cefprozil (Rx)

Brand and Other Names:Cefzil
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 250mg
  • 500mg

oral suspension

  • 125mg/5mL
  • 250mg/5mL

Pharyngitis & Tonsillitis

Caused by S. Pyogenes

500 mg PO qDay for 10 days

Respiratory Tract Infections

250-500 mg PO q12hr for10 days

Skin Infections

250-500 mg q12hr OR 500 mg qDay for10 days

Renal Impairment

CrCl <30 mL/min: Give 1/2 usual dose

Other Indications & Uses

Spectrum similar to cefuroxime; used for respiratory tract infections & otitis media

B. fragilis, C. perfringens, E. coli, H. influenzae, Klebsiella spp., M. catarrhalis, S. aureus, S. pyogenes

Dosage Forms & Strengths

tablet

  • 250mg
  • 500mg

oral suspension

  • 125mg/5mL
  • 250mg/5mL

Acute Otitis Media

6 months old-12 years old: 30 mg/kg/day divided q12hr PO x 10 days  

Acute Sinusitis

6 months old-12 years old: 15-30 mg/kg/day divided q12hr PO x10 days  

Pharyngitis & Tonsillitis

2-12 years old: 15 mg/kg/day divided q12hr PO x10 days  

Skin Infections

2-12 years old: 20 mg/kg PO qDay x10 days  

>12 years

As in adults

Pharyngitis & Tonsillitis

Caused by S. Pyogenes 500 mg PO qDay for 10 days

Respiratory Tract Infections

250-500 mg PO q12hr for10 days

Skin Infections

250-500 mg q12hr OR 500 mg qDay for10 days

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Interactions

Interaction Checker

and cefprozil

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    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            1-10%

            Nausea (3.5%)

            Diarrhea (2.9%)

            Elevated LFTs (2%)

            Diaper rash (1.5%)

            Abdominal pain (1%)

            Dizziness (1%)

            Vomiting (1%)

            eosinophilia

            superinfection

            vaginitis

            <1%

            Eosinophilia

            Superinfection

            Vaginitis

            Cholestatic jaundice

            Elevated BUN & creatinine

            Prolonged PT

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            Warnings

            Contraindications

            Documented hypersensitivity

            Cautions (additional)

            Oral suspension contains aspartame; not indicated for patients with phenylketonuria

            Careful inquiry should be made to determine if patient has had previous hypersensitivity to cephalosporins, penicillins or similar drugs; cross sensitivity reported among beta-lactam antibiotics; discontinue therapy if reaction occurs

            Hypersensitivity reactions may require treatment with epinephrine and emergency measures, including intravenous fluids, oxygen, corticosteroids, intravenous antihistamines, pressor amines, and airway management as indicated

            Prescribing antibiotics in the absence of proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to patient and increases risk of development of drug-resistant bacteria

            Prolonged use of therapy may result in overgrowth of nonsusceptible organisms; careful observation of patient essential; if superinfection occurs during therapy, appropriate measures should be taken

            Cefprozil should be prescribed with caution in individuals with a history of gastrointestinal disease particularly colitis

            Positive direct Coombs’ tests have been reported during treatment with cephalosporin antibiotics.

            Renal impairment

            • In patients with known or suspected renal impairment, careful clinical observation and appropriate laboratory studies should be done prior to and during therapy; total daily dose of drug should be reduced in these patients because high and/or prolonged plasma antibiotic concentrations can occur in such individuals from usual doses
            • Therapy should be given with caution to patients receiving concurrent treatment with potent diuretics since these agents are suspected of adversely affecting renal function

            Clostridium difficile associated diarrhea (CDAD)

            • CDAD reported; may range in severity from mild diarrhea to fatal colitis; treatment with antibacterial agents alters normal flora of colon leading to overgrowth of C. difficile, which produces toxins A and B and contribute to development of CDAD
            • Hypertoxin-producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy
            • CDAD must be considered in all patients who present with diarrhea following antibiotic use; careful medical history necessary since CDAD has been reported to occur over two months after administration of antibacterial agents
            • If CDAD suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued; appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated
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            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: low distribution into breast milk; use with 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

            Half-Life: 1.3 hr

            Peak Plasma Time: 1.5 hr

            Protein Bound: 35-45%

            Absorption: oral 94%

            Metabolism: liver

            Excretion: unchanged in urine: 61%

            Mechanism of Action

            Second-generation cephalosporin that binds to one or more of the penicillin-binding proteins, which in turn inhibits cell wall synthesis and results in bactericidal activity. Has gram-positive activity that first-generation cephalosporins have and adds activity against P mirabilis, H influenzae, E coli, K pneumoniae, and M catarrhalis

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

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

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            • View the formulary and any restrictions for each plan.
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            • Compare formulary status to other drugs in the same class.
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            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.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.