cefprozil (Rx)

Brand and Other Names:Cefzil
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 250mg
  • 500mg

oral suspension

  • 125mg/5mL
  • 250mg/5mL

Pharyngitis & Tonsillitis

Caused by S. Pyogenes

500 mg PO qDay for 10 days

Respiratory Tract Infections

250-500 mg PO q12hr for10 days

Skin Infections

250-500 mg q12hr OR 500 mg qDay for10 days

Renal Impairment

CrCl <30 mL/min: Give 1/2 usual dose

Other Indications & Uses

Spectrum similar to cefuroxime; used for respiratory tract infections & otitis media

B. fragilis, C. perfringens, E. coli, H. influenzae, Klebsiella spp., M. catarrhalis, S. aureus, S. pyogenes

Dosage Forms & Strengths

tablet

  • 250mg
  • 500mg

oral suspension

  • 125mg/5mL
  • 250mg/5mL

Acute Otitis Media

6 months old-12 years old: 30 mg/kg/day divided q12hr PO x 10 days  

Acute Sinusitis

6 months old-12 years old: 15-30 mg/kg/day divided q12hr PO x10 days  

Pharyngitis & Tonsillitis

2-12 years old: 15 mg/kg/day divided q12hr PO x10 days  

Skin Infections

2-12 years old: 20 mg/kg PO qDay x10 days  

>12 years

As in adults

Pharyngitis & Tonsillitis

Caused by S. Pyogenes 500 mg PO qDay for 10 days

Respiratory Tract Infections

250-500 mg PO q12hr for10 days

Skin Infections

250-500 mg q12hr OR 500 mg qDay for10 days

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Interactions

Interaction Checker

and cefprozil

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      Serious - Use Alternative

        Significant - Monitor Closely

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            Contraindicated (0)

              Serious - Use Alternative (3)

              • BCG vaccine live

                cefprozil decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.

              • cholera vaccine

                cefprozil, cholera vaccine. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid coadministration of cholera vaccine with systemic antibiotics since these agents may be active against the vaccine strain. Do not administer cholera vaccine to patients who have received oral or parenteral antibiotics within 14 days prior to vaccination.

              • typhoid vaccine live

                cefprozil decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.

              Monitor Closely (14)

              • bazedoxifene/conjugated estrogens

                cefprozil will decrease the level or effect of bazedoxifene/conjugated estrogens by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • dienogest/estradiol valerate

                cefprozil will decrease the level or effect of dienogest/estradiol valerate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. An alternate or additional form of birth control may be advisable during concomitant use.

              • estradiol

                cefprozil will decrease the level or effect of estradiol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • ethinylestradiol

                cefprozil will decrease the level or effect of ethinylestradiol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • furosemide

                furosemide will increase the level or effect of cefprozil by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.

              • hydrochlorothiazide

                hydrochlorothiazide will increase the level or effect of cefprozil by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.

              • levonorgestrel oral/ethinylestradiol/ferrous bisglycinate

                cefprozil will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. Antibiotics may decrease hormonal contraceptive efficacy.

              • mestranol

                cefprozil will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • probenecid

                probenecid will increase the level or effect of cefprozil by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.

              • sodium picosulfate/magnesium oxide/anhydrous citric acid

                cefprozil decreases effects of sodium picosulfate/magnesium oxide/anhydrous citric acid by altering metabolism. Use Caution/Monitor. Coadministration with antibiotics decreases efficacy by altering colonic bacterial flora needed to convert sodium picosulfate to active drug.

              • temocillin

                temocillin, cefprozil. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

              • ticarcillin

                ticarcillin, cefprozil. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

              • voclosporin

                voclosporin, cefprozil. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.

              • warfarin

                cefprozil increases effects of warfarin by Other (see comment). Use Caution/Monitor. Comment: Decr vitamin K-producing intestinal flora may increase INR after a few days.

              Minor (16)

              • aminohippurate sodium

                cefprozil will increase the level or effect of aminohippurate sodium by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • aspirin

                cefprozil will increase the level or effect of aspirin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • aspirin rectal

                cefprozil will increase the level or effect of aspirin rectal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • aspirin/citric acid/sodium bicarbonate

                cefprozil will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • bendroflumethiazide

                cefprozil will increase the level or effect of bendroflumethiazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • chloramphenicol

                chloramphenicol decreases effects of cefprozil by pharmacodynamic antagonism. Minor/Significance Unknown.

              • chlorothiazide

                cefprozil will increase the level or effect of chlorothiazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • choline magnesium trisalicylate

                cefprozil will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • cyclopenthiazide

                cefprozil will increase the level or effect of cyclopenthiazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • furosemide

                cefprozil increases toxicity of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of nephrotoxicity.

              • hydrochlorothiazide

                cefprozil will increase the level or effect of hydrochlorothiazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • methyclothiazide

                cefprozil will increase the level or effect of methyclothiazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • rose hips

                rose hips will increase the level or effect of cefprozil by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • salicylates (non-asa)

                cefprozil will increase the level or effect of salicylates (non-asa) by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • sulfasalazine

                cefprozil will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • willow bark

                cefprozil will increase the level or effect of willow bark by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

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              Adverse Effects

              1-10%

              Nausea (3.5%)

              Diarrhea (2.9%)

              Elevated LFTs (2%)

              Diaper rash (1.5%)

              Abdominal pain (1%)

              Dizziness (1%)

              Vomiting (1%)

              eosinophilia

              superinfection

              vaginitis

              <1%

              Eosinophilia

              Superinfection

              Vaginitis

              Cholestatic jaundice

              Elevated BUN & creatinine

              Prolonged PT

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              Warnings

              Contraindications

              Documented hypersensitivity

              Cautions (additional)

              Oral suspension contains aspartame; not indicated for patients with phenylketonuria

              Careful inquiry should be made to determine if patient has had previous hypersensitivity to cephalosporins, penicillins or similar drugs; cross sensitivity reported among beta-lactam antibiotics; discontinue therapy if reaction occurs

              Hypersensitivity reactions may require treatment with epinephrine and emergency measures, including intravenous fluids, oxygen, corticosteroids, intravenous antihistamines, pressor amines, and airway management as indicated

              Prescribing antibiotics in the absence of proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to patient and increases risk of development of drug-resistant bacteria

              Prolonged use of therapy may result in overgrowth of nonsusceptible organisms; careful observation of patient essential; if superinfection occurs during therapy, appropriate measures should be taken

              Cefprozil should be prescribed with caution in individuals with a history of gastrointestinal disease particularly colitis

              Positive direct Coombs’ tests have been reported during treatment with cephalosporin antibiotics.

              Renal impairment

              • In patients with known or suspected renal impairment, careful clinical observation and appropriate laboratory studies should be done prior to and during therapy; total daily dose of drug should be reduced in these patients because high and/or prolonged plasma antibiotic concentrations can occur in such individuals from usual doses
              • Therapy should be given with caution to patients receiving concurrent treatment with potent diuretics since these agents are suspected of adversely affecting renal function

              Clostridium difficile associated diarrhea (CDAD)

              • CDAD reported; may range in severity from mild diarrhea to fatal colitis; treatment with antibacterial agents alters normal flora of colon leading to overgrowth of C. difficile, which produces toxins A and B and contribute to 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 necessary since CDAD has been reported to occur over two months after administration of antibacterial agents
              • If CDAD 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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              Pregnancy & Lactation

              Pregnancy Category: B

              Lactation: low distribution into breast milk; use with caution

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Half-Life: 1.3 hr

              Peak Plasma Time: 1.5 hr

              Protein Bound: 35-45%

              Absorption: oral 94%

              Metabolism: liver

              Excretion: unchanged in urine: 61%

              Mechanism of Action

              Second-generation cephalosporin that binds to one or more of the penicillin-binding proteins, which in turn inhibits cell wall synthesis and results in bactericidal activity. Has gram-positive activity that first-generation cephalosporins have and adds activity against P mirabilis, H influenzae, E coli, K pneumoniae, and M catarrhalis

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              cefprozil oral
              -
              500 mg tablet
              cefprozil oral
              -
              250 mg tablet
              cefprozil oral
              -
              250 mg/5 mL suspension
              cefprozil oral
              -
              250 mg/5 mL suspension
              cefprozil oral
              -
              250 mg/5 mL suspension
              cefprozil oral
              -
              125 mg/5 mL suspension
              cefprozil oral
              -
              125 mg/5 mL suspension
              cefprozil oral
              -
              125 mg/5 mL suspension
              cefprozil oral
              -
              500 mg tablet
              cefprozil oral
              -
              250 mg/5 mL suspension
              cefprozil oral
              -
              250 mg tablet
              cefprozil oral
              -
              250 mg/5 mL suspension
              cefprozil oral
              -
              500 mg tablet
              cefprozil oral
              -
              250 mg/5 mL suspension
              cefprozil oral
              -
              250 mg/5 mL suspension
              cefprozil oral
              -
              250 mg/5 mL suspension
              cefprozil oral
              -
              125 mg/5 mL suspension
              cefprozil oral
              -
              250 mg/5 mL suspension
              cefprozil oral
              -
              250 mg/5 mL suspension
              cefprozil oral
              -
              250 mg tablet
              cefprozil oral
              -
              500 mg tablet
              cefprozil oral
              -
              250 mg tablet
              cefprozil oral
              -
              500 mg tablet
              cefprozil oral
              -
              125 mg/5 mL suspension
              cefprozil oral
              -
              250 mg/5 mL suspension
              cefprozil oral
              -
              125 mg/5 mL suspension
              cefprozil oral
              -
              250 mg/5 mL suspension

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              cefprozil oral

              CEFPROZIL SUSPENSION - ORAL

              (sef-PROE-zil)

              COMMON BRAND NAME(S): Cefzil

              USES: Cefprozil is used to treat a wide variety of bacterial infections. This medication is known as a cephalosporin antibiotic. It works by stopping the growth of bacteria.This antibiotic treats only bacterial infections. It will not work for viral infections (such as common cold, flu). Using any antibiotic when it is not needed can cause it to not work for future infections.

              HOW TO USE: Shake the bottle well before each dose. Measure the dose out carefully with a medication spoon/cup. Take this medication by mouth usually once or twice daily, or as directed by your doctor. You may take this medicine with food if stomach upset occurs. Dosage is based on your medical condition and response to therapy. In children, the dosage is also based on weight.For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same time(s) every day.Continue to take this medication until the full-prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may allow bacteria to continue to grow, which may result in a relapse of the infection.Inform your doctor if your condition persists or worsens.

              SIDE EFFECTS: Nausea, vomiting, diarrhea, stomach pain, or dizziness may occur. Diaper rash may occur in young children. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: unusual tiredness/weakness, yellowing of the eyes/skin, severe stomach/abdominal pain, persistent nausea/vomiting, dark urine, signs of kidney problems (such as change in the amount of urine), signs of new infection (e.g., fever, persistent sore throat), easy bruising/bleeding, mental/mood changes (such as confusion).This medication may rarely cause a severe intestinal condition due to a bacteria called C. difficile. This condition may occur during treatment or weeks to months after treatment has stopped. Tell your doctor right away if you develop: diarrhea that doesn't stop, abdominal or stomach pain/cramping, blood/mucus in your stool.If you have these symptoms, do not use anti-diarrhea or opioid products because they may make symptoms worse.Use of this medication for prolonged or repeated periods may result in oral thrush or a new vaginal yeast infection (oral or vaginal fungal infection). Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge or other new symptoms.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking cefprozil, tell your doctor or pharmacist if you are allergic to it; or to penicillins or other cephalosporin antibiotics (e.g., cephalexin); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, intestinal disease (colitis).This medicine may contain aspartame. If you have phenylketonuria (PKU) or any other condition where you must restrict your intake of aspartame (or phenylalanine), consult your doctor or pharmacist regarding the safe use of this medicine.This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Cefprozil may cause live bacterial vaccines (such as typhoid vaccine) to not work well. Tell your health care professional that you are using cefprozil before having any immunizations/vaccinations.Caution is advised when using this drug in the elderly because they may be more sensitive to its effects.Caution is advised when using this drug in children because they may be more sensitive to its effects, especially rash.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This medication passes into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.This medication may affect the results of certain lab tests. It may cause false positive results with certain diabetic urine testing products (cupric sulfate-type) and false negative results with certain blood glucose tests. Make sure laboratory personnel and your doctors know you use this drug.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include seizures.

              NOTES: Do not share this medication with others.This medication has been prescribed for your current condition only. Do not use it later for another infection unless your doctor tells you to.

              MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Refrigerate the suspension. Do not freeze. Discard any unused medication after 14 days. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              Information last revised October 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

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              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.