Alexid 200 mg (Tablet)

Indications

• Treatment of infections caused by mecillinam-sensitive organisms
• Acute cystitis
• Complicated urinary tract infections
• Salmonellosis
• Shigellosis
• Enteropathic E. coli diarrhoea
• Gram-negative septicaemia
• Billiary infections

Pharmacology

• Belongs to a new class of penicillin-the amdinopenicillin
• Prodrug formulation of mecillinam
• Bactericidal
• Interferes with bacterial cell wall synthesis
• Very active against Enterobacteriaceae
• Poor activity against Gram-positive organisms
• Poor activity against Pseudomonas aeruginosa
• Practically no activity against Enterococcus faecalis

Dosage

• Usual dose is 1-2 tablets 3 times daily
• For acute uncomplicated cystitis: initially 400 mg then 200 mg every 8 hours for 3 days
• For chronic or recurrent bacteriurea: 400 mg every 6-8 hours
• For salmonellosis (including enteric fever): 1.2-2.4 gm daily for 14 days
• Prophylactic treatment of recurrent urinary tract infections: 1 tablet every evening
• Dosage for children weighing less than 20 kg
• Dosage for shigellosis in children
• Dosage for UTI in children
• Dosage for salmonellosis in children

Administration

• Tablet should be taken with at least 50-100 ml fluid
• Bioavailability is practically unaffected by simultaneous food intake
• Best taken with or immediately after a meal

Contraindications

• No reports of allergy to Pivmecillinam among patients with a known history of hypersensitivity to penicillins and cephalosporins
• Exclusion of patients with known hypersensitivity to penicillins and cephalosporins from treatment

Side Effects

• Generally well tolerated even by patients with reduced kidney function
• Possible upper gastrointestinal disturbances
• Skin rashes reported in some cases
• No evidence of hepato-, nephro-, or ototoxicity
• Possible occurrence of anaphylaxis

Pregnancy & Lactation

• Use of pivmecillinam in pregnancy should be avoided
• Mecillinam not excreted into the milk of lactating mother

Precautions & Warnings

• Raised blood levels of mecillinam may occur if repeated doses are given with impaired renal function

Use in Special Populations

• Dosing adjustments based on renal function
• Avoid use in infants under 3 months of age

Overdose Effects

• Excessive doses likely to cause nausea, vomiting, and gastritis
• Treatment restricted to symptomatic and supportive measures
• Haemodialysis can reduce blood levels if necessary

Therapeutic Class

• Mecillinams

Storage Conditions

• Store at a cool and dry place
• Protect from light and moisture

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