CEPHALOSPORINS (Systemic)

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
• Omnicef ⁵
• Rocephin ¹⁹
• Tazicef ¹⁶
• Tazidime ¹⁶
• Vantin ¹⁴
• Velosef ²⁴
• Zinacef ²⁰

Note:

Suprax was withdrawn from the U.S. market by Wyeth in October 2002

In Canada?

• Ancef ⁴
• Apo-Cefaclor ¹
• Apo-Cephalex ²¹
• Ceclor ¹
• Cefizox ¹⁸
• Cefotan ¹²
• Ceftin ²⁰
• Cefzil ¹⁵
• Ceporacin ²²
• Ceptaz ¹⁶
• Claforan ¹¹
• Duricef ²
• Fortaz ¹⁶
• Keflex ²¹
• Keflin ²²
• Kefurox ²⁰
• Kefzol ⁴
• Mandol ³
• Maxipime ⁶
• Mefoxin ¹³
• Novo-Lexin ²¹
• Nu-Cephalex ²¹
• PMS-Cephalexin ²¹
• Rocephin ¹⁹
• Suprax ⁷
• Tazidime ¹⁶
• Zinacef ²⁰

Category

• Antibacterial, systemic?Cefaclor; Cefadroxil; Cefamandole; Cefazolin; Cefdinir; Cefditoren; Cefepime; Cefixime; Cefonicid; Cefoperazone; Cefotaxime; Cefotetan; Cefoxitin; Cefpodoxime; Cefprozil; Ceftazidime; Ceftibuten; Ceftizoxime; Ceftriaxone; Cefuroxime; Cephalexin; Cephalothin; Cephapirin; Cephradine

Description

Cephalosporins (sef-a-loe-SPOR-ins) are used in the treatment of infectionscaused by bacteria. They work by killing bacteria or preventing their growth.

Cephalosporins are used to treat infections in many different parts ofthe body. They are sometimes given with other antibiotics. Some cephalosporinsgiven by injection are also used to prevent infections before, during, andafter surgery. However, cephalosporins will not work for colds, flu, or othervirus infections.

Cephalosporins are available only with your doctor's prescription, in thefollowing dosage forms:

Oral
• Cefaclor
  • Capsules (U.S. and Canada)
  • Oral suspension (U.S. and Canada)
  • Extended-release tablets (U.S.)
• Cefadroxil
  • Capsules (U.S. and Canada)
  • Oral suspension (U.S.)
  • Tablets (U.S.)
• Cefdinir
  • Capsules (U.S.)
  • Oral Suspension (U.S.)
• Cefditoren
  • Tablets (U.S.)
• Cefixime
  • Oral suspension (Canada)
  • Tablets (Canada)

    Note:

    Cefixime was withdrawn from the U.S. market by Wyeth in October 2002

• Cefpodoxime
  • Oral suspension (U.S.)
  • Tablets (U.S.)
• Cefprozil
  • Oral suspension (U.S. and Canada)
  • Tablets (U.S. and Canada)
• Ceftibuten
  • Capsules (U.S.)
  • Oral suspension (U.S.)
• Cefuroxime
  • Oral suspension (U.S. and Canada)
  • Tablets (U.S. and Canada)
• Cephalexin
  • Capsules (U.S. and Canada)
  • Oral suspension (U.S. and Canada)
  • Tablets (U.S. and Canada)
• Cephradine
  • Capsules (U.S.)
  • Oral suspension (U.S.)

Parenteral
• Cefamandole
  • Injection (U.S. and Canada)
• Cefazolin
  • Injection (U.S. and Canada)
• Cefepime
  • Injection (U.S. and Canada)
• Cefonicid
  • Injection (U.S.)
• Cefoperazone
  • Injection (U.S.)
• Cefotaxime
  • Injection (U.S. and Canada)
• Cefotetan
  • Injection (U.S. and Canada)
• Cefoxitin
  • Injection (U.S. and Canada)
• Ceftazidime
  • Injection (U.S. and Canada)
• Ceftizoxime
  • Injection (U.S. and Canada)
• Ceftriaxone
  • Injection (U.S. and Canada)
• Cefuroxime
  • Injection (U.S. and Canada)
• Cephalothin
  • Injection (Canada)
• Cephapirin
  • Injection (U.S.)

Before Using This Medicine

In deciding to use a medicine,the risks of taking the medicine must be weighed against the good it willdo. This is a decision you and your doctor will make. For the cephalosporins,the following should be considered:

Allergies?Tell your doctor if you have ever had any unusual orallergic reaction to any of the cephalosporins, penicillins, penicillin-likemedicines, or penicillamine. Also tell your health care professional if youare allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy?Studies have not been done in humans. However, mostcephalosporins have not been reported to cause birth defects or other problemsin animal studies. Studies in rabbits have shown that cefoxitin may increasethe risk of miscarriages and cause other problems.

Breast-feeding?It is not known if cefditoren passes into breastmilk. Most cephalosporins pass into breast milk, usually in small amounts.However, cephalosporins have not been reported to cause problems in nursingbabies.

Children?Many cephalosporins have been tested in childrenand, in effective doses, have not been shown to cause different side effectsor problems than they do in adults. However, there are some cephalosporinsthat have not been tested in children up to 12 year of age.

Older adults?Cephalosporins have been used in the elderly, andthey are not expected to cause different side effects or problems in olderpeople than they do in younger adults.

Other medicines?Although certain medicines should not be usedtogether at all, in other cases two different medicines may be used togethereven if an interaction might occur. In these cases, your doctor may want tochange the dose, or other precautions may be necessary. When you are takinga cephalosporin, it is especially important that your health care professionalknow if you are taking any of the following:

• Alcohol or alcohol-containing medicine (cefamandole, cefoperazone,and cefotetan only)?Using alcohol and these cephalosporins togethermay cause abdominal or stomach cramps, nausea, vomiting, headache, dizzinessor light-headedness, shortness of breath, sweating, or facial flushing; thisreaction usually begins within 15 to 30 minutes after alcohol is consumedand usually goes away over several hours

• Aminoglycoside antibiotics, such as
  Amikacin (e.g., Amikin) or
  Gentamicin (e.g., Apogen) or
  Neomycin (e.g., Mycifradin)? use with cefuroxime may result in increasedchance of serious side effects

• Anticoagulants (blood thinners) or
• Carbenicillin by injection (e.g., Geopen) or
• Dipyridamole (e.g., Persantine) or
• Divalproex (e.g., Depakote) or
• Heparin (e.g., Hepalean, Liquaemin) or
• Pentoxifylline (e.g., Trental) or
• Plicamycin (e.g., Mithracin) or
• Sulfinpyrazone (e.g., Anturane) or
• Ticarcillin (e.g., Ticar) or
• Thrombolytic agents or
• Valproic acid (e.g., Depakene)?Any of these medicines may increasethe chance of bleeding, especially when used with cefamandole, cefoperazone,or cefotetan

• Diuretics, potent such as
  Furosemide (e.g., Lasix)? use with cefuroxime may cause higher bloodlevels of cefuroxime and result in increased side effects

• Iron?Iron supplements, including multivitamins that containiron, may decrease the effect of cefdinir. However, iron-fortified infantformula does not decrease the effect of cefdinir

• Probenecid (e.g., Benemid) (except cefoperazone, ceftazidime, orceftriaxone)?Probenecid increases the blood level of many cephalosporins.Although probenecid may be given with a cephalosporin by your doctor purposelyto increase the blood level to treat some infections, in other cases thiseffect may be unwanted and may increase the chance of side effects

Other medical problems?The presence of other medicalproblems may affect the use of cephalosporins. Make sure you tell your doctorif you have any other medical problems, especially:

• Bleeding problems, history of (cefamandole, cefditoren, cefoperazone,and cefotetan only)?These medicines may increase the chance of bleeding

• Carnitine, low levels?Cefditoren may cause carnitine levelsto decrease further.

• Kidney disease?Some cephalosporins need to be given at a lowerdose to people with kidney disease. Also, cephalothin, and cefuroxime especially,may increase the chance of kidney damage

• Liver disease (cefoperazone and cefuroxime)?Cefoperazone needsto be given at a lower dose to people with liver disease. Condition may beworsened by cefuroxime use.

• Phenylketonuria?Cefprozil oral suspension contains phenylalanine

• Poor nutritional status?these may be worsened by cefuroximeand you may need to have vitamin K

• Stomach or gastrointestinal disease, history of (especially colitis,including colitis caused by antibiotics, or enteritis)?Cephalosporinsmay cause colitis in some patients

Proper Use of This Medicine

Cephalosporinsmay be taken on a full or empty stomach. If this medicine upsets your stomach,it may help to take it with food.

Cefaclor extended-release tablets, cefditoren, cefpodoxime, and cefuroximeaxetil should be taken with food to increase absorption of the medicine. Ceftibutenoral suspension should be taken on an empty stomach, at least 2 hours beforeor 1 hour after a meal.

For patients taking the oral liquid form ofthis medicine:

• This medicine is to be taken by mouth. Use a specially marked measuringspoon or other device to measure each dose accurately. The average householdteaspoon may not hold the right amount of liquid.
• Do not use after the expiration date on the label since the medicinemay not work properly after that date. Check with your pharmacist if you haveany questions about this.

To help clear up your infection completely, keep takingthis medicine for the full time of treatment, even if you begin tofeel better after a few days. If you have a ?strep?infection, you should keep taking this medicine for at least 10 days. Thisis especially important in ?strep? infections since serious heartor kidney problems could develop later if your infection is not clearedup completely. Also, if you stop taking this medicine too soon, your symptomsmay return.

This medicine works best when there is a constant amount in the blood orurine. To help keep the amount constant, do not miss anydoses. Also, it is best to take the doses at evenly spaced times, day andnight. For example, if you are to take four doses a day, the dosesshould be spaced about 6 hours apart. If this interferes with your sleep orother daily activities, or if you need help in planning the best times totake your medicine, check with your health care professional.

Dosing?The dose of these medicines will be differentfor different patients. Follow your doctor's orders orthe directions on the label. The following information includes onlythe average doses of these medicines. Your dose may be different if you havekidney disease. If your dose is different, do not changeit unless your doctor tells you to do so.

The number of capsules or tablets or teaspoonfuls of suspension that youtake depends on the strength of the medicine. Also, thenumber of doses you take each day, the time allowed between doses, and thelength of time you take the medicine depend on the medical problem for whichyou are taking a cephalosporin.

For cefaclor
• For bacterial infections:
  • For capsule or oralsuspension dosage form:
    • Adults and teenagers?250 to 500 milligrams (mg) every eighthours.
    • Infants and children 1 month of age and older?6.7 to 13.4 mgper kilogram (kg) (3.04 to 6.09 mg per pound) of body weight every eight hours,or 10 to 20 mg per kg (4.54 to 9.09 mg per pound) of body weight every twelvehours.
  • For extended-release tablet dosage form:
    • Adults and teenagers 16 years of age and older?375 to 500 mgevery twelve hours for seven to ten days.
    • Children up to 16 years of age?Use and dose must be determinedby your doctor.

For cefadroxil
• For bacterial infections:
  • For oral dosage forms (capsules, oralsuspension, or tablets):
    • Adults and teenagers?500 milligrams (mg) or 1 gram every twelvehours, or 1 or 2 grams once a day.
    • Children?15 mg per kilogram (kg) (6.81 mg per pound) of bodyweight every twelve hours, or 30 mg per kg (13.63 mg per pound) of body weightonce a day.

For cefamandole
• For bacterial infections:
  • For injection dosage form:
    • Adults and teenagers?500 milligrams (mg) to 2 grams every fourto eight hours, injected into a muscle or vein.
    • Infants and children 1 month of age and older?8.3 to 50 mgper kilogram (kg) (3.77 to 22.72 mg per pound) of body weight every four toeight hours, injected into a muscle or vein.

For cefazolin
• For bacterial infections:
  • For injection dosage form:
    • Adults and teenagers?250 milligrams (mg) to 1.5 grams everysix to twelve hours, injected into a muscle or vein.
    • Infants and children 1 month of age and older?6.25 to 25 mgper kilogram (kg) (2.84 to 11.36 mg per pound) of body weight every six hours,or 8.3 to 33.3 mg per kg (3.77 to 15.13 mg per pound) of body weight everyeight hours, injected into a muscle or vein.
    • Newborns?20 mg per kg (9.09 mg per pound) of body weight everyeight to twelve hours, injected into a vein.

For cefdinir
• For bacterial infections:
  • For capsule or oral suspensiondosage form:
    • Adults and teenagers?300 milligrams (mg) ever twelve hoursor 600 mg once a day for 5 to 10 days.
    • Infants and children 6 months of age and older?7 milligrams(mg) per kilogram (3.18 mg per pound) of body weight every twelve hours or14 mg per kilogram (6.36 mg per pound) once a day for 5 to 10 days.

For cefditoren
• For acute bacterial bronchitis
  • For tablets dosage form:
    • Adults and children 12 years of age and older?400 milligrams(mg) twice a day for 10 days
    • Children under 12 years of age?Dose must be determined by yourdoctor
• For bacterial throat infections or tonsillitis:
  • For tablets dosage form:
    • Adults and children 12 years of age and older?200 milligrams(mg) twice a day for 10 days
    • Children under 12 years of age?Dose must be determined by yourdoctor

For cefepime
• For bacterial infections:
  • For injection dosage form:
    • Adults and teenagers?500 milligrams to 2 grams every eightto twelve hours, injected into a muscle or vein, for seven to ten days.
    • Infants and children 2 months to 16 years of age?50 milligramsper kilogram body weight injected into muscle or vein, every eight to twelvehours, for seven to ten days.

For cefixime

Note:

Was withdrawn from the U.S. market by Wyeth in October 2002

• For bacterial infections:
  • For oral dosage forms (oral suspensionor tablets):
    • Adults and teenagers?200 milligrams (mg) every twelve hours,or 400 mg once a day. Gonorrhea is treated with a single, oral dose of 400mg.
    • Children 6 months to 12 years of age?4 mg per kilogram (kg)(1.81 mg per pound) of body weight every twelve hours, or 8 mg per kg (3.63mg per pound) of body weight once a day.
    • Infants up to 6 months of age?Use and dose must be determinedby your doctor.

For cefonicid
• For bacterial infections:
  • For injection dosage form:
    • Adults and teenagers?500 milligrams (mg) to 2 grams every twenty-fourhours, injected into a muscle or vein.
    • Children?Use and dose must be determined by your doctor.

For cefoperazone
• For bacterial infections:
  • For injection dosage form:
    • Adults and teenagers?1 to 6 grams every twelve hours, or 2to 4 grams every eight hours, injected into a muscle or vein.
    • Children?Use and dose must be determined by your doctor.

For cefotaxime
• For bacterial infections:
  • For injection dosage form:
    • Adults and teenagers?1 to 2 grams every four to twelve hours,injected into a muscle or vein. Gonorrhea is usually treated with a singledose of 500 milligrams (mg) or 1 gram, injected into a muscle.
    • Children over 50 kg of body weight (110 pounds)?1 to 2 gramsevery four to twelve hours, injected into a muscle or vein.
    • Infants and children 1 month of age and older and up to 50 kg ofbody weight (110 pounds)?8.3 to 30 mg per kg (3.77 to 13.63 mg per pound)of body weight every four hours, or 12.5 to 45 mg per kg (5.68 to 20.45 mgper pound) of body weight every six hours, injected into a muscle or vein.
    • Newborns 1 to 4 weeks of age?50 mg per kg (22.72 mg per pound)of body weight every eight hours, injected into a vein.
    • Newborns up to 1 week of age?50 mg per kilogram (kg) (22.72mg per pound) of body weight every twelve hours, injected into a vein.

For cefotetan
• For bacterial infections:
  • For injection dosage form:
    • Adults and teenagers?500 milligrams to 3 grams every twelvehours, or 1 or 2 grams every twenty-four hours, injected into a muscle orvein.
    • Children?Use and dose must be determined by your doctor.

For cefoxitin
• For bacterial infections:
  • For injection dosage form:
    • Adults and teenagers?1 to 3 grams every four to eight hours,injected into a vein.
    • Infants and children 3 months of age and older?13.3 to 26.7milligrams (mg) per kilogram (kg) (6.04 to 12.13 mg per pound) of body weightevery four hours, or 20 to 40 mg per kg (9.09 to 18.18 mg per pound) of bodyweight every six hours, injected into a vein.
    • Infants 1 to 3 months of age?20 to 40 mg per kg (9.09 to 18.18mg per pound) of body weight every six to eight hours, injected into a vein.
    • Newborns 1 to 4 weeks of age?20 to 40 mg per kg (9.09 to 18.18mg per pound) of body weight every eight hours, injected into a vein.
    • Premature infants weighing 1500 grams and over to newborns up to1 week of age?20 to 40 mg per kg (9.09 to 18.18 mg per pound) of bodyweight every twelve hours, injected into a vein.

For cefpodoxime
• For bacterial infections:
  • For oral dosage forms (oral suspensionor tablets):
    • Adults and teenagers?100 to 400 milligrams (mg) every twelvehours for five to fourteen days. Gonorrhea is treated with a single, oraldose of 200 mg.
    • Infants and children 5 months to 12 years of age?5 mg per kilogram(kg) (2.27 mg per pound) of body weight every twelve hours for five to tendays, or 10 mg per kg (4.54 mg per pound) of body weight every twenty-fourhours for ten days.
    • Infants up to 5 months of age?Use and dose must be determinedby your doctor.

For cefprozil
• For bacterial infections:
  • For oral dosage forms (oral suspensionor tablets):
    • Adults and teenagers?250 or 500 milligrams (mg) every twelveto twenty-four hours for ten days.
    • Children 2 to 12 years of age?7.5 to 20 mg per kilogram (kg)(3.4 to 9.09 mg per pound) of body weight every twelve to twenty-four hoursfor ten days.
    • Infants and children 6 months to 12 years of age?7.5 to 15mg per kg (3.4 to 6.81 mg per pound) of body weight every twelve hours forten days.
    • Infants up to 6 months of age?Use and dose must be determinedby your doctor.

For ceftazidime
• For bacterial infections:
  • For injection dosage form:
    • Adults and teenagers?250 milligrams (mg) to 2 grams every eightto twelve hours, injected into a muscle or vein. Patients with cystic fibrosismay receive 30 to 50 mg per kilogram (kg) (13.63 to 22.72 mg per pound) ofbody weight every eight hours, injected into a vein.
    • Infants and children 1 month to 12 years of age?30 to 50 mgper kg (13.63 to 22.72 mg per pound) of body weight every eight hours, injectedinto a vein.
    • Newborns up to 4 weeks of age?30 mg per kg (13.63 mg per pound)of body weight every twelve hours, injected into a vein.

For ceftibuten
• For bacterial infections:
  • For oral dosage forms (capsules or oralsuspension):
    • Adults and teenagers?400 milligrams (mg) once a day for tendays.
    • Infants and children 6 months to 12 years of age?9 mg per kilogram(4.09 mg per pound) of body weight once a day for ten days.
    • Infants up to 6 months of age?Use and dose must be determinedby your doctor.

For ceftizoxime
• For bacterial infections:
  • For injection dosage form:
    • Adults and teenagers?500 milligrams (mg) to 4 grams every eightto twelve hours, injected into a muscle or vein. Gonorrhea is treated witha single dose of 1 gram, injected into a muscle.
    • Infants and children 6 months of age and older?50 mg per kilogram(22.72 mg per pound) of body weight every six to eight hours, injected intoa muscle or vein.
    • Infants up to 6 months of age?Use and dose must be determinedby your doctor.

For ceftriaxone
• For bacterial infections:
  • For injection dosage form:
    • Adults and teenagers?1 to 2 grams every twenty-four hours,or 500 milligrams (mg) to 1 gram every twelve hours, injected into a muscleor vein. Gonorrhea is treated with a single 250-mg dose, injected into a muscle.
    • Infants and children?25 to 37.5 mg per kilogram (kg) (11.36to 17.04 mg per pound) of body weight every twelve hours, or 50 to 75 mg perkg (22.72 to 34.09 mg per pound) of body weight once a day, injected intoa muscle or vein. Meningitis is treated with an initial dose of 100 mg perkg, then 100 mg per kg once a day or 50 mg per kg two times a day.

For cefuroxime
• For bacterial infections:
  • For oral suspension dosage form:
    • Adults and teenagers?The oral suspension is usually used onlyfor children. Refer to the dosing for cefuroxime tablets.
    • Infants and children 3 months to 12 years of age?10 to 15 milligrams(mg) per kilogram (kg) (4.54 to 6.81 mg per pound) of body weight every twelvehours for ten days.
  • For tablet dosage form:
    • Adults and teenagers?250 to 500 mg every twelve hours. Gonorrheais treated with a single, oral 1-gram dose.
    • Children up to 12 years of age who can swallow tablets whole?250mg every twelve hours for ten days.
  • For injection dosage form:
    • Adults and teenagers?750 mg to 3 grams every six to eight hoursusually for 5 to 14 days, injected into a muscle or vein. Gonorrhea is treatedwith a single dose of 1.5 grams, injected into a muscle; the total 1.5-gramdose is divided into two doses and injected into muscles at two separate placeson the body, and given along with a single, oral 1-gram dose of probenecid.
    • Infants and children 1 month of age and older?12.5 to 150 mgper kg (5.68 to mg per pound) of body weight every six to eight hours, injectedinto a muscle or vein.
    • Newborns?10 to 100 mg per kg (4.54 to 45.5 mg mg per pound)of body weight every eight to twelve hours, injected into a vein.

For cephalexin
• For bacterial infections:
  • For oral dosage forms (capsules, oralsuspension, or tablets):
    • Adults and teenagers?250 milligrams (mg) to 1 gram every sixto twelve hours.
    • Children 40 kg (88 pounds) of body weight and over?250 mg to1 gram every six to twelve hours.
    • Children 1 year of age and older and up to 40 kg (88 pounds) of bodyweight?6.25 to 25 mg per kilogram (kg) (2.84 to 11.36 mg per pound)of body weight every six hours, or 12.5 to 50 mg per kg (5.68 to 22.72 mgper pound) of body weight every twelve hours.
    • Infants and children 1 month to 1 year of age?6.25 to 12.5mg per kg (2.84 to 5.68 mg per pound) of body weight every six hours.

For cephalothin
• For bacterial infections:
  • For injection dosage form:
    • Adults and teenagers?500 milligrams (mg) to 2 grams every fourto six hours, injected into a muscle or vein.
    • Children?13.3 to 26.6 mg per kilogram (kg) (6.04 to 12.09 mgper pound) of body weight every four hours, or 20 to 40 mg per kg (9.09 to18.18 mg per pound) of body weight every six hours, injected into a muscleor vein.

For cephapirin
• For bacterial infections:
  • For injection dosage form:
    • Adults and teenagers?500 milligrams (mg) to 1 gram every fourto six hours, injected into a muscle or vein.
    • Infants and children 3 months of age and older?10 to 20 mgper kilogram (kg) (4.54 to 9.09 mg per pound) of body weight every six hours,injected into a muscle or vein.

For cephradine
• For bacterial infections:
  • For oral dosage forms (capsules or oralsuspension):
    • Adults and teenagers?250 milligrams (mg) to 1 gram every sixto twelve hours.
    • Infants and children 9 months of age and older?6.25 mg to 1gram per kilogram (kg) (2.84 to 454 mg per pound) of body weight every sixhours, or 12.5 to 50 mg per kg (5.68 to 22.72 mg per pound) of body weightevery twelve hours.

Missed dose?If you miss a dose of this medicine, take it assoon as possible. This will help to keep a constant amount of medicine inthe blood or urine. However, if it is almost time for your next dose, skipthe missed dose and go back to your regular dosing schedule. Do not doubledoses.

Storage?To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store the capsule or tablet form of this medicine in the bathroom,near the kitchen sink, or in other damp places. Heat or moisture may causethe medicine to break down.
• Store the oral liquid form of most cephalosporins in the refrigeratorbecause heat will cause this medicine to break down. However, keep the medicinefrom freezing. Follow the directions on the label. Cefixime oral suspension(Suprax) , cefuroxime axetil oral suspension (Ceftin), and cefdinir oral suspension (Omnicef) do not need to be refrigerated.
• Do not keep outdated medicine or medicine no longer needed. Be surethat any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

If yoursymptoms do not improve within a few days, or if they become worse, checkwith your doctor.

For patients with diabetes:

• This medicine may cause false test results withsome urine sugar tests. Check with your doctor before changing yourdiet or the dosage of your diabetes medicine.

For patients with phenylketonuria (PKU):

• Cefprozil oral suspension ( Cefzil) containsphenylalanine. Check with your doctor before taking this medicine.

In some patients, cephalosporins may cause diarrhea:

• Severe diarrhea may be a sign of a serious side effect. Do not take any diarrhea medicine without first checking with your doctor. Diarrhea medicines may make your diarrhea worse or make it last longer.
• For mild diarrhea, diarrhea medicine containing kaolin or attapulgite(e.g., Kaopectate tablets, Diasorb) may be taken. However, other kinds of diarrhea medicine shouldnot be taken. They may make your diarrhea worse or make it last longer.
• If you have any questions about this or if mild diarrhea continuesor gets worse, check with your health care professional.

For patients receiving cefamandole, cefoperazone, orcefotetan by injection:

• Drinking alcoholic beverages or taking other alcohol-containing preparations(for example, elixirs, cough syrups, tonics, or injections of alcohol) whilereceiving these medicines may cause problems. The problems may occur if youconsume alcohol even several days after you stop taking the cephalosporin.Drinking alcoholic beverages may result in increased side effects such asabdominal or stomach cramps, nausea, vomiting, headache, fainting, fast orirregular heartbeat, difficult breathing, sweating, or redness of the faceor skin. These effects usually start within 15 to 30 minutes after you drinkalcohol and may not go away for up to several hours. Therefore, you should not drink alcoholic beverages or take other alcohol-containingpreparations while you are receiving these medicines and for several daysafter stopping them.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects.Although not all of these side effects may occur, if they do occur they mayneed medical attention.

Check with your doctor immediately if any ofthe following side effects occur:

More common

Black, tarry stools; chest pain; chills; cough; fever; painful or difficult urination; shortness of breath; sore throat; sores, ulcers, or white spots on lips or in mouth; swollen glands; unusual bleeding orbruising (more common for cefamandole, cefoperazone, cefotetan and cefuroxime); unusual tiredness or weakness

Less common or rare

Abdominal or stomach cramps and pain (severe); abdominal tenderness; diarrhea (watery and severe,which may also be bloody); hives or welts, itchingredness of skin, or skin rash; pain, redness andswelling at site of injection; peeling of skin; seizures

Note:

Some of these side effects also may occur up to several weeks afteryou stop taking this medicine.

Rare

Blistering, peeling, or loosening of skin; decrease in urine output; hearing loss (more commonwith cefuroxime treatment for meningitis); jointpain; loss of appetite, nausea, or vomiting (morecommon with ceftriaxone); red or irritated eyes; trouble in breathing; yellowing of theeyes or skin

Other side effects may occur that usually do not need medicalattention. These side effects may go away during treatment as your body adjuststo the medicine. However, check with your doctor if any of the following sideeffects continue or are bothersome:

More common (less common with some cephalosporins)

Diarrhea (mild); headache; sore mouth or tongue; stomach cramps(mild); vaginal itching or discharge

Other side effects not listed abovemay also occur in some patients. If you notice any other effects, check withyour doctor.

Additional Information

Once a medicine has been approved for marketingfor a certain use, experience may show that it is also useful for other medicalproblems. Although these uses are not included in product labeling, cephalosporinsare used in certain patients with the following medical conditions:

• Amoxicillin-resistant sinusitis (treatment)?Cefaclor
• Bacterial endocarditis (Prophylaxis)?Cefadroxil, cefazolin,and cephalexin
• Melioidosis (treatment)?Ceftazidime

Other than the above information, there is no additional information relatingto proper use, precautions, or side effects for these uses.