Penicilina Fenoximetil Mintlab

Components:
Phenoxymethylpenicillin
Method of action:
Bactericidal, Bacteriostatic
Available in countries
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Medically reviewed by Oliinyk Elizabeth Ivanovna, Pharmacy Last updated on 2019.07.16

Name of the medicinal product

Penicilina Fenoximetil Mintlab

Qualitative and quantitative composition

Phenoxymethylpenicillin

Therapeutic indications

The information provided in Therapeutic indications of Penicilina Fenoximetil Mintlab is based on data of another medicine with exactly the same composition as the Penicilina Fenoximetil Mintlab of the medicine (Phenoxymethylpenicillin). Be careful and be sure to specify the information on the section Therapeutic indications in the instructions to the drug Penicilina Fenoximetil Mintlab directly from the package or from the pharmacist at the pharmacy.
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Penicilina Fenoximetil Mintlab and Penicilina Fenoximetil Mintlab potassium are indicated in the treatment of mild to moderately severe infections associated with micro-organisms whose susceptibility to penicillin is within the range of serum levels attained with the dosage form.

Penicilina Fenoximetil Mintlab is indicated for prophylaxis against:

- Pneumococcol infection (e.g. in asplenia and in patients with sickle cell disease).

Note: Severe empyema, bacteraemia, pericarditis, meningitis and arthritis should not be treated with Penicillin V during the acute phase.

Consideration should be given to official guidance on the appropriate use of antibacterial agents.

The following infections will usually respond to adequate doses:

Streptococcal infections (without bacteraemia): Mild to moderate infections of the upper respiratory tract, scarlet fever and mild erysipelas.

Pneumococcal infections: mild to moderately severe infections of the respiratory tract. Staphylococcal infections sensitive to penicillin: mild infections of the skin and soft tissues. Fusospirochaetosis (Vincent's gingivitis and pharyngitis): mild to moderately severe infections of the oropharynx usually respond to therapy with oral penicillin.

Prophylactic use: prophylaxis with oral penicillin has proved effective in preventing recurrence of rheumatic fever and chorea.

Patients with a past history of rheumatic fever receiving continuous prophylaxis may harbour penicillin-resistant organisms. In these patients, the use of another prophylactic agent should be considered.

Note: oral penicillin should not be used as adjunctive prophylaxis for genito - urinary instrumentation or surgery, lower intestinal tract surgery, sigmoidoscopy and child birth.

Dosage (Posology) and method of administration

The information provided in Dosage (Posology) and method of administration of Penicilina Fenoximetil Mintlab is based on data of another medicine with exactly the same composition as the Penicilina Fenoximetil Mintlab of the medicine (Phenoxymethylpenicillin). Be careful and be sure to specify the information on the section Dosage (Posology) and method of administration in the instructions to the drug Penicilina Fenoximetil Mintlab directly from the package or from the pharmacist at the pharmacy.
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Posology

Penicilina Fenoximetil Mintlab 125 mg/5ml Oral Solution should be given in divided doses (4 times a day) and preferably half an hour before meals or at least three hours after a meal.

The following dosage schedule applies to Penicilina Fenoximetil Mintlab 125 mg/5ml Oral Solution:

Adults (including the elderly) and children over 12 years:

Prophylactic use

250mg - 500mg every six hours

 

250mg twice daily is recommended for long term prophylaxis of rheumatic fever

Children:

Infants (up to 1 year)

1-5 years

6-12 years

 

62.5mg every six hours

125mg every six hours

250mg every six hours

Method of Administration

<

For oral administration only

Patients with Renal Impairment

Reduce dose if renal function is markedly impaired.

To avoid late complications (rheumatic fever), infections with β-haemolytic streptococci should be treated for 10 days.

Contraindications

The information provided in Contraindications of Penicilina Fenoximetil Mintlab is based on data of another medicine with exactly the same composition as the Penicilina Fenoximetil Mintlab of the medicine (Phenoxymethylpenicillin). Be careful and be sure to specify the information on the section Contraindications in the instructions to the drug Penicilina Fenoximetil Mintlab directly from the package or from the pharmacist at the pharmacy.
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Penicilina Fenoximetil Mintlab is contraindicated in patients known to be hypersensitive to Penicillin and should be used with caution in patients with known histories of allergy.

Special warnings and precautions for use

The information provided in Special warnings and precautions for use of Penicilina Fenoximetil Mintlab is based on data of another medicine with exactly the same composition as the Penicilina Fenoximetil Mintlab of the medicine (Phenoxymethylpenicillin). Be careful and be sure to specify the information on the section Special warnings and precautions for use in the instructions to the drug Penicilina Fenoximetil Mintlab directly from the package or from the pharmacist at the pharmacy.
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Penicillin should be used with caution in individuals with histories of significant allergies and/or asthma.

All degrees of hypersensitivity, including fatal anaphylaxis, have been observed with oral penicillin. These reactions are more likely to occur in individuals with a history of sensitivity to penicillins, cephalosporins and other allergens. Enquiries should be made for such a history before therapy is begun. If any allergic reaction occurs, the drug should be discontinued and the patient treated with the usual agents (e.g. adrenaline and other pressor amines, antihistamines and corticosteroids).

Oral therapy should not be relied upon for patients with severe illness, or with nausea, vomiting, gastric dilation, achalasia or intestinal hypermotility. Occasionally patients do not absorb therapeutic amounts of orally administered penicillin.

Administer with caution in the presence of markedly impaired renal function, as safe dosage may be lower than the usually recommended doses.

Streptococcal infections should be treated for a minimum of 10 days, and post therapy cultures should be performed to confirm the eradication of the organisms.

Prolonged use of antibiotics may promote the over growth of non-susceptible organisms, including fungi. If super infection occurs, appropriate measures should be taken.

Sucrose:

This product contains sucrose. Patients with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency should not take this medicine. Contains 2.80g of sucrose per 5ml dose. To be taken into consideration by patients with diabetes mellitus. May be harmful to the teeth.

E110 & E124:

This product contains Ponceau 4R (E124) and Sunset yellow (E110) which may cause allergic reactions.

Effects on ability to drive and use machines

The information provided in Effects on ability to drive and use machines of Penicilina Fenoximetil Mintlab is based on data of another medicine with exactly the same composition as the Penicilina Fenoximetil Mintlab of the medicine (Phenoxymethylpenicillin). Be careful and be sure to specify the information on the section Effects on ability to drive and use machines in the instructions to the drug Penicilina Fenoximetil Mintlab directly from the package or from the pharmacist at the pharmacy.
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None known

Undesirable effects

The information provided in Undesirable effects of Penicilina Fenoximetil Mintlab is based on data of another medicine with exactly the same composition as the Penicilina Fenoximetil Mintlab of the medicine (Phenoxymethylpenicillin). Be careful and be sure to specify the information on the section Undesirable effects in the instructions to the drug Penicilina Fenoximetil Mintlab directly from the package or from the pharmacist at the pharmacy.
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The most common reactions to oral penicillin are gastrointestinal effects and hypersensitivity reactions. Although hypersensitivity reactions have been reported much less frequently after oral than after parenteral therapy, it should be remembered that all forms of hypersensitivity, including fatal anaphylaxis have been observed with oral penicillin.

Blood and lymphatic disorders:

There have been very rare (<1/10,000) reports of changes in blood counts, including, thrombocytopenia, neutropenia, leucopenia, eosinophilia and haemolytic anaemia. Coagulation disorders (including prolongation of bleeding time and defective platelet function) have also been reported.

Gastrointestinal disorders:

Nausea, vomiting, abdominal pain, diarrhoea are common (>1/100 to <1/10). Sore mouth and black hairy tongue (discolouration of tongue) has been reported rarely (>1/10,000 to <1/1,000).

Hepatobiliary diorders:

Hepatitis and cholestatic jaundice have been reported very rarely (<1/10,000).

Immune disorders:

Allergic reactions may commonly occur (>1/100 to <1/10) and typically manifest as skin reactions (See Skin and subcutaneous disorders). Severe allergic reactions causing angioedema, laryngeal oedema and anaphylaxis have been reported rarely (>1/10,000 to <1/1,000).

Serum sickness-like reactions are characterised by fever, chills, arthralgia and oedema.

Infections and infestations:

Pseudomembranous colitis has rarely (>1/10,000 to <1/1,000) been reported.

Nervous system disorders:

Central nervous system toxicity including convulsions has been reported (especially with high doses or in severe renal impairment); paraesthesia may occur with prolonged use.

Neuropathy is an infrequent reaction and is usually associated with high doses of parenteral penicillin.

Renal and urinary disorders:

Interstitial nephritis has occurred in very rare cases (<1/10,000).

Nephropathy is an infrequent reaction and is usually associated with high doses of parenteral penicillin.

Skin and subcutaneous disorders

Urticarial, erythematous or mobilliform rash and pruritus occur commonly (>1/100 to <1/10), while exfoliative dermatitis occurs rarely (>1/10,000 to <1/1,000).

Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the yellow card scheme at www.mhra.gov.uk/yellowcard.

Overdose

The information provided in Overdose of Penicilina Fenoximetil Mintlab is based on data of another medicine with exactly the same composition as the Penicilina Fenoximetil Mintlab of the medicine (Phenoxymethylpenicillin). Be careful and be sure to specify the information on the section Overdose in the instructions to the drug Penicilina Fenoximetil Mintlab directly from the package or from the pharmacist at the pharmacy.
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Symptoms: A large oral overdose of penicillin may cause nausea, vomiting, stomach pain, diarrhoea, and rarely, major motor seizures. If other symptoms are present, consider the possibility of an allergic reaction. Hyperkalaemia may result from overdosage, particularly for patients with renal insufficiency.

Management: No specific antidote is known. Symptomatic and supportive therapy is recommended. Activated charcoal with a cathartic, such as sorbitol may hasten drug elimination. Penicillin may be removed by haemodialysis.

Pharmacodynamic properties

The information provided in Pharmacodynamic properties of Penicilina Fenoximetil Mintlab is based on data of another medicine with exactly the same composition as the Penicilina Fenoximetil Mintlab of the medicine (Phenoxymethylpenicillin). Be careful and be sure to specify the information on the section Pharmacodynamic properties in the instructions to the drug Penicilina Fenoximetil Mintlab directly from the package or from the pharmacist at the pharmacy.
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ATC code: J01CE02

Penicilina Fenoximetil Mintlab is a beta-lactamase sensitive natural penicillin.

Mechanism of Action:

Penicilina Fenoximetil Mintlab acts through interference with the final stage of synthesis of the bacterial cell wall. The action depends on its ability to bind certain membrane-bound proteins, (penicillin-binding proteins or PBPs) that are located beneath the cell wall. These proteins are involved in maintaining cell wall structure, in cell wall synthesis and in cell division, and appear to possess transpeptidase and carboxypeptidase activity.

PK/PD relationship

The time above the minimum inhibitory concentration (T>MIC) is considered to be the major determinant of efficacy for Penicilina Fenoximetil Mintlab.

Mechanism(s) of Resistance:

Penicilina Fenoximetil Mintlab is inhibited by penicillinase and other beta-lactamases that are produced by certain micro-organisms. The incidence of beta-lactamase producing organisms is increasing.

Mechanisms of resistance

The two main mechanisms of resistance to Penicilina Fenoximetil Mintlab are:

- Inactivation by bacterial penicillinases and other beta-lactamases

- Alteration of PBPs, which reduce the affinity of the antibacterial agent for the target.

Impermeability of bacteria or efflux pump mechanisms may cause or contribute to bacterial resistance.

EUCAST clinical MIC breakpoints to separate susceptible (S) pathogens from resistant (R) pathogens (version 1.0 22.11.210) are:

The susceptibility of streptococci Groups A, C and G and S. pneumoniae to Penicilina Fenoximetil Mintlab is inferred from the susceptibility to benzylpenicillin.

EUCAST Species-related breakpoints (Susceptible≦/Resistant>) Units: mg/L

Staphylococcus

≤0.12/>0.12

Streptococcus A, C, G

≤0.25/>0.25

S. pneumoniae

≤ 0.06/>2

Staphylococci: Most staphylococci are penicillinase-producers. Penicillinase-producing strains are resistant. The benzylpenicillin breakpoint (shown) will mostly, but not unequivocally, separate beta-lactamase producers from non-producers.

Streptococcus pneumoniae: For Penicilina Fenoximetil Mintlab, report S. pneumoniae with benzylpenicillin MICs above 0.06 mg/L resistant.

The prevalence of acquired resistance may vary geographically and with time for selected species and local information on resistance is desirable, particularly when treating severe infections. Expert advice should be sought as necessary when the local prevalence of resistance is such that the utility of the agent in at least some types of infection is questionable.

Commonly susceptible species

Streptococcus A, C, G

Species for which acquired resistance may be a problem

Staphylococcus aureus

Streptococcus pneumoniae

Staphylococcus epidermidis

Pharmacokinetic properties

The information provided in Pharmacokinetic properties of Penicilina Fenoximetil Mintlab is based on data of another medicine with exactly the same composition as the Penicilina Fenoximetil Mintlab of the medicine (Phenoxymethylpenicillin). Be careful and be sure to specify the information on the section Pharmacokinetic properties in the instructions to the drug Penicilina Fenoximetil Mintlab directly from the package or from the pharmacist at the pharmacy.
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Absorption: Rapidly but incompletely absorbed after oral administration (about 60% of an oral dose is absorbed). Calcium and potassium salts are better absorbed than the free acid. Absorption appears to be reduced in patients with coeliac disease. Absorption appears to be more rapid in fasting than non-fasting subjects.

Blood concentration: after an oral dose of 125mg, peak serum concentrations of 200 to 700ng/ml are attained in 2 hours. After an oral dose of 500mg, peak serum concentrations reach 3 to 5micrograms/ml in 30 to 60 minutes.

Half-life: Biological half-life is about 30 minutes, increased to about 4 hours in severe renal impairment.

Distribution: Widely distributed throughout the body and enters pleural and ascitic fluids and also in cerebrospinal fluid when the meninges are inflamed; Penicilina Fenoximetil Mintlab crosses the placenta and is secreted in the milk; (protein binding 50 to 80% bound plasma proteins).

Metabolic reactions: Hydroxylation may occur

Excretion: 20% to 35% of an oral dose is excreted in the urine in 24 hours

Preclinical safety data

The information provided in Preclinical safety data of Penicilina Fenoximetil Mintlab is based on data of another medicine with exactly the same composition as the Penicilina Fenoximetil Mintlab of the medicine (Phenoxymethylpenicillin). Be careful and be sure to specify the information on the section Preclinical safety data in the instructions to the drug Penicilina Fenoximetil Mintlab directly from the package or from the pharmacist at the pharmacy.
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Not applicable.

Incompatibilities

The information provided in Incompatibilities of Penicilina Fenoximetil Mintlab is based on data of another medicine with exactly the same composition as the Penicilina Fenoximetil Mintlab of the medicine (Phenoxymethylpenicillin). Be careful and be sure to specify the information on the section Incompatibilities in the instructions to the drug Penicilina Fenoximetil Mintlab directly from the package or from the pharmacist at the pharmacy.
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None known.

Special precautions for disposal and other handling

The information provided in Special precautions for disposal and other handling of Penicilina Fenoximetil Mintlab is based on data of another medicine with exactly the same composition as the Penicilina Fenoximetil Mintlab of the medicine (Phenoxymethylpenicillin). Be careful and be sure to specify the information on the section Special precautions for disposal and other handling in the instructions to the drug Penicilina Fenoximetil Mintlab directly from the package or from the pharmacist at the pharmacy.
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To reconstitute: Loosen powder, add 63ml water and shake well.

No special requirements for disposal.

Any unused medicinal product or waste material should be disposed of in accordance with local requirements.