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Cefoxitin Side Effects

For the Consumer

Applies to cefoxitin: intravenous powder for solution, intravenous solution

In addition to its needed effects, some unwanted effects may be caused by cefoxitin. In the event that any of these side effects do occur, they may require medical attention.

If any of the following side effects occur while taking cefoxitin, check with your doctor or nurse immediately:

More common:
  • Changes in skin color
  • pain
  • swelling of the foot or leg
  • tenderness
  • Agitation
  • coma
  • confusion
  • decreased urine output
  • depression
  • dizziness
  • headache
  • hostility
  • irritability
  • lethargy
  • muscle twitching
  • nausea
  • rapid weight gain
  • seizures
  • stupor
  • swelling of the face, ankles, or hands
  • unusual tiredness or weakness
Incidence not known:
  • Abdominal or stomach cramps or tenderness
  • back, leg, or stomach pains
  • bleeding and bruising
  • bleeding gums
  • blistering, peeling, or loosening of the skin
  • bloating
  • bloody or cloudy urine
  • bloody, black, or tarry stools
  • chest pain
  • chills
  • clay-colored stools
  • cloudy urine
  • cough
  • coughing up blood
  • cracks in the skin
  • dark urine
  • decrease in urine output or decrease in urine-concentrating ability
  • diarrhea
  • diarrhea, watery and severe, which may also be bloody
  • difficult or labored breathing
  • difficult or painful urination
  • difficulty with breathing, chewing, swallowing, or talking
  • dizziness
  • double vision
  • drooping eyelids
  • fast heartbeat
  • feeling of discomfort
  • fever
  • general body swelling
  • greatly decreased frequency of urination or amount of urine
  • headache
  • high fever
  • hives
  • increased menstrual flow or vaginal bleeding
  • increased thirst
  • inflammation of the joints
  • itching
  • itching of the vagina or genital area
  • joint or muscle pain
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • loss of appetite
  • loss of heat from the body
  • muscle aches
  • muscle weakness
  • nosebleeds
  • pain during sexual intercourse
  • pale skin
  • paralysis
  • prolonged bleeding from cuts
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • rash
  • red or black, tarry stools
  • red or dark brown urine
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • red, swollen skin
  • scaly skin
  • severe tiredness
  • shortness of breath
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • sudden decrease in the amount of urine
  • swelling of the feet or lower legs
  • swollen lymph glands
  • swollen or painful glands
  • thick, white vaginal discharge with no odor or with a mild odor
  • tightness in the chest
  • troubled breathing with exertion
  • unexplained bleeding or bruising
  • unpleasant breath odor
  • unusual bleeding or bruising
  • unusual weight loss
  • vomiting
  • vomiting of blood
  • wheezing
  • yellowing of the eyes or skin

Minor Side Effects

Some of the side effects that can occur with cefoxitin may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:
  • Red streaks on the skin
  • swelling, tenderness, or pain at the injection site
Incidence not known:
  • Hives or welts
  • redness of the skin

For Healthcare Professionals

Applies to cefoxitin: injectable powder for injection, intravenous solution


Cefoxitin is generally well-tolerated.[Ref]


Hypersensitivity reactions have included pruritus, rash, exfoliative dermatitis, toxic epidermal necrolysis, urticaria, flushing, dyspnea, angioedema, anaphylaxis, interstitial nephritis, eosinophilia, and fever. Cephalosporin class antibiotics have been associated with erythema multiforme, Stevens-Johnson syndrome, and serum sickness-like reactions.[Ref]

There is a 10% to 20% chance of an allergic reaction to cefoxitin (or any cephalosporin) among patients who are allergic to a penicillin.

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]


Gastrointestinal side effects have included nausea, vomiting, diarrhea, and pseudomembranous colitis. Cephalosporin class antibiotics have been associated with abdominal pain and colitis.[Ref]

A 60-year-old man with bilateral staghorn renal calculi, Proteus mirabilis urinary tract infection, and acute renal failure developed non-bloody diarrhea and fever associated with leukocytosis and ileus within two days after beginning cefoxitin 1 gram intravenously once a day. Sigmoidoscopy and stool pathology revealed innumerable small white plaques and Clostridium difficile toxin. The cefoxitin was stopped, vancomycin retention enemas were given (due to ileus, oral vancomycin was not tried), and the patient recovered.

A study of 374 patients demonstrated that of 21 patients developing Clostridium difficile colitis, 17.9% had received cefoxitin.

Pseudomembranous colitis may occur during or after treatment.[Ref]

Nervous system

Nervous system side effects have included somnolence, dizziness, and headache. Some cephalosporin-class antibiotics have been associated with seizures, especially in patients with renal dysfunction.[Ref]


Renal side effects have included increased serum creatinine and blood urea nitrogen, and acute renal failure (rare). Cephalosporin class antibiotics have been associated with renal dysfunction, toxic nephropathy, reversible, dose-related acute tubular necrosis, and interstitial nephritis. Interstitial nephritis manifests as reversible fever, azotemia, pyuria, and eosinophiluria.[Ref]


Local side effects have included thrombophlebitis with intravenous administration.[Ref]


Cardiovascular side effects have included hypotension.[Ref]


Musculoskeletal side effects have included exacerbation of myasthenia gravis.[Ref]


Hematologic side effects have included eosinophilia, leukopenia, granulocytopenia, neutropenia, anemia, hemolytic anemia, thrombocytopenia, bone marrow depression, and positive direct Coombs' test. Cephalosporin class antibiotics have been associated with aplastic anemia, hemorrhage, prolonged prothrombin time, pancytopenia, and agranulocytosis.[Ref]


Hepatic side effects have included transient elevations of SGOT, SGPT, LDH, and alkaline phosphatase, and jaundice. Cephalosporin class antibiotics have been associated with hepatic dysfunction, cholestasis, and elevated bilirubin.[Ref]


Genitourinary side effects associated with cephalosporin class antibiotics have included vaginitis, vaginal candidiasis, and false positive tests for urine glucose.[Ref]


Other side effects associated with cephalosporin class antibiotics have included superinfection.[Ref]

Other side effects associated with higher doses of cefoxitin have included an increased incidence of SGOT elevations and eosinophilia in pediatric patients.[Ref]


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

2. Tietze KJ, Gaska JA "Cefoxitin-induced exfoliative dermatitis." Clin Pharm 2 (1983): 582-4

3. Kannangara DW, Smith B, Cohen K "Exfoliative dermatitis during cefoxitin therapy." Arch Intern Med 142 (1982): 1031-2

4. Austin SM, Barooah B, Kim CS "Reversible acute cardiac injury during cefoxitin-induced anaphylaxis in a patient with normal coronary arteries." Am J Med 77 (1984): 729-32

5. 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

6. Yangco BG, Kenyon VS, Halkias KD, Toney JF, Chmel H "Comparative evaluation of safety and efficacy of cefmetazole and cefoxitin in lower respiratory tract infections." J Antimicrob Chemother 23 (1989): 39-46

7. Burstein M, Bloom A, Heyman A "Nonthrombocytopenic purpura induced by cefoxitin." DICP 24 (1990): 206

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

9. Shwed JA, Danziger LH, Wojtynek J, Rodvold KA "A comparative evaluation of the safety and efficacy of cefotetan and cefoxitin in surgical prophylaxis." DICP 25 (1991): 10-3

10. "Product Information. Mefoxin (cefoxitin)." Merck & Co, Inc, West Point, PA.

11. Block BS, Mercer LJ, Ismail MA, Moawad AH "Clostridium difficile-associated diarrhea follows perioperative prophylaxis with cefoxitin." Am J Obstet Gynecol 153 (1985): 835-8

12. Goodpasture HC, Dolan PJ, Jacobs ER, Meredith WT "Pseudomembranous colitis & antibiotics." Kans Med 87 (1986): 133, 146

13. Kent KC, Rubin MS, Wroblewski L, Hanff PA, Silen W "The impact of Clostridium difficile on a surgical service: a prospective study of 374 patients." Ann Surg 227 (1998): 296-301

14. Reddy J, Bailey RR "Cefoxitin-associated renal failure." N Z Med J 93 (1981): 337-9

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

16. Sherman RA, Eisinger RP, Weinstein MP, Samel J "Cefoxitin-induced pseudo acute renal failure." Clin Ther 4 (1981): 114-7

17. Haskell RJ, Fujita NK, Stevenson JA, Border WA "Cefoxitin-induced interstitial nephritis." Arch Intern Med 141 (1981): 1557

18. Whitman CB, Joseph JM, Sjoholm LO "Cephalosporin-induced leukopenia following rechallenge with cefoxitin." Ann Pharmacother 42 (2008): 1327-32

19. Brown RB, Klar J, Lemeshow S, Teres D, Pastides H, Sands M "Enhanced bleeding with cefoxitin or moxalactam." Arch Intern Med 146 (1986): 2159-64

20. Shansky M, Greenlaw CW "Reversible acute leukopenia and cefoxitin." Ann Intern Med 92 (1980): 874-5

21. Kaaja R, Valtonen VV "Leucopenia associated with beta-lactam antibiotic therapy." Acta Med Scand 216 (1984): 531-4

Not all side effects for cefoxitin may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.