Oxacillin 1gm Inj, 1 Vial
It is used to treat bacterial infections.
Drug Class
Antibiotic
Pharmacologic Class
Penicillinase-resistant penicillin; Beta-lactam antibiotic
Pregnancy Category
Category B
FDA Approved
Jun 1962
DEA Schedule
Not Controlled
Overview
What is this medicine?
Oxacillin is an antibiotic that belongs to the penicillin family. 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 receive guidance on what to do 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 receive guidance on what to do 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.
- Do not share this medication with others.
- Report any new or worsening symptoms to your healthcare provider.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
250 mg to 2 g IV/IM every 4-6 hours
Dose Range:
250 - 2000 mg
Condition-Specific Dosing:
mild_moderate_infections:
250-500 mg IV/IM every 4-6 hours
severe_infections:
1-2 g IV/IM every 4-6 hours
endocarditis_osteomyelitis:
1.5-2 g IV every 4 hours
Pediatric Dosing
Neonatal:
Premature: 25 mg/kg/dose IV/IM every 12 hours (age < 7 days), 25 mg/kg/dose IV/IM every 8 hours (age > 7 days). Term: 25-50 mg/kg/dose IV/IM every 8 hours (age < 7 days), 25-50 mg/kg/dose IV/IM every 6 hours (age > 7 days).
Infant:
100-200 mg/kg/day IV/IM in divided doses every 4-6 hours (max 12 g/day)
Child:
100-200 mg/kg/day IV/IM in divided doses every 4-6 hours (max 12 g/day)
Adolescent:
100-200 mg/kg/day IV/IM in divided doses every 4-6 hours (max 12 g/day), or adult dosing for severe infections.
Dose Adjustments
Renal Impairment:
Mild:
No adjustment typically needed (CrCl > 50 mL/min)
Moderate:
No adjustment typically needed (CrCl 10-50 mL/min), but monitor for toxicity with high doses.
Severe:
Consider dose reduction or increased dosing interval (e.g., 1-2 g every 6-8 hours) for CrCl < 10 mL/min, especially with high doses. Monitor for neurotoxicity.
Dialysis:
Hemodialysis: Administer dose after dialysis. Peritoneal Dialysis: No supplemental dose needed.
Hepatic Impairment:
Mild:
No specific adjustment recommended, but use with caution.
Moderate:
Use with caution; monitor liver function tests and for signs of toxicity.
Severe:
Use with caution; monitor liver function tests and for signs of toxicity. Dose adjustment may be necessary in severe cases due to partial hepatic elimination.
Pharmacology
Mechanism of Action
Oxacillin is a penicillinase-resistant penicillin that inhibits bacterial cell wall synthesis by binding to one or more penicillin-binding proteins (PBPs) which in turn inhibit the final transpeptidation step of peptidoglycan synthesis in the bacterial cell wall, thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested. Oxacillin is bactericidal.
Pharmacokinetics
Absorption:
Bioavailability:
100% (IV)
Tmax:
Immediate (IV); 30-60 minutes (IM)
FoodEffect:
Not applicable for IV/IM administration.
Distribution:
Vd:
0.3-0.4 L/kg
ProteinBinding:
89-94%
CnssPenetration:
Limited (unless meninges are inflamed)
Elimination:
HalfLife:
0.5-1.5 hours (adults with normal renal function)
Clearance:
Not readily available as a single rate, primarily renal and biliary.
ExcretionRoute:
Primarily renal (tubular secretion and glomerular filtration), with significant biliary excretion.
Unchanged:
30-60% (renal)
Pharmacodynamics
OnsetOfAction:
Rapid (minutes after IV administration)
PeakEffect:
Within minutes (IV); 30-60 minutes (IM)
DurationOfAction:
Dependent on dosing interval (typically 4-6 hours due to short half-life)
Safety & Warnings
Side Effects
Serious Side Effects: Seek Medical Attention Immediately
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical help 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 cramps or pain (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
Common Side Effects
Most people experience few or no side effects while taking this medication. However, some common side effects may occur, including:
Diarrhea
Upset stomach or vomiting
Change in tongue color
If any of these side effects or other symptoms bother you or do not go away, contact your doctor for advice.
Reporting Side Effects
If you have questions or concerns about side effects, you can:
Call your doctor for medical advice
Report side effects to the FDA at 1-800-332-1088
Submit a report 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 notice any of the following symptoms, contact your doctor or seek medical help 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 cramps or pain (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
Common Side Effects
Most people experience few or no side effects while taking this medication. However, some common side effects may occur, including:
Diarrhea
Upset stomach or vomiting
Change in tongue color
If any of these side effects or other symptoms bother you or do not go away, contact your doctor for advice.
Reporting Side Effects
If you have questions or concerns about side effects, you can:
Call your doctor for medical advice
Report side effects to the FDA at 1-800-332-1088
Submit a report online at https://www.fda.gov/medwatch
Seek Immediate Medical Attention If You Experience:
- Severe allergic reactions (e.g., rash, hives, itching, swelling of the face/lips/tongue/throat, severe dizziness, trouble breathing)
- Severe diarrhea (watery or bloody stools), even weeks after stopping the medication
- Signs of liver problems (e.g., yellowing of skin/eyes, dark urine, severe stomach pain, unusual tiredness)
- Signs of kidney problems (e.g., change in amount of urine, swelling in ankles/feet)
- Unusual bruising or bleeding
- Fever, sore throat, or other signs of infection (may indicate blood problems)
- Seizures
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 you experienced.
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.
Before starting, stopping, or changing the dose of any medication, including this one, consult with your doctor to confirm that it is safe to do so. This will help prevent any potential interactions or adverse effects.
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 you experienced.
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.
Before starting, stopping, or changing the dose of any medication, including this one, consult with your doctor to confirm that it is safe to do so. This will help prevent any potential interactions or adverse effects.
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 are 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 are 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:
- Nausea
- Vomiting
- Diarrhea
- Electrolyte imbalance
- Neuromuscular excitability (e.g., twitching, seizures), especially in patients with renal impairment
What to Do:
Seek immediate medical attention or call a Poison Control Center (1-800-222-1222). Treatment is supportive and symptomatic. Hemodialysis may be useful in removing oxacillin from the blood in patients with severe renal impairment.
Drug Interactions
Major Interactions
- Methotrexate (increased methotrexate levels/toxicity)
- Tetracyclines (antagonism of bactericidal effect)
Moderate Interactions
- Probenecid (increases and prolongs oxacillin levels)
- Warfarin (potential for altered INR, monitor closely)
- Oral Contraceptives (theoretical reduction in efficacy, consider backup method)
- Aminoglycosides (inactivation in vitro when mixed, administer separately)
Monitoring
Baseline Monitoring
Culture and Susceptibility
Rationale: To confirm susceptibility of the infecting organism to oxacillin.
Timing: Prior to initiation of therapy
Renal Function (BUN, Creatinine)
Rationale: To assess baseline kidney function, especially in patients with pre-existing renal impairment or those receiving high doses.
Timing: Prior to initiation of therapy
Hepatic Function (AST, ALT, Bilirubin)
Rationale: To assess baseline liver function, especially in patients with pre-existing hepatic impairment or those on prolonged therapy.
Timing: Prior to initiation of therapy
Complete Blood Count (CBC)
Rationale: To assess baseline hematologic status.
Timing: Prior to initiation of therapy
Routine Monitoring
Clinical Response (signs/symptoms of infection)
Frequency: Daily
Target: Resolution of infection symptoms
Action Threshold: Lack of improvement or worsening symptoms may indicate treatment failure or resistance.
Renal Function (BUN, Creatinine)
Frequency: Weekly (for prolonged therapy or renal impairment)
Target: Within patient's baseline or normal limits
Action Threshold: Significant increase may require dose adjustment or discontinuation.
Hepatic Function (AST, ALT, Bilirubin)
Frequency: Weekly (for prolonged therapy or hepatic impairment)
Target: Within patient's baseline or normal limits
Action Threshold: Significant increase may require discontinuation.
Complete Blood Count (CBC) with differential
Frequency: Weekly (for prolonged therapy)
Target: Within normal limits (monitor for leukopenia, eosinophilia, thrombocytopenia)
Action Threshold: Significant changes may require discontinuation.
Electrolytes (Potassium)
Frequency: Periodically (especially with high doses or prolonged therapy)
Target: Normal range
Action Threshold: Hypokalemia may occur with high doses.
Symptom Monitoring
- Rash
- Fever
- Diarrhea (especially severe or bloody)
- Signs of anaphylaxis (hives, swelling, difficulty breathing)
- Signs of superinfection (new fever, oral thrush, vaginal yeast infection)
- Nausea
- Vomiting
- Abdominal pain
- Signs of phlebitis at injection site
Special Patient Groups
Pregnancy
Oxacillin is classified as Pregnancy Category B. Animal reproduction studies have not demonstrated a fetal risk, but there are no adequate and well-controlled studies in pregnant women. 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 small amounts into breast milk. It is generally considered compatible with breastfeeding (Lactation Risk Category L2).
Infant Risk:
Low risk to infant. Monitor breastfed infants for potential adverse effects such as diarrhea, candidiasis (thrush, diaper rash), or allergic sensitization (rash).
Pediatric Use
Dosing must be carefully calculated based on age, weight, and severity of infection. Neonates and infants may have immature renal function, requiring careful monitoring and potential dose adjustments. Close monitoring for adverse effects is crucial.
Geriatric Use
Elderly patients may have reduced renal function, which can lead to higher plasma concentrations and a prolonged half-life of oxacillin. Dose adjustments may be necessary based on renal function. Monitor for adverse effects, particularly neurotoxicity and electrolyte imbalances.
Clinical Information
Clinical Pearls
- Oxacillin is a penicillinase-resistant penicillin, making it effective against Staphylococcus aureus (MSSA) that produce penicillinase, but it is NOT effective against Methicillin-Resistant Staphylococcus aureus (MRSA).
- Administer IV oxacillin slowly over 10 minutes to prevent vein irritation and phlebitis.
- Oxacillin is primarily used for serious staphylococcal infections such as endocarditis, osteomyelitis, and severe skin and soft tissue infections.
- Monitor for signs of hypersensitivity reactions, which can range from rash to anaphylaxis. Cross-reactivity with other beta-lactams can occur.
- High doses or prolonged therapy can lead to hypokalemia, interstitial nephritis, and hepatotoxicity. Regular monitoring of electrolytes, renal, and hepatic function is important.
Alternative Therapies
- Nafcillin (another penicillinase-resistant penicillin, often interchangeable)
- Dicloxacillin (oral penicillinase-resistant penicillin)
- Cefazolin (a first-generation cephalosporin, often used for MSSA infections)
- Vancomycin (for MRSA or severe penicillin allergies)
Cost & Coverage
Average Cost:
Relatively inexpensive per vial
Generic Available:
Yes
Insurance Coverage:
Tier 1 or 2 (Generic)
General Drug Facts
If your symptoms or health problems persist or worsen, it is essential to contact your doctor promptly. To ensure safe use, never share your medication with others, and do not take medication prescribed for 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. Unless instructed otherwise, do not flush medications down the toilet or pour them down the drain. If you are unsure about the correct disposal method, consult your pharmacist for guidance. Many communities offer drug take-back programs, which your pharmacist can help you locate. Some medications may come with an additional patient information leaflet; check with your pharmacist for more information. If you have any questions or concerns about your medication, discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately contact your local poison control center or seek emergency medical attention. Be prepared to provide details about the medication taken, the amount, and the time it was taken to ensure prompt and effective treatment.