Levexime Dosage/Direction for Use

Dosage and Directions for Use: General Dosage Recommendations: Adults: The dosage range for cefuroxime lies between 1.5 to 6.0 g/day. Many infections will respond to 750 mg three times daily by intramuscular or intravenous injection. For more severe infections, this dose should be increased to 1.5 g three times daily intravenously. The frequency of intramuscular or intravenous injection can be increased to six hourly if necessary.
Infants and Children: Doses of 30 to 100 mg/kg/day, given as 3 or 4 divided doses. A dose of 60 mg/kg/day will be appropriate for most infections.
Other Recommendations: Gonorrhoea: 1.5 g cefuroxime should be given as a single dose. This may be given as 2 x 750 mg injections into different sites, e.g. each buttock.
Prophylaxis: The usual dose is 1.5 g intravenously with induction of anaesthesia for abdominal and gynaecological operations, but may be supplemented with two 750 mg intramuscular doses 8 and 16 hours later. In cardiac and pulmonary operations, the usual dose is 1.5 g intravenously with induction of anaesthesia continuing with 750 mg intramuscularly three times daily for a further 24 to 48 hours.
Dosage in impaired renal function: Cefuroxime is excreted by the kidneys. Therefore, in patients with markedly impaired renal function it is recommended that the dosage of cefuroxime should be reduced to compensate for its slower excretion.
However, it is not necessary to reduce the dose until the GFR falls below 20 ml/min. In adults with marked impairment (GFR 10 to 20 ml/min) 750 mg twice daily is recommended and with severe impairment (GFR less than 10 ml/min) 750 mg once daily is adequate. For patients on dialysis a further 750 mg dose should be given at the end of each dialysis. When continuous peritoneal dialysis is being used, a suitable dosage is usually 750 mg twice daily.
Administration: Intramuscular injection: Add 1 ml sterile Water for Injections to 250 mg cefuroxime or 3 ml sterile Water for Injections to 750 mg cefuroxime. Shake gently to produce an opaque suspension. Suspensions which appear granular must be discarded.
Intravenous injection: Dissolve cefuroxime in sterile Water for Injections using at least 2 ml for 250 mg, at least 6 ml for 750 mg, or 15 ml for 1.5 g. Solutions which appear turbid must be discarded.
Intravenous infusion: For short intravenous infusion (30 to 60 minutes) 1.5 g may be dissolved in 50 ml sterile Water for Injections.
These solutions may be given directly into the vein or introduced into the tubing of the giving set if the patient is receiving parenteral fluids. Solutions which appear turbid must be discarded.
Suspensions of cefuroxime for intramuscular injection and aqueous solutions for direct intravenous injection should be used within 5 hours if kept below 25°C or within 48 hours if refrigerated. Some increase in colour may occur on storage. Solutions for short intravenous infusion (1.5 g plus 50 ml sterile Water for Injections) which show less increase in colour, should be used within 24 hours if kept below 25°C or within 72 hours if refrigerated.
Cefuroxime is compatible with the more commonly used intravenous fluids. It will retain potency for up to 24 hours at room temperature in Sodium Chloride Injection B.P. 0.9% m/v, 5% Dextrose Injection B.P., 0.18% m/v Sodium Chloride plus 4% Dextrose Injection B.P., and Compound Sodium Lactate Injection B.P. (Hartmann's solution). The pH of 2.74% m/v Sodium Bicarbonate Injection B.P. considerably affects the colour of the solution and therefore this solution is not recommended for the dilution of cefuroxime.
However, if required for patients receiving Sodium Bicarbonate Injection by infusion, the cefuroxime may be introduced into the tube of the giving set. The stability of cefuroxime in Sodium Chloride Injection B.P. 0.9% m/v and in 5% Dextrose Injection is not affected by the presence of hydrocortisone sodium phosphate.
Cefuroxime is also compatible with aqueous solutions containing up to 1% lignocaine hydrochloride.