24 . November , 2017 - Friday
Check todays hot topics or new products

Find a Drug: Advanced

Please Sign in or Register

All about: Cefoxitin Sodium

Big Image Pronouncation: (seff-OX-ih-tin SO-dee-uhm)
Class: Antibiotic, Cephalosporin

Trade Names:
Mefoxin
- Powder for Injection 1 g (2.3 mEq sodium/g)
- Powder for Injection 2 g (2.3 mEq sodium/g)
- Powder for Injection 10 g (2.3 mEq sodium/g)
- Injection 1 g
- Injection 2 g

Mechanism of Action

Pharmacology

Inhibits mucopeptide synthesis in bacterial cell wall.

Pharmacokinetics

Absorption

IV

C max is 110 mcg/mL (1 g dose). T max is 5 min.

Distribution

Passes into pleural and joint fluids and is detectable in antibacterial concentrations in the bile. Excreted in human milk (low concentrations).

Elimination

The t ½ is 41 to 59 min (IV). About 85% is excreted unchanged by the kidneys in 6 h.

Special Populations

Renal Function Impairment

The t ½ is increased. Dosage adjustment is recommended.

Indications and Usage

Treatment of infections of lower respiratory tract, urinary tract, skin and skin structures, bone and joint; treatment of intra-abdominal infections, gynecological infections, and septicemia caused by susceptible microorganisms; perioperative prophylaxis. Many infections caused by gram-negative bacteria resistant to some cephalosporins and penicillins respond to cefoxitin.

Contraindications

Hypersensitivity to cephalosporins.

Dosage and Administration

Infection
Adults

IV/IM 1 to 2 g every 6 to 8 h.

Children 3 mo of age and older

IV/IM 80 to 160 mg/kg/day in divided doses every 4 to 6 h (max, 12 g/day).

Surgical Prophylaxis
Adults

IV/IM 2 g just prior to surgery, then 2 g every 6 h for 24 h.

Children 3 mo of age and older

IV/IM 30 to 40 mg/kg just prior to surgery, then 30 to 40 mg/kg every 6 h for 24 h.

General Advice

  • For IM administration, reconstitute each gram with 2 mL of sterile water for injection or 2 mL of lidocaine 0.5% without epinephrine to minimize discomfort. Inject deeply into large muscle (eg, gluteus or lateral thigh).
  • For IV use, reconstitute each gram with 10 mL of sterile water for injection. Administer slowly over 3 to 5 min. Reconstituted drug may be diluted in 50 to 100 mL of sodium chloride 0.9% or D5W and infused over 30 min.

Storage/Stability

Store powder in vials between 36° and 77°F. Store the premixed IV solution at or below −4°F. The dry powder and solutions tend to darken, depending on storage conditions; however, product potency is not adversely affected.

Drug Interactions

Aminoglycosides

May increase risk of nephrotoxicity.

Probenecid

Inhibition of renal excretion of cefoxitin.

Incompatibility

Aminoglycosides

Do not add aminoglycosides to cefoxitin solutions because inactivation of both drugs may result; administer at separate sites if concurrent therapy is indicated.

Laboratory Test Interactions

May cause false-positive urine glucose test results with Benedict solution, Fehling solution, or Clinitest tablets but not with enzyme-based tests (eg, Clinistix , Tes-tape ); false-positive test result for proteinuria with acid and denaturization-precipitation tests; false-positive direct Coombs test result in certain patients (eg, those with azotemia); false elevations in urinary 17-ketosteroid values. High concentrations may interfere with creatinine concentrations measured by the Jaffe reaction, producing false results; do not analyze serum samples for creatinine if obtained within 2 hr of drug administration.

Adverse Reactions

Cardiovascular

Hypotension.

GI

Nausea; vomiting; diarrhea; colitis, including pseudomembranous colitis.

Genitourinary

Renal function impairment; elevated renal function tests; pyuria; dysuria; reversible interstitial nephritis; hematuria; toxic nephropathy.

Hematologic

Eosinophilia; neutropenia; lymphocytosis; leukocytosis; thrombocytopenia; decreased platelet function; anemia; hemolytic anemia; aplastic anemia; hemorrhage.

Hepatic

Hepatic function impairment; jaundice; abnormal LFT results.

Miscellaneous

Hypersensitivity, including Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis; candidal overgrowth; serum sickness–like reactions (eg, skin rashes, polyarthritis; arthralgia, fever); phlebitis, thrombophlebitis, and pain at injection site.

Precautions

Monitor

Coagulation abnormalities

Monitor for coagulation abnormalities. Elevated PT or abnormal platelet count may occur. If bleeding occurs and PT is prolonged, vitamin K may be indicated.

Response to therapy

Monitor patient's response to therapy. Notify health care provider if infection does not appear to improve or worsens.

Adverse reactions

Monitor patient for GI, DERM, and general body adverse reactions, and signs of superinfection. Inform health care provider if noted and significant. Immediately report severe diarrhea, diarrhea containing blood or pus, or severe abdominal cramping.


Pregnancy

Category B .

Lactation

Excreted in breast milk.

Children

In children 3 mo of age and older, high doses of cefoxitin have been associated with increased incidence of eosinophilia and elevated AST.

Hypersensitivity

Reactions range from mild to life-threatening. Administer drug with caution to penicillin-sensitive patients because of possible cross-reactivity.

Renal Function

Use drug with caution. Dosage adjustment based on renal function may be required.

Superinfection

May result in bacterial or fungal overgrowth of nonsusceptible microorganisms.

Pseudomembranous colitis

Consider in patients in whom diarrhea develops.

Overdosage

Symptoms

Seizures.

Patient Information

  • Instruct patient to check body temperature daily. If fever persists for more than a few days or if high fever (higher than 102°F) or shaking chills are noted, notify health care provider immediately.
  • Advise patient to maintain normal fluid intake while using this medication.
  • Advise diabetic patient to use enzyme-based tests (eg, Clinistix , Testape ) for monitoring urine glucose because drug may give false results with other tests.
  • Warn patient to report these symptoms to health care provider: nausea, vomiting, diarrhea, skin rash, hives, sore throat, bruising, bleeding, muscle or joint pain.
  • Instruct patient to report signs of superinfection: black “furry” tongue, white patches in mouth, foul-smelling stools, vaginal itching or discharge.
  • Warn patient that diarrhea that contains blood or pus may be a sign of serious disorders. Tell patient to seek medical care and not to treat at home.
  • Instruct patient to seek emergency care if he or she experiences wheezing or difficulty breathing.

Recent Drug Updates at DrugIndexOnline:





Alu-Cap Alu-Cap
Some commonly used brand names are: In the U.S.— Advanced Formula Di-Gel 29 Alamag 2 Alamag Plus 9 Alenic Alka 15 Alenic Alka Extra Strength 18 Alka-Mints 27 Alkets 27 Alkets Extra Strength 27 Almacone 9 Almacone II 9 AlternaGEL 21 Alu-Cap 25 Aludrox 9 Alu-Tab 25 Amitone 27 Amphojel 25 An more...

Cefixime Cefixime
Some commonly used brand names are: In the U.S.— Ancef 4 Ceclor 1 Ceclor CD 1 Cedax 17 Cefadyl 23 Cefditoren 8 Cefizox 18 Cefobid 10 Cefotan 12 Ceftin 20 Cefzil 15 Ceptaz 16 Claforan 11 Duricef 2 Fortaz 16 Keflex 21 Keftab 21 Kefurox 20 Kefzol 4 Mandol 3 Maxipime 6 Mefoxin 13 Monocid 9 Om more...

Chromic Chloride Chromic Chloride
Some commonly used brand names are: In the U.S.— Chroma-Pak 1 Note: For quick reference, the following chromium supplements are numbered to match the corresponding brand name. This information applies to the following: 1. Chromic Chloride (KROME-ik KLOR-ide)†‡ more...

Demerol Demerol
Generic Name: Meperidine Injection (me-PER-ih-deen) Brand Name: DemerolDemerol is used for:Treating moderate to severe pain. It may also be used before or during surgery (eg, to support anesthesia), for pain relief during labor and delivery, or for other conditions as determined by your doctor. more...

Galsulfase Galsulfase
Generic Name: Galsulfase (gal-SUL-fase) Brand Name: NaglazymeGalsulfase is used for:Treating patients with mucopolysaccharidosis type VI, a mucopolysaccharide enzyme deficiency. Galsulfase is an enzyme. It works by helping to decrease a substance in the body that can cause cell, tissue, and or more...

Kayexalate Powder Kayexalate Powder
Generic Name: Sodium Polystyrene Sulfonate Powder (SO-dee-uhm pah-lee-STYE-reen SULL-fuh-nate) Brand Name: Examples include Kayexalate and KionexKayexalate Powder is used for:Treating high potassium levels in the blood. Kayexalate Powder is a potassium-removing resin. It works by exchanging sod more...

Percussion ES Percussion ES
Generic Name: dextromethorphan (dex troe meth OR fan) Brand Names: Benylin, Delsym, Hold DM, Percussion CS Children, Percussion ES, Robitussin Cough Calmers, Robitussin Maximum Strength, Robitussin Pediatric Cough Suppressant, Scot-Tussin Diabetic, Scot-Tussin DM Cough Chasers, St. Joseph more...

Plavix Plavix
Generic Name: clopidogrel bisulfate Dosage Form: Tablets Plavix Description Plavix (clopidogrel bisulfate) is an inhibitor of ADP-induced platelet aggregation acting by direct inhibition of adenosine diphosphate (ADP) binding to its receptor and of the subsequent ADP-mediated activation of the gl more...