Cefiget (Cefixime) Tablet, Syrup, Suspension Uses Details
Cefiget Tablet, Syrup, Suspension contains Cefixime which considered a third generation semisynthetic cephalosporin antibiotic. Meanwhile, Cephalosporines are derivatives of 7 aminocephalosporic acid and closely related to penicillins in structure. On the other hand, Cephalosporins have six membered sulfur containing ring. However, it is effective in a large variety of bacterial infections such as respiratory tract, ear, skin, gonorrhea, otitis media and urinary tract infections.
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Cefiget Tablet, Syrup, Suspension Composition
Cefiget (Cefixime) is available for oral administration as:
1- Tablets 200 mg
Cefixime trihydrate equivalent to USP …… 200 mg.
2- Capsules 400 mg
Cefixime trihydrate equivalent to USP….. 400
3- Powder for oral Suspension 100 mg / 5 ml
Each 5 ml of reconstituted Suspension contains:
Cefixime trihydrate equivalent to USP …… 100 mg
4- DS Powder for oral Suspension 200 mg / 5 ml For Babies
Each 5 ml of reconstituted suspension contains:
Cefixime trihydrate equivalent to USP …… 200 mg
Cefiget Tablet, Syrup, Suspension Mechanism of Action
Cefixime has marked in vitro bactericidal activity of gram positive and gram negative. Like other cephalosporins, On the other hand, it exhibits its bactericidal action bye binding to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall. Meanwhile, It causing the inhibition of the third and last stage of bacterial cell wall synthesis. Cell lysis is then mediated by bacterail cell wall autolytic enzymes such as autolysins. However, The antibacterial effect of the medicine results from inhibition of mucopeptide synthesis in the bacterial cell wall.
Cefiget Tablet, Syrup, Suspension Pharmacokinetics
Absorption & Distribution:
Furthermore, Cefixime given orally about 40% - 50% absorbed whether administered with or without food. However, time to maximal absorption increased approximately 0.8 hours when administered with food. On the other hand, it better absorbed from oral suspension than from other oral dosage forms. Meanwhile, The plasma half-life is usually about 3-4 hours.
However, Cefixime approximately 65% bound to plasma proteins, independent of drug concentration. Meanwhile, it crosses the placenta.
Metabolism & Excretion:
Meanwhile, Approximately 50% of an absorbed dose of cefixime is excreted as unchanged drug in the urine in 24 hours. Therefore, Up to 60% may eliminated by non-renal mechanism. However, there is no evidence of metabolism but some is probably excreted into the feces from bile.
Tablet, Syrup, Suspension Special Populations
Renal Insufficiency:
In subjects with moderate impairment of renal function (20 to 40 ml/min creatinine clearance). Meanwhile, the average serum half-life of this medicine is prolonged to 6.4 hours. Therefore, In severe renal impairment (5 to 20 ml/min creatinine clearance), the half-life increased to an average of 11.5 hours. On the other hand, the drug is not cleared significantly from the blood by hemodialysis or peritoneal dialysis.
Microbiology:
Cefixime is highly stable in the presence of beta-lactamase enzymes. As a result many organisms resistant to penicillins and some cephalosporins due to the presence of beta-lactamases may be susceptible to this prodcut.
Spectrum of cefixime is broad and it is active against most strains of the following micro-organisms in both invitro and invivo. It has a longer duration of action than other cephalosporins that are active by mouth.
Gram-Positive Organisms:
- Streptococcus pneumoniae.
- Streptococcus pyogenes.
Gram-Negative Organisms:
- Haemophilus influenzae (beta-lactamase positive and negative strains).
- Moraxella (Branhamella) catarrhalis (most of which are beta-lactamase positive).
- Escherichia coli.
- Proteus mirabilis.
- Neisseria gonorrhoeae (including pencillinase and non-penicillinase-producing strains)
- Klebsiella species.
Cefiget Tablet, Syrup, Suspension Uses
Cefiget (Cefixime) Tablet, Syrup, Suspension indicated in the treatment of the following infection when caused by susceptible strains of the designated microorganisms:
- Uncomplicated urinary tract infections
- Otitis media
- Pharyngitis and tonsillitis
- Acute bronchitis and acute exacerbations of chronic bronchitis
- Uncomplicated gonorrhea (cervical/urethral)
Cefiget DS Syrup, Tablet, Suspension Dosage And Administration
Adults and children over 10 years:
The recommended adult dose is 200 - 400 mg daily according to the severity of infection, given either as a single dose or in two divide doses.
Uncomplicated cervical/urethral gonococcal infection: For the treatment of uncomplicated Cervical/urethral gonococcal infections, a single oral dose of 400 mg is recommended.
Children:
The recommended dose is 8 mg/kg/day of the suspension. This may be administered as a single daily dose or may be given in two divide doses, as 4 mg/kg/ every 12 hours except for urinary tract infection where once daily dosing must be used. As a general guide for prescribing in children the following daily doses in terms of volume of pediatric oral suspension are Suggested:
- 6 Months up to 1 year, 3.75ml daily
- Children 1-4 years, 5ml daily
- Children 5-10 years, 10ml daily
On the other hand, children weighting more than 50 kg or older than 10 years should be treated with recommended adult dose (200-400 mg daily depending i=on the severity of infection)
Otitis Media:
Otitis media should be treated with the suspension.
Duration Of Therapy:
The usual course of treatment is 7 days. This may be continued for up to 14 days if required.
In the treatment of infections due to S.pyogenes, a therapeutic dosage should be administered for at least 10 days.
How To Use And Prepare Cefiget DS Oral Suspension:
Fill previously boiled and cooled water up to the line mark on the bottle and shake vigorously.
- After reconstitution the suspension may be kept for 14 days either at room temperature,
- under refrigeration,
- Without significant loss of potency.
- Keep tightly closed.
- Shake well before using.
- Discard unused portion after 14 days.
Cefiget Tablets 400mg Syrup Suspension Side Effects
Cefixime generally well tolerated and side effects are usually transient,
Gastrointestinal Disturbance:
- Diarrhea (if severe diarrhea occurs, It should be discontinued) changes in the color of stool.
- Nausea
- Abdominal pain
- Dyspepsia
- Vomiting
- Flatulence have reported
- Pseudomembranous colities has also reported
- Central nervous system disturbance
- Headache
- Dizziness
- Seizures
Hepatic Disorders:
- Transient rises in liver transaminases
- Alkaline phosphatase and jaundice can also occur
Other Side Effects:
- Hypersensitivity reaction which usually subside upon discontinuation of therapy
- Ifrequent and reversible hematological changes
- Elevation of serum amylase
- Increase prothrombin time has reported in few patients
- Other possible reactions include genital pruritis and vaginitis
Contraindication For The Medication
Mainly it contraindicated in:
- Patients with hypersensitivity to any component of this medication.
- Patients with known allergy to the cephalosporin group of antibiotics.
- Children less than six months old as safety and efficacy of cefixime in these patients have not been established.
Precautions And Warnings Details
- Cephalosporuns should be given with caution to penicillin-sensitivity, as there is some evidence of partial cross-allergenicity between the penicillins and cephalosporins.
- It should administered with caution in patients with markedly impaired renal function.
- Treatment with broad spectrum antibiotic alters the normal flora of the colon and may permit overgrowth of clostridia.
- Pseudomembranous colitis associated with the use of board-spectrum antibiotics (including macrolides, semi-synthetic penicillins, lincosamides and cephalosporins). Therefore important to consider its diagnosis in patients who develop diarrhea in association with the use of antibiotics. Meanwhile, Symptoms of pseudomembranous colitis may occur during or after antibiotic treatment.
- Broad-spectrum antibiotics such as this medicine should prescribed with caution in individuals with a history of gastrointestinal disease, particularly colitis.
- Do not use it to treat S. aureus as this strain of staphylococci is resistant to cefixime.
Cefiget Use In Pregnancy
There are no adequate and well-controlled studies in pregnant women. Cefixime should therefore not used in pregnancy unless considered essential by the physician.
Nursing Mothers
Its not known whether it excreted in human milk. Meanwhile, consideration should given to discontinuing nursing temporarily during treatment with this drug.
Drug Interactions Guide
Anticoagulants:
Care should exercised in patients receiving anticoagulants and cefixime concomitantly due to the possibility that it may increase prothrombin time.
Carbamazepine:
Elevated carbamazepine levels have reported, when the product administered concomitantly. Meanwhile, drug monitoring may of assistance in detecting alterations in carbamazepine plasma concentrations.
Drug / Laboratory Interactions:
- A false-positive reaction for ketones in the urine may occur with tests using nitroprusside but not with those using nitroferricyanide.
- False-positive reaction for glucose in the urine may occur with Benadict’s or Fehling’s solution or with copper sulphate test tablets, but notwith tests based on enzymatic glucose oxidase reaction.
- A false-positive direct Coombs test has reported during treatment with cephalosporin antibiotics. Therefore it should recognized that a positive Coombs test may due to the drug.
Storage Instruction
Most importantly, always keep your medicine out of the reach of the children. On the other hand, protect it from direct sunlight and heat. Meanwhile, store the Cefiget Suspension, Syrup, Tablet, Capsules below 30 C temperature and protect it from moisture.
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Cefiget DS (Cefixime) Tablet, Syrup, Suspension, Capsule Price (Rs. 410 PKR)