Gramix
Generic composition: Cefixime Trihydrate
General description
It is a third generation cephalosporin highly active against Enterobacteriaceae, H. influenza, Strep. pyrogenes, Strep. pneumonia and is resistant to many ß-lactamases.
Therapeutic category
- Anti-bacterial – 3rd generation cephalosporins
Dosage forms available
- GRAMIX DT 100mg
- GRAMIX 200mg
- GRAMIX Dry Syrup 50mg/5ml
- GRAMIX HP 100mg/5ml
Mechanism of Action
- Like all beta-lactam antibiotics, cefixime binds to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall, causing the inhibition of the third and last stage of bacterial cell wall synthesis. Cell lysis is then mediated by bacterial cell wall autolytic enzymes such as autolysins
Pharmacokinetics
- Absorption: About 40%-50% absorbed orally whether administered with or without food,
- Metabolism: undergoes hepatic metabolism,
- Elimination: Approximately 50% of the absorbed dose is excreted unchanged in the urine in 24 hours.
- Half-life: 3-4 hours (may range up to 9 hours), in severe renal impairment (5 to 20 mL/min creatinine clearance), the half-life increased to an average of 11.5 hours.
Uses
- Typhoid
- Surgical Infections
- Upper and Lower respiratory tract infection
- Gynecological Infections
- Uncomplicated Gonorrhoea
- Otitis Media
Dose
- Adult: 400 mg daily as a single dose or in divided dose.
- Pediatric dose: 8 mg/kg/day of the suspension.
Drug Interaction
- Carbamazepine (carbamazepine level elevates)
- Warfarin and anti-coagulants (increased prothrombin time)
- Increased concentrations of Cefixime when taken with Probenecid.
Side effects
- GI: Stomach upset/pain, diarrhea, nausea, gas, headache, or dizziness may occur.
- CNS: headache, dizziness.
- Hematologic: thrombocytopenia, eosinophilia etc
Contraindications
- Allergic to cephalosporin group of anti-biotics.
- Pegnancy category: B
Precautions
- Special precautions need to be taken in the case of history of allergy to penicillin, pregnancy, lactation and renal failure.
Advantages
- High beta lactamases resistance and cure rate, excellent penetration in tissues,sputum and pleural fluid, safe and well tolerated due to minimum inhibitory concentration.
