efepime
Generic Name
cefepime-500-mg-injection
Manufacturer
Various Pharmaceutical Companies
Country
Global
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| efepime 500 mg injection | ৳ 300.00 | N/A |
Description
Overview of the medicine
Cefepime is a fourth-generation cephalosporin antibiotic used to treat a wide range of bacterial infections, including severe and hospital-acquired infections. It is effective against both Gram-positive and Gram-negative bacteria.
Uses & Indications
Dosage
Adults
General dosage is 0.5 g to 2 g intravenously or intramuscularly every 8 or 12 hours. For severe infections, 2 g IV every 8 hours. Dosage and route depend on the type and severity of infection.
Elderly
No specific dose adjustment for elderly patients with normal renal function. Dose should be adjusted based on renal function.
Renal_impairment
Dosage must be reduced in patients with impaired renal function (creatinine clearance ≤ 50 mL/min) to prevent accumulation and potential adverse effects. Consult specific dosing guidelines based on creatinine clearance.
How to Take
For intravenous administration, the 500 mg vial should be reconstituted with 5 mL of Sterile Water for Injection, 5% Dextrose Injection, or 0.9% Sodium Chloride Injection. The resulting solution should then be further diluted and infused over 30 minutes. For intramuscular administration, reconstitute with 2.5 mL of Sterile Water for Injection, 0.9% Sodium Chloride Injection, or 1% Lidocaine HCl Solution and inject into a large muscle mass.
Mechanism of Action
Cefepime exerts its bactericidal effect 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 strength and rigidity. This leads to cell lysis and bacterial death.
Pharmacokinetics
Onset
Rapid, typically within minutes after IV administration.
Excretion
Primarily renal excretion (approximately 85% of the administered dose is excreted unchanged in the urine). Glomerular filtration is the main route.
Half life
Approximately 2 hours in adults with normal renal function; prolonged in patients with renal impairment.
Absorption
Rapid and complete absorption after intramuscular (IM) or intravenous (IV) administration. Peak plasma concentrations are achieved within 30 minutes to 1 hour after IV dose.
Metabolism
Minimally metabolized; less than 1% of the administered dose is metabolized to N-methylpyrrolidine, which is then rapidly converted to the N-oxide.
Side Effects
Contraindications
- Known hypersensitivity to cefepime or any other cephalosporin.
- Previous immediate and severe hypersensitivity reaction to any beta-lactam antibiotic (e.g., penicillins, carbapenems).
Drug Interactions
Probenecid
Decreases renal tubular secretion of cefepime, resulting in increased and prolonged plasma concentrations.
Aminoglycosides
Increased risk of nephrotoxicity and ototoxicity.
Loop Diuretics (e.g., Furosemide)
May increase the risk of nephrotoxicity when co-administered with aminoglycosides and cephalosporins.
Oral Anticoagulants (e.g., Warfarin)
May enhance the anticoagulant effect, requiring monitoring of INR.
Storage
Store dry powder at controlled room temperature (20-25°C), protected from light. Keep out of reach of children. Reconstituted solutions should be used immediately or stored according to specific manufacturer guidelines.
Overdose
In case of severe overdose, particularly in patients with renal impairment, symptoms such as encephalopathy (confusion, hallucinations, stupor, coma), myoclonus, and seizures may occur. Treatment should be supportive, and hemodialysis may be useful in accelerating the removal of cefepime from the body.
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 very low concentrations; caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Known hypersensitivity to cefepime or any other cephalosporin.
- Previous immediate and severe hypersensitivity reaction to any beta-lactam antibiotic (e.g., penicillins, carbapenems).
Drug Interactions
Probenecid
Decreases renal tubular secretion of cefepime, resulting in increased and prolonged plasma concentrations.
Aminoglycosides
Increased risk of nephrotoxicity and ototoxicity.
Loop Diuretics (e.g., Furosemide)
May increase the risk of nephrotoxicity when co-administered with aminoglycosides and cephalosporins.
Oral Anticoagulants (e.g., Warfarin)
May enhance the anticoagulant effect, requiring monitoring of INR.
Storage
Store dry powder at controlled room temperature (20-25°C), protected from light. Keep out of reach of children. Reconstituted solutions should be used immediately or stored according to specific manufacturer guidelines.
Overdose
In case of severe overdose, particularly in patients with renal impairment, symptoms such as encephalopathy (confusion, hallucinations, stupor, coma), myoclonus, and seizures may occur. Treatment should be supportive, and hemodialysis may be useful in accelerating the removal of cefepime from the body.
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 very 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 when stored as dry powder. Reconstituted solutions have limited stability (e.g., 24 hours at room temperature, 7 days under refrigeration), depending on diluent.
Availability
Available in hospitals and retail pharmacies
Approval Status
Approved by major regulatory bodies globally, including DGDA in Bangladesh.
Patent Status
Patent expired, generics available
WHO Essential Medicine
YesClinical Trials
Cefepime underwent extensive clinical trials to establish its efficacy and safety for various bacterial infections, leading to its global approval. Post-market surveillance and ongoing studies continue to monitor its performance.
Lab Monitoring
- Renal function (creatinine, BUN) before and during treatment, especially in patients with pre-existing impairment.
- Complete Blood Count (CBC) with differential.
- Liver function tests (AST, ALT, bilirubin) periodically.
- Coagulation parameters (PT/INR) if co-administered with anticoagulants.
- Therapeutic drug monitoring may be considered in critically ill patients or those with severe renal impairment.
Doctor Notes
- Crucially, adjust dosage in renal impairment based on creatinine clearance to prevent neurotoxicity.
- Monitor for signs of hypersensitivity reactions, including anaphylaxis, especially after the first dose.
- Consider co-administration with metronidazole for intra-abdominal infections to cover anaerobes.
- Educate patients on the importance of completing the full course of therapy.
Patient Guidelines
- Complete the full course of treatment as prescribed by your doctor, even if you feel better.
- Report any severe side effects immediately to your healthcare provider.
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
- Do not share this medication with others, even if they have similar symptoms.
Missed Dose Advice
If a dose is missed, it should be administered as soon as possible. However, if it is almost time for the next scheduled dose, skip the missed dose and continue with the regular dosing schedule. Do not double the dose.
Driving Precautions
Cefepime may cause dizziness or confusion in some individuals. Patients should be cautioned about operating machinery or driving until they are reasonably certain that cefepime does not adversely affect their ability to engage in such activities.
Lifestyle Advice
- Maintain adequate hydration by drinking plenty of fluids.
- Practice good hygiene to prevent the spread of infection.
- Avoid alcohol consumption during antibiotic treatment as it may exacerbate side effects.
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International brand names for this medicine. Click a brand to search for detailed information.
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