Adult Dosing
Streptococcal infections: Mild-to-moderate upper respiratory tract infections, scarlet fever, erysipelas
- 125-250 mg PO tid-qid x 10 days
Pneumococcal infections: Mild to moderately severe respiratory tract infections, including otitis media
- 250-500 mg PO qid, until the patient has been afebrile for at least 2 days
Mild staphylococcal infections of skin and soft tissue
Vincent’s infection of the oropharynx
Prevention of recurrence following rheumatic fever and/or chorea
- 125-250 mg PO bid on a continuing basis
Prophylaxis against bacterial endocarditis in patients w/ congenital heart disease or rheumatic or other acquired valvular heart disease undergoing dental procedures or surgical procedures of the upper respiratory tract
- 2 g PO 1 hr before the procedure followed by 1 g PO 6 hrs later
Notes:- Dosage should be determined based on sensitivity of causative microorganisms and severity of infection, and adjusted to therapeutic response of the patient
Pharyngitis (Acute) [Non-FDA Approved]
- 250 mg PO qid or 500 mg PO bid x 10 days
Peritonsillar abscess [Non-FDA Approved]
Pediatric Dosing
Streptococcal infections: Mild-to-moderate upper respiratory tract infections, scarlet fever, erysipelas
- Children
12 yrs: 125-250 mg PO tid-qid x 10 days
Pneumococcal infections: Mild to moderately severe respiratory tract infections, including otitis media
- Children 12 yrs: 250-500 mg PO qid, until the patient has been afebrile for at least 2 days
Mild staphylococcal infections of skin and soft tissue
- Children 12 yrs: 250-500 PO tid-qid
Vincent’s infection of the oropharynx
- Children 12 yrs: 250-500 mg PO tid-qid
Prevention of recurrence following rheumatic fever and/or chorea
- Children 12 yrs: 125-250 mg PO bid on a continuing basis
Prophylaxis against bacterial endocarditis in patients w/ congenital heart disease or rheumatic or other acquired valvular heart disease undergoing dental procedures or surgical procedures of the upper respiratory tract
- Children <60 lbs: 1 g PO 1 hr before the procedure followed by 500 mg PO 6 hrs later
- Children >60 lbs: 2 g PO 1 hr before the procedure followed by 1 g PO 6 hrs later
Notes:- Dosage should be determined based on sensitivity of causative microorganisms and severity of infection, and adjusted to therapeutic response of the patient
- Recommended daily dose for treatment of infections in children >1 month of age is 15-62.5 mg/kg qd given in 3-6 divided doses
Pharyngitis (Acute) [Non-FDA Approved]
- 250 mg bid-tid PO x 10 days
Peritonsillar abscess [Non-FDA Approved]
- Children
12 yrs: 15 mg/kg PO bid x 10 days - Children 12 yrs: 500mg PO bid x 10 days
[Outline]
See Supplemental Patient Information
- Serious and occasionally fatal hypersensitivity or anaphylactic reactions have been reported in patients on penicillin therapy that are more likely to occur in individuals with a hx of penicillin hypersensitivity and/or a hx of sensitivity to multiple allergens. Cases of severe reactions have been reported in patients with a hx of penicillin hypersensitivity when treated with cephalosporins
- Carefully inquire regarding previous hypersensitivity reactions to penicillins, cephalosporins, or other allergens prior to initiating penicillin therapy. Discontinue therapy on occurrence of any allergic reactions and initiate appropriate medical therapy. Manage serious anaphylactic reactions using immediate treatment with epinephrine, oxygen, intravenous steroids, and airway management, including intubation, as indicated
- Therapy may cause Clostridium difficile associated diarrhea (CDAD) that may range from mild diarrhea to fatal colitis; may occur during therapy or >2 months after therapy discontinuation. Consider this diagnosis in patients presenting with diarrhea following administration of antibacterial agents
- Consider discontinuing treatment if CDAD is suspected or confirmed; provide fluid and electrolyte management, protein supplementation along with antibiotics for C. difficile, and consider surgical evaluation as clinically needed
- Treatment with antibacterial agents alters the normal flora of the colon and may permit overgrowth of clostridium. C. difficile produces toxins A and B which contribute to CDAD. Hypertoxin producing strains cause increased morbidity and mortality since these infections can be refractory to antibiotic therapy and may require colectomy
- Prolonged antibiotic use may result in overgrowth of nonsusceptible organisms, including fungi; monitor continuously. Discontinue therapy on occurrence of superinfections due to bacteria or fungi and institute appropriate measures
- To reduce the development of drug-resistant bacteria, use therapy only to treat infections proven or strongly suspected to be caused by susceptible bacteria. Obtain susceptibility tests before starting therapy
- In streptococcal infections, therapy should be sufficient to eliminate the organism (at least 10 days); otherwise the sequelae of streptococcal disease may occur. Perform cultures following completion of therapy to determine whether streptococci have been eradicated
- Oral route of administration is unreliable in patients with severe illness, or with nausea, vomiting, cardiospasm, gastric dilatation, or intestinal hypermotility
Caution: Use cautiously in
- Renal impairment
- Seizure disorder
- History of recent antibiotic-associated colitis
- Non-anaphylactic hypersensitivity to beta-lactams
- History of significant allergies and/or asthma
Supplemental Patient Information
- Advise patients to promptly report their physician if they develop watery and bloody stools during therapy or even as late as 2 or more months after therapy discontinuation
Pregnancy Category:B
Breastfeeding: Use of penicillin v is acceptable during breastfeeding. Single maternal doses of 1320 mg produce low levels in milk that are not expected to cause adverse effects in breastfed infants. Disruption of the infant's gastrointestinal flora, resulting in diarrhea or thrush, has been reported occasionally but has not been adequately evaluated. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 6 Sept 2011). Manufacturer advises caution.
US Trade Name(s)
US Availability
penicillin v potassium (generic)
- TABS: 250, 500 mg
- SOLN: 125 mg/5 mL
- SOLN: 250 mg/5 mL
Canadian Trade Name(s)
- APO PEN VK
- NOVO-PEN VK
- NU-PEN-VK
Canadian Availability
penicillin v potassium (generic)
APO PEN VK
- TABS: 500000 units
- SOLN: 200000 units/5 mL
- SOLN: 500000 units/5 mL
NOVO-PEN VK
- TABS: 500000 units
- SOLN: 500000 units/5 mL
NU-PEN-VK
UK Trade Name(s)
UK Availability
phenoxymethylpenicillin potassium (generic)
- SOLN: 125 mg/5 mL
- SOLN: 250 mg/5 mL
- SUSP: 125 mg/5 mL
- SUSP: 250 mg/5 mL
Penicillin VK
Australian Trade Name(s)
- Abbocillin V
- Abbocillin VK
- Cilicaine VK
- Cilopen VK
- LPV
Australian Availability
Abbocillin V
Abbocillin VK
Cilicaine VK, Cilopen VK, LPV
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- Penicillin V Potassium 250 MG TABS [Bottle] (SANDOZ)
30 mg = $13.99
60 mg = $16.98 - Penicillin V Potassium 500 MG TABS [Bottle] (TEVA PHARMACEUTICALS USA)
30 mg = $25.99
90 mg = $55.97 - Penicillin V Potassium 125 MG/5ML SOLR [Bottle] (TEVA PHARMACEUTICALS USA)
200 5ml = $15.99
400 5ml = $22.97 - Penicillin V Potassium 250 MG/5ML SOLR [Bottle] (TEVA PHARMACEUTICALS USA)
100 5ml = $14.99
200 5ml = $19.97
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.