Pivmecillinam is an orally active prodrug of Amdinocillin (A576300), an broad spectrum penicillin antibiotic that binds specifically to penicillin binding protein 2.
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.
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.
