Mahacef Plus

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Mahacef Plus

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Medically reviewed

Marina Burgos

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Mahacef Plus

Quick Facts

Property Description
Active Ingredients Cefixime, Ofloxacin
Form Oral tablet (Fixed-dose combination)
Pharmacological Class Broad-spectrum antibacterial agents
Common Use Combating systemic bacterial infections
Origin Synthetic compounds

What is the Composition and Nature of Mahacef Plus?

Mahacef Plus is fundamentally a pharmaceutical entity known as a Fixed-dose combination (FDC) product, designed for Systemic administration as an Oral tablet. It contains two distinct Active Ingredients [INN]: Cefixime and Ofloxacin, both of which are Synthetic compounds. The FDC structure is a distinctive feature of this formulation, ensuring both antibacterial agents are delivered simultaneously in a single pill.

The structural decision to combine a third-generation cephalosporin (Cefixime) and a fluoroquinolone (Ofloxacin) is clinically recognized as a strategy to enhance the scope of action against diverse pathogens. This fixed-ratio approach is often employed in situations requiring robust empirical treatment. The Oral tablet form provides convenience for administration, a typical characteristic for antibiotics intended for use in adults and adolescents.

What Type of Antibacterial Agent is Mahacef Plus?

This medicine is classified as a Broad-spectrum antibacterial agent, leveraging the combined efficacy of two different major classes of Antimicrobial drugs. Cefixime belongs to the cephalosporin class of beta-lactams, while Ofloxacin is from the quinolone class. This combination is designed to provide comprehensive coverage against a wide array of bacteria, including Gram-positive and Gram-negative organisms.

This dual-class architecture establishes a powerful Dual-action bactericidal effect. Ofloxacin is a synthetic drug that works by interfering with bacterial DNA function. By attacking two separate, vital pathways, the combination provides a robust approach for the clearance of underlying Bacterial infections requiring powerful Systemic treatment.

What is the General Purpose of the Cefixime-Ofloxacin Combination?

The primary purpose of the Mahacef Plus combination is to provide a systematic strategy for the Systemic elimination of ongoing Bacterial infections requiring prompt and powerful Antimicrobial intervention. A typical use scenario involves addressing infections where multidrug resistance is a potential concern. The key benefit lies in the combined Physiological actions which concurrently attack the bacteria's physical structure and its genetic replication process, offering a high-impact approach to clear the infectious load.

What side effects are possible with Mahacef Plus?

Possible Side Effects and Safety Information

This section describes the officially documented adverse reactions and safety characteristics of the Cefixime-Ofloxacin combination, categorized by frequency and the organ system affected, as established in government regulatory documents.

Adverse Reaction Scope

The most frequently observed adverse reactions, classified as Common in regulatory labeling, are related to Gastrointestinal disorders and Nervous system disorders. These include Diarrhea (a very common effect of Cefixime), Nausea, Abdominal pain, Headache, and Dizziness. Uncommon effects include Vomiting and Flatulence.

System-Organ Class Example Adverse Reactions
Gastrointestinal Diarrhea, Nausea, Vomiting, Dyspepsia
Nervous System Headache, Dizziness, Insomnia, Seizures
Musculoskeletal Tendinitis, Tendon rupture

Serious Adverse Reactions

The official safety profile highlights several serious adverse reactions, particularly associated with the Ofloxacin (fluoroquinolone) component. These include Tendon rupture and Tendinitis, which can occur within hours or months after exposure. Peripheral neuropathy and severe Central Nervous System effects (e.g., seizures, confusion) are also documented risks. Additionally, the label notes the potential for QT interval prolongation, a heart rhythm abnormality, and a rare but serious risk of Aortic aneurysm and dissection.

Severe hypersensitivity reactions, such as Anaphylaxis and Stevens-Johnson Syndrome (SJS), are critical documented safety concerns for both antibacterial classes.

Population-Specific Safety Considerations

Safety constraints are explicitly defined for specific groups. The risk of tendon rupture is noted to be higher in older adults and those taking corticosteroids. The Ofloxacin component is generally contraindicated in the pediatric population due to risks related to growing cartilage. Dose adjustment is required for patients with renal impairment to prevent drug accumulation and increased side effect risk. The label also contains constraints against use in patients with a history of tendon disorders related to fluoroquinolones or those at high risk for QT prolongation.

Overdose and Emergency Response

Overdose and when to seek help

The official regulatory documentation for the components of Mahacef Plus defines a risk profile for overdose involving systemic and neurological toxicity. Documented overdose manifestations include gastrointestinal effects such as nausea, vomiting, and diarrhea, along with Central Nervous System (CNS) disturbances including convulsions, tremors, agitation, toxic psychoses, and increased intracranial pressure.

Overdose carries the risk of severe and life-threatening outcomes. These include acute renal failure, cardiac issues such as QT interval prolongation and the serious risk of Torsades de pointes, and the documented potential for aortic dissection or rupture (risks associated with the fluoroquinolone component).

Immediate medical attention is required for any suspected overdose. Emergency help must also be sought for the sudden onset of severe, constant pain in the chest, back, or abdomen. Management is based on general supportive measures and symptomatic treatment, as no specific antidote exists for the Cefixime component, which is not removed in significant quantities by dialysis. The risk of encephalopathy is particularly increased in patients with pre-existing renal impairment, and heightened seizure risk is noted for individuals with underlying CNS disorders.

Therapeutic Uses of Mahacef Plus

Main Uses of Mahacef Plus

Mahacef Plus is a combination antibiotic medication prescribed for the treatment of various bacterial infections. It contains two active ingredients, Cefixime and Ofloxacin, which work together to eliminate a broad spectrum of bacteria. This combination is typically utilized when a physician determines that a multi-mechanism approach is necessary to resolve an infection.

Respiratory Tract Infections

The medication is frequently used to manage infections affecting the respiratory system. This includes:

  • Bronchitis: Inflammation of the lining of the bronchial tubes.
  • Pneumonia: A bacterial infection that inflames the air sacs in one or both lungs.
  • Sinusitis and Pharyngitis: Infections of the sinuses or throat that are confirmed to be bacterial in origin.

Urinary Tract Infections (UTIs)

Mahacef Plus is effective against bacteria that cause infections in the urinary system. It is used for both uncomplicated and complicated urinary tract infections, helping to clear the bacteria from the bladder, kidneys, or urethra.

Gastrointestinal Infections

One of the primary applications of this combination therapy is the treatment of typhoid fever (enteric fever). It is also used for other bacterial infections of the digestive tract that are susceptible to the combined action of Cefixime and Ofloxacin.

Other Bacterial Infections

Physicians may prescribe this medication for various other conditions, including:

  • Sexually Transmitted Infections: Certain bacterial infections such as gonorrhea.
  • Skin and Soft Tissue Infections: Bacterial growth affecting the skin layers or underlying tissues.
  • Otitis Media: Bacterial infections of the middle ear.

Benefits of Combination Therapy

Synergistic Effect

The primary benefit of Mahacef Plus is the synergy between its two components. Cefixime is a cephalosporin that inhibits the formation of the bacterial cell wall, while Ofloxacin is a fluoroquinolone that prevents bacteria from reproducing by interfering with their DNA replication.

Broad-Spectrum Coverage

By utilizing two different classes of antibiotics, the medication provides coverage against a wider variety of bacteria (both Gram-positive and Gram-negative) than either drug might achieve alone. This is particularly useful in empirical therapy, where the exact strain of bacteria may not yet be identified, or in cases where the infection is suspected to be resistant to single-agent treatments.

Regulatory References

  1. NIH MedlinePlus Drug Information

Eligibility and Restrictions for Use

The eligibility for Mahacef Plus, a fixed-dose combination of Cefixime and Ofloxacin, is determined by the most stringent regulatory requirements of both component antibiotics. The official labeling classifies patients into groups for whom use is prohibited, restricted, or allowed.

Contraindicated Populations (Absolute Non-Eligibility)

The medicine is contraindicated (must not be used) for several populations. These include patients with a known hypersensitivity to Cefixime, Ofloxacin, any cephalosporin, or any quinolone antibiotic. Due to the Ofloxacin component, Mahacef Plus is strictly prohibited for children and adolescents under 18 years of age. Use is also contraindicated for women who are pregnant or breastfeeding. Patients with a history of tendon disorders related to previous quinolone administration must also not take this medicine.

Restricted or Conditional Use

Use is restricted and requires special consideration in specific patient populations. Patients with impaired renal function require a label-mandated dose adjustment to prevent drug accumulation. Caution is necessary for older adults (generally over 60 years of age) and patients concurrently taking corticosteroid drugs, due to an increased risk of tendon rupture. Use is also restricted for patients with hepatic impairment or a known history of seizures or epilepsy.

What should I know about interactions with other medicines?

Mahacef Plus contains a fluoroquinolone component (Ofloxacin), which dictates the majority of the drug's official interaction profile established in government regulatory documents.

Contraindicated and Restricted Combinations

Co-administration with Class IA and Class III Antiarrhythmic Agents (such as quinidine, procainamide, amiodarone, or sotalol) is restricted or avoided due to the documented potential for the Ofloxacin component to prolong the QT interval.

Use with other medicinal products that are known to prolong the QT interval should also be avoided. The co-administration of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as fenbufen, may increase the risk of CNS stimulation and convulsive seizures.

Absorption Interference and Timing Rules

The absorption of the Ofloxacin component is substantially reduced when taken concurrently with substances containing polyvalent cations.

Interacting Product Category Regulatory Requirement
Antacids, Sucralfate, Metal Cations (e.g., iron, magnesium, aluminum) Must be taken at least two hours before or two hours after the Mahacef Plus dose.

Exposure and Pharmacodynamic Effects

Co-administration with Warfarin and other oral anticoagulants has been reported to cause an increase in prothrombin time, necessitating close monitoring. The simultaneous use of Theophylline may increase the risk of Theophylline-related adverse reactions.

Furthermore, elevated Carbamazepine levels have been reported when co-administered with the Cefixime component in postmarketing experience. Population-specific caution is advised for elderly patients receiving corticosteroids due to the documented increased risk of tendon rupture.

Mechanism of Action

Inhibition of Bacterial Growth via Dual Mechanism

Mahacef Plus employs a dual-mechanism to initiate a cascade leading to bacterial cell lysis. Cefixime, a cephalosporin, acts within the domain of bacterial cell wall synthesis. It binds to penicillin-binding proteins (PBPs), which are enzymes critical for the transpeptidation and cross-linking of peptidoglycans. This binding inhibits the final stage of cell wall assembly, causing structural failure, osmotic instability, lysis, and subsequent cell death.

Disruption of DNA Replication and Repair

Ofloxacin (when present) acts through a distinct mechanistic domain by targeting the bacteria's genetic machinery. Ofloxacin, a fluoroquinolone, inhibits bacterial enzymes DNA gyrase and topoisomerase IV. These enzymes are essential for managing DNA supercoiling and segregating daughter chromosomes. Inhibition of these targets prevents proper enzyme function, which compromises chromosomal integrity, inhibiting DNA replication, transcription, and repair processes.

Regulation of Intestinal Microbial Population Dynamics

In formulations containing Lactic Acid Bacillus (when present), this component modulates the dynamics of the gut microflora. The introduction of Lactic Acid Bacillus alters the microenvironment by producing lactic acid and engaging in localized microbial competition.

Dosage and Administration Information

Official Administration Guidelines

Mahacef Plus is a fixed-dose combination (FDC) medicine administered exclusively by the oral route. The guidance for use is derived from principles applied to its components, Cefixime and Ofloxacin, and the status of the FDC formulation.


Administration Scope

Instruction Detail
Dosing Schedule The standard regimen is one FDC tablet (Cefixime 200 mg / Ofloxacin 200 mg) per dose. The maximum total daily intake is Cefixime 400 mg and Ofloxacin 400 mg.
Frequency Pattern The dose must be taken twice daily (every 12 hours) to maintain consistent antimicrobial concentrations in the body.
Timing in Relation to Meals Administration may occur with or without food.

Procedural and Contextual Instructions

The official instructions establish specific conditions necessary for proper use:

  • Tablet Integrity: The tablet must be swallowed whole and is not to be crushed, chewed, or broken, which is necessary to maintain the integrity of the formulation and ensure the intended absorption profile.
  • Mineral Separation: The Ofloxacin component requires that the tablet be taken at least two hours before or two hours after consuming products containing divalent or trivalent cations (e.g., antacids, iron supplements) to prevent reduced absorption.
  • Course Duration: The full treatment course, as specified, must be completed to achieve effective bacterial clearance, even if symptoms show early improvement.

Population-Specific Rules

Dosage modification is a requirement for patients with impaired renal function, based on the rate of kidney clearance. Furthermore, the use of the Ofloxacin component (a fluoroquinolone) in children and growing adolescents is generally restricted or requires careful assessment.

Recent Clinical Evidence

The research evidence for the Cefixime-Ofloxacin fixed-dose combination (FDC) has been studied primarily in the context of systemic bacterial infections, particularly Typhoid Fever (Enteric Fever) and Urinary Tract Infections (UTIs).

For Typhoid Fever, the research consists mainly of post-marketing surveillance reports and retrospective clinician surveys. These studies explored how symptoms evolved, examining outcomes like the time required for fever clearance and whether microbiological clearance in the blood was observed. Findings describe patterns observed in these studies, but evidence is limited, and certainty remains low. Long-term effects are not fully established, and comparative evidence is lacking as large-scale, randomized studies comparing this FDC directly to other treatments are generally unavailable.

The evidence base for UTIs largely centers on research exploring the two individual components (Cefixime and Ofloxacin). Studies report that the measured outcomes for the individual component monotherapies were evaluated alongside other treatments studied in the trials. Dedicated, high-quality randomized controlled trials for the FDC itself in this context appear to be less referenced than the foundational research on the two single agents.

Across all indications, follow-up durations were limited, focusing mainly on the acute phase of illness. Data for certain groups remain limited, meaning there is insufficient information for long-term outcomes or short-term changes in populations such as children or individuals with certain chronic comorbid conditions. Overall, evidence quality varies across studies, and the evidence base continues to evolve, particularly concerning long-term effects and consistency across all populations.

Key Studies & References

  1. Ofloxacin Drug Information (NIH MedlinePlus) - Foundational Uses
  2. PubMed (National Library of Medicine) - Index of Peer-Reviewed Scientific Literature
  3. European Medicines Agency (EMA) - Regulatory and Scientific Guidance

Frequently Asked Questions (FAQ)

Common questions about Mahacef Plus (FAQ)

Q: What kind of infections is Mahacef Plus typically prescribed for?

A: Official information and research for this combination drug show it is primarily studied for use in systemic bacterial infections. This includes conditions such as Typhoid Fever and Urinary Tract Infections (UTIs). The documented scope of use also covers bacterial infections affecting the skin, ears, lungs, and prostate.

Q: Can I take Mahacef Plus at the same time as antacids or heartburn medication?

A: Regulatory documents describe a required separation in timing. The medicine must be taken at least two hours before or two hours after consuming products that contain metal cations. This rule applies to certain antacids and heartburn medications to ensure the Ofloxacin component is absorbed properly by the body.

Q: What are the major drug categories that Mahacef Plus is known to interact with?

A: Regulatory documents describe interactions with several drug categories. These include certain antiarrhythmic agents (drugs that affect heart rhythm), NSAIDs (non-steroidal anti-inflammatory drugs), and oral anticoagulants (blood thinners like warfarin). There are also necessary timing precautions for products containing metal cations, such as antacids and some mineral supplements.

Q: What is known about using Mahacef Plus during pregnancy or breastfeeding?

A: Official labeling states that use of Mahacef Plus is contraindicated (not recommended or allowed) for women who are pregnant or breastfeeding. This restriction is due to safety concerns documented for the drug's components.

Q: Are there any dietary restrictions I need to follow while taking Mahacef Plus?

A: Official instructions state the medicine may be taken with or without food. While there are specific timing requirements for certain non-food supplements and antacids, regulatory documents do not define any specific dietary restrictions related to typical foods.

Q: What non-drug products, like certain foods, are mentioned in interactions information for Mahacef Plus?

A: The official interaction warnings focus on non-drug products containing polyvalent cations (minerals). These include common products like antacids, sucralfate, and supplements containing minerals such as iron, magnesium, and aluminum. Foods are not generally listed as interactions.

Q: Does Mahacef Plus treat viral infections like the common cold or flu?

A: No. This medicine is classified as a Broad-spectrum antibacterial agent and is specifically designed to combat bacterial infections. Official documents do not indicate its use for treating viral infections like the common cold or flu.

Q: What is the expected timeline for feeling better after starting Mahacef Plus?

A: Official patient information states that symptom improvement is typically observed during the first few days of treatment. It is noted that if symptoms do not start to improve or if they worsen, a healthcare provider should be contacted.

Q: Can Mahacef Plus cause dark urine, and is that a serious side effect?

A: Dark urine is noted in official information as a potential sign of a serious liver problem. If this or other signs like yellowing skin or eyes are observed, official documents advise immediate communication with a healthcare professional.

Q: Is it common to feel tired or dizzy while taking Mahacef Plus?

A: According to official safety documents, dizziness is listed as a common adverse reaction associated with this medicine. Fatigue (tiredness) is also documented as a possible side effect of the Ofloxacin component.

Q: Are there any long-term side effects associated with Mahacef Plus use?

A: Regulatory documents note that the Ofloxacin component belongs to a class of drugs associated with disabling and potentially irreversible serious adverse reactions, such as peripheral neuropathy (nerve damage) and tendon issues, which can occur even after treatment is completed. The full long-term effects of the combination are not fully established in research.

Q: What happens if I miss a dose of Mahacef Plus?

A: Official patient instructions describe that if a dose is missed, it is generally advised to take it as soon as it is remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped, and the regular schedule should be continued. Official guidance indicates that a double dose should not be taken to compensate for a missed one.

Q: What should I know about the inactive ingredients in Mahacef Plus tablets?

A: Official patient information lists inactive ingredients, also called excipients, in the package insert. For example, some formulations contain phenylalanine, which carries a specific caution for individuals with the condition phenylketonuria (PKU).

Q: Does Mahacef Plus help with pain or just treat the infection?

A: This medicine is classified as a Broad-spectrum antibacterial agent with the purpose of combating bacterial infections. It is not classified as an analgesic and is not indicated for use as a primary pain reliever.

Q: Is the medication known by any other names in different countries?

A: Yes. While 'Mahacef Plus' is a specific brand name, the active components, Cefixime and Ofloxacin, are widely used drugs. They are marketed globally under numerous different brand names depending on the country and the manufacturing company.

Q: What is the risk of developing a secondary infection, like a yeast infection, with Mahacef Plus?

A: Yes. Disruption of the normal microbial balance by an antibiotic can lead to a secondary infection or superinfection. Official documents list fungal infection (such as candidiasis or a yeast infection) as a possible adverse effect.

Q: Can Mahacef Plus cause insomnia or changes in sleep patterns?

A: Yes. Insomnia (difficulty sleeping) is listed among the documented side effects that affect the nervous system. Any changes in sleep patterns should be noted, as they are part of the documented safety profile.

Q: What are the official recommendations regarding driving or operating heavy machinery while on Mahacef Plus?

A: Caution is advised because side effects such as dizziness, confusion, or feeling less alert may impair your ability to react. Official information advises that driving or operating machinery may be impaired, and is generally not recommended if these or other Central Nervous System effects are experienced.

Q: Are there official studies on the use of Mahacef Plus for extended periods?

A: Research evidence for this combination drug is described as having limited follow-up durations, focusing mainly on the acute phase of illness. This limitation means that comprehensive data on the effects of extended use are not fully established in official documents.

Q: What is the typical length of treatment prescribed for Mahacef Plus?

A: The typical duration of treatment is determined by a healthcare provider based on the type and severity of the infection being treated. Official prescribing information often lists various durations for the drug's components, which can range from a few days to two weeks depending on the specific condition.

Q: Does Mahacef Plus interact with herbal supplements or vitamins?

A: Yes. Interactions are officially described with certain herbal preparations and certain vaccines. Also, multivitamin and mineral supplements containing iron or zinc can interfere with the absorption of the Ofloxacin component and require a time separation from the dose.

Q: What is the mechanism by which the 'Plus' component assists the main drug?

A: The combination is a strategy designed to enhance the scope of action against diverse bacteria. The two components work by attacking two separate, vital pathways: Cefixime disrupts the bacterial cell wall, and Ofloxacin disrupts the bacteria's DNA replication and repair machinery.

Q: Why do official documents sometimes mention blood cell counts when discussing Mahacef Plus?

A: Monitoring of blood cell counts is sometimes advised because the drug class is associated with potential adverse effects on the Hemic and Lymphatic System (the system responsible for blood-forming functions). This may include possible decreases in certain blood cell types, such as leukopenia or thrombocytopenia, particularly during prolonged therapy.

Q: Is Mahacef Plus effective against all types of bacterial infections?

A: No. While this medicine is classified as a Broad-spectrum antibacterial agent designed to be effective against a wide array of Gram-positive and Gram-negative bacteria, it is not effective against all types of bacterial infections. Its use is limited to infections caused by organisms that are susceptible to the drug.

Q: Are there specific symptoms that indicate I should seek immediate medical attention while on Mahacef Plus?

A: Yes. The label specifies several serious reactions that are documented as needing immediate medical communication. These include signs of a severe allergic reaction (e.g., swelling of the face or throat), symptoms of tendon pain or rupture, and changes indicating liver problems (e.g., dark urine, yellowing skin or eyes).

Q: What should I do if a rash develops while taking Mahacef Plus?

A: A rash can be a sign of a severe hypersensitivity reaction. Official information states that a healthcare provider should be contacted immediately if a rash, hives, or swelling develops. Official guidance often indicates that stopping the drug (discontinuation) is advised if an allergic reaction is suspected.

Q: Does Mahacef Plus have any known impact on mood or mental clarity?

A: Yes. Official safety information for the Ofloxacin component includes potential serious adverse reactions affecting the Central Nervous System. These may present as changes in mood or behavior, including confusion, agitation, and issues with memory or concentration.

How should Mahacef Plus be stored and disposed of?

Official Storage and Disposal Requirements

The storage and disposal instructions for Mahacef Plus tablets, which contain Cefixime and Ofloxacin, are defined by regulatory labeling to maintain the product’s quality and safety.

Storage Component Requirement
Temperature Store below 25 C or 30 C (room temperature range).
Protection Store in a cool and dry place, protected from direct sunlight, heat, and moisture.
Container Rule Keep the medicine in its original container or pack and ensure it is tightly closed.
Child Safety Keep out of sight and reach of children and pets at all times.
Disposal Dispose of unused or expired medicine according to the instructions on the package, ensuring it cannot be consumed by children or pets.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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