Last update Feb. 5, 2024

Pivmecillinam / Mecilinam

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

Pivmecilinam or Amdinofilin pivoxil (USA) is a prodrug of the beta-lactam antibiotic mecilinam (amdinofilin). Pivmecillinam is well absorbed from the gastrointestinal tract and is rapidly hydrolysed to the active drug mecillinam. It is indicated for the treatment of urinary tract infections. Oral administration 2 to 4 times daily.

Pivmecilinam(mecilinam has not been found in breast milk (Seiga 1977) or in such a trace amount that no effects on breastfed infants/newborns are anticipated. (Karo 223, AEMPS 2023, Knight 2019)

The manufacturer considers it compatible with breastfeeding. (Karo 223, AEMPS 2023, Knight 2019)

The oral bioavailability of mecilinam is very low, so it is administered in the form of pivmecilinam (which is well absorbed) and immediately converted to mecilinam by enzymatic hydrolysis (Roholt 1975). The little mecilinam that may pass into breast milk will not be absorbed by the infant.

Alternatives

We do not have alternatives for Pivmecillinam / Mecilinam since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Pivmecillinam / Mecilinam is also known as


Pivmecillinam / Mecilinam in other languages or writings:

Group

Pivmecillinam / Mecilinam belongs to this group or family:

Tradenames

Main tradenames from several countries containing Pivmecillinam / Mecilinam in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. Pivmec: 45-70; Mecilinam: ≈ 0 %
Molecular weight Pivmec: 440; Mec: 325 daltons
Protein Binding 5 - 10 %
VD 0.2 l/Kg
Tmax 1 - 1.5 hours
1 hours

References

  1. Karo Pharma. Pivmecillinam Package leaflet: Information for the user. 2023 Consulted on Feb. 5, 2024 Full text (in our servers)
  2. AEMPS (Karo Ph).. Pivmecilinam (Selexid). Ficha técnica. 2023 Full text (in our servers)
  3. Knight. Pivmecillinam (Selexide). Drug Summary. 2019 Full text (in our servers)
  4. Neu HC, Srinivasan S, Francke EL, Ortiz-Neu C, Christenson JG. Pharmacokinetics of amdinocillin and pivamdinocillin in normal volunteers. Am J Med. 1983 Aug 29;75(2A):60-4. Abstract
  5. Gambertoglio JG, Barriere SL, Lin ET, Conte JE Jr. Pharmacokinetics of mecillinam in health subjects. Antimicrob Agents Chemother. 1980 Dec;18(6):952-6. Abstract Full text (link to original source)
  6. Seiga K, Minagawa M, Yamaji K. Studies on pivmecillinam. Chemotherapy (Tokyo). 1977;25:347–51 Studies on pivmecillinam. Chemotherapy (Tokyo). 1977;25:347–51 Full text (link to original source) Full text (in our servers)
  7. Roholt K, Nielsen B, Kristensen. Pharmacokinetic studies with mecillinam and pivmecillinam. Chemotherapy. 1975;21(3-4):146-66. Abstract

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