Cefuroxime


Full Generic Medicine Info
Dosage/Direction for Use

Oral
Uncomplicated urinary tract infections
Adult: 250 mg 12 hourly for 7-10 days.
Child: >3 mth to 2 yr
10 mg/kg bid. Max: 125 mg bid; >2 yr 15 mg/kg bid. Max: 250 mg bid.
Renal impairment: Patients on haemodialysis should receive an additional 750-mg dose after each dialysis. Patients on continuous peritoneal dialysis may be given 750 mg bid.
CrCl (ml/min)Dosage Recommendation
<10750 mg once daily.
10-20750 mg bid.

Reconstitution:
Powd for oral susp: Tap the bottle thoroughly to loosen the powd. Add the amount of water specified on the bottle to provide a susp containing 125 mg or 250 mg per 5 mL. Shake the bottle after addition.

Oral
Respiratory tract infections
Adult: 250 - 500 mg 12 hourly for 7-10 days.
Child: >3 months
10 mg/kg 12 hourly. Max: 125 mg 12 houry for 7-10 days
Renal impairment: Patients on haemodialysis should receive an additional 750-mg dose after each dialysis. Patients on continuous peritoneal dialysis may be given 750 mg bid.
CrCl (ml/min)Dosage Recommendation
<10750 mg once daily.
10-20750 mg bid.

Reconstitution:
Powd for oral susp: Tap the bottle thoroughly to loosen the powd. Add the amount of water specified on the bottle to provide a susp containing 125 mg or 250 mg per 5 mL. Shake the bottle after addition.

Oral
Uncomplicated gonorrhoea
Adult: As cefuroxime axetil: 1 g as a single dose. May be given w/ oral probenecid 1 g.
Renal impairment: Patients on haemodialysis should receive an additional 750-mg dose after each dialysis. Patients on continuous peritoneal dialysis may be given 750 mg bid.
CrCl (ml/min)Dosage Recommendation
<10750 mg once daily.
10-20750 mg bid.

Reconstitution:
Powd for oral susp: Tap the bottle thoroughly to loosen the powd. Add the amount of water specified on the bottle to provide a susp containing 125 mg or 250 mg per 5 mL. Shake the bottle after addition.

Oral
Lyme disease
Adult: As cefuroxime axetil: 500 mg bid for 20 days.
Child: >3 mth to 2 yr
10 mg/kg bid. Max: 125 mg bid; >2 yr 15 mg/kg bid. Max: 250 mg bid.
Renal impairment: Patients on haemodialysis should receive an additional 750-mg dose after each dialysis. Patients on continuous peritoneal dialysis may be given 750 mg bid.
CrCl (ml/min)Dosage Recommendation
<10750 mg once daily.
10-20750 mg bid.

Reconstitution:
Powd for oral susp: Tap the bottle thoroughly to loosen the powd. Add the amount of water specified on the bottle to provide a susp containing 125 mg or 250 mg per 5 mL. Shake the bottle after addition.

Oral
Susceptible infections
Adult: As cefuroxime axetil: 250 or 500 mg 12 hourly for 7-10 days.
Child: >3 months
weighing <40 kg: 15 mg/kg 12 hourly for 7-10 days. Max: 250 mg 12 hourly.
Renal impairment: Patients on haemodialysis should receive an additional 750-mg dose after each dialysis. Patients on continuous peritoneal dialysis may be given 750 mg bid.
CrCl (ml/min)Dosage Recommendation
<10750 mg once daily.
10-20750 mg bid.

Reconstitution:
Powd for oral susp: Tap the bottle thoroughly to loosen the powd. Add the amount of water specified on the bottle to provide a susp containing 125 mg or 250 mg per 5 mL. Shake the bottle after addition.

Intravenous
Meningitis
Adult: As cefuroxime Na: 3 g 8 hrly.
Child: ≤3 wk
30-100 mg/kg daily by IV inj given as 2 or 3 divided doses; >3 wk <40 kg: 30-100 mg/kg daily by IV inj given as 3 or 4 divided doses; 60 mg/kg daily to most infections.
Renal impairment: Patients on haemodialysis should receive an additional 750-mg dose after each dialysis. Patients on continuous peritoneal dialysis may be given 750 mg bid.
CrCl (ml/min)Dosage Recommendation
<10750 mg once daily.
10-20750 mg bid.

Reconstitution:
Powd for inj: Add 8 mL or 16 mL of sterile water for inj to a vial labelled as 0.75 g or 1.5 g, respectively, to provide a soln containing approx 90 mg/mL. For IV infusion: Reconstitute 50 mL or 100 mL of dextrose 5% inj, NaCl 0.9% inj or NaCl 0.45% inj to a vial labelled as 0.75 g or 1.5 g to a suitable container.
Incompatibility: Aminoglycosides. Y-site: Azithromycin, filgrastim, fluconazole, midazolam, pantoprazole, vinorelbine.

Intramuscular
Gonorrhoea

Adult: As cefuroxime Na: 1.5 g as a single dose divided between 2 inj sites. May be given w/ oral probenecid 1 g.
Renal impairment: Patients on haemodialysis should receive an additional 750-mg dose after each dialysis. Patients on continuous peritoneal dialysis may be given 750 mg bid.
CrCl (ml/min)Dosage Recommendation
<10750 mg once daily.
10-20750 mg bid.

Reconstitution:
Powd for inj: Add 8 mL or 16 mL of sterile water for inj to a vial labelled as 0.75 g or 1.5 g, respectively, to provide a soln containing approx 90 mg/mL.
Incompatibility:
Aminoglycosides. Y-site: Azithromycin, filgrastim, fluconazole, midazolam, pantoprazole, vinorelbine.

Parenteral
Prophylaxis of surgical infections
Adult: 1.5 g IV before the procedure followed by 750 mg IM 8 hrly for up to 24-48 hr depending on the procedure. For total joint replacement: 1.5 g, may be mixed w/ methylmethacrylate cement.
Renal impairment: Patients on haemodialysis should receive an additional 750-mg dose after each dialysis. Patients on continuous peritoneal dialysis may be given 750 mg bid.
CrCl (ml/min)Dosage Recommendation
<10750 mg once daily.
10-20750 mg bid.

Reconstitution:
Powd for inj: Add 8 mL or 16 mL of sterile water for inj to a vial labelled as 750 mg 0.75 g or 1.5 g, respectively, to provide a soln containing approx 90 mg/mL. For IV infusion: Reconstitute 50 mL or 100 mL of dextrose 5% inj, NaCl 0.9% inj or NaCl 0.45% inj to a vial labelled as 0.75 g or 1.5 g to a suitable container.
Incompatibility:
Aminoglycosides. Y-site: Azithromycin, filgrastim, fluconazole, midazolam, pantoprazole, vinorelbine.

Parenteral
Susceptible infections
Adult: As cefuroxime Na: 0.75 g 8 hrly, by deep IM or slow IV inj over 3-5 min or IV infusion, may increase up to 1.5 g 6-8 hrly in more severe infections.
Child: ≤3 wk
30-100 mg/kg daily by IV inj given as 2 or 3 divided doses; >3 wk <40 kg: 30-100 mg/kg daily by IV inj given as 3 or 4 divided doses; 60 mg/kg daily to most infections.
Renal impairment: Patients on haemodialysis should receive an additional 750-mg dose after each dialysis. Patients on continuous peritoneal dialysis may be given 750 mg bid.
CrCl (ml/min)Dosage Recommendation
<10750 mg once daily.
10-20750 mg bid.

Reconstitution:
Powd for inj: Add 8 mL or 16 mL of sterile water for inj to a vial labelled as 0.75 g or 1.5 g, respectively, to provide a soln containing approx 90 mg/mL. For IV infusion: Reconstitute 50 mL or 100 mL of dextrose 5% inj, NaCl 0.9% inj or NaCl 0.45% inj to a vial labelled as 0.75 g or 1.5 g to a suitable container.
Incompatibility:
Aminoglycosides. Y-site: Azithromycin, filgrastim, fluconazole, midazolam, pantoprazole, vinorelbine.

Parenteral
Pneumonia
Adult: 1.5 g bid by deep IM or slow IV inj over 3-5 min or IV infusion, followed by an oral dose 0.5 g bid.
Child: ≤3 wk
30-100 mg/kg daily by IV inj given as 2 or 3 divided doses; >3 wk <40 kg: 30-100 mg/kg daily by IV inj given as 3 or 4 divided doses; 60 mg/kg daily to most infections.
Renal impairment: Patients on haemodialysis should receive an additional 750-mg dose after each dialysis. Patients on continuous peritoneal dialysis may be given 750 mg bid.
CrCl (ml/min)Dosage Recommendation
<10750 mg once daily.
10-20750 mg bid.

Reconstitution:
Powd for inj: Add 8 mL or 16 mL of sterile water for inj to a vial labelled as 0.75 g or 1.5 g, respectively, to provide a soln containing approx 90 mg/mL. For IV infusion: Reconstitute 50 mL or 100 mL of dextrose 5% inj, NaCl 0.9% inj or NaCl 0.45% inj to a vial labelled as 0.75 g or 1.5 g to a suitable container.
Incompatibility: Aminoglycosides. Y-site: Azithromycin, filgrastim, fluconazole, midazolam, pantoprazole, vinorelbine.

Parenteral
Acute exacerbations of chronic bronchitis

Adult: 750 mg bid by deep IM or slow IV inj over 3-5 min or IV infusion, followed by an oral dose 500 mg bid.
Child: ≤3 wk
30-100 mg/kg daily by IV inj given as 2 or 3 divided doses; >3 wk <40 kg: 30-100 mg/kg daily by IV inj given as 3 or 4 divided doses; 60 mg/kg daily to most infections.
Renal impairment: Patients on haemodialysis should receive an additional 750-mg dose after each dialysis. Patients on continuous peritoneal dialysis may be given 750 mg bid.
CrCl (ml/min)Dosage Recommendation
10-20750 mg bid.
<10750 mg once daily.

Reconstitution:
Powd for inj: Add 8 mL or 16 mL of sterile water for inj to a vial labelled as 0.75 g or 1.5 g, respectively, to provide a soln containing approx 90 mg/mL. For IV infusion: Reconstitute 50 mL or 100 mL of dextrose 5% inj, NaCl 0.9% inj or NaCl 0.45% inj to a vial labelled as 0.75 g or 1.5 g to a suitable container.
Incompatibility: Aminoglycosides. Y-site: Azithromycin, filgrastim, fluconazole, midazolam, pantoprazole, vinorelbine.
Administration
Cefuroxime: May be taken with or without food.
Cefuroxime: Should be taken with food.
Contraindications
Hypersensitivity to cefuroxime or to other cephalosporins.
Special Precautions
History of hypersensitivity to penicillin, and GI disease (particularly colitis). Renal impairment. Pregnancy and lactation. Monitoring Parameters Monitor renal, hepatic and haematologic function periodically. Monitor prothrombin time in patients at risk of prolongation. Observe for signs and symptoms of anaphylaxis during 1st dose.
Adverse Reactions
Rash, fever, pruritus, erythema, urticaria, Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis, serum sickness-like reactions, angioedema; mild to moderate hearing loss (childn); nausea, vomiting, gagging, epigastric burning, GI bleeding and infection, abdominal pain, flatulence, ptyalism, indigestion, mouth ulcers, swollen tongue, anorexia, thirst, dyspepsia, stomach cramps, diarrhoea; decreased Hb and haematocrit, thrombocytosis, lymphocytosis, haemolytic anaemia, increased prothrombin time; transient increase in serum AST (SGOT), ALT (SGPT), alkaline phosphatase, LDH and bilirubin levels; transient increase in BUN and/or serum creatinine concentration, decreased CrCl, bilateral renal cortical necrosis; UTI, kidney pain, urethral pain or bleeding, dysuria, vaginitis, vag candidiasis, vulvovaginal pruritus, vag discharge or irritation; Jarisch-Herxheimer reaction; neck muscle spasm, muscle cramps or stiffness, chest pain or tightness, shortness of breath, tachycardia, chills, lockjaw-type reaction, viral illness, upper resp infection, sinusitis, cough, joint swelling, arthralgia; pain at inj site, thrombophlebitis (IV). Rarely, transient eosinophilia and neutropenia, pancytopenia, leucopenia, thrombocytopenia; headache, somnolence or sleepiness, dizziness, hyperactivity, irritable behaviour, myoclonic jerks, seizures, generalised hyperexcitability; jaundice; acute renal failure, interstitial nephritis.
Potentially Fatal: Anaphylaxis, pseudomembranous colitis.
Overdosage
Symptoms: Encephalopathy, convulsions and coma. Management: Haemodialysis or peritoneal dialysis may reduce serum levels.
Drug Interactions
May enhance the nephrotoxic effect of strong-acting diuretics (e.g. furosemide) and aminoglycosides. May enhance the effect of oral anticoagulants. May reduce the efficacy of OCs. Probenecid prolongs the excretion of cefuroxime and elevated peak serum level.
Food Interaction
May enhance absorption w/ food.
Lab Interference
Positive direct antiglobulin (Coombs') test. Slight interference w/ copper reduction methods (Benedict's, Fehling's, Clinitest®). False-negative result in ferricyanide test.
Action
Cefuroxime inhibits bacterial cell wall synthesis by binding to 1 or more of the penicillin-binding proteins (PBPs) which in turn inhibit the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis and arresting cell wall assembly resulting in bacterial cell death.
Absorption: Absorbed from the GI tract. Enhanced by the presence of food. Time to peak plasma concentration: Approx 2-3 hr (oral); 45 min (IM).
Distribution: Widely distributed into the body (including pleural fluid, synovial fluid, aqueous humour, sputum, bone), CSF even on inflamed meninges. Crosses the placenta and enters breast milk. Plasma protein binding: Up to 50%.
Excretion: Via urine (66-100% as unchanged drug); bile (small amounts). Plasma half-life: Approx 70 min.
Storage
Intramuscular: Powd for inj: Store between 15-30°C. After reconstitution: Store between 2-8°C. Protect from light. Intravenous: Powd for inj: Store between 15-30°C. After reconstitution: Store between 2-8°C. Protect from light. Oral: Tab: Store between 15-30°C. Powd for oral susp: Store between 2-30°C. After reconstitution: Store between 2-8°C. Parenteral: Powd for inj: Store between 15-30°C. After reconstitution: Store between 2-8°C. Protect from light.
CIMS Class
ATC Classification
S01AA27 - cefuroxime ; Belongs to the class of second-generation cephalosporins. Used in the treatment of eye infections.
J01DC02 - cefuroxime ; Belongs to the class of second-generation cephalosporins. Used in the systemic treatment of infections.
Disclaimer: This information is independently developed by CIMS based on cefuroxime from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 CIMS. All rights reserved. Powered by CIMSAsia.com
MORE
LESS
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in