How Genes Influence The Breakdown Of Flucloxacillin

What Is Flucloxacillin?

Flucloxacillin is a narrow-spectrum antibiotic (antibiotics that can kill only specific kinds of bacteria).

It can be bought only on prescription and is available in the form of capsules, oral liquids, and injections.

It is not a common antibiotic used in the United States and is sold under brand names Floxapen, Flopen, Staphylex, and Flupen in different parts of the world.

What Is Flucloxacillin Used For?

This drug is commonly used to treat:

Infections and wounds in the skin
Bone infections like osteomyelitis
Infection in the joints
Ear infections
Urinary Tract Infections (UTIs)
Pneumonia, along with other antibiotics

Flucloxacillin is also used before surgery to prevent infections.

Can I Use Flucloxacillin For A UTI?

Yes, your doctor may recommend flucloxacillin for treating Urinary Tract Infections (UTIs).

How Does Flucloxacillin Work?

Flucloxacillin belongs to the group of antibiotics called penicillin.

Bacteria grow and sustain by protecting themselves from their surroundings using a cell wall.

The work of penicillin-type antibiotics is to prevent bacteria from forming cell walls.

The bacterial cell walls need a substance called peptidoglycans to give them structure.

Peptidoglycans give mesh-like structures to the walls and make them stronger.

Flucloxacillin attacks the proteins in peptidoglycans and creates holes in them.

As a result, external fluid rushes in and bursts the wall.

This destroys the bacteria and helps bring down infection levels.

Is Flucloxacillin Stronger Than Penicillin?

Flucloxacillin is similar in effectiveness to other types of penicillin drugs.

However, it is known to be more stable than other penicillin types.

Side Effects Of Flucloxacillin

Some of the common side effects of flucloxacillin are:

Nausea
Rashes
Diarrhea
Bloating
Indigestion

One of the more severe side effects of flucloxacillin is flucloxacillin-induced delayed cholestatic hepatitis.

This condition leads to abnormal liver functioning, elevated bilirubin levels, and liver inflammation due to the use of flucloxacillin.

Flucloxacillin may also cause bloody stools and joint and muscle pain.

Interactions With Other Drugs

Flucloxacillin may interact with other drugs and lead to changes in drug efficacy or worse side effects.

Notify your doctor if you use flucloxacillin along with any of the below medicines.

Warfarin (blood thinner medication)
Direct Oral Anti-Coagulants (DOACs) including apixaban, rivaroxaban, and edoxaban (reduce the risk of strokes)
Methotrexate (chemotherapy drug)
Probenecid (to treat gout)
Lorazepam (treats anxiety and sleep disorders)

Flucloxacillin: Gene-Drug Interactions

The NR1I2 gene

The Nuclear receptor subfamily 1 group I member 2 gene (NR1I2 gene) provides instructions for producing the pregnane X receptor (PXR).

PXR identifies the presence of foreign substances in the body and increases or decreases the levels of enzymes and proteins needed for clearing these foreign substances.

rs3814055 is a Single Nucleotide Polymorphism (SNP) in the NR1I2 gene.

People with the CC genotype of this SNP have an increased risk of developing toxic liver diseases when treated with flucloxacillin compared to people with the CT and TT genotypes.

Genotypes	Implications
CC	Increased risk of developing toxic liver diseases when treated with flucloxacillin
CT	Regular risk of developing toxic liver diseases when treated with flucloxacillin
TT	Regular risk of developing toxic liver diseases when treated with flucloxacillin

Recommendations To Use Flucloxacillin

Flucloxacillin Hypersensitivity

Flucloxacillin may cause hypersensitivity in some.

A study analyzed the reaction of the drug in 108 patients. O

ut of them, 33 patients showed immediate hypersensitivity, and 7 had delayed hypersensitivity.

Contact your nearest ER or dial 911 if you experience any of the below hypersensitivity symptoms after consuming flucloxacillin.

Difficulty in breathing
Hives
Rashes in the skin
Dizziness

Pregnancy And Breastfeeding

It may be safe to use prescribed doses of flucloxacillin during pregnancy and breastfeeding.

It is better to talk to your doctor and get their approval before usage.

Flucloxacillin And Gastrointestinal Problems

Most antibiotics may cause gastrointestinal (GI) problems.

In the process of killing harmful bacteria in the body, antibiotics like flucloxacillin also kill the good bacteria in the gut, leading to problems like diarrhea, cramping, and bloating.

You can avoid this by including probiotic foods in your diet while on flucloxacillin.

This drug causes lesser GI problems when consumed on an empty stomach.

The absorption of the medicine is also better this way.

While on the drug, you can handle GI problems better by:

Consuming home-cooked, healthy meals
Eating smaller meals at a time
Avoiding spicy and sweet foods
Keeping your body hydrated
Avoiding foods that cause gas and flatulence, including beans, peas, and lentils

Genetic Testing

Genetic testing can help understand a person’s risk of developing extreme side effects on using flucloxacillin.

This will help plan the right dosages in patients who require long-term use of the drug.

It will also help doctors weigh the risks and benefits and choose between flucloxacillin and other antibiotics.

Analyze Your Genetic Response to Flucloxacillin

Can I Have Alcohol With Flucloxacillin?

Combining alcohol with flucloxacillin may worsen the gastric side effects of the drug.

Talk to your doctor if you want to consume alcohol while on this drug.

Is Flucloxacillin Safe While Breastfeeding?

There are no adverse effects noted on using flucloxacillin while breastfeeding.

However, consult your doctor and get approval if you are lactating and use flucloxacillin.

Summary

Flucloxacillin is a narrow-spectrum antibiotic that belongs to the penicillin category of medications.
Flucloxacillin is used to treat skin, bone and joint, urinary tract, and bacterial ear infections.
Flucloxacillin breaks bacteria cell walls and prevents bacteria from growing and dividing.
Some of the side effects of flucloxacillin are nausea, vomiting, other gastrointestinal troubles, blood in stools, and flucloxacillin-induced delayed cholestatic hepatitis (liver damage).
Flucloxacillin may interact with blood thinners, Direct Oral Anti-Coagulants (DOACs), chemotherapy drugs, and anti-anxiety drugs and lead to changes in drug efficacy or worse side effects.
Changes in the NR1I2 gene may increase or decrease a person’s risk of developing toxic liver diseases when treated with flucloxacillin.
Flucloxacillin, like other antibiotics, may cause gastrointestinal(GI) troubles. Adding probiotics to your diet, staying away from spicy, sweet foods, and keeping your body hydrated will all help bring down the intensity of GI problems.
Genetic testing can help understand a person’s risk of developing adverse side effects on using flucloxacillin. It can help doctors decide between choosing flucloxacillin and an alternate antibiotic.