Penicillin Vk 125mg/5ml Soln 100ml
It is used to treat or prevent bacterial infections.
Drug Class
Antibiotic
Pharmacologic Class
Penicillin antibiotic; Beta-lactam antibiotic
Pregnancy Category
Category B
FDA Approved
Jan 1959
DEA Schedule
Not Controlled
Overview
What is this medicine?
Penicillin V potassium is an antibiotic used to treat bacterial infections, such as strep throat, skin infections, and certain types of pneumonia. It works by killing the bacteria that cause these infections.
How to Use This Medicine
Taking Your Medication Correctly
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your medication and follow the instructions closely.
Take your medication on an empty stomach, either 1 hour before or 2 hours after meals. However, if it causes stomach upset, you can take it with food.
Continue taking your medication as directed by your doctor or healthcare provider, even if you start feeling well.
When taking the liquid form of this medication, measure your dose carefully using the measuring device provided. If one is not included, ask your pharmacist for a suitable measuring device.
Storing and Disposing of Your Medication
Store the liquid form of this medication in the refrigerator.
Discard any unused liquid medication after 2 weeks.
Keep all medications in a safe place, out of the reach of children and pets.
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. If you have questions about the best way to dispose of your medication, consult your pharmacist. You may also want to check if there are any drug take-back programs in your area.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember.
However, if it is close to the time for your next dose, skip the missed dose and resume your regular dosing schedule.
Do not take two doses at the same time or take extra doses to make up for a missed dose.
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your medication and follow the instructions closely.
Take your medication on an empty stomach, either 1 hour before or 2 hours after meals. However, if it causes stomach upset, you can take it with food.
Continue taking your medication as directed by your doctor or healthcare provider, even if you start feeling well.
When taking the liquid form of this medication, measure your dose carefully using the measuring device provided. If one is not included, ask your pharmacist for a suitable measuring device.
Storing and Disposing of Your Medication
Store the liquid form of this medication in the refrigerator.
Discard any unused liquid medication after 2 weeks.
Keep all medications in a safe place, out of the reach of children and pets.
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. If you have questions about the best way to dispose of your medication, consult your pharmacist. You may also want to check if there are any drug take-back programs in your area.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember.
However, if it is close to the time for your next dose, skip the missed dose and resume your regular dosing schedule.
Do not take two doses at the same time or take extra doses to make up for a missed dose.
Lifestyle & Tips
- Take the medication exactly as prescribed by your doctor, even if you start to feel better. Do not skip doses or stop taking it early, as this can lead to antibiotic resistance and the infection returning.
- Take with a full glass of water. It is best taken on an empty stomach (1 hour before or 2 hours after meals) for better absorption, but if it causes stomach upset, you can take it with food.
- Shake the oral solution well before each use.
- Use a measuring spoon or cup for the liquid form to ensure accurate dosing.
- Do not share this medication with others, even if they have similar symptoms.
- Avoid alcohol consumption, as it may worsen gastrointestinal side effects.
Available Forms & Alternatives
Available Strengths:
- Penicillin Vk 125mg/5ml Soln 100ml
- Penicillin Vk 125mg/5ml Soln 200ml
- Penicillin G Sodium 5 Million Units
- Penicillin Vk 250mg/5ml Soln 100ml
- Penicillin Vk 250mg/5ml Soln 200ml
- Penicillin Gk 5mu Inj, 1 Vial
- Penicillin Gk 20mu Inj, 1 Vial
- Penicillin Vk 250mg Tablets
- Penicillin Vk 500mg Tablets
- Penicillin Gk 5mu Inj, 1 Vial
- Penicillin Vk 500mg Tablets
- Penicillin Vk 250mg Tablets
- Penicillin Vk 250mg Tablets
- Penicillin Gk 20mu Inj, 1 Vial
- Penicillin Gk 20mu Inj, 1 Vial
Dosing & Administration
Adult Dosing
Standard Dose:
250 mg to 500 mg orally every 6 to 8 hours
Dose Range:
250 - 500 mg
Condition-Specific Dosing:
Streptococcal infections:
250 mg every 6 to 8 hours for 10 days
Pneumococcal infections:
250 mg every 6 hours until afebrile for at least 2 days
Staphylococcal infections (mild):
250 mg to 500 mg every 6 to 8 hours
Fusospirochetosis (Vincent's infection):
250 mg every 6 to 8 hours
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established (dosing typically for children >1 month)
Child:
25-50 mg/kg/day orally in 3 to 4 divided doses (maximum 3 g/day). For streptococcal infections: 250 mg 2-3 times daily for 10 days (for children >12 years or >27 kg, adult dose may apply).
Adolescent:
250 mg to 500 mg orally every 6 to 8 hours (or 25-50 mg/kg/day in divided doses, max 3g/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:
Dose reduction may be necessary (e.g., 250 mg every 8-12 hours for CrCl <10 mL/min)
Dialysis:
Administer dose after dialysis; supplemental dose may be needed. Penicillin V is dialyzable.
Hepatic Impairment:
Mild:
No adjustment
Moderate:
No adjustment
Severe:
No adjustment
Pharmacology
Mechanism of Action
Penicillin V potassium is a bactericidal 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 a defective and unstable cell wall, ultimately resulting in bacterial lysis and death.
Pharmacokinetics
Absorption:
Bioavailability:
60-73%
Tmax:
30-60 minutes
FoodEffect:
Food may decrease the rate and extent of absorption, but generally not clinically significant enough to preclude administration with food if stomach upset occurs. Best taken on an empty stomach (1 hour before or 2 hours after meals).
Distribution:
Vd:
0.3-0.8 L/kg
ProteinBinding:
20-30%
CnssPenetration:
Limited (poor penetration into CSF unless meninges are inflamed)
Elimination:
HalfLife:
0.5-1 hour
Clearance:
Approximately 300-500 mL/min (renal clearance)
ExcretionRoute:
Primarily renal (tubular secretion and glomerular filtration)
Unchanged:
25-50%
Pharmacodynamics
OnsetOfAction:
Rapid
PeakEffect:
Within 30-60 minutes (plasma concentration)
DurationOfAction:
Dependent on dosing interval (typically 6-8 hours)
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
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 immediate medical attention:
Signs of an allergic reaction, including:
+ 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
In rare cases, allergic reactions can be fatal.
Diarrhea: A Potential Serious Side Effect
Diarrhea is a common side effect of antibiotics. However, in rare cases, a severe form of diarrhea called Clostridioides difficile (C. diff)-associated diarrhea (CDAD) may occur. This condition can lead to a life-threatening bowel problem. If you experience any of the following symptoms, contact your doctor immediately:
Stomach pain
Cramps
Very loose, watery, or bloody stools
CDAD can occur during or several months after taking antibiotics.
Before treating diarrhea, consult your doctor.
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or if they persist or bother you, contact your doctor:
Upset stomach or vomiting
Stomach pain or diarrhea
Black, hairy tongue
Note: This list is not exhaustive, and you may experience other side effects. If you have questions or concerns, consult your doctor.
Reporting Side Effects
To report side effects, you can:
Contact your doctor for medical advice
Call the FDA at 1-800-332-1088
* Visit the FDA's MedWatch website 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 immediate medical attention:
Signs of an allergic reaction, including:
+ 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
In rare cases, allergic reactions can be fatal.
Diarrhea: A Potential Serious Side Effect
Diarrhea is a common side effect of antibiotics. However, in rare cases, a severe form of diarrhea called Clostridioides difficile (C. diff)-associated diarrhea (CDAD) may occur. This condition can lead to a life-threatening bowel problem. If you experience any of the following symptoms, contact your doctor immediately:
Stomach pain
Cramps
Very loose, watery, or bloody stools
CDAD can occur during or several months after taking antibiotics.
Before treating diarrhea, consult your doctor.
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or if they persist or bother you, contact your doctor:
Upset stomach or vomiting
Stomach pain or diarrhea
Black, hairy tongue
Note: This list is not exhaustive, and you may experience other side effects. If you have questions or concerns, consult your doctor.
Reporting Side Effects
To report side effects, you can:
Contact your doctor for medical advice
Call the FDA at 1-800-332-1088
* Visit the FDA's MedWatch website 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, wheezing. Seek immediate medical attention.
- Severe or persistent diarrhea, especially if it is watery or bloody, with or without fever and stomach cramps. This could be a sign of a serious intestinal infection (Clostridioides difficile-associated diarrhea).
- New or worsening fever, sore throat, or other signs of infection (may indicate a new infection or treatment failure).
- Unusual bruising or bleeding.
- Yellowing of the skin or eyes (jaundice).
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.
Certain health conditions that may affect your ability to take this medication, including:
+ Gastrointestinal (GI) tract problems, such as an enlarged stomach or esophagus spasms
+ Severe illness
+ Diarrhea, upset stomach, or vomiting
This list is not exhaustive, and it is crucial to discuss all your health problems with your doctor.
Additionally, provide your doctor and pharmacist with a comprehensive list of all the medications you are taking, including:
Prescription and over-the-counter (OTC) drugs
Natural products
* Vitamins
It is vital to verify that it is safe to take this medication with all your other medications and health conditions. Never start, stop, or change the dose of any medication without consulting your doctor first.
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.
Certain health conditions that may affect your ability to take this medication, including:
+ Gastrointestinal (GI) tract problems, such as an enlarged stomach or esophagus spasms
+ Severe illness
+ Diarrhea, upset stomach, or vomiting
This list is not exhaustive, and it is crucial to discuss all your health problems with your doctor.
Additionally, provide your doctor and pharmacist with a comprehensive list of all the medications you are taking, including:
Prescription and over-the-counter (OTC) drugs
Natural products
* Vitamins
It is vital to verify that it is safe to take this medication with all your other medications and health conditions. Never start, stop, or change the dose of any medication without consulting your doctor first.
Precautions & Cautions
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 drug for an extended period, 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 developing a second infection. If you become pregnant, plan to become pregnant, or are breastfeeding, notify your doctor immediately. You and your doctor will need to carefully weigh the benefits and risks of taking this medication to ensure the best possible outcome for you and your baby.
Do not take this medication for longer than prescribed, as this may increase the risk of developing a second infection. If you become pregnant, plan to become pregnant, or are breastfeeding, notify your doctor immediately. You and your doctor will need to carefully weigh the benefits and risks of taking this medication to ensure the best possible outcome for you and your baby.
Overdose Information
Overdose Symptoms:
- Nausea
- Vomiting
- Diarrhea
- Abdominal pain
- Neuromuscular hyperexcitability (e.g., twitching, tremors)
- Seizures (especially in patients with renal impairment or high doses)
- Electrolyte imbalances (e.g., hyperkalemia due to potassium salt)
What to Do:
In case of overdose, contact a poison control center immediately (Call 1-800-222-1222 in the US) or seek emergency medical attention. Treatment is generally supportive, including gastric lavage or emesis if recent ingestion, and monitoring of vital signs and electrolytes. Hemodialysis can remove penicillin V from the blood.
Drug Interactions
Major Interactions
- Methotrexate (increased methotrexate levels due to competition for renal tubular secretion)
- Tetracyclines (may antagonize the bactericidal effect of penicillin V)
Moderate Interactions
- Oral contraceptives (theoretical reduction in efficacy, though clinical significance is debated and not consistently proven)
- Warfarin (potential for increased INR, though rare and mechanism unclear, possibly due to altered gut flora)
- Probenecid (increases and prolongs penicillin V plasma levels by decreasing renal tubular secretion)
Monitoring
Baseline Monitoring
Allergy history (especially to penicillins or cephalosporins)
Rationale: To prevent severe hypersensitivity reactions
Timing: Prior to first dose
Renal function (CrCl, BUN, creatinine)
Rationale: Penicillin V is primarily renally eliminated; dose adjustment may be needed in severe impairment
Timing: Prior to initiation, especially in patients with known renal dysfunction
Routine Monitoring
Clinical response to therapy (e.g., resolution of fever, reduction in symptoms)
Frequency: Daily
Target: Improvement of symptoms
Action Threshold: Lack of improvement or worsening symptoms may indicate treatment failure, resistance, or incorrect diagnosis.
Signs and symptoms of hypersensitivity reactions (e.g., rash, itching, hives, difficulty breathing)
Frequency: Throughout therapy, especially during the first few doses
Target: Absence of allergic symptoms
Action Threshold: Any sign of allergic reaction requires immediate discontinuation and appropriate management.
Gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea)
Frequency: Daily
Target: Absence or mild, tolerable symptoms
Action Threshold: Severe or persistent diarrhea may indicate C. difficile infection.
Renal function (BUN, creatinine)
Frequency: Periodically, especially during prolonged therapy or in patients with pre-existing renal impairment
Target: Stable renal function
Action Threshold: Significant increase in BUN/creatinine may necessitate dose adjustment or discontinuation.
Symptom Monitoring
- Rash
- Hives
- Itching
- Swelling of face/lips/tongue/throat
- Difficulty breathing or swallowing
- Wheezing
- Severe diarrhea (especially if bloody or watery)
- Abdominal cramps
- Nausea
- Vomiting
- Fever (if not related to primary infection)
- Sore throat
- Oral thrush (white patches in mouth)
- Vaginal yeast infection (itching, discharge)
Special Patient Groups
Pregnancy
Penicillin V potassium is generally considered safe for use during pregnancy (Pregnancy Category B). Studies in animals have not shown harm to the fetus, and there is no evidence of harm in pregnant women. It is often a preferred antibiotic for susceptible infections during pregnancy.
Trimester-Specific Risks:
First Trimester:
Low risk; no evidence of increased risk of birth defects.
Second Trimester:
Low risk.
Third Trimester:
Low risk.
Lactation
Penicillin V potassium is excreted in small amounts into breast milk (Lactation Risk L1 - Safest). It is generally considered compatible with breastfeeding. Monitor the infant for potential adverse effects such as diarrhea, candidiasis (thrush, diaper rash), or allergic reactions.
Infant Risk:
Low risk. Potential for mild gastrointestinal upset, candidiasis, or sensitization in the infant.
Pediatric Use
Dosing is weight-based for children. Penicillin V potassium is commonly used in pediatric populations for susceptible infections, particularly streptococcal pharyngitis. Ensure accurate dosing using appropriate measuring devices for oral solution. Neonatal and very young infant dosing is not well-established, and other penicillins may be preferred.
Geriatric Use
No specific dose adjustment is typically needed based solely on age. However, elderly patients are more likely to have age-related decreases in renal function, which may necessitate dose adjustment based on creatinine clearance. Monitor for adverse effects, particularly gastrointestinal disturbances and potential for C. difficile infection.
Clinical Information
Clinical Pearls
- Penicillin V potassium is the oral penicillin of choice for most susceptible infections due to its better acid stability and absorption compared to penicillin G.
- It is the drug of choice for the treatment of streptococcal pharyngitis (strep throat) to prevent acute rheumatic fever.
- Always complete the full course of therapy, even if symptoms improve, to prevent antibiotic resistance and recurrence of infection.
- Advise patients to report any signs of allergic reaction immediately, as severe reactions can occur even with prior tolerance.
- While food can decrease absorption, taking it with food may help reduce gastrointestinal upset; the clinical impact on efficacy is usually minimal for most infections.
- The taste of the oral solution can be unpleasant for some children; mixing with a small amount of juice or milk (not acidic juices) may help, but ensure the full dose is consumed immediately.
Alternative Therapies
- Amoxicillin (for many similar infections, often preferred for pediatric use due to better taste and once/twice daily dosing)
- Cephalexin (a first-generation cephalosporin, often used for skin infections or in penicillin-allergic patients who can tolerate cephalosporins)
- Azithromycin (for penicillin-allergic patients, especially for respiratory tract infections)
- Clindamycin (for certain anaerobic infections or in penicillin-allergic patients)
- Erythromycin (a macrolide, for penicillin-allergic patients)
Cost & Coverage
Average Cost:
Varies widely, typically low per 100ml solution
Generic Available:
Yes
Insurance Coverage:
Tier 1 (Generic)
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to 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. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it occurred.