A-Clox

Cloxacillin is indicated for the treatment of infections caused by Gram-positive organisms. It is also indicated for infections caused by penicillinase-producing staphylococci. Such infections include:

Skin and Soft Tissue Infections

• Boils, abscesses, carbuncles, furunculosis, cellulitis, infected wounds, infected burns, protection for skin grafts, and various skin infections such as ulcers, eczema, and acne.

Respiratory Tract, Nose, Ear, and Throat Infections

• Pneumonia, lung abscess, empyema, sinusitis, pharyngitis, tonsillitis, quinsy, otitis media, and otitis externa.

Other Infections Caused by Cloxacillin-Sensitive Organisms

• Osteomyelitis, enteritis, endocarditis, urinary tract infections, and septicaemia.

Adults (Usual Doses)

Oral

500 mg four times daily, taken 30 minutes to 1 hour before meals.

Intramuscular injection

250 mg every 4 to 6 hours.

Intravenous injection

500 mg every 4 to 6 hours. The dose may be doubled if clinically necessary.

Intrapleural injection

500 mg once daily.

Intra-articular injection

500 mg once daily.

Children (Usual Doses)

Oral

• Ages 2 to 10 years: half the adult dose.
• Under 2 years: one-quarter of the adult dose.

Preparation and Administration of Injections

Intramuscular injection

Dissolve 250 mg in 1.5 mL, or 500 mg in 2 mL, of Water for Injections BP.

Intravenous injection

1. Dissolve 500 mg in 5–10 mL of Water for Injections BP.
2. Administer the resulting solution slowly over 3 to 4 minutes.

Alternatively, cloxacillin for injection may be added to a compatible infusion fluid or diluted appropriately and given via a drip tube over 3 to 4 minutes.

Intrapleural injection

Dissolve 500 mg in 5–10 mL of Water for Injections BP before administration.

Intra-articular injection

Dissolve 500 mg in not more than 5 mL of Water for Injections BP or 0.5% lignocaine hydrochloride solution before administration.

Oral

Administer 30 minutes to 1 hour before meals.

Cloxacillin is a semi-synthetic, penicillinase-resistant isoxazolyl penicillin. It exerts a bactericidal effect by inhibiting bacterial cell wall synthesis. Its resistance to hydrolysis by penicillinase (beta-lactamase) enzymes allows it to remain active against beta-lactamase-producing staphylococci that would otherwise inactivate standard penicillins.

Following oral administration, bioavailability ranges from approximately 37% to 60%; absorption is reduced when the drug is taken with food. Cloxacillin is widely distributed to the liver, kidneys, bone, bile, pleural fluid, synovial fluid, and ascitic fluid; only minimal amounts reach the cerebrospinal fluid. Approximately 90–95% of the drug is bound to plasma proteins. It is partially metabolised to active and inactive metabolites, and both the parent compound and metabolites are rapidly excreted in the urine by glomerular filtration and tubular secretion.

The side effects of cloxacillin are similar to those of other penicillins and are generally mild and transient. They include fever, diarrhoea, indigestion, and rash (urticarial or erythematous). If a rash of any type develops, cloxacillin should be discontinued immediately.

Cloxacillin is contraindicated in patients with a known hypersensitivity to penicillin.

Cloxacillin should be used with caution in patients with a history of allergy. It must not be administered as a subconjunctival injection or as eye drops.

Cloxacillin syrup and drops should be freshly prepared immediately before use and stored in a cool place (refrigerated if possible). Once reconstituted, syrup and drops must be used within 5 days if stored at room temperature, or within 7 days if refrigerated.

Solutions prepared for intramuscular or intravenous use should be administered within 30 minutes of preparation. However, aqueous solutions of cloxacillin remain stable at room temperature (25°C) for up to 24 hours.

Cloxacillin for injection may be mixed with most intravenous infusion fluids. It must never be mixed with protein-containing fluids such as protein hydrolysates.

Renal Impairment

Patients with significantly reduced renal function (creatinine clearance below 10 mL/min) are at increased risk of cloxacillin accumulation. Doses should be carefully monitored and reduced as appropriate in these patients.

Patients Requiring Sodium Restriction

Each 500 mg capsule of cloxacillin sodium contains a small amount of sodium. This should be taken into account in patients who require dietary sodium restriction, such as those with congestive heart failure, hypertension, or fluid retention.

Pregnancy

Cloxacillin is classified as Pregnancy Category B. There are no adequate and well-controlled studies in humans, and no literature reports of congenital abnormalities associated with its use. Cloxacillin should be used during pregnancy only when clearly necessary.

Lactation

Cloxacillin passes into breast milk in small amounts. After a single 500 mg intramuscular dose, milk concentrations of 0.1 to 0.3 mg/L have been measured at 1 to 6 hours post-dose. These levels are not expected to cause adverse effects in breastfed infants; however, as with other penicillins, occasional disruption of the infant's gastrointestinal flora resulting in diarrhoea may occur. Cloxacillin is generally considered acceptable for use in nursing mothers.

No specific overdose data for cloxacillin capsules are established. In cases of significant overdose, particularly in patients with severe renal impairment, high concentrations of cloxacillin may cause neurological effects. If overdose is suspected, discontinue the drug, provide symptomatic and supportive care, and seek immediate medical attention.

Warfarin: Cloxacillin may reduce the anticoagulant effect of warfarin. Patients receiving both drugs should have their coagulation status monitored closely.

Probenecid: Co-administration with probenecid may increase and prolong cloxacillin plasma concentrations by reducing renal tubular secretion of the antibiotic.

All dosage forms of cloxacillin should be stored in a cool, dry place. Cloxacillin injection vials should be stored at a temperature not exceeding 25°C.

What is the price of A-Clox 500 mg in Bangladesh (BD)?

A-Clox 500 mg price in Bangladesh is ৳5.98 per capsule (৳598 per strip). Prices may vary by pharmacy and are updated regularly on this page.

What is A-Clox used for?

Cloxacillin is indicated for the treatment of infections caused by Gram-positive organisms. It is also indicated for infections caused by penicillinase-producing staphylococci. Such infections include: Skin and Soft…

Is A-Clox an antibiotic?

Yes, A-Clox is an antibiotic. Antibiotics should only be taken on a doctor's advice and the full course should be completed even if symptoms improve early.