Second-generation cephalosporin (oral axetil prodrug) indicated for pharyngitis/tonsillitis, acute otitis media, sinusitis, acute exacerbations of chronic bronchitis, uncomplicated urinary tract infections and skin/soft-tissue infections.
Also known as: Cefuroxima, Zinnat
DailyMed approved label (Cefuroxime Axetil Tablet; setID 76cec54f-d167-4298-951b-5411a3c47f4a).
DailyMed approved label (Cefuroxime Axetil Tablet; setID 76cec54f-d167-4298-951b-5411a3c47f4a).
Cefuroxime + probenecid: probenecid increases systemic exposure to cefuroxime — combination not recommended.
The FDA cefuroxime label documents: "Co-administration with probenecid increases systemic exposure to cefuroxime axetil tablets and is therefore not recommended" (section 7.3). Probenecid blocks the renal tubular secretion of cefuroxime, raising its serum concentrations and prolonging exposure. Although the combination was historically explored to prolong antibiotic levels, it is not recommended in current practice — the increased exposure may potentiate dose-dependent adverse effects (neurotoxicity, diarrhoea, skin reactions). The practical guidance is to avoid the combination; if probenecid is essential (e.g., uricosuric in a gout patient with infection), consider reducing the cefuroxime dose and monitor for signs of toxicity.
Cefuroxime + probenecid: probenecid increases systemic exposure to cefuroxime — combination not recommended.
The FDA cefuroxime label documents: "Co-administration with probenecid increases systemic exposure to cefuroxime axetil tablets and is therefore not recommended" (7.3). Probenecid blocks cefuroxime tubular secretion, raising its serum concentrations.
Monitor for signs of toxicity if the combination is used.
Increased adverse effects or neurotoxicity with the combination.
Avoid the combination; if probenecid is essential, consider reducing the cefuroxime dose.
DailyMed/FDA (NIH/NLM) — approved Cefuroxime axetil label (WOCKHARDT), section 7.3: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=708b7a4d-ba1f-47b5-be4d-a01c2a7017ff ; approved Probenecid label (MARLEX): https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5d552de5-2d18-4464-bcaf-0311fa3f080d
Cefuroxime + oral contraceptives: effects on gut flora may reduce contraceptive efficacy.
The FDA cefuroxime label documents: "Oral Contraceptives: Effects on gut flora may lower estrogen reabsorption and reduce efficacy of oral contraceptives" (section 7.1). Broad-spectrum antibiotics may alter gut flora and reduce oestrogen reabsorption, compromising the contraceptive reliability of combined oral contraceptives. The risk is higher with prolonged therapy, but the precaution applies to any antibiotic course. The practical guidance is to advise users about the risk of reduced efficacy during and up to 7 days after antibiotic therapy and consider an additional barrier method; watch for spotting or breakthrough bleeding as a sign of possible loss of efficacy. Levonorgestrel (including the hormonal IUD) is not affected by this mechanism — the interaction applies mainly to combined oral contraceptives.
Cefuroxime + oral contraceptives: gut flora changes may reduce contraceptive efficacy — consider a barrier method.
The FDA cefuroxime label documents: "Oral Contraceptives: Effects on gut flora may lower estrogen reabsorption and reduce efficacy of oral contraceptives" (7.1). Broad-spectrum antibiotics may alter gut flora and reduce oestrogen reabsorption, compromising contraceptive reliability.
Watch for spotting/breakthrough bleeding as a sign of possible loss of efficacy.
Breakthrough bleeding or unplanned pregnancy during cefuroxime antibiotic therapy.
Advise users of oral contraceptives about the reduced efficacy risk during and up to 7 days after antibiotic therapy; consider an additional barrier method.
DailyMed/FDA (NIH/NLM) — approved Cefuroxime axetil label (WOCKHARDT), section 7.1: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=708b7a4d-ba1f-47b5-be4d-a01c2a7017ff ; approved Levonorgestrel label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=07567b80-d8a1-41c0-95e4-33afa584bbc4
Cefuroxime + antacids: antacids reduce the bioavailability of oral cefuroxime axetil.
The FDA cefuroxime label documents: "Drugs that reduce gastric acidity may lower the bioavailability of cefuroxime axetil tablets" (section 7.2). Oral cefuroxime axetil is a prodrug whose absorption depends on an acidic gastric pH; antacids (and also proton pump inhibitors and H2 antagonists) reduce that absorption and may compromise antibiotic efficacy. The clinical consequence is therapeutic failure in an orally treated infection. The practical guidance is to separate cefuroxime from antacids by 2-3 hours and assess clinical response; in severe infections or in patients with dyspepsia requiring continuous acid suppression, consider the parenteral route or an alternative antibiotic.
Cefuroxime + antacids: antacids reduce the bioavailability of oral cefuroxime axetil — separate doses.
The FDA cefuroxime label documents: "Drugs that reduce gastric acidity may lower the bioavailability of cefuroxime axetil tablets" (7.2). Oral cefuroxime axetil requires an acidic gastric pH for absorption; antacids reduce that absorption and may compromise antibiotic efficacy.
Assess clinical response to antibiotic therapy during the combination.
Therapeutic failure of antibiotic therapy with simultaneous antacid intake.
Separate oral cefuroxime from antacids by 2-3 hours.
DailyMed/FDA (NIH/NLM) — approved Cefuroxime axetil label (WOCKHARDT), section 7.2: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=708b7a4d-ba1f-47b5-be4d-a01c2a7017ff ; approved Antacids label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=0a13ac81-0c63-48c1-bbb0-f6e67f97b896
Alcohol may worsen the gastrointestinal effects of cefuroxime; limit intake.
Limit alcohol intake during treatment.
DailyMed/FDA (NIH/NLM) — approved Cefuroxime Axetil label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=76cec54f-d167-4298-951b-5411a3c47f4a
Cefuroxime axetil should be taken after meals: food improves its absorption and reduces gastrointestinal discomfort.
Take immediately after a meal.
DailyMed/FDA (NIH/NLM) — approved Cefuroxime Axetil label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=76cec54f-d167-4298-951b-5411a3c47f4a
Cefuroxime is renally excreted; in renal impairment the dose must be adjusted.
Adjust the dose to renal function.
DailyMed/FDA (NIH/NLM) — approved Cefuroxime Axetil label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=76cec54f-d167-4298-951b-5411a3c47f4a
Cefuroxime is a cephalosporin; it is contraindicated in prior cephalosporin allergy and requires caution in severe penicillin allergy.
Contraindicated in cephalosporin allergy; caution in severe penicillin allergy.
DailyMed/FDA (NIH/NLM) — approved Cefuroxime Axetil label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=76cec54f-d167-4298-951b-5411a3c47f4a
Cephalosporins, including cefuroxime, are generally safe in pregnancy when indicated.
May be used in pregnancy when indicated, at the usual doses.
Excreted into breast milk in small amounts; compatible with breastfeeding.
No specific additional contraception.
DailyMed/FDA (NIH/NLM) — approved Cefuroxime Axetil label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=76cec54f-d167-4298-951b-5411a3c47f4a
Clinical and educational support tool. The information does not replace a medical prescription or the opinion of a qualified healthcare professional.
Second-generation cephalosporin: time above the MIC is the predictive efficacy parameter. Extended Gram-negative spectrum, including beta-lactamase-producing strains of H. influenzae and M. catarrhalis.
Inhibition of cell-wall synthesis by binding to PBPs; axetil (oral prodrug) is hydrolyzed by intestinal mucosa and blood esterases to active cefuroxime.
Oral absorption is enhanced with food (bioavailability from 37% fasting to 52% fed); plasma peaks at 2–3 h; elimination half-life ~1.2 h.
Predominantly renal excretion unchanged; elimination half-life prolongs with severity of renal impairment (~3.4 h in moderate/severe impairment).
Mean elimination half-life ~1.2–1.3 h (125–1000 mg tablets).
Medicines from the same therapeutic group (ATC classification) or the same pharmacological class.
