Adult: Usual dose: 1-2 g daily in 2 divided doses. For severe infection, may be increased to 4 g daily in 2-4 divided doses. Child: Usual dose: 60-80 mg/kg daily in 3-4 divided doses. Newborn infants: 20 mg/kg 2-3 times daily within 3 days of birth, then 3-4 times daily from 4th day after birth. Dose may be increased to 150 mg/kg daily in 3-4 divided doses, adjusted according to severity of condition.
Reconstitution
Add at least 4 mL of water for inj, glucose 5% solution for inj or NaCl 0.9% solution to a vial containing 0.5 g or 10 g. Shake vigorously until solution is dissolved.
Contraindications
Hypersensitivity. History of shock.
Special Precautions
Patient with predisposition to allergic reactions (e.g. bronchial asthma, rash and urticaria), poor oral ingestion, poor general conditions, cardiac or circulatory disorder. Parenterally-fed patients. Renal and hepatic impairment. Children. Pregnancy and lactation.
Monitor renal function, LFT, and CBC periodically. Monitor signs and symptoms of hypersensitivity.
Drug Interactions
May exacerbate nephrotoxic effect with diuretics (e.g. furosemide).
Lab Interference
False-positive result in urine sugar test with Benedict’s solution. Positive reactions in direct Coombs’ test.
Action
Description: Mechanism of Action: Flomoxef is an oxacephalosporin, a bactericidal agent. It has affinity to penicillin-binding proteins and prevents action to peptidoglycan-crosslinking enzymes thus inhibiting bacterial cell wall synthesis. Pharmacokinetics: Absorption: Time to peak plasma concentration: 6 hours. Distribution: Well distributed and penetrates moderately into lung, mucosal tissue of the middle ear and bone. Plasma protein binding: 35%. Metabolism: Minimally metabolised in the liver into active metabolite and inactive hydroxy-ethyltetrazolethiol metabolite. Excretion: Via urine (80-90% as unchanged drug). Elimination half-life: Approx 50 minutes.
Chemical Structure
Flomoxef
Source: National Center for Biotechnology Information. PubChem Database. Flomoxef, CID=65864, https://pubchem.ncbi.nlm.nih.gov/compound/Flomoxef (accessed on Jan. 21, 2020)
J01DC14 - flomoxef ; Belongs to the class of second-generation cephalosporins. Used in the systemic treatment of infections.
References
Anon. Flomoxef. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 12/03/2018.Buckingham R (ed). Flomoxef Sodium. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 12/03/2018.Flomoxef. Gold Standard Drug Database in ClinicalKey [online]. Elsevier Inc. https://www.clinicalkey.com/. Accessed 14/03/2018.
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