Source:http://www4.wiwiss.fu-berlin.de/dailymed/resource/drugs/3226
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OMNICEF (Capsule)
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dailymed-instance:dosage |
(see INDICATIONS AND USAGE for Indicated Pathogens)<br/>Capsules: The recommended
dosage and duration of treatment for infections in adults and adolescents
are described in the following chart; the total daily dose for all
infections is 600 mg. Once-daily dosing for 10 days is as effective
as BID dosing. Once-daily dosing has not been studied in pneumonia
or skin infections; therefore, OMNICEF Capsules should be administeredtwice daily in these infections. OMNICEF Capsules may be taken without
regard to meals.<br/>Powder for Oral Suspension: The recommended
dosage and duration of treatment for infections in pediatric patients
are described in the following chart; the total daily dose for all
infections is 14 mg/kg, up to a maximum dose of 600 mg per day. Once-daily
dosing for 10 days is as effective as BID dosing. Once-daily dosing
has not been studied in skin infections; therefore, OMNICEF for Oral
Suspension should be administered twice daily in this infection.
OMNICEF for Oral Suspension may be administered without regard to
meals.<br/>Patients With Renal Insufficiency: For adult patients
with creatinine clearance<30 mL/min, the dose of cefdinir should
be 300 mg given once daily. Creatinine clearance is difficult to measure in outpatients. However,
the following formula may be used to estimate creatinine clearance
(CL) in adult patients. For estimates to be valid, serum
creatinine levels should reflect steady-state levels of renal function. where creatinine
clearance is in mL/min, age is in years, weight is in kilograms, and
serum creatinine is in mg/dL. The following formula
may be used to estimate creatinine clearance in pediatric patients: where K = 0.55
for pediatric patients older than 1 yearand 0.45 for
infants (up to 1 year). In the above equation,
creatinine clearance is in mL/min/1.73 m, body length
or height is in centimeters, and serum creatinine is in mg/dL. For pediatric patients
with a creatinine clearance of<30 mL/min/1.73 m,
the dose of cefdinir should be 7 mg/kg (up to 300 mg) given once daily.<br/>Patients on Hemodialysis: Hemodialysis removes
cefdinir from the body. In patients maintained on chronic hemodialysis,
the recommended initial dosage regimen is a 300-mg or 7-mg/kg dose
every other day. At the conclusion of each hemodialysis session,
300 mg (or 7 mg/kg) should be given. Subsequent doses (300 mg or
7 mg/kg) are then administered every other day. After mixing,
the suspension can be stored at room temperature (25��C/77��F).
The container should be kept tightly closed, and the suspension should
be shaken well before each administration. The suspension may be
used for 10 days, after which any unused portion must be discarded.
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dailymed-instance:descripti... |
OMNICEF (cefdinir) capsules
and OMNICEF (cefdinir) for oral suspension contain the active ingredient
cefdinir, an extended-spectrum, semisynthetic cephalosporin, for oral
administration. Chemically, cefdinir is [6R-[6��, 7��(Z)]]-7-[[(2-amino-4-thiazolyl)(hydroxyimino)acetyl]amino]-3-ethenyl-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic
acid. Cefdinir is a white to slightly brownish-yellow solid. It is
slightly soluble in dilute hydrochloric acid and sparingly soluble
in 0.1 M pH 7.0 phosphate buffer. The empirical formula is CHNOSand the molecular
weight is 395.42. Cefdinir has the structural formula shown below: OMNICEF Capsules contain 300
mg cefdinir and the following inactive ingredients: carboxymethylcellulose
calcium, NF; polyoxyl 40 stearate, NF; and magnesium stearate, NF.
The capsule shells contain FD&C Blue #1; FD&C Red #40; D&C
Red #28; titanium dioxide, NF; gelatin, NF; silicon dioxide, NF; and
sodium lauryl sulfate, NF. OMNICEF for Oral Suspension, after reconstitution, contains 125 mg
cefdinir per 5 mL or 250 mg cefdinir per 5 mL and the following inactive
ingredients: sucrose, NF; citric acid, USP; sodium citrate, USP;
sodium benzoate, NF; xanthan gum, NF; guar gum, NF; artificial strawberry
and cream flavors; silicon dioxide, NF; and magnesium stearate, NF.
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dailymed-instance:clinicalP... |
Pharmacokinetics and Drug Metabolism:<br/>Absorption:<br/>Distribution: The mean
volume of distribution (Vd) of cefdinir in adult subjects
is 0.35 L/kg (��0.29); in pediatric subjects (age 6 months-12
years), cefdinir Vdis 0.67 L/kg (��0.38).
Cefdinir is 60% to 70% bound to plasma proteins in both adult and
pediatric subjects; binding is independent of concentration.<br/>Metabolism and Excretion: Cefdinir
is not appreciably metabolized. Activity is primarily due to parent
drug. Cefdinir is eliminated principally via renal excretion with
a mean plasma elimination half-life (t) of 1.7 (��0.6) hours. In healthy subjects with normal renal function, renal
clearance is 2.0 (��1.0) mL/min/kg, and apparent oral clearance
is 11.6 (��6.0) and 15.5 (��5.4) mL/min/kg following
doses of 300- and 600-mg, respectively. Mean percent of dose recovered
unchanged in the urine following 300- and 600-mg doses is 18.4% (��6.4)
and 11.6% (��4.6), respectively. Cefdinir clearance is reduced
in patients with renal dysfunction (see Special Populations - Patients
with Renal Insufficiency). Because renal excretion is the predominant pathway of elimination,
dosage should be adjusted in patients with markedly compromised renal
function or who are undergoing hemodialysis (see DOSAGE AND ADMINISTRATION).<br/>Special Populations:<br/>Microbiology: As with other cephalosporins,
bactericidal activity of cefdinir results from inhibition of cell
wall synthesis. Cefdinir is stable in the presence of some, but not
all,��-lactamase enzymes. As a result, many organisms resistant
to penicillins and some cephalosporins are susceptible to cefdinir. Cefdinir has been shown
to be active against most strains of the following microorganisms,
both in vitro and in clinical
infections as described in INDICATIONS AND
USAGE.<br/>Aerobic Gram-Positive Microorganisms: Staphylococcus aureus (including��-lactamase
producing strains) NOTE: Cefdinir is inactive against methicillin-resistant staphylococci. Streptococcus pneumoniae (penicillin-susceptible
strains only) Streptococcus pyogenes<br/>Aerobic Gram-Negative Microorganisms: Haemophilus influenzae (including��-lactamase
producing strains) Haemophilus parainfluenzae (including��-lactamase producing strains) Moraxella catarrhalis (including��-lactamase
producing strains) The following in vitro data
are available, but their clinical significance is unknown. Cefdinir exhibits in vitro minimum inhibitory concentrations
(MICs) of 1��g/mL or less against (���90%) strains of the
following microorganisms; however, the safety and effectiveness of
cefdinir in treating clinical infections due to these microorganisms
have not been established in adequate and well-controlled clinical
trials.<br/>Aerobic Gram-Positive Microorganisms: Staphylococcus epidermidis (methicillin-susceptible
strains only) Streptococcus agalactiae Viridans groupstreptococci NOTE: Cefdinir is inactive against Enterococcus and methicillin-resistant Staphylococcus species.<br/>Aerobic Gram-Negative Microorganisms: Citrobacter diversus Escherichia coli Klebsiella pneumoniae Proteus mirabilis NOTE: Cefdinir
is inactive against Pseudomonas and Enterobacter species.<br/>Susceptibility Tests:
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dailymed-instance:activeIng... | |
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OMNICEF (cefdinir) is contraindicated
in patients with known allergy to the cephalosporin class of antibiotics.
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dailymed-instance:supply |
OMNICEF Capsules, containing
300 mg cefdinir, as lavender and turquoise capsules imprinted with
the product name, are available as follows: 60 Capsules/Bottle NDC 0074-3769-60 OMNI-PACcarton of
3 unit-of-use, 5-day, 10-capsule blister cards NDC 0074-3769-30 OMNICEF for Oral Suspension is a cream-colored powder formulation
that, when reconstituted as directed, contains 125 mg cefdinir/5 mL
or 250 mg cefdinir/5 mL. The reconstituted suspensions have a cream
color and strawberry flavor. The powder is available as follows: 125 mg/5 mL 60-mL bottles NDC 0074-3771-60 100-mL bottles NDC 0074-3771-13 250 mg/5 mL 60-mL
bottles NDC 0074-6151-60 100-mL bottles NDC 0074-6151-13 Store the capsules
and unsuspended powder at 25��C (77��F); excursions permitted
to 15��-30��C (59��-86��F) [see USP Controlled Room
Temperature]. Once reconstituted, the oral suspension can be stored
at controlled room temperature for 10 days.
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dailymed-instance:genericDr... | |
dailymed-instance:activeMoi... | |
dailymed-instance:inactiveI... |
dailymed-ingredient:D&C_Red_#28,
dailymed-ingredient:FD&C_Blue_#1,
dailymed-ingredient:FD&C_Red_#40,
dailymed-ingredient:carboxymethylcellulose_calcium,
dailymed-ingredient:gelatin,
dailymed-ingredient:magnesium_stearate,
dailymed-ingredient:polyoxyl_40_stearate,
dailymed-ingredient:silicon_dioxide,
dailymed-ingredient:sodium_lauryl_sulfate,
dailymed-ingredient:titanium_dioxide
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dailymed-instance:possibleD... | |
dailymed-instance:overdosag... |
Information on cefdinir
overdosage in humans is not available. In acute rodent toxicity studies,
a single oral 5600-mg/kg dose produced no adverse effects. Toxic
signs and symptoms following overdosage with other��-lactam
antibiotics have included nausea, vomiting, epigastric distress, diarrhea,
and convulsions. Hemodialysis removes cefdinir from the body. This
may be useful in the event of a serious toxic reaction from overdosage,
particularly if renal function is compromised.
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dailymed-instance:genericMe... |
cefdinir
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dailymed-instance:fullName |
OMNICEF (Capsule)
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dailymed-instance:warning |
BEFORE THERAPY WITH OMNICEF (CEFDINIR) IS INSTITUTED, CAREFUL INQUIRY
SHOULD BE MADE TO DETERMINE WHETHER THE PATIENT HAS HAD PREVIOUS HYPERSENSITIVITY
REACTIONS TO CEFDINIR, OTHER CEPHALOSPORINS, PENICILLINS, OR OTHER
DRUGS. IF CEFDINIR IS TO BE GIVEN TO PENICILLIN-SENSITIVE PATIENTS,
CAUTION SHOULD BE EXERCISED BECAUSE CROSS-HYPERSENSITIVITY AMONG��-LACTAM
ANTIBIOTICS HAS BEEN CLEARLY DOCUMENTED AND MAY OCCUR IN UP TO 10%
OF PATIENTS WITH A HISTORY OF PENICILLIN ALLERGY. IF AN ALLERGIC
REACTION TO CEFDINIR OCCURS, THE DRUG SHOULD BE DISCONTINUED. SERIOUS
ACUTE HYPERSENSITIVITY REACTIONS MAY REQUIRE TREATMENT WITH EPINEPHRINE
AND OTHER EMERGENCY MEASURES, INCLUDING OXYGEN, INTRAVENOUS FLUIDS,
INTRAVENOUS ANTIHISTAMINES, CORTICOSTEROIDS, PRESSOR AMINES, AND AIRWAY
MANAGEMENT, AS CLINICALLY INDICATED. Clostridium difficile associated diarrhea (CDAD) has been
reported with use of nearly all antibacterial agents, including OMNICEF,
and may range in severity from mild diarrhea to fatal colitis. Treatment
with antibacterial agents alters the normal flora of the colon leading
to overgrowth of C. difficile. C. difficile produces toxins A and B
which contribute to the 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 is necessary since CDAD has been reported
to occur over two months after the administration of antibacterial
agents. If CDAD is 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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dailymed-instance:indicatio... |
To reduce the development
of drug-resistant bacteria and maintain the effectiveness of OMNICEF
and other antibacterial drugs, OMNICEF should be used only to treat
or prevent infections that are proven or strongly suspected to be
caused by susceptible bacteria. When culture and susceptibility information
are available, they should be considered in selecting or modifying
antibacterial therapy. In the absence of such data, local epidemiology
and susceptibility patterns may contribute to the empiric selection
of therapy. OMNICEF (cefdinir)
capsules and OMNICEF (cefdinir) for oral suspension are indicated
for the treatment of patients with mild to moderate infections caused
by susceptible strains of the designated microorganisms in the conditions
listed below.<br/>Adults and Adolescents:<br/>Community-Acquired Pneumonia: caused by Haemophilus influenzae (including��-lactamase
producing strains), Haemophilus parainfluenzae (including��-lactamase producing strains), Streptococcus pneumoniae (penicillin-susceptible
strains only), and Moraxella catarrhalis (including��-lactamase producing strains) (see CLINICAL STUDIES).<br/>Acute Exacerbations of Chronic Bronchitis: caused by Haemophilus influenzae (including��-lactamase
producing strains), Haemophilus parainfluenzae (including��-lactamase producing strains), Streptococcus pneumoniae (penicillin-susceptible
strains only), and Moraxella catarrhalis (including��-lactamase producing strains).<br/>Acute Maxillary Sinusitis: caused by Haemophilus influenzae (including��-lactamase
producing strains), Streptococcus pneumoniae (penicillin-susceptible strains only), and Moraxella catarrhalis (including��-lactamase producing
strains). NOTE: For information on use in pediatric patients, see Pediatric Use and DOSAGE AND ADMINISTRATION.<br/>Pharyngitis/Tonsillitis: caused by Streptococcus pyogenes (see CLINICAL STUDIES). NOTE: Cefdinir is effective in the eradication of S. pyogenes from the oropharynx. Cefdinir
has not, however, been studied for the prevention of rheumatic fever
following S. pyogenes pharyngitis/tonsillitis.
Only intramuscular penicillin has been demonstrated to be effective
for the prevention of rheumatic fever.<br/>Uncomplicated Skin and Skin Structure Infections: caused by Staphylococcus aureus (including��-lactamase
producing strains) and Streptococcus
pyogenes.<br/>Pediatric Patients: Acute Bacterial Otitis Media caused by Haemophilus influenzae (including��-lactamase
producing strains), Streptococcus pneumoniae (penicillin-susceptible strains only), and Moraxella catarrhalis (including��-lactamase producing
strains).<br/>Pharyngitis/Tonsillitis: caused by Streptococcus pyogenes (see CLINICAL STUDIES). NOTE: Cefdinir is effective in the eradication of S. pyogenes from the oropharynx. Cefdinir
has not, however, been studied for the prevention of rheumatic fever
following S. pyogenes pharyngitis/tonsillitis.
Only intramuscular penicillin has been demonstrated to be effective
for the prevention of rheumatic fever.<br/>Uncomplicated Skin and Skin Structure Infections: caused by Staphylococcus aureus (including��-lactamase
producing strains) and Streptococcus
pyogenes.
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OMNICEF
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