Penicillin V potassium tablets and penicillin V potassium for oral solution are indicated in the treatment of mild to moderately severe infections due to penicillin G-sensitive microorganisms. Therapy should be guided by bacteriological studies (including sensitivity tests) and by clinical response.

Severe pneumonia, empyema, bacteremia, pericarditis, meningitis, and arthritis should not be treated with penicillin V during the acute stage. Indicated surgical procedures should be performed.

The following infections will usually respond to adequate dosage of penicillin V:

Streptococcal Infections (without bacteremia):

• Mild-to-moderate infections of the upper respiratory tract, scarlet fever, and mild erysipelas.

Streptococci in groups A, C, G, H, L, and M are very sensitive to penicillin. Other groups, including group D (enterococcus), are resistant.

Pneumococcal Infections:

• Mild to moderately severe infections of the respiratory tract.

Staphylococcal Infections:

• Penicillin G-sensitive. Mild infections of the skin and soft tissues.

Reports indicate an increasing number of strains of staphylococci resistant to penicillin G, emphasizing the need for culture and sensitivity studies in treating suspected staphylococcal infections.

Fusospirochetosis (Vincent’s gingivitis and pharyngitis):

• Mild to moderately severe infections of the oropharynx usually respond to therapy with oral penicillin.

Necessary dental care should be accomplished in infections involving the gum tissue.

Medical Conditions in Which Oral Penicillin Therapy is Indicated as Prophylaxis:

• For the prevention of recurrence following rheumatic fever and/or chorea: Prophylaxis with oral penicillin on a continuing basis has proven effective in preventing recurrence of these conditions.

Oral penicillin should not be used in those patients at particularly high risk for endocarditis (e.g., those with prosthetic heart valves or surgically constructed systemic pulmonary shunts).

Penicillin V should not be used as adjunctive prophylaxis for genitourinary instrumentation or surgery, lower-intestinal tract surgery, sigmoidoscopy, and childbirth. Since it may happen that alpha hemolytic streptococci relatively resistant to penicillin may be found when patients are receiving continuous oral penicillin for secondary prevention of rheumatic fever, prophylactic agents other than penicillin may be chosen for these patients and prescribed in addition to their continuous rheumatic fever prophylactic regimen.

Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients on penicillin therapy. These reactions are more likely to occur in individuals with a history of penicillin hypersensitivity and/or a history of sensitivity to multiple allergens.

Penicillin should be used with caution in individuals with histories of significant allergies and/or asthma.

Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including penicillin V potassium tablets and penicillin V potassium for oral solution, and may range in severity from mild diarrhea to fatal colitis.

The most common reactions to oral penicillin are nausea, vomiting, epigastric distress, diarrhea, and black hairy tongue. The hypersensitivity reactions reported are skin eruptions (maculopapular to exfoliative dermatitis), urticaria and other serum-sickness-like reactions, laryngeal edema, and anaphylaxis.

Fever and eosinophilia may frequently be the only reaction observed. Hemolytic anemia, leukopenia, thrombocytopenia, neuropathy, and nephropathy are infrequent reactions and usually associated with high doses of parenteral penicillin.

While taking penicillin, birth control medicines that contain estrogen might not be effective. Use a second birth control method for at least one (1) month after taking penicillin VK.

GoToSource

• Prophylactic treatment of sickle cell anemia in children. GoToSource

• Prophylaxis in neutropenic patients with hematological malignancies. GoToSource

• Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. GoToSource

Drug reaction with eosinophilia and systemic symptoms (potentially life-threatening drug reaction). GoToSource

Anaphylactic reaction (life-threatening allergic reaction). GoToSource 

Hives. GoToSource

Hoigne syndrome. GoToSource

Acute segmental hemorrhagic penicillin-associated colitis. GoToSource

Liver injury and cholestatic hepatitis. GoToSource

Seizures. GoToSource

Clostridium difficile-associated diarrhea. GoToSource

Black, “hairy” tongue and hypokalemia (low potassium level). GoToSource

Thrombocytopenia (deficiency of platelets in the blood) and hemolytic anemia (red blood cells are destroyed faster than they can be made). GoToSource

Serum sickness (hypersensitivity reaction). GoToSource

Encephalopathy (disorder or disease of the brain), behavioural changes and myoclonus (involuntary muscle jerk). GoToSource

No major injury lawsuits reported.