Adults

Not typically used for adults in suspension form; adult dosage for Cefixime is usually 200-400 mg daily in tablet form. If suspension is used due to swallowing difficulties, adjust dose based on standard Cefixime adult guidelines.

Elderly

No specific dosage adjustment needed unless severe renal impairment. Dose adjustment based on creatinine clearance is recommended for elderly patients with impaired renal function.

Renal_impairment

For creatinine clearance 21-60 ml/min, dose should be 75% of standard dose. For creatinine clearance < 20 ml/min, dose should be 50% of standard dose (e.g., 200 mg once daily or 100 mg twice daily).

Onset

Peak plasma concentrations reached within 2-6 hours.

Excretion

Approximately 50% of the absorbed dose is excreted unchanged in the urine over 24 hours. The remainder is excreted via biliary-fecal route.

Half life

Plasma half-life is typically 3-4 hours, but can be prolonged in renal impairment.

Absorption

Approximately 40-50% absorbed orally. Food may delay absorption but does not significantly affect the extent of absorption.

Metabolism

Not extensively metabolized in the body; primarily excreted unchanged.

Probenecid

Increases Cefixime plasma concentration by inhibiting its renal excretion, potentially leading to increased efficacy or toxicity.

Carbamazepine

Elevated carbamazepine levels have been reported with concomitant use of Cefixime. Monitoring of carbamazepine levels may be considered.

Oral Contraceptives

The efficacy of oral contraceptives may be reduced when co-administered with Cefixime; alternative contraception may be advised.

Anticoagulants (e.g., Warfarin)

Concomitant administration may increase prothrombin time (PT) with or without clinical bleeding. Close monitoring of INR and adjustment of anticoagulant dose are recommended.