Drug reference

Cefepime

Cephalosporin · Antibacterial

Also known as Renapime, Cefepime dihydrochloride monohydrate

CephalosporinAntibacterial

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

—

none in our sources

PREGNANCY

Manufacturer advises caution—no data available but not known to be harmful in animal studies.

FDA category + note

Mechanism

Cefepime, a fourth-generation cephalosporin, exhibits an extended spectrum of activity compared to third-generation agents. It possesses increased stability against hydrolysis by plasmid and chromosomally mediated β-lactamases.

Indications

Infections due to sensitive Gram-positive and Gram-negative bacteriaMild to moderate urinary tract infectionsMild to moderate infections due to sensitive Gram-positive and Gram-negative bacteriaSevere infections due to sensitive Gram-positive and Gram-negative bacteriaResistant pseudomonas infections where first-line agents are not effective or contra-indicatedNosocomial infections: pneumonia, meningitis, urinary tract infections, intra-abdominal infections

Dosing

Adult: Mild to moderate urinary tract infections (body-weight 41 kg and above): 0.5–1 g every 12 hours by intravenous injection, intravenous infusion, or intramuscular injection. Mild to moderate infections (body-weight 41 kg and above): 1 g every 12 hours by intravenous injection, intravenous infusion, or intramuscular injection.…
Pediatric: Body-weight up to 41 kg: 50 mg/kg every 12 hours (max. per dose 2 g), increased if necessary to 50 mg/kg every 8 hours (max. per dose 2 g) for severe infections, intravenous route preferred in severe infections.
Renal adjustment: Manufacturer advises reduce dose—consult product literature.
Max dose: 2 g

Pharmacokinetics

Half-life

2 h

Bioavailability

—

Protein binding

16–19%

Excretion

80%

Side effects

Common

AnaemiaGastrointestinal disordersIncreased risk of infectionGastrointestinal side effects (e.g., diarrhea)

Serious

Constipation
Dyspnoea
Genital pruritus
Paraesthesia
Seizure
Taste altered
Vasodilation
Anaphylactic shock
Aplastic anaemia
Coma
Confusion
Consciousness impaired
Encephalopathy
Haemorrhage
Hallucination
Myoclonus
Nephrotoxicity
Renal failure
Hypersensitivity reactions (rash to anaphylaxis)
Serum sickness
Stevens-Johnson syndrome
Nephropathy
Hematologic reactions (neutropenia, prolonged use)
Neurotoxicity (more commonly described, seizure, high doses, renal impairment)

Pregnancy & lactation

Pregnancy

Manufacturer advises caution—no data available but not known to be harmful in animal studies.

Lactation

Manufacturer advises caution—present in milk in very low quantities.

Drug interactions

Aminoglycosides (e.g., Gentamicin, Amikacin)

Moderate

Database

Increased risk of acute kidney injury (AKI), particularly in patients with pre-existing renal impairment, elderly patients, or those receiving high doses or prolonged therapy.

Monitor renal function closely (serum creatinine, urine output) during concomitant therapy. Adjust doses of both drugs based on renal function. Consider therapeutic drug monitoring for aminoglycosides.

Cyclosporine

Moderate

Database

Increased risk of acute kidney injury (AKI) and elevated cyclosporine levels due to impaired renal clearance.

Monitor renal function and cyclosporine trough levels closely. Adjust cyclosporine dose as needed. Consider alternative antibiotics if possible in high-risk patients.

Loop Diuretics (e.g., Furosemide)

Moderate

Database

Increased risk of acute kidney injury (AKI). Loop diuretics can also reduce renal clearance of cefepime, potentially increasing cefepime levels.

Monitor renal function closely. Be particularly cautious if other nephrotoxic agents are also being used. Adjust cefepime dose based on renal function.

Mycophenolate Mofetil

Moderate

Database

Decreased plasma concentrations of mycophenolic acid, potentially leading to reduced immunosuppressive effect and increased risk of transplant rejection.

Monitor mycophenolic acid levels (if available) and clinical signs of rejection. Consider increasing mycophenolate mofetil dose if clinically indicated. This interaction is more pronounced with prolonged antibiotic use.

Source: DDInter

Oral Anticoagulants (e.g., Warfarin)

Moderate

Database

Increased risk of bleeding (e.g., bruising, epistaxis, gastrointestinal bleeding).

Monitor International Normalized Ratio (INR) closely, especially at the initiation and discontinuation of cefepime therapy. Adjust warfarin dose as needed.

Probenecid

Moderate

Database

Increased and prolonged plasma concentrations of cefepime, potentially leading to increased risk of dose-dependent adverse effects such as neurotoxicity (seizures, encephalopathy).

Consider reducing the cefepime dose if co-administering with probenecid, especially in patients with renal impairment. Monitor for signs of neurotoxicity.

Source: DDInter

Tacrolimus

Moderate

Database

Increased risk of acute kidney injury (AKI) and elevated tacrolimus levels due to impaired renal clearance.

Monitor renal function and tacrolimus trough levels closely. Adjust tacrolimus dose as needed. Consider alternative antibiotics if possible in high-risk patients.

Vancomycin

Moderate

Database

Increased risk of acute kidney injury (AKI).

Monitor renal function closely (serum creatinine, urine output) during concomitant therapy. Adjust doses of both drugs based on renal function. Consider therapeutic drug monitoring for vancomycin.

4 additional low-confidence interactions hidden — those rows lack a documented mechanism or management plan in our sources.