Ximeclav
Generic Name
Cefixime Trihydrate and Clavulanic Acid Oral Suspension
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| ximeclav 125 mg suspension | ৳ 250.00 | N/A |
Description
Overview of the medicine
Ximeclav 125 mg Suspension is an antibiotic medication combining Cefixime, a third-generation cephalosporin, with Clavulanic Acid, a beta-lactamase inhibitor. This combination provides enhanced antibacterial activity against a wide range of gram-positive and gram-negative bacteria, including those that produce beta-lactamase enzymes, making it effective for various bacterial infections, particularly in pediatric patients.
Uses & Indications
Dosage
Adults
Not typically recommended for adults in this specific suspension strength; adult formulations are available. Consult a doctor for appropriate adult dosage.
Elderly
Not typically recommended for elderly in this specific suspension strength; adult formulations are available. Dosage adjustments may be needed based on renal function.
Renal_impairment
Dosage adjustments are necessary in patients with severe renal impairment (CrCl < 30 ml/min). Generally, 50% of the standard dose or increased dosing interval.
How to Take
For oral administration. The suspension should be shaken well before each use. It can be taken with or without food. Use an accurate measuring device provided with the medicine.
Mechanism of Action
Cefixime acts by inhibiting bacterial cell wall synthesis through binding to penicillin-binding proteins (PBPs), leading to bacterial cell lysis and death. Clavulanic Acid is a beta-lactamase inhibitor that irreversibly binds to and inactivates beta-lactamase enzymes produced by bacteria, thus protecting Cefixime from degradation and extending its antibacterial spectrum.
Pharmacokinetics
Onset
Typically within 1-2 hours for antibacterial action.
Excretion
Cefixime is primarily excreted unchanged in the urine (about 50%). Clavulanic acid is excreted in urine, partially as metabolites.
Half life
Cefixime: Approximately 3-4 hours. Clavulanic Acid: Approximately 1 hour.
Absorption
Both Cefixime and Clavulanic Acid are well absorbed from the gastrointestinal tract after oral administration. Cefixime bioavailability is 40-50%. Absorption of clavulanate is also good.
Metabolism
Cefixime is not extensively metabolized. Clavulanic acid is extensively metabolized.
Side Effects
Contraindications
- Hypersensitivity to cefixime, clavulanic acid, or any other cephalosporin antibiotics.
- History of severe hypersensitivity reactions to any other beta-lactam antibiotics (e.g., penicillins).
Drug Interactions
Probenecid
Increases cefixime plasma levels by decreasing renal excretion.
Carbamazepine
Cefixime may increase carbamazepine levels.
Oral Contraceptives
Antibiotics may potentially reduce the efficacy of oral contraceptives; advise additional contraceptive measures.
Anticoagulants (e.g., Warfarin)
May increase the anticoagulant effect, requiring close monitoring of INR.
Storage
Store dry powder below 30°C, protected from light and moisture. Reconstituted suspension should be stored in a refrigerator (2-8°C) and discarded after the recommended duration (e.g., 7-14 days).
Overdose
Symptoms may include gastrointestinal disturbances like nausea, vomiting, and diarrhea. In severe cases, neurotoxicity (e.g., seizures) is possible. Treatment is supportive and symptomatic; hemodialysis or peritoneal dialysis may be considered in severe renal impairment.
Pregnancy & Lactation
Pregnancy: Category B. Studies in animals have not shown harm, but human data are limited. Use only if clearly needed. Lactation: Both cefixime and clavulanic acid are excreted in breast milk in small amounts. Use with caution, monitor for diarrhea or fungal infections in infants.
Side Effects
Contraindications
- Hypersensitivity to cefixime, clavulanic acid, or any other cephalosporin antibiotics.
- History of severe hypersensitivity reactions to any other beta-lactam antibiotics (e.g., penicillins).
Drug Interactions
Probenecid
Increases cefixime plasma levels by decreasing renal excretion.
Carbamazepine
Cefixime may increase carbamazepine levels.
Oral Contraceptives
Antibiotics may potentially reduce the efficacy of oral contraceptives; advise additional contraceptive measures.
Anticoagulants (e.g., Warfarin)
May increase the anticoagulant effect, requiring close monitoring of INR.
Storage
Store dry powder below 30°C, protected from light and moisture. Reconstituted suspension should be stored in a refrigerator (2-8°C) and discarded after the recommended duration (e.g., 7-14 days).
Overdose
Symptoms may include gastrointestinal disturbances like nausea, vomiting, and diarrhea. In severe cases, neurotoxicity (e.g., seizures) is possible. Treatment is supportive and symptomatic; hemodialysis or peritoneal dialysis may be considered in severe renal impairment.
Pregnancy & Lactation
Pregnancy: Category B. Studies in animals have not shown harm, but human data are limited. Use only if clearly needed. Lactation: Both cefixime and clavulanic acid are excreted in breast milk in small amounts. Use with caution, monitor for diarrhea or fungal infections in infants.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Dry powder: 24-36 months. Reconstituted suspension: 7-14 days (check specific product leaflet for exact duration) when stored at recommended temperature (usually 2-8°C).
Availability
Pharmacies, hospitals, clinics
Approval Status
Approved in many countries including Bangladesh
Patent Status
Generically available
Clinical Trials
Multiple clinical trials have demonstrated the efficacy and safety of Cefixime-Clavulanic Acid combinations in treating various bacterial infections, particularly in pediatric populations, showing superiority over cefixime alone for resistant strains.
Lab Monitoring
- Complete Blood Count (CBC) in prolonged therapy
- Renal function tests (BUN, creatinine) in patients with pre-existing renal impairment or during prolonged therapy
- Liver function tests (ALT, AST) if hepatic dysfunction is suspected.
Doctor Notes
- Ensure accurate diagnosis of bacterial infection before prescribing.
- Educate parents/guardians on proper reconstitution, administration, and completion of the full course.
- Monitor for signs of hypersensitivity reactions, especially in patients with a history of penicillin allergy.
- Consider renal function when adjusting dosage, especially in younger children or those with underlying conditions.
Patient Guidelines
- Complete the full course of antibiotics, even if symptoms improve.
- Shake the suspension well before each use.
- Use the provided measuring spoon or cup for accurate dosing.
- Report any severe or persistent side effects to your doctor.
Missed Dose Advice
If a dose is missed, take it as soon as remembered. 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
This medicine may cause dizziness or headaches in some individuals. If you experience these symptoms, avoid driving or operating machinery until you know how the medicine affects you.
Lifestyle Advice
- Maintain good hydration by drinking plenty of fluids.
- Eat a balanced diet. Probiotics may help manage antibiotic-associated diarrhea.
- Avoid self-medication with antibiotics.
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