Nafcillin Brand Name– Nallpen
What is Nafcillin
Nafcillin is a semisynthetic antistaphylococcal penicillin. Unlike penicillin, ampicillin, or the extended-spectrum penicillins, nafcillin resists hydrolysis by penicillinase.
As a result, nafcillin, along with other agents in the same group (e.g., oxacillin, dicloxacillin), is active against penicillinase-producing S.aureus.
The risk of interstitial nephritis is less with nafcillin than with methicillin; however, dicloxacillin is preferred over nafcillin when oral therapy is desired due to more reliable gastrointestinal absorption.
Clinical uses of nafcillin include bacteremia, skin and soft-tissue infections, respiratory tract infections, bone and joint infections, and urinary tract infections.
Nafcillin was approved by the FDA in 1964.
Indications
- bacteremia
- bone and joint infections
- cellulitis
- community-acquired pneumonia
- endocarditis
- infectious arthritis
- lower respiratory tract infections
- mastitis
- meningitis
- neonatal mastitis
- osteomyelitis
- pneumonia
- skin and skin structure infections
- Staphylococcus aureus (MSSA)
- Staphylococcus sp.
Side Effects
- abdominal pain
- agranulocytosis
- anaphylactic shock
- anaphylactoid reactions
- angioedema
- arthralgia
- bronchospasm
- cholestasis
- diarrhea
- elevated hepatic enzymes
- eosinophilia
- exfoliative dermatitis
- fever
- hematuria
- hypotension
- injection site reaction
- interstitial nephritis
- laryngeal edema
- laryngospasm
- malaise
- myalgia
- nausea
- neutropenia
- phlebitis
- proteinuria
- pruritus
- pseudomembranous colitis
- rash
- renal tubular necrosis
- seizures
- serum sickness
- Stevens-Johnson syndrome
- stomatitis
- superinfection
- tissue necrosis
- tongue discoloration
- toxic epidermal necrolysis
- urticaria
- vomiting
Hematologic adverse effects such as agranulocytosis, neutropenia, and bone marrow depression have occurred during nafcillin therapy.
Monitoring Parameters
- CBC
- LFTs
- serum alkaline phosphatase
- serum bilirubin
- serum creatinine/BUN
- urinalysis
Contraindications
- asthma
- breast-feeding
- carbapenem hypersensitivity
- cephalosporin hypersensitivity
- colitis
- diarrhea
- eczema
- electrolyte imbalance
- extravasation
- geriatric
- GI disease
- heart failure
- hepatic disease
- inflammatory bowel disease
- jaundice
- penicillin hypersensitivity
- pregnancy
- pseudomembranous colitis
- ulcerative colitis
Interactions
- Abemaciclib
- Acetaminophen; Aspirin, ASA; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Codeine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Amlodipine
- Amlodipine; Atorvastatin
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Aprepitant, Fosaprepitant
- Artemether; Lumefantrine
- Aspirin, ASA
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Citric Acid; Sodium Bicarbonate
- Aspirin, ASA; Dipyridamole
- Aspirin, ASA; Omeprazole
- Aspirin, ASA; Oxycodone
- Aspirin, ASA; Pravastatin
- Atazanavir
- Atazanavir; Cobicistat
- Avapritinib
- Axitinib
- Bedaquiline
- Benzhydrocodone; Acetaminophen
- Boceprevir
- Brigatinib
- Bromocriptine
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Budesonide
- Budesonide; Formoterol
- Capmatinib
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Choline Salicylate; Magnesium Salicylate
- Cobicistat
- Cobimetinib
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Colchicine; Probenecid
- Cyclophosphamide
- Cyclosporine
- Daclatasvir
- Dapsone
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Deflazacort
- Dichlorphenamide
- Digoxin
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Dolutegravir; Rilpivirine
- Doravirine
- Doravirine; Lamivudine; Tenofovir disoproxil fumarate
- Doxorubicin
- Dronabinol
- Dronedarone
- Elbasvir; Grazoprevir
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Encorafenib
- Entrectinib
- Erdafitinib
- Erlotinib
- Ethacrynic Acid
- Fedratinib
- Fentanyl
- Flibanserin
- food
- Furosemide
- Glasdegib
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Homatropine; Hydrocodone
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Ibrutinib
- Ibuprofen; Oxycodone
- Ifosfamide
- Indomethacin
- Isavuconazonium
- Ixabepilone
- Lefamulin
- Lemborexant
- Letermovir
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Lorlatinib
- Lumateperone
- Lurbinectedin
- Magnesium Salicylate
- Maraviroc
- Methotrexate
- Nanoparticle Albumin-Bound Paclitaxel
- Neratinib
- Nisoldipine
- Olaparib
- Ombitasvir; Paritaprevir; Ritonavir
- Oral Contraceptives
- Oxycodone
- Pazopanib
- Pemigatinib
- Perampanel
- Perindopril; Amlodipine
- Pimavanserin
- Praziquantel
- Probenecid
- Rilpivirine
- Rimegepant
- Ritonavir
- Rivaroxaban
- Romidepsin
- Ruxolitinib
- Salsalate
- Selpercatinib
- Selumetinib
- Siponimod
- Sodium Benzoate; Sodium Phenylacetate
- Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
- Sofosbuvir; Velpatasvir
- Sofosbuvir; Velpatasvir; Voxilaprevir
- Sonidegib
- Sufentanil
- Sunitinib
- Tazemetostat
- Telaprevir
- Terbinafine
- Tetracyclines
- Tolvaptan
- Typhoid Vaccine
- Ubrogepant
- Venetoclax
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- Vincristine Liposomal
- Vorapaxar
- Voxelotor
- Warfarin
- Zanubrutinib