Patient leaflet - Phenoxymethylpenicillin 250 mg / 5 ml granules for oral solution
1. What Phenoxymethylpenicillin Oral Solution is and what it is used for
This medicine belongs to the penicillin group of antibiotics. Phenoxymethylpenicillin is an antibacterial drug used in the treatment of mild to moderately severe infections such as chest and throat infections, skin and soft tissue infections, infections of the mouth, gums and teeth, scarlet fever (characterised by high fever, sore throat and skin rashes), and mild erysipelas (disease marked by red skin eruptions, chills and fever). Also used in the prevention of rheumatic fever and chorea (a group of disorders characterised by brief rapid involuntary movements of limbs, face, trunk and head).
2. What you need to know before you take
Phenoxymethylpenicillin Oral Solution Do not take Phenoxymethylpenicillin Oral Solution if:
- you have a history of allergic reactions to any penicillins, cephalosporins or other allergy causing agents
- you are allergic to phenoxymethylpenicillin or any of the other ingredients of this medicine (listed in section 6). Warnings and precautions
Talk to your doctor before taking Phenoxymethylpenicillin Oral Solution if:
- you are suffering from severe illness, nausea, vomiting, stomach bloating/cramping or difficulty swallowing
- suffer from stomach problems accompanied by vomiting or diarrhoea – your doctor may decide that an oral antibiotic is not of benefit to you
- you suffer from allergies and/or asthma
- suffer from any kidney problems, as you may be given a lower dose than normal
- suffer from allergic reactions to penicillin, cephalosporins or other drugs
- have an intolerance to some sugars, as this medicine contains sucrose
- if you are taking the contraceptive pill. You may need to take extra contraceptive precaution such as using a condom. Potentially life-threatening skin rashes (Stevens Johnson syndrome, toxic epidermal necrolysis) have been reported with the use of some penicillin’s appearing initially as reddish target-like spots or circular patches often with central blisters on the trunk. Additional signs to look for include ulcers in the mouth, throat, nose, genitals and conjunctivitis (red and swollen eyes). If you develop a rash or these skin symptoms, stop taking Phenoxymethylpenicillin Granules for Oral Solution, seek urgent advice from a doctor and tell them that you are taking this medicine.
Prolonged use of an antibiotic may result in infections due to bacteria resistance to the antibiotic.
Other medicines and Phenoxymethylpenicillin Oral Solution
Your medicine may interfere with other medicines that you may be taking. Please inform your doctor or pharmacist if you are taking, or have recently taken, any other medicines even those not prescribed, including herbal and homeopathic remedies. Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, especially:
- antibacterial medicines e.g. tetracycline, erythromycin, neomycin and chloramphenicol have been reported to reduce the effect of penicillin
probenecid or sulfinpyrazone - used for treatment of gout
- guar gum – used in diabetes
- anticoagulants e.g. warfarin (to prevent blood clots)
- methotrexate (to treat cancer or psoriasis)
- oral typhoid vaccine (penicillin can stop this from working)
- The contraceptive pill (you will need to take extra contraceptive precautions such as using a condom).
Laboratory tests
In patients undergoing long-term treatment with
phenoxymethylpenicillin, blood counts and also liver and kidney function should be monitored.
- Tell your doctor if you are having urine tests for diabetes or certain liver function tests, as the medicine can affect the results of some tests.
Phenoxymethylpenicillin Oral Solution with food and drink
Guar gum (used as a thickening agent and normally found in puddings and ice-cream and benefiber) can reduce the absorption of phenoxymethylpenicillin.
Pregnancy, breast-feeding and fertility
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
This medicine may be present in breast milk and can cause an allergic reaction in the infant.
Driving and using machines
It is not known if Phenoxymethylpenicillin Granules for Oral Solution has an effect on your ability to drive and use machines however some of the side effects may affect your ability to drive and use machines.
Phenoxymethylpenicillin Oral Solution contains sucrose and E124
Each 5ml of this medicine contains 2.55g of sucrose, this should be taken into account in patients with diabetes mellitus. May be harmful to the teeth. Also if you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.
This medicine contains E124 which may cause allergic reactions. This medicine contains less than 1 mmol sodium (23 mg) per 5ml that is to say essentially ‘sodium-free’.
3. How to take Phenoxymethylpenicillin Oral Solution
For oral use. Shake the bottle well before use. Take the medicine half an hour before or at least 2 hours after a meal. The dose will be different for different medical conditions and patients. Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
The recommended dose is:
Adults (including the elderly): 125 – 500mg (half to two 5ml spoonfuls), every 4 to 6 hours.
For long-term preventative treatment of rheumatic fever, the dose is 125mg (2.5ml/half a 5ml spoonful) twice a day. The dose will be reduced if you have kidney problems. Children up to 1 year of age: 62.5mg every 6 hours (The 250mg/5ml strength is not suitable for use).
Children 1 to 5 years of age: 125mg (2.5ml/half a 5ml spoonful), every 6 hours.
Children 6 to 12 years of age: 250mg (one 5ml spoonful), every 6 hours.
Patients with kidney and liver problems
- If you have kidney problems the dose might be changed by your doctor.
- Dosage might be changed by your doctor if you have liver problems along with kidney problem.
In patients with bacterial infection (such as streptococcal infection), treatment is continued at the full dosage for 10 days to minimise complications.
Product: Phenoxymethylpenicillin 250mg/5ml Granules for Oral Solution - PL 20416/0132
Contact your doctor straight away or go to the nearest hospital casualty department. Take with you any remaining oral solution and the container so that the medicine can be identified.
If you forget to take Phenoxymethylpenicillin Oral Solution
Take it as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and continue with the regular dosing schedule. Do not take a double dose to make up for a forgotten dose.
If you stop taking Phenoxymethylpenicillin Oral Solution
It is important to finish your prescribed course of this medicine. If you stop taking your medicine too soon, your infection may come back.
If you have any further questions on the use of this medicine, ask your doctor, pharmacist or nurse.
4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Hypersensitivity/Allergic reactions of all intensity levels - to the point of anaphylactic shock-have also been observed after oral penicillin use. Severe anaphylactoid reactions, which occur significantly less often after oral administration of penicillin than after intravenous or intramuscular administration, may require appropriate emergency management.
If you develop any of the reactions listed below – IMMEDIATELY STOP taking your medicine and contact your doctor or go to the nearest hospital.
hypersensitivity of all severities (allergic reaction)
- symptoms may include - difficulty breathing, muscle weakness, fever, joint pain, changes in blood counts, sudden swelling of the lips, cheeks, eyelids, tongue and throat, laryngeal oedema (accumulation of fluid in the larynx), bronchospasm (wheezing, shortness of breath), increase in the heartbeat, vasculitis (inflammation of blood vessels) and a sudden drop in blood pressure up to life threatening shock
- allergic skin reactions including rash, itching, hives and rarely, severe blistering/peeling of the skin
- pseudomembranous enterocolitis (bacterial infection of the large intestine. Symptoms include abdominal pain and diarrhoea)
Tell your doctor or pharmacist if you notice any of the side effects in the following sections:
Common: (may affect more than 1 in 10 people)
- nausea (feeling sick)
- vomiting (getting sick)
- stomach ache
- pain or discomfort in the upper abdomen (gastric discomfort)
- cramps and diarrhoea
- gas (flatulence)
- inflamed and sore mouth (stomatitis), inflammation of the tongue (glossitis)
- rash, itchy skin, hives (immediate presence of hives indicates penicillin allergy, use of Phenoxymethylpenicillin should be discontinued)
- eruption of the skin (exanthema)
Very common: (may affect more than 1 in 10 people)
- loss of appetite
Uncommon: (may affect up to 1 in 100 people)
- sore mouth
- black hairy tongue (discolouration of tongue) Rare: (may affect up to 1 in 1,000 people)
- blistering and/or peeling of the skin, severe inflammation of the entire skin surface (shedding of the top layers of your skin (Exfoliative dermatitis)), Toxic epidermal necrolysis (which causes severe illness and flaking of the skin)
- dry mouth and changes in taste
- change in liver test results
- blood pressure decreased
- allergic vasculitis (sudden blue colouring of the skin, painful joints, kidney inflammation, mild fever)
- growth of bacteria or yeast on the tongue
Very rare: may affect up to 1 in 10,000 people
- a change in the number of white or red blood cells and platelets (symptoms can be bleeding under the skin and easier bruising, pale yellow skin, weakness or breathlessness, or make infections more likely)
yellowing of the skin or whites of the eyes, pale stools and dark urine, loss of appetite, stomach discomfort caused by
liver or blood problems(all symptoms of cholestatic jaundice)
- inflammation of the kidney which can cause swollen ankles or high blood pressure.
- kidney problems, which might cause blood in the urine or increased amounts of urine (interstitial nephritis)
- severe skin reactions such as Stevens-Johnson syndrome
- serum sickness-like reactions (characterised by fever, chills, arthralgia and oedema)
- tooth discolouration
- severe, watery diarrhoea, along with pus/mucus in stool, severe cramps/abdominal tenderness, nausea (pseudomembranous enterocolitis)
- hepatitis
- sore throats, infections or fever/chills, faster heart rate (may be caused by low levels of white blood cells)
- lower-than-normal levels of white blood cells
- higher than normal level of white blood cells (eosinophilia)
- coagulation disorders (problems with blood clotting (easy bruising or prolonged bleeding))
- haemolytic anaemia (anaemia (lack of energy or tiredness, cold hands/feet, pale skin))
- lower-than-normal levels of platelets (a type of blood cell) (more bruises than normal, or worse than normal, small red dots under skin, unusually bleeding (gums/nose), blood in urine/stools)
Not known: frequency cannot be estimated from the available data
- pins and needles or numbness (paraesthesia)
- central nervous system toxicity (symptoms including but not limited to anxiety, dizziness, numbness, light-headedness, and tinnitus)
If you notice any of the above side effects or notice any other side effects and think your medicine may be causing them you should contact your doctor or pharmacist.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard. Or search for MHRA Yellow Card in the Google Play or Apple App store. By reporting side effects you can help provide more information on the safety of this medicine.
5. How to store Phenoxymethylpenicillin Oral Solution
Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the pack. The expiry date refers to the last day of that month. Dry granules: Do not store above 25°C. Keep the bottle tightly closed.
Oral Solution: Store in a refrigerator (2 - 8°C). Keep the bottle tightly closed. Use within 7 days of preparation. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
6. Contents of the pack and other information
What Phenoxymethylpenicillin Oral Solution contains Each 5ml of oral solution contains 250mg of
phenoxymethylpenicillin (as potassium salt) as the active ingredient.
The other ingredients are sucrose, saccharin sodium, ponceau 4R (E124) and strawberry flavour.
What Phenoxymethylpenicillin Oral Solution looks like and contents of the pack
Phenoxymethylpenicillin Oral Solution is a clear pink solution with an odour of strawberry.
Prior to reconstitution with water the product is a pale pink granule with an odour of strawberry.
This medicine is available in a pack size of 100 ml. Marketing Authorisation Holder and Manufacturer
Marketing Authorisation Holder: Crescent Pharma Ltd., Units 3 & 4, Quidhampton Business Units, Polhampton Lane, Overton, Hampshire, RG25 3ED, UK.
Manufacturer: Crescent Manufacturing Ltd,
2 Cunard Road, Park Royal, London, NW10 6PN, UK This leaflet was last revised in 06/2025.
If you would like this leaflet in a different format, please contact the Marketing Authorisation Holder at the above address.