Cefradine

Oral Antibiotics

Drug class: First-Generation Cephalosporin Antibiotic; beta-lactam antibiotics, specifically categorized as a First-generation cephalosporin.

Cefradine (VELOCEF)（中文：頭孢拉定）

Common Strengths

• Capsules: 250 mg, 500 mg
• Injection: 500 mg, 1 g

Drug Trade Name

Cefradine is marketed under several trade names, including:

• Velocef
• Intracef
• Cephradine (in the US)

Drug Usage

Cefradine is used to treat a variety of bacterial infections, including:

• Respiratory tract infections (e.g. pneumonia, bronchitis)
• Urinary tract infections
• Skin and soft tissue infections
• Otitis media (ear infections)
• Surgical prophylaxis to prevent infections

Mechanism of Action

Cefradine works by binding to specific penicillin-binding proteins (PBPs) in bacterial cell walls, inhibiting cell wall synthesis, and leading to bacterial cell lysis and death.

Route of Administration

Cefradine can be administered via:

• Oral (capsules)
• Intramuscular (IM)
• Intravenous (IV)

Dosages

• Adults:
  • Oral: 250-500 mg every 6-8 hours (max 4 g/day)
  • IV/IM: 500 mg to 1 g every 6-8 hours (max 8 g/day for severe infections)
• Children:
  • Oral: 25-50 mg/kg/day divided into 2-4 doses
  • IV/IM: 50-100 mg/kg/day divided into 4 doses
• Renal Dosing
  • Dosing adjustments are required in patients with renal impairment based on the estimated glomerular filtration rate (eGFR). Generally, if eGFR is less than 30 mL/min, the dose should be reduced.

Side Effects

Frequency	Adverse reactions
Common Side Effects	Nausea
	Diarrhea
	Rash
	Dizziness
Serious Side Effects	Severe allergic reactions (anaphylaxis)
	Clostridium difficile-associated diarrhea
	Liver dysfunction (jaundice)
	Blood disorders (e.g. thrombocytopenia)

Pharmacokinetics

• Half-life: Approximately 0.9 hours
• Excretion: Primarily renal, unchanged
• The onset of action:
  • For oral cefradine typically occurs within one hour after ingestion.
  • For IV and IM routes, the onset can be as quick as 30 minutes, providing rapid therapeutic effects in acute situations.
• The duration of action for cefradine generally aligns with its half-life. Given its half-life of around 1 hour, the effects can last several hours, necessitating frequent dosing to maintain effective serum levels. For example:
  • In uncomplicated urinary tract infections: 500 mg every 12 hours or 250 mg every 6 hours.
  • For more severe infections, higher doses may be required.

Drug Precautions

Pregnancy

Cefradine is generally considered safe during pregnancy, but it should only be used if clearly needed.

Breastfeeding

Cefradine is excreted in breast milk in small amounts. It is usually considered safe, but caution is advised.

Children and Elderly

Cefradine can be used in children and elderly patients, but dosage adjustments may be necessary based on renal function.

Monitoring Items

• Renal function (eGFR)
• Liver function tests
• Complete blood count (CBC) for signs of blood dyscrasias

Drug Interactions

Cefradine can interact with various medications, including:

• Aminoglycosides (increased nephrotoxicity risk)
• Probenecid (increased cefradine levels)
• Anticoagulants (potential increased bleeding risk)

FAQ

How Should I Take the Tablet?

Take cefradine with a full glass of water, either with or without food.

What Should I Avoid While Taking?

Avoid taking other antibiotics unless prescribed, and be cautious with medications that can affect kidney function.

What Happens if I Miss a Dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose. Do not double the dose.