Cepokem (Cefuroxime Sod. I.P)

CEPOKEM Injections
Composition
CEPOKEM 250 Inj
Each vial contains Cefuroxime (as sodium salt) 250 mg
CEPOKEM 750 Inj
Each vial contains Cefuroxime (as sodium salt) 750 mg
CEPOKEM Injection (IM/IV) permits use of sequential therapy with the same antibiotics when a change from parenteral to oral therapy is indicated.

Indications
* Respiratory tract infections (LRTIs)
eg. Lung abscess, bronchiectasis (infected)
* Urinary tract infections
eg. Uncomplicated UTI (asymptomatic bacteriuria, chronic pyelonephritis, cystitis, chronic UTI)
* Skin & soft tissue infections
eg. Cellulitis, erysipelas, peritonitis and wound infections
* Severe and complicated infections or bone & joint infections
* Septicemia
* Gonorrhoea
* Obstetric and gynaecological infections
* Meningitis
* Pre- peri- post operative surgical procedures
a) Cardiac surgery
b) Non-cardiac thoracic surgery, close tube thoracostomy
c) Orthopaedic surgery / obstetric and gynaecological surgery / GI surgery
eg. Hip replacement, knee arthroplasty, large bowel surgery, elective colorectal and biliary surgery

Dosage And Administration
* General dosing
Many infections will respond to 750 mg tid IM/IV
* Severe Infections – 1.5 gm tid IV
Can be increased to 6 mg if necessary, giving total dosage of 3-6 gm daily
* Infants and children
30-100 mg/kg/day in two or three divided doses
* Specific dosing
Sequential Therapy
To switch IV CEPOKEM with oral CEPOKEM in CAP (community acquired pneumonia)
1.5 gm bid IV or IM for 48–72 hrs followed by 500 mg bid oral therapy for 7 days
* Sequential therapy in AECB (acute exacerbation of chronic bronchitis)
750 mg bid IV or IM for 48–72 hrs followed by 500 mg bid oral therapy for 5-7 days
* Gonorrhoea & associated infections
Single dose of 1.5 gm of CEPOKEM Inj. IM & 1 gm oral Probenecid. The dose of CEPOKEM injection should be divided and given at 2 different sites
* Meningitis

Adults: 3 gm IV every 8 hrs
Infants and children: 200-240 mg/kg/day in three of four divided doses
This dosage may be reduced to 100 mg/kg/day IV after 3 days or when clinical improvement occurs.

* Neonates
Initial dose should be 100 mg/kg/day IV
Reduction of 50 mg/kg/day IV may be made when clinically indicated
* Pre- peri- post operative surgical procedures
a) Cardiac surgery
Single 1.5 gm of CEPOKEM IV at the time of induction of anaesthesia and every 12 hrs thereafter for total dosage of 6 gm
b) Non-cardiac thoracic surgery
1.5 gm IV prior to surgery
c) Orthopaedic surgery / Obstetric and gynaecological surgery / GI surgery
1.5 gm CEPOKEM IV just prior to surgery and in lengthy operations 750 mg IV or IM bid
d) In contaminated surgery
1.5 gm CEPOKEM IV + Metronidazole 500 mg/ml OD
e) Well established mixed infection
1.5 gm CEPOKEM IV + Metronidazole 500 mg/ml tid
* Intramuscular
Add 1 ml water for injection to Cefuroxime sodium injection 250 mg or 3 ml water for injection to Cefuroxime sodium injection 750 mg. Shake gently to produce opaque suspension
* Intravenous
Dissolve Cefuroxime Sodium in water for injection using at least 2 ml for 250 mg & at least 6 ml for 750 mg

Dilution
Cefuroxime Sodium for injection is compatible with the more commonly used intravenous infusion fluids. It will retain potency for up to 24 hrs at room temperature in:
* Sodium chloride injection BP 0.9% w/v
* 5% Dextrose Injection BP
* 0.18% w/v sodium chloride plus 4% Dextrose diluent BP
* 5% Dextrose and 0.9% sodium chloride for injection
* 5% Dextrose and 0.45% sodium chloride injection
* 5% Dextrose and 0.225% sodium chloride infection
* 10% invert sugar in water for injection
* Ringer’s Solution USP

Contraindications
Patients with known hypersensitivity to cephalosporin antibiotics

Presentation
CEPOKEM Injection ........................Vial of 250 mg
CEPOKEM Injection ........................Vial of 750 mg

Dosage : Adults: The usual adult dosage range for Cepokem is 750 mg to 1.5 grams every 8 hours, usually for 5 to 10 days.

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