t needed.
CrCl 10—29 mL/min: Reduce frequency to once every 24 hours.
CrCl < 10 mL/min: Reduce frequency to once every 48 hours.
For intravenous/intramuscular formulations:
CrCl > 20 mL/min: No dosage adjustment needed.
CrCl 10—20 mL/min: For adults, give a loading dose of 0.75—1.5 g IV or IM, followed by 750 mg IV or IM every 12 hours. In pediatric patients, the frequency of dosing should be modified consistent with the recommendations for adults.
CrCl < 10 mL/min: For adults, give a loading dose of 0.75—1.5 g IV or IM, followed by 750 mg IV or IM every 24 hours. In pediatric patients, the frequency of dosing should be modified consistent with the recommendations for adults.
Intermittent hemodialysis
Cefuroxime is significantly removed during a standard hemodialysis session. A supplemental IV/IM or oral dose should be given after each dialysis, or the dosing regimen should be timed so that the dose of cefuroxime is scheduled at the end of the dialysis session
ADMINISTRATION
Oral Administration
NOTE: Tablets and suspension are NOT bioequivalent and can not be substituted on a mg/mg basis.
Oral Solid Formulations
Tablets: May be administered without regard to meals. Tablets should be swallowed whole.
Oral Liquid Formulations
Oral Suspension: Must be administered with food. Shake well prior to each use. For accurate dosage, use a calibrated device, such as an oral syringe, calibrated spoon, or dosage cup.
Taste and palatability of the suspension have been reported to be unpleasant, particularly compared with other oral cephalosporins.
Reconstitution of oral suspension
Review the reconstitution instructions for the particular product and package size, as the amount of water required for reconstitution may vary between manufacturers.
Prior to reconstitution, tap the bottle several times to loosen the powder. Add the total amount of water, invert the bottle and vigorously rock the bottle from side to side so that water rises through the powder. Once the sound of the powder against the bottle disappears, turn the bottle upright and vigorously shake it in a diagonal direction.
Storage after reconstitution: After mixing, store suspension in a refrigerator between 2 and 8 degrees C (36 and 46 degrees F). Discard any unused suspension after 10 days.
Injectable Administration
Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit.
Intravenous Administration
Reconstitution
Vials: Reconstitute 750-mg or 1.5-g vial with 8.3 or 16 mL, respectively, of sterile water for injection to give a solution containing 90 mg/mL of cefuroxime.
Pharmacy bulk package: Reconstitute 7.5 g vial with 77 mL of sterile water for injection to give a solution containing 95 mg/mL of cefuroxime.
Storage: Reconstituted solutions are stable for 24 hours at room temperature and for 48 hours (750-mg and 1.5-g vials) or 7 days (7.5-g pharmacy bulk vial) under refrigeration (5 degrees C).
ADD-Vantage vials: Reconstitute only with 5% Dextrose injection, 0.9% Sodium Chloride injection, or 0.45% Sodium Chloride injection in 50 mL or 100 mL flexible diluent container.
Storage: Reconstituted ADD-Vantage vials are stable for 24 hours at room temperature and for 7 days under refrigeration. Joined vials not activated may be used within a 14-day period.
Dilution
For IV infusion, further dilute in compatible solution (i.e., 0.9% Sodium Ch |
