Enocef
Generic Name
Cefepime 1 gm Injection
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| enocef 1 gm injection | ৳ 201.35 | N/A |
Description
Overview of the medicine
Enocef 1 gm Injection contains Cefepime, a fourth-generation cephalosporin antibiotic used to treat a wide range of bacterial infections. It is a broad-spectrum antibiotic effective against both Gram-positive and Gram-negative bacteria.
Uses & Indications
Dosage
Adults
Typical dose is 1-2 gm administered intravenously (IV) every 8 or 12 hours, depending on the severity and type of infection. For febrile neutropenia, 2 gm IV every 8 hours. For meningitis, 2 gm IV every 8 hours.
Elderly
Dosage adjustment is usually required based on renal function, similar to patients with renal impairment.
Renal_impairment
Dosage must be adjusted based on creatinine clearance (CrCl). Reduced doses and/or extended dosing intervals are necessary.
How to Take
Enocef 1 gm Injection is administered either intravenously (IV) as an infusion over 30 minutes or via deep intramuscular (IM) injection. The powder must be reconstituted with an appropriate diluent (e.g., Sterile Water for Injection, 0.9% Sodium Chloride Injection) before administration.
Mechanism of Action
Cefepime acts by inhibiting bacterial cell wall synthesis. It binds to penicillin-binding proteins (PBPs) located inside the bacterial cell wall, which are essential for peptidoglycan synthesis. This binding leads to inhibition of cell wall formation, causing bacterial cell lysis and death.
Pharmacokinetics
Onset
Rapid, typically within minutes of IV administration.
Excretion
Primarily excreted unchanged in the urine by glomerular filtration.
Half life
Approximately 2 hours in adults with normal renal function.
Absorption
Rapid and complete absorption after intramuscular (IM) administration; immediate and complete absorption after intravenous (IV) administration.
Metabolism
Minimally metabolized; primarily hydrolyzed to N-methylpyrrolidine (NMP) which is active to a minor extent and rapidly eliminated.
Side Effects
Contraindications
- Hypersensitivity to Cefepime or any other cephalosporin antibiotics
- History of severe hypersensitivity reaction (e.g., anaphylaxis) to any other beta-lactam antibiotic (e.g., penicillins, carbapenems)
Drug Interactions
Metronidazole
No significant interaction, often co-administered for broader coverage in mixed infections.
Loop Diuretics
May increase the risk of nephrotoxicity with cephalosporins.
Aminoglycosides
Increased risk of nephrotoxicity and ototoxicity when co-administered.
Oral Anticoagulants (e.g., Warfarin)
May enhance the anticoagulant effect and increase the risk of bleeding; monitor INR closely.
Storage
Store the dry powder vials at controlled room temperature, below 30°C (86°F). Protect from light. Do not freeze. Reconstituted solutions should be stored as per manufacturer's guidelines.
Overdose
In cases of overdose, symptoms may include encephalopathy, seizures, myoclonus, and neuromuscular excitability, particularly in patients with renal impairment. Management is primarily supportive; hemodialysis may be useful in enhancing the removal of cefepime from the body, especially in patients with impaired renal function.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have shown no evidence of fetal harm, but there are no adequate and well-controlled studies in pregnant women. Use during pregnancy only if clearly needed. Cefepime is excreted in human breast milk in low concentrations; use with caution in nursing mothers.
Side Effects
Contraindications
- Hypersensitivity to Cefepime or any other cephalosporin antibiotics
- History of severe hypersensitivity reaction (e.g., anaphylaxis) to any other beta-lactam antibiotic (e.g., penicillins, carbapenems)
Drug Interactions
Metronidazole
No significant interaction, often co-administered for broader coverage in mixed infections.
Loop Diuretics
May increase the risk of nephrotoxicity with cephalosporins.
Aminoglycosides
Increased risk of nephrotoxicity and ototoxicity when co-administered.
Oral Anticoagulants (e.g., Warfarin)
May enhance the anticoagulant effect and increase the risk of bleeding; monitor INR closely.
Storage
Store the dry powder vials at controlled room temperature, below 30°C (86°F). Protect from light. Do not freeze. Reconstituted solutions should be stored as per manufacturer's guidelines.
Overdose
In cases of overdose, symptoms may include encephalopathy, seizures, myoclonus, and neuromuscular excitability, particularly in patients with renal impairment. Management is primarily supportive; hemodialysis may be useful in enhancing the removal of cefepime from the body, especially in patients with impaired renal function.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have shown no evidence of fetal harm, but there are no adequate and well-controlled studies in pregnant women. Use during pregnancy only if clearly needed. Cefepime is excreted in human breast milk in low concentrations; use with caution in nursing mothers.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Varies by manufacturer, typically 2-3 years from manufacturing date. Reconstituted solutions have limited stability and must be used within specified timeframes (e.g., 24 hours at room temperature or 7 days refrigerated).
Availability
Hospitals and licensed pharmacies
Approval Status
Approved by regulatory authorities (e.g., FDA, DGDA)
Patent Status
Generic available (original patent expired)
WHO Essential Medicine
YesClinical Trials
Cefepime has undergone extensive clinical trials demonstrating its efficacy and safety for various bacterial infections, including comparative studies against other antibiotics.
Lab Monitoring
- Renal function tests (serum creatinine, BUN) periodically, especially in patients with pre-existing renal impairment.
- Complete Blood Count (CBC) for prolonged therapy.
- Liver function tests (LFTs) if clinically indicated.
- Prothrombin Time (PT)/International Normalized Ratio (INR) for patients on concomitant anticoagulants.
Doctor Notes
- Ensure proper renal dose adjustment for patients with impaired kidney function to minimize the risk of neurological toxicity.
- Monitor for signs of Clostridium difficile-associated diarrhea, especially in patients presenting with new-onset diarrhea during or after treatment.
- Consider culture and susceptibility testing to guide therapy, especially in severe or persistent infections.
Patient Guidelines
- Complete the full course of treatment as prescribed by the doctor, even if symptoms improve.
- 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 medicine with others, even if they have similar symptoms.
Missed Dose Advice
If a dose is missed, it should be administered as soon as remembered. 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 to catch up.
Driving Precautions
Cefepime may cause dizziness or confusion in some individuals, particularly with higher doses or in patients with renal impairment. Patients should be advised to use caution when driving or operating machinery until they know how the medication affects them.
Lifestyle Advice
- Maintain adequate hydration during treatment.
- Avoid alcohol consumption if feeling unwell or if it exacerbates side effects.
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