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Antacids (aluminum- or magnesium-containing): Concomitant administration of 300-mg cefdinir capsules with 30 mL aluminum- or magnesium-containing suspension reduces the rate (Cmax) and extent (AUC) of absorption by approximately 40%. Time to reach Cmax is also prolonged by 1 hour. There are no significant effects on cefdinir pharmacokinetics if the antacid is administered 2 hours before or 2 hours after cefdinir. If antacids are required during CEFDINIR therapy, CEFDINIR should be taken at least 2 hours before or after the antacid.
Probenecid: As with other β-lactam antibiotics, probenecid inhibits the renal excretion of cefdinir, resulting in an approximate doubling in AUC, a 54% increase in peak cefdinir plasma levels, and a 50% prolongation in the apparent elimination t½.
Iron Supplements and Foods Fortified With Iron: Concomitant administration of cefdinir with a therapeutic iron supplement containing 60 mg of elemental iron (as FeSO4) or vitamins supplemented with 10mg of elemental iron reduced extent of absorption by 80% and 31%, respectively. If iron supplements are required during CEFDINIR therapy, CEFDINIR should be taken at least 2 hours before or after the supplement.
The effect of foods highly fortified with elemental iron (primarily iron-fortified breakfast cereals) on cefdinir absorption has not been studied.
There have been reports of reddish stools in patients receiving cefdinir. In many cases, patients were also receiving iron-containing products. The reddish color is due to the formation of a nonabsorbable complex between cefdinir or its breakdown products and iron in the gastrointestinal tract.
