Zinacef, 750 mg

Active ingredient

Composition

1 vial contains:

Active ingredients:

cefuroxime (in the form of sodium salt) 750 mg.

In a vial 750 mg of powder.

There is 1 vial in the carton pack.

How to take, the dosage

Adults are administered v/m or intravenously 750 mg 3 times/day. In more severe cases the drug is administered by IV in a dose of 1.5 g 3 times/day. If necessary, Zinacef may be administered every 6 hours, and the daily dose may be 3 to 6 g.

In some infections, it is effective to prescribe Zinacef in a dose of 750 mg or 1.5 g 2 times/day (w/v or iv) followed by an oral dose of Zinnate.

In children the drug is prescribed in a dose of 30-100 mg/kg/day in 3-4 doses. For most infections the optimal dose is 60 mg/kg/day.

In newborns 30-100 mg/kg/day in 2-3 doses.

To treat gonorrhea, 1.5 g is prescribed once (two doses of 750 mg w/o in different sites, e.g., both gluteal muscles).

In meningitis, adults are prescribed 3 g v/v every 8 hours; children, 150-250 mg/kg/day v/v in 3-4 doses; newborns, 100 mg/kg/day v/v.

In order to prevent infectious complications during abdominal, pelvic and orthopedic surgeries Zinacef is administered in dose of 1.5 g by IV fluids during induction anesthesia. Eight hours and 16 hours after surgery, 750 mg of Zinacef may be administered additionally by intravenous injection.

In order to prevent infectious complications during cardiac, pulmonary, esophageal and vascular surgeries during induction anesthesia Zinacef is administered in 1.5 g dose by IV and then 750 mg 3 times per day by IV for 24-48 hours.

In case of total joint replacement, 1.5 g of cefuroxime powder can be mixed with a polymer packet of methyl methacrylate cement before adding the liquid polymer.

Stage therapy

In pneumonia, Zinacef is given in a dose of 1.5 g 2-3 times/day (IV or IM) for 48-72 h, followed by administration of Zinnate (oral) in a dose of 500 mg 2 times/day for 7-10 days.

In exacerbation of chronic bronchitis Zinacef is prescribed at a dose of 750 mg 2-3 times/day (IV or IM) for 48-72 hours followed by administration of Zinnate (oral) 500 mg 2 times/day for 5-10 days.

The duration of each period (parenteral therapy and oral administration) is determined by the severity of the infection and the overall condition of the patient.

Renal failure

In cases of renal failure, a reduction in the dose of Zinacef is recommended. However, it is not necessary to decrease the standard dose of the drug (0.75-1.5 g 3 times/day) in patients with CKR over 20 ml/min.

The dose adjustment of Zinacef in adult renal failure

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Creatinine clearance

Dose of Zinacef

>20 ml/min

0.75-1.5 g 3 times/day

10-20 ml/min

750 mg 2 times/day

<10 ml/min

750 mg/d

Patients on hemodialysis should be given an additional dose of Zinacef equal to 750 mg at the end of each hemodialysis session.

Patients in the ICU on continuous hemodialysis using an arterio-venous shunt or on high-speed hemofiltration are recommended a dose of 750 mg twice daily. If low rate hemofiltration is used, doses as in renal failure are used.

Regulations for preparing solution for injection

To prepare solution for injection, add 1 ml of water for injection to 250 mg of Zinacef or 3 ml of water for injection to 750 mg of Zinacef. Shake gently until a suspension is formed.

To prepare a solution for intravenous injection, dissolve 250 mg of Zinacef in 2 ml or more of water for injection, 750 mg of Zinacef in 6 ml or more of water for injection, 1.5 g of Zinacef in 15 ml or more of water for injection.

To prepare a solution for short-term IV infusions (up to 30 minutes), 1.5 g of the drug is dissolved in 50 ml of water for injection. These solutions may be injected directly into a vein or into a tube of an infusion system.

Interaction

Simultaneous administration with “loop” diuretics (furosemide) and aminoglycosides slows down tubular secretion, reduces renal clearance, increases plasma concentrations and increases T1/2 cefuroxime, which increases the risk of nephrotoxic effects. Zinacef in combination with aminoglycosides acts additively, but synergism may sometimes be observed.

Pharmaceutical interactions

When a solution of cefuroxime (1.5 g in 15 ml of water for injection) and metronidazole (500 mg/100 ml) is mixed, both components retain their activity for up to 24 hours at a temperature not exceeding 25°C. Zinacef in dose 1.5 g is compatible with azlocillin solution (1 g in 15 ml or 5 g in 50 ml); both components retain their activity for up to 24 hours at 4°C or up to 6 hours at a temperature not exceeding 25°C. A solution of Zinacef (5 mg/ml) in 5% or 10% xylitol solution can be stored for up to 24 h at a temperature not exceeding 25°C.

Zinacef is compatible with aqueous solutions containing up to 1% lidocaine hydrochloride.

Zinacef is compatible with the most commonly used infusion solutions.

When mixed with the following solutions the drug is stable for up to 24 hours at room temperature: 0.9% sodium chloride solution; 5% dextrose solution for injection; 0.18% sodium chloride solution and 4% dextrose solution for injection; 5% dextrose solution and 0.9% sodium chloride solution; 5% dextrose solution and 0.45% sodium chloride solution; 5% dextrose solution and 0.225% sodium chloride solution; 10% dextrose solution for injection; Ringer’s solution; Ringer’s lactate solution; Hartmann’s solution.

The stability of cefuroxime in 0.9% sodium chloride solution and 5% dextrose solution is not impaired in the presence of hydrocortisone sodium phosphate.

The following solutions of Zinacef are compatible and stable for 24 h at room temperature: heparin (10 U/ml and 50 U/ml) in 0.9% sodium chloride solution; potassium chloride (10 mEq/L and 40 mEq/L) in 0.9% sodium chloride solution.

Zinacef should not be mixed in the same syringe with antibiotics from the group of aminoglycosides.

Sodium bicarbonate solution 2.74% has a pH value that significantly affects the color of the cefuroxime solution, so it is not recommended to use it to dilute Zinacef. However, if the patient is administered sodium bicarbonate solution by infusion, Zinacef can be injected directly into the tube of the infusion system if needed.

Special Instructions

Contraindications

Side effects

Overdose

Symptoms: increased cortical excitability with the development of convulsions.

Treatment: symptomatic therapy, hemodialysis, peritoneal dialysis.

Pregnancy use

The drug is classified as category B. Caution should be exercised when prescribing the drug in pregnancy.

Cefuroxime is excreted with breast milk, therefore caution should be exercised when prescribing the drug to nursing mothers.

There are no data on the development of embryotoxic or teratogenic effects of cefuroxime.

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