the cell wall during growth and division. Penicillins bind to, and inactivate, penicillin-binding proteins, resulting in the weakening of the bacterial cell wall and lysis. /Penicillins/|TOLERANCE DEVELOPED TO MULTIPLE DOSING. /PENICILLINS/

1. ESTABLISHMENT OF RESP & CREATION OF ARTIFICIAL AIRWAY... CHECK ADEQUACY OF TIDAL VOL... 2. ACUTE TOXICITY: HYPERSENSITIVITY REACTION. DRUG SHOULD BE IMMEDIATELY DISCONTINUED & PT OBSERVED FOR POSSIBILITY OF ANAPHYLACTIC SHOCK. ... 3. CHRONIC TOXICITY: DISCONTINUE USE OF DRUG. /PENICILLINS/|4. PREVENTION OF ABSORPTION: A. EMESIS SHOULD BE INITIATED UNLESS PT IS COMATOSE, CONVULSING OR HAS LOST GAG REFLEX. B. ...ENDOTRACHEAL INTUBATION SHOULD PRECEDE GASTRIC LAVAGE WITH LARGE BORE TUBE. C. ACTIVATED CHARCOAL... D. SODIUM OR MAGNESIUM SULFATE...AS CATHARTIC... /PENICILLINS/

RASH & URTICARIA ARE PRINCIPAL ALLERGIC MANIFESTATIONS. NOT ALL PT ALLERGIC TO PENICILLIN G ARE SENSITIVE TO CLOXACILLIN, BUT CROSS-SENSITIZATION DOES OCCUR. CLOXACILLIN MAY ALSO CAUSE OCCASIONAL NAUSEA, VOMITING, ABDOMINAL DISCOMFORT, EPIGASTRIC FULLNESS, OR DIARRHEA. SUPERINFECTIONS OCCASIONALLY OCCUR. /MONOHYDRATE/|SKIN RASHES OF ALL TYPES HAVE BEEN OBSERVED WHEN PENICILLIN SENSITIZATION HAS OCCURRED. ...VESICULAR, & BULLOUS ERUPTIONS MAY DEVELOP. PURPURIC LESIONS ARE UNCOMMON & ARE USUALLY RESULT OF VASCULITIS; THROMBOPENIC PURPURA MAY OCCUR VERY RARELY. HENOCH-SCHOENLEIN PURPURA WITH RENAL INVOLVEMENT HAS BEEN RARE... /PENICILLINS/|CONTACT DERMATITIS IS OBSERVED...IN PHARMACISTS, NURSES, & PHYSICIANS WHO PREPARE PENICILLIN SOLN... MORE SEVERE REACTIONS INVOLVING SKIN ARE EXFOLIATIVE DERMATITIS & EXUDATIVE ERYTHEMA MULTIFORME OF EITHER ERYTHEMATOPAPULAR OR VESICULOBULLOUS TYPE...CONSTITUTE CHARACTERISTIC STEVENS-JOHNSON SYNDROME. /PENICILLINS/|VARIETY OF ORAL LESIONS HAVE RESULTED FROM SENSITIZATION TO PENICILLIN. AMONG THESE ARE ACUTE GLOSSITIS, SEVERE STOMATITIS WITH LOSS OF BUCCAL MUCOUS MEMBRANES, FURRED TONGUE, BLACK OR BROWN TONGUE, & CHEILOSIS. /PENICILLINS/|For more Human Toxicity Excerpts (Complete) data for CLOXACILLIN (42 total), please visit the HSDB record page.

Chloroxacillin

NOT RECOMMENDED IN US FOR USE IN FOOD PRODUCING ANIMALS.|MORE RECENTLY INTRODUCED SEMISYNTHETIC DERIVATIVES OF PENICILLIN... CLOXACILLIN...SIMILAR IN ACTION TO PARENT COMPD BUT SOME ARE ALSO EFFECTIVE AGAINST...PENICILLINASE PRODUCING STAPHYLOCOCCI. /PENICILLINS/|...SAFE TO ASSUME THAT AFTER...RECOMMENDED OR NON-RECOMMENDED USAGE FDA INSISTS TO ZERO TOLERANCE FOR DRUG IN EDIBLE TISSUES OF ANIMALS & POULTRY INCLUDING THEIR BY-PRODUCTS, MILK, OR EGGS DESTINED FOR HUMAN USE...CURRENTLY PERMITTING 0.05 PPM FOR ITS NEGLIGIBLE RESIDUE IN UNCOOKED EDIBLE TISSUES OF CATTLE. /PENICILLINS/|PROPERTIES & PHARMACOLOGY: NAYLOR ET AL, NATURE 195, 1264 (1962).

DIRECT TITRATIONS OF SOME SELECTED PENICILLINS WITH IODATE SOLUTION.|ANTIBIOTIC DETERMINATIONS WITH NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY.|THIN-LAYER CHROMATOGRAPHY OF SOME PENICILLINS AND CEPHALOSPORINS ON SILANIZED SILICAGEL.|A method using an automated liquid chromatography (LC) cleanup sensitive to 1 ng/ml was developed for penicillin V and cloxacillin.|For more Analytic Laboratory Methods (Complete) data for CLOXACILLIN (6 total), please visit the HSDB record page.

DETERMINATION OF PENICILLINS IN URINE WITH ELLMAN'S REAGENT BY SPECTROPHOTOMETRY AT 412 NM.

Human Drugs -> FDA Approved Drug Products with Therapeutic Equivalence Evaluations (Orange Book) -> Active Ingredients|Animal Drugs -> FDA Approved Animal Drug Products (Green Book) -> Active Ingredients