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Flucloxacillin

Classification: B

Drug products: Flucloxacillin, Flucloxacillin Orion, Flucloxacillin Sandoz, Flukloxacillin Athlone, Flukloxacillin Meda, Heracillin, Heracillin®

ATC code: J01CF05

Substances: flucloxacillin, flucloxacillin magnesium, flucloxacillin sodium

Summary

Controlled studies on differences between men and women regarding efficacy and pharmacokinetics of pivmecillinam are lacking.
 
The present evidence concerning differences between men and women is limited and do not motivate differentiation in dosing or treatment.

Additional information

Pharmacokinetics and dosing

No studies with a clinically relevant sex analysis regarding the pharmacokinetics or dosing of flucloxacillin have been found.

Effects

No studies with a clinically relevant sex analysis regarding the effects of flucloxacillin have been found.

Adverse effects

Clinical studies have reported a higher incidence of drug-induced liver injury in women with certain drugs such as nitrofurantoin, flucloxacillin, erythromycin and isoniazid [1]. Several retrospective observational studies have reported a female preponderance in flucloxacillin-induced liver injury. However, numbers of reported cases have been small and the differences between men and women have not reached statistical significance. [2-4]. A UK study of flucloxacillin-induced drug-induced liver injury (15 men, 36 women) showed association with HLA-B*5701 genotype [4].

Reproductive health issues

Regarding teratogenic aspects, please consult the Drugs and Birth Defects Database (in Swedish, Janusmed fosterpåverkan).

Updated: 2019-02-26

Date of litterature search: 2016-02-03

References

  1. Leise MD, Poterucha JJ, Talwalkar JA. Drug-induced liver injury. Mayo Clin Proc. 2014;89:95-106. PubMed
  2. Olsson R, Wiholm BE, Sand C, Zettergren L, Hultcrantz R, Myrhed M. Liver damage from flucloxacillin, cloxacillin and dicloxacillin. J Hepatol. 1992;15:154-61. PubMed
  3. Fairley CK, Boyd I, Purcell P, McNeil J. Flucloxacillin jaundice. Lancet. 1992;339:679. PubMed
  4. Daly AK, Donaldson PT, Bhatnagar P, Shen Y, Pe'er I, Floratos A et al. HLA-B*5701 genotype is a major determinant of drug-induced liver injury due to flucloxacillin. Nat Genet. 2009;41:816-9. PubMed
  5. Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2015 [cited 2016-04-05.] länk

Authors: Linnéa Karlsson Lind, Desirée Loikas

Reviewed by: Mia von Euler

Approved by: Karin Schenck-Gustafsson