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cefotetan (Rx)Brand and Other Names:

 
 
 

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

injectable solution

  • 20mg/mL
  • 40mg/mL

powder for injection

  • 1g
  • 2g
  • 10g
more...

Skin & Skin Structure (Mild to Moderate)

2 g IV q24hr

Skin & Skin Structure (Severe)

2 g IV q12hr

Urinary Tract

500 mg IV/IM q12hr; 1-2 g IV/IM q24hr; 1-2 g IV/IM q12hr

Other Infection Sites

1-2 g IV/IM q12hr

Severe Infection

2 g IV q12hr

Life-Threatening Infection

3 g IV q12hr

Surgery Infection Prophylaxis

Colorectal, non-perforated appendectomy, hysterectomy: 1-2 g IV

Ruptured viscus: 1-2 g IV q12hr

Renal Impairment

CrCl 10-30 mL/min: Give qDay

CrCl <10 mL/min: Give q48hr

Other Indications & Uses

Dosage and route of administration depends on condition of patient, severity of infection, and susceptibility of causative organism

Bacteroides spp., C. perfringens, E. coli, H. influenzae, Klebsiella spp., M. morganii, N. gonorrhoeae, P. mirabilis, Peptococcus spp., Peptostreptococcus spp., Serratia spp., Staphylococci, group A beta-hemolytic Streptococcus, S. agalactiae, S. epidermidis, S. pyogenes

Dosage Forms & Strengths

injectable solution

  • 20mg/mL
  • 40mg/mL

powder for injection

  • 1g
  • 2g
  • 10g
more...

Severe Infection (Off-label)

40-80 mg/kg/day IV/IM divided q12hr 

Skin & skin structure (mild to moderate)

2 g IV q24hr

Skin & skin structure (severe)

2 g IV q12hr

Urinary tract

500 mg IV/IM q12hr; 1-2 g IV/IM q24hr; 1-2 g IV/IM q12hr

Other infection sites

1-2 g IV/IM q12hr

Severe infection

2 g IV q12hr

Life-threatening infection

3 g IV q12hr

Surgery infection prophylaxis

Colorectal, non-perforated appendectomy, hysterectomy: 1-2 g IV

Ruptured viscus: 1-2 g IV q12hr

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Interactions

Interaction Checker

cefotetan and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            1-10%

            Diarrhea (1%)

            Hepatic enzyme elevation (1%)

            Hypersensitivity reaction (1%)

            <1%

            Prolongation of bleeding time

            Neutropenia

            Thrombocytopenia

            Immune-mediated hemolytic anemia

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            Warnings

            Contraindications (additional)

            Documented hypersensitivity

            Coagulation disorders

            Cautions (additional)

            Reduce dosage by 1/2 if <10-30 mL/min creatinine clearance and by 1/4 if <10 mL/min; (high doses may cause CNS toxicity); bacterial or fungal overgrowth of nonsusceptible organisms may occur with prolonged or repeated therapy

            Associated with rare but potentially fatal hemolytic anemia - monitor as needed

            Current US formulation does not allow direct IV or IM administration

            Inappropriate for pediatric mild-moderate infections (AAP)

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            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: excreted in breast milk, use caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Second-generation cephalosporin used as single-drug therapy to provide broad gram-negative coverage and anaerobic coverage. Also provides some coverage of gram-positive bacteria. Half-life is 3.5 h. Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins; inhibits final transpeptidation step of peptidoglycan synthesis, resulting in cell wall death

            Pharmacokinetics

            Half-Life: 2.8-4.6 hr

            Peak Plasma Time: 1.5-3 hr (IM)

            Protein Bound: 76-90%

            Distribution: Body fluids & tissue, including bile, sputum, prostatic & peritoneal fluids, low in CSF

            Metabolism: Liver

            Excretion: urine primarily unchanged; feces (20%)

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            Administration

            IV Incompatibilities

            Additive: aminoglycosides, heparin, tetracyclines

            Syringe: doxapram, promethazine

            Y-site: cisatracurium(?), promethazine, vancomycin, vinorelbine

            IV Compatibilities

            Solution: D5W, NS

            Y-site: allopurinol, amifostine, aztreonam, bivalirudin, dexmedetomidine, diltiazem, docetaxel, etoposide PO4, famotidine, fenoldopam, filgrastim, fluconazole, fludarabine, gatifloxacin, gemcitabine, granisetron, heparin, Hextend, reg insulin, linezolid, melphalan, meperidine, morphine SO4, paclitaxel, propofol, remifentanil, sargramostim, tacrolimus, teniposide, theophylline, thiotepa

            IV Preparation (for powder)

            Solution: add 10 mL diluent to 1 g vial; withdraw 10.5 mL (95 mg/mL)

            IV Administration

            Intermittent infusion over 20-60 min

            Do not administer with other drugs

            Canadian (but not US) formulations allow for IV inj or deep IM

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Add or Remove Plans
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            Select a box to add or remove a plan.

            Select a class to view formulary status for similar drugs

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