Carbenicillin

378.4

378.40

225-171-0

G42ZU72N5G

DTXSID6048464

C343

J - Antiinfectives for systemic use

149

1.8

Solid

1.53g/cm3

737.8ºC at 760mmHg

400ºC

1.675

3.90e-01 g/L

−20°C

PH: (1% SOLN, WT/VOL) BETWEEN 6.8 & 7.5

UN 1170 3/PG 3

2

10-42/43

36/37-45-22

Xn

Extended-spectrum penicillins are generally stable for several yr in the dry state @ room temp; however, the drugs are stable only for short periods of time in soln unless frozen. Like other penicillins, stability of extended-spectrum penicillins is pH and temp dependent carbenicillin indanyl sodium is more resistant to acid-catalyzed hydrolysis than carbenicillin and is generally stable in the presence of acidic gastric secretions following oral admin.

P261, P272, P280, P285, P302+P352, P304+P341, P321, P333+P313, P342+P311, P363, P501

H317

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.

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|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 38 companies from 1 notifications to the ECHA C&L Inventory. Each notification may be associated with multiple companies.

Carbenicillin blood levels achievable are very low, and toxic reactions as a function of overdosage should not occur systematically. The oral LD50 in mice is 3,600 mg/kg, in rats 2,000 mg/kg, and in dogs is in excess of 500 mg/kg. The lethal human dose is not known. Symptoms of overdose include diarrhea, nausea, stomach upset, and vomiting.

Extended-spectrum penicillins are physically and/or chemically incompatible with aminoglycosides and can inactivate the drugs in vitro. The extent of in vitro inactivation of aminoglycosides by penicillins depends on the specific drugs involved and appears to be directly proportional to the penicillin concn, length of exposure, and temp ... Most in vitro studies indicate that carbenicillin ... inactivates aminoglycosides at a faster rate than mazlocillin, piperacillin, or ticarcillin.|Extended-spectrum penicillins can also inactivate aminoglycosides in vivo. In patients with impaired renal function, concomitant admin of carbenicillin ... and gentamicin has resulted in decreased serum aminoglycoside concn and serum half-lives compared with admin of the aminoglycoside alone.|Some in vitro studies indicate that the antibacterial activity of extended-spectrum penicillins may be additive or partially synergistic with other beta-lactam antibiotics ... . /Extended-spectrum penicillins/|In vitro studies indicate that the combination of carbenicillin ... with clavulanic acid, a beta-lactamase inhibitor, results in a synergistic bactericidal effect against many strains of beta-lactamase-producing bacteria.|For more Interactions (Complete) data for CARBENICILLIN (7 total), please visit the HSDB record page.

30 to 60%

For the treatment of acute and chronic infections of the upper and lower urinary tract and in asymptomatic bacteriuria due to susceptible strains of bacteria.

Penicillins|MAJOR ADVANTAGE OF THIS AGENT IS THAT IT OFTEN CURES SERIOUS INFECTIONS CAUSED BY PSEUDOMONAS SPECIES /PRC: ESP PSEUDOMONAS AEROGINOSA/, PROTEUS STRAINS RESISTANT TO AMPICILLIN, & CERTAIN OTHER GRAM-NEGATIVE MICROORGANISMS.|Carbenicillin (parenteral) /is/ indicated in the treatment of bacterial pneumonia caused by susceptible organisms. /Included in US product labeling/|Carbenicillin (parenteral) /is/ indicated in the treatment of bone and joint infections caused by susceptible organisms. /Included in US product labeling/|For more Therapeutic Uses (Complete) data for CARBENICILLIN (14 total), please visit the HSDB record page.

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 THE INGESTION OF VERY SMALL DOSES OF THIS ANTIBIOTIC. /PENICILLINS/|THESE AGENTS ARE...LESS EFFECTIVE AGAINST MICROORGANISMS SUSCEPTIBLE TO PENICILLIN G, & THEY ARE NOT USEFUL AGAINST GRAM-NEGATIVE BACTERIA, MICROORGANISMS CAN BECOME RESISTANT TO THESE DRUGS IN STEPWISE FASHION, & CROSS-RESISTANCE TO ALL PENICILLINS IS USUALLY COMPLETE /PENICILLINS/|Because of the risk of therapeutic failure from subtherapeutic drug concn, carbenicillin indanyl sodium should not be used when rapid high blood and/or urine concn are necessary or in patients with severe renal impairment (i.e., creatinine clearances less than 10 ml/min). /Carbenicillin indanyl sodium/|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/|For more Drug Warnings (Complete) data for CARBENICILLIN (24 total), please visit the HSDB record page.

...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/

Carbenicillin is a semisynthetic penicillin. Though carbenicillin provides substantial in vitro activity against a variety of both gram-positive and gram-negative microorganisms, the most important aspect of its profile is in its antipseudomonal and antiproteal activity. Because of the high urine levels obtained following administration, carbenicillin has demonstrated clinical efficacy in urinary infections due to susceptible strains of: Escherichia coli, Proteus mirabilis, Proteus vulgaris, Morganella morganii, Pseudomonas species, Providencia rettgeri, Enterobacter species, and Enterococci (S. faecalis).

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

Rapidly absorbed from the small intestine following oral administration. Oral bioavailability is 30 to 40%.|CARBENICILLIN IS NOT ABSORBED FROM GI TRACT &, THEREFORE MUST BE GIVEN PARENTERALLY. ... IM INJECTION OF 1 G PRODUCES PEAK PLASMA CONCN OF 15-20 UG/ML IN 1/2-2 HR... MAX PLASMA CONCN ARE ABOUT 4 TIMES HIGHER AFTER IV THAN AFTER IM ADMIN... IV INFUSION...1 G/HR RESULTS IN AVG PLASMA CONCN OF APPROX 150 UG/ML.|ABOUT 50% OF ANTIBIOTIC IN PLASMA IS PROTEIN BOUND. ...CARBENICILLIN IS EXCRETED PRIMARILY BY RENAL TUBULES. ABOUT 75-80%...IS RECOVERABLE IN ACTIVE FORM IN URINE IN 9 HR.|Carbenicillin is not stable in acids nor does it resist penicillinases; thus it is administered parenterally because of poor absorption following oral administration. A parenteral dose of 50-200 mg/kg is divided for administration every 4-6 hr.|Although carbenicillin is eliminated from the bovine mammary gland within 72 hr posttreatment, mastitis produced by P. aeruginosa is not effectively treated; resistant organisms are recovered 24-48 hr postinfusion.|For more Absorption, Distribution and Excretion (Complete) data for CARBENICILLIN (11 total), please visit the HSDB record page.

Minimal.

1 hour|...T 1/2...IN INDIVIDUALS WITH NORMAL RENAL FUNCTION IS ABOUT 1 HR...PROLONGED TO ABOUT 2 HR IN PRESENCE OF HEPATIC DYSFUNCTION.

Free carbenicillin is the predominant pharmacologically active fraction of the salt. Carbenicillin exerts its antibacterial activity by interference with final cell wall synthesis of susceptible bacteria. Penicillins acylate the penicillin-sensitive transpeptidase C-terminal domain by opening the lactam ring. This inactivation of the enzyme prevents the formation of a cross-link of two linear peptidoglycan strands, inhibiting 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 carbenicillin interferes with an autolysin inhibitor.|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/

MASSIVE IV DOSES IN MAN...MAY RESULT IN AN ENCEPHALOPATHY WITH MUSCULAR HYPERIRRITABILITY, MYOCLONUS, VISUAL & AUDITORY HALLUCINATIONS & GENERALIZED CONVULSIONS. ... ALLERGIC REACTIONS ARE FAR MORE COMMON THAN FRANK TOXICITY. ANAPHYLACTIC SHOCK IS RARE, BUT CAN FOLLOW ONE-MICROGRAM TEST DOSE. /PENICILLINS/|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 CARBENICILLIN (48 total), please visit the HSDB record page.

Anabactyl

ESSENTIALLY 100% AS AN ANTIBIOTIC (AS DISODIUM SALT)

BRL-2064, CARBENICILLIN DISODIUM, CP-15-639-2, ANABACTYL, CARBAPEN, CARBECIN, GEOPEN, HYOPER, MICROCILLIN, PYOCIANIL, PYOPEN /DISODIUM/

THIS DRUG IS PENICILLINASE-SUSCEPTIBLE DERIVATIVE OF 6-AMINOPENICILLANIC ACID.|PREPN OF DISODIUM SALT: BELG PATENT 646,991, CORRRESPONDING TO BRAIN, NAYLER, US PATENT 3,282,926 (1964 & 1966 TO BEECHAM).

CHROMATOGRAPHY OF PENICILLINS IN SORBENT THIN LAYERS.|CHARACTERIZATIION OF SOME PENICILLINS & CEPHALOSPORINS BY PYROLYSIS MASS SPECTROMETRY.

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