Adults

Most infections: 250 mg twice daily. More severe infections or lower respiratory tract infections: 500 mg twice daily. Uncomplicated gonorrhea: 1000 mg as a single dose. Early Lyme disease: 500 mg twice daily for 20 days.

Elderly

No special precautions for patients with normal renal function. Adjust dosage in severe renal impairment.

Renal_impairment

Creatinine clearance 10-29 mL/min: 250 mg once daily. Creatinine clearance <10 mL/min: 250 mg every 48 hours. Hemodialysis patients: 250 mg once daily after each dialysis session.

Onset

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

Excretion

Mainly excreted unchanged in the urine by both glomerular filtration and tubular secretion.

Half life

Approximately 1-1.5 hours in healthy adults.

Absorption

Rapidly absorbed from the gastrointestinal tract after oral administration and rapidly hydrolyzed by non-specific esterases in the intestinal mucosa and blood to release cefuroxime. Absorption is enhanced when taken with food.

Metabolism

Cefuroxime itself is not metabolized significantly in the liver.

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.

Aminoglycosides and potent diuretics

Concurrent administration with aminoglycosides or potent diuretics should be avoided, as it may increase the risk of nephrotoxicity (though rare with oral cefuroxime).

Antacids/H2-receptor antagonists/PPIs

Drugs that reduce gastric acidity may result in a lower bioavailability of cefuroxime axetil and should be used with caution.