Ceftin 250mg Tablets
It is used to treat or prevent bacterial infections.
Drug Class
Antibiotic
Pharmacologic Class
Second-generation cephalosporin
Pregnancy Category
Category B
FDA Approved
Dec 1987
DEA Schedule
Not Controlled
Overview
What is this medicine?
Cefuroxime is an antibiotic used to treat various bacterial infections, such as bronchitis, sinusitis, ear infections, skin infections, and urinary tract infections. It works by stopping the growth of bacteria. It is important to take this medication exactly as prescribed and to finish the entire course, even if you start feeling better, to prevent the infection from returning.
How to Use This Medicine
Taking Your Medication Correctly
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions closely. You can take this medication with or without food, but if it causes stomach upset, take it with food to help minimize discomfort. Swallow the tablet whole - do not chew, break, or crush it. If you have difficulty swallowing, consult your doctor for guidance.
It's essential to continue taking your medication as directed, even if your symptoms improve. Do not take antacids at the same time as this medication. If you have questions about taking antacids with this medication, ask your doctor for advice.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry place, away from the bathroom. Keep all medications in a safe location, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so. If you're unsure about the best way to dispose of your medication, consult your pharmacist. You may also want to check if there are drug take-back programs in your area.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next dose, skip the missed dose and return to your regular schedule. Do not take two doses at the same time or take extra doses to make up for the missed one.
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions closely. You can take this medication with or without food, but if it causes stomach upset, take it with food to help minimize discomfort. Swallow the tablet whole - do not chew, break, or crush it. If you have difficulty swallowing, consult your doctor for guidance.
It's essential to continue taking your medication as directed, even if your symptoms improve. Do not take antacids at the same time as this medication. If you have questions about taking antacids with this medication, ask your doctor for advice.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry place, away from the bathroom. Keep all medications in a safe location, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so. If you're unsure about the best way to dispose of your medication, consult your pharmacist. You may also want to check if there are drug take-back programs in your area.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next dose, skip the missed dose and return to your regular schedule. Do not take two doses at the same time or take extra doses to make up for the missed one.
Lifestyle & Tips
- Take with food: Cefuroxime axetil tablets should be taken with food to enhance absorption and reduce stomach upset.
- Complete the full course: Do not stop taking the medication early, even if symptoms improve, to prevent antibiotic resistance and recurrence of infection.
- Stay hydrated: Drink plenty of fluids to help prevent dehydration, especially if experiencing diarrhea.
- Avoid antacids/PPIs: If possible, avoid taking antacids, H2-blockers, or proton pump inhibitors around the same time as cefuroxime, as they can reduce its absorption. Consult your doctor or pharmacist for timing advice.
- Store properly: Store at room temperature away from moisture and heat.
Available Forms & Alternatives
Available Strengths:
Generic Alternatives:
Dosing & Administration
Adult Dosing
Standard Dose:
250 mg to 500 mg orally twice daily
Dose Range:
250 - 500 mg
Condition-Specific Dosing:
Pharyngitis/Tonsillitis:
250 mg orally twice daily for 10 days
Acute Bacterial Maxillary Sinusitis:
250 mg orally twice daily for 10 days
Acute Bacterial Exacerbations of Chronic Bronchitis:
250 mg or 500 mg orally twice daily for 10 days
Secondary Bacterial Infections of Acute Bronchitis:
250 mg orally twice daily for 5-10 days
Uncomplicated Skin and Skin Structure Infections:
250 mg orally twice daily for 10 days
Uncomplicated Urinary Tract Infections:
250 mg orally twice daily for 7-10 days
Uncomplicated Gonorrhea:
1000 mg orally as a single dose
Early Lyme Disease:
500 mg orally twice daily for 20 days
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established for oral tablets under 3 months of age.
Child:
Pharyngitis/Tonsillitis: 20 mg/kg/day divided twice daily (max 500 mg/day) for 10 days. Acute Otitis Media/Acute Bacterial Maxillary Sinusitis: 30 mg/kg/day divided twice daily (max 1000 mg/day) for 10 days. Impetigo: 30 mg/kg/day divided twice daily (max 1000 mg/day) for 10 days.
Adolescent:
Same as adult dosing for specific indications.
Dose Adjustments
Renal Impairment:
Mild:
No adjustment needed (CrCl > 30 mL/min)
Moderate:
250-500 mg every 24 hours (CrCl 10-29 mL/min)
Severe:
250-500 mg every 48 hours (CrCl < 10 mL/min)
Dialysis:
Administer a single dose after each dialysis session. Cefuroxime is significantly removed by hemodialysis.
Hepatic Impairment:
Mild:
No adjustment needed
Moderate:
No adjustment needed
Severe:
No adjustment needed
Pharmacology
Mechanism of Action
Cefuroxime is a bactericidal antibiotic that acts by inhibiting bacterial cell wall synthesis. It binds to penicillin-binding proteins (PBPs) located inside the bacterial cell wall, thereby inhibiting the transpeptidation step of peptidoglycan synthesis. This leads to the disruption of the cell wall, causing cell lysis and death.
Pharmacokinetics
Absorption:
Bioavailability:
37% (fasted) to 52% (with food) for tablets
Tmax:
2-3 hours
FoodEffect:
Enhanced absorption when taken with food, leading to higher and more prolonged serum concentrations.
Distribution:
Vd:
0.16-0.23 L/kg
ProteinBinding:
33-50%
CnssPenetration:
Limited (achieves therapeutic concentrations in CSF only when meninges are inflamed)
Elimination:
HalfLife:
1.2-1.5 hours
Clearance:
Not available (primarily renal excretion)
ExcretionRoute:
Renal (glomerular filtration and tubular secretion)
Unchanged:
Approximately 50% to 100% of the dose is excreted unchanged in urine within 24 hours.
Pharmacodynamics
OnsetOfAction:
Rapid (within hours of first dose)
PeakEffect:
Within 2-3 hours (Tmax)
DurationOfAction:
Dependent on dosing frequency (typically 12 hours for BID dosing)
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Urination problems, such as:
+ Inability to pass urine
+ Changes in urine output
Dark urine or yellowing of the skin or eyes
Fever, chills, or sore throat
Unexplained bruising or bleeding
Feeling extremely tired or weak
Seizures
Vaginal itching or discharge
Hearing loss
Diarrhea, especially if it is severe, bloody, or accompanied by stomach pain or cramps (see below for more information on diarrhea)
Important Information About Diarrhea
Diarrhea is a common side effect of antibiotics. However, in rare cases, a severe form of diarrhea called C. diff-associated diarrhea (CDAD) may occur. CDAD can happen during or several months after taking antibiotics and may lead to a life-threatening bowel problem. If you experience stomach pain, cramps, or very loose, watery, or bloody stools, contact your doctor immediately. Before treating diarrhea, consult with your doctor.
Other Possible Side Effects
Like all medications, this drug may cause side effects. Many people experience no side effects or only mild ones. If you notice any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
Diarrhea
Upset stomach
Vomiting
Bad taste in your mouth
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Urination problems, such as:
+ Inability to pass urine
+ Changes in urine output
Dark urine or yellowing of the skin or eyes
Fever, chills, or sore throat
Unexplained bruising or bleeding
Feeling extremely tired or weak
Seizures
Vaginal itching or discharge
Hearing loss
Diarrhea, especially if it is severe, bloody, or accompanied by stomach pain or cramps (see below for more information on diarrhea)
Important Information About Diarrhea
Diarrhea is a common side effect of antibiotics. However, in rare cases, a severe form of diarrhea called C. diff-associated diarrhea (CDAD) may occur. CDAD can happen during or several months after taking antibiotics and may lead to a life-threatening bowel problem. If you experience stomach pain, cramps, or very loose, watery, or bloody stools, contact your doctor immediately. Before treating diarrhea, consult with your doctor.
Other Possible Side Effects
Like all medications, this drug may cause side effects. Many people experience no side effects or only mild ones. If you notice any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
Diarrhea
Upset stomach
Vomiting
Bad taste in your mouth
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Signs of a severe allergic reaction (hives, difficulty breathing, swelling of face/lips/tongue/throat)
- Severe or watery diarrhea, especially if persistent or bloody (may be a sign of C. difficile infection)
- New signs of infection (e.g., fever, sore throat, rash) that may indicate a superinfection
- Unusual bruising or bleeding
- Yellowing of the skin or eyes (jaundice)
- Dark urine or pale stools
- Persistent nausea or vomiting
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced.
If you are currently taking probenecid.
* If you are taking any of the following medications: cimetidine, dexlansoprazole, esomeprazole, famotidine, lansoprazole, nizatidine, omeprazole, pantoprazole, rabeprazole, or ranitidine.
Please note that this is not an exhaustive list of all potential interactions with this medication. To ensure your safety, it is crucial to discuss all of your medications (including prescription and over-the-counter drugs, natural products, and vitamins) and health conditions with your doctor and pharmacist. Before starting, stopping, or changing the dose of any medication, consult with your doctor to confirm that it is safe to do so in conjunction with this medication.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced.
If you are currently taking probenecid.
* If you are taking any of the following medications: cimetidine, dexlansoprazole, esomeprazole, famotidine, lansoprazole, nizatidine, omeprazole, pantoprazole, rabeprazole, or ranitidine.
Please note that this is not an exhaustive list of all potential interactions with this medication. To ensure your safety, it is crucial to discuss all of your medications (including prescription and over-the-counter drugs, natural products, and vitamins) and health conditions with your doctor and pharmacist. Before starting, stopping, or changing the dose of any medication, consult with your doctor to confirm that it is safe to do so in conjunction with this medication.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
This drug can cause severe and potentially life-threatening allergic reactions, although this is rare. If you are taking this medication long-term, your doctor may recommend regular blood tests to monitor your condition.
Additionally, this medication may interfere with certain laboratory tests. Be sure to notify all your healthcare providers and laboratory personnel that you are taking this drug. If you have diabetes and test your urine glucose levels, consult with your doctor to determine the most suitable testing method.
Do not take this medication for longer than prescribed, as this may increase the risk of a secondary infection.
If you have phenylketonuria (PKU), discuss this with your doctor, as some formulations of this medication may contain phenylalanine.
Women taking birth control pills or other hormone-based contraceptives should be aware that this medication may reduce their effectiveness. To prevent pregnancy, use an additional form of birth control, such as a condom, while taking this drug.
If you are 65 years or older, use this medication with caution, as you may be more susceptible to side effects.
If you are pregnant, plan to become pregnant, or are breastfeeding, consult with your doctor to discuss the potential benefits and risks of this medication to both you and your baby.
This drug can cause severe and potentially life-threatening allergic reactions, although this is rare. If you are taking this medication long-term, your doctor may recommend regular blood tests to monitor your condition.
Additionally, this medication may interfere with certain laboratory tests. Be sure to notify all your healthcare providers and laboratory personnel that you are taking this drug. If you have diabetes and test your urine glucose levels, consult with your doctor to determine the most suitable testing method.
Do not take this medication for longer than prescribed, as this may increase the risk of a secondary infection.
If you have phenylketonuria (PKU), discuss this with your doctor, as some formulations of this medication may contain phenylalanine.
Women taking birth control pills or other hormone-based contraceptives should be aware that this medication may reduce their effectiveness. To prevent pregnancy, use an additional form of birth control, such as a condom, while taking this drug.
If you are 65 years or older, use this medication with caution, as you may be more susceptible to side effects.
If you are pregnant, plan to become pregnant, or are breastfeeding, consult with your doctor to discuss the potential benefits and risks of this medication to both you and your baby.
Overdose Information
Overdose Symptoms:
- Cerebral irritation leading to convulsions (seizures)
- Encephalopathy
- Asterixis
- Neuromuscular excitability
What to Do:
In case of overdose, seek immediate medical attention or call a poison control center (1-800-222-1222). Hemodialysis can effectively remove cefuroxime from the body.
Drug Interactions
Major Interactions
- Oral Contraceptives (potential for reduced efficacy, though clinical significance debated)
- Typhoid Vaccine (live, oral) (may inactivate the vaccine)
Moderate Interactions
- Antacids/H2-receptor antagonists/Proton Pump Inhibitors (PPIs) (decrease bioavailability of cefuroxime axetil by raising gastric pH)
- Probenecid (increases cefuroxime plasma concentrations and prolongs half-life by decreasing renal tubular secretion)
- Warfarin (potential for increased INR/bleeding risk, monitor)
Monitoring
Baseline Monitoring
Renal function (BUN, serum creatinine, CrCl)
Rationale: Cefuroxime is primarily renally eliminated; baseline assessment is crucial for dose adjustment in patients with impaired renal function.
Timing: Prior to initiation of therapy, especially in elderly or renally impaired patients.
Routine Monitoring
Clinical response to therapy
Frequency: Daily
Target: Resolution of signs and symptoms of infection
Action Threshold: Lack of improvement or worsening symptoms may indicate treatment failure, resistance, or incorrect diagnosis.
Signs and symptoms of superinfection (e.g., oral thrush, vaginal candidiasis, severe diarrhea)
Frequency: Daily throughout therapy and for several weeks post-treatment
Target: Absence of new infections
Action Threshold: Development of new or worsening symptoms, especially severe or persistent diarrhea (Clostridioides difficile-associated diarrhea).
Renal function (BUN, serum creatinine)
Frequency: Periodically, especially during prolonged therapy or in patients with pre-existing renal impairment or concurrent nephrotoxic drugs.
Target: Within patient's baseline range
Action Threshold: Significant increase in BUN or creatinine may necessitate dose adjustment or discontinuation.
Symptom Monitoring
- Allergic reactions (rash, itching, hives, swelling of face/lips/tongue, difficulty breathing)
- Gastrointestinal disturbances (nausea, vomiting, diarrhea, abdominal pain)
- Headache
- Dizziness
- Signs of C. difficile-associated diarrhea (severe, watery, or bloody diarrhea, fever, abdominal cramps)
- Signs of liver dysfunction (yellowing of skin/eyes, dark urine, persistent nausea/vomiting)
Special Patient Groups
Pregnancy
Cefuroxime is classified as Pregnancy Category B. Animal reproduction studies have not demonstrated a risk to the fetus, but there are no adequate and well-controlled studies in pregnant women. It is generally considered safe for use during pregnancy when clearly needed.
Trimester-Specific Risks:
First Trimester:
No increased risk of congenital malformations observed in human studies.
Second Trimester:
Generally considered safe.
Third Trimester:
Generally considered safe.
Lactation
Cefuroxime is excreted in human milk in small quantities. It is generally considered compatible with breastfeeding (Lactation Risk L1). Monitor breastfed infants for potential alterations in bowel flora (e.g., diarrhea, candidiasis) or allergic reactions.
Infant Risk:
Low risk; potential for mild gastrointestinal upset or sensitization in the infant.
Pediatric Use
Oral cefuroxime axetil tablets are not recommended for children younger than 3 months of age. Dosing adjustments are based on weight and specific infection. Close monitoring for adverse effects is important.
Geriatric Use
No overall differences in safety or effectiveness have been observed between elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. Dosage adjustment is necessary in elderly patients with impaired renal function.
Clinical Information
Clinical Pearls
- Always advise patients to take cefuroxime axetil tablets with food to optimize absorption and minimize GI upset.
- Emphasize the importance of completing the full course of therapy, even if symptoms improve, to prevent resistance and relapse.
- Be aware of potential drug interactions with gastric acid suppressants (antacids, H2-blockers, PPIs) which can significantly reduce cefuroxime absorption. Advise patients to separate administration times or consider alternative antibiotics if concurrent use is unavoidable.
- Cefuroxime is a good option for community-acquired respiratory tract infections and skin/soft tissue infections, particularly when a second-generation cephalosporin is indicated.
- Monitor for C. difficile-associated diarrhea, which can occur during or even several weeks after antibiotic therapy.
Alternative Therapies
- Other second-generation cephalosporins (e.g., cefaclor, cefprozil)
- Macrolides (e.g., azithromycin, clarithromycin) for respiratory tract infections, especially in penicillin-allergic patients
- Penicillins (e.g., amoxicillin, amoxicillin/clavulanate) for susceptible infections
- Fluoroquinolones (e.g., levofloxacin, moxifloxacin) for certain respiratory or urinary tract infections (consider resistance patterns and side effects)
- Tetracyclines (e.g., doxycycline) for certain respiratory or skin infections
Cost & Coverage
Average Cost:
$15 - $50 per 30 tablets (generic 250mg)
Generic Available:
Yes
Insurance Coverage:
Tier 1 (Preferred Generic) or Tier 2 (Non-Preferred Generic)
General Drug Facts
If your symptoms or health issues persist or worsen, it is essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist for more information. If you have any questions or concerns about this medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide details about the medication, including the amount taken and the time it happened, to help healthcare professionals provide the best possible care.