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Ampicillin and Probenecid


Pronunciation

 (am pi SIL in & proe BEN e sid)


U.S. Brand Names

 Probampacin®


Synonyms

 Probenecid and Ampicillin (Dental)


Generic Available

 No


Use

 Uncomplicated infections caused by susceptible strains of Neisseria gonorrhoeae in adults


Pregnancy Risk Factor

 B


Adverse Reactions

>10%:

Central nervous system: Headache

Dermatologic: Rash

Gastrointestinal: Anorexia, nausea, vomiting, diarrhea, oral candidiasis

Neuromuscular & skeletal: Gouty arthritis (acute)

1% to 10%:

Cardiovascular: Flushing of face

Central nervous system: Dizziness

Dermatologic: Skin rash, itching

Gastrointestinal: Sore gums, severe abdominal or stomach cramps and pain

Genitourinary: Dysuria

Renal: Renal calculi

<1%: Anaphylaxis, aplastic anemia, hemolytic anemia, hepatic necrosis leukopenia, lymphocytic leukemia. nephrotic syndrome, penicillin encephalopathy, seizure, urate nephropathy


Drug Interactions

 Probenecid: Inhibits CYP2C19 (weak)

Allopurinol: Theoretically has an additive potential for ampicillin/amoxicillin rash.

Aminoglycosides: May be synergistic against selected organisms.

Disulfiram: May increase levels of penicillins (ampicillin), potentially leading to increased toxicity.

Ketorolac: Avoid concomitant use with ketorolac since its half-life is increased twofold.

Methotrexate: Penicillins may increase the exposure to methotrexate during concurrent therapy; monitor.

Oral contraceptives: Anecdotal reports suggesting decreased contraceptive efficacy with penicillins have been refuted by more rigorous scientific and clinical data.

Warfarin: Effects of warfarin may be increased.


Pharmacodynamics/Kinetics

 See individual agents.


Dosage

 Administer entire contents of bottle as a single one time dose


Patient Education

 Shake well


Dental Health: Effects on Dental Treatment

 Key adverse event(s) related to dental treatment: Oral candidiasis (after chronic dosing), facial flushing, and sore gums.


Dental Health: Vasoconstrictor/Local Anesthetic Precautions

 No information available to require special precautions


Mental Health: Effects on Mental Status

 Large I.V. doses may rarely produce encephalopathy; penicillins have been reported to cause apprehension, illusions, agitation, insomnia, depersonalization, and encephalopathy


Mental Health: Effects on Psychiatric Treatment

 Rarely may cause bone marrow suppression; may rarely produce seizures; use caution with clozapine, carbamazepine, antidepressants, abruptly discontinued benzodiazepines


Dosage Forms

 Powder for oral suspension: Ampicillin 3.5 g and probenecid 1 g per bottle


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