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Cefonicid Side Effects

Applies to cefonicid: injectable powder for injection


Cefonicid is generally well tolerated.[Ref]


Hypersensitivity reactions are rare, and may include urticaria, rash, eosinophilia, and fever.[Ref]

Up to 20% of patients with penicillin allergy may demonstrate allergic reactions to cefonicid. Rare cases of a "flu-like syndrome" (fever, chronic fatigue, and myalgias) are reported in patients who received cefonicid for two weeks.

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.[Ref]


A disulfiram-like reaction is associated with some cephalosporins, including cefonicid, which have a methylthiotetrazole ring in their chemical structure. This chemical moiety is associated with inhibition of aldehyde dehydrogenase, which may result in accumulation of acetaldehyde, especially after alcohol consumption. This mechanism is not proven with cefonicid, but is demonstrated with similar cephalosporins, such as cefamandole.

Pseudomembranous colitis has been reported in patients treated with cephalosporins. If diarrhea occurs and it is unresponsive to discontinuation of the drug and/or standard therapy, pseudomembranous colitis should be considered.

Elevations of serum transaminases may be important for patients with liver disease.[Ref]

Gastrointestinal effects include mild, reversible elevations of serum transaminases in 2% to 22% of patients. Nausea and vomiting, mild epigastric discomfort, and loose stools are reported, and may be more likely if this patient consumes alcohol. While no disulfiram-like reactions are associated with cefonicid, they are theoretically possible based on the chemical structure of the drug.[Ref]


Hematologic side effects include rare instances of thrombocytosis and thrombocytopenia, eosinophilia, positive Coombs' tests, and leukopenia.[Ref]


Interstitial nephritis has been reported with some cephalosporins. Reversible fever, azotemia, pyuria, and eosinophilia are the hallmarks of cephalosporin-induced interstitial nephritis.[Ref]

Renal adverse effects are rare. Increases in BUN and serum creatinine occur in less than 1% of patients.[Ref]


Genitourinary side effects including increased incidences of vaginal yeast infections have been reported.[Ref]


1. "Multum Information Services, Inc. Expert Review Panel"

2. Romano A, Mayorga C, Torres MJ, Artesani MC, Suau R, Sanchez F, Perez E, Venuti A, Blanca M "Immediate allergic reactions to cephalosporins: Cross-reactivity and selective responses." J Allerg Clin Immunol 106 (2000): 1177-83

3. Gremillion DH, Winn RE, Vandenbout E "Clinical trial of cefonicid for treatment of skin infections." Antimicrob Agents Chemother 23 (1983): 944-6

4. Dudley MN, Quintiliani R, Nightingale CH "Review of cefonicid, a long-acting cephalosporin." Clin Pharm 3 (1984): 23-32

5. Martin JA, Alonso MD, Lazaro M, Parra F, Compaired JA, Alvarezcuesta E "Delayed allergic reaction to cefonicid." Ann Allergy 72 (1994): 341-2

6. Filipe P, Almeida RSLS, Rodrigo FG "Occupational allergic contact dermatitis from cephalosporins." Contact Dermatitis 34 (1996): 226

7. Wallace RJ, Niefield SL, Waters S, et al "Comparative trial of cefonicid and cefamandole in the therapy of community-acquired pneumonia." Antimicrob Agents Chemother 21 (1982): 231-5

8. Cazzola M, Santangelo G, Paizis G, et al "Effects of cefonicid on platelet aggregation." Drugs Exp Clin Res 17 (1991): 105-8

9. Riancho JA, Olmos JM, Sedano C "Life-threatening bleeding in a patient treated with cefonicid." Ann Intern Med 123 (1995): 472-3

10. Pontzer RE, Kaye D "Cefonicid: a long-acting, second-generation cephalosporin: antimicrobial activity, pharmacokinetics, clinical efficacy and adverse effects." Pharmacotherapy 4 (1984): 325-33

11. Toll LL, Lee M, Sharifi R "Cefoxitin-induced interstitial nephritis." South Med J 80 (1987): 274-5

12. "Product Information. Monocid (cefonicid)." SmithKline Beecham, Philadelphia, PA.

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

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