Uses
Pivmecillinam is an orally active prodrug of Amdinocillin (A576300), an broad spectrum penicillin antibiotic that binds specifically to penicillin binding protein 2.
Clinical Use
Antibacterial agent
Drug interactions
Potentially hazardous interactions with other drugs
Antiepileptics: avoid concomitant use with valproate.
Methotrexate: penicillins can reduce the excretion of
methotrexate (increased risk of toxicity).
Probenecid: reduces excretion of penicillins.
Metabolism
Pivmecillinam is rapidly hydrolysed to mecillinam which
is the active drug, plus pivalic acid and formaldehyde.
About 45% of a dose may be excreted in the urine as
mecillinam, mainly within the first 6 hours. Mecillinam
is partly excreted with bile, giving rise to biliary
concentrations about 3 times the serum levels.
