Adults

Adults: 250 mg twice daily for most infections. For more severe infections like pyelonephritis, 500 mg twice daily. Note: 125 mg suspension is typically for pediatric use; adults may use other forms or higher concentrations.

Elderly

Similar to adults, but renal function should be assessed and dosage adjusted if necessary.

Children

Children (3 months to 12 years): 125 mg (5 ml) twice daily for most infections. For otitis media or more severe infections, 250 mg (10 ml) twice daily.

Renal_impairment

Dosage adjustment is necessary in patients with significant renal impairment. For creatinine clearance 10-29 mL/min, 125 mg or 250 mg once daily. For CrCl <10 mL/min, 125 mg or 250 mg every 48 hours.

Onset

Peak plasma concentrations usually occur 2-3 hours after administration with food.

Excretion

Excreted unchanged primarily by the kidneys, via glomerular filtration and tubular secretion.

Half life

Approximately 1-1.5 hours in healthy adults.

Absorption

Rapidly absorbed from the gastrointestinal tract and rapidly hydrolyzed by esterases in the intestinal mucosa and blood to cefuroxime. Absorption is enhanced when taken with food.

Metabolism

Hydrolyzed to the active drug cefuroxime in the intestinal mucosa and blood. Cefuroxime itself is not significantly metabolized further.

Probenecid

Concomitant administration with probenecid increases the area under the serum concentration-time curve by 50%.

Nephrotoxic drugs

Concomitant use of highly active diuretics or aminoglycosides might increase the risk of nephrotoxicity.

Oral Contraceptives

Cefuroxime may affect gut flora, leading to lower estrogen reabsorption and reduced efficacy of combined oral contraceptives. Consider alternative contraception.

Antacids/H2 blockers/PPIs

Drugs that reduce gastric acidity (e.g., antacids, H2-blockers, proton pump inhibitors) may result in lower bioavailability of cefuroxime axetil. It is generally recommended to administer cefuroxime at least 2 hours before or 4 hours after antacids.