Cephalosporins (Systemic)

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For the cephalosporins, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to any of the cephalosporins, penicillins, penicillin-like medicines, or penicillamine. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy - Studies have not been done in humans. However, most cephalosporins have not been reported to cause birth defects or other problems in animal studies. Studies in rabbits have shown that cefoxitin may increase the risk of miscarriages and cause other problems.

Breast-feeding - It is not known if cefditoren passes into breast milk. Most cephalosporins pass into breast milk, usually in small amounts. However, cephalosporins have not been reported to cause problems in nursing babies.

Children - Many cephalosporins have been tested in children and, in effective doses, have not been shown to cause different side effects or problems than they do in adults. However, there are some cephalosporins that have not been tested in children up to 12 year of age.

Older adults - Cephalosporins have been used in the elderly, and they are not expected to cause different side effects or problems in older people than they do in younger adults.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking a cephalosporin, it is especially important that your health care professional know if you are taking any of the following:

• Alcohol or alcohol-containing medicine (cefamandole, cefoperazone, and cefotetan only) - Using alcohol and these cephalosporins together may cause abdominal or stomach cramps, nausea, vomiting, headache, dizziness or light-headedness, shortness of breath, sweating, or facial flushing; this reaction usually begins within 15 to 30 minutes after alcohol is consumed and usually goes away over several hours

• Aminoglycoside antibiotics, such as
  Amikacin (e.g., Amikin) or
  Gentamicin (e.g., Apogen) or
  Neomycin (e.g., Mycifradin) - use with cefuroxime may result in increased chance of serious side effects

• Anticoagulants (blood thinners) or
• Carbenicillin by injection (e.g., Geopen) or
• Dipyridamole (e.g., Persantine) or
• Divalproex (e.g., Depakote) or
• Heparin (e.g., Hepalean, Liquaemin) or
• Pentoxifylline (e.g., Trental) or
• Plicamycin (e.g., Mithracin) or
• Sulfinpyrazone (e.g., Anturane) or
• Ticarcillin (e.g., Ticar) or
• Thrombolytic agents or
• Valproic acid (e.g., Depakene) - Any of these medicines may increase the chance of bleeding, especially when used with cefamandole, cefoperazone, or cefotetan

• Diuretics, potent such as
  Furosemide (e.g., Lasix) - use with cefuroxime may cause higher blood levels of cefuroxime and result in increased side effects

• Iron - Iron supplements, including multivitamins that contain iron, may decrease the effect of cefdinir. However, iron-fortified infant formula does not decrease the effect of cefdinir

• Probenecid (e.g., Benemid) (except cefoperazone, ceftazidime, or ceftriaxone) - Probenecid increases the blood level of many cephalosporins. Although probenecid may be given with a cephalosporin by your doctor purposely to increase the blood level to treat some infections, in other cases this effect may be unwanted and may increase the chance of side effects

Other medical problems - The presence of other medical problems may affect the use of cephalosporins. Make sure you tell your doctor if you have any other medical problems, especially:

• Bleeding problems, history of (cefamandole, cefditoren, cefoperazone, and cefotetan only) - These medicines may increase the chance of bleeding

• Carnitine, low levels - Cefditoren may cause carnitine levels to decrease further.

• Kidney disease - Some cephalosporins need to be given at a lower dose to people with kidney disease. Also, cephalothin, and cefuroxime especially, may increase the chance of kidney damage

• Liver disease (cefoperazone and cefuroxime) - Cefoperazone needs to be given at a lower dose to people with liver disease. Condition may be worsened by cefuroxime use.

• Phenylketonuria - Cefprozil oral suspension contains phenylalanine

• Poor nutritional status - these may be worsened by cefuroxime and you may need to have vitamin K

• Stomach or gastrointestinal disease, history of (especially colitis, including colitis caused by antibiotics, or enteritis) - Cephalosporins may cause colitis in some patients