Mextil
Cefuroxime
Presentation
Mextil 125 tablet: Each film coated tablet contains Cefuroxime axetil BP equivalent to Cefuroxime 125 mg.
Mextil 250 tablet: Each film coated tablet contains Cefuroxime axetil BP equivalent to Cefuoxime 250 mg.
Mextil 500 tablet: Each film coated tablet contains Cefuroxime axetil BP equivalent to Cefuoxime 500 mg.
Mextil powder for suspenion: Each 5 ml reconstituted suspension contains Cefuroxime axetil BP equivalent to Cefuroxime 125 mg.
Mextil DS powder for suspenion: Each 5 ml reconstituted suspension contains Cefuroxime axetil BP equivalent to Cefuroxime 250 mg.
Mextil 250 mg IV/IM Inj: Each vial contains sterile Cefuroxime Sodium USP equivalent to Cefuroxime 250 mg & each ampoule contains 5 ml Water For Injection BP for reconstitution.
Mextil 750 mg IV/IM Inj: Each vial contains sterile Cefuroxime Sodium USP equivalent to Cefuroxime 750 mg & each ampoule contains 10 ml Water For Injection BP for reconstitution.
Mextil 1.5 g IV Inj: Each vial contains sterile Cefuroxime Sodium USP equivalent to Cefuroxime 1.5 g & each ampoule contains 10 ml Water For Injection BP for reconstitution.
Description
Mextil(Cefuroxime) is a well characterized and effective antibacterial agent, which has broad-spectrum bactericidal activity against a wide range of common pathogens, including beta-lactamase producing strains. Cefuroxime has good stability to bacterial beta-lactamase and consequently, is active against many ampicillin-resistant and amoxicillin-resistant strains.
Indications and uses
Mextil (Cefuroxime) is indicated in the treatment of:
1. Upper respiratory tract infections, for example, ear, nose and throat infections such as otitis media, sinusitis, tonsillitis and pharyngitis.
2. Lower respiratory tract infections: for example, acute bronchitis, acute exacerbations of chronic bronchitis and pneumonia.
3. Skin and soft tissue infections: such as furunculosis, pyoderma, and impetigo.
4. Genito-urinary tract infections: such as pyelonephritis, urethritis, and cystitis.
5. Gonorrhoea: acute uncomplicated gonococcal urethritis, and cervicitis.
6. Early Lyme disease and subsequent prevention of late-Lyme disease.
Dosage & administration
Oral
For adult patients:
Most infections will respond to 250 mg b.d.
In mild to moderate lower respiratory tract infections e.g. bronchitis 250 mg b.d. should be given.
For more severe lower respiratory tract infections, or if pneumonia is suspected then 500 mg b.d. should be given.
For urinary tract infections a dose of 125 mg b.d. is usually adequate.
In pyelonephritis the recommended dose is 250 mg b.d. A single dose of one gram is recommended for the treatment of uncomplicated gonorrhoea.
Lyme disease in adults and children over the age of 12 years: the recommended dose is 500 mg b.d. for 20 days.
For Children:
The usual dose is 125 mg b.d., or 10 mg/ kg b.d. to a maximum of 250 mg daily.
For otitis media, in children less than 2 years of age: The usual dosage is 125 mg b.d., or 10 mg/kg b.d. to a maximum of 250 mg daily.
In children over 2 years of age: 250 mg b .d., or 15 mg/kg to a maximum of 500 mg daily.
There is no experience in children under three months of age. The usual course of therapy is seven days.
Cefuroxime should be taken after food for optimum absorption.
Injection:
Adults: Many infections will respond to 750 mg three times daily by IM or IV infection. For more severe infections, this dose should be increased to 1.5 g three times daily by IV. The frequency of IM or IV injection can be increased to six hourly if necessary, giving total doses of 3-6 g daily.
Infants & Children: Doses of 30-100 mg/kg/day given as three or four divided doses. A dose of 60 mg/kg/day will be appropriate for most infections.
Neonates: Doses of 30-100 mg/kg/day given as two or three divided doses.
Prophylaxis: 1.5 g IV with induction of anesthesia followed by 750 mg IM at 8 hours & 16 hours or three times daily for a further 24-48 hours.
Otgher recommendation:
Gonorrhoea: 1.5 g should be given as a single dose. This may be given as 2x750 mg injection (IM) into different sites, e.g. each buttock.
Meningitis:
Adults: 3 g IV every 8 hours. Children (above 3 months of age): 200-240 mg/kg daily IV (in 3-4 divided doses) reduced to 100 mg/kg daily after 3 days or clinically improvement. Neonates: 100 mg/kg daily reduced to 50 mg/kg daily; Bone & joint infections: 1.5 g every 8 hours. Children (above 3 months of age): 150 mg/kg/day (not to exceed the maximum adult dose) every 8 hours.
Contra-indication
Cefuroxime is contraindicated in patients with known allergy to cephalosporins.
Side effects:
Cefuroxime has been associated with nausea and vomiting in a small number of patients.
Acute overdosage
Excessively large doses of all cephalosporins can cause cerebral irritation and may cause convulsions. This complication is unlikely to occur in routine practice unless the patient is in renal failure. Hemodialysis or peritoneal dialysis can remove Cefuroxime.
Precautions
As with other antibiotics, prolonged use of Cefuroxime may result in the over growth of non-susceptible organisms (e.g. Candida, Enterococci, Clostridium diffecile), which may require interruption of treatment. Pseudomonas colitis has been reported with the use of broad-spectrum antibiotics, therefore, it is important to consider its diagnosis in patients who develop serious diarrhoea during of after antibiotic use.
Use in pregnancy & lactation:
While all antibiotics should be avoided in the first trimester if possible, Cefuroxime has been safely used in later pregnancy to treat urinary and other infections. The placental transfer of Cefuroxime into the fetus was studied in 20 women and therapeutically active concentrations were found in the serum of infants for up to 6 hours after delivery. Cefuroxime is excreted in human milk, and consequently caution should be exercised when Cefuroxime is administered to a nursing mother.
Storage condition
Mextil powder for suspenion: Store below 30o C, Protect from light and moisture.
The reconstituted suspension to be stored below 25o C and to be used within 10 days.
Drug interactions: No potentially hazardous interactions have been reported
Commercial Pack
Mextil 125 tablet: Each box contains 2 alu-alu blister strips of 10 tablets.
Mextil 250 tablet: Each box contains 2 alu-alu blister strips of 10 tablets.
Mextil 500 tablet: Each box contains 3 alu-alu blister strips of 4 tablets.
Mextil powder for suspenion: Each amber colored glass bottle containing dry powder to reconstitute 70 ml suspension.
Mextil DS powder for suspenion: Each amber colored glass bottle containing dry powder to reconstitute 50 ml suspension.
Mextil 250 mg IV/IM Inj: Each combipack contains one vial of sterile Cefuroxime Sodium USP equivalent to Cefuroxime 250 mg & one ampoule of 5 ml Water For Injection BP for reconstitution.
Mextil 750 mg IV/IM Inj: Each combipack contains one vial of sterile Cefuroxime Sodium USP equivalent to Cefuroxime 750 mg & one ampoule of 10 ml Water For Injection BP for reconstitution.
Mextil 1.5 g IV Inj: Each combipack contains one vial of sterile Cefuroxime Sodium USP equivalent to Cefuroxime 1.5 g & two ampoule of 10 ml Water For Injection BP for reconstitution.
