Home > Medical Reference > Encyclopedia (English)

Please install flash player to see this video.

Hospital Virtual Tour

Related Content

Pronunciation:

(SEF ra deen)

U.S. Brand Names:

Velosef®

Generic Available:

Use:

Treatment of infections when caused by susceptible strains in respiratory, genitourinary, gastrointestinal, skin and soft tissue, bone and joint infections; treatment of susceptible gram-positive bacilli and cocci (never enterococcus); some gram-negative bacilli including E. coli, Proteus, and Klebsiella may be susceptible

Use - Dental:

Prophylaxis in total joint replacement patients undergoing dental procedures which produce bacteremia

Pregnancy Risk Factor:

Lactation:

Enters breast milk/use caution

Contraindications:

Hypersensitivity to cephradine, any component of the formulation, or cephalosporins

Warnings/Precautions:

Use caution with renal impairment; dose adjustment required. Prolonged use may result in superinfection; use with caution in patients with a history of penicillin allergy, especially IgE-mediated reactions (eg, anaphylaxis, urticaria). May cause antibiotic-associated colitis or colitis secondary to C. difficile.

Adverse Reactions:

Frequency not defined.

Central nervous system: Dizziness

Dermatologic: Rash, pruritus

Gastrointestinal: Diarrhea, nausea, vomiting, pseudomembranous colitis

Hematologic: Leukopenia, neutropenia, eosinophilia

Neuromuscular & skeletal: Joint pain

Renal: BUN increased, creatinine increased

Reactions reported with other cephalosporins include anaphylaxis, erythema multiforme, toxic epidermal necrolysis, Stevens-Johnson syndrome, fever, headache, encephalopathy, asterixis, neuromuscular excitability, seizure, agranulocytosis, pancytopenia, aplastic anemia, hemolytic anemia, interstitial nephritis, toxic nephropathy, vaginitis, angioedema, cholestasis, hemorrhage, prolonged PT, serum-sickness reactions, superinfection

Overdosage/Toxicology:

Symptoms of overdose include neuromuscular hypersensitivity and convulsions. Many beta-lactam containing antibiotics have the potential to cause neuromuscular hyperirritability or convulsive seizures. Hemodialysis may be helpful to aid in removal of the drug from blood; otherwise, treatment is supportive or symptom-directed.

Drug Interactions:

Increased effect: High-dose probenecid decreases clearance

Increased toxicity: Aminoglycosides may increase nephrotoxic potential

Ethanol/Nutrition/Herb Interactions:

Food: Food delays cephradine absorption but does not decrease extent.

Stability:

Capsule: Store at controlled room temperature.

Powder for oral suspension: Store at controlled room temperature. Following reconstitution, refrigerated storage of oral suspension maintains potency for 14 days. Room temperature storage maintains potency for 7 days.

Mechanism of Action:

Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs) which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested.

Pharmacodynamics/Kinetics:

Absorption: Well absorbed

Distribution: Widely into most body tissues and fluids including gallbladder, liver, kidneys, bone, sputum, bile, and pleural and synovial fluids; CSF penetration is poor; crosses placenta; enters breast milk

Protein binding: 18% to 20%

Half-life elimination: 1-2 hours; prolonged with renal impairment

Time to peak, serum: 1-2 hours

Excretion: Urine (~80% to 90% as unchanged drug) within 6 hours

Dosage:

Oral:

Children 9 months: Usual dose: 25-50 mg/kg/day in divided doses every 6 hours

Otitis media: 75-100 mg/kg/day in divided doses every 6 or 12 hours (maximum: 4 g/day)

Adults: 250-500 mg every 6-12 hours

Dosing adjustment in renal impairment: Adults:

Clcr 10-50 mL/minute: 250 mg every 6 hours

Clcr<10 mL/minute: 125 mg every 6 hours

Administration:

Administer around-the-clock to promote less variation in peak and trough serum levels. Shake oral suspension well.

Monitoring Parameters:

Observe for signs and symptoms of anaphylaxis during first dose

Test Interactions:

Positive direct Coombs', false-positive urinary glucose test using cupric sulfate (Benedict's solution, Clinitest®, Fehling's solution), false-positive serum or urine creatinine with Jaffé reaction, false-positive urinary proteins and steroids

Dietary Considerations:

May administer with food to decrease GI distress.

Patient Education:

Inform prescriber of all prescriptions, OTC medications, or herbal products you are taking, and any allergies you have. Do not take any new medication during therapy with without consulting prescriber. Take as directed, at regular intervals around-the-clock (with or without food). Chilling oral suspension improves flavor (do not freeze). Maintain adequate hydration (2-3 L/day of fluids) unless instructed to restrict fluid intake. Complete full course of medication, even if you feel better. May cause false test results with Clinitest®; use of another type of glucose testing is preferable. May cause diarrhea (buttermilk, boiled milk, or yogurt may help). Report unresolved, persistent diarrhea; unusual bruising or bleeding; changes in urinary pattern (decreased output); persistent nausea, vomiting, or abdominal pain; opportunistic infection (vaginal itching or drainage, sores in mouth, blood in urine or stool). Breast-feeding precaution: Consult prescriber if breast-feeding.

Dental Health: Effects on Dental Treatment:

No significant effects or complications reported

Dental Health: Vasoconstrictor/Local Anesthetic Precautions:

No information available to require special precautions

Mental Health: Effects on Mental Status:

May cause nervousness; case reports of euphoria, delusion, illusions, and depersonalization with cephalosporins

Mental Health: Effects on Psychiatric Treatment:

May rarely cause neutropenia; use caution with clozapine and carbamazepine

Dosage Forms:

[DSC] = Discontinued product

Capsule: 250 mg, 500 mg [DSC]

Powder for oral suspension: 250 mg/5 mL (100 mL) [fruit flavor]

References

"Advisory Statement. Antibiotic Prophylaxis for Dental Patients With Total Joint Replacements. American Dental Association; American Academy of Orthopedic Surgeons,"J Am Dent Assoc, 1997, 128(7):1004-8.

Donowitz GR and Mandell GL, "Beta-Lactam Antibiotics,"N Engl J Med, 1988, 318(7):419-26 and 318(8):490-500.

Donowitz GR and Mandell GL, "Drug Therapy. Beta-Lactam Antibiotics (1),"N Engl J Med, 1988, 318(7):419-26.

Donowitz GR and Mandell GL, "Drug Therapy. Beta-Lactam Antibiotics (2),"N Engl J Med, 1988, 318(8):490-500.

Smith GH, "Oral Cephalosporins in Perspective,"DICP, 1990, 24(1):45-51.

Wise R, "The Pharmacokinetics of the Oral Cephalosporins - A Review,"J Antimicrob Chemother, 1990, 26(Suppl E):13-20.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.