cefditoren (Rx)

Brand and Other Names:Spectracef

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 200mg
  • 400mg

Chronic Bronchitis

Acute Bacterial Exacerbation of Chronic Bronchitis

400 mg PO q-12hr for 10 days

Pneumonia

Community-acquired

400 mg PO q12hr for 14 days

Other Infections

Pharyngitis, Tonsilitis, Uncomplicated Skin and Skin Structure Infections

200 mg PO q12hr for 10 days

Renal Impairment

CrCl 30-49 mL/minute/1.73 sq.meter: No more than 200 mg PO q12hr

CrCl <30 mL/minute/1.73/sq.meter: 200 mg PO qDay

End-stage: Dosing not established

Other Information

Take with meal to enhance absorption

Other Indications & Uses

(H. influenzae, H. parainfluenzae, S. pneumoniae, M. catarrhalis); pharyngitis/tonsillitis (S. pyogenes); skin infections (S. aureus, S. pyogenes)

<12 years old: Safety & efficacy not established

>12 years old: As in adults

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Interactions

Interaction Checker

and cefditoren

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (9)

              • argatroban

                cefditoren will increase the level or effect of argatroban by anticoagulation. Avoid or Use Alternate Drug. cephalosporins may decrease prothrombin activity

              • BCG vaccine live

                cefditoren decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.

              • bivalirudin

                cefditoren will increase the level or effect of bivalirudin by anticoagulation. Avoid or Use Alternate Drug. cephalosporins may decrease prothrombin activity

              • cholera vaccine

                cefditoren, 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.

              • dalteparin

                cefditoren will increase the level or effect of dalteparin by anticoagulation. Avoid or Use Alternate Drug. cephalosporins may decrease prothrombin activity

              • enoxaparin

                cefditoren will increase the level or effect of enoxaparin by anticoagulation. Avoid or Use Alternate Drug. cephalosporins may decrease prothrombin activity

              • fondaparinux

                cefditoren will increase the level or effect of fondaparinux by anticoagulation. Avoid or Use Alternate Drug. cephalosporins may decrease prothrombin activity

              • heparin

                cefditoren will increase the level or effect of heparin by anticoagulation. Avoid or Use Alternate Drug. cephalosporins may decrease prothrombin activity

              • microbiota oral

                cefditoren decreases effects of microbiota oral by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Microbiota oral contains bacterial spores. Antibacterial agents may decrease efficacy if coadministered. Complete antibiotic regimens 2-4 days before initiating microbiota oral. .

              Monitor Closely (26)

              • aluminum hydroxide

                aluminum hydroxide will decrease the level or effect of cefditoren by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • azithromycin

                azithromycin decreases effects of cefditoren by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

              • bazedoxifene/conjugated estrogens

                cefditoren 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.

              • calcium carbonate

                calcium carbonate will decrease the level or effect of cefditoren by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • cimetidine

                cimetidine will decrease the level or effect of cefditoren by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • clarithromycin

                clarithromycin decreases effects of cefditoren by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

              • demeclocycline

                demeclocycline decreases effects of cefditoren by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

              • dexlansoprazole

                dexlansoprazole will decrease the level or effect of cefditoren by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • dienogest/estradiol valerate

                cefditoren 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.

              • doxycycline

                doxycycline decreases effects of cefditoren by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

              • erythromycin base

                erythromycin base decreases effects of cefditoren by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

              • erythromycin ethylsuccinate

                erythromycin ethylsuccinate decreases effects of cefditoren by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

              • erythromycin lactobionate

                erythromycin lactobionate decreases effects of cefditoren by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

              • erythromycin stearate

                erythromycin stearate decreases effects of cefditoren by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

              • estrogens conjugated synthetic

                cefditoren will decrease the level or effect of estrogens conjugated synthetic by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • famotidine

                famotidine will decrease the level or effect of cefditoren by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • ibuprofen/famotidine

                ibuprofen/famotidine will decrease the level or effect of cefditoren by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • minocycline

                minocycline decreases effects of cefditoren by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

              • nizatidine

                nizatidine will decrease the level or effect of cefditoren by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • probenecid

                probenecid will increase the level or effect of cefditoren by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.

              • sodium bicarbonate

                sodium bicarbonate will decrease the level or effect of cefditoren by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • sodium picosulfate/magnesium oxide/anhydrous citric acid

                cefditoren 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.

              • sodium zirconium cyclosilicate

                sodium zirconium cyclosilicate will decrease the level or effect of cefditoren by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Check specific recommendations for drugs that exhibit pH-dependent solubility that may affect their systemic exposure and efficacy. In general, administer drugs at least 2 hr before or after sodium zirconium cyclosilicate.

              • tetracycline

                tetracycline decreases effects of cefditoren by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

              • voclosporin

                voclosporin, cefditoren. 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

                cefditoren increases effects of warfarin by unspecified interaction mechanism. Use Caution/Monitor.

              Minor (5)

              • chloramphenicol

                chloramphenicol decreases effects of cefditoren by pharmacodynamic antagonism. Minor/Significance Unknown.

              • choline magnesium trisalicylate

                cefditoren will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • furosemide

                cefditoren increases toxicity of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of nephrotoxicity.

              • rose hips

                rose hips will increase the level or effect of cefditoren by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • willow bark

                cefditoren will increase the level or effect of willow bark by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

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              Adverse Effects

              >10%

              Diarrhea (11-15%)

              1-10%

              Nausea (4-6%)

              Headache (2-3%)

              Abdominal pain (2%)

              Dyspepsia (1-2%)

              Vomiting (1%)

              <1%

              Bacterial/fungal superinfection

              C. difficile colitis

              Hypersensitivity

              Increased bleeding time

              Stevens-Johnson syndrome

              Vaginal moniliasis

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              Warnings

              Contraindications

              Documented hypersensitivity to drug, penicillin, related compounds, or milk protein sodium caseinate; carnitine deficiency or inborn errors of metabolism that may result in clinically significant carnitine deficiency

              Cautions

              May cause diarrhea, nausea, and vaginal moniliasis (yeast infection); pseudomembranous colitis may occur; clinical manifestations of carnitine deficiency may occur with prolonged use; prolonged use may result in emergence and overgrowth of resistant organisms; caution in breastfeeding

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              Pregnancy & Lactation

              Pregnancy Category: B

              Lactation: excretion in milk unknown; 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: 1.2-2 hr

              Peak Plasma Time: 1.5-3 hr

              Excretion: urine

              Mechanism of Action

              Semi-synthetic cephalosporin administered as prodrug. Hydrolyzed by esterases during absorption and distributed in circulating blood as active cefditoren. Bactericidal activity results from inhibition of cell wall synthesis via affinity for penicillin-binding proteins. No dose adjustment necessary for mild renal impairment (CrCl 50-80 mgL/min/1.73 m2) or mild to moderate hepatic impairment.

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              Patient Handout

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              Formulary

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              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
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              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
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              Code Definition
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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.