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Cefixime oral

Updated 2 Feb 2023 | Cephalosporins


Oral formulations of cefixime.

Drugs List

  • cefixime 200mg tablets
  • cefixime 400mg tablets
  • SUPRAX 200mg tablets
  • Therapeutic Indications


    Acute lower respiratory tract infections - treatment
    Acute upper respiratory tract infections - treatment
    Acute urinary tract infections - treatment

    Unlicensed Uses

    Uncomplicated gonorrhoea


    Usual course of treatment seven days. May be extended to fourteen days if required.


    200mg to 400mg daily, given either as one single or two divided doses.

    Uncomplicated gonorrhoea (unlicensed)
    400mg as a single dose.


    Children aged over 10 years old or weighing more than 50kg
    200mg to 400mg daily, given either as one single or two divided doses.

    The following alternative dosing schedule may be suitable:
    Children aged 5 to 9 years: 200mg daily.
    Children aged 1 to 4 years: 100mg daily.
    Children aged 6 month to 1 year: 75mg daily.

    Uncomplicated gonorrhoea (unlicensed)
    Children aged 12 to 17 years: 400mg as a single dose.

    Patients with Renal Impairment

    Creatinine clearance greater than or equal to 20ml/minute
    Dose as in normal renal function.

    Creatinine clearance below 20ml/minute, patients on chronic ambulatory peritoneal dialysis or haemodialysis
    200mg maximum daily dose.


    Children under 6 months

    Precautions and Warnings

    Children under 10 years
    Renal impairment - creatinine clearance below 20ml/minute

    Dialysis patients may require dose reduction
    Reduce dose in patients with creatinine clearance below 20ml/min
    Before initiating therapy enquire about previous hypersensitivity reactions
    Consult national/regional policy on the use of anti-infectives
    Not all formulations are suitable for all age groups/body weights
    Assess renal function prior to prescribing in the elderly
    Monitor renal function in patients with renal impairment
    Advise patient to report diarrhoea
    Consider pseudomembranous colitis if patient presents with diarrhoea
    Prolonged use may result in superinfection with non-susceptible organisms
    Test interference: May cause false positive Coombs test
    May cause false positive for glycosuria : Benedict's / Fehling's solution
    Discontinue at once if pseudomembranous colitis occurs
    Discontinue if drug-related rash or other hypersensitivity reactions occur
    Discontinue if renal failure develops

    Pregnancy and Lactation


    Use cefixime with caution in pregnancy.

    Briggs suggests cefixime is compatible in pregnancy. No detectable teratogenic risk with cephalosporins was found in a large study in 2001. The manufacturer suggests cefixime should not be used in pregnancy unless essential.

    At the time of writing, there are limited data available on the use of cefixime in pregnancy. Animal studies have not shown any evidence of teratogenicity.

    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 to 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 ( ) or if this is unavailable at the backup site ( ).


    Use cefixime with caution in breastfeeding.

    The Drugs and Lactation Database (LactMed) suggests cephalosporins are not expected to cause adverse effects in breastfed infants and considers cefixime as acceptable to use during breastfeeding. The manufacturer suggest cefixime should not be used in breastfeeding unless essential.

    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

    Side Effects

    Abdominal pain
    Acute renal failure
    Alanine aminotransferase increased
    Altered liver enzymes values
    Altered liver function tests
    Anaphylactic shock
    Angioneurotic oedema
    Antibiotic-associated colitis
    Aplastic anaemia
    Aspartate aminotransferase increased
    Blood urea increased
    Cholestatic jaundice
    Drug fever
    Drug rash with eosinophilia and systemic symptoms (DRESS)
    Erythema multiforme
    Facial oedema
    False positive Benedict's test (transient)
    False positive Coombs test
    Genital pruritus
    Haemolytic anaemia
    Hypersensitivity reactions
    Impaired consciousness
    Increase in blood urea or creatinine
    Increases in hepatic enzymes
    Interstitial nephritis
    Movement disturbances
    Mucosal inflammation
    Pseudomembranous colitis
    Psychomotor excitation
    Serum bilirubin increased
    Serum creatinine increased
    Serum sickness
    Serum sickness-like reactions
    Stevens-Johnson syndrome
    Toxic epidermal necrolysis

    Effects on Laboratory Tests

    May cause false positive Coombs test.

    May cause false positive with Benedict's or Fehling's solutions or with copper sulfate test tablets but not with tests based on enzymatic glucose oxidase reactions.


    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 ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: December 2017

    Reference Sources

    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: Suprax Tablets 200mg. Sanofi-Aventis. Revised June 2018.

    Summary of Product Characteristics: Cefixime Tablets 400mg. Rivopharma. Revised March 2016.

    NICE Evidence Services Available at: Last accessed: 14 September 2018

    US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
    Available at:
    Cefixime. Last revised: 10 March 2015
    Last accessed: 20 December 2017

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