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Cefepime Side Effects

For the Consumer

Applies to cefepime: injection powder for solution

Along with its needed effects, cefepime may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking cefepime:

More Common

  • Abdominal or stomach cramps
  • back, leg, or stomach pains
  • bleeding gums, nosebleeds
  • confusion
  • convulsions
  • dark urine
  • difficulty with breathing
  • fever, chills
  • general body swelling
  • headache
  • irregular heartbeats
  • loss of appetite
  • mood or mental changes
  • muscle cramps in the hands, arms, feet, legs, or face
  • nausea or vomiting
  • numbness and tingling around the mouth, fingertips, or feet
  • tremor
  • yellowing of the eyes or skin

Less Common

  • Bluish color
  • pain, tenderness
  • swelling of the foot or leg


  • Diarrhea
  • inflammation or swelling
  • watery or bloody diarrhea

Incidence Not Known

  • Agitation
  • blistering, peeling, or loosening of the skin
  • bloody or cloudy urine
  • bloody, black, or tarry stools
  • blurred vision
  • change in consciousness
  • chest pain
  • cough or hoarseness
  • difficult or painful urination
  • difficulty with swallowing
  • dizziness
  • fast heartbeat
  • general feeling of tiredness or weakness
  • itching, hives
  • muscle twitching or jerking
  • paralysis
  • pinpoint red spots on the skin
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • red skin lesions, often with a purple center
  • rhythmic movement of the muscles
  • seeing, hearing, or feeling things that are not there
  • seizures
  • severe sleepiness
  • stiff neck
  • sudden decrease in the amount of urine
  • swollen or painful glands
  • unpleasant breath odor
  • unusual bleeding or bruising
  • vomiting of blood

Some side effects of cefepime may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less Common

  • Red streaks on the skin
  • swelling, tenderness, or pain at the injection site


  • Itching of the vagina or genital area
  • pain during sexual intercourse
  • redness of the skin
  • sore mouth or tongue
  • thick, white vaginal discharge with no odor or with a mild odor
  • white patches in the mouth, tongue, or throat

For Healthcare Professionals

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


Cefepime is generally well tolerated. It has been reported that 1.5% of patients discontinued medication due to adverse events.[Ref]


If diarrhea occurs which is unresponsive to discontinuation of cefepime and/or standard therapy, pseudomembranous colitis should be considered.

Higher doses (2 grams every 8 hours) have been associated with a greater incidence of side effects, including diarrhea (3%), nausea (2%), and vomiting (1%).[Ref]

Uncommon (0.1% to 1%): Colitis (including pseudomembranous colitis), diarrhea, nausea, vomiting, oral moniliasis

Frequency not reported: Abdominal pain, anorexia, stomatitis, Clostridium difficile associated diarrhea[Ref]


Common (1% to 10%): Local reactions (3%)

Uncommon (0.1% to 1%): Phlebitis (1.3%), pain and/or inflammation (0.6%)

Frequency not reported: Infusion site reaction[Ref]

Local reactions (3%), including phlebitis (1.3%) and pain and/or inflammation (0.6%), have been reported irrespective to cefepime in patients who received intravenous infusion.[Ref]

Nervous system

Uncommon (0.1% to 1%): Headache

Frequency not reported: Somnolence

Postmarketing reports: Neurotoxicity, encephalopathy (disturbance of consciousness including confusion, hallucinations, stupor, coma), myoclonus, seizures, nonconvulsive status epilepticus[Ref]

Encephalopathy, myoclonus, seizures, and nonconvulsive status epilepticus have been reported. Although most cases occurred in patients with renal impairment who received higher than recommended doses of cefepime, some cases of neurotoxicity occurred in patients receiving an appropriate dosage for their degree of renal impairment. In the majority of cases, symptoms of neurotoxicity were reversible and resolved after discontinuation of cefepime and/or after hemodialysis.

Case reports of seizure activity, with and without convulsions, associated with cefepime have been published in the medical literature. In the vast majority of cases, the patient involved had a clinically significant degree of renal dysfunction. In each case, seizure activity abated upon the discontinuation of cefepime.

Higher doses (2 grams every 8 hours) have been associated with a greater incidence of side effects, including headache (1%).

A 66-year-old female developed acute renal failure, altered level of consciousness (Glasgow Coma Scale 6), and nonconvulsive status epilepticus after 10 days of cefepime 2 g every 8 hours. Symptoms resolved and she completely recovered 72 hours after discontinuation of cefepime.[Ref]


Common (1% to 10%): Rash (1.1%)

Uncommon (0.1% to 1%): Urticaria, pruritus, erythema

Rare (less than 0.1%): Red man syndrome (at least 1 case)

Frequency not reported: Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis[Ref]

Higher doses (2 grams every 8 hours) have been associated with a higher incidence of side effects, including rash (4%) and pruritus (1%).

Cephalosporin class antibiotics have been associated with Stevens-Johnson syndrome, erythema multiforme, and toxic epidermal necrolysis.[Ref]


Cephalosporins as a class have been associated with aplastic anemia, hemolytic anemia, prolonged prothrombin time, hemorrhage, and pancytopenia.[Ref]

Very common (10% or more): Positive Coombs' test (without hemolysis; 16.2%)

Common (1% to 10%): Increased eosinophils (1.7%), abnormal PTT (1.6%), abnormal PT (1.4%)

Uncommon (0.1% to 1%): Decreased hematocrit, decreased neutrophils, decreased platelets, decreased white blood cells, anemia

Frequency not reported: Epistaxis, aplastic anemia, hemolytic anemia, prolonged prothrombin time, hemorrhage, pancytopenia[Ref]


Anaphylactic reactions are rare, but may occur, especially in patients with a history of penicillin allergy.

Cephalosporin class antibiotics have been associated with allergic reactions.[Ref]

Frequency not reported: Acute hypersensitivity myocarditis, allergic reactions

Postmarketing reports: Anaphylaxis (including anaphylactic shock, transient leukopenia, neutropenia, agranulocytosis, thrombocytopenia)[Ref]


Cephalosporins as a class have been associated with hepatic dysfunction including cholestasis.[Ref]

Common (1% to 10%): Increased ALT (2.8%), increased AST (2.4%)

Uncommon (0.1% to 1%): Increased alkaline phosphatase, increased total bilirubin

Frequency not reported: Hepatic dysfunction including cholestasis[Ref]


Hypocalcemia was more common among elderly patients. Clinical consequences from changes in either calcium or phosphorus were not reported.[Ref]

Common (1% to 10%): Decreased phosphorus (2.8%)

Uncommon (0.1% to 1%): Decreased calcium, increased calcium, increased phosphorus, increased potassium

Frequency not reported: Hypokalemia, hypomagnesemia[Ref]


Higher doses (2 grams every 8 hours) have been associated with a greater incidence of side effects, including fever (1%).[Ref]

Uncommon (0.1% to 1%): Fever[Ref]


Uncommon (0.1% to 1%): Increased BUN, increased creatinine

Frequency not reported: Renal failure, renal dysfunction, toxic nephropathy[Ref]

Renal failure, mostly in patients with renal impairment who received higher than recommended doses of cefepime, has been reported.

Cephalosporins as a class have been associated with renal dysfunction and toxic nephropathy.[Ref]


Uncommon (0.1% to 1%): Vaginitis[Ref]


Frequency not reported: Cough, dyspnea[Ref]


Frequency not reported: Tachycardia[Ref]


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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.