Ceforan
Generic Name
cefixime
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Description
Overview of the medicine
Cefixime is a third-generation cephalosporin antibiotic used to treat a variety of bacterial infections, including those of the respiratory tract, urinary tract, ear, nose, throat, and uncomplicated gonorrhea.
Uses & Indications
Dosage
Adults
Adults and children over 12 years or weighing more than 50 kg: 200 mg to 400 mg daily, given as a single dose or in two divided doses (e.g., 200 mg every 12 hours).
Elderly
No specific dosage adjustment is required for the elderly unless there is severe renal impairment. Monitor renal function.
Renal_impairment
Creatinine clearance 21-60 mL/min or patients on continuous ambulatory peritoneal dialysis: 300 mg daily. Creatinine clearance <20 mL/min or patients on hemodialysis: 200 mg daily.
How to Take
Administer orally, with or without food. For best absorption, it can be taken with food to minimize gastrointestinal upset. Oral suspension should be shaken well before use.
Mechanism of Action
Cefixime works by inhibiting bacterial cell wall synthesis. It binds to penicillin-binding proteins (PBPs) located inside the bacterial cell wall, thereby interfering with the peptidoglycan synthesis, leading to cell lysis and bacterial death.
Pharmacokinetics
Onset
Therapeutic effects are generally observed within a few hours of administration as adequate plasma concentrations are achieved.
Excretion
Excreted primarily in the urine (about 50% unchanged) and to a lesser extent in the bile and feces.
Half life
Plasma elimination half-life is typically 3-4 hours, potentially longer in patients with renal impairment.
Absorption
Approximately 40-50% of an oral dose is absorbed. Peak plasma concentrations occur between 2-6 hours.
Metabolism
Cefixime is not extensively metabolized in the liver; a small portion may be metabolized to inactive products.
Side Effects
Contraindications
- Known hypersensitivity to cefixime, other cephalosporins, or any component of the formulation
- History of serious hypersensitivity reactions to penicillin (cross-allergenicity)
Drug Interactions
Nifedipine
May increase cefixime peak plasma concentrations and AUC.
Carbamazepine
Elevated carbamazepine levels have been reported when administered concomitantly.
Oral Contraceptives
Some antibiotics may reduce the effectiveness of oral contraceptives, although this interaction is controversial for cephalosporins.
Warfarin and other anticoagulants
May increase prothrombin time (INR), requiring close monitoring and dose adjustment.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children. Reconstituted suspension should be stored in a refrigerator (2-8°C) and used within 14 days.
Overdose
In case of overdose, gastric lavage may be indicated. Cefixime is not removed in significant quantities by hemodialysis or peritoneal dialysis. Treatment is largely symptomatic and supportive.
Pregnancy & Lactation
Pregnancy Category B. Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women. Use with caution. Small amounts are excreted in breast milk; generally considered compatible with breastfeeding, but monitor infant for potential adverse effects like diarrhea or candidiasis.
Side Effects
Contraindications
- Known hypersensitivity to cefixime, other cephalosporins, or any component of the formulation
- History of serious hypersensitivity reactions to penicillin (cross-allergenicity)
Drug Interactions
Nifedipine
May increase cefixime peak plasma concentrations and AUC.
Carbamazepine
Elevated carbamazepine levels have been reported when administered concomitantly.
Oral Contraceptives
Some antibiotics may reduce the effectiveness of oral contraceptives, although this interaction is controversial for cephalosporins.
Warfarin and other anticoagulants
May increase prothrombin time (INR), requiring close monitoring and dose adjustment.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children. Reconstituted suspension should be stored in a refrigerator (2-8°C) and used within 14 days.
Overdose
In case of overdose, gastric lavage may be indicated. Cefixime is not removed in significant quantities by hemodialysis or peritoneal dialysis. Treatment is largely symptomatic and supportive.
Pregnancy & Lactation
Pregnancy Category B. Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women. Use with caution. Small amounts are excreted in breast milk; generally considered compatible with breastfeeding, but monitor infant for potential adverse effects like diarrhea or candidiasis.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from the date of manufacture, varies by specific formulation and packaging. Refer to product packaging for exact expiry.
Availability
Available in retail pharmacies, hospital pharmacies, and clinics
Approval Status
Approved by regulatory bodies (e.g., FDA, DGDA)
Patent Status
Patent expired, generic versions available
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials have established the efficacy and safety of cefixime in various bacterial infections, demonstrating its broad-spectrum activity and favorable tolerability profile.
Lab Monitoring
- Monitor renal function (creatinine clearance) in patients with pre-existing renal impairment.
- Periodic monitoring of complete blood counts (CBC) during prolonged therapy.
- Liver function tests (LFTs) if clinical indications arise.
Doctor Notes
- Confirm bacterial susceptibility before initiating treatment, especially for severe infections.
- Adjust dosage in patients with renal impairment.
- Counsel patients on the importance of completing the full course of therapy to prevent resistance.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor, even if your symptoms improve before the course is finished.
- Do not skip doses or stop taking the medicine prematurely, as this may lead to antibiotic resistance.
- Do not share this medication with others, even if they have similar symptoms.
- Report any severe or persistent side effects to your doctor immediately.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double dose to catch up.
Driving Precautions
Cefixime may cause dizziness in some individuals. Patients should be advised to exercise caution when driving or operating machinery until they know how the medication affects them.
Lifestyle Advice
- Maintain adequate hydration by drinking plenty of fluids.
- Consider consuming probiotics (e.g., yogurt) to help prevent antibiotic-associated diarrhea, especially if recommended by your doctor.
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