Dosing and uses of Ceclor, Raniclor (cefaclor)
Adult dosage forms and strengths
capsule
- 250mg
- 500mg
tablet, extended release
- 500mg
Infections
250-500 mg PO q8hr
Renal Impairment
CrCl: 10-50 mL/min: Half to full dose
CrCl: <10 mL/min: Half dose
Other Indications & Uses
E. coli, H. influenzae, Klebsiella spp., P. mirabilis, Staphylococci, group A beta-hemolytic streptococci
Pediatric dosage forms and strengths
capsule
- 250mg
- 500mg
tablet, extended release
- 500mg
Infections
<1 month old: Safety & efficacy not established
>1 month old: 20-40 mg/kg/day PO divided q8hr; not to exceed 1 g/day
Geriatric dosage forms and strengths
Infections
250-500 mg PO q8hr
Ceclor, Raniclor (cefaclor) adverse (side) effects
1-10%
Diarrhea (3%)
Increased transaminases (3%)
Eosinophilia (2%)
Moniliasis (2%)
Vaginitis (2%)
Rash (maculopapular, erythematous, or morbiliform) (1-2%)
<1%
Stevens-Johnson syndrome
Pseudomembranous colitis
Nausea
Vomiting
Anemia
Neutropenia
Jaundice
Warnings
Contraindications
Documented hypersensitivity
Cautions
Safety/efficacy of ext rel tablets not established in <16 yo
Reduce dosage by 1/2 if creatinine clearance is 10-30 mL/min, and by 3/4 if <10 mL/min (high doses may cause CNS toxicity); bacterial or fungal overgrowth of non-susceptible organisms may occur with prolonged or repeated therapy
Pregnancy and lactation
Pregnancy category: B
Lactation: enters breast milk; use with caution
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Ceclor, Raniclor (cefaclor)
Mechanism of action
Second-generation cephalosporin that binds to one or more of the penicillin-binding proteins, which in turn inhibits cell wall synthesis and results in bactericidal activity. Has gram-positive activity that first-generation cephalosporins have and adds activity against Proteus mirabilis, H influenzae, Escherichia coli, Klebsiella pneumoniae, and Moraxella catarrhalis. Indicated for management of infections caused by susceptible mixed aerobic-anaerobic microorganisms. Determine proper dosage and route based on condition of patient, severity of infection, and susceptibility of causative organism
Pharmacokinetics
Half-Life: 0.5-1 hr, prolonged with renal impairment
Peak Plasma Time: capsule 60 min, suspension 45 min
Protein Bound: 25%
Absorption: well absorbed, acid stable
Distribution: crosses placenta
Metabolism: Partial, hepatic
Excretion: Unchanged in urine: 80%