cefpodoxime (Rx)

Brand and Other Names:Vantin
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

oral suspension

  • 50mg/5mL
  • 100mg/5mL

tablet

  • 100mg
  • 200mg

Acute Bronchitis & Acute Exacerbations of Chronic Bronchitis

200 mg PO q12hr for 10 days

Acute Community-Acquired Pneumonia

200 mg PO q12hr for 14 days

Acute Maxillary Sinusitis

200 mg PO q12hr for 10 days

Pharyngitis/Tonsillitis

100 mg PO q12hr for 5-10 days

Skin/Skin Structure Infections

400 mg PO q12hr for 7-14 days

Gonorrhea

Uncomplicated gonorrhea in men and women; rectal gonococcal infections in women

200 mg PO once

Urinary Tract Infections

Acute uncomplicated

  • 100 mg PO q12hr 5-7 days

Complicated, including pyelonephritis

  • 200 mg PO q12hr

Dosing Modifications

Renal impairment

  • CrCl <30 mL/min: Give q24hr
  • Hemodialysis: Give 3 times weekly after dialysis

Hepatic impairment

  • Dosage adjustment not necessary

Dosing Considerations

Susceptible organisms

  • Bacteroides fragilis, Clostridium perfringens, Escherichia coli, Haemophilus influenzae, Klebsiella spp, Moraxella catarrhalis, Neisseria gonorrhoeae, Proteus mirabilis, staphylococci, group A beta-hemolytic streptococci, Streptococcus pyogenes

Dosage Forms & Strengths

oral suspension

  • 50mg/5mL
  • 100mg/5mL

tablet

  • 100mg
  • 200mg

General Dosage Range

<2 months: Safety and efficacy not established

2 months to 12 years: 5 mg/kg/day PO q12hr; not to exceed 200 mg/dose

>12 years: 100-400 mg PO q12hr

Acute Maxillary Sinusitis

<2 months: Safety and efficacy not established

2 months-12 years: 5 mg/kg PO q12hr for 10 days; individual doses not to exceed 200 mg  

>12 years: 200 mg PO q12hr for 10 days

Acute Otitis Media

<2 months: Safety and efficacy not established

2 months-12 years: 5 mg/kg PO q12hr for 5 days; individual doses not to exceed 200 mg  

>12 years: 200 mg PO q12hr for 5 days

Pharyngitis/Tonsillitis

<2 months: Safety and efficacy not established

2 months-12 years: 5 mg/kg PO q12hr for 5-10 days; individual doses not to exceed 100 mg  

>12 years: 100 mg PO q12hr for 5-10 days

Chronic Bronchitis, Bacterial Exacerbation

>12 years: 200 mg PO q12hr for 10 days

Cystitis, Acute Uncomplicated

>12 years: 100 mg PO q12hr 5-7 days

Acute Community-Acquired Pneumonia

200 mg PO q12hr for 14 days

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Interactions

Interaction Checker

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              Serious - Use Alternative (9)

              • argatroban

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

              • BCG vaccine live

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

              • bivalirudin

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

              • cholera vaccine

                cefpodoxime, 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

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

              • enoxaparin

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

              • fondaparinux

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

              • heparin

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

              • warfarin

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

              Monitor Closely (30)

              • aluminum hydroxide

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

              • azithromycin

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

              • bazedoxifene/conjugated estrogens

                cefpodoxime 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 cefpodoxime by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • cimetidine

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

              • clarithromycin

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

              • demeclocycline

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

              • didanosine

                didanosine will decrease the level or effect of cefpodoxime by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Applies to didanosine chewable tablets and powder for oral solution; administer 2 hr before or several hours after didanosine oral solution or chewable tablet administration

              • dienogest/estradiol valerate

                cefpodoxime 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.

              • digoxin

                cefpodoxime will increase the level or effect of digoxin by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.

              • doxycycline

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

              • erythromycin base

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

              • erythromycin ethylsuccinate

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

              • erythromycin lactobionate

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

              • erythromycin stearate

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

              • esomeprazole

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

              • famotidine

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

              • minocycline

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

              • nizatidine

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

              • omeprazole

                omeprazole decreases effects of cefpodoxime by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • probenecid

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

              • rabeprazole

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

              • sodium bicarbonate

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

              • sodium citrate/citric acid

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

              • sodium picosulfate/magnesium oxide/anhydrous citric acid

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

              • voclosporin

                voclosporin, cefpodoxime. 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

                cefpodoxime increases effects of warfarin by Other (see comment). Use Caution/Monitor. Comment: Decr vitamin K-producing intestinal flora may increase INR after a few days.

              Minor (5)

              • ceftibuten

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

              • choline magnesium trisalicylate

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

              • furosemide

                cefpodoxime 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 cefpodoxime by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • willow bark

                cefpodoxime 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 in infants and toddlers (15.4%)

              Diaper rash (12.1%)

              1-10%

              Diarrhea (7.4%)

              Nausea (3.8%)

              Vaginal infection (3.1%)

              Vomiting (1.1-2.1%)

              Abdominal pain (1.6%)

              Rash (1.4%)

              Headache (1.1%)

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              Warnings

              Contraindications

              Documented hypersensitivity

              Cautions

              Reduce dosage by 50% if CrCl is 10-30 mL/min and by 75% if CrCl is <10 mL/min (high dosages may cause CNS toxicity)

              Bacterial or fungal overgrowth of nonsusceptible organisms may occur with prolonged or repeated therapy

              Use with caution in patients with history of penicillin allergy

              Use caution in patients with history of beta-lactam allergy, especially IGE mediated reactions, including angioedema, anaphylaxis, urticaria)

              Some dosage forms may contain the metabolite of benzyl alcohol benzoic acid; large amounts of benzyl alcohol associated with potentially fatal toxicity (gasping syndrome) in neonates; avoid or use dosage forms containing benzyl alcohol derivative with caution in neonates

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              Pregnancy & Lactation

              Pregnancy category: B

              Lactation: Drug excreted in breast milk in low concentrations; not recommended

              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

              Bactericidal against gram-positive and gram-negative bacteria; inhibits bacterial cell-wall synthesis by binding to 1 or more of penicillin-binding proteins; bacteria eventually lyse because activity of cell-wall autolytic enzymes continues while cell-wall assembly is arrested

              Absorption

              Bioavailability: 50%; acid stable

              Peak plasma time: ≤1 hr

              Distribution

              Distributed well into tissues, including lungs and tonsils; penetrates into pleural fluid

              Protein bound: 18-23%

              Metabolism

              Metabolized in liver to active metabolite

              Elimination

              Half-life: 2-3 hr; prolonged with renal impairment

              Excretion: Urine (80% as unchanged drug) in 24 hr

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              cefpodoxime oral
              -
              100 mg tablet
              cefpodoxime oral
              -
              200 mg tablet
              cefpodoxime oral
              -
              100 mg/5 mL suspension
              cefpodoxime oral
              -
              50 mg/5 mL suspension
              cefpodoxime oral
              -
              100 mg/5 mL suspension
              cefpodoxime oral
              -
              100 mg tablet
              cefpodoxime oral
              -
              200 mg tablet
              cefpodoxime oral
              -
              100 mg/5 mL suspension
              cefpodoxime oral
              -
              200 mg tablet
              cefpodoxime oral
              -
              100 mg tablet
              cefpodoxime oral
              -
              100 mg/5 mL suspension
              cefpodoxime oral
              -
              50 mg/5 mL suspension
              cefpodoxime oral
              -
              100 mg/5 mL suspension

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              cefpodoxime oral

              CEFPODOXIME PROXETIL - ORAL

              (seff-poh-DOX-eem PROX-eh-til)

              COMMON BRAND NAME(S): Vantin

              USES: This medication is used to treat a wide variety of bacterial infections. This medication is known as a cephalosporin antibiotic. It works by stopping the growth of bacteria.This antibiotic treats only bacterial infections. It will not work for viral infections (such as common cold, flu). Using any antibiotic when it is not needed can cause it to not work for future infections.

              HOW TO USE: Take this medication by mouth, usually every 12 hours or as directed by your doctor.If you are using the tablet form of this medication, take it with food to help increase the absorption of the drug.If you are using the suspension form of this medication, take it with or without food. Shake the bottle well before each dose.The dosage is based on your medical condition and response to therapy. In children, the dose is also based on weight.Medications which reduce or block stomach acid (such as proton pump inhibitors/PPIs, H2 blockers, antacids) may reduce the absorption of cefpodoxime, making it work less well. Ask your doctor or pharmacist how to use PPIs and H2 blockers safely with cefpodoxime. If you take antacids, take the antacids at least 2 hours before or 2 hours after this medication.For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same time(s) every day.Continue to take this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection.Inform your doctor if your condition persists or worsens.

              SIDE EFFECTS: Diarrhea, nausea/vomiting, or headache may occur. If any of these effects persist or worsen, notify 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 any of these unlikely but serious side effects occur: swelling of the ankles/feet, tiredness, fast/pounding heartbeat, trouble breathing, new signs of infection (e.g., fever, persistent sore throat), dark urine, persistent nausea/vomiting, yellowing eyes/skin, easy bruising/bleeding, signs of kidney problems (such as change in the amount of urine).Seek immediate medical attention if any of these rare but very serious side effects occur: vision changes, trouble speaking, mental/mood changes (such as confusion).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 vaginal 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, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction: 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 taking cefpodoxime proxetil, tell your doctor or pharmacist if you are allergic to it; or to penicillins or other cephalosporin antibiotics (e.g., cephalexin); 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 disease (e.g., colitis).This medication may cause live bacterial vaccines (such as typhoid vaccine) to not work as well. Do not have any immunizations/vaccinations while using this medication unless your doctor tells you to.Kidney function declines as you grow older. This medication is removed by the kidneys. Elderly people may be at greater risk for side effects while using this drug.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This drug passes into breast milk and could have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: See also How To Use section.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 laboratory tests (including Coombs' test, certain urine glucose tests), possibly causing false test results. Make sure laboratory 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.

              NOTES: Do not share this medication with others.This medication has been prescribed for your current condition only. Do not use it later for another infection unless your doctor tells you to.

              MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store the tablets at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Do not store in the bathroom.Store the suspension in the refrigerator between 36-46 degrees F (2-8 degrees C) away from light and heat. Do not freeze. Keep the container tightly closed. Throw away any unused medication after 14 days.Keep all medicines 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 for more details about how to safely discard your product.

              Information last revised August 2021. Copyright(c) 2021 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.

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              Formulary

              FormularyPatient Discounts

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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.
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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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              NC NOT COVERED – Drugs that are not covered by the plan.
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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.