Cefadroxil

Trade Names:Cefadroxil- Capsules 500 mg (as monohydrate)- Tablets 1 g (as monohydrate)- Powder for Oral Suspension 250 mg/5 mL- Powder for Oral Suspension 500 mg/5 mL

Pharmacology

Inhibits mucopeptide synthesis in bacterial cell wall.

Pharmacokinetics

Absorption

Rapidly absorbed. C _max is about 16 mcg/mL (500 mg dose) and 28 mcg/mL (1,000 mg dose).

Distribution

20% protein bound.

Elimination

More than 90% is excreted in the urine as unchanged drug within 24 h; t _½ is 78 to 96 min.

Special Populations

The t _½ is increased. Adjust dose.

Indications and Usage

Treatment of infections of urinary tract, skin and skin structures; treatment of pharyngitis and tonsillitis caused by susceptible strains of specific microorganisms.

Contraindications

Hypersensitivity to cephalosporins.

Dosage and Administration

PO 1 to 2 g/day in single dose or 2 divided doses.

PO 30 mg/kg/day in single dose or 2 divided doses.

General Advice

• Administer with food or milk if GI upset occurs.

Storage/Stability

Oral suspension must be refrigerated and will remain stable for up to 14 days. Do not freeze. Shake well before use.

Drug Interactions

Inhibition of renal excretion of cefadroxil.

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 results for proteinuria with acid and denaturization-precipitation tests; false-positive direct Coombs test results in certain patients (eg, those with azotemia); false elevations in urinary 17-ketosteroid values.

Adverse Reactions

GI

Nausea; vomiting; diarrhea; anorexia; abdominal pain or cramps; flatulence; colitis, including pseudomembranous colitis.

Genitourinary

Pyuria; renal dysfunction; dysuria; reversible interstitial nephritis; hematuria; toxic nephropathy.

Hematologic

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

Hepatic

Hepatic dysfunction, abnormal LFT results.

Miscellaneous

Hypersensitivity, including Stevens-Johnson syndrome, erythema multiforme and toxic epidermal necrolysis; serum sickness–like reactions (eg, skin rash, polyarthritis, arthralgia, fever); candidal overgrowth.

Precautions

Pregnancy

Category B .

Lactation

Excreted in breast milk.

Children

In infants, consider benefits relative to risks. Drug may accumulate in newborns.

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 in patients with renal function impairment. 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 complete full course of therapy.
• Instruct patient to check body temperature daily. If fever persists more than a few days or if high fever (above 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.
• Instruct patient to report these symptoms to health care provider: nausea, vomiting, diarrhea, skin rash, hives, 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 immediately if wheezing or difficulty in breathing occurs.

Copyright © 2009 Wolters Kluwer Health.