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cefuroxime

Pronunciation

Generic Name: cefuroxime (SEF ue ROX eem)
Brand Name: Ceftin, Kefurox, Zinacef, Zinacef ADD-Vantage, Zinacef TwistVial

What is cefuroxime?

Cefuroxime is in a group of drugs called cephalosporin (SEF a low spor in) antibiotics. It works by fighting bacteria in your body.

Cefuroxime is used to treat many kinds of bacterial infections, including severe or life-threatening forms.

Cefuroxime may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about cefuroxime?

Do not take this medication if you are allergic to cefuroxime, or to similar antibiotics, such as Cefzil, Keflex, Omnicef, and others.

Before taking this medication, tell your doctor if you are allergic to any drugs (especially penicillin). Also tell your doctor if you have liver or kidney disease, diabetes, a history of intestinal problems, or if you are malnourished.

Slideshow: The Shocking Truth About Antibiotic Resistance

Cefuroxime can make birth control pills less effective, which may result in pregnancy. Tell your doctor if you are taking birth control pills to prevent pregnancy. You may need to use another form of birth control during treatment with cefuroxime.

Take this medication for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated. Cefuroxime will not treat a viral infection such as the common cold or flu.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

This medication can cause you to have false results with certain medical tests, including urine glucose (sugar) tests. Tell any doctor who treats you that you are using cefuroxime.

What should I discuss with my health care provider before taking cefuroxime?

Do not take this medication if you are allergic to cefuroxime, or to other cephalosporin antibiotics, such as:

  • cefaclor (Raniclor);

  • cefadroxil (Duricef);

  • cefazolin (Ancef);

  • cefdinir (Omnicef);

  • cefditoren (Spectracef);

  • cefpodoxime (Vantin);

  • cefprozil (Cefzil);

  • ceftibuten (Cedax);

  • cephalexin (Keflex); or

  • cephradine (Velosef).

Before taking cefuroxime, tell your doctor if you are allergic to any drugs (especially penicillins), or if you have:

  • kidney disease;

  • liver disease;

  • a history of intestinal problems, such as colitis;

  • diabetes; or

  • if you are malnourished.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take cefuroxime.

The oral suspension (liquid) form of cefuroxime may contain phenylalanine. Talk to your doctor before using this form of cefuroxime if you have phenylketonuria (PKU).

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Cefuroxime can make birth control pills less effective, which may result in pregnancy. Tell your doctor if you are taking birth control pills to prevent pregnancy. You may need to use another form of birth control during treatment with cefuroxime.

Cefuroxime can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take cefuroxime?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

You may take cefuroxime tablets with or without meals.

Cefuroxime oral suspension (liquid) must be taken with food.

Shake the oral liquid well just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

If you switch from using the tablet form to using the oral suspension (liquid) form of cefuroxime, you may not need to use the same exact dosage in number of milligrams. The medication may not be as effective unless you use the exact form and strength your doctor has prescribed.

Use this medication for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated. Cefuroxime will not treat a viral infection such as the common cold or flu.

This medication can cause you to have false results with certain medical tests, including urine glucose (sugar) tests. Tell any doctor who treats you that you are using cefuroxime.

Store cefuroxime tablets at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

Store cefuroxime oral liquid in the refrigerator. Do not allow it to freeze. Throw away any unused medication that is older than 10 days.

What happens if I miss a dose?

Take the medication as soon as you remember the missed dose. If it is almost time for your next dose, skip the missed dose and use the medicine at your next regularly scheduled time. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include seizure (black-out or convulsions).

What should I avoid while taking cefuroxime?

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

Cefuroxime side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • diarrhea that is watery or bloody;

  • fever, chills, body aches, flu symptoms;

  • chest pain, fast or pounding heartbeats;

  • unusual bleeding;

  • blood in your urine;

  • seizure (convulsions);

  • pale or yellowed skin, dark colored urine, fever, confusion or weakness;

  • jaundice (yellowing of the skin or eyes);

  • fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;

  • skin rash, bruising, severe tingling, numbness, pain, muscle weakness;

  • increased thirst, loss of appetite, swelling, weight gain, feeling short of breath; or

  • painful or difficult urination, urinating less than usual or not at all.

Less serious side effects may include:

  • nausea, vomiting, stomach pain, mild diarrhea, gas, upset stomach;

  • cough, stuffy nose;

  • stiff or tight muscles, muscle pain;

  • joint pain or swelling;

  • headache, drowsiness;

  • feeling restless, irritable, or hyperactive;

  • white patches or sores inside your mouth or on your lips;

  • unusual or unpleasant taste in your mouth;

  • diaper rash in an infant taking liquid cefuroxime;

  • mild itching or skin rash; or

  • vaginal itching or discharge.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Cefuroxime dosing information

Usual Adult Dose for Bronchitis:

250 to 500 mg orally twice a day or 750 mg to 1.5 grams IV or IM every 8 hours for 5 to 10 days

Usual Adult Dose for Cystitis:

Uncomplicated: 250 mg orally twice a day or 750 mg IV or IM every 8 hours for 7 to 10 days

Usual Adult Dose for Epiglottitis:

1.5 g IV every 6 to 8 hours for 7 to 10 days, depending on the nature and severity of the infection

Usual Adult Dose for Gonococcal Infection -- Disseminated:

750 mg to 1.5 g IV every 8 hours

Parenteral therapy should be continued for 24 to 48 hours after clinical improvement is demonstrated. Oral therapy with cefixime or cefpodoxime may then be continued to complete a total course of at least 1 week.

Doxycycline therapy for 7 days (if not pregnant) or single dose azithromycin (1 g) is also recommended to treat possible concurrent chlamydial infection.

The patient's sexual partner(s) should also be evaluated/treated.

Usual Adult Dose for Gonococcal Infection -- Uncomplicated:

Uncomplicated infections of the cervix, urethra, or rectum:
Oral: 1 g orally one time
Intramuscular: 1.5 g IM (0.75 g administered in two separate sites) one time with 1 g probenecid orally

Doxycycline therapy for 7 days (if not pregnant) or single dose azithromycin (1 g) is also recommended to treat possible concurrent chlamydial infection.

The patient's sexual partner(s) should also be evaluated/treated.

The Centers for Disease Control and Prevention suggest cefuroxime axetil may be effective as an oral alternative for the treatment of uncomplicated gonorrhea of the cervix, urethra, or rectum.

Usual Adult Dose for Joint Infection:

1.5 g IV every 8 hours
Therapy should be continued for approximately 3 to 4 weeks, depending on the nature and severity of the infection. Longer therapy, 6 weeks or more, may be required for prosthetic joint infections. In addition, removal of the involved prosthesis is usually required.

Usual Adult Dose for Lyme Disease:

500 mg orally twice a day for 20 days

The Infectious Diseases Society of America has recommended oral cefuroxime as an alternative to amoxicillin or doxycycline for the treatment of Lyme disease when oral therapy is appropriate (erythema chronicum migrans, cranial nerve palsy, first or second degree heart block, and arthritis). Febrile patients should also be evaluated/treated for human granulocytic ehrlichiosis (HGE) and babesiosis.

Usual Adult Dose for Meningitis:

1.5 g IV every 6 hours or 3 g IV every 8 hours for 14 days

Usual Adult Dose for Osteomyelitis:

1.5 g IV every 8 hours
Therapy should be continued for approximately four to six weeks depending on the nature and severity of the infection. Chronic osteomyelitis may require an additional one to two months of oral antimicrobial therapy.

Usual Adult Dose for Otitis Media:

250 mg orally twice a day for 10 days

Usual Adult Dose for Peritonitis:

750 mg to 1.5 g IV every 8 hours for 10 to 14 days

CAPD-associated peritonitis: 1 gram per 2 liters of dialysate intraperitoneally, followed by a continuous maintenance dosage of 150 to 400 mg per 2 liters of dialysate

Usual Adult Dose for Pneumonia:

Uncomplicated: 750 mg IV or IM every 8 hours
Complicated: 1.5 g IV or IM every 8 hours

Once the patient responds clinically to parenteral therapy, cefuroxime 250 mg to 500 mg orally every 8 hours for 7 to 21 days may be administered. Duration of therapy is dependent upon the suspected causative organism's sensitivity to cefuroxime.

Usual Adult Dose for Pyelonephritis:

750 mg to 1.5 g every 8 hours or 250 to 500 mg orally twice a day for 14 days, depending on the nature and severity of the infection

Usual Adult Dose for Sepsis:

1.5 g IV every 6 to 8 hours, in combination with an aminoglycoside
Therapy should be continued for 7 to 21 days depending on the nature and severity of the infection.

Usual Adult Dose for Sinusitis:

250 mg orally twice a day for 10 to 14 days

Usual Adult Dose for Skin or Soft Tissue Infection:

250 to 500 mg orally twice a day (uncomplicated infections) or 750 mg IV every 8 hours for 10 days

Usual Adult Dose for Surgical Prophylaxis:

Preoperative: 1.5 g IV 30 to 60 minutes before the initial incision
Postoperative: 750 mg IV or IM every 8 hours when the procedure is prolonged
Open heart surgery: 1.5 g IV at induction and every 12 hours thereafter for a total of 6 g

Cefuroxime prophylaxis is recommended as alternative to cefazolin for cardiothoracic surgery, heart transplantation, and lung or heart-lung transplantation. Cefazolin is considered the drug of choice in clean operations because it is active against Staphylococcus aureus and S epidermidis, has a long duration of action, and is relatively inexpensive. Alternatively, vancomycin may be indicated in patients with severe beta-lactam hypersensitivity or for major surgeries at institutions with high rates of MRSA or MRSE infections.

Usual Adult Dose for Tonsillitis/Pharyngitis:

250 mg orally twice a day for 10 days

Usual Adult Dose for Upper Respiratory Tract Infection:

250 to 500 mg orally twice a day

Usual Adult Dose for Urinary Tract Infection:

Uncomplicated: 250 mg orally twice a day for 7 to 10 days or 750 mg IV every 8 hours
Complicated: 1.5 g IV every 8 hours

Usual Pediatric Dose for Epiglottitis:

3 months to 12 years: 50 to 100 mg/kg/day IV in divided doses every 6 to 8 hours (maximum 6 g/day) for 7 to 10 days, depending on the nature and severity of the infection

Usual Pediatric Dose for Joint Infection:

3 months to 12 years: 50 mg/kg IV every 8 hours (maximum 6 g/day)
13 years or older: Adult dose

Usual Pediatric Dose for Osteomyelitis:

3 months to 12 years: 50 mg/kg IV every 8 hours (maximum 6 g/day)
13 years or older: Adult dose

Usual Pediatric Dose for Meningitis:

3 months to 12 years: 200 mg to 240 mg/kg/day IV in divided doses every 6 to 8 hours (maximum 9 g/day)
13 years or older: Adult dose

Usual Pediatric Dose for Otitis Media:

3 months to 12 years: 250 mg tablet orally twice a day for 10 days or 15 mg/kg of the suspension twice a day for 10 days; maximum daily dose is 1000 mg
13 years or older: Adult dose

Usual Pediatric Dose for Sinusitis:

3 months to 12 years: 250 mg tablet orally twice a day for 10 days or 15 mg/kg of the suspension orally twice a day for 10 to 14 days; maximum daily dose is 1000 mg
13 years or older: Adult dose

Usual Pediatric Dose for Skin and Structure Infection:

3 months to 12 years: 15 mg/kg of the suspension orally twice a day for 10 days; maximum daily dose is 1000 mg

Usual Pediatric Dose for Impetigo:

3 months to 12 years: 15 mg/kg of the suspension orally twice a day for 10 days; maximum daily dose is 1000 mg

Usual Pediatric Dose for Tonsillitis/Pharyngitis:

3 months to 12 years: 10 mg/kg of the suspension twice a day for 10 days; maximum daily dose is 500 mg
13 years or older: Adult dose

Usual Pediatric Dose for Bacterial Infection:

3 months to 12 years:
Parenteral: 50 to 100 mg/kg/day IV or IM in divided doses every 6 to 8 hours (maximum daily dose 6 g), depending on the nature and severity of the infection
Oral:
Suspension: 10 to 15 mg/kg orally twice a day (maximum dose 1000 mg/day)
Tablets: 250 mg orally twice a day

13 years or older: Adult dose

What other drugs will affect cefuroxime?

Before taking cefuroxime, tell your doctor if you are taking any of the following drugs:

  • probenecid (Benemid);

  • a blood thinner such as warfarin (Coumadin);

  • a medication that reduces stomach acid, such as an antacid, or cimetidine (Tagamet), famotidine (Pepcid), omeprazole (Prilosec), ranitidine (Zantac), and others; or

  • a diuretic (water pill) such as bumetanide (Bumex), furosemide (Lasix), indapamide (Lozol), hydrochlorothiazide (HCTZ, HydroDiuril, Hyzaar, Lopressor, Vasoretic, Zestoretic), metolazone (Mykrox, Zarxolyn), spironolactone (Aldactazide, Aldactone), torsemide (Demadex), and others.

This list is not complete and there may be other drugs that can interact with cefuroxime. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start taking a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about cefuroxime.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 6.03. Revision Date: 2010-12-15, 5:01:39 PM.

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