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Nafcillin

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Nafcillin, Nafcil, Unipen

  • See Also
  1. Penicillin
  2. Penicillinase-Resistant Penicillin
  3. Dicloxacillin
  4. Oxacillin
  • Indications
  1. See Penicillinase-Resistant Penicillin
  2. Methicillin-Sensitive Staphylococcus Aureus (MSSA)
  3. Osteomyelitis
  • Mechanism
  1. See Penicillin
  2. See Penicillinase-Resistant Penicillin
  • Dosing
  1. Adult (or child, weight >40 kg)
    1. Give 1 to 2 grams IV every 4 to 6 hours OR
    2. Give 500 mg IM every 4 to 6 hours
    3. Use 1 to 2 grams IV every 4 hours in Osteomyelitis
  2. Child (weight <40 kg)
    1. Mild to Moderate Infection
      1. Give 50 to 100 mg/kg/day IM or IV divided every 6 hours OR
      2. Give 25 mg mg/kg IM twice daily (has been used in low resource regions)
    2. Severe Infection
      1. Give 100 to 200 mg/kg/day IM or IV divided every 6 hours
  3. Newborns (Weight >2 kg)
    1. Age <1 week
      1. Give 25 mg/kg IM or IV every 8 hours
    2. Age >1 week
      1. Give 25 to 35 mg/kg IM or IV every 6 hours
  • Adverse Effects
  1. Venous inflammation
  2. Neutropenia
    1. Occurs with prolonged use
    2. Resolves on discontinuation of Nafcillin
  • Drug Interactions
  1. Warfarin
    1. Nafcillin may decrease INR
  2. Cyclosporine
    1. Nafcillin may decrease Cyclosporine levels
  • Safety
  1. Safe in Pregnancy
  2. Safe in Lactation
  • Resources
  1. Nafcillin (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=0f21384c-0f82-4d99-a05c-6773d1ee4bcf
  • References
  1. Hamilton (2020) Tarascon Pocket Pharmacopoeia
  2. Miller (2002) J Midwifery Womens Health 47(6):426-34 +PMID: 12484664 [PubMed]
  3. Bush (2016) Cold Spring Harb Perspect Med 6(8):a025247 +PMID: 27329032 [PubMed]