Cefpodoxime information from DrugsUpdate
P - Caution when used during pregnancy
L - Caution when used during lactation
FI - Food*
LI - Lab*
Cefpodoxime (marketed as the prodrug cefpodoxime proxetil by Pharmacia & Upjohn under the trade name Vantin and under the name Orelox by Sanofi-Aventis), is an oral third generation cephalosporin. It is active against most Gram positive and Gram negative organisms. Notable exceptions include Pseudomonas aeruginosa, Enterococcus, and Bacteroides fragilis. It is commonly used to treat acute otitis media, pharyngitis, and sinusitis. It also finds use as oral continuation therapy when intravenous cephalosporins (such as ceftriaxone) are no longer necessary for continued treatment.
Pharmacodynamics
Pharmacokinetics
Cefpodoxime binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.
Absorption
Decreased absorption in conditions of low gastric acidity. Bioavailability: about 50%.
Distribution
Respiratory and GU tract (therapeutic concentrations); enters breast milk (low concentrations). Protein-binding: 20-30%.
Metabolism
De-esterified to cefpodoxime in the intestinal lumen.
Excretion
Via the urine (as unchanged); removed by dialysis; 2-3 hours (elimination half-life); prolonged in renal impariment.
Cefpodoxime Indications / Cefpodoxime Uses
Information Not Available
Cefpodoxime Adverse Reactions / Cefpodoxime Side Effects
Anaphylactic shock; purpuric nephritis, skin rash, pruritus; diarrhoea, nausea, abdominal pain, vomiting.
Potentially Fatal: Pseudomembranous colitis; nephrotoxicity.
Precautions
Monitor
Response to therapy
Monitor patient's response to therapy. Notify health care provider if infection does not appear to improve or worsens.
Adverse Reactions
Monitor patient for GI, DERM, and general body adverse reactions, and signs of superinfection. Inform health care provider if noted and significant. Immediately report severe diarrhea, diarrhea containing blood or pus, or severe abdominal cramping.
Overdosage
Toxic symptoms may include nausea, vomiting, epigastric distress and diarrhoea. Haemodialysis or peritoneal dialysis may aid in the removal of cefpodoxime from the body, particularly if renal function is compromised.
Special Precautions
History of allergy to penicillin; severe renal impairment; pregnancy and lactation.
Other Drug Interactions
Antacids or H2-blockers may decrease the absorption of cefpodoxime. Probenecid inhibits renal excretion.
Potentially Fatal: Monitor renal function during admin. Additive nephrotoxic effects with furosemide.
Other Interactions
Food Interaction
Food delays absorption; cefpodoxime levels may be increased with food.
Dosage
Oral
Urinary tract infections
Adult: 100-200 mg every 12 hours.
Child: 8-10 mg/kg/day in 2 divided doses. Max dose: 400 mg daily.
Renal impairment: Patients on haemodialysis: Dose should be given after each dialysis session.
CrCl (ml/min) Dosage Recommendation
10-39 Increase dosing intervals to 24 hourly.
<10 Increase dosing intervals to 48 hourly.
Oral
Respiratory tract infections
Adult: 100-200 mg every 12 hours.
Child: 8-10 mg/kg/day in 2 divided doses. Max dose: 400 mg daily.
Renal impairment: Patients on haemodialysis: Dose should be given after each dialysis session.
CrCl (ml/min) Dosage Recommendation
10-39 Increase dosing intervals to 24 hourly.
<10 Increase dosing intervals to 48 hourly.
Oral
Skin infections
Adult: 200-400 mg every 12 hours.
Child: 8-10 mg/kg/day in 2 divided doses. Max dose: 400 mg/day.
Renal impairment: Patients on haemodialysis: Dose should be given after each dialysis session.
CrCl (ml/min) Dosage Recommendation
10-39 Increase dosing intervals to 24 hourly.
<10 Increase dosing intervals to 48 hourly.
Oral
Otitis media
Child: 8-10 mg/kg/day in 2 divided doses. Max dose: 400 mg daily.
Renal impairment: Patients on haemodialysis: Dose should be given after each dialysis session.
CrCl (ml/min) Dosage Recommendation
10-39 Increase dosing intervals to 24 hourly.
<10 Increase dosing intervals to 48 hourly.
Oral
Uncomplicated gonorrhoea
Adult: A single dose of 200 mg may be used.
Renal impairment: Dose reduction may be required.
Food(before/after)
Information Not Available
List of Contraindications
Cefpodoxime and Pregnancy
Caution when used during pregnancy
Cefpodoxime and Lactation
Caution when used during lactation
Cefpodoxime and Children
Consider benefits relative to risks. Safety and efficacy in children younger than 6 months of age not established.
Cefpodoxime and Geriatic
Information Not Available
Cefpodoxime and Other Contraindications
Hypersensitivity
Storage
Oral
Store at 20-25°C.
Lab interference
Oral
Store at 20-25°C.
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