Cefixime

About Cefixime

Cefixime kills bacteria by blocking the building of their cell walls. Its label covers uncomplicated urinary tract infections, middle ear infections, strep throat and tonsillitis, flare-ups of chronic bronchitis and uncomplicated gonorrhea of the cervix or urethra, which is treated with a single 400 mg dose. Adults take 400 mg a day, and children from 6 months old take the suspension at a dose based on weight; the dose is lowered when kidney function is reduced.

For middle ear infections the label says to use the suspension. The trials used it, and it gives higher peak blood levels than a tablet at the same dose, so a capsule or tablet should not be substituted for it.

Diarrhea is the most common side effect, followed by nausea, loose stools, stomach pain and indigestion. Severe, watery or bloody diarrhea, even weeks after the course, can signal a C. difficile infection and needs prompt care. Cefixime must not be taken by anyone allergic to it or to another cephalosporin, and because cross-reactions among beta-lactam antibiotics are well documented, the label calls for caution with a penicillin allergy; tell the prescriber what reaction you had.

Taking Cefixime

How to take it

Every 12 or 24 hours as prescribed, with or without food, and for the whole course even if you feel better. Shake the suspension well before each dose and measure it carefully.

If you miss a dose

Take it as soon as you remember, unless it is almost time for the next dose; then skip the missed dose and continue your regular schedule.

Storage

Capsules and tablets at room temperature, away from excess heat and moisture (not in a bathroom). Keep the mixed suspension tightly closed, at room temperature or in the refrigerator, and throw away any left after 14 days.

Interactions to know about

Cefixime can raise carbamazepine levels and increase the effect of warfarin, so bleeding and INR are watched. It can make some urine tests for ketones or sugar read falsely positive, so tell anyone testing your urine that you take it. Seek care promptly for severe or bloody diarrhea, a rash, hives, or swelling of the face or throat.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Cefixime differs from pharmacy to pharmacy

Cefixime has far fewer makers than everyday antibiotics such as amoxicillin or cephalexin, so there is less competition on price and quotes vary more between pharmacies. A pharmacy that does not stock it must order it, which can delay the start of a course.

The suspension is priced by the bottle, mixed with water before use and kept for only 14 days, so anything left over is wasted. The capsule and the tablet are separate products that a pharmacy may price differently.

Ways to pay less for Cefixime without insurance

• Call ahead to check that the pharmacy has your form in stock.
• If the prescriber agrees that either the capsule or the tablet would do, ask the pharmacy to quote both.
• For a child, ask for the bottle size the course needs, since mixed suspension is thrown away after 14 days.
• If cost is a barrier, ask whether a more widely made antibiotic would work as well.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Cefixime

1. 1.Is it safe with my penicillin allergy?
2. 2.Should my child’s ear infection be treated with the liquid rather than capsules?
3. 3.How should I store the mixed suspension, and when do I throw it away?
4. 4.Does it interact with my blood thinner or carbamazepine?
5. 5.What kind of diarrhea means I should call?

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