dicloxacillin (Rx)

Brand and Other Names:
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

capsule

  • 250mg
  • 500mg

Infections

Indicated for Staphylococcus aureus infections

125-500 mg PO q6hr

Take on empty stomach

Renal Impairment

Not studied; total dosage reduction should be considered

Hepatic Impairment

Not studied

Dosage Forms & Strengths

capsule

  • 250mg
  • 500mg

Infections

Indicated for Staphylococcus aureus infections

<40 kg: 12.5-25 mg/kg/day PO divided q6hr  

Severe infection: 50-100 mg/kg/day PO divided q6hr

≥40 kg: 125-500 mg PO q6hr

Take on empty stomach

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Interactions

Interaction Checker

and dicloxacillin

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            Contraindicated (0)

              Serious - Use Alternative (9)

              • BCG vaccine live

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

              • cholera vaccine

                dicloxacillin, 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 dicloxacillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug.

              • doxycycline

                doxycycline decreases effects of dicloxacillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug.

              • minocycline

                minocycline decreases effects of dicloxacillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug.

              • omadacycline

                omadacycline decreases effects of dicloxacillin 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 dicloxacillin 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 dicloxacillin by pharmacodynamic antagonism. Avoid or Use Alternate Drug.

              • typhoid vaccine live

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

              Monitor Closely (29)

              • aspirin

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

              • aspirin rectal

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

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

              • aspirin/citric acid/sodium bicarbonate

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

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

              • axitinib

                dicloxacillin decreases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • bendroflumethiazide

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

              • chlorothiazide

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

              • choline magnesium trisalicylate

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

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

              • dienogest/estradiol valerate

                dicloxacillin will decrease the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Advise women to use alternative method of contraception or back-up method when moderate or weak enzyme inducer is used with combination contraceptives. Back-up contraception should be continued for 28 days after discontinuing medication to ensure contraceptive reliability.

                dicloxacillin will decrease the level or effect of dienogest/estradiol valerate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. An alternate or additional form of birth control may be advisable during concomitant use.

              • ethinylestradiol

                dicloxacillin will decrease the level or effect of ethinylestradiol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • hydrochlorothiazide

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

              • levonorgestrel oral/ethinylestradiol/ferrous bisglycinate

                dicloxacillin will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. Antibiotics may decrease hormonal contraceptive efficacy.

              • mestranol

                dicloxacillin will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • methotrexate

                dicloxacillin increases levels of methotrexate by decreasing renal clearance. Use Caution/Monitor. Increased serum concentrations of methotrexate with concomitant hematologic and gastrointestinal toxicity have been observed with concurrent administration of high or low doses of methotrexate and penicillins.

              • methyclothiazide

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

              • metolazone

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

              • mycophenolate

                dicloxacillin decreases levels of mycophenolate by decreasing metabolism. Use Caution/Monitor. decreases concentrations of active metabolite of mycophenolate possibly by reducing/impairing enterohepatic circulation.

              • parecoxib

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

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

              • phenindione

                dicloxacillin decreases levels of phenindione by increasing metabolism. Use Caution/Monitor.

              • piroxicam

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

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

              • probenecid

                probenecid increases levels of dicloxacillin by decreasing renal clearance. Use Caution/Monitor.

              • salicylates (non-asa)

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

              • salsalate

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

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

              • sodium picosulfate/magnesium oxide/anhydrous citric acid

                dicloxacillin 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.

              • sulfasalazine

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

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

              • tazemetostat

                dicloxacillin will decrease the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • tinidazole

                dicloxacillin will decrease the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • ubrogepant

                dicloxacillin will decrease the level or effect of ubrogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Dose adjustment is recommended with concomitant use of ubrogepant and moderate and weak CYP3A4 inducers. (see Dosage Modifications)

              • warfarin

                dicloxacillin decreases levels of warfarin by increasing metabolism. Use Caution/Monitor.

              • willow bark

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

              Minor (11)

              • azithromycin

                azithromycin decreases effects of dicloxacillin by pharmacodynamic antagonism. Minor/Significance Unknown.

              • aztreonam

                aztreonam, dicloxacillin. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Combination may be used synergistically against Enterobacteriaceae.

              • chloramphenicol

                chloramphenicol decreases effects of dicloxacillin by pharmacodynamic antagonism. Minor/Significance Unknown.

              • clarithromycin

                clarithromycin decreases effects of dicloxacillin by pharmacodynamic antagonism. Minor/Significance Unknown.

              • colestipol

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

              • erythromycin base

                erythromycin base decreases effects of dicloxacillin by pharmacodynamic antagonism. Minor/Significance Unknown.

              • erythromycin ethylsuccinate

                erythromycin ethylsuccinate decreases effects of dicloxacillin by pharmacodynamic antagonism. Minor/Significance Unknown.

              • erythromycin lactobionate

                erythromycin lactobionate decreases effects of dicloxacillin by pharmacodynamic antagonism. Minor/Significance Unknown.

              • erythromycin stearate

                erythromycin stearate decreases effects of dicloxacillin by pharmacodynamic antagonism. Minor/Significance Unknown.

              • nitazoxanide

                nitazoxanide, dicloxacillin. Either increases levels of the other by Mechanism: plasma protein binding competition. Minor/Significance Unknown.

              • pyridoxine (Antidote)

                dicloxacillin will decrease the level or effect of pyridoxine (Antidote) by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

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              Adverse Effects

              1-10%

              Abdominal pain

              Diarrhea

              Nausea

              <1%

              Anemia

              Elevated LFTs

              Fever

              Hypersensitivity

              Nephritis

              Pseudomembranous colitis

              Seizures with extremely high doses &/or renal failure

              Rash (maculopapular to exfoliative)

              Vomiting

              Vaginitis

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              Warnings

              Contraindications

              Hypersensitivity to penicillins, cephalosporins, imipenem

              Initial treatment of severe infections

              Concomitant live bacterial vaccines

              Cautions

              Monitor PT if patient is taking warfarin concurrently

              Prolonged use may result in superinfection

              Elimination of drug in neonates is slow; use caution

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              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.

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              Pharmacology

              Mechanism of Action

              Binds to one or more penicillin binding proteins, which in turn inhibit synthesis of bacterial cell wall synthesis. For treatment of infections caused by penicillinase-producing staphylococci.

              Resistance to this drug results from alterations in penicillin-binding proteins.

              Pharmacokinetics

              Half-Life: 0.6-0.8 hr

              Peak Plasma Time: 0.5-2 hr

              Protein Bound: 96%

              Absorption: 35-76%, decreased by food

              Distribution: widespread, highest in kidneys & liver, CSF low

              Metabolism: hepatic CYP3A4

              Excretion: Urine (56%), feces

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              dicloxacillin oral
              -
              250 mg capsule
              dicloxacillin oral
              -
              500 mg capsule
              dicloxacillin oral
              -
              250 mg capsule
              dicloxacillin oral
              -
              250 mg capsule
              dicloxacillin oral
              -
              500 mg capsule
              dicloxacillin oral
              -
              500 mg capsule
              dicloxacillin oral
              -
              500 mg capsule

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              dicloxacillin oral

              DICLOXACILLIN - ORAL

              (dye-kloks-a-SIL-in)

              COMMON BRAND NAME(S): Dynapen

              USES: Dicloxacillin is used to treat a wide variety of bacterial infections. It is a penicillin-type antibiotic. It works by stopping the growth of bacteria.This antibiotic treats only bacterial infections. It will not work for viral infections (such as common cold, flu). Using any antibiotic when it is not needed can cause it to not work for future infections.

              HOW TO USE: Take this medication by mouth usually 4 times a day (every 6 hours), or as directed by your doctor. Take dicloxacillin on an empty stomach (1 hour before or 2 hours after a meal) with a full glass of water. Drink plenty of fluids while using this medication unless your doctor tells you otherwise.The dosage is based on your medical condition and response to therapy.For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same time(s) every day.Continue to take this medication until the full-prescribed amount is finished even if symptoms disappear after a few days. Stopping the medication too early may allow bacteria to continue to grow, which may result in a relapse of the infection.Inform your doctor if your condition persists or worsens.

              SIDE EFFECTS: Nausea, vomiting, or diarrhea may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.Remember that your doctor has prescribed this medication because he or she 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: dark urine, persistent nausea/vomiting, stomach/abdominal pain, yellowing eyes/skin, easy bruising or bleeding, persistent sore throat or fever.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 vaginal yeast infection (oral or vaginal fungal 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 taking dicloxacillin, tell your doctor or pharmacist if you are allergic to it; or to penicillin or cephalosporin antibiotics; or if you have any other allergies. This product may contain inactive ingredients, 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.Dicloxacillin 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.This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor.Dicloxacillin passes into breast milk. 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.Some of the products that may interact with this drug include: methotrexate, tetracyclines, warfarin.Dicloxacillin may cause false positive results with certain diabetic urine testing products (cupric sulfate-type). This drug may also affect the results of certain lab tests. Make sure laboratory personnel and 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: severe vomiting, persistent diarrhea, unusual change in the amount of urine, or seizures.

              NOTES: Do not share this medication with others.This medication has been prescribed for your current condition only. Do not use it later for another infection unless your doctor tells you to.With prolonged treatment, laboratory and/or medical tests (e.g., kidney and liver function, complete blood counts) should be performed periodically to monitor your progress or check for side effects. Consult the doctor for more details.

              MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. 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 May 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.

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              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.