Cloxadol is a preparation of flucloxacillin. It is active against Gram-positive organisms including penicillinase producing strains. After an oral dose peak plasma concentrations are achieved in about 1 hour in fasting subjects. About 95% of flucloxacillin in the circulation is bound to plasma proteins and its plasma half life is approximately 1 hour. Flucloxacillin is metabolized to a limited extent, and the unchanged drug is excreted mainly in urine.

Flucloxacillin is indicated for the treatment of infections due to Gram-positive organisms, including infections caused by ß-lactamase producing staphylococci. Typical indications include:

Skin and soft tissue infections Boils, abscesses, carbuncles, infected skin conditions, e.g. ulcer, eczema and acne. Furunculosis, cellulitis, infected wounds, infected burns, protection for skin grafts, otitis media and externa, impetigo.

Respiratory tract infections Pneumonia, lung abscess, empyema, sinusitis, pharyngitis, tonsillitis, quinsy.

Other infections caused by flucloxacillin-sensitive organisms Osteomyelitis, enteritis, endocarditis, urinary tract infection, meningitis, septicaemia. Flucloxacillin is also indicated for use as a prophylactic agent during major surgical procedures where appropriate; for example, cardiothoracic and orthopaedic surgery.

Usual adult dosage (including elderly patients) 250 mg four times daily. Dosage may be doubled in severe infections. Osteomyelitis, endocarditis - upto 8g daily, in divided doses six to eight hourly.

Usual children's dosage
2-10 years: 1/2 adult dose.
Under 2 years : 1/4 adult dose.

Impaired renal function: In common with other penicillins, flucloxacillin usage in patients with renal impairment dose not usually require dosage reduction. However, in the presence of severe renal failure (creatinine clearance <10 ml/min) a reduction in dose or an extension of dose interval should be considered. Flucloxacillin is not significantly removed by dialysis and hence no supplementary dosage need to be administered either during or at the end of the dialysis period.

Hypersensitivity to penicillins.

Animal studies with flucloxacillin have shown no teratogenic effects. The drug has been in clinical use since 1970 and the limited number of reported cases of use in human pregnancy have shown no evidence of untoward effect. The use of flucloxacillin in pregnancy should be reserved for cases considered essential by the clinician. During lactation, trace quantities of penicillins can be detected in breast milk.

Side-effects, as with other penicillins, are uncommon and mainly of a mild and transitory nature. Gastrointestinal upsets (e.g. nausea, diarrhoea) and skin rashes have been reported infrequently. If a skin rash occurs, treatment should be discontinued.

Problems of over dosage with flucloxacillin are unlikely to occur; if encountered they may be treated symptomatically.

Cloxadol capsule and powder for syrup should be stored in a cool, dry place and should be protected from light. Keep out of reach of children.

Cloxadol 250 mg capsule: Box containing 10 strips of 10 capsules. Each capsule contains 250 mg flucloxacillin as flucloxacillin sodium BP.
Cloxadol 500 mg capsule: Box containing 5 strips of 6 capsules. Each capsule contains 500 mg flucloxacillin as flucloxacillin sodium BP.
Cloxadol syrup: Amber glass bottle containing powder for the preparation of 100 ml syrup. After reconstitution each 5 ml contains 125 mg flucloxacillin as flucloxacillin sodium BP.