2.1 Important Administration Instructions
•
CEFTIN tablets and CEFTIN for oral suspension are not bioequivalent and are therefore not substitutable on a milligram-per-milligram basis
[see Clinical Pharmacology (12.3)].
•
Administer CEFTIN tablets or oral suspension as described in the appropriate dosage guidelines
[see Dosage and Administration (2.2, 2.3, 2.4)].
•
Administer CEFTIN tablets with or without food.
•
Administer CEFTIN for oral suspension with food.
•
Pediatric patients (aged 13 years and older) who cannot swallow the CEFTIN tablets whole should receive CEFTIN for oral suspension because the tablet has a strong, persistent bitter taste when crushed
[see Dosage and Administration (2.2)].
2.2 Dosage for CEFTIN Tablets
Administer CEFTIN tablets as described in the dosage guidelines table below with or without food.
Table 1. Adult Patients and Pediatric Patients Dosage Guidelines for CEFTIN Tablets
Infection
Dosage
Duration
(Days)
Adults and Adolescents (13 years and older)
Pharyngitis/tonsillitis (mild to moderate)
250 mg every 12 hours
10
Acute bacterial maxillary sinusitis (mild to moderate)
250 mg every 12 hours
10
Acute bacterial exacerbations of chronic bronchitis (mild to moderate)
250 or 500 mg every 12 hours
10a
Secondary bacterial infections of acute bronchitis
250 or 500 mg every 12 hours
5 to 10
Uncomplicated skin and skin-structure infections
250 or 500 mg every 12 hours
10
Uncomplicated urinary tract infections
250 mg every 12 hours
7 to 10
Uncomplicated gonorrhea
1,000 mg
single dose
Early Lyme disease
500 mg every 12 hours
20
Pediatric Patients younger than 13 years (who can swallow tablets whole)b
Acute bacterial otitis media
250 mg every 12 hours
10
Acute bacterial maxillary sinusitis
250 mg every 12 hours
10
a The safety and effectiveness of CEFTIN administered for less than 10 days in patients with acute exacerbations of chronic bronchitis have not been established.
b When crushed, the tablet has a strong, persistent bitter taste. Therefore, patients who cannot swallow the tablet whole should receive the oral suspension.
2.3 Dosage for CEFTIN for Oral Suspension
Administer CEFTIN for oral suspension as described in the dosage guidelines table below with food.
Table 2. Pediatric Patients (3 months to 12 years) Dosage Guidelines for CEFTIN for Oral Suspension
Infection
Recommended Daily Dosea
Maximum Daily Dose
Duration (Days)
Pharyngitis/tonsillitis
20 mg/kg
500 mg
10
Acute bacterial otitis media
30 mg/kg
1,000 mg
10
Acute bacterial maxillary sinusitis
30 mg/kg
1,000 mg
10
Impetigo
30 mg/kg
1,000 mg
10
a Recommended daily dose given twice daily divided in equal doses.
2.4 Preparation and Administration of CEFTIN for Oral Suspension
Prepare a suspension at the time of dispensing as follows:
1.
Shake the bottle to loosen the powder.
2.
Remove the cap.
3.
Add the total amount of water for reconstitution (Table 3) and replace the cap.
4.
Invert the bottle and vigorously rock the bottle from side to side so that water rises through the powder.
5.
Once the sound of the powder against the bottle disappears, turn the bottle upright and vigorously shake it in a diagonal direction.
Table 3. Amount of Water Required for Reconstitution of Labeled Volumes of CEFTIN for Oral Suspension
Oral Suspension
Amount of Water Required for Reconstitution
Labeled Volume after Reconstitution
125 mg/5 mL
37 mL
100 mL
250 mg/5 mL
19 mL
50 mL
35 mL
100 mL
•
Shake the oral suspension well before each use.
•
Replace cap securely after each opening.
•
Store the reconstituted suspension refrigerated between 2° and 8°C (36° and 46°F).
•
Discard the reconstituted suspension after 10 days.
2.5 Dosage in Patients with Impaired Renal Function
A dosage interval adjustment is required for patients whose creatinine clearance is <30 mL/min, as listed in Table 4 below, because cefuroxime is eliminated primarily by the kidney [see Clinical Pharmacology (12.3)].
Table 4. Dosing in Adults with Renal Impairment
Creatinine Clearance (mL/min)
Recommended Dosage
≥30
No dosage adjustment
10 to ˂30
Standard individual dose given every 24 hours
˂10 (without hemodialysis)
Standard individual dose given every 48 hours
Hemodialysis
A single additional standard dose should be given at the end of each dialysis