Peringatan Keamanan

Patients who receive a cefepime overdose should be carefully observed and given supportive treatment. In case of renal insufficiency, peritoneal dialysis should not be performed.L42095,L42100 Instead, hemodialysis is recommended to aid in the removal of cefepime from the body. Some of the symptoms of a cefepime overdose are encephalopathy (disturbance of consciousness including confusion, hallucinations, stupor, and coma), myoclonus, seizures, neuromuscular excitability and nonconvulsive status epilepticus.L42095,L42100 In vivo carcinogenicity studies for cefepime have not been performed. In chromosomal aberration studies, this antibiotic was positive for clastogenicity in primary human lymphocytes, but negative in Chinese hamster ovary cells. Cefepime does not exhibit genotoxic effects in in vitro assays, and in vivo assessments of clastogenicity are negative. In rats given up to 1000 mg/kg/day (1.6 times the recommended maximum human dose), cefepime did not have negative effects on fertility.L42095,L42100

Cefepime

DB01413

small molecule approved investigational

Deskripsi

Cefepime is a fourth-generation cephalosporin antibiotic developed in 1994. Cefepime is active against Gram-positive and Gram-negative bacteria, and has greater activity against both compared to third-generation antibiotics.A2457,A249050 Cefepime is normally used to treat severe nosocomial pneumonia and infections caused by multi-resistant microorganisms such as Pseudomonas aeruginosa, and is also indicated for the empirical treatment of febrile neutropenia.A249050 The popularity of its third-generation predecessors, its clinical efficacy, and the high prevalence of multidrug-resistant bacteria might be some of the factors leading to an increase in the use of cefepime. The activity of cefepime against Enterobacteriaceae, Pseudomonas aeruginosa, and Staphylococcus aureus is due to its high stability toward beta-lactamases.A249050 In general, cefepime seems to be well tolerated; however, patients treated with this antibiotic, especially those with renal impairment, may develop neurotoxicity.A249050,L42095,L42100

Struktur Molekul 2D

Berat 480.561
Wujud solid

Peta Jejaring Molekuler
Legenda: Obat • Target • Gen • Enzim • (Panah → menunjukkan arah efek / relasi) • Transporter • Carrier

Profil Farmakokinetik

Waktu Paruh (Half-Life) Healthy adult male volunteers (n=9) given cefepime had an average half-life of 2 hours. In patients requiring hemodialysis, the average half-life was 13.5 hours, and in patients requiring continuous peritoneal dialysis, the average half-life was 19 hours.[L42095,L42100]
Volume Distribusi The average steady-state volume of distribution of cefepime is 18.0 L. In pediatric patients, the average steady-state volume of distribution is 0.3 L/kg.[L42095,L42100]
Klirens (Clearance) Cefepime has a total body clearance of 120 mL/min in healthy volunteers, and in pediatric patients, the average total body clearance is 3.3 mL/min/kg.[L42095,L42100] In geriatric patients (65 years of age and older) and patients with abnormal renal function, cefepime total body clearance decreases proportionally with creatinine clearance.[L42095,L42100]

Absorpsi

Healthy adult male volunteers (n=9) given a single intravenous infusion of 500 mg, 1 g, and 2 g of cefepime had a corresponding Cmax of 39.1, 81.7 and 163.9 ?g/mL, and a corresponding AUC of 70.8, 148.5 and 284.8 h??g/mL.L42095,L42100 On the other hand, healthy adult male volunteers given a single intramuscular infusion of 500 mg, 1 g, and 2 g of cefepime had a corresponding Cmax of 13.9, 29.6 and 57.5 ?g/mL, a corresponding AUC of 60, 137 and 262 h??g/mL, and a corresponding Tmax of 1.4, 1.6 and 1.5 h.L42095 A study in healthy adult male volunteers (n=7) that received clinically relevant doses for 9 days suggests that cefepime is not accumulated in the body. Between 250 mg and 2 g, cefepime follows a linear pharmacokinetic model, and the absolute bioavailability of cefepime in pediatric patients (n=8) given an intramuscular dose of 50 mg/kg was 82.3%.L42095,L42100

Metabolisme

Less than 1% of cefepime is metabolized in the liver.A249045 Cefepime is metabolized to N-methylpyrrolidine (NMP), which then undergoes rapid oxidation to form NMP-N-oxide, a more stable compound.L42095,L42100 NMP-N-oxide is the predominant metabolite of cefepime, while NMP and the 7-epimer of cefepime are minor byproducts.A249040 It has been suggested that flavin-containing mixed-function oxygenase mediates the oxidation of NMP to NMP-N-oxide.A249040

Rute Eliminasi

Cefepime is mainly eliminated by the kidneys, and most of it is excreted unchanged. Approximately 85% of cefepime administered to normal subjects is excreted unchanged in urine. Less than 1% of the administered dose is recovered from urine as N-methylpyrrolidine (NMP), 6.8% as NMP-N-oxide, and 2.5% as an epimer.L42095,L42100 Dosage adjustments are required in patients with renal dysfunction or those undergoing hemodialysis, due to the importance of renal excretion in eliminating cefepime.L42095,L42100

Interaksi Obat

802 Data
Probenecid The serum concentration of Cefepime can be increased when it is combined with Probenecid.
Foscarnet The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Foscarnet.
Mannitol The risk or severity of nephrotoxicity can be increased when Mannitol is combined with Cefepime.
Tenofovir disoproxil Cefepime may increase the nephrotoxic activities of Tenofovir disoproxil.
Tenofovir alafenamide Cefepime may increase the nephrotoxic activities of Tenofovir alafenamide.
Tenofovir Cefepime may increase the nephrotoxic activities of Tenofovir.
Cyclosporine The risk or severity of nephrotoxicity can be increased when Cyclosporine is combined with Cefepime.
Icosapent The risk or severity of nephrotoxicity can be increased when Icosapent is combined with Cefepime.
Cefotiam The risk or severity of nephrotoxicity can be increased when Cefotiam is combined with Cefepime.
Mesalazine The risk or severity of nephrotoxicity can be increased when Mesalazine is combined with Cefepime.
Cefmenoxime The risk or severity of nephrotoxicity can be increased when Cefmenoxime is combined with Cefepime.
Cefmetazole The risk or severity of nephrotoxicity can be increased when Cefmetazole is combined with Cefepime.
Indomethacin The risk or severity of nephrotoxicity can be increased when Indomethacin is combined with Cefepime.
Triamterene The risk or severity of nephrotoxicity can be increased when Triamterene is combined with Cefepime.
Cefpiramide The risk or severity of nephrotoxicity can be increased when Cefpiramide is combined with Cefepime.
Loracarbef The risk or severity of nephrotoxicity can be increased when Loracarbef is combined with Cefepime.
Cefalotin The risk or severity of nephrotoxicity can be increased when Cefalotin is combined with Cefepime.
Nabumetone The risk or severity of nephrotoxicity can be increased when Nabumetone is combined with Cefepime.
Ketorolac The risk or severity of nephrotoxicity can be increased when Ketorolac is combined with Cefepime.
Tenoxicam The risk or severity of nephrotoxicity can be increased when Tenoxicam is combined with Cefepime.
Celecoxib The risk or severity of nephrotoxicity can be increased when Celecoxib is combined with Cefepime.
Cefotaxime The risk or severity of nephrotoxicity can be increased when Cefotaxime is combined with Cefepime.
Tolmetin The risk or severity of nephrotoxicity can be increased when Tolmetin is combined with Cefepime.
Rofecoxib The risk or severity of nephrotoxicity can be increased when Rofecoxib is combined with Cefepime.
Fenoprofen The risk or severity of nephrotoxicity can be increased when Fenoprofen is combined with Cefepime.
Valdecoxib The risk or severity of nephrotoxicity can be increased when Valdecoxib is combined with Cefepime.
Diclofenac The risk or severity of nephrotoxicity can be increased when Diclofenac is combined with Cefepime.
Sulindac The risk or severity of nephrotoxicity can be increased when Sulindac is combined with Cefepime.
Bacitracin The risk or severity of nephrotoxicity can be increased when Bacitracin is combined with Cefepime.
Amphotericin B The risk or severity of nephrotoxicity can be increased when Amphotericin B is combined with Cefepime.
Cephaloglycin The risk or severity of nephrotoxicity can be increased when Cephaloglycin is combined with Cefepime.
Adefovir dipivoxil The risk or severity of nephrotoxicity can be increased when Adefovir dipivoxil is combined with Cefepime.
Pentamidine The risk or severity of nephrotoxicity can be increased when Pentamidine is combined with Cefepime.
Mefenamic acid The risk or severity of nephrotoxicity can be increased when Mefenamic acid is combined with Cefepime.
Naproxen The risk or severity of nephrotoxicity can be increased when Naproxen is combined with Cefepime.
Sulfasalazine The risk or severity of nephrotoxicity can be increased when Sulfasalazine is combined with Cefepime.
Phenylbutazone The risk or severity of nephrotoxicity can be increased when Phenylbutazone is combined with Cefepime.
Meloxicam The risk or severity of methemoglobinemia can be increased when Cefepime is combined with Meloxicam.
Carprofen The risk or severity of nephrotoxicity can be increased when Carprofen is combined with Cefepime.
Tacrolimus The risk or severity of nephrotoxicity can be increased when Tacrolimus is combined with Cefepime.
Etacrynic acid The risk or severity of nephrotoxicity can be increased when Etacrynic acid is combined with Cefepime.
Ceforanide The risk or severity of nephrotoxicity can be increased when Ceforanide is combined with Cefepime.
Salicylic acid The risk or severity of nephrotoxicity can be increased when Salicylic acid is combined with Cefepime.
Acetylsalicylic acid The risk or severity of nephrotoxicity can be increased when Acetylsalicylic acid is combined with Cefepime.
Hydrochlorothiazide The risk or severity of nephrotoxicity can be increased when Hydrochlorothiazide is combined with Cefepime.
Balsalazide The risk or severity of nephrotoxicity can be increased when Balsalazide is combined with Cefepime.
Cefditoren The risk or severity of nephrotoxicity can be increased when Cefditoren is combined with Cefepime.
Atazanavir The risk or severity of nephrotoxicity can be increased when Atazanavir is combined with Cefepime.
Colistimethate The risk or severity of nephrotoxicity can be increased when Colistimethate is combined with Cefepime.
Cefuroxime The risk or severity of nephrotoxicity can be increased when Cefuroxime is combined with Cefepime.
Cefapirin The risk or severity of nephrotoxicity can be increased when Cefapirin is combined with Cefepime.
Cefprozil The risk or severity of nephrotoxicity can be increased when Cefprozil is combined with Cefepime.
Olsalazine The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Olsalazine.
Lumiracoxib The risk or severity of nephrotoxicity can be increased when Lumiracoxib is combined with Cefepime.
Cefamandole The risk or severity of nephrotoxicity can be increased when Cefamandole is combined with Cefepime.
Cefazolin The risk or severity of nephrotoxicity can be increased when Cefazolin is combined with Cefepime.
Cefonicid The risk or severity of nephrotoxicity can be increased when Cefonicid is combined with Cefepime.
Cefoperazone The risk or severity of nephrotoxicity can be increased when Cefoperazone is combined with Cefepime.
Cefoxitin The risk or severity of nephrotoxicity can be increased when Cefoxitin is combined with Cefepime.
Ceftizoxime The risk or severity of nephrotoxicity can be increased when Ceftizoxime is combined with Cefepime.
Magnesium salicylate The risk or severity of nephrotoxicity can be increased when Magnesium salicylate is combined with Cefepime.
Salsalate The risk or severity of nephrotoxicity can be increased when Salsalate is combined with Cefepime.
Choline magnesium trisalicylate The risk or severity of nephrotoxicity can be increased when Choline magnesium trisalicylate is combined with Cefepime.
Cefacetrile The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Cefacetrile.
Cefpodoxime The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Cefpodoxime.
Antrafenine The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Antrafenine.
Aminophenazone The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Aminophenazone.
Antipyrine The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Antipyrine.
Tiaprofenic acid The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Tiaprofenic acid.
Lopinavir The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Lopinavir.
Etoricoxib The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Etoricoxib.
Hydrolyzed Cephalothin The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Hydrolyzed Cephalothin.
Cephalothin Group The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Cephalothin Group.
Oxyphenbutazone The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Oxyphenbutazone.
Latamoxef The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Latamoxef.
Nimesulide The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Nimesulide.
Benoxaprofen The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Benoxaprofen.
Metamizole The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Metamizole.
Zomepirac The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Zomepirac.
Ceftobiprole The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Ceftobiprole.
Cimicoxib The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Cimicoxib.
Ceftaroline fosamil The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Ceftaroline fosamil.
Lornoxicam The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Lornoxicam.
Zaltoprofen The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Zaltoprofen.
Azapropazone The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Azapropazone.
Parecoxib The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Parecoxib.
Salicylamide The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Salicylamide.
Kebuzone The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Kebuzone.
Isoxicam The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Isoxicam.
Indoprofen The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Indoprofen.
Ibuproxam The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Ibuproxam.
Floctafenine The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Floctafenine.
Fenbufen The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Fenbufen.
Etofenamate The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Etofenamate.
Epirizole The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Epirizole.
Cefaloridine The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Cefaloridine.
Cefminox The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Cefminox.
Dexibuprofen The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Dexibuprofen.
Droxicam The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Droxicam.
Tolfenamic acid The risk or severity of nephrotoxicity can be increased when Cefepime is combined with Tolfenamic acid.

Target Protein

Penicillin-binding protein 1A mrcA
Penicillin-binding protein 1B mrcB
Penicillin-binding protein 2 mrdA
Peptidoglycan synthase FtsI ftsI
Penicillin-binding protein 1B ponB
Cell division protein pbpB
Penicillin-binding protein 2 pbpA

Referensi & Sumber

Synthesis reference: Kaplan, MA., et al. (1990). Cefepime cephalosporin salts (U.S. Patent No. 4,910,301). U.S. Patent and Trademark Office. https://patentimages.storage.googleapis.com/43/8a/fa/0010ba48b44ce5/US4910301.pdf
Artikel (PubMed)
  • PMID: 14720024
    Chapman TM, Perry CM: Cefepime: a review of its use in the management of hospitalized patients with pneumonia. Am J Respir Med. 2003;2(1):75-107.
  • PMID: 1673424
    Barbhaiya RH, Knupp CA, Forgue ST, Matzke GR, Halstenson CE, Opsahl JA, Pittman KA: Disposition of the cephalosporin cefepime in normal and renally impaired subjects. Drug Metab Dispos. 1991 Jan-Feb;19(1):68-73.
  • PMID: 34796060
    Ortega AJ, Ghafouri SR, Vu L, Edwards B, Nickel N: Cefepime-Induced Encephalopathy in a High-Risk Patient With Renal Insufficiency and Cirrhosis. Cureus. 2021 Oct 14;13(10):e18767. doi: 10.7759/cureus.18767. eCollection 2021 Oct.
  • PMID: 18613802
    Drago L, De Vecchi E: The safety of cefepime in the treatment of infection. Expert Opin Drug Saf. 2008 Jul;7(4):377-87. doi: 10.1517/14740338.7.4.377.

Contoh Produk & Brand

Produk: 66 • International brands: 4
Produk
  • Apo-cefepime
    Powder, for solution • 1 g / vial • Intramuscular; Intravenous • Canada • Generic • Approved
  • Apo-cefepime
    Powder, for solution • 2 g / vial • Intravenous • Canada • Generic • Approved
  • Cefepime
    Injection • 500 mg/1 • Intramuscular; Intravenous • US • Generic • Approved
  • Cefepime
    Injection • 1 g/1 • Intramuscular; Intravenous • US • Generic • Approved
  • Cefepime
    Injection • 2 g/1 • Intravenous • US • Generic • Approved
  • Cefepime
    Injection, powder, for solution • 1 g/1 • Intravenous • US • Generic • Approved
  • Cefepime
    Injection, powder, for solution • 2 g/1 • Intravenous • US • Generic • Approved
  • Cefepime
    Injection, powder, for solution • 1 g/1 • Intramuscular; Intravenous • US • Generic • Approved
Menampilkan 8 dari 66 produk.
International Brands
  • Axepim
  • Cepimax
  • Cepimex
  • Maxipime

Sekuens Gen/Protein (FASTA)

Sekuens dimuat saat dibutuhkan agar halaman tetap ringan.
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