Dosing and uses of Pen Vee K, Penicillin V (penicillin VK)
Adult dosage forms and strengths
oral solution
- 125mg/5mL
- 250mg/5mL
tablet
- 250mg
- 500mg
Streptococcal Pharyngitis
500 mg PO q12hr or 250 mg PO q6hr for 10 days
Actinomycosis
Mild: 2-4 g/day PO divided q6hr for 8 weeks
Surgical: 2-4 g/day PO divided q6hr for 6-12 months
Erysipelas
500 mg PO q6hr
Periodontal Infections
250-500 mg PO q6hr for 5-7 days
Recurrent Rheumatic Fever
Prophylaxis
250 mg PO q12hr
Prosthetic Joint Infection (Off-label)
500 mg PO q6-12hr
Dosing Considerations
Monitor renal and hematologic systems
Administration
Take on empty stomach
Pediatric dosage forms and strengths
oral solution
- 125mg/5mL
- 250mg/5mL
tablet
- 250mg
- 500mg
Pneumococcal Systemic Infections
<12 years
- 50-75 mg/kg/day PO q6-8hr
- Not to exceed 3 g/day
>12 years
- 250-500 mg PO q6-8hr until the patient is afebrile for at least 2 days
Pneumococcal Infection Prophylaxis
<5 years: 125 mg PO q12hr
>5 years: 250 mg PO q12hr
Streptococcal Pharyngitis
Children: 250 mg PO q8-12hr for 10 days
Adolescents: 250 mg PO q6hr or 500 mg PO q12hr for 10 days
Rheumatic Fever
Primary prevention
<5 years: 125 mg q12hr PO for 10 days
>5 years: 250 mg q12hr PO for 10 days
Recurrent Rheumatic Fever
Prophylaxis
Children: 125-250 mg PO q12hr on a continuing basis
Administration
Take on empty stomach
Pen Vee K, Penicillin V (penicillin VK) adverse (side) effects
Frequency not defined
Diarrhea
Nausea
Oral candidiasis
Vomiting
Seizure
Anemia
Interstitial nephritis
Hypersensitivity
Anaphylaxis
Positive Coombs reaction
Warnings
Contraindications
Allergy to penicillins, cephalosporins, or imipenem
Cautions
Caution in severe renal impairment
Prolonged use may result in superinfection
Use with caution in patients with asthma history; IGE mediated anaphylactic reactions (eg, urticaria, anaphylaxis) reported
Use with caution in neonates; some dosage forms may contain sodium benzoate/benzoic acid, which may cause fatal toxicity (gasping syndrome) when used in large amounts
Adverse effects, including hemolytic anemia, serum sickness, or neutropenia, may occur with prolonged use; serum concentrations may increase with extended duration of therapy, especially in patients with renal insufficiency
Use caution in patients with history of seizure disorders; high serum levels, especially in the presence of renal impairment, may increase risk of seizures
Pregnancy and lactation
Pregnancy category: B
Lactation: Excreted in breast milk; compatible with breastfeeding
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Pen Vee K, Penicillin V (penicillin VK)
Mechanism of action
Inhibits the biosynthesis of cell wall mucopeptide; bactericidal against sensitive organisms when adequate concentrations are reached, and most effective during the stage of active multiplication; inadequate concentrations may produce only bacteriostatic effects.
Absorption
Bioavailability: 60-73%
Peak plasma time: 0.5-1 hr
Distribution
Protein bound: 80%
Crosses placenta; poor blood-brain barrier diffusion
Metabolism
Hepatic
Elimination
Half-life: 0.5-0.6 hr
Excretion: Urine
