INN monograph
Cloxacillin
Beta-lactam antibiotic — penicillin · POM
Verified · Updated 01 Aug 2026 · Source: Local active-ingredient clinical extract; Professional class pharmacology (Beta-lactam antibiotic — penicillin)
Kenya market
Wholesale / list prices where loaded
Risk first
Contraindications
- History of serious immediate hypersensitivity (e.g. anaphylaxis, angioedema, urticaria) to any penicillin.
- Caution with prior severe cephalosporin reaction (cross-reactivity risk).
- Avoid in infectious mononucleosis if using aminopenicillins (rash risk).
Precautions
- Risk of kernicterus in jaundiced neonates when high doses are given parenterally.
- Serious and occasionally fatal immediate hyper- sensitivity reactions may occur
Point of care
Dosing
Adult
Orally: Adult; 500mg QID [orally]. Children; 25-50mg/kg/day. I.M: Adult; 250mg every 4-6 hours. I.V inj or inf. 500mg every 4-6 hours. Children; 25-50mg/kg/day. In severe case doses may be doubled.
Paediatric
See label paediatric section if present; otherwise use paediatric formulary — do not extrapolate adult doses.
Renal
Renal excretion dominant — reduce dose or extend interval in significant renal impairment; risk of accumulation and seizures at high levels.
- CrCl 0–120: Confirm renal dosing in product SmPC / primary label.
Hepatic
Low intrinsic hepatotoxicity; cholestatic hepatitis rare (notably flucloxacillin/co-amoxiclav patterns for related agents).
Strengths
Forms
Safety
Drug interactions
- For professionals: select agent by suspected pathogen and local resistance.
- Natural penicillins remain first-line for many streptococcal infections when susceptibility expected.
- Do not use penicillin alone for beta-lactamase-producing staphylococci.
- Document allergy phenotype (immediate vs delayed).
- De-escalate once cultures allow.
Safety
Adverse effects
- Allergic reactions that include skin rashes and immediate anaphylaxis
- sterile inflammationca at the site of intramuscular injec- tion
- peripheral nerve pain and dysfunction
- Nephropathy manifested as interstitial nephritis has been reported neutropenia and thrombocytopenia
Use
Indications
- Infections, especially those due to penicillinase-producing staphylococci.
- Clinical selection for Cloxacillin should follow culture results where relevant, Kenya STG/EML recommendations, and the current product SmPC.
- Class context: Beta-lactam antibiotic — penicillin.
- Confirm site-specific dose, duration and monitoring before prescribing.
Pharmacology
Mode of action
Inhibits synthesis of bacterial cell wall, causing cell death, hence bactericidal.
Full mechanism text
Inhibits synthesis of bacterial cell wall, causing cell death, hence bactericidal. Penicillins bind penicillin-binding proteins (PBPs) and inhibit the final transpeptidation step of peptidoglycan synthesis, weakening the bacterial cell wall. Osmotic lysis follows; activity is bactericidal against susceptible organisms in the growth phase. Spectrum and beta-lactamase stability vary by agent (narrow natural penicillins vs aminopenicillins vs antipseudomonal/anti-staphylococcal agents).
ADME
Pharmacokinetics & PD
| Onset | Within 1 hour (oral); faster IV |
|---|---|
| Duration | 4–8 hours typical (agent/formulation dependent) |
| Route | ORAL / PARENTERAL (agent-dependent) |
| Elimination | is predominantly renal (glomerular filtration and tubular secretion). Dose adjustment is often required in severe renal impairment. Probenecid reduces tubular secretion and prolongs levels. |
| Half-life | differ by agent and salt/ester. Most penicillins distribute widely into extracellular fluid; CSF penetration is poor unless meninges are inflamed. |
Full PK/PD text
Absorption, protein binding and half-life differ by agent and salt/ester. Most penicillins distribute widely into extracellular fluid; CSF penetration is poor unless meninges are inflamed. Elimination is predominantly renal (glomerular filtration and tubular secretion). Dose adjustment is often required in severe renal impairment. Probenecid reduces tubular secretion and prolongs levels.
Kenya
Brands & prices
| Brand | Company | Pack | KES |
|---|---|---|---|
| Cloxisel | Distributed by Medisel (K) Limited | Standard Commercial Pack | — |
| Dawaclox | Dawa Limited | Standard Commercial Pack | — |
| Dawaflox | Dawa Limited | 250mg [Vial] | — |
| Floxapen | GSK Kenya (GlaxoSmithKline) | 250mg [1000s] | — |
| Kloxy | Laboratory & Allied Ltd. | Standard Commercial Pack | — |
Special populations
Pregnancy & lactation
Pregnancy
Penicillins are generally considered compatible in pregnancy when clearly indicated (decades of clinical use). Prefer agents with the best safety record for the indication; confirm current SmPC.
Lactation
Usually compatible with breastfeeding; small amounts excreted in milk. Monitor infant for diarrhoea, thrush or rash.
Diet
Food & alcohol
- Food
- Food
Trust
Sources & disclaimer
Source: Local active-ingredient clinical extract; Professional class pharmacology (Beta-lactam antibiotic — penicillin)
Last reviewed: 01 Aug 2026
Decision support only — not a substitute for clinical judgment, product SmPC, or Kenya STG/EML.