Cepime
Generic Name
Cefepime
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| cepime 1 gm injection | ৳ 550.00 | N/A |
Description
Overview of the medicine
Cefepime is a broad-spectrum, fourth-generation cephalosporin antibiotic used to treat a wide variety of bacterial infections. It is effective against both Gram-positive and Gram-negative bacteria.
Uses & Indications
Dosage
Adults
1-2 gm IV/IM every 8-12 hours, depending on the severity and type of infection. For severe infections, 2 gm IV every 8 hours.
Elderly
Dosage adjustment may be necessary based on renal function (creatinine clearance). Monitor renal function closely.
Renal_impairment
Significant dosage reduction is required. Initial dose remains the same, but subsequent doses and frequency are adjusted based on creatinine clearance (e.g., 1 gm every 24 hours for CrCl 30-60 mL/min, 0.5 gm every 24 hours for CrCl 11-29 mL/min).
How to Take
Cefepime 1 gm injection is typically administered as an intravenous (IV) infusion over 30 minutes or as a deep intramuscular (IM) injection. The powder must be reconstituted with an appropriate diluent (e.g., Sterile Water for Injection, 0.9% Sodium Chloride Injection).
Mechanism of Action
Cefepime exerts its bactericidal activity by inhibiting bacterial cell wall synthesis. It binds to penicillin-binding proteins (PBPs) located inside the bacterial cell wall, which prevents the cross-linking of peptidoglycan, essential for bacterial cell wall integrity.
Pharmacokinetics
Onset
Rapid, with peak plasma concentrations occurring within minutes after IV infusion and 1-2 hours after IM administration.
Excretion
Primarily excreted unchanged by the kidneys (approximately 85% of the dose) via glomerular filtration and tubular secretion. Dose adjustment is necessary in renal impairment.
Half life
Approximately 2 hours in individuals with normal renal function.
Absorption
Administered intravenously (IV) or intramuscularly (IM), cefepime is rapidly and completely absorbed. Bioavailability is 100% for IV administration.
Metabolism
Cefepime is minimally metabolized; approximately 20% is hydrolyzed to N-methylpyrrolidine (NMP) which is inactive.
Side Effects
Contraindications
- Known hypersensitivity to cefepime, any other cephalosporin, penicillins, or other beta-lactam antibiotics.
- History of severe hypersensitivity reactions (e.g., anaphylaxis, severe skin reactions) to any beta-lactam antibiotic.
Drug Interactions
Warfarin
Cephalosporins, including cefepime, may enhance the anticoagulant effect of warfarin, requiring INR monitoring.
Aminoglycosides
Concurrent use may increase the risk of nephrotoxicity and ototoxicity.
Loop Diuretics (e.g., Furosemide)
May increase the risk of nephrotoxicity when given with aminoglycosides and cefepime.
Live Bacterial Vaccines (e.g., Typhoid vaccine)
Antibiotics may reduce the therapeutic effect of live bacterial vaccines. Administer at least 24 hours apart.
Storage
Store intact vials below 30°C (86°F). Protect from light and moisture. After reconstitution, refer to the manufacturer's specific instructions for storage conditions and duration.
Overdose
In the event of an overdose, symptomatic and supportive treatment should be initiated. Hemodialysis may be helpful in removing cefepime from the systemic circulation, particularly in patients with impaired renal function.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have not shown harm to the fetus, but there are no adequate and well-controlled studies in pregnant women. Use during pregnancy only if clearly needed. Cefepime is excreted in human milk in low concentrations; caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Known hypersensitivity to cefepime, any other cephalosporin, penicillins, or other beta-lactam antibiotics.
- History of severe hypersensitivity reactions (e.g., anaphylaxis, severe skin reactions) to any beta-lactam antibiotic.
Drug Interactions
Warfarin
Cephalosporins, including cefepime, may enhance the anticoagulant effect of warfarin, requiring INR monitoring.
Aminoglycosides
Concurrent use may increase the risk of nephrotoxicity and ototoxicity.
Loop Diuretics (e.g., Furosemide)
May increase the risk of nephrotoxicity when given with aminoglycosides and cefepime.
Live Bacterial Vaccines (e.g., Typhoid vaccine)
Antibiotics may reduce the therapeutic effect of live bacterial vaccines. Administer at least 24 hours apart.
Storage
Store intact vials below 30°C (86°F). Protect from light and moisture. After reconstitution, refer to the manufacturer's specific instructions for storage conditions and duration.
Overdose
In the event of an overdose, symptomatic and supportive treatment should be initiated. Hemodialysis may be helpful in removing cefepime from the systemic circulation, particularly in patients with impaired renal function.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have not shown harm to the fetus, but there are no adequate and well-controlled studies in pregnant women. Use during pregnancy only if clearly needed. Cefepime is excreted in human milk in low concentrations; caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date, when stored as directed. Reconstituted solution stability varies (e.g., 24 hours at room temperature, 7 days under refrigeration).
Availability
Hospitals and Pharmacies
Approval Status
Approved (DGDA, FDA)
Patent Status
Expired
WHO Essential Medicine
YesClinical Trials
Cefepime has undergone extensive clinical trials demonstrating its efficacy and safety across various bacterial infections. Ongoing post-market surveillance continues to monitor its use and identify rare adverse events.
Lab Monitoring
- Renal function (BUN, creatinine) should be monitored, especially in patients with pre-existing renal impairment or those receiving concomitant nephrotoxic drugs.
- Liver function tests (ALT, AST) may be monitored periodically.
- Complete blood count (CBC) with differential.
- Prothrombin time/INR if co-administered with anticoagulants like warfarin.
Doctor Notes
- Monitor renal function closely, especially in elderly patients or those with pre-existing renal impairment, and adjust dosage accordingly to prevent neurotoxicity.
- Be aware of potential drug interactions, particularly with nephrotoxic agents and anticoagulants.
- Consider cefepime for empiric therapy in febrile neutropenia or severe hospital-acquired infections due to its broad spectrum and activity against resistant Gram-negative organisms.
Patient Guidelines
- Complete the entire course of medication as prescribed, even if symptoms improve.
- Report any severe or persistent side effects to your doctor immediately.
- Do not share this medication with others.
- Inform your doctor about all other medications, including over-the-counter drugs and herbal supplements.
Missed Dose Advice
If a dose is missed, administer it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Cefepime may cause dizziness or lightheadedness in some patients. If you experience these symptoms, avoid driving or operating machinery.
Lifestyle Advice
- Maintain adequate hydration by drinking plenty of fluids.
- Avoid alcohol consumption during the course of treatment, as it may exacerbate side effects like nausea.
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