1 May 2026Oral drugsSource update: January 2024
Phenoxymethylpenicillin = Penicillin V oral
Phenoxymethylpenicillin guidance for streptococcal pharyngitis, scarlet fever, and diphtheria completion therapy.
Prescription under medical supervision
This guide page is for structured reference only and does not replace a clinician, pharmacist, or emergency review. Dose choice, route choice, interactions, and safety decisions still need professional judgment.
Therapeutic action
Penicillin antibacterial.
Indications
- Streptococcal pharyngitis and scarlet fever.
- Alternative to first-line antibiotic treatment of diphtheria.
- Completion treatment following parenteral therapy with penicillin.
Forms and strengths
- 250 mg tablet (400,000 IU).
- Powder for oral suspension, 125 mg/5 ml (200,000 IU/5 ml), to be reconstituted with filtered water and administered using a measuring device.
Dose
Streptococcal pharyngitis, scarlet fever
- Child under 1 year and under 10 kg: 125 mg 2 times daily, corresponding to 5 ml 2 times daily.
- Child 1 to under 6 years and 10 to under 21 kg: 250 mg 2 times daily, corresponding to 10 ml 2 times daily.
- Child 6 to under 12 years and 21 to under 39 kg: 500 mg 2 times daily, corresponding to 20 ml 2 times daily or 2 tablets 2 times daily.
- Age 12 years and over and adult, 39 kg and over: 1 g 2 times daily, corresponding to 4 tablets 2 times daily.
Diphtheria
- Child under 40 kg: 10 to 15 mg/kg, maximum 500 mg, 4 times daily.
- Child 40 kg and over and adult: 500 mg 4 times daily.
Duration
- Streptococcal pharyngitis and scarlet fever: 10 days.
- Diphtheria: 14 days.
Contra-indications, adverse effects, precautions
- Do not administer to patients with allergy to penicillin.
- Administer with caution to patients with allergy to cephalosporin because cross-sensitivity may occur, or severe renal impairment where dose reduction may be needed.
- May cause diarrhoea, nausea, and allergic reactions that may be severe.
- Do not combine with methotrexate.
- Pregnancy: no contra-indication.
- Breast-feeding: no contra-indication.
- Take between meals.
Dose and duration
| Age | Weight | Daily dose | 125 mg/5 ml oral susp. | 250 mg tablet |
|---|---|---|---|---|
| < 1 year | < 10 kg | 125 mg x 2 | 5 ml x 2 | − |
| 1 to < 6 years | 10 to < 21 kg | 250 mg x 2 | 10 ml x 2 | − |
| 6 to < 12 years | 21 to < 39 kg | 500 mg x 2 | 20 ml x 2 | 2 tab x 2 |
| ≥ 12 years and adult | ≥ 39 kg | 1 g x 2 | − | 4 tab x 2 |
Source
MSF Essential drugs practical guidelines (January 2026)
This page reproduces the structured reference information for this batch while leaving out the Storage and Remarks sections.
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