Cefixime
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Cefixime – uses, side effects, Dosage, Interaction, warnings

What is Cefixime? what are the use, dose, side effects, interaction, and warnings of Cefixime?

Cefixime

General Introduction !

Category :Third generation cephalosporins
Schedule :Schedule “H”
Prescription : Required
Available as : Cefixime 100 mg Tablet, Cefixime 200 mg Tablet, Cefixime 400 mg Tablet, Chewable Tablets, Capsules and Liquids.

Description

What is Cefixime ?

Cefixime is a broad-spectrum antibiotic used to treat a variety of conditions like urinary tract infections, ear infections and lung infections caused by bacteria.

Cefixime is used in the treatment of bacterial infections. It is used for short-term treatment of bacterial infections of urinary tract, skin and soft-tissue, ear, bone, blood, abdomen, genital and lungs (pneumonia).

It has the advantage of once-daily dosing. This medicine is not recommended for use in case of common cold, flu or viral infections since it is active against the infections caused by certain bacterial species only.

It is also used to prevent infections after surgery.


Uses of Cefixime

Why Cefixime is Prescribed?

Cefixime is used to treat a wide variety of bacterial infections. This medication is known as a cephalosporin antibiotic. It works by stopping the growth of bacteria.

Urinary Tract Infection

Cefixime is used in the treatment of urinary tract infection caused by E. coli, Pseudomonas aeruginosa, Enterococci, and Klebsiella pneumoniae.

Tonsilitis/Pharyngitis

Cefixime is used in the treatment of Tonsillitis/Pharyngitis caused by Streptococcus pneumoniae, Haemophilus influenzae, and some fungal infections.

Ear Infection 

Cefixime is used in the treatment of otitis media caused by Streptococcus pneumoniae, E. coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae.

Bronchitis

Cefixime is used in the treatment of bronchitis caused by Streptococcus pneumoniae, Haemophilus influenzae, and some Mycoplasma pneumoniae.

Gonococcal infection

Cefixime is used in the treatment of Gonococcal infection caused by Neisseria gonorrhoeae.

Cefixime is also sometimes used to treat sinus infections in penicillin allergic patients, pneumonia, shigella (an infection that causes severe diarrhea), salmonella (an infection that causes severe diarrhea), and typhoid fever (a serious infection that is common in developing countries).

Talk to your doctor about the risks of using this medication for your condition.


Side effects

What are the Major & minor side effects for Cefixime?
  • Diarrhoea
  • Vomiting
  • Abdominal pain
  • Nausea
  • Dark or clay colored stools
  • Dizziness
  • Acid or sour stomach / Stomach Pain
  • Excessive air or gas in stomach
  • Gas
  • Heartburn
  • Indigestion
  • Redness of skin

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment:

  • Watery or bloody stools, stomach cramps
  • Fever during treatment or for up to two or more months after stopping treatment
  • Rash
  • Itching
  • Hives
  • Difficulty breathing or swallowing
  • Wheezing
  • Swelling of the face, throat, tongue, lips, and eyes
  • A return of sore throat, fever, chills, or other signs of infection

When not to use?

Contraindications of Cefixime

  • Allergy  : This medicine is not recommended for use if you have a known allergy to Cefixime or any other Beta lactam antibiotics.

Expert Advice for Cefixime

What are the Advice from Doctors for taking Cefixime?

  • Your doctor has prescribed Cefixime to cure your infection and improve your symptoms.
  • Do not skip any doses and finish the full course of treatment even if you feel better. Stopping it early may make the infection to come back and harder to treat.
  • Discontinue Cefixime and inform your doctor immediately if you get a rash, itchy skin, swelling of face and mouth, or have difficulty in breathing.
  • Diarrhea may occur as a side effect but should stop when your course is complete. Inform your doctor if it doesn’t stop or if you find blood in your stools.
  • Take it with food to avoid an upset stomach.
  • Avoid consuming alcohol while taking Cefixime as it may cause increased side effects.

How to use Cefixime Tablet

Cefixime comes as a tablet, chewable tablet, capsule, and suspension (liquid) to take by mouth.

Take this medication by mouth with or without food as directed by your doctor, usually once a day. In children, this medication may also be taken twice a day (every 12 hours). If you are taking the chewable tablets, chew thoroughly and then swallow.

Shake the suspension well before each use to mix the medication evenly.

The dosage is based on your medical condition and response to treatment. In children, the dosage is also based on weight.

For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same time(s) every day.

Continue to use this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may allow bacteria to continue to grow, which may result in a relapse of the infection.

Cefixime tablets come with a line down the middle of the tablet. If your doctor tells you to take half a tablet, break it carefully on the line. Take half the tablet as directed, and save the other half for your next dose.


Cefixime precautions

What special precautions should I follow?

Before taking cefixime : 

  • Tell your doctor and pharmacist if you are allergic to cefixime; other cephalosporin antibiotics.
  • Tell your doctor and pharmacist what prescription and nonprescription medications you are currently taking.
  • Tell your doctor if you have or have ever had gastrointestinal disease
  • Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding.
  •  Tell your doctor or pharmacist your medical history, especially of: kidney disease, a certain intestinal disease (colitis).
  •  If you have phenylketonuria (PKU) or any other condition that requires you to limit/avoid aspartame (or phenylalanine) in your diet, ask your doctor or pharmacist about using this medication safely.

Dosage of Cefixime

Usual Adult Dose for Urinary Tract Infection
Uncomplicated infections: 400 mg orally once a day or 200 mg orally every 12 hours

Usual Adult Dose for Otitis Media
Oral suspension, chewable tablets: 400 mg orally once a day or 200 mg orally every 12 hours

Usual Adult Dose for Tonsillitis/Pharyngitis
400 mg orally once a day or 200 mg orally every 12 hours

Usual Adult Dose for Bronchitis
Acute exacerbations of chronic bronchitis: 400 mg orally once a day or 200 mg orally every 12 hours

Usual Adult Dose for Gonococcal Infection – Uncomplicated
Uncomplicated cervical/urethral infections: 400 mg orally as a single dose

Usual Adult Dose for Gonococcal Infection – Disseminated
(Not approved by FDA) CDC recommendations: 400 mg orally twice a day

Usual Pediatric Dose for Otitis Media
Oral suspension, chewable tablets:
6 months to 12 years (weighing 45 kg or less): 8 mg/kg orally once a day or 4 mg/kg orally every 12 hours
Children weighing more than 45 kg or older than 12 years: 400 mg orally once a day or 200 mg orally every 12 hours

Usual Pediatric Dose for Urinary Tract Infection
Uncomplicated infections:

6 months to 12 years (weighing 45 kg or less): Oral suspension, chewable tablets: 8 mg/kg orally once a day or 4 mg/kg orally every 12 hours

Children weighing more than 45 kg or older than 12 years: 400 mg orally once a day or 200 mg orally every 12 hours

Usual Pediatric Dose for Tonsillitis/Pharyngitis
6 months to 12 years (weighing 45 kg or less): Oral suspension, chewable tablets: 8 mg/kg orally once a day or 4 mg/kg orally every 12 hours

Children weighing more than 45 kg or older than 12 years: 400 mg orally once a day or 200 mg orally every 12 hours

Usual Pediatric Dose for Bronchitis
Acute exacerbations of chronic bronchitis:

6 months to 12 years (weighing 45 kg or less):Oral suspension, chewable tablets: 8 mg/kg orally once a day or 4 mg/kg orally every 12 hours

Children weighing more than 45 kg or older than 12 years: 400 mg orally once a day or 200 mg orally every 12 hours

Missed Dose – What should I do if I forget a dose?
The missed dose should be taken as soon as possible. It is advisable to skip the missed dose if it is already time for your next scheduled dose. Do not use extra medicine to make up for the missed dose.

Overdose
Seek emergency medical treatment or contact the doctor in case of an overdose.


Interaction of Cefixime 

Drug interactions may change how your medications work or increase your risk for serious side effects. All drugs interact differently for person to person. You should check all the possible interactions with your doctor before starting any medicine.

Interaction with Alcohol : 

  • Interaction with alcohol is unknown. It is advisable to consult your doctor before consumption.

Interaction with Medicine :

  • Amikacin : MODERATE
  • Chloramphenicol : MODERATE
  • Nifedipine : MAJOR
  • Warfarin : MODERATE
  • Ethinyl Estradiol : MODERATE
  • Cholera Vaccine : SEVERE
  • Furosemide : MODERATE

Disease interactions

  • Colitis : MODERATE
  • Renal Disease  : MODERATE

Food interactions

  • Information not available.

Lab interactions

  • Coombs test : MODERATE
  • Urine ketones test : MODERATE

Cefixime During Pregnancy and Breastfeeding

Pregnancy

Cefixime has been assigned to pregnancy category B by the FDA. Animal studies failed to reveal evidence of fetal harm. There are no controlled data in human pregnancy. Cefixime is only recommended for use during pregnancy when benefit outweighs risk.

Breastfeeding 

There are no data on the excretion of cefixime into human milk. Other cephalosporins are excreted into human milk in small amounts. While adverse effects are unlikely, the infant should be monitored closely.


General warnings

Allergy

This medicine is not recommended for use if you have a known allergy to Cefixime or Beta-lactam Antibiotics. Seek immediate medical attention if you experience any allergic symptoms like rash, itching, nausea or vomiting, swelling of lips, hands, and feet.

Clostridium difficile-associated Diarrhea

Discontinue the use of this medicine as per the doctor’s instructions if severe diarrhea occurs after receiving Cefixime. This medicine may cause an imbalance in the microbial flora of the large intestine, decreasing the gut-friendly bacteria and promoting the growth of a bacteria called Clostridium difficile, resulting in severe diarrhea.

Bleeding disorders

This medicine should be used with caution in patients with bleeding disorders due to the increased risk of excessive bleeding. Regular monitoring of prothrombin time is necessary in such cases. Appropriate dose adjustments or replacement with a suitable alternative may be required based on the clinical condition.

Kidney disease

This medicine should be used with caution in patients with an impaired kidney function due to the increased risk of severe adverse effects. Appropriate dose adjustments are to be made based on the CrCl or eGFR.

Use in pediatrics

This medicine is not recommended for use in children less than 6 months of age since the safety and efficacy of use are not clinically established in this particular age group.

Drug resistance

Usage of Cefixime without sufficient proof or suspicion of a bacterial infection should be avoided. Irrational dosing might fail in providing the benefits and even cause toxicity. It may also increase the risk of development of bacteria that are drug resistant.


Quick Facts and Information

Onset of action : The peak effect of this medicine can be observed within 3 to 4 hours of administration of the dose.

Duration of effect :The effect of this medicine lasts for an average duration of 3 to 4 hours after onset of action.

Safe with alcohol? : Interaction with alcohol is unknown. It is advisable to consult your doctor before consumption.

Is it habit forming? : No habit forming tendency has been reported.


How Cefixime works?

This medicine works by interfering with certain processes that help the bacteria to grow and increase in number.

storage and disposal of Cefixime

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store the tablets, chewable tablets, and capsules at room temperature and away from excess heat and moisture (not in the bathroom).

Keep liquid medicine at room temperature or in the refrigerator, closed tightly, and dispose of any unused medication after 14 days. .

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them.


Common Brand Names of Cefixime

  • Axim o
  • Texit
  • Cef-3
  • Denvar
  • 3-C
  • Zifi

Legal Status :

Approved


Commonly Asked Questions / FAQs

What is Cefixime and what is it used for?

Cefixime is a cephalosporin antibiotic used for treating many infections, for eg: infections of the ear, throat (e.g. tonsillitis, pharyngitis), chest and lungs (e.g. bronchitis, pneumonia) and urinary tract (e.g. cystitis and kidney infections).

Is Cefixime used for diarrhea?

Cefixime has not been indicated for the treatment of diarrhea. Please talk to your doctor if you have diarrhea before taking any antibiotics.

Is Cefixime a cephalosporin?

Yes, Cefixime belongs to a group of antibiotics called ‘cephalosporins’.

Is Cefixime safe for infants?

Safety of Cefixime in children less than 6 months of age (includes premature and newborn infants) has not been established. Please consult your doctor before starting any antibiotics in children.

Is Cefixime a penicillin?

Cefixime is not a penicillin. It belongs to a different class of medicines known as cephalosporin and it works in a similar way as penicillins. However, they are different antibiotics. Please consult your doctor regarding their use.

Does Cefixime cause diarrhea?

Diarrhea is a common side effect of Cefixime. Diarrhea has been more commonly associated with higher doses. Stop the medicine if you have severe watery diarrhea that will not stop and you are feeling weak and have a fever. immediately consult your doctor.

Does Cefixime cause constipation?

Constipation has not been reported as a side effect with Cefixime. Please consult your doctor in case you experience constipation while taking Cefixime.

Does Cefixime cure chlamydia?

Cefixime is not effective against chlamydia infections, so, it is not used for its treatment. Please consult your doctor if you have been diagnosed with a chlamydial infection.

Does Cefixime contain penicillin?

Cefixime is a cephalosporin which has an action similar to penicillins but it does not contain any penicillin.

Does Cefixime cover pseudomonas?

No, Cefixime is not active against pseudomonas. Most strains of pseudomonas are resistant to Cefixime. Please consult your doctor if you have pseudomonas infections for the appropriate antibiotic treatment.

Does Cefixime contain sulfur?

No, Cefixime does not contain sulfur. Please check the package leaflet (patient information leaflet) before using any medicine for its contents.

Does Cefixime cure syphilis?

Cefixime is not active against the bacteria (Treponema pallidum) which causes syphilis. So, it is not used for the treatment of syphilis. Please consult your doctor if you have signs and symptoms of syphilis.

Does Cefixime cure gonorrhea?

Cefixime can be used to treat uncomplicated gonorrhea caused by Neisseria gonorrhoeae (both penicillinase and non-penicillinase producing bacteria). However, always talk to your doctor if you have any infection as it should be diagnosed properly by a doctor before the start of antibiotics. Never take antibiotics yourself.

Does Cefixime treat typhoid?

Cefixime is not indicated for the treatment of typhoid by the government regulatory authorities. However, Indian Academy of Pediatrics recommend the use of Cefixime in children for uncomplicated typhoid fever. It is hence, advisable that you must take the antibiotics for typhoid fever only when it is recommended by your doctor. Do not take antibiotics yourself.

Does Cefixime affect birth control?

There is no evidence of cefexime affecting birth control (contraception). However, interactions may occur and Cefixime may affect the action of birth control pills. Please consult your doctor to confirm whether you require a extra birth control measure while taking Cefixime.

Can I take Cefixime with azithromycin?

No interactions have been clinically observed between Cefixime and azithromycin. However, interactions may occur. Always consult with your doctor before taking two medicines together.

Can I take Cefixime and doxycycline together?

No interactions have been clinically observed between Cefixime and doxycycline. However, interactions may occur. Always consult with your doctor before taking two medicines together.

Can I take Cefixime with paracetamol?

No interactions have been clinically observed between Cefixime and paracetamol. However, interactions may occur. Always consult with your doctor before taking two medicines together.

Can I take Cefixime with folic acid?

Folic acid can be taken with Cefixime as no drug-drug interactions have been clinically observed between them. However, interactions may occur. Please consult your doctor before taking the two medicines together.

Also Read

Notice : This information is to supplement, not substitute to the judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any medicine, changing any diet or commencing or discontinuing any course of treatment.

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