Cefuroxime 750mg Inj, 1 Vial
It is used to treat or prevent bacterial infections.
Drug Class
Antibiotic
Pharmacologic Class
Second-generation Cephalosporin
Pregnancy Category
Category B
FDA Approved
Jan 1978
DEA Schedule
Not Controlled
Overview
What is this medicine?
Cefuroxime is an antibiotic medication given by injection (into a vein or muscle) to treat various bacterial infections. It works by killing the bacteria that cause the infection.
How to Use This Medicine
Taking Your Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided to you. It is essential to follow the instructions carefully. This medication can be administered in two ways: as an injection into a muscle or as an infusion into a vein over a period of time. In some cases, it may also be given as an injection into a vein.
Storing and Disposing of Your Medication
If you need to store this medication at home, consult with your doctor, nurse, or pharmacist to determine the best way to store it.
Missing a Dose
If you miss a dose, contact your doctor to find out what steps to take next.
To use this medication correctly, follow your doctor's instructions and read all the information provided to you. It is essential to follow the instructions carefully. This medication can be administered in two ways: as an injection into a muscle or as an infusion into a vein over a period of time. In some cases, it may also be given as an injection into a vein.
Storing and Disposing of Your Medication
If you need to store this medication at home, consult with your doctor, nurse, or pharmacist to determine the best way to store it.
Missing a Dose
If you miss a dose, contact your doctor to find out what steps to take next.
Lifestyle & Tips
- Complete the full course of treatment as prescribed, even if you start feeling better. Stopping early can lead to the infection returning and bacteria becoming resistant to the antibiotic.
- Report any signs of allergic reaction (rash, itching, swelling, difficulty breathing) immediately.
- Report severe or watery diarrhea, especially if it persists, as it could be a sign of a more serious infection (Clostridioides difficile-associated diarrhea).
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
750 mg to 1.5 g IV/IM every 8 hours
Dose Range:
750 - 1500 mg
Condition-Specific Dosing:
Uncomplicated UTI:
750 mg IV/IM every 8 hours
Severe or complicated infections:
1.5 g IV/IM every 8 hours
Surgical prophylaxis:
1.5 g IV 30-60 minutes prior to incision, then 750 mg IV/IM every 8 hours for 24 hours
Pediatric Dosing
Neonatal:
Not established for neonates <3 months. For 3 months and older: 50-100 mg/kg/day divided every 8 hours (max 6 g/day)
Infant:
50-100 mg/kg/day divided every 8 hours (max 6 g/day)
Child:
50-100 mg/kg/day divided every 8 hours (max 6 g/day)
Adolescent:
Adult dosing (750 mg to 1.5 g IV/IM every 8 hours)
Dose Adjustments
Renal Impairment:
Mild:
No adjustment needed (CrCl >30 mL/min)
Moderate:
750 mg IV/IM every 12 hours (CrCl 10-29 mL/min)
Severe:
750 mg IV/IM every 24 hours (CrCl <10 mL/min)
Dialysis:
Administer 750 mg IV/IM at the end of each dialysis session. For continuous ambulatory peritoneal dialysis (CAPD), 750 mg IV/IM every 24 hours.
Hepatic Impairment:
Mild:
No adjustment
Moderate:
No adjustment
Severe:
No adjustment
Pharmacology
Mechanism of Action
Cefuroxime is a bactericidal antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs) located inside the bacterial cell wall. This binding prevents the cross-linking of peptidoglycan chains, leading to the disruption of cell wall integrity and ultimately bacterial cell lysis and death.
Pharmacokinetics
Absorption:
Bioavailability:
100% (for IV/IM administration)
Tmax:
0.5-1 hour (IM)
FoodEffect:
Not applicable for injectable form
Distribution:
Vd:
0.15-0.2 L/kg
ProteinBinding:
33-50%
CnssPenetration:
Yes (especially with inflamed meninges)
Elimination:
HalfLife:
1-1.5 hours
Clearance:
Not available (primarily renal clearance)
ExcretionRoute:
Renal (glomerular filtration and tubular secretion)
Unchanged:
Approximately 89% within 24 hours
Pharmacodynamics
OnsetOfAction:
Rapid (within minutes of IV administration)
PeakEffect:
Within 1 hour
DurationOfAction:
Approximately 8 hours (based on dosing interval)
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 (this could be a sign of a rare but potentially life-threatening condition called C. diff-associated diarrhea, or CDAD)
Common Side Effects
Most people experience few or no side effects when taking this medication. However, some common side effects may occur, including:
Diarrhea
Upset stomach
Nausea or vomiting
Irritation at the injection site
If any of these side effects or any other symptoms bother you or do not go away, contact your doctor for advice.
Reporting Side Effects
If you have questions or concerns about side effects, you can:
Contact your doctor for medical advice
Report side effects to the FDA at 1-800-332-1088
* Submit a report online at https://www.fda.gov/medwatch
Remember, this is not a comprehensive list of all possible side effects. If you experience any unusual symptoms, contact your doctor for guidance.
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 (this could be a sign of a rare but potentially life-threatening condition called C. diff-associated diarrhea, or CDAD)
Common Side Effects
Most people experience few or no side effects when taking this medication. However, some common side effects may occur, including:
Diarrhea
Upset stomach
Nausea or vomiting
Irritation at the injection site
If any of these side effects or any other symptoms bother you or do not go away, contact your doctor for advice.
Reporting Side Effects
If you have questions or concerns about side effects, you can:
Contact your doctor for medical advice
Report side effects to the FDA at 1-800-332-1088
* Submit a report online at https://www.fda.gov/medwatch
Remember, this is not a comprehensive list of all possible side effects. If you experience any unusual symptoms, contact your doctor for guidance.
Seek Immediate Medical Attention If You Experience:
- Severe allergic reaction (anaphylaxis): difficulty breathing, swelling of face/throat, severe rash, dizziness.
- Severe, watery, or bloody diarrhea.
- New signs of infection (e.g., fever, chills, sore throat, unusual bruising or bleeding).
- Signs of kidney problems (e.g., changes in urination, swelling in ankles/feet).
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 allergic reaction you experienced, including any symptoms that occurred.
If you are currently taking probenecid, as this may interact with the medication.
Additionally, to ensure safe treatment, it is crucial to provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter (OTC) medications you are taking
Any natural products or vitamins you are using
* Your existing health problems
This information will help your doctor determine whether it is safe for you to take this medication in conjunction with your other medications and health conditions. Never start, stop, or adjust the dosage of any medication without first consulting your doctor to confirm that it is safe to do so.
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 allergic reaction you experienced, including any symptoms that occurred.
If you are currently taking probenecid, as this may interact with the medication.
Additionally, to ensure safe treatment, it is crucial to provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter (OTC) medications you are taking
Any natural products or vitamins you are using
* Your existing health problems
This information will help your doctor determine whether it is safe for you to take this medication in conjunction with your other medications and health conditions. Never start, stop, or adjust the dosage of any medication without first consulting your doctor to confirm that it is safe to do so.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
Rarely, drugs like this one can cause severe and potentially life-threatening allergic reactions.
If you are taking this medication for an extended period, your doctor may recommend regular blood tests to monitor your condition. Be sure to discuss this with your doctor.
This medication may interfere with certain laboratory tests. Therefore, it is crucial to inform all your healthcare providers and laboratory personnel that you are taking this drug. If you have diabetes and test your urine for glucose, 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.
When taking this medication, birth control pills and other hormone-based contraceptives may be less effective in preventing pregnancy. To minimize the risk of unplanned 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, planning to become pregnant, or breastfeeding, inform your doctor. You and your doctor will need to discuss the potential benefits and risks of this medication to both you and your baby.
Rarely, drugs like this one can cause severe and potentially life-threatening allergic reactions.
If you are taking this medication for an extended period, your doctor may recommend regular blood tests to monitor your condition. Be sure to discuss this with your doctor.
This medication may interfere with certain laboratory tests. Therefore, it is crucial to inform all your healthcare providers and laboratory personnel that you are taking this drug. If you have diabetes and test your urine for glucose, 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.
When taking this medication, birth control pills and other hormone-based contraceptives may be less effective in preventing pregnancy. To minimize the risk of unplanned 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, planning to become pregnant, or breastfeeding, inform your doctor. You and your doctor will need to discuss the potential benefits and risks of this medication to both you and your baby.
Overdose Information
Overdose Symptoms:
- Encephalopathy (impaired consciousness, seizures, myoclonus, asterixis)
- Renal tubular necrosis (rare)
- Nausea, vomiting, diarrhea
What to Do:
Call 1-800-222-1222 (Poison Control). Treatment is primarily supportive. Hemodialysis may be useful in removing cefuroxime from the body, especially in patients with impaired renal function.
Drug Interactions
Major Interactions
- Aminoglycosides (e.g., gentamicin, tobramycin): Increased risk of nephrotoxicity.
- Loop diuretics (e.g., furosemide): Increased risk of nephrotoxicity.
Moderate Interactions
- Probenecid: Decreases renal tubular secretion of cefuroxime, leading to increased and prolonged serum concentrations of cefuroxime.
- Oral anticoagulants (e.g., warfarin): May enhance anticoagulant effect (rare, but monitor INR).
Minor Interactions
- Oral contraceptives: Theoretical reduction in efficacy (not well-established for cephalosporins, but advise backup method if concerned).
Monitoring
Baseline Monitoring
Renal function (BUN, serum creatinine)
Rationale: Cefuroxime is primarily renally eliminated; baseline assessment helps guide dosing, especially in patients with pre-existing renal impairment.
Timing: Prior to initiation of therapy
Allergy history (especially to penicillins or other cephalosporins)
Rationale: To identify potential hypersensitivity reactions.
Timing: Prior to initiation of therapy
Routine Monitoring
Renal function (BUN, serum creatinine)
Frequency: Periodically, especially in patients with renal impairment or on prolonged therapy
Target: Within normal limits or stable for patient's baseline
Action Threshold: Significant increase in BUN/creatinine; consider dose adjustment or alternative therapy
Signs and symptoms of superinfection (e.g., oral thrush, vaginal yeast infection, severe diarrhea)
Frequency: Daily during therapy
Target: Absence of new infections
Action Threshold: Development of new infections; consider antifungal/antibiotic therapy or discontinuation of cefuroxime
Complete Blood Count (CBC) with differential
Frequency: Periodically, especially with prolonged therapy
Target: Within normal limits
Action Threshold: Significant changes (e.g., leukopenia, thrombocytopenia, eosinophilia); consider discontinuation
Symptom Monitoring
- Signs of allergic reaction (rash, itching, hives, swelling of face/lips/tongue, difficulty breathing)
- Severe or persistent diarrhea (may indicate Clostridioides difficile-associated diarrhea)
- Nausea, vomiting, abdominal pain
- Injection site reactions (pain, swelling, redness)
- Signs of superinfection (e.g., white patches in mouth, vaginal itching/discharge)
Special Patient Groups
Pregnancy
Cefuroxime is generally considered safe for use during pregnancy (Pregnancy Category B). Studies in animals have not shown harm to the fetus, and there are no adequate and well-controlled studies in pregnant women, but clinical experience suggests low risk.
Trimester-Specific Risks:
First Trimester:
Low risk, generally considered safe if indicated.
Second Trimester:
Low risk, generally considered safe if indicated.
Third Trimester:
Low risk, generally considered safe if indicated.
Lactation
Cefuroxime is excreted in breast milk in small amounts. It is generally considered compatible with breastfeeding (Lactation Risk L2). Monitor breastfed infant for potential adverse effects such as diarrhea, candidiasis (thrush, diaper rash), or allergic reactions.
Infant Risk:
Low risk. Potential for alteration of bowel flora, candidiasis, or allergic sensitization in the infant.
Pediatric Use
Dosing must be carefully calculated based on age, weight, and severity of infection. Not recommended for neonates younger than 3 months due to limited data. Close monitoring for adverse effects is crucial.
Geriatric Use
No specific dose adjustment is needed based on age alone, but dose adjustments are necessary for age-related decline in renal function. Elderly patients may be more susceptible to adverse effects, particularly gastrointestinal disturbances and C. difficile-associated diarrhea.
Clinical Information
Clinical Pearls
- Cefuroxime is a second-generation cephalosporin with good activity against a wide range of Gram-positive and Gram-negative bacteria, including many beta-lactamase producing strains.
- It is often used for respiratory tract infections, skin and soft tissue infections, urinary tract infections, and surgical prophylaxis.
- Good CSF penetration when meninges are inflamed, making it useful for bacterial meningitis.
- Can be administered intravenously (IV) or intramuscularly (IM). IM injections should be given deep into a large muscle mass.
- Always check for penicillin allergy history due to potential cross-reactivity, though it is generally low for second-generation cephalosporins.
Alternative Therapies
- Other cephalosporins (e.g., Ceftriaxone, Cefazolin, Cefoxitin)
- Penicillins (e.g., Amoxicillin/clavulanate, Ampicillin/sulbactam)
- Carbapenems (e.g., Meropenem, Imipenem/cilastatin) for broader spectrum or resistant infections
- Fluoroquinolones (e.g., Levofloxacin, Ciprofloxacin) for specific indications
- Macrolides (e.g., Azithromycin) for atypical pathogens or specific respiratory infections
Cost & Coverage
Average Cost:
Varies widely, typically low per vial
Generic Available:
Yes
Insurance Coverage:
Tier 1 or 2 (Generic)
General Drug Facts
If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. To ensure safe and effective treatment, 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 your 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 emergency medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.