Medicine Information

Holicef

Name: Holicef
Brand: Holicef
Rating: 4.5 (117 reviews)

Injection500 mgAntibiotic, CephalosporinATC: J01DE01

Generic Name

Cefepime

Manufacturer

Square Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
holicef 500 mg injection	৳ 125.00	N/A

Description

Overview of the medicine

Holicef 500 mg Injection contains Cefepime, a fourth-generation cephalosporin antibiotic, used to treat a wide range of bacterial infections.

Uses & Indications

Moderate to severe pneumonia

Urinary tract infections (complicated and uncomplicated)

Skin and skin structure infections (complicated)

Intra-abdominal infections (complicated, in combination with metronidazole)

Febrile neutropenia (empiric therapy)

Bacterial meningitis

Dosage

Adults

Typical dose is 1-2 g IV every 8-12 hours, depending on the severity of infection. For febrile neutropenia, 2 g IV every 8 hours. For urinary tract infections, 500 mg - 1 g IV/IM every 12 hours.

Elderly

Dosage adjustment may be necessary based on renal function.

Renal_impairment

Dosage must be adjusted based on creatinine clearance (e.g., lower doses or extended dosing intervals for CrCl < 60 mL/min).

How to Take

Administer intravenously (IV) over 30 minutes or intramuscularly (IM) into a large muscle mass. Reconstitute the powder with sterile water for injection or compatible diluent.

Mechanism of Action

Cefepime is a bactericidal antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs) inside the bacterial cell.

Pharmacokinetics

Onset

Within minutes after IV administration; within 1 hour after IM administration.

Excretion

Primarily renal excretion (glomerular filtration); approximately 85% of the dose is recovered in the urine as unchanged drug.

Half life

Approximately 2 hours (longer in renal impairment).

Absorption

Rapidly and completely absorbed following intramuscular (IM) administration; immediate and complete bioavailability following intravenous (IV) administration.

Metabolism

Minimally metabolized; primarily excreted as unchanged drug.

Side Effects

Contraindications

Known hypersensitivity to cefepime or any other cephalosporin
Known hypersensitivity to penicillin or other beta-lactam antibiotics (cross-reactivity)

Drug Interactions

Metronidazole

No known significant pharmacokinetic interaction, often used in combination for broad-spectrum coverage.

Aminoglycosides

Increased risk of nephrotoxicity and ototoxicity.

Loop Diuretics (e.g., Furosemide)

May increase cefepime concentrations and risk of nephrotoxicity.

Storage

Store reconstituted solution at room temperature (20°C to 25°C) for up to 24 hours, or under refrigeration (2°C to 8°C) for up to 7 days. Store dry powder below 30°C, protected from light.

Overdose

Symptoms of overdose may include encephalopathy (impaired consciousness, hallucinations, stupor, coma), myoclonia, and seizures, especially in patients with renal impairment. Treatment is supportive; hemodialysis may be useful in removing the drug.

Pregnancy & Lactation

Pregnancy Category B. Use only if clearly needed. Cefepime is excreted in small amounts in breast milk; use with caution in nursing mothers.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

1 vial per pack

Shelf Life

Typically 2-3 years, refer to specific product labeling for exact duration.

Availability

Hospitals and Pharmacies

Approval Status

Approved by regulatory bodies worldwide

Patent Status

Generic available

WHO Essential Medicine

Yes

Clinical Trials

Cefepime has been extensively studied in numerous clinical trials demonstrating its efficacy and safety across various bacterial infections.

Lab Monitoring

Renal function (creatinine, BUN)
Liver function tests (ALT, AST)
Complete blood count (CBC) with differential, especially for prolonged therapy
Prothrombin time (PT) / International Normalized Ratio (INR) if on anticoagulants

Doctor Notes

Consider cefepime for empiric therapy in severe nosocomial infections or febrile neutropenia where broad-spectrum coverage against Gram-positive and Gram-negative bacteria (including Pseudomonas aeruginosa) is required.
Renal dose adjustment is crucial to prevent accumulation and neurotoxicity, especially in elderly or renally impaired patients.
Be vigilant for neurological adverse events, particularly in patients with pre-existing CNS disorders or renal dysfunction.

Patient Guidelines

Inform your doctor about any allergies, especially to penicillin or other antibiotics.
Complete the full course of treatment as prescribed, even if you start feeling better.
Report any unusual side effects, especially severe diarrhea or neurological changes, to your doctor immediately.

Missed Dose Advice

If a dose is missed, administer it as soon as possible. If it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose.

Driving Precautions

Cefepime may cause dizziness or confusion in some patients. Patients should be advised to exercise caution when driving or operating machinery until they know how the drug affects them.