pivampicillin pivampicillin pivampicillin is a pivaloyloxymethyl ester of ampicillin. it is a prodrug, which is thought to enhance the oral bioavailability of ampicillin because of its greater lipophilicity compared to that of ampicillin. pivampicillinclinical dataahfs/drugs.commicromedex detailed consumer informationroutes ofadministrationoralatc codej01ca02 (who) pharmacokinetic dataexcretionrenal (76%)identifiers iupac name 2,2-dimethylpropanoyloxymethyl (2s,5r,6r)-6--3,3-dimethyl-7-oxo-4-thia-1-azabicycloheptane-2-carboxylate cas number33817-20-8 ypubchem cid33478drugbankdb01604 ychemspider30899 yunii0hlm346ll7keggd08396 ychebichebi:8255 ychemblchembl323354 ncomptox dashboard (epa)dtxsid1045459 echa infocard100.046.975 chemical and physical dataformulac22h29n3o6smolar mass463.55 g·mol−13d model (jsmol)interactive image smiles o=c(ococ(=o)c(c)(c)c)2n3c(=o)(nc(=o)(c1ccccc1)n)3sc2(c)c inchi inchi=1s/c22h29n3o6s/c1-21(2,3)20(29)31-11-30-19(28)15-22(4,5)32-18-14(17(27)25(15)18)24-16(26)13(23)12-9-7-6-8-10-12/h6-10,13-15,18h,11,23h2,1-5h3,(h,24,26)/t13-,14-,15+,18-/m1/s1 ykey:zemijudplilvnq-zxfnitatsa-n y ny (what is this?) (verify) adverse effects prodrugs that release pivalic acid when broken down by the body—such as pivampicillin, pivmecillinam, and cefditoren pivoxil—have long been known to deplete levels of carnitine. this effect is not due to the drug itself but to pivalate, which is mostly removed from the body by forming a conjugate with carnitine. although short-term use of these drugs can cause a marked decrease in blood levels of carnitine, it is unlikely to be of clinical significance; long-term use, however, is not recommended. availability worldwide, pivampicillin is only available in denmark, where it is sold as pondocillin® by pharmacodane, or miraxid® by leo pharma.