Ultrapime
Generic Name
Cefepime
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| ultrapime 2 gm injection | ৳ 1,100.00 | N/A |
Description
Overview of the medicine
Ultrapime 2 gm Injection is an antibacterial medicine containing Cefepime, a fourth-generation cephalosporin antibiotic. It is used to treat a wide range of severe bacterial infections including pneumonia, complicated urinary tract infections, skin and soft tissue infections, intra-abdominal infections, and febrile neutropenia.
Uses & Indications
Dosage
Adults
Typical dose: 1-2 gm IV or IM every 12 hours. For severe infections, up to 2 gm IV every 8 hours.
Elderly
Dosage adjustment based on renal function is often necessary due to age-related decline in kidney function.
Renal_impairment
Significant dosage reduction is required; consult dose adjustment tables based on creatinine clearance (e.g., CrCl 30-60 mL/min: 1 gm every 24 hours; CrCl 11-29 mL/min: 0.5 gm every 24 hours).
How to Take
For intravenous (IV) administration, dissolve the powder in an appropriate diluent (e.g., Sterile Water for Injection, 0.9% Sodium Chloride Injection) and infuse over 30 minutes. For intramuscular (IM) administration, dissolve in a suitable diluent (e.g., Sterile Water for Injection, Lidocaine HCl 0.5% or 1%) and inject deep into a large muscle mass.
Mechanism of Action
Cefepime is a bactericidal antibiotic that acts by inhibiting bacterial cell wall synthesis. It binds to penicillin-binding proteins (PBPs) located in the bacterial cell wall, thereby interfering with the cross-linking of peptidoglycan chains, which are essential for bacterial cell wall integrity and rigidity. This leads to osmotic instability and lysis of the bacterial cell.
Pharmacokinetics
Onset
Rapid after IV administration, within minutes.
Excretion
Primarily excreted unchanged in the urine, mainly via glomerular filtration. Approximately 85% of the dose is recovered in the urine.
Half life
Approximately 2 hours in adults with normal renal function.
Absorption
Administered intravenously (IV) or intramuscularly (IM); rapidly and completely absorbed. Peak plasma concentrations are attained rapidly after IV infusion and within 1-2 hours after IM injection.
Metabolism
Poorly metabolized; approximately 15% metabolized to N-methylpyrrolidine, which is then rapidly converted to the N-oxide.
Side Effects
Contraindications
- Hypersensitivity to cefepime or other cephalosporins, penicillins, or other beta-lactam antibiotics
- History of severe hypersensitivity reaction to any beta-lactam antibiotic
Drug Interactions
Probenecid
Increases plasma concentrations and prolongs the half-life of cefepime by decreasing renal tubular secretion.
Aminoglycosides
Increased risk of nephrotoxicity and ototoxicity.
Other nephrotoxic drugs
Concurrent administration with other drugs that are potentially nephrotoxic (e.g., aminoglycosides, colistin) may increase the risk of renal toxicity.
Loop diuretics (e.g., Furosemide)
May increase plasma concentrations of cefepime and prolong its elimination, particularly in patients with renal impairment.
Storage
Store intact vials at 20°C to 25°C (68°F to 77°F). Protect from light. Reconstituted solutions are stable for a certain period at room temperature or under refrigeration; follow manufacturer guidelines.
Overdose
Symptoms of overdose may include encephalopathy (impaired consciousness, confusion, seizures, myoclonus), particularly in patients with renal impairment. Management involves supportive care. Hemodialysis may be useful in enhancing the removal of cefepime from the body, especially in patients with impaired renal function.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have shown no evidence of harm to the fetus. Use during pregnancy only if clearly needed. Cefepime is excreted in human milk in very low concentrations; caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Hypersensitivity to cefepime or other cephalosporins, penicillins, or other beta-lactam antibiotics
- History of severe hypersensitivity reaction to any beta-lactam antibiotic
Drug Interactions
Probenecid
Increases plasma concentrations and prolongs the half-life of cefepime by decreasing renal tubular secretion.
Aminoglycosides
Increased risk of nephrotoxicity and ototoxicity.
Other nephrotoxic drugs
Concurrent administration with other drugs that are potentially nephrotoxic (e.g., aminoglycosides, colistin) may increase the risk of renal toxicity.
Loop diuretics (e.g., Furosemide)
May increase plasma concentrations of cefepime and prolong its elimination, particularly in patients with renal impairment.
Storage
Store intact vials at 20°C to 25°C (68°F to 77°F). Protect from light. Reconstituted solutions are stable for a certain period at room temperature or under refrigeration; follow manufacturer guidelines.
Overdose
Symptoms of overdose may include encephalopathy (impaired consciousness, confusion, seizures, myoclonus), particularly in patients with renal impairment. Management involves supportive care. Hemodialysis may be useful in enhancing the removal of cefepime from the body, especially in patients with impaired renal function.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have shown no evidence of harm to the fetus. Use during pregnancy only if clearly needed. Cefepime is excreted in human milk in very low concentrations; caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from manufacture date, check specific packaging for details.
Availability
Hospitals, Clinics, Pharmacies
Approval Status
Approved by regulatory authorities worldwide (e.g., FDA, DGDA)
Patent Status
Generic versions available, original patent expired
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated cefepime's efficacy and safety in various bacterial infections, leading to its widespread approval and use. Ongoing surveillance studies contribute to understanding resistance patterns and optimizing treatment strategies.
Lab Monitoring
- Renal function tests (BUN, creatinine) regularly, especially in patients with pre-existing renal impairment or those receiving concomitant nephrotoxic drugs.
- Liver function tests occasionally.
- Complete blood count (CBC) during prolonged therapy.
- Culture and sensitivity testing to confirm pathogen susceptibility.
Doctor Notes
- Always confirm renal function before initiating cefepime, especially in elderly patients.
- Monitor for signs of neurotoxicity (e.g., confusion, seizures) and adjust dose or discontinue if symptoms occur.
- Ensure appropriate culture and susceptibility testing is performed to guide therapy and prevent resistance.
- Advise patients on the importance of completing the full course.
Patient Guidelines
- Complete the full course of antibiotics as prescribed, even if symptoms improve, to prevent recurrence and development of antibiotic resistance.
- Report any signs of allergic reaction immediately.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs and herbal supplements.
- Do not stop the medication without consulting your doctor.
Missed Dose Advice
If a dose is missed, administer it as soon as possible. However, if it is almost time for the next scheduled dose, skip the missed dose and continue with the regular dosing schedule. Do not double the dose to catch up.
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 medicine affects them.
Lifestyle Advice
- Maintain good hydration.
- Ensure adequate rest.
- Follow general hygiene practices to prevent spread of infection.
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