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Cefepime Injections to Cefepime for Injection

Cefepime Injection

Cefepime is a broad‐spectrum, fourth-generation cephalosporin antibiotic given by injection (intravenous or intramuscular). It acts by inhibiting bacterial cell wall synthesis and is active against many Gram-positive and Gram-negative organisms (including Pseudomonas aeruginosa). Because of its potency, cefepime is reserved for serious infections, typically in a hospital setting.

Indications and Uses

Cefepime injection is indicated for severe life-threatening infections caused by susceptible bacteria. Approved uses include:

  • Pneumonia: hospital-acquired or severe pneumonia.
  • Febrile neutropenia: empiric therapy of fever in neutropenic cancer patients.
  • Urinary tract infections (UTIs): both uncomplicated and complicated UTIs (including pyelonephritis).
  • Skin/soft tissue infections: moderate to severe uncomplicated skin infections.
  • Intra-abdominal infections: complicated intra-abdominal infections (only used with metronidazole).

Example: Cefepime is often chosen for hospital sepsis or pneumonia when drug-resistant Gram-negative coverage (e.g. Pseudomonas) is needed. (Intramuscular injection is rarely used in practice – it’s only indicated for mild E. coli UTIs; almost all doses are given IV.)

Dosage and Administration

Cefepime is supplied as a sterile dry powder in single-dose vials (1 g and 2 g). It must be reconstituted with fluid before injection. It is usually administered intravenously (IV) by infusion; occasionally intramuscular (IM) for specific outpatient cases. Important points:

  • Typical adult dose (IV): 1–2 g infused every 8–12 hours (for example, 2 g IV q8h for febrile neutropenia or suspected Pseudomonas). For moderate infections (e.g. mild UTI or skin infection), 1 g q12h may suffice. For complicated UTIs, doses up to 2 g q12h are used.
  • Infusion time: Each dose is typically diluted in IV fluid and given over about 30 minutes. (Slow infusion minimizes local irritation.)
  • Intramuscular use: If needed, IM injections (usually 0.5–1 g) are only indicated for mild E. coli UTIs. No other IM uses are standard.
  • Pediatric dosing: In children (2 months–16 years) with normal kidney function, the usual dose is ~50 mg/kg IV every 12 hours (every 8 hours for neutropenic fever).
  • Renal impairment: Cefepime is largely excreted by the kidneys. If creatinine clearance (CrCl) ≤60 mL/min, the dose or frequency must be reduced to prevent drug accumulation. Dosing guidelines give specific adjustments based on CrCl (see FDA label for details).

In all cases, follow the full prescribed course even if symptoms improve, and use only under medical supervision.

Pharmacokinetics

After IV infusion, cefepime distributes into body tissues. It is eliminated primarily by the kidneys; about 85% of a dose is excreted unchanged in urine. The elimination half-life in healthy adults is roughly 2 hours. Pharmacokinetics are linear over doses from 250 mg to 2 g. In renal impairment, clearance drops and half-life rises, hence dose adjustment is critical. Cefepime is compatible with common IV fluids (normal saline, dextrose solutions, etc.).

Side Effects and Precautions

Cefepime is generally well tolerated, but as a broad-spectrum antibiotic it carries risks:

  • Allergic reactions: Patients with a history of penicillin or cephalosporin allergy may react; cross-sensitivity occurs in ~1–10% of penicillin-allergic patients. Signs of allergy include rash, itching, hives, and rarely anaphylaxis. If serious allergy occurs, stop cefepime immediately.
  • Neurologic toxicity: High levels of cefepime (especially in renal failure) can cause neurotoxicity (confusion, encephalopathy, myoclonus, seizures). Elderly or renally impaired patients are at greatest risk. Discontinue cefepime if unexplained neurologic symptoms develop.
  • Injection site: Pain or inflammation can occur at the IV site. Switching infusion sites or diluting more can help if irritation occurs. Rarely, IM injection can hurt or cause muscle induration.
  • Gastrointestinal: Common side effects include diarrhea, nausea, vomiting, abdominal pain, and rash. As with any broad antibiotic, there is a risk of Clostridioides difficile–associated diarrhea; monitor for severe or persistent diarrhea.
  • Laboratory: Cefepime can cause increased liver enzymes (ALT, AST), elevated INR, low phosphate, and positive direct Coombs’ test. These changes are usually mild; for prolonged therapy, periodic blood counts and liver tests are prudent.
  • Drug interactions: Concomitant nephrotoxic drugs (e.g. aminoglycosides, high-dose diuretics) can increase kidney toxicity. If used together, monitor renal function closely. (No significant cytochrome P450 interactions are known since cefepime is renally cleared.)
  • Pregnancy/Lactation: Cefepime is category B; it crosses the placenta and enters breastmilk in small amounts. Use in pregnancy only if clearly indicated.

Always use cefepime strictly as prescribed. Do not use for viral infections. Complete the full course to prevent resistance.

Key Points

  • Broad-spectrum beta-lactam: Cefepime injection is a 4th-generation parenteral cephalosporin. It treats many Gram-negative and Gram-positive infections, including drug-resistant strains.
  • Severe infections: It is indicated in hospitals for serious infections (e.g. pneumonia, complicated UTIs, skin infections, neutropenic fever).
  • Administration: Given IV (1–2 g every 8–12 h) by healthcare staff. Each dose is reconstituted and infused over ~30 minutes (IM only in specific mild cases)..
  • Renal dosing: It is eliminated by the kidneys (half-life ≈2 h). Reduce dose or extend interval if renal function is impaired.
  • Allergy and precautions: Avoid in patients allergic to cephalosporins/penicillins. Monitor for side effects like rash, gastrointestinal upset, and neurotoxicity.
  • Use guidelines: Only use when bacterial infection is confirmed or strongly suspected to avoid resistance. Do not share injections or reuse vials.

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Antibiotic Medications Bacterial Infection Medicines, Antibiotics & Drugs Pneumonia Medications & Pneumonia Treatments Skin Infection Medications Urinary Tract Infection Relief Products Sagent Pharmaceuticals Skin Medications Apotex Corporation

Cefepime Injection

Cefepime is a broad‐spectrum, fourth-generation cephalosporin antibiotic given by injection (intravenous or intramuscular). It acts by inhibiting bacterial cell wall synthesis and is active against many Gram-positive and Gram-negative organisms (including Pseudomonas aeruginosa). Because of its potency, cefepime is reserved for serious infections, typically in a hospital setting.

Indications and Uses

Cefepime injection is indicated for severe life-threatening infections caused by susceptible bacteria. Approved uses include:

  • Pneumonia: hospital-acquired or severe pneumonia.
  • Febrile neutropenia: empiric therapy of fever in neutropenic cancer patients.
  • Urinary tract infections (UTIs): both uncomplicated and complicated UTIs (including pyelonephritis).
  • Skin/soft tissue infections: moderate to severe uncomplicated skin infections.
  • Intra-abdominal infections: complicated intra-abdominal infections (only used with metronidazole).

Example: Cefepime is often chosen for hospital sepsis or pneumonia when drug-resistant Gram-negative coverage (e.g. Pseudomonas) is needed. (Intramuscular injection is rarely used in practice – it’s only indicated for mild E. coli UTIs; almost all doses are given IV.)

Dosage and Administration

Cefepime is supplied as a sterile dry powder in single-dose vials (1 g and 2 g). It must be reconstituted with fluid before injection. It is usually administered intravenously (IV) by infusion; occasionally intramuscular (IM) for specific outpatient cases. Important points:

  • Typical adult dose (IV): 1–2 g infused every 8–12 hours (for example, 2 g IV q8h for febrile neutropenia or suspected Pseudomonas). For moderate infections (e.g. mild UTI or skin infection), 1 g q12h may suffice. For complicated UTIs, doses up to 2 g q12h are used.
  • Infusion time: Each dose is typically diluted in IV fluid and given over about 30 minutes. (Slow infusion minimizes local irritation.)
  • Intramuscular use: If needed, IM injections (usually 0.5–1 g) are only indicated for mild E. coli UTIs. No other IM uses are standard.
  • Pediatric dosing: In children (2 months–16 years) with normal kidney function, the usual dose is ~50 mg/kg IV every 12 hours (every 8 hours for neutropenic fever).
  • Renal impairment: Cefepime is largely excreted by the kidneys. If creatinine clearance (CrCl) ≤60 mL/min, the dose or frequency must be reduced to prevent drug accumulation. Dosing guidelines give specific adjustments based on CrCl (see FDA label for details).

In all cases, follow the full prescribed course even if symptoms improve, and use only under medical supervision.

Pharmacokinetics

After IV infusion, cefepime distributes into body tissues. It is eliminated primarily by the kidneys; about 85% of a dose is excreted unchanged in urine. The elimination half-life in healthy adults is roughly 2 hours. Pharmacokinetics are linear over doses from 250 mg to 2 g. In renal impairment, clearance drops and half-life rises, hence dose adjustment is critical. Cefepime is compatible with common IV fluids (normal saline, dextrose solutions, etc.).

Side Effects and Precautions

Cefepime is generally well tolerated, but as a broad-spectrum antibiotic it carries risks:

  • Allergic reactions: Patients with a history of penicillin or cephalosporin allergy may react; cross-sensitivity occurs in ~1–10% of penicillin-allergic patients. Signs of allergy include rash, itching, hives, and rarely anaphylaxis. If serious allergy occurs, stop cefepime immediately.
  • Neurologic toxicity: High levels of cefepime (especially in renal failure) can cause neurotoxicity (confusion, encephalopathy, myoclonus, seizures). Elderly or renally impaired patients are at greatest risk. Discontinue cefepime if unexplained neurologic symptoms develop.
  • Injection site: Pain or inflammation can occur at the IV site. Switching infusion sites or diluting more can help if irritation occurs. Rarely, IM injection can hurt or cause muscle induration.
  • Gastrointestinal: Common side effects include diarrhea, nausea, vomiting, abdominal pain, and rash. As with any broad antibiotic, there is a risk of Clostridioides difficile–associated diarrhea; monitor for severe or persistent diarrhea.
  • Laboratory: Cefepime can cause increased liver enzymes (ALT, AST), elevated INR, low phosphate, and positive direct Coombs’ test. These changes are usually mild; for prolonged therapy, periodic blood counts and liver tests are prudent.
  • Drug interactions: Concomitant nephrotoxic drugs (e.g. aminoglycosides, high-dose diuretics) can increase kidney toxicity. If used together, monitor renal function closely. (No significant cytochrome P450 interactions are known since cefepime is renally cleared.)
  • Pregnancy/Lactation: Cefepime is category B; it crosses the placenta and enters breastmilk in small amounts. Use in pregnancy only if clearly indicated.

Always use cefepime strictly as prescribed. Do not use for viral infections. Complete the full course to prevent resistance.

Key Points

  • Broad-spectrum beta-lactam: Cefepime injection is a 4th-generation parenteral cephalosporin. It treats many Gram-negative and Gram-positive infections, including drug-resistant strains.
  • Severe infections: It is indicated in hospitals for serious infections (e.g. pneumonia, complicated UTIs, skin infections, neutropenic fever).
  • Administration: Given IV (1–2 g every 8–12 h) by healthcare staff. Each dose is reconstituted and infused over ~30 minutes (IM only in specific mild cases)..
  • Renal dosing: It is eliminated by the kidneys (half-life ≈2 h). Reduce dose or extend interval if renal function is impaired.
  • Allergy and precautions: Avoid in patients allergic to cephalosporins/penicillins. Monitor for side effects like rash, gastrointestinal upset, and neurotoxicity.
  • Use guidelines: Only use when bacterial infection is confirmed or strongly suspected to avoid resistance. Do not share injections or reuse vials.

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