Rexocef

Rexocef

• Active ingredient: Cefpodoxime proxetil

Rexocef is available in several forms to suit different ages and conditions:

• Film-coated tablets: 100 mg and 200 mg

• Powder for oral suspension: 50 mg/5 ml and 100 mg/5 ml

Tablets are suitable for adults and adolescents, while the suspension is typically used for young children.

Cefpodoxime is used to treat infections caused by susceptible bacteria. It is typically prescribed for:

• Upper respiratory tract infections: tonsillitis, pharyngitis, sinusitis, otitis media

• Lower respiratory tract infections: bronchitis (including chronic), pneumonia

• Urinary tract infections: cystitis, urethritis, pyelonephritis

• Skin and soft tissue infections: furuncles, impetigo, erysipelas, abscesses

• Uncomplicated gonorrhea

Bacteriological testing is recommended before prescription to confirm the susceptibility of the pathogen to cefpodoxime.

Like any antibiotic, Rexocef must be taken strictly as prescribed by a doctor. Dosage is determined individually, taking into account age, body weight, infection severity, and kidney function. It is important to follow the regimen—this affects treatment effectiveness and reduces the risk of bacterial resistance.

General recommendations:

• The medication is taken orally, with food—this improves its absorption in the intestine.

• Tablets should be swallowed whole, without chewing, and with sufficient water.

• The powder for suspension is diluted with water strictly according to instructions. The resulting liquid should be well shaken before use.

Dosages for different ages. Adults and adolescents over 12 years (weight more than 50 kg):

• Usually prescribed from 100 to 400 mg every 12 hours. The exact dose depends on the location of the infection and its severity.

Children from 5 months to 12 years (weight less than 50 kg):

• Recommended daily dose is 8 mg per kilogram of body weight, divided into two doses.

For treatment of uncomplicated gonorrhea:

• Single dose of 200 mg of cefpodoxime.

Dose adjustment:

• Patients with impaired kidney function may require dose reduction—this is important to avoid drug accumulation and side effects.

Duration of treatment:

• Usually ranges from 5 to 10 days but may be adjusted by the doctor depending on the diagnosis and body response.

• Even if you feel better—the course needs to be completed, otherwise infection recurrence is possible.

Before starting treatment, it is important to ensure that the patient has no contraindications. In some cases, taking Rexocef may be unsafe.

The drug is not used in:

• Hypersensitivity (allergy) to cefpodoxime or other antibiotics from the cephalosporin group

• Severe allergic reactions to penicillins in history—cross-allergy is possible

• Kidney dysfunction with creatinine clearance below 30 ml/min

• Congenital or acquired carnitine deficiency (rare metabolic disorder)

• Age under 5 months—for suspension

• Age under 12 years—for the 100 mg tablet form

If the patient has at least one of these points, alternatives should be discussed with the treating physician.

Although Rexocef is an effective antibiotic, its use requires caution in several cases. It is especially important to inform the doctor if the patient has concomitant diseases.

The drug is used with caution in:

• Allergic diseases (bronchial asthma, allergic rhinitis)—increased risk of cross-reaction

• Gastrointestinal tract diseases, especially in the acute stage (e.g., ulcerative colitis or Crohn's disease)—cephalosporins may enhance mucosal irritation

• Renal insufficiency—dose adjustment required

• Hepatic insufficiency—the drug is minimally metabolized, but the doctor should consider the patient's general condition

Also possible:

• Development of superinfection, e.g., candidiasis, especially with prolonged use

• Development of bacterial resistance with drug abuse

• Pseudomembranous colitis caused by Clostridium difficile—requires urgent antibiotic discontinuation and special treatment

• Severe allergic reactions—anaphylaxis, angioedema (requires immediate medical attention)

Elderly patients more frequently develop gastrointestinal side effects such as diarrhea or dyspepsia.

Before starting Rexocef, it is important to inform the doctor about all medications being taken — even those "for the liver" or "for pressure." Some combinations may be dangerous.

Not recommended combining with:

• Antacids (e.g., aluminum hydroxide or magnesium)—reduce cefpodoxime absorption

• H2-histamine receptor blockers (e.g., ranitidine, famotidine)—same effect

• Loop diuretics (e.g., furosemide)—increase the risk of nephrotoxicity

• Aminoglycosides—increase kidney stress

• Polymyxin B and ethacrynic acid—same effect

• Probenecid—slows drug elimination, may enhance its action

• NSAIDs—may slow elimination and increase the risk of side effects

• Bacteriostatic antibiotics (e.g., tetracyclines, macrolides)—antagonism possible

• Indirect anticoagulants—anticoagulant effect enhanced, risk of bleeding

Some of these interactions may be critical, especially in chronic diseases or elderly patients.

• The use of Rexocef during these periods requires special caution.
• Pregnancy: Cefpodoxime can be used if the expected benefit outweighs the potential risk to the fetus. Clinical data is insufficient, so during pregnancy it is prescribed only according to strict indications.
• Breastfeeding: The drug passes into breast milk in small amounts. Although no serious side effects have been reported in infants, it should be used with caution during lactation.
• Fertility: There is no data on the effect on fertility—neither positive nor negative.
• In each of these cases, the decision to take the drug should be made by a doctor. Do not start or discontinue use independently.

In most cases, Rexocef does not affect the ability to drive or work with machinery. But individual reactions are possible, especially in the first days of use.

Possible side effects that may impair concentration:

• Dizziness

• Seizures (especially in patients with impaired kidney function)

If such symptoms appear—it is better to refrain from driving and working with dangerous mechanisms until the condition normalizes.

Like any antibiotic, Rexocef can cause side effects. Their frequency depends on individual sensitivity, duration of use, and concomitant diseases.

Common side effects (occur in 1-10% of patients):

• Nausea

• Vomiting

• Diarrhea

• Abdominal pain

• Headache

• Skin rash or itching

Uncommon (0.1-1%):

• Dizziness

• Urticaria

• Angioneurotic edema (Quincke's edema)

• Increased liver enzyme activity

Rare (0.01-0.1%):

• Anaphylactic shock

• Pseudomembranous colitis (inflammation of the intestine, often after prolonged antibiotic use)

• Hepatitis

• Decreased platelet count (thrombocytopenia)

• Decreased white blood cell count (leukopenia)

• Anemia

• Seizures

If unusual symptoms appear after starting treatment (especially rash, facial swelling, difficulty breathing, bloody diarrhea), immediate medical attention is required—this may be a sign of a serious reaction.

Overdose of Rexocef most often occurs in two situations:

• Intentional or accidental dose excess (e.g., a child drank the contents of a bottle)

• Drug accumulation in the body in patients with impaired kidney function, especially if the dose was not adjusted

Since cefpodoxime is excreted through the kidneys, even standard doses can cause toxic effects in patients with reduced function of these organs.

Typical overdose symptoms include:

• Nausea and vomiting—the body tries to get rid of excess drug

• Diarrhea—may be due to irritation of the GI tract mucosa or microflora disruption

• Epigastric pain—discomfort in the upper abdomen, most often associated with the stomach

• Seizures—a particularly dangerous symptom, usually develops in patients with chronic renal failure, due to drug accumulation and its possible effect on the central nervous system

In severe cases, other signs may manifest: confusion, tremor, dizziness, coordination disorders.

What to do in case of Rexocef overdose:

• Immediately stop taking the drug. Even if there are doubts—better to be safe.

• Gastric lavage. Effective if not more than 1-2 hours have passed since taking a large dose.

• Activated charcoal. Helps reduce cefpodoxime absorption, but only in the absence of vomiting and with preserved consciousness.

• Symptomatic therapy. This may include antipyretics, antispasmodics, infusion therapy (intravenous fluid administration to eliminate the drug through the kidneys).

• Hemodialysis. May be used in severe overdose, especially in patients with renal failure. Although cefpodoxime is not completely removed, dialysis helps reduce its concentration in the blood.

Important: In young children and elderly patients, symptoms may develop faster and be less specific, so at the slightest suspicion of overdose—seek immediate medical attention.

Cefpodoxime is a broad-spectrum antibiotic from the third-generation cephalosporin group. It works by disrupting bacterial cell wall synthesis, leading to their death.

A key feature is resistance to most beta-lactamases (enzymes that destroy antibiotics), making it effective against many resistant microorganisms.

The drug is active against:

• Gram-positive bacteria (including streptococci, staphylococci)

• Gram-negative bacteria (e.g., Haemophilus influenzae, Moraxella catarrhalis, some strains of E. coli and Clostridium)

It is ineffective against Pseudomonas aeruginosa and some strains of enterococci.

• Absorption: Cefpodoxime proxetil is a prodrug. After oral administration, it is rapidly hydrolyzed in the intestinal mucosa to form the active substance—cefpodoxime. Absorption of cefpodoxime improves when taken with food.

• Distribution: Penetrates well into tissues and body fluids. Plasma protein binding is about 40%.

• Metabolism: Practically not metabolized in the body.

• Elimination: Excreted predominantly by the kidneys in unchanged form (about 80%). The half-life is about 2-3 hours.

Rexocef belongs to the group:

• Third-generation cephalosporins

• Systemic antibacterial drugs

The drug is prescribed for systemic (i.e., affecting the whole body) bacterial infections and has an expanded spectrum of action compared to older antibiotics.

Each dosage form of Rexocef has its own auxiliary components. They do not have therapeutic effects but are necessary to maintain the stability of the drug, ease of use, and improve taste (especially in suspensions for children).

The composition of excipients may include: In tablets:

• lactose monohydrate

• microcrystalline cellulose

• crospovidone

• povidone

• magnesium stearate

• film-forming coating (hypromellose, titanium dioxide, etc.)

In powder for suspension:

• sucrose

• flavorings (e.g., strawberry or orange)

• thickeners (xanthan gum)

• sodium benzoate (preservative)

• citric acid

If the patient has lactose intolerance, allergy to flavorings, or tendency to allergies to food additives—it is essential to clarify the composition of the specific form with the doctor or pharmacist.

The complete list of excipients is indicated in the instructions for each specific package.

The shelf life of the drug is indicated on the package and depends on the dosage form:

• Tablets and powder for suspension preparation are usually valid for 2-3 years from the date of issue

• Ready suspension (after dilution with water) can be stored for no more than 14 days in the refrigerator

After the expiration date, the drug should not be used—its effectiveness and safety are not guaranteed. Even if it "looks normal," it should not be taken.

To maintain the properties of the drug, it is important to observe storage conditions:

• Store at temperatures not exceeding 25°C (unless otherwise specified on the package)

• Protect from moisture and direct sunlight

• Ready suspension—store in the refrigerator (at temperatures from 2 to 8°C), no more than 14 days after preparation

• Keep out of reach of children

If the suspension has changed color, smell, or consistency—it should be discarded, even if the storage period has not expired.

The packaging form depends on the dosage form and manufacturer. In stores, you may find:

• Blisters with tablets, packed in cardboard boxes. The package indicates the number of tablets (e.g., 10, 14, or 20 pcs.)

• Bottles with powder for suspension preparation. Usually, water is added to the bottle up to the mark, shaken, and the resulting solution is ready for oral administration

Also, the box should always include instructions for use—with detailed information on dosage, application, possible side effects, and interactions.

Medicines should not be disposed of with ordinary household waste or flushed down the drain—this can harm the environment and aquatic organisms. Antibiotic residues, entering nature, contribute to the development of bacterial resistance, making subsequent treatment less effective.

Important to know:

• Remains of suspension whose storage period has expired should be disposed of separately

• Tablets that have lost their marketable appearance or expiration date are also subject to special disposal

• Do not throw away the package with instructions until the end of the course—it may be needed in case of side effects or interactions

How to properly dispose of the drug:

• Return expired or unnecessary medication to a pharmacy participating in the medication collection program

• Or consult a pharmacist or doctor—they will suggest a safe method

These measures will help not only protect the environment but also reduce risks for people and animals.

• The drug Rexocef is registered and available under this name in North Macedonia, the producing country. Alkaloid also actively exports its products, including antibiotics, to more than 30 countries in Europe, Asia, and Africa.

• Alkaloid AD Skopje (North Macedonia)

• Rexocef belongs to systemic antibiotics, so it is dispensed strictly by prescription. Do not start or stop taking an antibiotic on your own—it can be dangerous to health.

To make treatment as effective and safe as possible, when taking Rexocef it is important to follow several key rules:

• Take only as prescribed by a doctor

• Do not exceed the dose, even if symptoms persist—changing the treatment regimen is possible only after consultation

• Take with food to improve drug absorption

• The duration of treatment is determined by the doctor, usually—from 5 to 10 days

• Do not stop treatment ahead of schedule, even if you feel better—this reduces the effectiveness of therapy and increases the risk of relapse

• Inform the doctor about all medications being taken to avoid interactions

• In case of side effects—immediately consult a doctor

• Before the first dose, it is important to exclude allergy to cephalosporins or penicillins, especially if there have been severe reactions in the past

Following these recommendations allows minimizing risks and increasing the chances of successful recovery.

• J01DD13 — Cefpodoxime

The drug Rexocef can be used in the treatment of infectious diseases corresponding to the following codes of the International Classification of Diseases (ICD-10):

• J01 — Acute sinusitis

• J02 — Acute pharyngitis

• J03 — Acute tonsillitis

• J04 — Acute laryngitis and tracheitis

• J20 — Acute bronchitis

• J42 — Unspecified chronic bronchitis

• L01 — Impetigo

• L02 — Cutaneous abscess, furuncle, and carbuncle

• L03 — Cellulitis

• N30 — Cystitis

• N34 — Urethritis and urethral syndrome

• N10 — Acute tubulo-interstitial nephritis (acute pyelonephritis)

• A54 — Gonococcal infection