Sumapen Special Precautions

Serious and occasionally fatal hypersensitivity (anaphylactoid) reactions have been reported in patients on penicillin therapy. Careful inquiry should be made concerning previous hypersensitivity to penicillins, cephalosporins, or other allergens before initiating therapy with phenoxymethylpenicillin. If an allergic reaction occurs, the medicine should be discontinued and the appropriate therapy instituted. Serious anaphylactoid reactions require immediate emergency treatment with epinephrine. Oxygen, intravenous steroids, and airway management, including intubation, should also be instituted.
Use with caution in patients with a history of allergy and/or asthma.
Clostridium difficile-associated diarrhea (CDAD) and colitis have been reported with the use of nearly all antibacterial agents, including phenoxymethylpenicillin, and may range in severity from mild to life threatening. It is important to consider this diagnosis in patients who present with diarrhea following administration of antibacterial agents.
Orally administered phenoxymethylpenicillin should not be relied upon to achieve therapeutic levels in some patients with severe infections or with nausea, vomiting, gastric dilatation, esophageal achalasia, cardiospasm, or intestinal hypermotility. Occasionally patients will not absorb therapeutic amounts of oral penicillin. Parenteral administration of suitable antibiotics is recommended in these patients.
Use of an alternative or an additional method of contraception is strongly advised if an estrogen-containing contraceptive is taken concomitantly [see Interactions].
As with other antibacterial drugs, long term or repeated use may result in overgrowth of non-susceptible organisms, including fungi.
Use in Patients with Renal Impairment: Elimination is delayed in patients with renal impairment and a modest dose reduction is recommended in patients with severe renal impairment.
Use in Patients with Hepatic Impairment: Phenoxymethylpenicillin can be used safely in patients with hepatic impairment without dose adjustment.
Use in Elderly: There are no special problems relating to the use of penicillin in the elderly.