Meicelin Special Precautions

For treatment of tonsillitis (including peritonsillar abscess) and acute bronchitis, Manual of Antimicrobial Stewardship (The Government of Japan, Ministry of Health, Labour and Welfare) should be consulted to decide whether administration of antimicrobials is necessary, and then this drug should be administered in cases where treatment with this drug is determined to be appropriate.
Careful Administration (MEICELIN For Injection should be administered with care in the following patients): Patients with a history of hypersensitivity to penicillins.
Patients with a personal or familial predisposition to allergic symptoms such as bronchial asthma, exanthema or urticaria.
Patients with severely impaired renal function [High drug blood level is maintained (See PHARMACOLOGY: PHARMACOKINETICS under Actions)].
Elderly patients. [See Use in the Elderly as follows.]
Patients who are poorly-nourished, parenterally nourished or in poor general condition. (Sufficient observation should be performed because vitamin K deficiency symptoms may develop.)
Important Precautions: Since no methods are available to reliably predict the potential occurrence of shock or anaphylactic reaction due to this product, the following measures should be taken: Patients should be carefully interviewed in advance to obtain any past history of such reactions to drugs. Any history of allergy to antibiotics or other agents must be ascertained.
Emergency measures must be available readily for the treatment of shock etc., when this product is used.
Patients should be resting and kept under careful observation from the beginning until after the end of administration of this product. Patients should be observed especially carefully immediately after the beginning of administration.
Alcohol intake may cause lushed face, palpitation, dizziness, headache, nausea, etc. Therefore, alcohol intake should be avoided during treatment and at least one week after completion of treatment.
Other Precautions: It has been reported that when this product was administered subcutaneously to juvenile rats, testicular atrophy and spermatogenic suppression occurred.
It has been reported that there is a possibility of development of Clostridium difficile and Klebsiella oxytoca due to administration of the product.
Use in Children: The safety of this product in newborns and premature infants has not been established (few clinical experiences).
Use in the Elderly: The product should be administered carefully to elderly patients, paying attention to the following two points, and dose and dose intervals should be adjusted to meet the patients condition.
Adverse reactions are likely to occur in elderly patients since their physiological function is generally reduced.
A bleeding tendency due to vitamin K deficiency may occur in elderly patients.