Indications for PCE:
Treatment of susceptible infections including upper and lower respiratory, skin and skin structure, genitourinary, Legionnaires' disease, pertussis, listeriosis. Prophylaxis for rheumatic fever attacks in penicillin-allergic patients.
Give preferably 2hrs before meals. Usual dose: 333mg every 8hrs or 500mg every 12hrs; max 4g/day (1g/day for twice daily dosing). Legionnaires: 1–4g daily in divided doses. Prophylaxis: 250mg twice daily. See full labeling.
Give preferably 2hrs before meals. Usual dose: 30–50mg/kg/day in divided doses; may double dose in severe infections. Max 4g/day. See full labeling.
Concomitant terfenadine, astemizole, cisapride, pimozide, ergotamine, dihydroergotamine, statins (eg, lovastatin, simvastatin).
Avoid in proarrhythmic conditions (eg, uncorrected hypokalemia or hypomagnesemia, clinically significant bradycardia); risk of QT prolongation. Myasthenia gravis. Hepatic impairment. Elderly. Infants: risk of infantile hypertrophic pyloric stenosis; monitor for vomiting or irritability with feeding. Pregnancy (Cat.B). Nursing mothers.
See Contraindications. May potentiate theophylline (reduce dose of theophylline), digoxin, oral anticoagulants, hexobarbital, phenytoin, valproate. May potentiate CYP3A substrates (eg, triazolam, midazolam, statins [rhabdomyolysis], sildenafil [reduce dose of sildenafil], colchicine [reduce starting dose of colchicine, max dose should be lowered; monitor], verapamil, amlodipine, diltiazem, carbamazepine, cyclosporine, tacrolimus, alfentanil, disopyramide, bromocriptine, rifabutin, quinidine, methylprednisolone, cilostazol, vinblastine); consider dose adjustments and monitor. May be antagonized by theophylline. Hypotension, bradyarrhythmias, lactic acidosis with verapamil. QT prolongation with concomitant Class 1A (quinidine, procainamide) or Class III (dofetilide, amiodarone, sotalol) antiarrhythmics; avoid. May interfere with fluorometric detection of urinary catecholamines.
GI upset, abdominal pain, anorexia, hepatic dysfunction; QT prolongation, C. difficile-associated diarrhea, superinfection (discontinue if occurs).
Tabs 333mg—60; 500mg—100