Dosing & Uses
Dosage Forms & Strengths
injectable solution
- 20mg/mL
- 40mg/mL
powder for injection
- 500mg
- 1g
- 2g
- 10g
Gonococcal Urethritis/Cervicitis
0.5 g IM once
Gonorrhea, Rectal
Men: 1 g IM once
Women: 0.5 g IM once
Infections Caused by Susceptible Organisms
Uncomplicated: 1 g IV or IM q12hr
Moderate to severe: 1-2 g IV or IM q8hr
More serious (bloodstream infection [septicemia]): 2 g IV q6-8hr
Life-threatening: 2 g IV q4hr; not to exceed 12 g/day
Preparation for Surgery
Prophylaxis of surgical infection
1 g IM/IV once 30-90 minutes before start of procedure
Dosing Considerations
Susceptible organisms
- Bacteroides spp, Citrobacter spp, Clostridium spp, Enterobacter spp, Escherichia coli, Haemophilus influenzae, Klebsiella spp, Moraxella catarrhalis, Morganella morganii, Neisseria gonorrhoeae, Neisseria meningitidis, Peptococcus spp, Peptostreptococcus spp, Proteus mirabilis, Providencia rettgeri, Pseudomonas spp, Serratia spp, Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus pyogenes
Dosage Forms & Strengths
injectable solution
- 20mg/mL
- 40mg/mL
powder for injection
- 500mg
- 1g
- 2g
- 10g
Infections Caused by Susceptible Organisms
<12 years or <50 kg: 50-200 mg/kg/day IV/IM divided q6-8hr
>12 years or >50 kg: 1-2 g IV/IM q8hr
Epiglottitis
<12 years or <50 kg: 150-200 mg/kg/day IV/IM divided q6hr plus clindamycin for 7-10 days
>12 years or >50 kg: 1-2 g IV/IM q8hr
Meningitis
<12 years or <50 kg: 200 mg/kg/day IV/IM divided q6hr
>12 years or >50 kg: 2 g IV q4-6hr in combination with other antimicrobial therapy as necessary
Pneumonia
<12 years or <50 kg: 200 mg/kg/day IV divided q8hr
>12 years or >50 kg: 1-2 g IV/IM q8hr
Sepsis
<12 years or <50 kg: 150 mg/kg/day IV divided q8hr
>12 years or >50 kg: 2 g IV q6-8hr
Typhoid Fever
<12 years or <50 kg: 150-200 mg/kg/day IV/IM divided q6-8hr; not to exceed 12 g/day
Fluoroquinolone resistant: 80 mg/kg/day IV/IM divided q6-8hr; not to exceed 12 g/day
>12 years or >50 kg: 1-2 g IV/IM q4-8hr
Dosing Considerations
Usual dosage range in children
- 0-1 week: 50 mg/kg IV q12hr
- 1-4 weeks: 50 mg/kg IV q8hr
- 1 month-12 years: 50-180 mg/kg/day IV divided q4-6hr
- >12 years: 1-2 g IV/IM q4-8hr
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (3)
- BCG vaccine live
cefotaxime decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.
- cholera vaccine
cefotaxime, cholera vaccine. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid coadministration of cholera vaccine with systemic antibiotics since these agents may be active against the vaccine strain. Do not administer cholera vaccine to patients who have received oral or parenteral antibiotics within 14 days prior to vaccination.
- typhoid vaccine live
cefotaxime decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.
Monitor Closely (9)
- bazedoxifene/conjugated estrogens
cefotaxime will decrease the level or effect of bazedoxifene/conjugated estrogens by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.
- dienogest/estradiol valerate
cefotaxime will decrease the level or effect of dienogest/estradiol valerate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. An alternate or additional form of birth control may be advisable during concomitant use.
- ethinylestradiol
cefotaxime will decrease the level or effect of ethinylestradiol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.
- levonorgestrel oral/ethinylestradiol/ferrous bisglycinate
cefotaxime will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. Antibiotics may decrease hormonal contraceptive efficacy.
- probenecid
probenecid will increase the level or effect of cefotaxime by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.
- sodium picosulfate/magnesium oxide/anhydrous citric acid
cefotaxime decreases effects of sodium picosulfate/magnesium oxide/anhydrous citric acid by altering metabolism. Use Caution/Monitor. Coadministration with antibiotics decreases efficacy by altering colonic bacterial flora needed to convert sodium picosulfate to active drug.
- ticarcillin
ticarcillin, cefotaxime. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
- voclosporin
voclosporin, cefotaxime. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- warfarin
cefotaxime increases effects of warfarin by unspecified interaction mechanism. Use Caution/Monitor.
Minor (6)
- aminohippurate sodium
cefotaxime will increase the level or effect of aminohippurate sodium by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- chloramphenicol
chloramphenicol decreases effects of cefotaxime by pharmacodynamic antagonism. Minor/Significance Unknown.
- choline magnesium trisalicylate
cefotaxime will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- rose hips
rose hips will increase the level or effect of cefotaxime by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- sulfasalazine
cefotaxime will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- willow bark
cefotaxime will increase the level or effect of willow bark by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Adverse Effects
Frequency Not Defined
Colitis
Diarrhea
Elevated blood urea nitrogen (BUN) and creatinine
Elevated hepatic transaminases
Eosinophilia
Fever
Injection site pain
Nausea
Pruritus
Rash
Thrombocytopenia
Transient neutropenia
Vomiting
Warnings
Contraindications
Documented hypersensitivity to drug or components
Cautions
Potentially life-threatening arrhythmia reported in patients receiving rapid bolus injection through central venous catheter
Prolonged treatment has been associated with granulocytopenia (>10 days)
Change infusion sites to minimize inflammation
Use with caution in patients with history of penicillin allergy
Use with caution in patients with history of colitis
Bacterial or fungal overgrowth of nonsusceptible organisms may occur with prolonged or repeated therapy
May need to adjust dose in renal impairment
Cefotaxime may potentiate the nephrotoxic effects of nephrotoxic drugs, including aminoglycosides, NSAIDs, and furosemide
Pregnancy & Lactation
Pregnancy category: B
Lactation: Drug enters 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.Pharmacology
Mechanism of Action
Binds to penicillin-binding proteins and inhibits final transpeptidation step of peptidoglycan synthesis, resulting in cell-wall death; resists degradation by beta-lactamase; proper dosing and appropriate route of administration are determined by condition of patient, severity of infection, and susceptibility of microorganism
Absorption
Peak plasma time: IM, 30 min
Distribution
Distribution: widely distributed to body tissues and fluids, including aqueous humor, ascitic and prostatic fluids, bone, penetrates CSF when meninges inflamed
Widely distributed to body tissues and fluids, including aqueous humor, ascitic and prostatic fluids, and bone; penetrates CSF when meninges are inflamed
Metabolism
Partially metabolized in liver
Metabolite: Desacetylcefotaxime (active)
Elimination
Half-life: Parent drug, 1-1.5 hr; active metabolite, 1-1.9 hr
Excretion: Urine
Administration
IV Incompatibilities
Additive: Aminoglycosides, aminophylline, sodium bicarbonate
Syringe: Doxapram
Y-site: Allopurinol, filgrastim, fluconazole, gemcitabine, hetastarch, pentamidine
IV Preparation
Intermittent injection: Reconstitute 1 or 2 g with 10 mL SWI
Infusion: Reconstitute infusion bottles with 50 or 100 mL NS or D5W
May be diluted further
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| cefotaxime injection - | 1 gram vial |  | |
| Claforan injection - | 2 gram vial |  | |
| Claforan injection - | 10 gram vial |  | |
| Claforan injection - | 2 gram vial |  | |
| Claforan intravenous - | 2 gram vial |  | |
| Claforan intravenous - | 1 gram vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
cefotaxime injection
CEFOTAXIME - INJECTION
(SEF-oh-TAX-eem)
COMMON BRAND NAME(S): Claforan
USES: Cefotaxime is used to treat a wide variety of bacterial infections. It may also be used to prevent infection from certain surgeries. This medication belongs to a class of drugs known as cephalosporin antibiotics. It works by stopping the growth of bacteria.
HOW TO USE: This medication is given by injection into a muscle or vein as directed by your doctor. If given by injection into a vein, inject the drug slowly over at least 3 minutes to avoid possible serious side effects (such as irregular heartbeat). The dosage is based on your medical condition and response to treatment.If you are using this medication at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.If you are using the frozen pre-mixed solution, thaw the bag at room temperature or in the refrigerator. If the bag is thawed in the refrigerator, let it sit at room temperature at least 1 hour before using. Do not thaw by putting in a water bath or microwaving. After thawing, shake well and squeeze the bag to check for leaks. Discard solution if the bag leaks. Do not re-freeze the solution after thawing.For the best effect, use this antibiotic at evenly spaced times. To help you remember, use this medication at the same time(s) every day.Continue to use this medication for the full time prescribed, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection.Tell your doctor if your condition lasts or gets worse.
SIDE EFFECTS: Swelling, redness, or pain at the injection site may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: easy bruising/bleeding, unusual tiredness, uncontrollable movements, mental/mood changes (such as confusion), seizures, signs of kidney problems (such as change in the amount of urine), signs of liver problems (such as nausea/vomiting that doesn't stop, loss of appetite, stomach/abdominal pain, yellowing eyes/skin, dark urine).Get medical help right away if you have any very serious side effects, including: fast/slow/irregular heartbeat.This medication may rarely cause a severe intestinal condition due to a bacteria called C. difficile. This condition may occur during treatment or weeks to months after treatment has stopped. Tell your doctor right away if you develop: diarrhea that doesn't stop, abdominal or stomach pain/cramping, blood/mucus in your stool.If you have these symptoms, do not use anti-diarrhea or opioid products because they may make symptoms worse.Use of this medication for prolonged or repeated periods may result in oral thrush or a new yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before using cefotaxime, tell your doctor or pharmacist if you are allergic to it; or to other antibiotics (such as penicillins, other cephalosporins); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, stomach/intestinal diseases (such as colitis).Cefotaxime may cause live bacterial vaccines (such as typhoid vaccine) to not work well. Tell your health care professional that you are using cefotaxime before having any immunizations/vaccinations.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Tell your doctor if you are pregnant before using this medication.This medication passes into breast milk in small amounts and is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.This medication may interfere with certain lab tests (including certain urine glucose tests), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: seizures.
NOTES: Do not share this medication with others.Lab and/or medical tests (such as complete blood count, kidney function tests) should be done while you are using this medication. Keep all medical and lab appointments.
MISSED DOSE: It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Do not double the dose to catch up.
STORAGE: Consult the product instructions and your pharmacist for storage details. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised October 2021. Copyright(c) 2022 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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