Pharmacokinetics: After oral administration, cefuroxime axetil is absorbed from the gastrointestinal tract and rapidly hydrolyzed by nonspecific esterases in the intestinal mucosa and blood to cefuroxime; absorption is enhanced in the presence of food. Cefuroxime is subsequently distributed throughout the body including pleural fluid, sputum bone, synovial fluid and aqueous humour, but only achieves therapeutic concentrations in the cerebrospinal fluid when the meninges are inflamed. Cefuroxime crosses the placenta and has been detected in breast milk. Approximately 50% of serum cefuroxime is bound to protein. Serum pharmacokinetic parameters are shown in the table.
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Cefuroxime is excreted unchanged by glomerular filtration and renal tubular secretion and high concentrations are achieved in the urine. Small amounts are excreted in bile. Dialysis reduces plasma concentrations.
The axetil moiety is metabolized to acetaldehyde and acetic acid.