Cefuroxime

Cefuroxime oral

CLINICAL USE

Antibacterial agent

DOSE IN NORMAL RENAL FUNCTION

125–500 mg every 12 hoursGonorrhoea: single dose of 1 g

PHARMACOKINETICS

Molecular weight :510.5 (as axetil)

%Protein binding :50

%Excreted unchanged in urine : 85–90

Volume of distribution (L/kg) :0.13–1.8

half-life – normal/ESRD (hrs) :1.2/17

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Dialysed. Dose as in normal renal function

HD :Dialysed. Dose as in normal renal function

HDF/high flux :Dialysed. Dose as in normal renal function

CAV/VVHD :Dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAnticoagulants: effects of coumarins may be enhanced

ADMINISTRATION

Reconstition

Route

Oral

Rate of Administration

–

Comments

Take with or after food .134 CEFUroXiME (PArEnTErAL)

CLINICAL USE

Antibacterial agent

DOSE IN NORMAL RENAL FUNCTION

750 mg – 1.5 g every 6–8 hoursMeningitis: 3 g every 8 hours

PHARMACOKINETICS

Molecular weight :446.4 (as sodium salt)

%Protein binding :50

%Excreted unchanged in urine : 85–90

Volume of distribution (L/kg) :0.13–1.8

half-life – normal/ESRD (hrs) :1.2/17

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : 750 mg – 1.5 g every 8 hours

10 to 20 : 750 mg – 1.5 g every 8–12 hours

<10 : 750 mg – 1.5 g every 12–24 hours

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :dialysed. Dose as in GFR

<10 : mL/min

HD :Dialysed. Dose as in GFR

<10 : mL/min

HDF/high flux :Dialysed. Dose as in GFR

<10 : mL/min

CAV/VVHD :Dialysed. Dose as in GFR=10–20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAnticoagulants: effects of coumarins may be enhanced

ADMINISTRATION

Reconstition

IM: 1 mL of water for injection to each 250 mgIV bolus: 2 mL of water for injection to each 250 mg, but 15 mL of water for injection to 1.5 g

IV infusion

: 1.5 g in 50 mL of water for injection

Route

IM, IV

Rate of Administration

IV bolus: over 3–5 minutes

IV infusion

: over 30 minutes

Comments

Do not mix in syringe with aminoglycoside antibioticsInjection may also be reconstituted with: sodium chloride 0.9%, glucose 5%, glucose saline, Hartmann’s solutionCefuroxime and metronidazole can be mixed (see manufacturer’s guidelines)

OTHER INFORMATION

At high doses, take care in patients receiving concurrent treatment with potent diuretics such as furosemide, or aminoglycosides, as combination can adversely affect renal functionEach 750 mg vial ≡ 1.8 mmol sodiumCefuroxime (parenteral).

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