oxacillin (Rx)

Brand and Other Names:Bactocill
  • Print

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

infusion solution

  • 1g/50mL
  • 2g/50mL

powder for injection

  • 1g
  • 2g
  • 10g

Staphylococcal Infections

Mild to moderate infections: 250-500 mg IV/IM q4-6hr

Severe infections: 1 g IV/IM q4-6hr

Acute/chronic osteomyelitis/staphylococci infections: 1.5-2 g IV q4-6hr

Renal Infection

CrCl < 10 mL/min: May consider adjusting to the lower range of the usually recommended dose depending on severity of infection

Dosage Forms & Strengths

infusion solution

  • 1g/50mL
  • 2g/50mL

powder for injection

  • 1g
  • 2g
  • 10g

Susceptible Staph Infections in Infants & Children

Mild to moderate infections: 100-200 mg/kg/day IV/IM divided q6hr  

Severe infections: 150-200 mg/kg/day IV/IM divided q6hr

Maximum 4g/day for mild to moderate infections

Maximum 12g/day for severe infections

Susceptible Staph Infections in Neonates

(<7 days old, <2 kg) OR (>7 days old, <1.2 kg): 50 mg/kg/day divided q12hr IV/IM  

(<7 days old, >2 kg) OR (>7 days old, 1.2-2 kg): 75 mg/kg/day divided q8hr IV/IM

>7 days old, >2 kg: 100 mg/kg/day divided q6hr IV/IM

Next:

Interactions

Interaction Checker

and oxacillin

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (9)

              • BCG vaccine live

                oxacillin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.

              • cholera vaccine

                oxacillin, cholera vaccine. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid coadministration of cholera vaccine with systemic antibiotics since these agents may be active against the vaccine strain. Do not administer cholera vaccine to patients who have received oral or parenteral antibiotics within 14 days prior to vaccination.

              • demeclocycline

                demeclocycline decreases effects of oxacillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. bacteriostatic agents may inhibit the effects of bactericidal agentsba.

              • doxycycline

                doxycycline decreases effects of oxacillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. bacteriostatic agents may inhibit the effects of bactericidal agents.

              • minocycline

                minocycline decreases effects of oxacillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. bacteriostatic agents may inhibit the effects of bactericidal agents.

              • omadacycline

                omadacycline decreases effects of oxacillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Tetracyclines may interfere with the bactericidal action of penicillins. Monitor for decreased therapeutic effects of penicillins if concomitantly used with a tetracycline.

              • sarecycline

                sarecycline decreases effects of oxacillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Tetracyclines may interfere with the bactericidal action of penicillins. Monitor for decreased therapeutic effects of penicillins if concomitantly used with a tetracycline.

              • tetracycline

                tetracycline decreases effects of oxacillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. bacteriostatic agents may inhibit the effects of bactericidal agents.

              • typhoid vaccine live

                oxacillin decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.

              Monitor Closely (11)

              • aspirin

                oxacillin, aspirin. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

                oxacillin, aspirin. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

              • aspirin rectal

                oxacillin, aspirin rectal. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

                oxacillin, aspirin rectal. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

              • aspirin/citric acid/sodium bicarbonate

                oxacillin, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

                oxacillin, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

              • chloramphenicol

                chloramphenicol decreases effects of oxacillin by pharmacodynamic antagonism. Use Caution/Monitor. Bacteriostatic agents may inhibit the effects of bactericidal agents.

              • choline magnesium trisalicylate

                oxacillin, choline magnesium trisalicylate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

                oxacillin, choline magnesium trisalicylate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

              • ibuprofen IV

                oxacillin, ibuprofen IV. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

                oxacillin, ibuprofen IV. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

              • rose hips

                oxacillin, rose hips. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

              • salicylates (non-asa)

                oxacillin, salicylates (non-asa). Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

              • salsalate

                oxacillin, salsalate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

              • sodium picosulfate/magnesium oxide/anhydrous citric acid

                oxacillin decreases effects of sodium picosulfate/magnesium oxide/anhydrous citric acid by altering metabolism. Use Caution/Monitor. Coadministration with antibiotics decreases efficacy by altering colonic bacterial flora needed to convert sodium picosulfate to active drug.

              • willow bark

                oxacillin, willow bark. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

              Minor (8)

              • azithromycin

                azithromycin decreases effects of oxacillin by pharmacodynamic antagonism. Minor/Significance Unknown. bacteriostatic antibiotics may interfere with the bactericidal actions of penicillins.

              • clarithromycin

                clarithromycin decreases effects of oxacillin by pharmacodynamic antagonism. Minor/Significance Unknown. bacteriostatic agents may inhibit the effects of bactericidal agents.

              • colestipol

                colestipol decreases levels of oxacillin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • erythromycin base

                erythromycin base decreases effects of oxacillin by pharmacodynamic antagonism. Minor/Significance Unknown. bacteriostatic agents may inhibit the effects of bactericidal agents.

              • erythromycin ethylsuccinate

                erythromycin ethylsuccinate decreases effects of oxacillin by pharmacodynamic antagonism. Minor/Significance Unknown. bacteriostatic agents may inhibit the effects of bactericidal agents.

              • erythromycin lactobionate

                erythromycin lactobionate decreases effects of oxacillin by pharmacodynamic antagonism. Minor/Significance Unknown. bacteriostatic agents may inhibit the effects of bactericidal agents.

              • erythromycin stearate

                erythromycin stearate decreases effects of oxacillin by pharmacodynamic antagonism. Minor/Significance Unknown. bacteriostatic agents may inhibit the effects of bactericidal agents.

              • rifampin

                rifampin decreases levels of oxacillin by increasing metabolism. Minor/Significance Unknown.

              Previous
              Next:

              Adverse Effects

              1-10%

              Diarrhea

              Nausea

              Fever

              Rash

              <1%

              Eosinophilia

              Leukopenia

              Neutropenia

              Thrombocytopenia

              Hepatotoxicity

              Elevated AST

              Acute interstitial nephritis

              Serum sickness-like reaction

              Previous
              Next:

              Warnings

              Contraindications

              Allergy to penicillins, cephalosporins, imipenem

              Solutions containing dextrose may be contraindicated in patients with known allergy to corn or corn products

              Cautions

              Evaluate renal, hepatic, hematologic systems periodically during prolonged treatment

              Monitor neonates for renal impairment

              Monitor organ systems/serum concentrations of drug in neonates

              Prolonged treatment may result in bacterial or fungal superinfection

              Clostridium difficile associated diarrhea (CDAD) must be considered in all patients who present with diarrhea following antibiotic; CDAD has been reported to occur over two months after the administration of antibacterial agents; careful medical history is necessary; if CDAD suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued; appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation should be instituted as indicated

              Previous
              Next:

              Pregnancy & Lactation

              Pregnancy Category: B

              Lactation: excreted in breast milk; use caution

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

              Previous
              Next:

              Pharmacology

              Mechanism of Action

              Bactericidal antibiotic that inhibits cell wall synthesis by binding to one or more of the penicillin binding proteins. Used in the treatment of infections caused by penicillinase-producing staphylococci. May be used to initiate therapy when a staphylococcal infection is suspected.

              Pharmacokinetics

              Half-Life: 23-60 min (adults; prolonged in renal insufficiency); 0.9-1.8 hr (children)

              Peak Plasma Time: 30-60 min

              Protein binding: 94%

              Distribution: Bile, synovial, pleural, peritoneal, pericardial fluids

              Metabolism: Hepatic to active metabolites

              Excretion: Urine and feces

              Previous
              Next:

              Administration

              IV Incompatibilities

              Additive: amikacin(?), cytarabine

              Syringe: caffeine

              Y-site: Na bicarb, verapamil

              Aminoglycosides & tetracyclines, but compatibility depends on several factors (eg, concentrations of the drugs, specific diluents used, resulting pH, temperature)

              IV Compatibilities

              Solution: compatible w/ most common solvents

              Additive: Chloramphenicol Na succinate, dopamine, KCl, verapamil

              Y-site (partial list): Acyclovir, diltiazem, fluconazole, heparin, hydromorphone, MgSO4, meperidine, morphine, KCl, vit B/C, zidovudine

              IV/IM Preparation

              IM Injection

              • For IM injection, reconstitute by adding 5.7 or 11.4 mL of SWI to a vial containing 1 or 2 g of oxacillin, respectively, to provide solutions containing 167 mg of oxacillin per mL (250 mg/1.5 mL)
              • Shake vials well

              IV Injection

              • For direct injection, prepare a solution containing approximately 100 mg/mL by adding 10 or 20 mL SWI, ½NS or NS to vials containing 1 or 2 g of oxacillin, respectively

              Intermittent or Continuous IV Infusion

              • For intermittent IV infusion, reconstitute vials containing 1 or 2 g as for direct IV injection & further dilute with a compatible IV solution to a concentration of 0.5-40 mg/mL
              • Alternatively, reconstitute ADD-Vantage vials containing 1 or 2 g according to the mfr's directions

              IV/IM Administration

              Administer by IM injection or slow IV injection or infusion

              IM: deep into a large muscle (eg, gluteus maximus) & care should be taken to avoid sciatic nerve injury

              IV Injection: slowly over about 10 min

              Intermittent or Continuous IV Infusion: injections should not be used in series connections with other plastic containers: could result in air embolism from residual air being drawn from primary container before administration of fluid from secondary container is complete

              Storage

              Oxacillin powder: store at controlled room temp

              Oxacillin in dextrose injection: store <-20°C

              Previous
              Next:

              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              oxacillin intravenous
              -
              1 gram vial
              oxacillin intravenous
              -
              1 gram vial
              oxacillin injection
              -
              10 gram vial
              oxacillin injection
              -
              10 gram vial
              oxacillin injection
              -
              2 gram vial
              oxacillin injection
              -
              1 gram vial
              oxacillin injection
              -
              10 gram vial
              oxacillin injection
              -
              1 gram vial
              oxacillin injection
              -
              1 gram vial
              oxacillin injection
              -
              2 gram vial
              oxacillin injection
              -
              10 gram vial
              oxacillin injection
              -
              2 gram vial
              oxacillin injection
              -
              10 gram vial
              oxacillin injection
              -
              2 gram vial
              oxacillin injection
              -
              2 gram vial
              oxacillin injection
              -
              1 gram vial
              oxacillin injection
              -
              10 gram vial
              oxacillin injection
              -
              2 gram vial
              oxacillin injection
              -
              1 gram vial

              Copyright © 2010 First DataBank, Inc.

              Previous
              Next:

              Patient Handout

              Select a drug:
              Patient Education
              oxacillin injection

              OXACILLIN - INJECTION

              (OX-a-SIL-in)

              USES: Oxacillin is used to treat a wide variety of bacterial infections. It is a penicillin antibiotic. It works by stopping the growth of bacteria.

              HOW TO USE: This medication is given by injection into a vein or into a muscle as directed by your doctor, usually every 4 to 6 hours. The dosage is based on your medical condition and response to treatment. For children, the dosage is also based on weight.If you are using this medication at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.If you are using the frozen pre-mixed solution, thaw the container at room temperature or in the refrigerator. If the bag is thawed in the refrigerator, let it sit at room temperature for at least 1 hour before using. Do not thaw by putting in warm/hot water or microwaving. After thawing, shake well and squeeze the container to check for leaks. Discard if the container leaks. Do not re-freeze the solution after thawing.For the best effect, use this antibiotic at evenly spaced times. To help you remember, use this medication at the same time(s) every day.Continue to use this medication for the full time prescribed, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection.Tell your doctor if your condition lasts or gets worse.

              SIDE EFFECTS: Pain/redness/swelling at the injection site may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: easy bruising/bleeding, signs of a new infection (such as sore throat that doesn't go away, fever, chills), foamy/pink/bloody/dark urine, signs of kidney problems (such as a change in the amount of urine), swelling hands/ankles/feet, stomach/abdominal pain, nausea/vomiting that doesn't stop, unusual tiredness, yellowing eyes/skin, seizures, uncontrolled movements, mental/mood changes (such as confusion, hallucinations).This medication may rarely cause a severe intestinal condition due to a bacteria called C. difficile. This condition may occur during treatment or weeks to months after treatment has stopped. Tell your doctor right away if you develop: diarrhea that doesn't stop, abdominal or stomach pain/cramping, blood/mucus in your stool.If you have these symptoms, do not use anti-diarrhea or opioid products because they may make symptoms worse.Use of this medication for prolonged or repeated periods may result in oral thrush or a new yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before using oxacillin, tell your doctor or pharmacist if you are allergic to it; or to other antibiotics (such as penicillins, cephalosporins); or if you have any other allergies. This product may contain inactive ingredients (such as corn for products containing dextrose), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease.This medication contains sodium. Consult your doctor or pharmacist if you are on a salt-restricted diet or if you have a condition that could be worsened by an increase in salt intake (such as heart failure, high blood pressure).Oxacillin may cause live bacterial vaccines (such as typhoid vaccine) to not work as well. Do not have any immunizations/vaccinations while using this medication unless your doctor tells you to.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the extra sodium in this medication.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This drug passes into breast milk in small amounts. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.One product that may interact with this drug is: methotrexate.This medication may interfere with certain lab tests (including certain urine protein tests), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: seizures, mental/mood changes (such as agitation, confusion).

              NOTES: Lab and/or medical tests (such as complete blood count, sodium/potassium blood levels, kidney/liver function tests) should be done while you are using this medication. Keep all medical and lab appointments.

              MISSED DOSE: It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Do not double the dose to catch up.

              STORAGE: Consult the product instructions or your pharmacist for storage details. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

              Previous
              Next:

              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
              Additional Offers
              Email to Patient

              From:

              To:

              The recipient will receive more details and instructions to access this offer.

              By clicking send, you acknowledge that you have permission to email the recipient with this information.

              Email Forms to Patient

              From:

              To:

              The recipient will receive more details and instructions to access this offer.

              By clicking send, you acknowledge that you have permission to email the recipient with this information.

              Previous
              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.