Adults

Adults and adolescents ≥12 years: 250 mg twice daily for most infections. For more severe infections or bronchitis/pneumonia, 500 mg twice daily. For uncomplicated urinary tract infections, 125 mg twice daily. For early Lyme disease, 500 mg twice daily for 20 days.

Elderly

No special dose adjustments are generally required in elderly patients, unless there is significant renal impairment.

Renal_impairment

For creatinine clearance 10-29 mL/min, 125 mg or 250 mg once daily. For creatinine clearance <10 mL/min, 125 mg or 250 mg every 48 hours. Hemodialysis patients should receive an additional dose after dialysis.

Onset

Within 1-2 hours (antibacterial activity)

Excretion

Excreted unchanged by the kidneys via glomerular filtration and tubular secretion. Approximately 50% of an administered dose is excreted in the urine within 12 hours.

Half life

Approximately 1.2 to 1.5 hours in adults

Absorption

Cefuroxime axetil is absorbed from the gastrointestinal tract and rapidly hydrolyzed by esterases to cefuroxime. Absorption is enhanced with food. Peak plasma concentrations are reached approximately 2-3 hours after administration.

Metabolism

Cefuroxime itself is not significantly metabolized; cefuroxime axetil is hydrolyzed in the intestinal mucosa and blood to active cefuroxime.

Probenecid

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

Oral Contraceptives

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

Oral anticoagulants

Concurrent use may enhance anticoagulant effects due to reduction of vitamin K synthesis by gut flora.

Antacids/H2 blockers

Drugs that reduce gastric acidity may result in lower bioavailability of cefuroxime axetil. Take at least 1-2 hours apart.