Emcil 200mg Tab

Overview

Emcil 200 mg Tablet contains Pivmecillinam, a prodrug that is rapidly hydrolysed in the body to mecillinam (amdinocillin), an amidinopenicillin antibiotic, manufactured by Square Pharmaceuticals PLC. Mecillinam has a unique mechanism — it selectively binds to penicillin-binding protein 2 (PBP2) of Gram-negative bacteria, causing spherical cell formation and lysis. It is highly effective for lower urinary tract infections (UTIs) caused by Gram-negative organisms, especially E. coli, Klebsiella, and Enterobacter species.

Dosage and Administration

Adults: 400 mg (2 tablets) three times daily for 3–7 days for uncomplicated UTI, or as prescribed. Take with food and adequate water to reduce the risk of oesophageal injury from the tablet.

Interaction

Concurrent use with other beta-lactam antibiotics may have additive effects. Probenecid inhibits renal excretion and may increase mecillinam levels. May affect methotrexate excretion.

Contraindications

Contraindicated in known hypersensitivity to penicillins or other beta-lactam antibiotics (risk of cross-reactivity), and in patients with carnitine deficiency syndromes.

Side Effects

Nausea, vomiting, diarrhoea, and abdominal pain. Hypersensitivity reactions (rash, urticaria). Oesophageal ulceration if taken without adequate water. Prolonged use may cause carnitine deficiency.

Pregnancy and Lactation

Use with caution in pregnancy — generally considered acceptable for UTI treatment if benefit outweighs risk. Limited data during breastfeeding; use with physician guidance.

Precautions and Warnings

Take with food and a full glass of water. Supplement carnitine levels (via balanced diet) if prolonged courses are prescribed. Complete the full course to prevent UTI recurrence and resistance.

Storage Conditions

Store below 25°C in a cool, dry place. Keep out of the reach of children.

Frequently Asked Questions

Why is pivmecillinam particularly useful for UTIs?
Mecillinam is predominantly excreted renally in active form and achieves high urinary concentrations; its unique PBP2-selective mechanism is effective even against some strains resistant to conventional beta-lactams.

Does pivmecillinam cause the same allergy risks as amoxicillin?
Yes — cross-reactivity with other penicillins is possible; patients with documented penicillin allergy must not take pivmecillinam without specialist assessment.

This content is for informational purposes only and does not substitute professional medical advice. Please consult a registered physician before taking any medication.