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Cefuroxime Axetil USP

Merocef 250 250 mg 2X4 Tablet
Merocef 500 500 mg 2X4 Tablet
Merocef-750 750 mg 1's IV/IM injection
Merocef 70 125 mg/ 5 ml 70 ml Powder for suspension


Merocef (Cefuroxime) is a 2nd generation cephalosporin antibacterial agent, which has broad-spectrum bactericidal activity against a wide range of common pathogens, including b-lactamase producing strains. Cefuroxime has good stability to bacterial b-lactamase and consequently, is active against many Ampicillin-resistant and Amoxycillin-resistant strains.

Merocef 250 Tablet: Each tablet contains Cefuroxime 250 mg as Cefuroxime Axetil USP. Merocef 500 Tablet: Each tablet contains Cefuroxime 500 mg as Cefuroxime Axetil USP. Merocef 70 ml suspension: Each 5 ml suspension contains Cefuroxime 125 mg as Cefuroxime Axetil USP. Merocef 750 injection: Each vial contains Cefuroxime 750 mg as Cefuroxime Sodium USP.

Merocef is indicated in the treatment of mild to moderate infections as - Upper respiratory tract infections - ear, nose and throat infections such as otitis media, sinusitis, tonsillitis and pharyngitis. Lower respiratory tract infections - acute bronchitis, acute exacerbations of chronic bronchitis and pneumonia. Skin and soft tissue infections - furunculosis, pyoderma, and impetigo. Genito-urinary tract infections - pyelonephritis, urethritis and cystitis. Gonorrhoea - acute uncomplicated gonococcal urethritis and cervicitis. Obstetric and gynaecological infection – pelvic inflammatory diseases. Bone and joint infections – osteomyelitis and septic arthritis. Other infections - Meningitis, Septicemia and as surgical prophylaxis in abdominal, pelvic, orthopedic, cardiac, pulmonary, esophageal and vascular surgery where there is increased risk from infection.

ORAL: Adults (13 years and older): Most infections will respond to 250 mg b.i.d. In mild to moderate lower respiratory tract infections e.g. bronchitis 250 mg b.i.d. should be given. For more severe lower respiratory tract infections, or if pneumonia is suspected then 500 mg b.i.d. should be given. For urinary tract infections a dose of 125 mg b.i.d. is usually adequate; in pyelonephritis the recommended dose is 250 mg b.i.d. A single dose of one gram is recommended for the treatment of uncomplicated gonorrhoea. Lyme disease in adults and children over the age of 12 years: the recommended dose is 500 mg b.i.d. for 20 days. Children (upto 12 years who can swallow tablet): The usual dose is 125 mg b.i.d., or 10 mg/kg b.i.d. to a maximum of 250 mg daily. For otitis media, in children less than 2 years of age the usual dosage is 125 mg b.i.d., or 10 mg/kg b.i.d. to a maximum of 250 mg daily and in children over 2 years of age, 250 mg b.i.d., or 15 mg/kg b.i.d. to a maximum of 500 mg daily. Dry Powder for Suspension: (3 months to 12 years): The usual dose is 10-15 mg / kg bid. In pharyngitis/tonsillitis dosage is 10 mg/kg bid for 10 days, in acute otitis media dosage is 15 mg/kg bid for 10 days, in acute bacterial maxillary sinusitis dosage is 15 mg/kg bid for 10 days and in impetigo and other skin infections dosage is 15 mg/kg bid for 10 days. PARANTERAL: General Dosage Recommendation: Adult and Adolescent: Many infections will respond to 750 mg tds by IM/IV injection. For more severe infections, this dose should be increased to 1.5 g tds IV. The frequency of IM or IV can be increased to to six hourly if necessary, giving total doses of 3g to 6g daily. Infants and children: 16.7 to 33.3 mg/kg of body weight tds. A dose of 60 mg/kg/day will be appropriate for most infections. Neonates: 10 to 33.3 mg/kg body weight tds by IM/IV injection or 15 to 50 mg/kg body weight bid. Some special dosage recommendations: Meningitis: Adults: Recommended dose is upto 3g IV tds. Infants and children: 50 to 60 mg/kg of body weight every six hours. Or 66.7 to 80 mg/kg of body weight tds. This dose may be reduced to 100 mg/kg/day IV after 3 days or when clinical improvement occurs. Neonates: 33.3 mg/kg of body weight tds or 50 mg/kg of body weight bid (the initial dosage should be 100 mg/kg/day IV. A reduction to 50 mg/kg/day IV may be made when clinically indicated.Gonorrhoea: Adults: 1.5 g IM should be given as single dose or divided into two doses (2 x 750 mg) and administered two separate sites eg. each buttock. Children: Recommended children single dose is 25 mg/kg body weight. Bone and joint infection: Adults: 1.5 g IV tds. Children above 3 months: 150 mg/kg/day (not exceed the maximum adult dosage) in equally divided doses every 8 hours. Surgical prophylaxis: Clean-contaminated or potentially contaminated procedure: 1.5g IV before ½ - 1 hour before the initial incision. Thereafter 750 mg IV/IM 8 hours when the procedure is prolonged. Open heart surgery: 1.5 g IV at the induction of anesthesia and every 12 hours thereafter for a total of 6 gms is recommended.

As with other antibiotics, prolonged use of Cefuroxime may result in the over growth of non-susceptible organisms (e.g. Candida, Enterococci, Clostridium difficile), which may require interruption of treatment.

While all antibiotics should be avoided in the first trimester if possible, Cefuroxime has been safely used in later pregnancy to treat urinary and other infections. Cefuroxime is excreted in human milk, and consequently caution should be exercised when Cefuroxime is administered to a nursing mother.

Concomitant administration of probenecid with Cefuroxime axetil increases the area under the serum concentration versus time curve by 50%. Drugs that reduce gastric acidity may result in a lower bioavailability of Cefuroxime axetil compared with that of fasting state and tend cancel the effect of postprandial absorption.

Excessively large doses of all Cephalosporins can cause cerebral irritation and may cause convulsions. This complication is unlikely to occur in routine practice unless the patient is in renal failure. Haemodialysis or peritoneal dialysis can remove Cefuroxime.

Tablet: Store in a cool and dry place protected from light. Suspension: Store below 30°C protected from light and moisture. Injection: Store below 25°C protected from light. The reconstituted solution for IV or IM administration maintains potency for 24 hours at room temperature and for 48 hours when refrigerated at 5°C.

Cefuroxime is contraindicated in patients with known allergy to Cephalosporins.

Merocef 250 Tablet: Each box contains 8 tablets in alu-alu blister pack. Merocef 500 Tablet: Each box contains 8 tablets in alu-alu blister pack. Merocef 70 ml suspension: Each bottle contains dry powder for 70 ml suspension. Merocef 750 injection: Each box contains 1 vial injection and 1 ampoule of 10 ml WFI.