Oxacillin 10gm Inj, 1 Vial
It is used to treat bacterial infections.
Drug Class
Antibiotic
Pharmacologic Class
Beta-lactam antibiotic; Penicillinase-resistant penicillin
Pregnancy Category
Category B
FDA Approved
Sep 1961
DEA Schedule
Not Controlled
Overview
What is this medicine?
Oxacillin is an antibiotic medication given by injection into a vein. It is used to treat serious bacterial infections, especially those caused by Staphylococcus bacteria that are resistant to other penicillins. It works by killing the bacteria that cause the infection.
How to Use This Medicine
Taking Your Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided to you. It is essential to follow the instructions carefully. This medication can be administered in two ways: as an injection into a muscle or as an infusion into a vein over a period of time. In some cases, it may also be given as a direct injection into a vein.
Storing and Disposing of Your Medication
If you need to store this medication at home, consult with your doctor, nurse, or pharmacist to determine the best storage method.
Missing a Dose
If you miss a dose, contact your doctor to find out what steps to take next.
To use this medication correctly, follow your doctor's instructions and read all the information provided to you. It is essential to follow the instructions carefully. This medication can be administered in two ways: as an injection into a muscle or as an infusion into a vein over a period of time. In some cases, it may also be given as a direct injection into a vein.
Storing and Disposing of Your Medication
If you need to store this medication at home, consult with your doctor, nurse, or pharmacist to determine the best storage method.
Missing a Dose
If you miss a dose, contact your doctor to find out what steps to take next.
Lifestyle & Tips
- Complete the full course of treatment as prescribed, even if you start feeling better, to prevent the infection from returning and to reduce the risk of antibiotic resistance.
- Stay well-hydrated unless otherwise instructed by your doctor.
- Report any new or worsening symptoms to your healthcare provider immediately.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
250 mg to 2 g IV every 4-6 hours
Dose Range:
250 - 2000 mg
Condition-Specific Dosing:
mildToModerateInfections:
250-500 mg IV every 4-6 hours
severeInfections:
1-2 g IV every 4-6 hours
endocarditis:
2 g IV every 4 hours
Pediatric Dosing
Neonatal:
25-50 mg/kg/day IV divided every 6-12 hours (dose varies by age and weight)
Infant:
100-200 mg/kg/day IV divided every 4-6 hours
Child:
100-200 mg/kg/day IV divided every 4-6 hours (max 12 g/day)
Adolescent:
100-200 mg/kg/day IV divided every 4-6 hours (max 12 g/day)
Dose Adjustments
Renal Impairment:
Mild:
No adjustment typically needed (CrCl > 50 mL/min)
Moderate:
No adjustment typically needed (CrCl 10-50 mL/min)
Severe:
No adjustment typically needed (CrCl < 10 mL/min), but monitor for accumulation with very high doses or prolonged therapy. Some sources suggest reducing dose by half for CrCl < 10 mL/min.
Dialysis:
Hemodialysis: No supplemental dose needed after dialysis. Peritoneal Dialysis: No supplemental dose needed.
Hepatic Impairment:
Mild:
No specific adjustment recommended
Moderate:
Use with caution; monitor liver function tests. Dose adjustment may be considered in severe impairment.
Severe:
Use with caution; monitor liver function tests. Dose adjustment may be considered, especially with concomitant renal impairment.
Pharmacology
Mechanism of Action
Oxacillin is a bactericidal beta-lactam antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs) located inside the bacterial cell wall. This binding prevents the cross-linking of peptidoglycan units, leading to defective cell walls and osmotic lysis of the bacterial cell. It is resistant to degradation by staphylococcal penicillinase (beta-lactamase).
Pharmacokinetics
Absorption:
Bioavailability:
100% (IV administration)
Tmax:
Not applicable (IV)
FoodEffect:
Not applicable (IV)
Distribution:
Vd:
0.15-0.2 L/kg
ProteinBinding:
90-94%
CnssPenetration:
Limited (poor penetration into CSF unless meninges are inflamed)
Elimination:
HalfLife:
0.5-1.5 hours (adults with normal renal function)
Clearance:
Not available
ExcretionRoute:
Primarily renal (30-60% unchanged drug) and biliary/fecal (significant portion)
Unchanged:
30-60%
Pharmacodynamics
OnsetOfAction:
Rapid (within minutes of IV administration)
PeakEffect:
End of infusion
DurationOfAction:
Dependent on half-life and MIC of pathogen (typically requires dosing every 4-6 hours)
Safety & Warnings
Side Effects
Important Side Effects to Report to Your Doctor Immediately
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you experience any of the following symptoms, seek medical attention right away:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of liver problems, including:
+ Dark urine
+ Tiredness
+ Decreased appetite
+ Upset stomach or stomach pain
+ Light-colored stools
+ Vomiting
+ Yellow skin or eyes
Signs of kidney problems, such as:
+ Inability to pass urine
+ Changes in urine output
+ Blood in the urine
+ Sudden weight gain
Severe dizziness or fainting
Muscle or joint pain
Mouth irritation
Feeling extremely tired or weak
Severe stomach pain
Twitching
Seizures
Diarrhea, especially if it is severe, bloody, or accompanied by stomach pain or cramps (a rare but potentially life-threatening condition called C. diff-associated diarrhea, or CDAD, may occur during or after antibiotic treatment)
Unexplained bruising or bleeding, signs of infection (such as fever, chills, or sore throat), or feeling extremely tired or weak, which may indicate low blood cell counts
Other Possible Side Effects
Most people experience no side effects or only mild side effects while taking this medication. However, if you experience any of the following side effects, or if they bother you or do not go away, contact your doctor:
Diarrhea
Upset stomach or vomiting
* Change in tongue color
Reporting Side Effects
This is not a comprehensive list of all possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you experience any of the following symptoms, seek medical attention right away:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of liver problems, including:
+ Dark urine
+ Tiredness
+ Decreased appetite
+ Upset stomach or stomach pain
+ Light-colored stools
+ Vomiting
+ Yellow skin or eyes
Signs of kidney problems, such as:
+ Inability to pass urine
+ Changes in urine output
+ Blood in the urine
+ Sudden weight gain
Severe dizziness or fainting
Muscle or joint pain
Mouth irritation
Feeling extremely tired or weak
Severe stomach pain
Twitching
Seizures
Diarrhea, especially if it is severe, bloody, or accompanied by stomach pain or cramps (a rare but potentially life-threatening condition called C. diff-associated diarrhea, or CDAD, may occur during or after antibiotic treatment)
Unexplained bruising or bleeding, signs of infection (such as fever, chills, or sore throat), or feeling extremely tired or weak, which may indicate low blood cell counts
Other Possible Side Effects
Most people experience no side effects or only mild side effects while taking this medication. However, if you experience any of the following side effects, or if they bother you or do not go away, contact your doctor:
Diarrhea
Upset stomach or vomiting
* Change in tongue color
Reporting Side Effects
This is not a comprehensive list of all possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Signs of a severe allergic reaction: rash, hives, itching, swelling of the face, lips, tongue, or throat, difficulty breathing or swallowing, dizziness, rapid heartbeat.
- Severe or watery diarrhea, especially if it contains blood or mucus, which may occur even weeks after stopping the medication (could be C. difficile infection).
- Yellowing of the skin or eyes (jaundice), dark urine, light-colored stools, severe nausea or vomiting, or unusual tiredness (signs of liver problems).
- Unusual bleeding or bruising.
- Fever, chills, sore throat, or other signs of new infection (superinfection).
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction and its symptoms.
If you are allergic to penicillin, as this may be relevant to your treatment.
* If you are currently taking tetracycline, as this may interact with the medication.
Please note that this is not an exhaustive list of potential interactions. To ensure your safety, it is crucial to discuss all of your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. Additionally, inform them about any existing health problems.
Remember, before starting, stopping, or changing the dose of any medication, you must consult with your doctor to confirm that it is safe to do so in conjunction with this medication and your individual health circumstances.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction and its symptoms.
If you are allergic to penicillin, as this may be relevant to your treatment.
* If you are currently taking tetracycline, as this may interact with the medication.
Please note that this is not an exhaustive list of potential interactions. To ensure your safety, it is crucial to discuss all of your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. Additionally, inform them about any existing health problems.
Remember, before starting, stopping, or changing the dose of any medication, you must consult with your doctor to confirm that it is safe to do so in conjunction with this medication and your individual health circumstances.
Precautions & Cautions
Important Warnings and Cautions for Patients Taking This Medication
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
If you are taking this medication long-term, your doctor may recommend regular blood tests to monitor your condition. Be sure to discuss this with your doctor.
Do not take this medication for longer than prescribed, as this may increase the risk of a second infection.
If you are following a low-sodium or sodium-free diet, consult your doctor before taking this medication, as some products may contain sodium.
Patients 65 years or older should exercise caution when taking this medication, as they may be more susceptible to side effects.
If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor to discuss the potential benefits and risks to you and your baby.
Special Considerations for Children
When administering this medication to children, use with caution, as the risk of certain side effects may be higher in pediatric patients.
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
If you are taking this medication long-term, your doctor may recommend regular blood tests to monitor your condition. Be sure to discuss this with your doctor.
Do not take this medication for longer than prescribed, as this may increase the risk of a second infection.
If you are following a low-sodium or sodium-free diet, consult your doctor before taking this medication, as some products may contain sodium.
Patients 65 years or older should exercise caution when taking this medication, as they may be more susceptible to side effects.
If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor to discuss the potential benefits and risks to you and your baby.
Special Considerations for Children
When administering this medication to children, use with caution, as the risk of certain side effects may be higher in pediatric patients.
Overdose Information
Overdose Symptoms:
- Neurological symptoms (e.g., seizures, confusion, agitation, myoclonus), especially in patients with renal impairment or high doses.
- Nausea, vomiting, diarrhea.
- Electrolyte imbalances (e.g., hypernatremia if administered as sodium salt).
What to Do:
Seek immediate medical attention or call a poison control center (1-800-222-1222). Treatment is largely supportive and symptomatic. Hemodialysis may be used to remove oxacillin from the blood in severe cases, especially with renal impairment.
Drug Interactions
Major Interactions
- Methotrexate (increased methotrexate levels and toxicity due to competition for renal tubular secretion)
- Warfarin (may enhance anticoagulant effect, monitor INR)
Moderate Interactions
- Tetracyclines (may antagonize the bactericidal effect of oxacillin)
- Aminoglycosides (physical incompatibility in vitro; administer separately)
- Probenecid (decreases renal tubular secretion of oxacillin, leading to increased and prolonged serum levels)
- Oral Contraceptives (may reduce efficacy of oral contraceptives, advise backup method)
Monitoring
Baseline Monitoring
Complete Blood Count (CBC)
Rationale: To establish baseline and monitor for potential hematologic abnormalities (e.g., eosinophilia, leukopenia, neutropenia, thrombocytopenia) during prolonged therapy.
Timing: Prior to initiation of therapy
Renal Function (BUN, Creatinine)
Rationale: To establish baseline and monitor for potential nephrotoxicity, especially in patients with pre-existing renal impairment or on high doses.
Timing: Prior to initiation of therapy
Liver Function Tests (ALT, AST, Bilirubin)
Rationale: To establish baseline and monitor for potential hepatotoxicity (e.g., cholestatic hepatitis), especially with prolonged or high-dose therapy.
Timing: Prior to initiation of therapy
Routine Monitoring
Signs and Symptoms of Infection
Frequency: Daily
Target: Resolution of fever, improved clinical status, decreased inflammatory markers
Action Threshold: Lack of improvement or worsening symptoms may indicate treatment failure or resistant organism
Renal Function (BUN, Creatinine)
Frequency: Weekly for prolonged therapy or in patients with renal impairment
Target: Within normal limits or stable baseline
Action Threshold: Significant increase (e.g., >25% from baseline) may indicate nephrotoxicity; consider dose adjustment or alternative
Liver Function Tests (ALT, AST, Bilirubin)
Frequency: Weekly for prolonged therapy (>2 weeks)
Target: Within normal limits or stable baseline
Action Threshold: Significant elevation (e.g., >3x ULN) may indicate hepatotoxicity; consider discontinuation
Complete Blood Count (CBC)
Frequency: Weekly for prolonged therapy (>2 weeks)
Target: Within normal limits
Action Threshold: Significant decrease in WBC, neutrophils, or platelets; or significant eosinophilia may indicate drug-induced hematologic reaction
Potassium levels
Frequency: Periodically, especially with high doses or in patients predisposed to hypokalemia
Target: 3.5-5.0 mEq/L
Action Threshold: Hypokalemia may occur with high doses; supplement as needed
Symptom Monitoring
- Signs of allergic reaction (rash, itching, hives, swelling, difficulty breathing)
- Severe or persistent diarrhea (may indicate C. difficile infection)
- Nausea, vomiting, abdominal pain
- Signs of superinfection (new or worsening fever, oral thrush, vaginal yeast infection)
- Unusual bleeding or bruising (if on warfarin)
- Yellowing of skin or eyes, dark urine, light-colored stools (signs of liver problems)
Special Patient Groups
Pregnancy
Oxacillin is classified as Pregnancy Category B. Animal reproduction studies have shown no evidence of harm to the fetus. Human data are limited but do not suggest an increased risk of major birth defects or other adverse outcomes. It is generally considered safe for use during pregnancy when clearly needed.
Trimester-Specific Risks:
First Trimester:
No increased risk of congenital anomalies observed in human studies.
Second Trimester:
Generally considered safe.
Third Trimester:
Generally considered safe.
Lactation
Oxacillin is excreted in breast milk in small amounts. It is generally considered compatible with breastfeeding (Lactation Risk Category L2 - Safer).
Infant Risk:
Low risk of adverse effects in breastfed infants. Potential for mild gastrointestinal disturbances (e.g., diarrhea, candidiasis) or sensitization in the infant. Monitor infant for rash or diarrhea.
Pediatric Use
Dosing is weight-based and varies significantly by age, especially in neonates and young infants due to immature renal function. Close monitoring for adverse effects and therapeutic response is essential. Neonates may have prolonged half-life due to immature renal and hepatic function.
Geriatric Use
No specific dose adjustment is typically required based solely on age, but elderly patients are more likely to have decreased renal function. Monitor renal function closely and adjust dose if significant renal impairment is present. Increased susceptibility to adverse effects like C. difficile-associated diarrhea.
Clinical Information
Clinical Pearls
- Oxacillin is a narrow-spectrum penicillinase-resistant penicillin, primarily used for Methicillin-Susceptible Staphylococcus aureus (MSSA) infections.
- It is often preferred over nafcillin in some institutions due to a potentially lower risk of interstitial nephritis, though both are effective.
- Administer IV slowly over 30-60 minutes to minimize vein irritation and phlebitis.
- High doses or prolonged therapy may lead to hypokalemia; monitor potassium levels.
- Monitor liver function tests, especially with prolonged therapy, as cholestatic hepatitis can occur.
- Not effective against MRSA (Methicillin-Resistant Staphylococcus aureus).
- Physical incompatibility with aminoglycosides; do not mix in the same syringe or IV bag.
Alternative Therapies
- Nafcillin (another penicillinase-resistant penicillin)
- Cefazolin (a first-generation cephalosporin, often used for MSSA)
- Vancomycin (for MRSA or severe MSSA infections in penicillin-allergic patients)
- Clindamycin (for MSSA, but resistance can be an issue)
- Daptomycin (for MSSA, particularly in complicated skin and soft tissue infections or bacteremia)
Cost & Coverage
Average Cost:
Highly variable, typically $10-$50 per 10gm vial per 10gm vial
Generic Available:
Yes
Insurance Coverage:
Tier 1 or Tier 2 (Generic)
General Drug Facts
If your symptoms or health problems do not improve or worsen over time, it is essential to contact your doctor for further evaluation and guidance. To ensure safe use, never share your prescription medications with others, and do not take medications prescribed to someone else. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion. Dispose of unused or expired medications properly; do not flush them down the toilet or pour them down the drain unless instructed to do so by a healthcare professional or pharmacist. If you are unsure about the correct disposal method, consult with your pharmacist, who can also inform you about potential drug take-back programs in your area. Additionally, some medications may have a separate patient information leaflet; check with your pharmacist for more information. If you have any questions or concerns about your medication, consult with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. Be prepared to provide information about the medication taken, the amount, and the time it was taken to ensure prompt and effective treatment.