Cefpodoxime: Indication, Dosage, Side Effect, Precaution

Generic Medicine Info Patient Medicine Information

This information is not country-specific. Please refer to the Malaysia prescribing information.

Generic Medicine Info

Indications and Dosage

Oral
Pharyngitis, Tonsillitis

Adult: Dosage is expressed in terms of the active cefpodoxime moiety: 100 mg 12 hourly for 5-10 days. Dosage recommendations may vary among countries or individual products. Refer to country- or product-specific guidelines.
Child: Dosage is expressed in terms of the active cefpodoxime moiety: 2 months to 12 years As susp: 4-5 mg/kg 12 hourly for 5-10 days. Max: 200 mg daily. >12 years Same as adult dose. Dosage recommendations may vary among countries or individual products. Refer to country- or product-specific guidelines.

Oral
Skin and skin structure infections

Adult: Dosage is expressed in terms of the active cefpodoxime moiety: 400 mg 12 hourly for 7-14 days. Dosage recommendations may vary among countries or individual products. Refer to country- or product-specific guidelines.
Child: Dosage is expressed in terms of the active cefpodoxime moiety: ≥12 years Same as adult dose. Dosage recommendations may vary among countries or individual products. Refer to country- or product-specific guidelines.

Oral
Acute otitis media

Adult: Dosage is expressed in terms of the active cefpodoxime moiety: 200 mg 12 hourly, 5-7 days for mild to moderate infection and 10 days for severe infection. Dosage recommendations may vary among countries or individual products. Refer to country- or product-specific guidelines.
Child: Dosage is expressed in terms of the active cefpodoxime moiety: 2 months to 12 years As susp: 4-5 mg/kg 12 hourly for 5 days. Max: 200-400 mg daily. >12 years Same as adult dose. Dosage recommendations may vary among countries or individual products. Refer to country- or product-specific guidelines.

Oral
Uncomplicated gonorrhoea

Adult: Dosage is expressed in terms of the active cefpodoxime moiety: 200 mg as a single dose. Dosage recommendations may vary among countries or individual products. Refer to country- or product-specific guidelines.

Oral
Acute bacterial sinusitis, Acute maxillary sinusitis

Adult: Dosage is expressed in terms of the active cefpodoxime moiety: 200 mg 12 hourly for 10 days. Dosage recommendations may vary among countries or individual products. Refer to country- or product-specific guidelines.
Child: Dosage is expressed in terms of the active cefpodoxime moiety: 2 months to 12 years As susp: 4-5 mg/kg 12 hourly for 10 days. Max: 200-400 mg daily. >12 years Same as adult dose. Dosage recommendations may vary among countries or individual products. Refer to country- or product-specific guidelines.

Oral
Acute bacterial exacerbation of chronic bronchitis

Adult: Dosage is expressed in terms of the active cefpodoxime moiety: 200 mg 12 hourly for 10 days. Dosage recommendations may vary among countries or individual products. Refer to country- or product-specific guidelines.
Child: Dosage is expressed in terms of the active cefpodoxime moiety: ≥12 years Same as adult dose. Dosage recommendations may vary among countries or individual products. Refer to country- or product-specific guidelines.

Oral
Uncomplicated urinary tract infections

Adult: Dosage is expressed in terms of the active cefpodoxime moiety: 100 mg 12 hourly for 7 days. Dosage recommendations may vary among countries or individual products. Refer to country- or product-specific guidelines.
Child: Dosage is expressed in terms of the active cefpodoxime moiety: ≥12 years Same as adult dose. Dosage recommendations may vary among countries or individual products. Refer to country- or product-specific guidelines.

Oral
Community-acquired pneumonia

Adult: Dosage is expressed in terms of the active cefpodoxime moiety: 200 mg 12 hourly for 14 days. Dosage recommendations may vary among countries or individual products. Refer to country- or product-specific guidelines.
Child: Dosage is expressed in terms of the active cefpodoxime moiety: Infants (15 days) to 11 years As susp: 4 mg/kg 12 hourly. Max: 200 mg daily. ≥12 years Same as adult dose. Dosage recommendations may vary among countries or individual products. Refer to country- or product-specific guidelines.

Renal Impairment

Acute otitis media; Tonsillitis; Pharyngitis; Acute bacterial sinusitis; Acute maxillary sinusitis; Acute bacterial exacerbation of chronic bronchitis; Skin and skin structure infections; Community-acquired pneumonia; Uncomplicated urinary tract infections:
Haemodialysis patient: Administer dose after dialysis.

CrCl (mL/min)	Dosage
<10	Administer the usual recommended dose as a single dose 48 hourly.
10-39	Administer the usual recommended dose as a single dose 24 hourly.

Reconstitution

Oral susp: Reconstitute by adding the amount of water specified on the container to provide a susp containing 50 mg or 100 mg/5 mL. Add water in 2 equal parts and shake the bottle vigorously after each addition.

Contraindications

Hypersensitivity to cefpodoxime or any other cephalosporins; history of immediate and/or severe hypersensitivity reaction to penicillin or to any other β-lactam antibiotic.

Special Precautions

Patient with a history of any other type of hypersensitivity to penicillin or any other β-lactam antibiotic, history of gastrointestinal disease (e.g. colitis). Renal impairment. Children. Pregnancy and lactation.

Adverse Reactions

Significant: Fungal or bacterial superinfection, Clostridium difficile-associated diarrhoea (CDAD), pseudomembranous colitis, neutropenia (prolonged use). Rarely, agranulocytosis (prolonged use), haemolytic anaemia.
Ear and labyrinth disorders: Tinnitus.
Gastrointestinal disorders: Nausea, vomiting, abdominal pain, flatulence, gastric pressure.
General disorders and administration site conditions: Asthenia, malaise.
Metabolism and nutrition disorders: Decreased appetite.
Nervous system disorders: Headache, dizziness, paraesthesia.
Reproductive system and breast disorders: Vaginal infection.
Skin and subcutaneous tissue disorders: Rash, diaper rash.
Potentially Fatal: Hypersensitivity reactions (e.g. anaphylaxis).

Pregnancy Category (US FDA)

PO: B

Monitoring Parameters

Perform culture and susceptibility tests; consult local institutional recommendations before treatment initiation due to antibiotic resistance risks. Assess the patient's allergy history to cefpodoxime, cephalosporins, penicillins, or to other β-lactam antibiotics before treatment initiation. Monitor renal function. Assess for signs and symptoms of anaphylaxis (during initial dose). Test for CDAD if the patient develops diarrhoea.

Overdosage

Symptoms: Nausea, vomiting, diarrhoea, epigastric distress, encephalopathy. Management: Supportive and symptomatic treatment. May perform haemodialysis or peritoneal dialysis if renal function is compromised.

Drug Interactions

Decreased bioavailability with antacids and H₂ receptor antagonists (e.g. ranitidine); separate administration by at least 2-3 hours. Decreased excretion with probenecid. May increase the therapeutic efficacy of coumarin anticoagulants. Diminished contraceptive effect of estrogens.

Food Interaction

Tab: Increased extent of absorption and peak plasma concentrations when taken with food.

Lab Interference

May lead to a positive direct Coombs' test. May cause false-positive urinary glucose test using cupric sulfate (e.g. Benedict's solution, Fehling's solution, Clinitest^®), and false-positive serum or urine creatinine with Jaffe reaction.

Action

Description:
Mechanism of Action: Cefpodoxime, a 3rd generation cephalosporin, is the active metabolite of the prodrug cefpodoxime proxetil. It binds to 1 or more penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in the bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell lysis and death.
Pharmacokinetics:
Absorption: Rapidly and well absorbed. Increased absorption with food (tab). Bioavailability: Approx 50%. Time to peak plasma concentration: Within 2-3 hours (tab).
Distribution: Distributed in the lung parenchyma, bronchial mucosa, interstitial fluid, pleural fluid, prostate tissue, and tonsils. Enters breast milk (small amount). Volume of distribution: 32.3 L (tab). Plasma protein binding: 20-30%.
Metabolism: De-esterified in the gastrointestinal tract to the active metabolite, cefpodoxime.
Excretion: Mainly via urine (80% as unchanged drug). Elimination half-life: Approx 2-3 hours.

Chemical Structure

Storage

Store between 20-25°C. Tab: Protect from light. Reconstituted oral susp: Store between 2-8°C for 14 days.

MIMS Class

Cephalosporins

ATC Classification

J01DD13 - cefpodoxime ; Belongs to the class of third-generation cephalosporins. Used in the systemic treatment of infections.

References

Anon. Cefpodoxime (Briggs Drugs in Pregnancy and Lactation). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 03/01/2022.

Anon. Cefpodoxime Proxetil. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 17/03/2022.

Anon. Cefpodoxime. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 03/01/2022.

Buckingham R (ed). Cefpodoxime Proxetil. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/01/2022.

Cefpodoxime Proxetil (NorthStar Rx LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 03/01/2022.

Cefpodoxime Proxetil (PD-Rx Pharmaceuticals, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 03/01/2022.

Cefpodoxime Proxetil 100 mg Film-Coated Tablets (Sandoz Ltd). MHRA. https://products.mhra.gov.uk. Accessed 03/01/2022.

Cefpodoxime Proxetil 40 mg/5 mL Powder for Oral Suspension (Sandoz Ltd). MHRA. https://products.mhra.gov.uk. Accessed 03/01/2022.

Zudem 200 mg Film-Coated Tablet (Lloyd Laboratories. Inc.). MIMS Philippines. http://www.mims.com/philippines. Accessed 03/01/2022.

Zudem 50 mg/5 mL Granules for Suspension (Lloyd Laboratories. Inc.). MIMS Philippines. http://www.mims.com/philippines. Accessed 03/01/2022.

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