Travellers familiar with Selexid from the United Kingdom or parts of Europe are unlikely to encounter the same brand much further afield — it is registered in only five countries. The brand has a notably narrow international footprint, with marketing authorisations clustered across Western Europe, the eastern Mediterranean, and North Africa.
The active ingredient in Selexid is pivmecillinam, an orally administered antibiotic from the penicillin family. It is used in the management of bacterial infections, with a particular role in urinary tract infections, and is also referenced in connection with febrile enteric infections including typhoid and other salmonella-related illness. The structured indication block below this introduction details the registered uses recognised in the markets where Selexid is sold.
Outside its core markets — the United Kingdom, Portugal, Austria, Tunisia, and Lebanon — Selexid as a brand is rarely on pharmacy shelves. In several large markets, including most of the Americas and much of Asia, pivmecillinam itself is not part of standard antibiotic prescribing, and clinicians manage urinary or enteric infections with different molecules altogether. Travellers carrying a Selexid prescription from home should expect that a like-for-like substitution may not be straightforward in every destination.
A local pharmacist or physician familiar with the regional formulary is the right person to identify what is available and appropriate locally; antibiotic choice depends on the specific infection, local resistance patterns, and the patient's broader clinical picture. Anyone taking Selexid, considering it, or trying to understand a foreign prescription that mentions pivmecillinam should treat the conversation as one for a qualified healthcare provider rather than a self-service decision at the counter.
There has been no experience of overdosage with Selexid. However, excessive doses of Selexid are likely to induce nausea, vomiting, abdominal pain and diarrhoea. Treatment should be restricted to symptomatic and supportive measures.
3 years
Hypersensitivity to penicillins and/or cephalosporins. Any conditions resulting in impaired transit through the oesophagus.
Genetic metabolism anomalies known to be leading to severe carnitine deficiency, such as carnitine transporter defect, methylmalonic aciduria or propionic acidaemia.
Not applicable.
Cellulose microcrystalline
Hydroxypropyl cellulose
Magnesium stearate
Hypromellose
Simethicone
Paraffin, synthetic
Film-coated tablet
A white circular film-coated convex tablet embossed with an Assyrian lion on one side and 137 on the other.
The estimation of the frequency of undesirable effects is based on an analysis of pooled data from clinical studies and spontaneous reporting.
The most frequently reported undesirable effects are nausea and diarrhoea.
Anaphylactic reactions and fatal pseudomembranous colitis have been reported.
Undesirable effects are listed by MedDRA SOC and the individual undesirable effects are listed starting with the most frequently reported. Within each frequency grouping, adverse reactions are presented in the order of decreasing seriousness.
Very common > 1/10
Common > 1/100 and < 1/10
Uncommon > 1/1,000 and < 1/100
Rare > 1/10,000 and < 1/1,000
Very Rare < 1/10,000
| Infections and infestations | |
| Common: | Vulvovaginal mycotic infection |
| Uncommon: | Clostridium difficile colitis |
| Blood and lymphatic system disorders | |
| Uncommon: | Thrombocytopenia |
| Immune system disorders | |
| Uncommon: | Anaphylactic reaction |
| Metabolism and nutrition disorders | |
| Uncommon: | Carnitine decreased |
| Nervous system disorders | |
| Uncommon: | Headache Dizziness |
| Ear and labyrinth disorders | |
| Uncommon: | Vertigo |
| Gastrointestinal disorders | |
| Common: | Diarrhoea Nausea |
| Uncommon: | Vomiting Abdominal pain Dyspepsia Oesophageal ulcer Oesophagitis Mouth ulceration |
| Hepatobiliary disorders | |
| Uncommon: | Hepatic function abnormal |
| Skin and subcutaneous tissue disorders | |
| Uncommon: | Rash* Urticaria Pruritus |
| General disorders and administration site conditions | |
| Uncommon: | Fatigue |
*Various types of rash reactions such as erythematous, macular or maculo-papular have been reported
Class adverse reactions of beta-lactam antibiotics:
Slight reversible increase in ASAT, ALAT, alkaline phosphatase, and bilirubin
Neutropenia
Eosinophilia
Paediatric population
Frequency, type and severity of adverse reactions in children are expected to be the same as in adults, based on limited data.
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard.
There are no pre-clinical data of relevance to the prescriber which are additional to that already included in other sections of the SPC.
Selexid is indicated for the treatment of infections due to mecillinam sensitive organisms , including:
- urinary tract infections
- salmonellosis
Preliminary experience in a small number of patients suggests that Selexid tablets may be a useful alternative antibiotic in the treatment of acute typhoid fever and in some carriers of salmonellae when antibiotic treatment is considered essential.
Consideration should be given to official guidance on the appropriate use of antibacterial agents.
Pharmacotherapeutic group: antibacterial products for systemic use, penicillins with extended spectrum, ATC code: J01CA08
Selexid is an orally active antibiotic. Chemically it is the pivaloyloxymethylester of the amidinopenicillanic acid, mecillinam. On oral administration it is well absorbed and subsequently hydrolysed in the body to mecillinam, the active antibacterial agent, by non-specific esterases present in blood, gastro-intestinal mucosa and other tissues.
Selexid is highly active against most enterobacteriaceae, including E. coli, Klebsiella, Proteus, Enterobacter, Serratia, Salmonella, Shigella and Yersina.
Selexid is less active against gram positive bacteria and organisms such as Pseudomonas aeruginosa and Streptococcus faecalis are practically resistant to mecillinam.
Whilst Selexid, like the penicillins and cephalosporins, interferes with the biosynthesis of the bacterial cell wall, the target of the inhibition is different. This different mode of action is probably responsible for the synergistic action which has been found, both in vitro and in vivo, between Selexid and various penicillins and cephalosporins.
Peak serum levels of mecillinam averaging 5 microgram/ml are reached after 1 hour following a dose of 10 mg/kg body weight in children and 400 mg in adults.
The serum half-life is 1.2 hours. The protein binding amounts to 5-10%. Approximately 50% of the administered dose is excreted as mecillinam in the urine within the first six hours. Mecillinam is partly excreted with bile, giving rise to biliary concentrations about 3 times the serum levels.
Concurrent administration of probenecid delays the renal excretion of mecillinam, producing more sustained serum levels. The absorption of Selexid is practically unaffected by taking the tablets with food.
05/08/2016
Selexid 200 mg Film-coated Tablets
LEO Laboratories Limited
Horizon
Honey Lane
Hurley
Maidenhead
Berkshire
SL6 6RJ
UK
Store below 25°C in a dry place.
Aluminium/PVC-Aluminium blister packs containing 10 or 18 tablets.
PL 00043/0048
Pivmecillinam hydrochloride 200 mg
During long term use, it is advisable to carry out routine liver and kidney function tests.
Pseudomembranous colitis caused by Clostridium difficile may occur. If diarrhoea occurs after use, the possibility of pseudomembranous colitis should be considered, and appropriate actions should be taken.
Selexid tablets should be used with caution in patients with porphyria since pivmecillinam has been associated with acute attacks of porphyria.
As with other antibiotics which are excreted mainly by the kidneys, raised blood levels of mecillinam may occur if repeated doses are given to patients with impaired renal function.
Selexid tablets should be used with caution for long-term or frequently-repeated treatment, due to the possibility of carnitine depletion. Symptoms of carnitine depletion include muscle aches, fatigue, and confusion.
Concurrent treatment with valproic acid, valproate or other medication liberating pivalic acid should be avoided due to increased risk of carnitine depletion.
The tablets must be taken with at least half a glass of fluid due to risk of oesophageal ulceration.
Selexid has no or negligible influence on the ability to drive or use machines.
Posology
Adults and children weighing more than 40 kg:
Urinary tract infections:
- Acute uncomplicated cystitis: 72 hour course of 2 tablets immediately followed by 1 tablet 3 times daily to a total of 10 tablets.
- Chronic or recurrent bacteriuria: 2 tablets three to four times daily.
Salmonellosis:
- Enteric fever: 1.2-2.4 g daily for 14 days.
- Salmonella carriers: 1.2-2.4 g daily for 2-4 weeks.
Children weighing less than 40 kg:
- Urinary tract infections: 20-40 mg/kg body weight, daily, in 3 to 4 divided doses.
- Salmonellosis: 30-60 mg/kg body weight, daily, in 3 to 4 divided doses.
Dosage in the elderly:
Renal excretion of mecillinam is delayed in the elderly, but significant accumulation of the drug is not likely at the recommended adult dosage of Selexid tablets.
Method of administration
Route of administration is oral. The tablets must be taken with at least half a glass of fluid, and preferably taken with or immediately after a meal.
No special requirements for disposal.
Date of first authorisation: 20 May 1977
Date of last renewal: 29 October 2004
Selexid is prescribed for bacterial infections, with a particular role in urinary tract infections. It is also referenced in the context of febrile enteric infections, including typhoid and other salmonella-related illness. The active ingredient is an orally administered antibiotic in the penicillin family. The structured indication block on this page details each registered use as recognised by national regulators in the markets where Selexid is sold.
Selexid contains pivmecillinam, an orally administered antibiotic that belongs to the broader penicillin family. The same active ingredient is used in other countries under different brand names where it is available, though pivmecillinam is not part of routine antibiotic prescribing in every market — its role in urinary and enteric infections is more established in some regulatory regions than others.
Selexid is registered in five countries: the United Kingdom, Portugal, Austria, Tunisia, and Lebanon. This is a narrow international footprint spanning Western Europe, the eastern Mediterranean, and North Africa. If your country is not on this list, a local pharmacist can advise on whether pivmecillinam is available locally under a different brand name, or whether a different antibiotic is the standard local choice for the same indication.
Pivmecillinam is sold under additional brand names in some of the markets where it is registered, and the broader penicillin family of antibiotics is represented worldwide under many molecules and trade names. These alternatives are not interchangeable — antibiotic selection depends on the specific infection, local resistance patterns, and patient factors. To explore options, search the active ingredient on Pill2Trip or ask a local pharmacist or physician.
Selexid is a prescription medication, and antibiotic therapy in particular should always be guided by a healthcare provider. Self-directed antibiotic use contributes to resistance and can mask or mistreat the underlying infection. Travellers should also be aware that prescription rules, available molecules, and standard first-line antibiotics for conditions such as urinary tract infections vary significantly between countries, so a local clinician's input matters.
