Cefprozil
Pronouncation: (SEFF-pro-zill)Class: Antibiotic, Cephalosporin
Trade Names:
Cefzil
- Tablets 250 mg (as anhydrous)
- Tablets 500 mg (as anhydrous)
- Powder for oral suspension 125 mg per 5 mL (as anhydrous). Contains sucrose, aspartame, 28 mg per 5 mL phenylalanine
- Powder for oral suspension 250 mg per 5 mL (as anhydrous). Contains sucrose, aspartame, 28 mg per 5 mL phenylalanine
Pharmacology
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Inhibits mucopeptide synthesis in bacterial cell wall.
Pharmacokinetics
Absorption
Cefprozil is about 95% absorbed. Food increased T max 0.25 to 0.75 h. T max is about 1.5 h. C max is 18.3 mcg/mL.
Distribution
Vd is about 0.23 L/kg. Cefprozil is about 36% protein bound.
Elimination
Plasma t ½ is 1.3 h. Total body Cl is about 3 mL/min/kg. Renal Cl is about 2.3 mL/min/kg. The 8-h urinary excretion accounted for 54% to 62% of the dose.
Special Populations
Renal Function ImpairmentThe t ½ may be up to 5.2 h.
Hepatic Function ImpairmentThe t ½ increases to about 2 h.
ElderlyAUC is about 35% to 60% higher.
Indications and Usage
Treatment of infections of skin and skin structures, bronchitis, pharyngitis, tonsillitis, and otitis media caused by susceptible strains of specific microorganisms.
Contraindications
Hypersensitivity to cephalosporins.
Dosage and Administration
AdultsPO 250 to 500 mg every 12 to 24 h.
Children 6 mo to 12 yr of agePO 7.5 to 15 mg/kg every 12 h.
General Advice
May be given without regard to meals. Administer with food or milk if GI upset occurs. Food slows but does not decrease absorption.
Storage/Stability
Oral suspensionAfter reconstitution, oral suspension must be refrigerated. Solution may be stored for up to 14 days in refrigerator. Do not freeze. Shake well before use.
TabletsStore tablets at room temperature.
Drug Interactions
ProbenecidInhibition of renal excretion of cefprozil.
Laboratory Test Interactions
May cause false-positive urine glucose test results with Benedict solution, Fehling solution, or Clinitest tablets but not with enzyme-based tests (eg, Clinistix , Tes-tape ); false-positive test results for proteinuria with acid and denaturization-precipitation tests; false-positive direct Coombs test result in certain patients (eg, those with azotemia); false elevations in urinary 17-ketosteroid values.
Adverse Reactions
CNS
Headache, dizziness; fatigue; paresthesia; confusion; nervousness; sleeplessness; insomnia.
GI
Nausea; vomiting; diarrhea; abdominal pain or cramps; flatulence; colitis, including pseudomembranous colitis.
Genitourinary
Genital pruritus; vaginitis; renal function impairment.
Hematologic
Eosinophilia; neutropenia; lymphocytosis; leukocytosis; thrombocytopenia; decreased platelet function; anemia; aplastic anemia; hemorrhage.
Hepatic
Hepatic function impairment; cholestatic jaundice; abnormal LFT results.
Miscellaneous
Hypersensitivity, including Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis; candidal overgrowth; serum sickness–like reactions (eg, skin rashes, polyarthritis, arthralgia, fever).
Precautions
MonitorResponse to therapyMonitor patient's response to therapy. Notify health care provider if infection does not appear to improve or worsens. Adverse reactionsMonitor patient for GI, DERM, and general body adverse reactions, and signs of superinfection. Inform health care provider if noted and significant. Immediately report severe diarrhea, diarrhea containing blood or pus, or severe abdominal cramping. |
Pregnancy
Category B .
Lactation
Excreted in breast milk.
Children
Safety and efficacy in children younger than 6 mo of age not established.
Hypersensitivity
Reactions range from mild to life-threatening. Administer drug with caution to penicillin-sensitive patients because of possible cross-reactivity.
Renal Function
Use drug with caution in patients with renal function impairment. Dosage adjustment based on renal function may be required.
Superinfection
May result in bacterial or fungal overgrowth of nonsusceptible microorganisms.
Pseudomembranous colitis
Consider in patients in whom diarrhea develops.
Overdosage
Symptoms
Seizures.
Patient Information
- Instruct patient to complete full course of therapy.
- Remind patient to check body temperature daily. If fever persists for more than a few days or if high fever (higher than 102°F) or shaking chills are noted, notify health care provider immediately.
- Advise patient to maintain normal fluid intake while using this medication.
- Remind diabetic patient to use enzyme-based tests (eg, Clinistix , Testape ) for monitoring urine glucose because drug may give false results with other tests.
- Advise patient to report these symptoms to health care provider: nausea, vomiting, diarrhea, skin rash, hives, muscle or joint pain.
- Instruct patient to report signs of superinfection: black “furry” tongue, white patches in mouth, foul-smelling stools, vaginal itching or discharge.
- Warn patient that diarrhea that contains blood or pus may be a sign of serious disorders. Tell patient to seek medical care and not to treat at home.
- Instruct patient to seek emergency care immediately if he or she experiences wheezing or difficulty breathing.
- Caution patient to avoid alcohol intake while taking medication.
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More Cefprozil resources:
Cefprozil - Includes detailed dosage instructions.
Sinusitis, Skin or Soft Tissue Infection, Bronchitis, Upper Respiratory Tract Infection, Pneumonia, Middle Ear Infection, Bladder Infections, Sore Throat, Kidney Infection
