Cefepime

(sef' e pim)

PCaution when used during lactation : Caution when used during pregnancy

Molecule Info

 | See TERMINOLOGY & ABBREVIATIONS |
Indication(s) & Dosage Intravenous route
Urinary tract infections
Adult: 0.5-1 g every 12 hr for 7-10 days. May be given via direct inj over 5 minutes or infuse over 30 minutes. 
Child: 2 mth - 16 yr: ≤40 kg: 50 mg/kg every 12 hr for 7-10 days. May be given via direct inj over 5 minutes or infuse over 30 minutes. Dose may also be given via IM inj for mild-moderate infections; for IM inj, it should be given via deep inj into large muscle mass. 


Empiric therapy for febrile neutropenic patients
Adult: 2 g every 8 hr for 7 days or until resolution of neutrpenia. For patients who remain neutropenic for >7 days despite fever resolution, the need for continued anti-microbial treatment should be reviewed. May be given via direct inj over 5 minutes or infuse over 30 minutes. 
Child: 2 mth - 16 yr: ≤40 kg: 50 mg/kg every 8 hr for 7 days or until neutropeniaresolves. May be given via direct inj over 5 minutes or infuse over 30 minutes. 

Moderate to severe pneumonia
Adult: 1-2 g every 12 hr for 10 days. May be given via direct inj over 5 minutes or infuse over 30 minutes. 
Child: 2 mth - 16 yr: ≤40 kg: 50 mg/kg every 12 hr for 10 days. May be given via direct inj over 5 minutes or infuse over 30 minutes. 

Complicated intra-abdominal infections
Adult: 2 g every 12 hr for 7-10 days. Usually used in combination with metronidazole. May be given via direct inj over 5 minutes or infuse over 30 minutes. 


Uncomplicated skin and skin structure infections
Adult: 2 g every 12 hr for 10 days. May be given via direct inj over 5 minutes or infuse over 30 minutes. 
Child: 2 mth - 16 yr: ≤40 kg: 50 mg/kg every 12 hr for 10 days. May be given via direct inj over 5 minutes or infuse over 30 minutes. 

Renal impairment: Haemodialysis: 1 g on the 1st day of treatment, followed by 500 mg every 24 hr; dose should be given after haemodialysis on dialysis days and preferably at the same time each day. CAPD: Normal recommended doses every 48 hr.

CrCl (ml/min) Dosage Recommendation
30-60 2 g every 24 hr.
11-29 1 g every 24 hr.
≤10 0.5 g every 24 hr.
Incompatibility: Y-site admin: Acyclovir, amphotericin B, amphotericin B cholesteryl sulfate complex, chlordiazepoxide, chlorpromazine, cimetidine, famotidine, ciprofloxacin, filgrastim, floxuridine, ganciclovir, haloperidol, hydroxyzine, idarubicin, ifosfamide, magnesium sulfate, mannitol, mechlorethamine, meperidine, metoclopramide, mitomycin, mitoxantrone, morphine, nalbuphine, ofloxacin, ondansetron, plicamycin, prochlorperazine edisylate, promethazine, streptozocin, vancomycin, vinblastine, vincristine, cisplatin, dacarbazine, daunorubicin, diazepam, diphenhydramine, dobutamine, dopamine, doxorubicin, droperidol, enalaprilat, etoposide, etoposide phosphate. Admixture incompatibility: Metronidazole, vancomycin, gentamicin, tobramycin, netilmicin sulfate, aminophylline or solutions of ampicillin at concentrations >40 mg/ml.
Administration Erythromycin base: Should be taken on an empty stomach. Best taken on an empty stomach at least ½ hr & preferably 2 hr before meals.
Overdosage Symptoms include encephalopathy, myoclonus, seizures and neuromuscular excitability. Careful observation and supportive treatment are recommended. In the presence of renal insufficiency, haemodialysis may be used to remove cefepime from the body.
Contraindications Hypersensitivity to cefepime or other cephalosporins.
Special Precautions Renal impairment; history of penicillin or cephalosporin allergy; lactation, pregnancy. Caution when used in patients with history of GI diseases, especially colitis. May decrease prothrombin activity; monitor prothrombin time in patients with poor nutritional state, renal or hepatic impairment and those on prolonged treatment. Prolonged treatment may result in overgrowth of nonsusceptible organisms, resulting in superinfection. Consider the possibility of Clostridium difficile associated diarrhoea in patients who present with diarrhoea after treatment. Caution when used in patients with a history of seizures.
Adverse Drug Reaction(s) Positive Coombs' test without haemolysis; rash, pruritus; diarrhoea, nausea, vomiting; fever, headache; pain and erythema at inj site; agranulocytosis; anaphylactic shock; leucopenia; neutropenia; thrombocytopenia.
Drug Interactions Increased effect with high-dose probenecid; increased nephrotoxic potential with aminoglycosides. Please consult detailed drug interactions before prescribing.
Pregnancy Category (FDA) Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1sttrimester (and there is no evidence of a risk in later trimesters).
Storage Intravenous: In dry state: Store at 2-25°C and protected from light. After reconstitution: Cefepime solution is stable for 24 hr at controlled room temperature (2-25°C) and for 7 days under refridgeration (2-8°C).
Pharmacology Cefepime is a 4th generation cephalosporin which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall by binding to one or more of the penicillin-binding proteins (PBPs).
Absorption: IM admin: Rapid and almost complete absorption.
Distribution: 16-19% bound to plasma proteins. Volume of distribution: 14-20 L; crosses the blood brain barrier. Penetrates into inflammatory fluid at concentrations of about 80% of serum levels.
Metabolism: Minimally hepatic.
Excretion: Plasma half-life: 2 hr. Excreted in urine with 85% as unchanged drug.
ATC Classification J01DE01 - cefepime.

Brand/Product Info


Total Products : 29                             
Brand Name Manufacturer/Marketer Composition Dosage Form Pack Size & Price
CEFA-4 2gm I/V Popular Pharmaceuticals Ltd. Cefepime hydrochloride 2gm (I/V) with water Injection 2gm: 1100.00 MRP
CEFA-4 IM/IV Popular Pharmaceuticals Ltd. Cefepime hydrochloride 500mg & 1gm (IV/IM) with water Injection 500mg,1gm: 300.00 & 550.00 MRP
CEFTIPIME 2gm I/V Renata Limited Cefepime hydrochloride 2gm (I/V) with water Injection 2gm: 1104.15 MRP
CEFTIPIME IM/IV Renata Limited Cefepime hydrochloride 500mg & 1gm (IV/IM) with water Injection 500mg,1gm: 301.13 & 552.08 MRP
EFEPIME IM/IV Ziska Pharmaceuticals Ltd. Cefepime hydrochloride 500mg & 1gm (IV/IM) with water Injection 500mg,1gm: 300.00 & 550.00 MRP
FORGEN 2gm I/V Aristopharma Ltd. Cefepime hydrochloride 2gm (I/V) with water Injection 2gm: 1100.00 MRP
FORGEN IM/IV Aristopharma Ltd. Cefepime hydrochloride 500mg & 1gm (IV/IM) with water Injection 500mg,1gm: 300.00 & 550.00 MRP
GEN 4 I/V IBN SINA Pharmaceutical Industry Ltd. Cefepime hydrochloride 2gm (I/V) with water Injection 2gm: 1010.00 IP
GEN 4 IM/IV IBN SINA Pharmaceutical Industry Ltd. Cefepime hydrochloride 500mg & 1gm (IV/IM) with water Injection 500mg,1gm: 305.00, 555.00 IP
JAPIME IM/IV Jayson Pharmaceuticals Ltd. Cefepime hydrochloride 1gm (I/V) with water Injection 1gm (combipack): 526.98 IP
MAXPIME 1G Square Pharmaceuticals Ltd. Cefepime 1 gm IM/IV Injection 1x1's: 551.65 MRP
MAXPIME 500 Square Pharmaceuticals Ltd. Cefepime 500mg IM/IV Injection 1x1's: 300.90 MRP
MEGAPIME IM/IV Eskayef Bangladesh Ltd Cefepime 500mg & 1gm as Cefepime Hydrochloride USP IV/IM Injection 500mg & 1gm, MRP: 300.00 & 550.00
MEGAPIME IV Eskayef Bangladesh Ltd Cefepime 2gm as Cefepime Hydrochloride USP IV Injection 2gm MRP: 1100.00
PIME-4 2gm ACI Ltd. Cefepime hydrochloride 2gm (I/V) with water Injection 2gm: 1104.15 MRP
PIME-4 IM/IV ACI Ltd. Cefepime hydrochloride 500mg & 1gm (IV/IM) with water Injection 500mg,1gm: 301.13 & 552.07 MRP
TETRACEF 1G Beximco Pharmaceuticals Ltd Cefepime 1gm IV/IM Injection 1's: 550.00 MRP
TETRACEF 2G Beximco Pharmaceuticals Ltd Cefepime 2gm IV Injection 1's: 1100.00 MRP
TETRACEF 500 Beximco Pharmaceuticals Ltd Cefepime 500mg IV/IM Injection 1's: 300.00 MRP
TUPIME Kemiko Pharmaceuticals Ltd Cefepime hydrochloride 1gm (I/V) with water Injection 1gm: 550.00 MRP
Ultrapime Incepta Pharmaceuticals Limited Cefepime 500mg as Cefepime Hydrochloride USP IM/IV Injection 1x1's:MRP 300 Tk
Ultrapime 1g Incepta Pharmaceuticals Limited Cefepime 1 gm as Cefepime Hydrochloride USP IM/IV Injection 1x1's:MRP 550 Tk
UNIPIM Drug International Ltd Cefepime hydrochloride 500mg & 1gm (IV/IM) with water Injection 500mg,1gm: 230.00 & 401.00 MRP
WINNIPIME 2gm I/V Sanofi Cefepime hydrochloride 2gm (I/V) with water Injection 2gm (combipack): 1100.00 MRP
WINNIPIME IM/IV Sanofi Cefepime hydrochloride 500mg & 1gm (IV/IM) with water Injection 500mg & 1gm (combipack): 300.00 & 550.00 MRP
XENIM IM/IV Opsonin Pharma Limited Cefepime hydrochloride 500mg & 1gm (IV/IM) with water Injection 500mg,1gm: 300.00 & 550.00 MRP
XIMEPIME IM/IV Globe Pharmaceuticals Ltd Cefepime hydrochloride 500mg & 1gm (IV/IM) with water Injection 500mg,1gm: 300.00 & 550.00 MRP
ZOPIME 1gm Healthcare Pharmacuticals Ltd. Cefepime 1gm as Cefepime Hydrochloride USP Injection 1gm, MRP 550 Tk
ZOPIME 500mg Healthcare Pharmacuticals Ltd. Cefepime 500mg as Cefepime Hydrochloride USP Injection 500mg, MRP 300 Tk

Gen. MedInfo

Why is Cefepime prescribed?

Cefepime eliminates bacteria that cause many infections, including pneumonia and skin and urinary tract infections. Cefepime is sometimes prescribed for other uses; ask your doctor or pharmacist for more information. The drug will be either injected into a large muscle (such as your buttock or hip) or added to an intravenous fluid that will drip through a needle or catheter placed in your vein for 30 minutes, one or two times a day.

Your health care provider (e.g. doctor) may measure the effectiveness and side effects of your treatment using laboratory tests and physical examinations. It is important to keep all appointments with your doctor and the laboratory. The length of treatment depends on how your infection and symptoms respond to the medication.

Precautions

Before administering cefepime,

  • inform your doctor if you are allergic to cefepime, penicillin, cephalosporins [cefaclor, cefadroxil, or cephalexin], or any other drugs.
  • inform your doctor what prescription and nonprescription medications you are taking, including vitamins.
  • inform your doctor if you have or have ever had kidney, liver, or gastrointestinal disease (especially colitis).
  • inform your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking cefepime, call your doctor.
  • if you have diabetes and regularly check your urine for sugar.

Administering your medication

 

Before you administer cefepime, look at the solution closely. It should be clear and free of floating material. Gently squeeze the bag or observe the solution container to make sure there are no leaks. Do not use the solution if it is discolored, if it contains particles, or if the bag or container leaks. Use a new solution, but show the damaged one to your health care provider.

It is important that you use your medication exactly as directed. Do not stop your therapy on your own for any reason because your infection could worsen and result in hospitalization. Do not change your dosing schedule without talking to your health care provider. Your health care provider may inform you to stop your infusion if you have a mechanical problem (such as a blockage in the tubing, needle, or catheter); if you have to stop an infusion, call your health care provider immediately so your therapy can continue.

Side effects

Cefepime may cause side effects. If you are administering cefepime into a muscle, it may be mixed with lidocaine (Xylocaine) to reduce pain at the injection site. Tell your health care provider if any of these symptoms are severe or do not go away:

  • diarrhea

  • stomach pain

  • upset stomach

  • vomiting

If you experience any of the following symptoms, call your health care provider immediately or get emergency medical attention:

  • rash

  • unusual bleeding or bruising

  • difficulty breathing

  • hives

  • sore mouth or throat

  • confusion

  • changes in thinking or behavior

  • not responding to others or the world around you as usual

Storing your medication

 
  • Your health care provider probably will give you a several-day supply of cefepime at a time. If you are receiving cefepime intravenously (in your vein), you probably will be told to store it in the refrigerator.

  • Take your next dose from the refrigerator 1 hour before using it; place it in a clean, dry area to allow it to warm to room temperature.

If you are receiving cefepime intramuscularly (in your muscle), your health care provider will inform you how to store it properly.

Store your medication only as directed. Make sure you understand what you need to store your medication properly.

Keep your supplies in a clean, dry place when you are not using them, and keep all medications and supplies out of reach of children. Your health care provider will inform you how to throw away used needles, syringes, tubing, and containers to avoid accidental injury.

In case of emergency/overdose

 

In case of overdose, consult your doctor. If the victim has collapsed or is not breathing, consult local medical emergency services.

Signs of infection

If you are receiving cefepime in your vein or under your skin, you need to know the symptoms of a catheter-related infection (an infection where the needle enters your vein or skin). If you experience any of these effects near your intravenous catheter, inform your health care provider as soon as possible:

  • tenderness

  • warmth

  • irritation

  • drai nage

  • redness

  • swelling

  • pain 

Cefepime may cause other side effects.  Consult your doctor if you have any unusual problems while taking this.

In case of emergency/overdose

In case of overdose, consult your doctor. If the victim has collapsed or is not breathing, consult local medical emergency services. 

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to Cefepime.

Do not let anyone else use your medication. If you still have symptoms and need further treatment, consult your doctor.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Ref:  U.S. National Library of Medicine.


This information is provided for reference only and not a replacement for and should only be used in conjunction with full consultation with a registered medical practitioner. It may not contain all the available information you require and cannot substitute professional medical care, nor does it take into account all individual circumstances. Although great effort has been made to ensure content accuracy, mph-bd shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise.