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Cefpodoxime Proxetil
Pronunciation: SEF-pode-OX-eem PROX-uh-til
Class: Antibiotic, Cephalosporin
Trade Names
Cefpodoxime Proxetil
- Granules for Suspension 50 mg/5 mL
- Granules for Suspension 100 mg/5 mL
Vantin
- Tablets 100 mg
- Tablets 200 mg
Pharmacology
Inhibits mucopeptide synthesis in bacterial cell wall.
Pharmacokinetics
Absorption
About 50% absorbed.
TabletsC max is 1.4 to 3.9 mcg/mL (100 to 400 mg dose). T max is about 2 to 3 h.
SuspensionC max is about 1.5 mcg/mL (100 mg dose).
FoodAUC and C max are increased when tablets are taken with food. T max is increased 48% when suspension is taken with food.
Distribution
21% to 29% plasma protein bound.
Metabolism
Cefpodoxime proxetil is a prodrug and de-esterified to cefpodoxime (active).
Elimination
About 29% to 33% of the absorbed dose is excreted unchanged in the urine in 12 h. The t ½ is 2.09 to 2.84 h.
Special Populations
Renal Function ImpairmentElimination is reduced in those with CrCl less than 50 mL/min. Dosage adjustment is recommended.
ElderlyThe t ½ is increased to about 4.2 h. Dosage adjustment is recommended in those with diminished renal function.
Indications and Usage
Treatment of infections of respiratory tract, urinary tract, skin and skin structures; treatment of STDs caused by susceptible strains of specific microorganisms.
Contraindications
Hypersensitivity to cephalosporins.
Dosage and Administration
AdultsPO 100 to 400 mg every 12 h.
Children 6 mo to 12 yr of agePO 10 mg/kg/day in divided doses every 12 h (max 200 mg/dose).
General Advice
Administer with food to enhance absorption.
Storage/Stability
Store tablets at controlled room temperature (68° to 77°F). Store unsuspended granules at controlled room temperature (68° to 77°F). Store reconstituted suspension in refrigerator (36° to 46°F); discard any unused portion after 14 days.
Drug Interactions
ProbenecidInhibition of renal excretion of cefpodoxime.
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
GI
Nausea; vomiting; diarrhea; anorexia; abdominal pain or cramps; flatulence; colitis, including pseudomembranous colitis.
Genitourinary
Pyuria; renal function impairment; dysuria; reversible interstitial nephritis; hematuria; toxic nephropathy.
Hematologic
Eosinophilia; neutropenia; lymphocytosis; leukocytosis; thrombocytopenia; decreased platelet function; anemia; aplastic anemia; hemorrhage.
Hepatic
Hepatic function impairment; abnormal LFT results.
Miscellaneous
Hypersensitivity, including Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis; serum sickness–like reactions (eg, skin rashes, polyarthritis, arthralgia, fever); candidal overgrowth.
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
Consider benefits relative to risks. 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.
- Advise patient to take with food to enhance absorption.
- 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.
- Advise diabetic patient to use enzyme-based tests (eg, Clinistix , Testape ) for monitoring urine glucose because drug may give false results with other tests.
- Instruct 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 wheezing or difficulty breathing occurs.
Copyright © 2009 Wolters Kluwer Health.
Further information
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