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Cloxacillin

Penicillin · Antibiotic

PenicillinAntibiotic
CDSCO approvedSchedule H1
EXCRETION
not curated
INTERACTIONS
2 major
SEVERE in our sources
PREGNANCY
. Single dose of oral metronidazole (additional intraoperative or postoperative doses may be given for
FDA category + note
Top interactions
  • AmpicillinSevereTextbookKDT 7e · p723
  • MethotrexateSevereDatabaseDDInter

Mechanism

Cloxacillin is an isoxazolyl penicillin (penicillinase-resistant penicillin) that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs) and blocking transpeptidation of peptidoglycan. The bulky isoxazolyl side chain at the 6-position of the beta-lactam ring provides steric hindrance that prevents access by staphylococcal penicillinases (beta-lactamases), conferring activity against methicillin-susceptible Staphylococcus aureus (MSSA). Its narrow spectrum is restricted primarily to gram-positive cocci.

Indications

penicillinase producing staphylococcal infection (uncommon in urinary tract)

Dosing

Adult
is ~0.5 unit/mL (0.3 μg/mL) after an oral dose of 400,000 units. (~250 mg) in an adult. Ingestion of food may interfere with enteric. 500 mg is nearly 3 μg/mL. Once absorbed, penicillin V is distributed in the body and excreted by the kidney in a manner similar to

Pregnancy & lactation

Pregnancy

. Single dose of oral metronidazole (additional intraoperative or postoperative doses may be given for

Drug interactions

Ampicillin
Severe
Textbook

Reduced efficacy, increased bacterial resistance, higher cost, and more adverse effects. Ineffective against MRSA.

Blind therapy with this fixed-dose combination is irrational and harmful and should be avoided.

Source: KDT 7e · p723

Methotrexate
Severe
Database

Drug interaction classified as: excretion

Source: DDInter

10 additional low-confidence interactions hidden — those rows lack a documented mechanism or management plan in our sources.

Related guidelines

Other Penicillin drugs

Ask House about Cloxacillin

Continue into a citation-backed clinical answer with the drug context already attached.

Sources: KD Tripathi 7e·Verified: 2026-05-10 · House clinical team