Zinacef Side Effects

Generic name: cefuroxime

Medically reviewed by Drugs.com. Last updated on Jun 8, 2024.

Note: This document provides detailed information about Zinacef Side Effects associated with cefuroxime. Some dosage forms listed on this page may not apply specifically to the brand name Zinacef.

Applies to cefuroxime: powder for solution.

Other dosage forms:

• oral powder for suspension, oral tablet

Serious side effects of Zinacef

Along with its needed effects, cefuroxime (the active ingredient contained in Zinacef) 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 immediately if any of the following side effects occur while taking cefuroxime:

More common side effects

• black, tarry stools
• chest pain
• chills
• cough
• fever
• painful or difficult urination
• shortness of breath
• sore throat
• sores, ulcers, or white spots on lips or in mouth
• swollen glands
• unusual bleeding or bruising
• unusual tiredness or weakness

Less common side effects

• abdominal or stomach cramps
• abdominal or stomach tenderness or pain
• bloating
• bluish color or changes in skin color
• diarrhea, watery and severe, which may also be bloody
• difficulty in breathing or swallowing, wheezing, shortness of breath
• fast heartbeat
• fever
• hives or welts
• increased thirst
• muscle spasm or jerking of all extremities
• nausea or vomiting
• pain
• skin itching, rash, or redness
• sudden loss of consciousness
• swelling of face, throat, or tongue
• swelling of foot or leg
• tenderness
• unusual weight loss

Rare side effects

• blistering, peeling, loosening of skin
• bloody or cloudy urine
• dizziness
• fast heartbeat
• greatly decreased frequency of urination or amount of urine
• hearing loss, mild to moderate
• joint or muscle pain
• puffiness or swelling of the eyelids or around the eyes, face, lips or tongue
• red or irritated eyes
• redness, tenderness, itching, burning, or peeling of skin
• red skin lesions, often with a purple center
• sore throat
• tightness in chest

Other side effects of Zinacef

Some side effects of cefuroxime 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:

More common side effects

• gas
• loss of appetite

For healthcare professionals

Applies to cefuroxime: injectable powder for injection, intravenous solution, oral powder for reconstitution, oral tablet.

General adverse events

This drug was generally well tolerated. The side effects most commonly reported with the parenteral formulation have included neutropenia, eosinophilia, transient liver enzyme/bilirubin elevations, and injection site reactions. The side effects most commonly reported with the oral formulations have included Candida overgrowth, eosinophilia, headache, dizziness, gastrointestinal disturbances, and transient liver enzyme elevations.^[Ref]

Gastrointestinal

• Common (1% to 10%): Diarrhea/loose stools, nausea/vomiting, abdominal pain, nausea
• Uncommon (0.1% to 1%): Abdominal cramps, flatulence, indigestion, mouth ulcers, swollen tongue, dyspepsia, gastrointestinal (GI) infection, ptyalism/excess salivation, GI disturbance, vomiting
• Frequency not reported: Abdominal discomfort, dry mouth, Clostridioides difficile-associated diarrhea
• Postmarketing reports: GI disturbances (including diarrhea, nausea, vomiting, abdominal pain), pseudomembranous colitis

Cephalosporin-class:

• Frequency not reported: Vomiting, abdominal pain, colitis^[Ref]

The onset of pseudomembranous colitis symptoms has been reported during or after antibacterial therapy.^[Ref]

Hepatic

• Common (1% to 10%): Transient increase in AST, transient increase in ALT, transient increase in liver enzyme levels
• Uncommon (0.1% to 1%): Transient increase in bilirubin
• Postmarketing reports: Hepatic dysfunction, hepatitis, cholestasis, jaundice (mainly cholestatic)

Cephalosporin-class:

• Frequency not reported: Hepatic dysfunction (including cholestasis)^[Ref]

Nervous system

• Common (1% to 10%): Headache, dizziness
• Uncommon (0.1% to 1%): Sleepiness, somnolence, hyperactivity
• Postmarketing reports: Seizures, encephalopathy^[Ref]

Cephalosporin-class antibiotics (including this drug) have been associated with seizures, especially in patients with renal dysfunction when the dose was not reduced.^[Ref]

Hypersensitivity

• Common (1% to 10%): Delayed hypersensitivity reaction
• Uncommon (0.1% to 1%): Hypersensitivity reactions (including rash, pruritus, urticaria)
• Rare (0.01% to 0.1%): Severe hypersensitivity reactions
• Frequency not reported: Serum sickness
• Postmarketing reports: Anaphylaxis, serum sickness-like reaction^[Ref]

Delayed hypersensitivity reaction to this drug has been reported in 2.9% of patients with history of delayed hypersensitivity to penicillin (but not a cephalosporin).

Rare cases of severe hypersensitivity reactions (including erythema multiforme, toxic epidermal necrolysis [exanthematic necrolysis], drug fever, serum sickness-like reaction, anaphylaxis, Stevens-Johnson syndrome) have been reported.^[Ref]

Hematologic

• Common (1% to 10%): Eosinophilia, decreased hemoglobin and hematocrit, neutropenia, decreased hemoglobin concentration
• Uncommon (0.1% to 1%): Positive Coombs test, leukopenia, thrombocytopenia
• Frequency not reported: Autoimmune granulocytopenia, increased coagulation time
• Postmarketing reports: Hemolytic anemia, pancytopenia, increased prothrombin time

Cephalosporin-class:

• Frequency not reported: Aplastic anemia, hemolytic anemia, hemorrhage, prolonged prothrombin time, pancytopenia, agranulocytosis, positive Coombs test^[Ref]

Profound leukopenia has sometimes been profound with oral therapy.^[Ref]

Renal

• Frequency not reported: Increased BUN, increased creatinine, decreased CrCl, acute renal failure
• Postmarketing reports: Renal dysfunction, interstitial nephritis (including reversible fever, azotemia, pyuria, eosinophilia)

Cephalosporin-class:

• Frequency not reported: Toxic nephropathy^[Ref]

Acute renal failure has been reported. Renal function improved after this drug was stopped, and deteriorated upon rechallenge.^[Ref]

Genitourinary

• Common (1% to 10%): Vaginitis
• Uncommon (0.1% to 1%): Vulvar itch, dysuria, vaginal candidiasis, vaginal discharge, vaginal itch, urethral pain/bleeding, kidney pain, urinary tract infection, vaginal irritation

Cephalosporin-class:

• Frequency not reported: Vaginitis (including vaginal candidiasis)^[Ref]

Dermatologic

• Common (1% to 10%): Diaper/nappy rash
• Uncommon (0.1% to 1%): Rash, urticaria/hives, pruritus, erythema
• Rare (0.01% to 0.1%): Erythema multiforme, toxic epidermal necrolysis (exanthematic necrolysis), Stevens-Johnson syndrome
• Frequency not reported: Acute generalized exanthematous pustulosis
• Postmarketing reports: Angioedema/angioneurotic edema, urticaria, toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme, cutaneous vasculitis

Beta-lactam antibiotics:

• Frequency not reported: Severe cutaneous adverse reactions (including Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms [DRESS], acute generalized exanthematous pustulosis)^[Ref]

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]

Metabolic

• Uncommon (0.1% to 1%): Anorexia

Cephalosporin-class:

• Frequency not reported: Urine glucose false positive^[Ref]

Other

• Common (1% to 10%): Transient increase in LDH, transient increase in alkaline phosphatase, Candida overgrowth, dislike of taste
• Uncommon (0.1% to 1%): Chest pain/tightness, chills, thirst, viral illness, candidiasis, fever
• Rare (0.01% to 0.1%): Drug fever
• Frequency not reported: C difficile overgrowth, disulfiram reaction^[Ref]

Respiratory

• Uncommon (0.1% to 1%): Shortness of breath, sinusitis, cough, upper respiratory infection^[Ref]

Musculoskeletal

• Uncommon (0.1% to 1%): Muscle cramps, muscle stiffness, muscle spasm of the neck, lockjaw-type reaction, joint swelling, arthralgia^[Ref]

Cardiovascular

• Uncommon (0.1% to 1%): Tachycardia
• Frequency not reported: Kounis syndrome type I variant
• Postmarketing reports: Acute myocardial ischemia (with or without myocardial infarction)^[Ref]

A 90-year-old man, with no history of coronary artery disease, diabetes mellitus, hypertension, or hyperlipidemia, was administered 750 mg cefuroxime axetil IM for urinary tract infection. About 10 minutes after the injection, the patient developed chest pain and pruritic skin rashes. Kounis syndrome type I variant was diagnosed secondary to the drug. Five days after stopping the drug, the patient's symptoms had resolved.

Acute myocardial ischemia (with or without myocardial infarction) has occurred as part of an allergic reaction.^[Ref]

Local

• Common (1% to 10%): Injection site reactions (including pain, thrombophlebitis), thrombophlebitis with IV administration, phlebitis, transient pain at injection site
• Frequency not reported: Pain at IM injection site^[Ref]

Immunologic

• Common (1% to 10%): Jarisch-Herxheimer reaction^[Ref]

Psychiatric

• Uncommon (0.1% to 1%): Irritable behavior

Further information

Zinacef side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer