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Cefixime: Drug information

Cefixime: Drug information
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For additional information see "Cefixime: Patient drug information" and "Cefixime: Pediatric drug information"

For abbreviations, symbols, and age group definitions show table
Brand Names: US
  • Suprax [DSC]
Brand Names: Canada
  • Auro-Cefixime;
  • Suprax
Pharmacologic Category
  • Antibiotic, Cephalosporin (Third Generation)
Dosing: Adult

Usual dosage range: Oral: 400 mg/day divided every 12 or 24 hours.

Gonococcal infection, uncomplicated

Gonococcal infection, uncomplicated (infection of the cervix, rectum [off-label use], or urethra) (alternative agent):

Note: Use cefixime only if ceftriaxone cannot be used because cefixime is not as effective (Ref).

Oral: 800 mg as a single dose; give in combination with treatment for chlamydia if it has not been excluded (Ref). When treatment failure is suspected (eg, detection of N. gonorrhoeae after treatment without additional sexual exposure), consult an infectious diseases specialist. Report failures to the CDC through state and local health departments (Ref).

Gonococcal infection, expedited partner therapy

Gonococcal infection, expedited partner therapy (off-label use): Oral: 800 mg as a single dose; give in combination with treatment for chlamydia if it has not been excluded (Ref). Note: Expedited partner therapy (EPT) involves the delivery of medication and educational materials directly to a sex partner by the patient or collaborating pharmacy. Only use EPT if public health strategies are impractical/unavailable and there is concern that the partner will not otherwise get prompt evaluation and treatment. Use EPT with caution in men who have sex with men because of uncertain efficacy and lost opportunities for sexually transmitted infection/HIV risk assessment (Ref).

Rhinosinusitis, acute bacterial

Rhinosinusitis, acute bacterial (alternative agent) (off-label use):

Note: For patients with penicillin allergy who are able to tolerate cephalosporins. In uncomplicated acute bacterial rhinosinusitis, initial observation and symptom management without antibiotic therapy is appropriate in most patients. Reserve antibiotic therapy for poor follow-up or lack of improvement over the observation period (Ref).

Oral: 400 mg once daily with clindamycin for 5 to 7 days (Ref); some experts use as monotherapy when the risk of drug-resistant S. pneumoniae is low (eg, <65 years of age, low endemic resistance, few comorbidities, no recent hospitalization or antibiotic use) (Ref).

Streptococcal pharyngitis, group A

Streptococcal pharyngitis, group A (alternative agent):

Note: For patients with penicillin allergy who are able to tolerate cephalosporins. Cephalosporin selection depends on the type of hypersensitivity reaction to penicillin. To avoid the development of resistance, narrower spectrum cephalosporins (eg, cephalexin or cefadroxil) are preferred when possible (Ref).

Oral: 400 mg once daily for 10 days (Ref).

Typhoid fever

Typhoid fever (off-label use): Oral: 100 to 200 mg twice daily for 7 to 14 days (Ref).

Urinary tract infection

Urinary tract infection (alternative agent): Note: Use only when preferred agents cannot be used; limited evidence suggests inferior efficacy of oral beta-lactams (Ref).

Cystitis, acute uncomplicated or acute simple cystitis (infection limited to the bladder without signs/symptoms of upper tract, prostate, or systemic infection): Oral: 400 mg once daily for 7 days (Ref).

Urinary tract infection, complicated (including pyelonephritis): Oral: 400 mg once daily for 10 to 14 days (Ref); for patients with symptomatic improvement within the first 48 to 72 hours of therapy, some experts recommend shorter courses of 7 to 10 days (Ref). Note: Oral therapy should follow appropriate parenteral therapy (Ref).

Dosing: Kidney Impairment: Adult

The renal dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.

Note: Single-dose regimens (eg, 800 mg as a single dose) do not need to be dose adjusted for any degree of kidney dysfunction or type of renal replacement therapy. Renally adjusted dose recommendations are based on doses of 400 mg/day. Use only chewable tablets or oral suspension for patients with kidney dysfunction since unable to achieve recommended doses using capsules. Recommendations below are expert opinion derived from Dhib 1991, Guay 1986, and manufacturer's labeling.

Altered kidney function:

CrCl ≥60 mL/minute: No dosage adjustment necessary.

CrCl >20 to <60 mL/minute: 300 mg once daily.

CrCl ≤20 mL/minute: 200 mg once daily.

Hemodialysis, intermittent (thrice weekly): Limited dialyzability (Ref): 300 mg once daily.

Peritoneal dialysis: Minimally dialyzed (Ref): 200 mg once daily.

CRRT: No data available; use of an alternative agent is recommended (Ref).

PIRRT (eg, sustained, low-efficiency diafiltration): No data available; use of an alternative agent is recommended (Ref).

Dosing: Liver Impairment: Adult

No dosage adjustment provided in manufacturer’s labeling.

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric

(For additional information see "Cefixime: Pediatric drug information")

Dosage guidance:

Dosage form information: Unless otherwise specified, any dosage form may be used. Oral suspension is available in multiple concentrations; use caution.

General dosing: Infants, Children, and Adolescents: Oral: 8 mg/kg/day once daily or in divided doses every 12 hours; maximum daily dose: 400 mg/day (Ref).

Febrile neutropenia

Febrile neutropenia (low-risk): Limited data available: Infants, Children, and Adolescents: Oral: 8 mg/kg/day once daily or in divided doses every 12 hours; in most trials, cefixime therapy was initiated as step-down therapy after 48 to 72 hours of empiric parenteral antibiotic therapy with first cefixime dose administered at the end of the last IV infusion (Ref). Note: In one study, doses were repeated if patient vomited within 2 hours (Ref).

Gonococcal infection, uncomplicated infections of the cervix, urethra, or rectum

Gonococcal infection, uncomplicated infections of the cervix, urethra, or rectum (alternative agent): Children ≥45 kg and Adolescents: Oral: 800 mg as a single dose. If chlamydial infection has not been excluded, give as part of an appropriate combination regimen (Ref). Note: Cefixime should only be used if ceftriaxone is unavailable (Ref).

Irinotecan-associated diarrhea, prophylaxis

Irinotecan-associated diarrhea, prophylaxis: Limited data available: Infants ≥2 months, Children, and Adolescents: Oral: 8 mg/kg once daily; maximum dose: 400 mg/dose. Typically begin 2 days before irinotecan initiation and continue throughout the irinotecan course (eg, 5 to 10 days); time of initiation and duration may vary with treatment protocol (Ref).

Otitis media, acute

Otitis media, acute (AOM) (alternative agent): Oral suspension or chewable tablets: Infants ≥2 months, Children, and Adolescents: Oral: 8 mg/kg/day once daily or in divided doses every 12 hours; maximum daily dose: 400 mg/day (Ref). For patients with severe or recurrent AOM, tympanic membrane perforation, or who are <2 years of age, treat for 10 days; for patients ≥2 years of age with mild to moderate, nonrecurrent disease without tympanic membrane perforation, shorter durations of 5 to 7 days may be sufficient (Ref). Note: Not preferred therapy; may be considered in combination with clindamycin in certain scenarios after failure of first-line agents; other agents preferred for treatment of Streptococcus pneumoniae (Ref).

Rhinosinusitis, acute bacterial

Rhinosinusitis, acute bacterial (alternative agent): Infants, Children, and Adolescents: Oral: 8 mg/kg/day once daily or in divided doses every 12 hours; maximum daily dose: 400 mg/day (Ref); 5 to 7 days of therapy is likely adequate, though older guidelines recommend 10 to 14 days of therapy (Ref). Note: Not first-line therapy; may be considered after failure of initial therapy or in patients with non-type I penicillin allergy. Recommended to be used as part of combination therapy; suboptimal for Streptococcus pneumoniae as monotherapy (Ref).

Streptococcus, group A; pharyngitis/tonsillitis

Streptococcus, group A; pharyngitis/tonsillitis (alternative agent for nonanaphylactic penicillin allergy): Note: Narrow-spectrum cephalosporins (eg, cephalexin) are preferred over broad-spectrum cephalosporins such as cefixime (Ref).

Infants, Children, and Adolescents: Oral: 8 mg/kg/day once daily or in divided doses every 12 hours for 10 days; maximum daily dose: 400 mg/day (Ref).

Typhoid fever

Typhoid fever ( Salmonella typhi ): Limited data available; efficacy results variable: Infants, Children, and Adolescents: Oral: 15 to 20 mg/kg/day in divided doses every 12 hours for 7 to 14 days (Ref). Usual adult dose is 100 to 200 mg twice daily (Ref).

Urinary tract infection, acute

Urinary tract infection (UTI), acute: Infants ≥2 months, Children, and Adolescents: Limited data available in infants <6 months: Oral: 8 mg/kg/day once daily or in divided doses every 12 hours (Ref). Duration of therapy should be individualized based on patient-specific factors such as age, severity/extent of infection, clinical response, etc; some patients may require longer than the minimum treatment duration (eg, patients with slower clinical improvement or more complicated disease). For uncomplicated cystitis, 5 days of treatment is typically adequate (Ref). For complicated UTI, including pyelonephritis, treatment for 7 to 10 days is likely appropriate; longer duration (≥10 days) was not shown to improve outcomes as compared to shorter duration (6 to 9 days) in an observational study of patients ≥6 months of age (Ref).

Dosing: Kidney Impairment: Pediatric

Infants ≥6 months, Children, and Adolescents: Very limited data available; some clinicians have suggested the following (Ref):

Mild to moderate impairment: Oral: No adjustment recommended.

Severe impairment (eg, GFR ≤10 to 20 mL/minute/1.73 m2): Oral: Reduce dose by 50%.

Anuric: Oral: Reduce dose by 50%.

Hemodialysis, peritoneal dialysis: Oral: Not significantly removed.

Dosing: Liver Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

>10%: Gastrointestinal: Gastrointestinal sign and symptoms (30%; including abdominal pain [3%], diarrhea [16%], dyspepsia [3%], flatulence [4%], frequent bowel movements [≤6%], loose stools [≤6%], nausea [7%], vomiting)

Postmarketing:

Dermatologic: Acute generalized exanthematous pustulosis (Kumar 2018), bullous pemphigoid (Sandakly 2024), erythema multiforme, fixed drug eruption (Kulhas Celik 2018), Stevens-Johnson syndrome (Shrestha 2022), toxic epidermal necrolysis (Babu 2022)

Endocrine & metabolic: Increased lactate dehydrogenase

Gastrointestinal: Clostridioides difficile-associated diarrhea, Clostridioides difficile colitis (Chyung 2013)

Genitourinary: Genital pruritus, vaginitis

Hematologic & oncologic: Agranulocytosis, autoimmune hemolytic anemia (Kaya 2019), eosinophilia, leukopenia, neutropenia, pancytopenia, prolonged prothrombin time, thrombocytopenia

Hepatic: Hepatic failure (Kaya 2019), hepatitis, hyperbilirubinemia, increased serum alanine aminotransferase (Yilmaz 2011), increased serum alkaline phosphatase, increased serum aspartate aminotransferase (Yilmaz 2011), jaundice

Hypersensitivity: Anaphylactic shock, anaphylaxis, angioedema, nonimmune anaphylaxis, serum sickness-like reaction (Mohsenzadeh 2020)

Infection: Candidiasis

Nervous system: Dizziness, headache, seizure

Ophthalmic: Acute angle-closure glaucoma (Mirshahi 2020), oculogyric crisis (Bayram 2012)

Renal: Acute kidney injury, increased blood urea nitrogen, increased serum creatinine

Miscellaneous: Drug fever

Contraindications

Hypersensitivity to cefixime, other cephalosporins, or any component of the formulation.

Warnings/Precautions

Concerns related to adverse effects:

• Dermatologic reactions: Severe cutaneous reactions (eg, toxic epidermal necrolysis, Stevens-Johnson syndrome, drug rash with eosinophilia and systemic symptoms [DRESS]) have been reported. If a reaction occurs, discontinue and institute supportive therapy.

• Hemolytic anemia: Immune-mediated hemolytic anemia (including fatalities) has been reported. Monitor patient (including hematologic parameters and drug-induced antibody testing when clinically appropriate) during and for 2 to 3 weeks after therapy. If hemolytic anemia occurs during therapy, discontinue use.

• Hypersensitivity: Hypersensitivity and anaphylaxis have been reported in patients receiving beta-lactam drugs. Use caution in patients with a history of hypersensitivity to cephalosporins, penicillins, or other beta-lactams. If administered to penicillin-sensitive patients, use with caution and discontinue use if allergic reaction occurs.

• Renal failure: May cause acute renal failure, including tubulointerstitial nephritis. If renal failure occurs, discontinue and initiate appropriate supportive therapy.

• Superinfection: Prolonged use may result in fungal or bacterial superinfection, including C. difficile–associated diarrhea (CDAD) and pseudomembranous colitis; CDAD has been observed >2 months postantibiotic treatment.

Disease-related concerns:

• Renal impairment: Use with caution in patients with renal impairment; may increase the risk of seizures if dosage not reduced.

• Gastrointestinal disease: Use with caution in patients with a history of GI disease.

• Hemolytic anemia: Do not administer to patients with a history of cephalosporin-associated hemolytic anemia; recurrence of hemolysis is more severe.

Dosage form specific issues:

• Benzyl alcohol and derivatives: Some dosage forms may contain sodium benzoate/benzoic acid; benzoic acid (benzoate) is a metabolite of benzyl alcohol; large amounts of benzyl alcohol (≥99 mg/kg/day) have been associated with a potentially fatal toxicity (“gasping syndrome”) in neonates; the “gasping syndrome” consists of metabolic acidosis, respiratory distress, gasping respirations, CNS dysfunction (including convulsions, intracranial hemorrhage), hypotension, and cardiovascular collapse (AAP ["Inactive" 1997]; CDC 1982); some data suggest that benzoate displaces bilirubin from protein binding sites (Ahlfors 2001); avoid or use dosage forms containing benzyl alcohol derivative with caution in neonates. See manufacturer’s labeling.

• Phenylalanine: Chewable tablets contain phenylalanine; avoid use or use with caution in patients with phenylketonuria (PKU).

Warnings: Additional Pediatric Considerations

May cause diarrhea; reported incidence (~16%) similar in children receiving oral suspension and adults receiving tablet dosage form. Use caution when interchanging product formulations; oral suspension and chewable tablets are bioequivalent but oral immediate release tablets are not bioequivalent; for some infections (eg, otitis media), dosing recommendations are product specific.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Capsule, Oral:

Suprax: 400 mg [DSC]

Generic: 400 mg

Suspension Reconstituted, Oral:

Suprax: 100 mg/5 mL (50 mL [DSC]) [strawberry flavor]

Suprax: 200 mg/5 mL (50 mL [DSC], 75 mL [DSC]); 500 mg/5 mL (10 mL [DSC], 20 mL [DSC]) [contains sodium benzoate]

Generic: 100 mg/5 mL (50 mL); 200 mg/5 mL (50 mL, 75 mL)

Tablet Chewable, Oral:

Suprax: 100 mg [DSC], 200 mg [DSC] [contains aspartame, fd&c red #40(allura red ac)aluminum lake]

Generic Equivalent Available: US

May be product dependent

Pricing: US

Capsules (Cefixime Oral)

400 mg (per each): $23.53 - $24.91

Suspension (reconstituted) (Cefixime Oral)

100 mg/5 mL (per mL): $4.45

200 mg/5 mL (per mL): $8.91

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Suspension Reconstituted, Oral:

Suprax: 100 mg/5 mL (50 mL) [contains sodium benzoate]

Generic: 100 mg/5 mL (50 mL, 100 mL)

Tablet, Oral:

Suprax: 400 mg

Generic: 400 mg

Administration: Adult

May be administered with or without food. Shake oral suspension well before use. Chewable tablets must be chewed or crushed before swallowing.

Administration: Pediatric

Oral: May be administered with or without food; administer with food to decrease GI distress.

Oral suspension: Shake suspension well before use. Oral suspension is available in multiple concentrations; use caution.

Tablets, chewable: Must be chewed or crushed before swallowing.

Use: Labeled Indications

Treatment of uncomplicated urinary tract infections (due to Escherichia coli and Proteus mirabilis), otitis media (due to Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pyogenes), pharyngitis and tonsillitis (due to S. pyogenes), acute exacerbations of chronic bronchitis (due to Streptococcus pneumoniae and H. influenzae); uncomplicated cervical/urethral gonorrhea (due to Neisseria gonorrhoeae [penicillinase- and nonpenicillinase-producing])

Note: Due to concerns of resistance and less optimal pharmacokinetics (compared to ceftriaxone), the CDC recommends use of cefixime as an alternative agent in the treatment of uncomplicated cervical/urethral gonorrhea in the US only when ceftriaxone is unavailable (CDC [Workowski 2021]).

Use: Off-Label: Adult

Gonococcal infection, expedited partner therapy; Gonococcal, uncomplicated infection of the rectum; Rhinosinusitis, acute bacterial; Typhoid fever

Medication Safety Issues
Sound-alike/look-alike issues:

Cefixime may be confused with cefepime

Suprax may be confused with Sporanox

International issues:

Cefiton: Brand name for cefixime [Portugal] may be confused with Ceftim brand name for ceftazidime [Portugal]; Ceftime brand name for ceftazidime [Thailand]; Ceftin brand name for cefuroxime [US, Canada]

Metabolism/Transport Effects

Substrate of OAT1/3;

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.

Aminoglycosides: Cephalosporins may increase nephrotoxic effects of Aminoglycosides. Cephalosporins may decrease serum concentration of Aminoglycosides. Risk C: Monitor

Bacillus clausii: Antibiotics may decrease therapeutic effects of Bacillus clausii. Management: Bacillus clausii should be taken in between antibiotic doses during concomitant therapy. Risk D: Consider Therapy Modification

BCG (Intravesical): Antibiotics may decrease therapeutic effects of BCG (Intravesical). Risk X: Avoid

BCG Vaccine (Immunization): Antibiotics may decrease therapeutic effects of BCG Vaccine (Immunization). Risk C: Monitor

Cholera Vaccine: Antibiotics may decrease therapeutic effects of Cholera Vaccine. Management: Avoid cholera vaccine in patients receiving systemic antibiotics, and within 14 days following the use of oral or parenteral antibiotics. Risk X: Avoid

Fecal Microbiota (Live) (Oral): May decrease therapeutic effects of Antibiotics. Risk X: Avoid

Fecal Microbiota (Live) (Rectal): Antibiotics may decrease therapeutic effects of Fecal Microbiota (Live) (Rectal). Risk X: Avoid

Furosemide: May increase nephrotoxic effects of Cephalosporins. Risk C: Monitor

Immune Checkpoint Inhibitors (Anti-PD-1, -PD-L1, and -CTLA4 Therapies): Antibiotics may decrease therapeutic effects of Immune Checkpoint Inhibitors (Anti-PD-1, -PD-L1, and -CTLA4 Therapies). Risk C: Monitor

Lactobacillus and Estriol: Antibiotics may decrease therapeutic effects of Lactobacillus and Estriol. Risk C: Monitor

Mycophenolate: Antibiotics may decrease active metabolite exposure of Mycophenolate. Specifically, concentrations of mycophenolic acid (MPA) may be reduced. Risk C: Monitor

Probenecid: May increase serum concentration of Cephalosporins. Risk C: Monitor

Sodium Picosulfate: Antibiotics may decrease therapeutic effects of Sodium Picosulfate. Management: Consider using an alternative product for bowel cleansing prior to a colonoscopy in patients who have recently used or are concurrently using an antibiotic. Risk D: Consider Therapy Modification

Typhoid Vaccine: Antibiotics may decrease therapeutic effects of Typhoid Vaccine. Only the live attenuated Ty21a strain is affected. Management: Avoid use of live attenuated typhoid vaccine (Ty21a) in patients being treated with systemic antibacterial agents. Postpone vaccination until 3 days after cessation of antibiotics and avoid starting antibiotics within 3 days of last vaccine dose. Risk D: Consider Therapy Modification

Vitamin K Antagonists: Cephalosporins may increase anticoagulant effects of Vitamin K Antagonists. Risk C: Monitor

Food Interactions

Food delays cefixime absorption. Management: May administer with or without food.

Pregnancy Considerations

Cefixime crosses the placenta and can be detected in the amniotic fluid (Ozyüncü 2010).

An increased risk of major birth defects or other adverse fetal or maternal outcomes has generally not been observed following use of cephalosporin antibiotics.

Breastfeeding Considerations

It is not known whether cefixime is present in breast milk.

According to the manufacturer, the decision to breastfeed during therapy should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and benefits of treatment to the mother.

Dietary Considerations

Chewable tablets contain phenylalanine; avoid use or use with caution in patients with phenylketonuria (PKU).

Monitoring Parameters

Renal function; with prolonged therapy, monitor renal and hepatic function periodically. Observe for signs and symptoms of anaphylaxis during first dose.

Mechanism of Action

Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs); which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested.

Pharmacokinetics (Adult Data Unless Noted)

Note: Chewable tablets and oral suspension are bioequivalent. However, oral suspension and capsule formulation are not considered bioequivalent.

Absorption: 40% to 50%; Note: Capsule AUC reduced by ~15% and Cmax by ~25% when taken with food.

Distribution: Widely throughout the body and reaches therapeutic concentration in most tissues and body fluids, including synovial, pericardial, pleural, peritoneal; bile, sputum, and urine; bone, myocardium, gallbladder, and skin and soft tissue

Protein binding: 65%

Half-life elimination: Normal renal function: 3 to 4 hours; Moderate impairment (CrCl 20 to 40 mL/minute): 6.4 hours; Renal failure: Up to 11.5 hours

Time to peak, serum: Suspension: 2 to 6 hours; Capsule: 3 to 8 hours; Delayed with food

Excretion: Urine (50% of absorbed dose as active drug); feces (10%)

Pharmacokinetics: Additional Considerations (Adult Data Unless Noted)

Older adult: Average AUCs at steady state in elderly patients are ~40% higher than average AUCs in healthy adults.

Anti-infective considerations:

Parameters associated with efficacy: Time dependent; associated with time free drug concentration (fT) > minimum inhibitory concentration (MIC): Goal: ≥40% to 50% (fT) > MIC (bacteriostatic), ≥60% to 70% (fT) > MIC (bactericidal) (Craig 1996; Craig 1998; Owens 2001; Turnidge 1998).

Expected drug exposure in normal renal function:

Pediatric patients, Cmax (peak): Single dose: Oral: 8 mg/kg:

Infants ≥2 months of age and children ≤2 years of age: 3.1 ± 1.8 mg/L (Nahata 1993).

Children ≥6 years of age and adolescents ≤13 years of age: 4.04 ± 1.51 mg/L (Mamzoridi 1996).

Adults, Cmax (peak):

Single dose: 400 mg: 3.85 to 4.4 mg/L (Brittain 1985; Faulkner 1988).

Steady state: 400 mg once daily: 4.74 ± 1.43 mg/L.

Postantibiotic effect: Generally <1 hour; varies based on organism (Craig 1991; Craig 1998; Dubois 2000).

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Apex | Cefim | Cefix | Dynaceph | Ixime | Magnacef | Mixif | Ranpime | Suprax | Taxim o | Winex;
  • (AR) Argentina: Cefixima Fabra | Cefixima richet | Cefixime ilab | Cimacefi | Novacef | Vixcef;
  • (AT) Austria: Aerocef | Cefixim Hexal | Tricef;
  • (BD) Bangladesh: 3 C | 3-Geocef | Afix | Afixime | Amucef | Antima | Bactazim | Bestcef | Bioxim | C 3 | Cef 3 | Cefadyl | Cefcil | Cefesta | Ceficap | Cefim 3 | Cefivic | Cefix | Cefixim | Cefmix | Cefocef | Ceftem | Ceftid | Cefurex | Cephoral | Cexime | D fix | Defim 3 | Duracef | Duracef max | Elexim | Emixef | Evofix | Excef | Fexim | Fix A | Fix a max | Fixbac | Fixpro | G-fix | Gen-3 | Infa-3 | Kefim | Keor | Kuracef | Loxim | Microcef | Odacef | Ofex | Onefix | Orcef | Orfix | Orgaxim | Polyxim | Prex 3 | Prexim | Prioxim | Profix | Rofixim | Roxim | Sanfix | Saver | Starcef | Sufix | Supraxim | T cef | Texit | Tgocef | Tocef | Tricef | Trifix | Triocef | Triocim | Trixim | Truso | Tyfax 3 | Unibac | Unifix | Velofix | Verixim | Ximbac | Xylocef | Zenicef;
  • (BF) Burkina Faso: Asmoxime | Ceficap | Cefix | Cefolac | Cielcef | Intercef | Mephixime | Ofiken | Oroken | Solexim | Sufix | Tocfim | Umexim;
  • (BG) Bulgaria: Cefixim actavis | Cefixime abr | Neocef | Pancef | Zefacet;
  • (BR) Brazil: Neo cefix | Plenax;
  • (CH) Switzerland: Cephoral;
  • (CI) Côte d'Ivoire: Asmoxime | Bestcef | Brufix | C tax p | Cefaxe | Cefexol | Ceficap | Cefim | Cefiron | Cefix | Cefixime sp | Cefolac | Cielcef | Ebuxime | Eficef | Fixim | Fixinect | Fixiser | Intercef | Megacef | Melcef | Ofiken | Oroken | Sanix | Secef | Solexim | Sufix | Taxim o | Theofix | Tocfim | Win md | Zexim | Zexim ds;
  • (CL) Chile: Cefspan | Tricef | Urotricef;
  • (CN) China: An de ke wei | An di ke tuo | An di ke wei | Ao de ning | Bi you su | Cefspan | Da li fen | Fu xin kang | Han guang tuo | Heng da fei | Hui xin sha | Ji da xi fu | Jida xi fu | Jiu bang | Jun te | Kang pai | Ke li luo | Ke lin dun | Ke wo sha | Kui ke | Luo wei ke | Nuo bai you | Ou jian | Qi an | Qin ke wo | Qing ke yi | Sai fu mei | Shi fu su | Si li jie | Suprax | Te pu ning | Xin da xin | Xin fu su | Yan yi | Yu shu | Zai wo;
  • (CO) Colombia: Cefixima | Denvar | Devoxim | Gynoblen;
  • (CZ) Czech Republic: Cefixime innfarm | Suprax;
  • (DE) Germany: Aerocef | Cefixdura | Cefixim 1 A Pharma | Cefixim al | Cefixim Al 100mg/5ml | Cefixim Beta | Cefixim ct | Cefixim Hexal | Cefixim ratiopharm | Cefixim Sandoz | Cefixim Stada | Cefixim-ratiopharm | Ceftoral | Cephoral | Infectoopticef | Suprax | Uro cephoral;
  • (DO) Dominican Republic: Betaxima | Caulis | Cefimax 5d | Cefixima | Cimafix | Defixim | Denvar | Eticefa | Eurocefa 3 | Fixem | Fixim | Orobact | Probacter | Unocef | Zidicef;
  • (EC) Ecuador: Cefixima | Denvar | Fixim | Longacef | Quazten;
  • (EE) Estonia: Cefixdura;
  • (EG) Egypt: Biocefixim | Cefabrum | Cefalotrigenex | Flavicef | Hebixime | Rivaxime | Suprax | Viodrilnex | Wideprex | Ximacef;
  • (ES) Spain: Cefixima | Cefixima mabo | Cefixima Sandoz | Denvar | Necopen;
  • (ET) Ethiopia: Bactofix | Cefimed | Cefix | Cefixime | Mahacef | Sanix | Winex;
  • (FI) Finland: Supracef;
  • (FR) France: Cefixime actavis | Cefixime Almus | Cefixime arrow | Cefixime arrow enfants | Cefixime Biogaran | Cefixime cristers | Cefixime EG | Cefixime eg labo | Cefixime Evolugen | Cefixime innfarm | Cefixime mylan | Cefixime neclife | Cefixime qualimed | Cefixime Ranbaxy | Cefixime Ratiopharm | Cefixime Teva | Cefixime Winthrop | Cefixime Zydus | Oroken;
  • (GB) United Kingdom: Suprax;
  • (GR) Greece: Ceftoral;
  • (HR) Croatia: Cefexin | Cefiksim alkaloid | Cefiksim cln | Cefiksim Jadran | Cefiksim nectar | Cefixim | Cefixim Alkaloid | Cefixim CLN;
  • (HU) Hungary: Cefixim Stada | Sufixin forte | Suprax;
  • (ID) Indonesia: Abixim | Anfix | Befixim | Cefacef | Cefarox | Cefika | Cefila | Cefspan | Ceptik | Cerafix | Cfx | Comsporin | Ethifix | Fixacep | Fixam | Fixatic | Fixef | Fiximca | Fixiphar | Helixim | Infix | Lanfix | Maxpro | Nucef | Opixime | Oracef | Pyxime | Simfix | Sofix | Spancef | Spaxim | Sporetik | Starcef | Suprax | Tocef | Trixim | Urticef | Ximecef | Yafix;
  • (IE) Ireland: Suprax;
  • (IL) Israel: Supran;
  • (IN) India: AB Cef | Acef | Acrotex | Acufix | Afixe | Akraxime | Alcef O | Almocef | Altracef | Amicef | Ancef o | Anfix | Aucef | Axim-o | Axime | Axiom-or | Bafix | Bijocef | Biofix | Biotax-o | Bioxin | Briscef | Brufix | Brutacef | C Let O | C Tax O | Cadixim | Cebay | Cedro CF | Ceefix | Ceemi | Cefal-o | Cefaxet | Cefi | Cefi od | Ceficad o | Ceficant | Ceficin | Ceficrat | Cefidoc | Cefiglen | Cefilab | Cefimed | Cefimo | Cefinar | Cefine | Cefio | Cefirap | Cefisuch | Cefix | Cefixain | Cefixinat | Cefkim | Ceflab | Cefluv | Cefma | Cefnij | Cefo | Cefocef O | Cefolac | Cefomarc-o | Cefoped | Cefox | Cefrax | Cefspan | Cefsung | Ceftas | Ceftiwin | Ceftobac | Cefxi O | Celitol | Cemax-o | Cf Xim | Cfx | Cifadin | Cifibac | Cifigold | Clasifix | Delbi | Desatax O | Dp | Dp cef | Durocef ds | Efixim | Efixime | Efoxim | Elcef | Enzacef | Estacef | Esyfex | Evacef-o | Exim | Exime | Extacef | Feeximm | Femcef | Fevorit | Fexim | Fixi | Fixicom | Fixim | Fixime | Fixinic | Fixivio | Fixx | G Xime | Goldfin | Grafix | Gramocef o | Hhcefi | Hicef | Hifen | Hofim | Ifeoma | Ifixime | Indcef | Jetex | Jifon | Kefotax O | Labocef dt | Laricef o | Letix | Lupicef-o | Lyceft-o | Mahacef | Marixime | Maxicef o | Mdcef | Mefim | Micfox | Milixim | N cef | Necee | Nestocef | Nitaxim O | Novafex | O-powerceff | Obefex | Odicef-o | Omnatax-o | Omnix | Onicef Lb D T | Oraxim | Orfix | Oritaxim O | Pancef-o | Pedicef | Pedixim | Pokecef | Raxcef | Raxim O | Redicate | Refix | Rhoxim | Rintax O | Rite-O-Cef | S fix | Secef | Seffix | Segofix | Si Fixim | Siffy | Skifi | Speedoxime | Starfix | Sufax | Supexim | Suprax | Swifix | Synercef | Synocef | Taxfax | Taxim o | Taxone-o | Topcef | Tox O | Traxol o | Trixon-o | Trusten o | U Fixim | Unitax O | Unocef | Vcef o | Verixime | Vexim | Wicef | Xecute | Xifbull | Xim | Xipil | Zafil | Zeefix | Zefix | Zencef | Zifi | Zimnic | Ziprax | Zofix | Zofixi | Zoftax o;
  • (IQ) Iraq: Acacime | Cefixime | Samaxime;
  • (IT) Italy: Cefixima | Cefixima acv | Cefixima aurobindo | Cefixima Aurobindo Italia | Cefixima Doc | Cefixima EG | Cefixima Mylan | Cefixima Sand. | Cefixoral | Stadium | Supracef | Suprax | Unixime;
  • (JO) Jordan: Apex | Betixim | Cefim | Cefix | Magnacef | Mixif | Pancef | Suprax | Winex;
  • (JP) Japan: Cefspan | Cexim | Sefeena;
  • (KE) Kenya: Aivxim | Bactifix | Biofix | Biozil | Biozil ds | C mark | C od | C tax p | C tax t | Cebay | Cef 3 ds | Cef 3 forte | Cef od | Cefatax o | Cefcy | Cefexol | Cefim | Cefiwel | Cefix | Cefiz | Ceflorex | Cefraz | Cefty | Cifex | Fimabute | Fix | Fixem | Fixem ds | Fixime | Fixinect | Flamifix | Gramocef o | Inoxime | Ixime | Mahacef | Nefexim | Orcef | Orfix | Pancef-o | Procefix | Raincef | Refixime | Rivaxime | Rofix | Seffix | Sirobact | Striaxime | Taxim o | Theofix | Triaxon | Triocim | Viprax | Xifix | Ximacef | Xime | Xime od | Zemicef | Zifax;
  • (KR) Korea, Republic of: Apexim | Aprogen cefixime | Ausfixime | Binex cefixime | Cebixim | Cefacime | Cefaxamin | Cefick | Cefik | Cefimaxin | Cefime | Cefirax | Cefirexim | Cefirix | Cefix | Cefixime | Cefixime hanall | Cefixt | Ceforax | Cefra | Cefrion | Cefsin | Cemixim | Cepac | Ceprion | Ceracin | Cexime | Cifixim | Cifixime | Dong a suprax | Dongkoo cefixime hydrate | Dongsung cefixime | Efixim | Efixime | Eipecsim | Etex cefixime | Fixima | Fixtin | Fofix | Fofixime | Jr cefixime | Kukje cefixime | Kyungbang cefixime | M xime | Mothers cefixime | Nelson cefixime | Pocef | Reyon cefixime | Samsung cefixime | Senex | Seoul cefixime | Shinfixim | Sucef | Sufixime | Suprax | Unifixime | Unixim | Withus cefixime | Wonfixime;
  • (KW) Kuwait: Cefim | Cefix | Cefrax | Magnacef | Mixif | Suprax | Winex;
  • (LB) Lebanon: Betixim | Cefdia | Cefim | Cefix | Fixef | Fixim | Humaxim | Magnacef | Murex | Neocef | Suprax | Tox O | Winex;
  • (MA) Morocco: Cefico | Ofiken | Oroken;
  • (MX) Mexico: Amixbru | Bafexal | Bandrol | Beneventol | Biomics | Cefixima | Denvar | Sunderin | Ulkro;
  • (MY) Malaysia: Cefix | Ixime | Minixime | Orfix | Yspcefixycin | Zifi;
  • (NG) Nigeria: Acofix | Afrixime | Bioxime | Brodcef | Cefest | Cefimax | Cefixime | Cefot | Clafix | Emzifix | Evofix | Ezcef | Gelxim | Ixime | Maydon cefixime | Meem cefixime | Mirafix | Nci cefixime | Sanfix | Surexime | Tamaxim | Zemicef | Zofixime;
  • (NO) Norway: Cefixim ct | Cefixime dr reddys;
  • (PE) Peru: Cefrom | Cimafix | Denvar | Maxefim;
  • (PH) Philippines: Accefixime ds | Acecef | Actimax | Aeruxim | Afix | Amkofix | Argifix | Axetef | Bacticef | Bactixime | Beraxime ds | C tax p | Cefilim | Cefisal | Cefixmycin | Cefixsaph 100 | Cefolin plus ds | Cefsea | Cefzin | Cephoral | Cexime | Cifacure | Citroen | Comfixime | Dancef ds | Diaxime | Dyruxim | Elvofix | Eriexef | Evofix | Ezcef | Fexitas | Fimabute | Fix A | Fixbact | Fixcef | Fixcure | Fixim | Fixsil | Fixxx | Flamifix | Flexime | Gracefix | Ixime | Maedix | Myrecef | Ofex | Penxime | Refix | Refixime | Regecef | Retracef | Rexmecef | Robetrix | Sanix | Saphixime | Septipan | Soniceph | Sufice | Sunxime | Surixime | Synmex | Taxim o | Taxocef o | Tergecef | Trifixime | Trimax | Trinifix | Triocef | Triolev | Trufix | Typhofix | Ultraxime | Umexim | Unifix | Vamocef | Viprax ds | Vispoxime ds | Winfix | Zefaxim | Zefifarm | Zefitas | Zefixmed | Zefral | Zemfix;
  • (PK) Pakistan: Accumax | Aerocef | Afixim | Agrofix | Aksoxime | Akurate | Amber | Arco Fix | Arcofix suspension ds | Avecef | Bactirid | Baxacim forte | Bectazim | Benifix | Berxime | Bestar | Bestcef | Biozil | C mark | Carazime | Caricef | Cebosh | Cef od | Cefaim | Cefamax | Cefask | Cefexol | Cefgen | Cefia | Cefia duo | Cefial | Cefidon | Cefiget | Cefim | Cefipex | Cefipex ds | Cefirant | Cefiscot | Cefitax | Cefitest | Cefitol | Cefivant | Cefivel | Cefivid | Cefivid ds | Cefix | Cefkan | Cefkar | Ceflorex | Cefman | Ceforal-3 | Cefsel | Cefspan | Ceftas | Cefto | Cefzime | Cesave | Cestar | Cewel | Cexime | Cezox | Cezox ds | Cili cef | Cilicef | Cimonil | Cinklare | Cixim | Conspan | Corinef | Danxime | Devyn | Devyn ds | Dispel | Ds cefivid | Duet | Eficef | Efix | Epan | Epofix | Evofix | Exime | Fasxime | Fedixime | Ficsi | Finex | Fixcy | Fixef | Fixicef | Fixikef | Fixil | Fixim | Fixime | Fiximtas | Fixirin | Fixitil | Fixitil t | Fixval | Flexeril | Flozid | Fredixime | Genixime | Getxime | Gilspan | Gyala | Hefixim | Hispan | Hixime | Iboxime | Iboxime DS | If tar | Infix | Inxime | Isocef | Jencef | Kafixime | Kamcef | Kayfix | Lexime ds | Libroxime | Linzim | M span | Macxime | Magaxim | Magnett | Maxima | Maxophine | Maxpan | Medispan | Medixime | Medoxim | Mefixim | Megazime | Mimlux | Mixel | Mixime | Navexim | Nenxime | Nexcef | Nowcef | Omixim | Orcef | Orpase | Ortazim | Palxime | Palxime ds | Parsim | Pharxime | Procef | Rafix | Rayfix | Rayfix ds | Rayxime | Reyan | Ricxime | Rofil | Rutex | Ruwin | Ruwin ds | Sallar | Sayfim | Scifix | Seaxim | Secure | Sefixim | Septipan | Serve | Sivarol | Sixime | Sn xime | Snapcef | Solixim | Solixim ds | Spanix | Spaxime | Spectracef | Sporzim | Spril | Suncef | Superixime | Supracef | Suprin | Surexime | Swicef | Synocef | Tamcef | Theraxim | Tinocef | Triban | Trispan | Tycef | Tysen | Ur Cef | Vanil | Vefixim | Vencef | Vfix | Vg Span | Vimacef | Viospan | Vioxime | Vixime | Wizy | Xalfocin | Xeerak | Xerak | Xim | Xim ds | Ximbact | Xime c | Ximemor | Ximex | Xival | Xpertec | Y Fix | Zanxim | Zaxime | Ziac | Zifi | Zix | Zyacef | Zynoxim;
  • (PL) Poland: Cephoral | Cetix | Suprax;
  • (PR) Puerto Rico: Suprax;
  • (PT) Portugal: Bonocef | Cefimix | Cefiton | Cefixima | Cefixima aurobindo | Cefixima Baldacci | Cefixima Generis | Cefixima Germed | Cefixima Jaba | Neocef | Tricef;
  • (PY) Paraguay: Cefimex | Cefixiland | Cefixima caplin point | Cefixima cefen guayaki | Cefixima dallas | Cefixima dutriec | Cefixima genfar | Cefixima vivele | Celef | Ceprin | Cexima | Cimafix | Cimafix forte | Flupiral | Oralcef | Pedicepha;
  • (QA) Qatar: Betixim | Cefix | Cefrax | Evofix | Fixef | Magnacef | Mixif | Suprax | Winex | Zycef;
  • (RO) Romania: Cefixima aurobindo | Cefixima stada | Eficef | Suprax | Xifia;
  • (RU) Russian Federation: Cemidexor | Iksim | Ixime lupin | Pancef | Suprax;
  • (SA) Saudi Arabia: Cefamax | Cefim | Cefix | Cefrax | Magnacef | Midixime | Mixif | Suprax | Winex;
  • (SE) Sweden: Tricef;
  • (SI) Slovenia: Pancef;
  • (SK) Slovakia: Cefimed | Cefixim Stada | Cefixime innfarm | Suprax;
  • (SY) Syrian Arab Republic: Nidaprax;
  • (TH) Thailand: Cefspan | Sixime;
  • (TN) Tunisia: Cefoken | Faloxim | Megacef | Oroken;
  • (TR) Turkey: Cefdia | Cefixima | Cephix | Fixef | Molcef | Suprax | Zimaks;
  • (TW) Taiwan: Ceficin | Cefixmycin | Cefspan | Cexim;
  • (UA) Ukraine: Cefinak | Cefixim Kmp | Cefixime vista | Fixx | Flamifix | Ixime | Loprax | Maxibat | Opticef | Sorcef | Suprax;
  • (UG) Uganda: Arcelia cefixime | Cachmax | Cebay | Cef 3 | Cef 3 ds | Cefdia | Cefexol | Cefexol ds | Cefim | Cefimcz | Cefimed | Cefiwel | Cefiwel 100 dt | Cefix | Cefraz | Fimabute | Fix A | Fixime | Fixinect | Gramocef o | Infixime | Mixif | Sanfixime | Sanix | Sanix ds | Sefixi | Taxim o | Theofix | Theofix 100 ds | Theofix 50 ds | Topcef | Triaxon | Tryfix | Tryfix 100 ds | Virexim;
  • (UY) Uruguay: Fiximax | Maxicef | Novacef | Oralcef | Supracef;
  • (VE) Venezuela, Bolivarian Republic of: Cefaspan | Cefixima | Cefixtan | Defalox | Kazepina | Longacef | Unixime;
  • (VN) Viet Nam: Bicebid | Crocin | Daxame | Egofixim | Hafixim | Imerixx | Imexime | Infilong | Kivacef | Nimemax;
  • (ZA) South Africa: Exsef | Fixime;
  • (ZM) Zambia: C tax p | Cebay | Cefix ds | Cefolac | Cifex | Fixinect | Gramocef o | Marixime | Orfix | Taxocef o | Zoocef
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