Cefaclor

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Side Effects & Adverse Reactions

BEFORE THERAPY WITH CEFACLOR IS INSTITUTED, CAREFUL INQUIRY SHOULD BE MADE TO DETERMINE WHETHER THE PATIENT HAS HAD PREVIOUS HYPERSENSITIVITY REACTIONS TO CEFACLOR, CEPHALOSPORINS, PENICILLINS, OR OTHER DRUGS. IF THIS PRODUCT IS TO BE GIVEN TO PENICILLIN-SENSITIVE PATIENTS, CAUTION SHOULD BE EXERCISED BECAUSE CROSS-HYPERSENSITIVITY AMONG β-LACTAM ANTIBIOTICS HAS BEEN CLEARLY DOCUMENTED AND MAY OCCUR IN UP TO 10% OF PATIENTS WITH A HISTORY OF PENICILLIN ALLERGY.

IF AN ALLERGIC REACTION TO CEFACLOR OCCURS, DISCONTINUE THE DRUG. SERIOUS ACUTE HYPERSENSITIVITY REACTIONS MAY REQUIRE TREATMENT WITH EPINEPHRINE AND OTHER EMERGENCY MEASURES, INCLUDING OXYGEN, INTRAVENOUS FLUIDS, INTRAVENOUS ANTIHISTAMINES, CORTICOSTEROIDS, PRESSOR AMINES, AND AIRWAY MANAGEMENT, AS CLINICALLY INDICATED.

Antibiotics, including cefaclor, should be administered cautiously to any patient who has demonstrated some form of allergy, particularly to drugs.

Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including cefaclor, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile.

C. difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents.

If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C difficile, and surgical evaluation should be instituted as clinically indicated.

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Legal Issues

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FDA Safety Alerts

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Manufacturer Warnings

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FDA Labeling Changes

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Uses

Cefaclor is indicated in the treatment of the following infections when caused by susceptible strains of the designated microorganisms:

Otitis media caused by Streptococcus pneumoniae, Haemophilus influenzae, staphylococci, and Streptococcus pyogenes

Lower respiratory tract infections, including pneumonia caused by Streptococcus pneumoniae, Haemophilus influenzae, and Streptococcus pyogenes

Pharyngitis and Tonsillitis, caused by Streptococcus pyogenes

Note: Penicillin is the usual drug of choice in the treatment and prevention of streptococcal infections, including the prophylaxis of rheumatic fever. Cefaclor is generally effective in the eradication of streptococci from the nasopharynx; however, substantial data establishing the efficacy of cefaclor in the subsequent prevention of rheumatic fever are not available at present.

Urinary tract infections, including pyelonephritis and cystitis, caused by Escherichia coli, Proteus mirabilis, Klebsiella spp., and coagulase-negative staphylococci

Skin and skin structure infections caused by Staphylococcus aureus and Streptococcus pyogenes

Appropriate culture and susceptibility studies should be performed to determine susceptibility of the causative organism to cefaclor.

To reduce the development of drug-resistant bacteria and maintain the effectiveness of cefaclor and other antibacterial drugs, cefaclor should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

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History

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Other Information

Cefaclor Capsules, USP are a semisynthetic cephalosporin antibiotic for oral administration. It is chemically designated as 3-chloro-7-D-(2-phenylglycinamido)-3-cephem-4-carboxylic acid monohydrate. The molecular formula for cefaclor is C15H14ClN3O4S•H2O and the molecular weight is 385.82.

Each capsule contains cefaclor monohydrate equivalent to 250 mg (0.68 mmol) or 500 mg (1.36 mmol) anhydrous cefaclor. The capsules also contain black iron oxide, croscarmellose sodium, FD & C Red No.3, FD & C Blue No.2, gelatin, magnesium stearate, corn starch, and titanium dioxide.

The color of the capsule powder is white to off white.

Sources

Cefaclor Manufacturers

West-ward Pharmaceutical Corp

Cefaclor | West-ward Pharmaceuticals Corp

Cefaclor is administered orally.

Adults–The usual adult dosage is 250 mg every 8 hours. For more severe infections (such as pneumonia) or those caused by less susceptible organisms, doses may be doubled.

Pediatric patients–The usual recommended daily dosage for children is 20 mg/kg/day in divided doses every 8 hours. In more serious infections, otitis media, and infections caused by less susceptible organisms, 40 mg/kg/day are recommended, with a maximum dosage of 1 g/day.

Cefaclor may be administered in the presence of impaired renal function. Under such a condition, the dosage usually is unchanged (see PRECAUTIONS).

In the treatment of β-hemolytic streptococcal infections, a therapeutic dosage of cefaclor should be administered for at least 10 days.

No Recall
Bryant Ranch Prepack

Cefaclor | Bryant Ranch Prepack

Cefaclor is administered orally.

Adults –The usual adult dosage is 250 mg every 8 hours. For more severe infections (such as pneumonia) or those caused by less susceptible organisms, doses may be doubled.

Pediatric patients–The usual recommended daily dosage for pediatric patients is 20 mg/kg/day in divided doses every 8 hours. In more serious infections, otitis media, and infections caused by less susceptible organisms, 40 mg/kg/day are recommended, with a maximum dosage of 1 g/day.

Cefaclor may be administered in the presence of impaired renal function. Under such a condition, the dosage usually is unchanged (see Precautions).

In the treatment of β-hemolytic streptococcal infections, a therapeutic dosage of cefaclor should be administered for at least 10 days.

No Recall
Physicians Total Care, Inc.

Cefaclor | Physicians Total Care, Inc.

Cefaclor is administered orally.

Adults –The usual adult dosage is 250 mg every 8 hours. For more severe infections (such as pneumonia) or those caused by less susceptible organisms, doses may be doubled.

Pediatric patients–The usual recommended daily dosage for children is 20 mg/kg/day in divided doses every 8 hours. In more serious infections, otitis media, and infections caused by less susceptible organisms, 40 mg/kg/day are recommended, with a maximum dosage of 1 g/day.

Cefaclor Suspension
20 mg/kg/day Weight 125 mg/5 mL 250 mg/5 mL 9 kg 1/2 tsp t.i.d.
18 kg 1 tsp t.i.d. 1/2 tsp t.i.d.
40 mg/kg/day 9 kg 1 tsp t.i.d. ½ tsp t.i.d 18 kg
1 tsp t.i.d.
B.I.D. Treatment Option–For the treatment of otitis media and pharyngitis, the total daily dosage may be divided and administered every 12 hours.

Cefaclor Suspension
20 mg/kg/day
(Pharyngitis) Weight 187 mg/5 mL 375 mg/5 mL 9 kg 1/2 tsp b.i.d.
18 kg 1 tsp b.i.d. 2 tsp b.i.d.
40 mg/kg/day
(Otitis Media) 9 kg 1 tsp b.i.d. 1/2 tsp b.i.d. 18 kg
1 tsp b.i.d.
Cefaclor may be administered in the presence of impaired renal function. Under such a condition, the dosage usually is unchanged (see PRECAUTIONS).

In the treatment of β-hemolytic streptococcal infections, a therapeutic dosage of cefaclor should be administered for at least 10 days.

No Recall
Alvogen, Inc.

Cefaclor | Alvogen, Inc.

Cefaclor is administered orally.

Adults -- The usual adult dosage is 250 mg every 8 hours. For more severe infections (such as

pneumonia) or those caused by less susceptible organisms, doses may be doubled.

Pediatric Patients -- The usual recommended daily dosage for pediatric patients is 20 mg/kg/day in divided doses every 8 hours. In more serious infections, otitis media, and infections caused by less susceptible organisms, 40 mg/kg/day are recommended, with a maximum dosage of 1 g/day.
Cefaclor Suspension 20 mg/kg/day Weight 124 mg/5mL 250 mg/5mL 9 kg ½ tsp t.i.d. 18 kg 1 tsp t.i.d. ½ tsp t.i.d. 40 mg/kg/day 9 kg 1 tsp t.i.d. ½ tsp t.i.d. 18 kg 1 tsp t.i.d.
B.I.D. Treatment Option – For the treatment of

otitis media and pharyngitis, the total daily dosage

may be divided and administered every 12 hours.
Cefaclor Suspension 20 mg/kg/day Weight 187 mg/5mL 375 mg/5mL 9 kg ½ tsp b.i.d. 18 kg 1 tsp b.i.d. ½ tsp b.i.d. 40 mg/kg/day 9 kg 1 tsp b.i.d. ½ tsp b.i.d. 18 kg 1 tsp b.i.d.
Cefaclor may be administered in the presence of impaired renal function. Under such a condition, the dosage usually is unchanged (see PRECAUTIONS).

In the treatment of β-hemolytic streptococcal infections, a therapeutic dosage of cefaclor should be administered for at least 10 days.

No Recall
Pd-rx Pharmaceuticals, Inc.

Cefaclor | Pd-rx Pharmaceuticals, Inc.

Cefaclor is administered orally.

Adults –The usual adult dosage is 250 mg every 8 hours. For more severe infections (such as pneumonia) or those caused by less susceptible organisms, doses may be doubled.

Pediatric patients–The usual recommended daily dosage for pediatric patients is 20 mg/kg/day in divided doses every 8 hours. In more serious infections, otitis media, and infections caused by less susceptible organisms, 40 mg/kg/day are recommended, with a maximum dosage of 1 g/day.

Cefaclor may be administered in the presence of impaired renal function. Under such a condition, the dosage usually is unchanged (see PRECAUTIONS).

In the treatment of β-hemolytic streptococcal infections, a therapeutic dosage of cefaclor should be administered for at least 10 days.

No Recall
Carlsbad Technology, Inc.

Cefaclor | Carlsbad Technology, Inc.

Cefaclor is administered orally.

Adults -- The usual adult dosage is 250 mg every 8 hours. For more severe infections (such as pneumonia) or those caused by less susceptible organisms, doses may be doubled.

Pediatric Patients -- The usual recommended daily dosage for pediatric patients is 20 mg/kg/day in divided doses every 8 hours. In more serious infections, otitis media, and infections caused by less susceptible organisms, 40 mg/kg/day are recommended, with a maximum dosage of 1 g/day.
Cefaclor Suspension 20 mg/kg/day Weight 125 mg/5 mL 250 mg/5 mL 9 kg 1/2 tsp t.i.d. 18 kg 1 tsp t.i.d. 1/2 tsp t.i.d. 40 mg/kg/day 9 kg 1 tsp t.i.d. 1/2 tsp t.i.d. 18 kg 1 tsp t.i.d.
B.I.D. Treatment Option - For the treatment of otitis media and pharyngitis, the total daily dosage may be divided and administered every 12 hours.
Cefaclor Suspension 20 mg/kg/day
(Pharyngitis) Weight 187 mg/5 mL 375 mg/5 mL 9 kg 1/2 tsp b.i.d. 18 kg 1 tsp b.i.d. 1/2 tsp b.i.d. 40 mg/kg/day
(Otitis Media) 9 kg 1 tsp b.i.d. 1/2 tsp b.i.d. 18 kg 1 tsp b.i.d.
Cefaclor may be administered in the presence of impaired renal function. Under such a condition, the dosage usually is unchanged (see PRECAUTIONS).

In the treatment of β-hemolytic streptococcal infections, a therapeutic dosage of cefaclor should be administered for at least 10 days.

No Recall
A-s Medication Solutions Llc

Cefaclor | A-s Medication Solutions Llc

Cefaclor is administered orally.

Adults –The usual adult dosage is 250 mg every 8 hours. For more severe infections (such as pneumonia) or those caused by less susceptible organisms, doses may be doubled.

Pediatric patients–The usual recommended daily dosage for pediatric patients is 20 mg/kg/day in divided doses every 8 hours. In more serious infections, otitis media, and infections caused by less susceptible organisms, 40 mg/kg/day are recommended, with a maximum dosage of 1 g/day.

Cefaclor may be administered in the presence of impaired renal function. Under such a condition, the dosage usually is unchanged (see PRECAUTIONS).

In the treatment of β-hemolytic streptococcal infections, a therapeutic dosage of cefaclor should be administered for at least 10 days.

No Recall
Teva Pharmaceuticals Usa Inc

Cefaclor | Teva Pharmaceuticals Usa Inc

The absorption of cefaclor extended-release tablets is enhanced when it is administered with food. (See CLINICAL PHARMACOLOGY.) Therefore, cefaclor extended-release tablets should be administered with meals (i.e., at least within one hour of eating). The extended-release tablets should not be cut, crushed, or chewed.

See INDICATIONS AND USAGE for information about patients for whom cefaclor extended-release tablets are indicated.

NOTE: 500 mg BID of cefaclor extended-release tablets is clinically equivalent to 250 mg TID of cefaclor immediate-release as a capsule in those indications listed in the INDICATIONS AND USAGE section of this label. 500 mg BID of cefaclor extended-release tablets is NOT equivalent to 500 mg TID of other cefaclor formulations.

Adults (age 16 years and older):

Type of Infection (as qualified in the INDICATIONS AND USAGE section of this labeling)

Total Daily Dose

Dose and Frequency

Duration

Acute Bacterial Exacerbations of Chronic Bronchitis due to H. influenzae (non-ß-lactamase-producing strains only). Moraxella catarrhalis (including ß-lactamase-producing strains), or Streptococcus pneumoniae (See INDICATIONS AND USAGE.)

1000 mg

500 mg q 12 hours

7 days

Secondary Bacterial Infection of Acute Bronchitis due to H. influenzae (non-ß-lactamase-producing strains only). M. catarrhalis (including ß-lactamase-producing strains), or S. pneumoniae (See INDICATIONS AND USAGE.)

1000 mg

500 mg q 12 hours

7 days

Pharyngitis and/or tonsillitis due to S. pyogenes

750 mg

375 mg q 12 hours

10 days

Uncomplicated Skin and Skin Structure Infections due to S. aureus (methicillin-susceptible strains) (See INDICATIONS AND USAGE.)

750 mg

375 mg q 12 hours

7 to 10 days

Elderly patients with normal renal function do not require dosage adjustments.

No Recall
Bryant Ranch Prepack

Cefaclor | Bryant Ranch Prepack

Cefaclor is administered orally.

Adults –The usual adult dosage is 250 mg every 8 hours. For more severe infections (such as pneumonia) or those caused by less susceptible organisms, doses may be doubled.

Pediatric patients–The usual recommended daily dosage for pediatric patients is 20 mg/kg/day in divided doses every 8 hours. In more serious infections, otitis media, and infections caused by less susceptible organisms, 40 mg/kg/day are recommended, with a maximum dosage of 1 g/day.

Cefaclor may be administered in the presence of impaired renal function. Under such a condition, the dosage usually is unchanged (see PRECAUTIONS).

In the treatment of β-hemolytic streptococcal infections, a therapeutic dosage of cefaclor should be administered for at least 10 days.

No Recall