Co-fluampicil (Magnapen)

How does it work?

Magnapen injection contains two active ingredients, flucloxacillin and ampicillin, which together are known as co-fluampicil. (NB. Co-fluampicil is also available without a brand name, ie as the generic medicine.) Flucloxacillin and ampicillin are both penicillin-type antibiotics. They are used to treat infections caused by bacteria.

Flucloxacillin and ampicillin both work by interfering with the ability of bacteria to form cell walls. The cell walls of bacteria are vital for their survival. They keep unwanted substances from entering their cells and stop the contents of their cells from leaking out. Flucloxacillin and ampicillin impair the bonds that hold the bacterial cell wall together. This allows holes to appear in the cell walls and kills the bacteria.

Flucloxacillin differs from other penicillin-type antibiotics. When bacteria become resistant to penicillin antibiotics it is because they produce an enzyme called penicillinase. This enzyme breaks down the penicillin and makes it ineffective at killing the bacteria. Flucloxacillin is not affected by this enzyme. This means it is used primarily to treat infections caused by bacteria that are resistant to other penicillin-type antibiotics.

The combination of flucloxacillin with ampicillin gives a broad-spectrum antibiotic, which kills a wide variety of bacteria that cause a wide variety of commonly-occuring infections. It is usually reserved for treating severe infections where the bacteria causing the infection are unknown, and for mixed infections involving staphylococci bacteria that are known to be producing penicillinase.

To make sure the bacteria causing an infection are susceptible to co-fluampicil, your doctor may take a tissue sample, for example a swab from the throat or skin, or a urine or blood sample.

Co-fluampicil injection is used to treat more serious infections, or in cases where the medicine can't be taken by mouth. It may also be given to prevent infection following surgery. The injection is given by injection into a muscle or vein, or via infusion (drip) into a vein.

What is it used for?

Co-fluampicil is usually reserved for treating severe infections where the bacteria causing the infection are unknown, and for mixed infections involving staphylococci bacteria that are known to be producing penicillinase. These include the following types of infections:

  • Bacterial infections of the upper respiratory tract (nasal passages, sinuses etc) eg sinusitis.
  • Bacterial infections of the lower respiratory tract (lungs, airways) eg bronchitis, pneumonia.
  • Bacterial infections of the ears, nose or throat, eg otitis media, tonsillitis.
  • Bacterial infections of the skin and soft tissue, eg cellulitis, animal bites.
  • Bacterial infections of the genital organs, including those following childbirth or abortion.
  • Bacterial infections of the blood (septicaemia or blood poisoning).
  • Preventing infections following major surgery.

Warning!

  • Broad-spectrum antibiotics can sometimes cause inflammation of the bowel (colitis). For this reason, if you get diarrhoea that becomes severe or persistent or contains blood or mucus, either during or after treatment with this medicine, you should consult your doctor immediately.
  • It is recommended that your kidney and liver function are monitored if you receive prolonged treatment (longer than two weeks) with this medicine.
  • On very rare occasions this medicine may cause liver problems, either during treatment, or up to a few months after treatment is finished. For this reason, you should consult your doctor promptly if you experience symptoms that could suggest a liver problem either during or after being treated with this medicine. These symptoms might include unexplained itching, nausea and vomiting, abdominal pains, loss of appetite or flu-like symptoms, yellowing of the skin or whites of the eyes (jaundice), or unusually dark urine.

Use with caution in

  • Newborn babies.
  • People over 50 years of age.
  • People with serious underlying illness.
  • Decreased liver function.
  • Decreased kidney function.
  • History of allergies.
  • People with suspected glandular fever, acute or chronic lymphoid leukaemia, or cytomegalovirus (CMV), as ampicillin commonly causes a rash in people with these conditions.

Not to be used in

  • People allergic to penicillin or cephalosporin-type antibiotics.
  • People with a history of liver problems or jaundice caused by previous treatment with flucloxacillin.
  • This injection should not be administered into the eye.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

  • There are no known harmful effects when this medicine is used during pregnancy. However, as with all medicines, it should be used with caution during pregnancy and only if the expected benefits outweigh any potential risk. Seek further medical advice from your doctor.
  • This medicine passes into breast milk in small amounts that are unlikely to be harmful to the nursing infant. However, as with all medicines it should be used with caution in breastfeeding mothers, and only if the expected benefit outweighs any possible risk. Seek further medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Prolonged treatment with antibiotics can sometimes cause overgrowth of other organisms that are not susceptible to the antibiotic, for example fungi or yeasts such as Candida. This may sometimes cause infections such as thrush. Tell your doctor if you think you have developed a new infection during or after taking this antibiotic.

  • Diarrhoea.
  • Nausea and vomiting.
  • Rash or hives.
  • Itching (pruritus).
  • Allergic reaction to active ingredient.
  • Severe allergic skin reactions.
  • Fever.
  • Inflammation of the large intestine (pseudomembranous colitis) - see warning section above.
  • Yellowing of the skin and eyes (jaundice).
  • Inflammation of the liver (hepatitis) - see warning section above.
  • Aching muscles or joints.
  • Disturbance in the number of white blood cells or platelets in the blood.

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

You should tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, ask your doctor or pharmacist before taking any new medicines while taking this one, so they can check that the combination is safe.

In the past, women using hormonal contraception such as the pill or patch would be advised to use an extra method of contraception (eg condoms) while taking an antibiotic like this one and for seven days after finishing the course. However, this advice has now changed. You no longer need to use an extra method of contraception with the pill, patch or vaginal ring while you take a course of antibiotics. This change in advice comes because to date there is no evidence to prove that antibiotics (other than rifampicin or rifabutin) affect these contraceptives. This is the latest guidance from the Faculty of Sexual & Reproductive Healthcare.

However, if you are taking the contraceptive pill and experience vomiting or diarrhoea as a result of treatment with this antibiotic, you should follow the instructions for vomiting and diarrhoea described in the leaflet provided with your pills.

Co-fluampicil may rarely alter the anti-blood-clotting effects of anticoagulant medicines such as warfarin. Your doctor may want to do extra tests of your blood clotting time (INR) while you are taking both medicines.

Co-fluampicil may on rare occasions decrease the removal of the medicine methotrexate from the body, which could increase the risk of its side effects. If you are taking methotrexate, your doctor may want to perform some extra checks while you are having a course of this antibiotic. You should let your doctor know if you think you have experienced any new or increased side effects after starting this antibiotic.

There may be an increased risk of experiencing a rash as a side effect of this medicine if you are also taking allopurinol.

Oral typhoid vaccine (Vivotif) should not be taken until at least three days after you have finished a course of this antibiotic, because the antibiotic could make this vaccine less effective.

Probenecid may increase the blood level of co-fluampicil and people taking probenecid may be prescribed a lower dose of this antibiotic.

Other medicines containing the same active ingredients

Co-fluampicil capsules and syrup are also available without a brand name, ie as the generic medicine.