Cefutil
Cefutil: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. Drug interactions
- 13. Analogs
- 14. Terms and conditions of storage
- 15. Terms of dispensing from pharmacies
- 16. Reviews
- 17. Price in pharmacies
Latin name: Cefutil
ATX code: J01DC02
Active ingredient: cefuroxime (cefuroximum)
Producer: Pharma International (Jordan)
Description and photo updated: 2018-23-11
Cefutil is an antibacterial drug for systemic use, a second generation cephalosporin.
Release form and composition
Dosage form Cefutil - film-coated tablets: oval, biconvex, blue, on one side there is an imprint "PhI"; in a dosage of 125 mg - on the other side of the notch (in a dosage of 125 mg and 250 mg - 10 tablets in a blister, in a cardboard box 1 blister; in a dosage of 500 mg - 10 tablets in a bottle, in a cardboard box 1 bottle) …
Composition of 1 tablet:
- active substance: cefuroxime - 125, 250 or 500 mg (in the form of axetil);
- auxiliary components: microcrystalline cellulose, colloidal silicon dioxide, croscarmellose sodium, sodium lauryl sulfate, magnesium stearate, sodium starch glycolate, Opadry OY-L white [lactose monohydrate, hydroxypropyl methylcellulose, titanium dioxide (E 171), blue polyethylene glycol (E&C No. 1) 133), polyethylene glycol 6000.
Pharmacological properties
Pharmacodynamics
Axetil cefuroxime is an oral form of the bactericidal cephalosporin antibiotic cefuroxime, which is resistant to the action of most β-lactamases and is active against a wide range of gram-positive / gram-negative microorganisms.
The bactericidal effect of cefuroxime is achieved by inhibiting the synthesis of the cell membrane of microorganisms.
Cefutil is highly active against the following microorganisms:
- gram-positive aerobes: Staphylococcus aureus and Staphylococcus epidermidis (including strains producing penicillinase, except strains resistant to methicillin), Streptococcus pyogenes (and other beta-hemolytic streptococci), Streptococcus pneumoniae group; Streptococcus pneumoniae;
- gram-negative aerobes: Haemophilus influenzae (including ampicillin-resistant strains), Haemophilus parainfluenzae, Moraxella (Branhamella) catarrhalis, Neisseria gonorrhoeae (including strains producing / non-producing), Penicillinase Escherichiaella spp., Penicillinase Proteus mirabilis, Providencia spp., Proteus rettgeri;
- anaerobes: gram-positive / gram-negative cocci (including Peptococcus and Peptostreptococcus spp.), gram-positive / gram-negative bacteria (including Clostridium, Fusobacterium and Bacteroides spp.), Propionibacterium spp.;
- other microorganisms: Borrelia burgdorferi.
Microorganisms that are not sensitive to the effects of cefuroxime: Clostridium difficile, Acinetobacter calcoaceticus, Pseudomonas spp., Campylobacter spp., Listeria monocytogenes, methicillin-insensitive strains of Staphylococcus epidermidis and Staphylococcus appureus.
Some strains of the following microorganisms are insensitive to cefuroxime: Bacteroides fragilis, Morganella morganii, Enterococcus (Streptococcus) faecalis, Enterobacter spp., Proteus vulgaris, Serratia spp., Citrobacter spp.
Pharmacokinetics
Axetil cefuroxime after oral administration of cefutil is absorbed in the intestine, hydrolyzed on its mucous membrane and enters the bloodstream in the form of cefuroxime.
Optimal absorption is observed immediately after a meal. The maximum serum level of cefuroxime in the blood is observed approximately 2–3 hours after taking Cefutil.
T 1/2 (half-life) - about 1-1.5 hours. The level of protein binding, depending on the determination method, is 33–55%. Cefuroxime is excreted unchanged by the kidneys by tubular secretion and glomerular filtration.
With simultaneous use with probenecid, the area under the curve of the average concentration in serum increases by 50%.
Due to dialysis, the serum cefuroxime level in the blood decreases.
Indications for use
According to the instructions, Cefutil is prescribed for the treatment of infections caused by microorganisms sensitive to the action of cefuroxime:
- otitis media, tonsillitis, sinusitis, pharyngitis (ENT organs);
- pneumonia, acute and chronic bronchitis in the acute stage (respiratory tract);
- pyelonephritis, cystitis, urethritis (urinary tract);
- pyoderma, furunculosis, impetigo (skin and soft tissues);
- gonorrhea, acute uncomplicated gonococcal cervicitis and urethritis;
- Lyme disease (therapy of early manifestations and prevention of late complications in children from 12 years of age and adults).
Contraindications
Absolute:
- age up to 2 years (in this dosage form);
- individual intolerance to the components of the drug, as well as other cephalosporins.
Relative (Cefutil is prescribed under medical supervision):
- established intolerance to some sugars (the drug contains lactose);
- the first months of pregnancy;
- lactation period.
Instructions for the use of Cefutil: method and dosage
Cefutil is taken orally, preferably after meals.
Sensitivity to the action of Cefutil depends on the region and may change over time. The choice of antibiotic should be based on local antibiotic susceptibility data.
Average duration of use is 7 days.
In the treatment of most infections for adults, Cefutil is prescribed in a daily dose of 500 mg (in 2 divided doses in equal parts).
The recommended dosage regimen of the drug, depending on the indications:
- urinary tract infections: 2 times a day, 125 mg;
- respiratory tract infections (bronchitis): with infections of moderate severity - 250 mg of Cefutil 2 times a day, with more severe infections or if pneumonia is suspected - 500 mg 2 times a day;
- pyelonephritis: 2 times a day, 250 mg of Cefutil;
- uncomplicated gonorrhea: 1000 mg once;
- Lyme disease (children from 12 years old and adults): 2 times a day, 500 mg for a course of 20 days.
Cefuroxime is also available for parenteral use, which, if clinically indicated, allows for sequential treatment with one antibiotic (switching from parenteral to oral administration). The effectiveness of this method of application is noted in the treatment of pneumonia and exacerbations of chronic bronchitis.
Sequential therapy scheme:
- pneumonia: 2–3 times a day, 1500 mg of cefuroxime sodium (intramuscularly or intravenously) for 2–3 days, then 2 times a day, 500 mg of Cefutil, a course of 7 days;
- exacerbation of chronic bronchitis: 2-3 times a day, 750 mg of cefuroxime sodium (intramuscularly or intravenously) for 2-3 days, then 2 times a day, 500 mg of Cefutil for 5-7 days
The duration of parenteral and oral treatment may vary depending on the patient's condition and the severity of the infection.
The average dose for children from 2 years of age is 125 mg 2 times a day (maximum 250 mg per day). When treating otitis media or more severe infections, a single dose is doubled (maximum - 500 mg per day).
Axetil cefuroxime suspension is recommended for children under 2 years of age.
Elderly patients do not need dose adjustment. The maximum daily dose for this group of patients is 1000 mg.
The dose of Cefutil for patients with renal insufficiency is determined by CC (creatinine clearance), which is associated with the need to compensate for the slow excretion of the active substance.
With CC ≥ 30 ml / min (T 1/2 - 1.4–2.4 hours), a standard dose is prescribed - 125–500 mg 2 times a day. With CC 10-29 ml / min (T 1/2 - 4.6 hours) and <10 ml / min (T 1/2 - 16.8 hours), the standard dose should be applied once every 24 or 48 hours, respectively. After each dialysis, one additional unit dose is prescribed.
Side effects
When using Cefutil, side reactions are usually moderately pronounced, reversible.
Possible violations:
- infestations / infections: Candida overgrowth;
- immune system: allergic reactions, including from the skin (manifested in the form of drug fever, rash, itching, urticaria, anaphylactic shock, serum sickness); cases of Stevens-Johnson syndrome, polymorphic erythema, toxic epidermal necrolysis have been reported;
- digestive system: gastroenterological disorders (in the form of vomiting, diarrhea, nausea, abdominal pain; in case of severe diarrhea, the likelihood of pseudomembranous colitis associated with Cefutil therapy should be taken into account);
- hepatobiliary system: against the background of liver diseases - hepatitis, jaundice, a temporary increase in the level of hepatic transaminases in serum and serum bilirubin;
- blood and lymphatic system: hemolytic anemia, thrombocytopenia, eosinophilia, neutropenia, leukopenia, decreased hemoglobin, positive Coombs' test;
- nervous system: dizziness, headache.
Overdose
The main symptoms are convulsions.
Therapy: hemodialysis / peritoneal dialysis.
special instructions
The possibility of switching from parenteral therapy to oral administration of Cefutil is determined by the doctor, taking into account the severity of the infection, the clinical condition of the patient and the sensitivity of the pathogenic microorganism. If, after 3 days of parenteral administration, clinical improvement does not occur, therapy is continued without transferring the patient to taking the drug inside.
Overgrowth of Candida is possible during therapy. A long course can lead to excessive growth of other insensitive microorganisms, including Enterococci, Clostridium difficile (Cefutil may need to be canceled).
In case of severe disorders of the digestive system, accompanied by diarrhea and vomiting, it is not recommended to take Cefutil, since in this case the level of absorption decreases. It is more expedient to transfer the patient to the parenteral form of cefuroxime.
With a twenty-day course of Lyme disease therapy, an increase in the incidence of diarrhea is possible.
During the period of treatment, the likelihood of the appearance of pseudomembranous colitis (from a mild form to a life-threatening condition) cannot be ruled out. When symptoms such as severe / prolonged diarrhea, sharp cramping abdominal pains appear, Cefutil is immediately canceled and a thorough examination is performed.
In the treatment of Lyme disease, the development of the Jarisch-Herxheimer reaction can be observed (additional therapy is not required).
During therapy, it is recommended to determine the concentration of glucose in blood plasma using methods with hexokinase / glucose oxidase. Cefuroxime has no effect on creatinine determination using a study with alkaline picrate.
Influence on the ability to drive vehicles and complex mechanisms
During the period of therapy with Cefutil, dizziness may develop, which must be taken into account when driving.
Application during pregnancy and lactation
Cefutil in the first months of pregnancy / lactation should be used with caution.
There are no experimental data confirming the embryotoxic / teratogenic effect of axetil cefuroxime. It should be taken into account that small concentrations of cefuroxime pass into breast milk.
Pediatric use
Cefutil therapy is contraindicated in patients under 2 years of age (cefuroxime can be prescribed in a different dosage form).
With impaired renal function
With CC <29 ml / min, correction of the Cefutil dosage regimen is required.
Drug interactions
Possible interactions:
- drugs that reduce the acidity of gastric juice: the bioavailability of cefuroxime decreases, the effect of improved absorption after meals is also reduced;
- drugs that increase the acidity of gastric juice: the absorption of cefuroxime may be impaired; the combination is not recommended;
- combined oral contraceptives: their effectiveness decreases, which is associated with a decrease in estrogen reabsorption;
- potent diuretics (ethacrynic acid, furosemide), aminoglycosides, amphotericin, colistin and polymyxin (with high doses of Cefutil): the risk of renal failure increases;
- phenylbutazone, probenecid: renal clearance of cefuroxime decreases, and its plasma concentration increases.
Analogs
Cefutil's analogs are: Zinnat, Cefuroxime, Cefumax, Zinacef, Axosef, Proxim, Baktil, Aksetin.
Terms and conditions of storage
Store in original packaging at temperatures up to 30 ° C. Keep out of the reach of children.
Shelf life:
- 125 and 250 mg - 4 years;
- 500 mg each - 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Cefutil
Reviews about Cefutil are mostly positive. Its quick effect is noted. In some cases, they indicate the development of pronounced side effects and insufficient therapeutic effect.
Price for Cefutil in pharmacies
The price of Cefutil is unknown because the drug is not available in pharmacies.
Approximate price for analogues: Zinnat - 200–260 rubles. (10 tablets of 125 mg) or 363–455 rubles. (10 tablets of 250 mg), Axosef (14 tablets of 500 mg) - 535-610 rubles.
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
