Drugs List

Therapeutic Indications

Uses

Genitourinary tract infection
Lower respiratory tract infections
Skin and soft tissue infections
Upper respiratory tract infections

Contraindications

Children under 6 years

Precautions and Warnings

History of allergies including anaphylaxis
Asthma
Breastfeeding
History of gastrointestinal disorder
Pregnancy
Renal impairment - eGFR below 50ml/ minute/ 1.73m squared
Ulcerative colitis

Advise ability to drive/operate machinery may be affected by side effects
Before initiating therapy enquire about previous hypersensitivity reactions
Consult national/regional policy on the use of anti-infectives
Monitor liver function on prolonged therapy
Monitor renal function during prolonged/high dose therapy
Perform blood counts on prolonged use of this treatment
Consider pseudomembranous colitis if patient presents with diarrhoea
Prolonged use may result in superinfection with non-susceptible organisms
May cause false positive Coomb's test and glycosuria test
Neonate exposed in utero: Risk of false positive Coomb's test
Discontinue if drug-related rash or other hypersensitivity reactions occur

Pregnancy and Lactation

Pregnancy

Safety of cefadroxil administration during pregnancy has not been established. Animal studies and clinical experience have not shown any evidence of teratogenicity. Cephalosporins are usually considered safe to use during pregnancy.

Cephalosporins cross the placenta, and can reach therapeutic levels in amniotic fluid and fetal tissues.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14-17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Use with caution while breastfeeding. Cefadroxil is excreted in low concentrations in human breast milk.

Occasionally, disruption of the infant's gastrointestinal flora, resulting in diarrhoea or thrush, has been reported with cephalosporins, however, these effects have not been adequately evaluated.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Abdominal discomfort
Agranulocytosis
Anaphylaxis
Angioedema
Arthralgia
Cholestasis
Cholestatic jaundice
Diarrhoea
Dizziness
Drug fever
Dyspepsia
Eosinophilia
Erythema multiforme
Exanthema
Fatigue
Gastro-intestinal disturbances
Genital moniliasis
Glossitis
Haemolytic anaemia
Headache
Hepatic failure
Hepatic impairment
Hepatitis
Hypersensitivity reactions
Increase in serum transaminases
Interstitial nephritis
Leucopenia
Nausea
Nervousness
Neutropenia
Pruritus
Pseudomembranous colitis
Rash
Serum sickness-like reactions
Sleep disturbances
Stevens-Johnson syndrome
Thrombocytopenia
Toxic epidermal necrolysis
Urticaria
Vomiting

Presentation

Cefadroxil capsules

Drugs List

Therapeutic Indications

Uses

Genitourinary tract infection
Lower respiratory tract infections
Skin and soft tissue infections
Upper respiratory tract infections

Dosage

Adults

Children

Patients with Renal Impairment

Contraindications

Children under 6 years

Precautions and Warnings

History of allergies including anaphylaxis
Asthma
Breastfeeding
History of gastrointestinal disorder
Pregnancy
Renal impairment - eGFR below 50ml/ minute/ 1.73m squared
Ulcerative colitis

Advise ability to drive/operate machinery may be affected by side effects
Before initiating therapy enquire about previous hypersensitivity reactions
Consult national/regional policy on the use of anti-infectives
Monitor liver function on prolonged therapy
Monitor renal function during prolonged/high dose therapy
Perform blood counts on prolonged use of this treatment
Consider pseudomembranous colitis if patient presents with diarrhoea
Prolonged use may result in superinfection with non-susceptible organisms
May cause false positive Coomb's test and glycosuria test
Neonate exposed in utero: Risk of false positive Coomb's test
Discontinue if drug-related rash or other hypersensitivity reactions occur

Pregnancy and Lactation

Pregnancy

Safety of cefadroxil administration during pregnancy has not been established. Animal studies and clinical experience have not shown any evidence of teratogenicity. Cephalosporins are usually considered safe to use during pregnancy.

Cephalosporins cross the placenta, and can reach therapeutic levels in amniotic fluid and fetal tissues.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14-17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Use with caution while breastfeeding. Cefadroxil is excreted in low concentrations in human breast milk.

Occasionally, disruption of the infant's gastrointestinal flora, resulting in diarrhoea or thrush, has been reported with cephalosporins, however, these effects have not been adequately evaluated.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Abdominal discomfort
Agranulocytosis
Anaphylaxis
Angioedema
Arthralgia
Cholestasis
Cholestatic jaundice
Diarrhoea
Dizziness
Drug fever
Dyspepsia
Eosinophilia
Erythema multiforme
Exanthema
Fatigue
Gastro-intestinal disturbances
Genital moniliasis
Glossitis
Haemolytic anaemia
Headache
Hepatic failure
Hepatic impairment
Hepatitis
Hypersensitivity reactions
Increase in serum transaminases
Interstitial nephritis
Leucopenia
Nausea
Nervousness
Neutropenia
Pruritus
Pseudomembranous colitis
Rash
Serum sickness-like reactions
Sleep disturbances
Stevens-Johnson syndrome
Thrombocytopenia
Toxic epidermal necrolysis
Urticaria
Vomiting

Effects on Laboratory Tests

A false positive reaction for glucose in the urine may occur with Benedict's or Fehling's solutions. This does not occur with enzyme-based tests.

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: February 2013

Reference Sources

Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 2nd edition (2007) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 9th edition (2011) ed. Briggs, G., Freeman, R. and Yaffe, S. Lippincott Williams & Wilkins, Philadelphia.

Summary of Product Characteristics: Cefadroxil 500mg Capsules. Sandoz Ltd. Revised January 2012

NICE Evidence Services Available at: www.nice.org.uk Last accessed: 22 June 2017