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Phenoxymethylpenicillin (Penicillin V)

Overview

Field Detail
Drug class Natural penicillin / Phenoxypenicillin
Route Oral
Forms 250 mg, 500 mg tablets; 150 mg/5 mL, 250 mg/5 mL suspension
Storage Room temp before; refrigerate suspension after mixing

Preparation for Oral Challenge

Before you start

Ensure the patient has fasted if required. Use a calibrated oral syringe for all volumes. Check the concentration of the suspension (150 mg/5 mL or 250 mg/5 mL).

Reagents

  • Phenoxymethylpenicillin Suspension (e.g., Cilicaine VK)
  • Syringes: 1 mL, 3 mL, 5 mL, 10 mL oral syringes
  • Measuring cup

Step-by-step Challenge Protocol

Option A: Using 150 mg/5 mL (30 mg/mL) Suspension:

Step Dose Volume Cumulative Dose
1 30 mg 1.0 mL 30 mg
2 60 mg 2.0 mL 90 mg
3 120 mg 4.0 mL 210 mg
4 300 mg 10.0 mL 510 mg

Option B: Using 250 mg/5 mL (50 mg/mL) Suspension:

Step Dose Volume Cumulative Dose
1 30 mg 0.6 mL 30 mg
2 60 mg 1.2 mL 90 mg
3 120 mg 2.4 mL 210 mg
4 300 mg 6.0 mL 510 mg

Challenge Protocol

Intervals: Observe for 30–60 minutes between each step. Final Observation: Monitor for 1–2 hours after the final dose.


Notes

  • Phenoxymethylpenicillin is not routinely used for skin testing. If required, test with Benzylpenicillin, PPL and MD.
  • Commonly used for treating mild-to-moderate infections including tonsillitis and pharyngitis.