Cefazolin Side Effects

Some side effects of cefazolin may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

For the Consumer

Applies to cefazolin: injectable powder for injection, injectable solution, intravenous solution

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

Call your doctor at once if you have a serious side effect such as:

• diarrhea that is watery or bloody;

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

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

• fever, swollen glands, body aches, flu symptoms;

• unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

• urinating less than usual or not at all;

• seizure (black-out or convulsions); or

• severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Less serious side effects of cefazolin may include:

• pain, swelling, or a hard lump where the injection was given;

• stomach pain, nausea, vomiting, loss of appetite;

• skin rash or itching;

• rectal itching; or

• vaginal itching or discharge.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

For Healthcare Professionals

Applies to cefazolin: injectable powder for injection, injectable solution, intravenous solution

Hypersensitivity

Hypersensitivity side effects have included anaphylaxis, eosinophilia, urticaria, itching, drug fever, skin rash, Stevens-Johnson syndrome, and allergic cross-sensitivity. Cephalosporin-class side effects have included allergic reactions, urticaria, serum sickness-like reaction, erythema multiforme, and toxic epidermal necrolysis.

There is a 10% to 20% risk of allergic cross-sensitivity in patients with a history of allergy to penicillins. A 100% risk of cross-sensitivity should be assumed in all patients with a history of anaphylaxis to penicillins or other cephalosporins.

Dermatologic

Dermatologic side effects have included pruritus (including genital, vulvar, and anal pruritus), allergic skin rash, Stevens-Johnson syndrome, fixed drug eruptions, pustular skin eruptions, and contact dermatitis. Cephalosporin-class side effects have included urticaria, serum sickness-like reaction, Stevens-Johnson syndrome, erythema multiforme, and toxic epidermal necrolysis.

A case of occupational contact dermatitis due to cephalosporin allergy has been reported in a nurse who prepared cephalosporin solutions for administration to patients. The dermatitis resolved after the nurse stopped preparing the solutions.

Gastrointestinal

Gastrointestinal side effects have included diarrhea, oral candidiasis (oral thrush), mouth ulcers, vomiting, nausea, abdominal/stomach cramps, epigastric pain, heartburn, flatus, anorexia, anal pruritus, Clostridium difficile-associated diarrhea, and pseudomembranous colitis. Cephalosporin-class side effects have included colitis and abdominal pain.

Onset of pseudomembranous colitis symptoms have been reported during or after antibacterial therapy.

Hematologic

Hematologic side effects have included neutropenia, leukopenia, thrombocytopenia, and thrombocythemia. Cephalosporin-class side effects have included aplastic anemia, hemolytic anemia, hemorrhage, prolonged prothrombin time, pancytopenia, and agranulocytosis.

A 26-year-old hemodialysis patient with a coagulase-positive staphylococcal arteriovenous fistula graft infection was found to have a hematoma and increased thrombin, prothrombin, and partial thromboplastin times after receiving cefazolin 1 gram intravenously followed by 0.5 gram every 8 hours for 12 days. The laboratory changes resolved after cefazolin therapy was stopped, but recurred when cefazolin was reinstituted.

Hematologic side effects may be more likely in patients with renal insufficiency.

Nervous system

There may be an association between renal failure, high cefazolin levels, and neurological symptoms.

Nervous system side effects have included dizziness, fainting, lightheadedness, confusion, tiredness, somnolence, and headache. Seizures have been reported when inappropriately high doses were administered to patients with renal dysfunction (CrCl less than 55 mL/min). Cephalosporin-class side effects have included reversible hyperactivity and hypertonia.

Renal

Renal side effects have included increased BUN, increased creatinine levels, and renal failure. Cephalosporin-class side effects have included renal dysfunction, toxic nephropathy, elevated bilirubin, and increased creatinine. Interstitial nephritis (reversible fever, azotemia, pyuria, and eosinophiluria) has been associated with some cephalosporins.

Hepatic

Hepatic side effects have included transient rise in SGOT, SGPT, and alkaline phosphatase, and hepatitis. Cephalosporin-class side effects have included hepatic dysfunction (including cholestasis) and elevated bilirubin.

Local

Local side effects have included phlebitis at the injection site, pain at the injection site after intramuscular administration, and induration.

Genitourinary

Genitourinary side effects have included genital pruritus, vulvar pruritus, vaginitis, and genital moniliasis.

Cardiovascular

Cardiovascular side effects have included hypotension.

Musculoskeletal

Musculoskeletal side effects have included weakness.

Metabolic

Metabolic side effects associated with cephalosporins as a class have included elevated lactate dehydrogenase.

Other

Other side effects associated with cephalosporins as a class have included superinfection, positive direct Coombs' test, and false-positive test for urinary glucose.

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