Cefuvex Special Precautions

1.5 g: This drug has cross allergy with penicillin. It should be given with caution to penicillin-allergic patients and is not recommended in patients who have had an anaphylactic shock to penicillin.
Evaluation of renal status during therapy is recommended, especially in seriously ill patients receiving the maximum doses.
The total daily dose of the drug should be reduced in patients with renal insufficiency. It should be given with caution to patients receiving concurrent treatment with potent diuretics or aminoglycoside antibiotics, as these regimens have been reported to induce renal impairment. So for this kind of patients, evaluation of renal status during therapy is recommended.
It should be notified that this drug can induce pseudomembranous colitis. After the diagnosis of pseudomembranous colitis has been established, appropriate therapeutic measures should be initiated. Mild cases of pseudomembranous colitis usually respond to drug discontinuation alone. In moderate to severe cases, consideration should be given to management with fluids and electrolytes, protein supplementation and treatment with an antibacterial drug clinically effective against Clostridium difficile colitis.
Mild-to-moderate hearing loss has been reported in a few pediatric patients treated with this drug.
Laboratory test interactions: Positive Coombs' test may occur which may interfere with blood cross matching. A false-positive reaction for glucose in the urine may occur with copper reduction tests (Benedict's or Fehling's solution or with CLINITEST tablets) but not with enzyme-based tests for glycosuria. A false-negative result may occur in the ferricyanide test to determine blood plasma glucose levels in patients receiving this drug.
Use in pregnancy & lactation: This drug should be used during pregnancy only if the therapeutic benefit outweighs the risk to the patient. Since cefuroxime is excreted in human milk, caution should be exercised when this drug is administered to a nursing woman.
Use in children: Accumulation of other members of the cephalosporin class in newborn infants (with resulting prolongation of drug half-life) has been reported. Safety and effectiveness in pediatric patients below 3 months of age have not been established, so it is not recommended to be used in these patients.
Use in the elderly: Dosage in elderly patients of 65 years and over should be reduced to 2/3~1/2 of the usual adult dose. The total daily dose should not exceed 3 grams.