* Aged penicillin is not an adequate source of minor determinants. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Data sources include IBM Watson Micromedex (updated 2 Sep 2020), Cerner Multum™ (updated 1 Sep 2020), Wolters Kluwer™ (updated 31 Aug 2020) and others. PEDIATRIC PATIENTS (older than 2 years): A dosage of 10 mg/kg daily is usually adequate (pediatric patients from 30 to 50 lb, 125 mg to 250 mg daily; pediatric patients over 50 lb, 250 mg to 500 mg daily, in divided doses). Griseofulvin may be active against most strains of the following dermatophytes as described in the INDICATIONS AND USAGE section: Epidermophyton floccosum, Microsporum audouinii, Microsporum canis, Microsporum gypseum, Trichophyton crateriformis, Trichophyton gallinae, Trichophyton interdigitalis, Trichophyton megnini, Trichophyton mentagrophytes, Trichophyton rubrum, Trichophyton sulphureum, Trichophyton schoenleini, Trichophyton tonsurans, and Trichophyton verrucosum. Pre-Pen is provided full-strength (6 x 10–5 meq penicilloyl) in a single dose ampoule. Safety and efficacy of Griseofulvin for prophylaxis of fungal infections have not been established. Griseofulvin may cause fetal harm when administered to a pregnant woman.


§ The specific amount of drug was diluted in approximately 30 mL of water and then administered orally. The peak serum level in fasting adults given 0.5 g of Griseofulvin microsize occurs at about four hours and ranges between 0.5 to 2 mcg/mL. This is a straightforward, relatively safe procedure that can be performed orally or intravenously. Griseofulvin is a pink to orange colored, tutti-frutti flavored, uniform suspension. Administration of the drug should be discontinued if granulocytopenia occurs. Cross sensitivity Patients who are allergic to one penicillin will be allergic to all because the hypersensitivity is related to the basic penicillin structure. Griseofulvin has been reported in the literature to interfere with the metabolism of various compounds. These reactions may be serious and may result in hospitalization or death. If higher doses than 500 mg/day were used clinically, then the multiple of human exposure would be correspondingly reduced for that dose. Stevens-Johnson syndrome, toxic epidermal necrolysis) and erythema multiforme have been reported with Griseofulvin use. The serum level may be increased by giving the drug with a meal with a high fat content. Saving Lives, Protecting People, 2015 Sexually Transmitted Diseases Treatment Guidelines, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, HIV Infection: Detection,Counseling and Referral, Diseases Characterized by Genital, Anal, or Perianal Ulcers, Management of Persons Who Have a History of Penicillin Allergy, Diseases Characterized by Urethritis and Cervicitis, Diseases Characterized by Vaginal Discharge, Terms and Abbreviations Used in This Report, Screening Recommendations Referenced in Treatment Guidelines and Original Recommendation Sources, U.S. Department of Health & Human Services, Benzylpenicilloyl poly-L-lysine (PrePen) (AllerQuest, Plainville Connecticut) (6 x 10–5M), Benzylpenicillin G (10–2M, 3.3 mg/mL, 10,000 units/mL), Benzylpenicilloate (or penicilloyl propylamine) (10–2M, 3.3 mg/mL), Commercial histamine for scratch testing (1.0 mg/mL), Diluent (usually saline) or allergen diluent. Unchanged Griseofulvin in the urine accounts for less than 1% of the administered dose. Disturbances in porphyrin metabolism have been reported in Griseofulvin-treated laboratory animals. 19 This potential rate of cross-reactivity was alarming; however, this study had a small sample size and used a nonstandard imipenem skin test. The prevalence of reported penicillin allergy in developing countries is unknown; however, limited data suggest that penicillin is one of the most frequently reported allergies in some developing countries (455,456). Penicillin-Cephalosporin Cross-Sensitivity Background The rate of penicillin-cephalosporin cross-sensitivity is overestimated in the literature and is likely dependent on the presence of a shared side chain with the penicillin rather than the core beta-lactam ring of the drug’s molecular structure. Dilute the antigens in saline either 100-fold for preliminary testing (if the patient has had a IgE- mediated reaction to penicillin) or 10-fold (if the patient has had another type of immediate, generalized reaction to penicillin within the preceding year). Griseofulvin is metabolized by the liver to 6-desmethylGriseofulvin and its glucuronide conjugate. Otherwise, the tests are negative. It was originally theorized that the common beta-lactam ring was the cause of cross-sensitivity, but further research suggests the cause to be similar side-chains. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. † Interval between doses, 15–30 minutes; elapsed time, 4–8 hours; cumulative dose, 1.3 million units. Nausea, vomiting, flushing, tachycardia, and severe hypotension have been reported following alcohol ingestion during Griseofulvin therapy. In these situations, testing should be performed in a monitored setting in which treatment for an anaphylactic reaction is available. In addition, for persons with a history of severe or recent suspected IgE-mediated reactions to penicillin with negative skin testing, the penicillin of choice should be given by graded challenge. However, a single study reported the prevalence of cross reactivity with cefadroxil as high as 27%. Return the product to, clotrimazole topical, ketoconazole topical, terbinafine, Jublia, Lamisil, Lotrisone, itraconazole, Kerydin, Terbinex, ciclopirox topical. Note: The Maximum Recommended Human Dose (MRHD) was set at 500 mg/day for the multiple of human exposure calculations performed in this label.
PHARMACIST: Dispense in a tight, light-resistant container as defined in the USP, with a child-resistant closure as required. If the full battery of skin-test reagents, including the minor determinants, is not available, skin testing should be conducted using the major determinant (Pre-Pen) and penicillin G. Those persons who have positive test results should be desensitized.

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