Cefuroxime

10-20

750 mg bid.

<10

750 mg once daily.

Incompatibility: Incompatible with aminoglycosides.

Administration

Should be taken with food.

Contraindications

Hypersensitivity to cephalosporins.

Special Precautions

Severe renal impairment; pregnancy, lactation; hypersensitivity to penicillins.

Adverse Drug Reactions

Large doses can cause cerebral irritation and convulsions; nausea, vomiting, diarrhoea, GI disturbances; erythema multiforme, Stevens-Johnson syndrome, epidermal necrolysis.

Potentially Fatal: Anaphylaxis, nephrotoxicity, pseudomembranous colitis.

Drug Interactions

Probenecid decreases renal clearance of cefuroxime.

Potentially Fatal: Nephrotoxicity with aminoglycosides and furosemide.

Food Interaction

Oral cefuroxime axetil is better absorbed after food intake.

Lab Interference

False-positive for Coombs' test. It may interfere with urine-sugar estimation.

Pregnancy Category (US FDA)

Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).

Storage

Intramuscular: Store at 15-30°C. Intravenous: Store at 15-30°C. Oral: Store at 15-30°C. Parenteral: Inj: Store at 15-30°C.

Mechanism of Action

Cefuroxime binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.

Absorption: Absorbed from the GI tract with peak plasma concentrations after 2-3 hr (oral); may be enhanced by the presence of food.

Distribution: Pleural and synovial fluid, sputum, bone and aqueous fluids; CSF (therapeutic concentrations). Crosses the placenta and enters breast milk. Protein-binding: Up to 50%.

Metabolism: Rapidly hydrolysed (intestinal mucosa and blood).

Excretion: Via the urine by glomerular filtration and renal tubular secretion (as unchanged); via bile (small amounts); 70 min (elimination half-life); prolonged in neonates and renal impairment.

Cephalosporins

ATC Classification

J01DC02 - cefuroxime;

*cefuroxime information:

Brands : 3a-CEF dispertab AAXIM tab ACTUM tab ADEXIM tab ALTACEF susp ALTACEF tab ALTACEF vial ALTACEF-OD tab ALTUM film-coated tab ANOREX vial ANOREX-D tab ANOREX-S tab ARIXIME dry syr ARIXIME tab ARIXIME vial ATOM tab AUCEE tab AXACEF tab AXEPTIL film-coated tab AXERIS tab AXETIM tab AXTL tab BACTICEF tab BACTICEF vial BACTOCEF vial BAROCEF tab BENCEF inj BIGCEF dispertab BIGCEF tab BIGCEF vial BIOCEF tab BULLCEF tab CASCEF tab CEAX tab CEFAKIND tab CEFAM tab CEFAM vial CEFAR tab CEFASYN inj CEFASYN tab CEFEXL tab CEFIES tab CEFKING tab CEFKING vial CEFLET inj CEFOB cap CEFOGEN vial CEFOPRIM inj CEFOPRIM tab CEFOPRIT tab CEFOPRIT vial CEFORIM tab CEFORIM vial CEFOROX tab CEFOS inj CEFOS tab CEFOS-S inj CEFOXIM dry syr CEFOXIM tab CEFOXIM vial CEFPIL tab CEFRACE tab CEFTA vial CEFTAB tab CEFTAL dispertab CEFTAL dry syr CEFTAL tab CEFTAL vial CEFTAZ inj CEFTRA tab CEFTUM tab CEFU vial CEFUBIR vial CEFUCIN tab CEFUCOS tab CEFUMAX tab CEFUNIS tab CEFUNIS vial CEFUPET tab CEFURICA film-coated tab CEFURICA vial CEFURIN dispertab CEFURIN tab CEFUSYM tab CEFUTAB-O dry syr CEFUTAB-O tab CEFUVIK tab CEFUVIK vial CEF-VEPAN DS susp CEF-VEPAN film-coated tab CEFYREX tab CEFYREX vial CEFZIM dry syr CEFZIM tab CEFZIM-750 inj CEPLEX dry syr CEPLEX inj CEPLEX tab CEPOKEM inj CEPOKEM susp CEPOKEM tab CEROM tab CEROXIM-XP tab CEROXITUM tab CESAI dry syr CETIL film-coated tab CETIL vial CEUROX FC-tab C-FURO film-coated tab C-FURO-CV film-coated tab CILIXEM tab COVATIL-CV film-coated tab C-TRI EM cap C-TRI-T film-coated tab C-TRI-T vial CTROX dry syr CTROX inj CTROX tab CUROXIM tab CUROXIM vial CUTIL vial CUXIM tab DALTUM inj DALTUM syr DALTUM tab DERICEF dispertab DIFU vial DUXIM tab EDUCEF tab ETHICEF tab EVERCEF tab EXEPTION tab EXEPTION vial EXIME vial FLAMICEF vial FORCEF tab FORCEF vial FORCEZ dispertab FORCEZ tab FOREX tab FORKEM tab FUCEF inj FUCEF tab FURION tab FUROBID tab FUROMAX inj FUROMAX tab FUROX tab FUROXIL vial FYDOROXIM tab GLYPH-ZM tab GOCEF tab IFLACEF dry syr IFLACEF tab INSIFU inj INSIFU tab INTRACEF dispertab INTRACEF inj INTRACEF tab INTRACEF-CV tab IVIROXIME vial JOXCY inj KAIRCEF tab KAXITEL tab KEFSTAR tab KEFSTAR vial KEFUEL tab KEM vial KINCEF tab KLIME tab L-TUM tab LUROXIME tab MAGNA dispertab MAGNA tab MAGNACEF tab MAXIM tab MAXTUM tab METUMP vial MILCEF tab MILCEF vial NEFTUM-AXT tab NEROXIM film-coated tab NEROXIM vial NIFOXIME dry syr NIFOXIME tab NIFOXIME vial NOVAROXIM film-coated tab NOVAROXIM vial OCEF 250 vial OCEF 750 vial OCEF TAB tab OCEF-CV tab OMNIXIM tab ORUF tab POLOSEF dispertab PULMOCEF INJ inj PULMOCEF tab RELICEF dispertab RELICEF INJ vial RELICEF tab RIXIME inj RIXIME tab ROXIME D-syr ROXTIL tab SAFON tab SALCEF tab SAYFUR dispertab SCOTIL inj SCOTIL tab SEAZOX tab SIFUROXIM vial SOZIFUR tab SPECTRAXIME susp SPECTRAXIME tab SPECTRAXIME vial SPIZEF tab SPIZEF vial STACEY tab STAROX dry syr SUPACEF cap SUPACEF vial SVCEF tab SWECEF vial SWECEF-LB tab SYCEF tab TOPXIME inj TOPXIME tab TRAXOCEF-O tab TUFBACT tab ULTROXIME tab UMPIRE tab UREX tab UROX vial WIDECEF susp WIDECEF tab WIDECEF vial XE tab XE vial XIBID tab XIMBEL tab XTIL tab X-TIL tab ZAXI tab ZEFU dispertab ZEFU dry syr ZEFU film-coated tab ZEFU-CV dry syr ZEFU-CV tab ZEFUR tab ZENOXIM tab ZITUM tab ZOCEF SYR dry syr ZOCEF tab ZOCEF vial ZOXTIL tab ZYMOCEF vial ZYTIL tab

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Dosage Adult: PO Uncomplicated UTI 125 mg twice daily. Resp tract infections 250-500 mg twice daily. Uncomplicated gonorrhoea W/ oral probenecid: 1 g as a single dose. IV Meningitis 3 g 8 hrly. IM Gonorrhoea W/ oral probenecid: 1.5 g as a single dose. IV/IM Surgical prophylaxis 1.5 g IV per-op, then 750 mg IM 8 hrly for up to 24-48 hr. Susceptible infections 750 mg 8 hrly, up to 1.5 g 6-8 hrly for severe infections.

Administration Should be taken with food.

Contraindications Hypersensitivity to cephalosporins.

Special Precautions Severe renal impairment; pregnancy, lactation; hypersensitivity to penicillins.

Adverse Drug Reactions Large doses can cause cerebral irritation and convulsions; nausea, vomiting, diarrhoea, GI disturbances; erythema multiforme, Stevens-Johnson syndrome, epidermal necrolysis.

Potentially Fatal: Anaphylaxis, nephrotoxicity, pseudomembranous colitis.

Drug Interactions Probenecid decreases renal clearance of cefuroxime.

Potentially Fatal: Nephrotoxicity with aminoglycosides and furosemide.

CEFAKIND Tab

250 mg x 10's (80 INR)

500 mg x 6's (95.04 INR)

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