Adults

Typically 250 mg to 500 mg twice daily, depending on the severity and type of infection. For most infections, 250 mg twice daily. For more severe infections or those of the lower respiratory tract, 500 mg twice daily.

Elderly

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

Renal_impairment

Dosage reduction is required in patients with significant renal impairment. Refer to specific guidelines based on creatinine clearance (e.g., reduce frequency).

Onset

Peak plasma concentrations are achieved approximately 2-3 hours after oral administration with food.

Excretion

Mainly excreted unchanged by the kidneys, primarily by glomerular filtration and tubular secretion.

Half life

Approximately 1 to 1.5 hours.

Absorption

Rapidly absorbed from the gastrointestinal tract, especially when taken with food. The axetil ester is hydrolyzed to cefuroxime in the intestinal mucosa and blood.

Metabolism

The axetil ester is hydrolyzed to the active compound cefuroxime. Cefuroxime itself is not significantly metabolized in the body.

Probenecid

Concomitant administration with probenecid increases the area under the serum concentration versus time curve (AUC) of cefuroxime by about 50%, prolonging its half-life.

Aminoglycosides

May increase the risk of nephrotoxicity when used concomitantly.

Oral Anticoagulants

Cefuroxime may alter gut flora, potentially enhancing the effect of oral anticoagulants (e.g., warfarin), leading to increased INR.

Oral Contraceptives

May decrease the efficacy of estrogen/progesterone oral contraceptives. Advise patients to use additional barrier contraception.