Cefuroxime

Cefuroxime is a prescription medication used to treat the symptoms of bacterial infections of the ear, nose, throat, lungs, skin, bones, joints, bladder, or kidneys as well as Gonorrhea, Meningitis, Sepsis, or early Lyme disease. 

• Cefuroxime is available under the following different brand names: Ceftin, Zinacef

Adult and pediatric dosage

Oral suspension (discontinued; anticipated final availability early 2018)

• 125mg/5mL
• 250mg/5mL

Powder for Injection

• 750mg
• 1.5g
• 7.5g
• 75g
• 225g

Tablet

• 250mg
• 500mg

Pharyngitis/Tonsillitis

• 250 mg orally every 12 hours for 10 days
• Safety and efficacy in children younger than 3 months of age has not been established
• Children 3 months-12 years: 20 mg/kg daily orally divided every 12 hours for 10 days; not to exceed 500 mg/day or 75-150 mg/kg day IV/IM divided every 8 hours, not to exceed 6 g/day; alternative 125-250 mg orally every 12 hours for 10 days. 
• Children 12 years or older: 250 mg orally every 12 hours for 10 days

Acute Bacterial Maxillary Sinusitis

• 250 mg orally every 12 hours for 10 days

Acute Bacterial Exacerbations of Chronic Bronchitis

• 250-500 mg orally every 12 hours for 10 days
• 500-750 mg IV every 8 hours, switch to oral therapy as soon as clinically possible

Secondary Bacterial Infections of Acute Bronchitis

• 250-500 mg orally every 12 hours for 5-10 days

Uncomplicated Pneumonia

• 750 mg IV or IM every 8 hours

Uncomplicated Skin/Skin Structure Infections

• 250-500 mg orally every 12 hours for 10 days
• 750 mg IV or IM every 8 hours, switch to oral therapy as soon as clinically possible

Uncomplicated Urinary Tract Infections

• 125-250 mg orally every 12 hours for 7-10 days
• 750 mg IV or IM every 8 hours, switch to oral therapy as soon as clinically possible

Gonorrhea

• Uncomplicated: 1g orally once or 1.5 g IM once at 2 different sites with 1 g probenecid orally
• Disseminated: 750 mg IV/IM every 8 hours

Early Lyme Disease

• 500 mg orally every 12 hours for 20 days

Severe or Complicated Infections

• 1.5g IV or IM every 8 hours; may be administered every 6 hours in life-threatening situations

Impetigo

• Safety and efficacy in children younger than 3 months of age has not been established
• Children 3 months-12 years: 30 mg/kg per day suspension orally divided every 12 hours for 10 days; not to exceed 1000 mg/day; alternative, 75-150 mg/kg IV/IM divided every 8 hours, not to exceed 6 g/day; Alternative: 125-250 mg orally every 12 hours for 10 days
• Children 12 years or older: 250-500 mg tablet orally every 12 hours for 10 days

Acute Otitis Media

• Safety and efficacy in children younger than 3 months of age has not been established
• Children 3 months-12 years: 30 mg/kg per day suspension orally divided every 12 hours for 10 days; not to exceed 1000 mg/day; alternative, 75-150 mg/kg IV/IM divided every 8 hours, not to exceed 6 g/day; Alternative: 125-250 mg orally every 12 hours for 10 days
• Children 12 years or older: 250-500 mg tablet orally every 12 hours for 10 days

Acute Bacterial Maxillary Sinusitis

• Safety and efficacy in children younger than 3 months of age has not been established
• Children 3 months-12 years: 30 mg/kg per day suspension orally divided every 12 hours for 10 days; not to exceed 1000 mg/day; alternative, 75-150 mg/kg IV/IM divided every 8 hours, not to exceed 6 g/day; Alternative: 125-250 mg orally every 12 hours for 10 days
• Children 12 years or older: 250-500 mg tablet orally every 12 hours for 10 days

Dosage Considerations – Should be Given as Follows: 

• See "Dosages."

• Common side effects of Cefuroxime include:
  • diarrhea, 
  • fever, 
  • body aches, 
  • nausea, 
  • vomiting, and
  • vaginal itching or discharge
• Serious side effects of Cefuroxime include:
  • hives, 
  • difficulty breathing, 
  • swelling in face or throat, 
  • fever, 
  • sore throat, 
  • burning in the eyes, 
  • skin pain, 
  • red or purple skin rash that spreads and causing blistering and peeling, 
  • severe stomach pain, 
  • diarrhea that is watery or bloody (even if it occurs months after your last dose), 
  • yellowing of the skin or eyes (jaundice), 
  • fever, 
  • chills, 
  • headache, 
  • muscle pain, 
  • lightheadedness, 
  • problems with hearing, 
  • seizure, 
  • little or no urination, 
  • painful or difficult urination, 
  • swelling in feet or ankles, 
  • tiredness, and 
  • shortness of breath
• Rare side effects of Cefuroxime include:
  • none 

This is not a complete list of side effects and other serious side effects or health problems may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them.  Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first

• Cefuroxime has no known severe interactions with other drugs.
• Cefuroxime has serious interactions with the following drugs:
  • argatroban
  • BCG vaccine live
  • bivalirudin
  • cholera vaccine
  • dalteparin
  • enoxaparin
  • fondaparinux
  • heparin
  • warfarin
• Cefuroxime has moderate interactions with at least 30 other drugs.
• Cefuroxime has minor interactions with the following drugs:
  • chloramphenicol
  • choline magnesium trisalicylate
  • furosemide
  • rose hips

This information does not contain all possible interactions or adverse effects.  Visit the RxList Drug Interaction Checker for any drugs interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use.  Keep a list of all your medications with you, and share this information with your doctor and pharmacist.  Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns.

Contraindications

• Hypersensitivity 

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Cefuroxime?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Cefuroxime?”

Cautions

• Do not crush tablet
• Prolonged INR in nutritionally deficient patients, prolonged treatment, and hepatic and renal disease reported
• Film-coated tablet and oral solution are not bioequivalent; tablets should not be crushed
• Use caution in patients with history of colitis, renal impairment, or with a history of seizure disorders
• Use with caution in patients with history of penicillin allergy
• Reduce dosage by 50% if creatinine clearance (CrCl) is 10-30 mL/min and by 75% if CrCl less than 10 mL/min (high doses may cause CNS toxicity)
• Some products may contain phenylalanine
• Bacterial or fungal overgrowth of nonsusceptible organisms may occur with prolonged or repeated therapy

Pregnancy and Lactation

• Available data from published epidemiologic studies, case series, and case reports over several decades in pregnant women have not established drug-associated risks of major birth defects, miscarriage, or adverse maternal or fetal outcomes
• Based on several published case reports describing multiple lactating women receiving therapy via intravenous, intramuscular, and oral routes, drug is present in human milk; the highest maternal milk concentration described occurred in lactating women 8 hours after an intramuscular administration of 750 mg; allowing for an infant milk consumption of 150 mL/kg/day, the estimated breastfed infant dose would be less than 1% of adult dose
• No data are available on effects of drug on breastfed infant or on milk production; developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for therapy and any potential adverse effects on breastfed infant from drug or from underlying maternal condition