Zifi-O

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Zifi-O

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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 Zifi-O

Quick Facts

Property Description
Active ingredient Cefixime and Ofloxacin
Form Tablet / Dispersible Tablet (DT)
Pharmacological class Combination Antibiotic / Antimicrobial drug
General purpose Management of bacterial infections
Origin Semisynthetic (Cefixime) and Synthetic (Ofloxacin)

What Type of Medicine is Zifi-O?

Zifi-O is an oral Fixed-Dose Combination (FDC) antibiotic preparation, classified as an Antimicrobial drug, which is used to fight infections caused by bacteria. This medicine is a combination product, typically presented as either a standard Tablet or a Dispersible Tablet (DT), and is strictly available as a prescription-only medicine. Its design as an FDC product means two distinct active ingredients are combined into a single pill to provide a broader therapeutic reach and enhanced effectiveness against various pathogens, a strategy widely adopted in antimicrobial protocols. The combination of Cefixime and Ofloxacin is also known under other trade names globally, such as Mahacef Plus and Taxim Of, highlighting its established presence in the management of specific systemic infections.

Composition and Pharmacological Class of Zifi-O

The composition of Zifi-O features the dual active ingredients Cefixime and Ofloxacin. Cefixime is classified as a semisynthetic third-generation cephalosporin antibiotic, a type of agent that achieves bactericidal activity by interfering with the structure-building process of bacteria. Ofloxacin is a synthetic compound belonging to the fluoroquinolone antibiotic class, which operates by preventing bacteria from copying and repairing their genetic material. The combination of these two agents from different classes, a cephalosporin and a fluoroquinolone, is clinically recognized for its ability to target bacterial strains that may be resistant to a single drug. This combined approach is implemented to ensure the highest likelihood of pathogen elimination.

General Purpose and Mechanism: Why is a Combination Antibiotic Used?

The general purpose of Zifi-O is to resolve systemic bacterial infections by eliminating the responsible disease-causing microorganisms. This is achieved through a synergistic or dual mechanism. The resulting broad-spectrum capability provides a comprehensive approach to managing complex or resistant infections, such as severe Urinary Tract Infections (UTIs) or certain cases of Typhoid fever. Merging different mechanisms of action often improves the overall potency and efficacy against key infectious pathogens. This means that by using both agents, the medicine is likely to be more effective at killing a wider range of bacteria than either component used alone.

Regulatory References

  1. World Health Organization Drug Protocols
  2. NIH Drug Information (Ofloxacin)

What side effects are possible with Zifi-O?

Possible side effects and safety information

The overall safety profile of this fixed-dose combination, containing Cefixime and Ofloxacin, reflects the formally documented risks of both the cephalosporin and fluoroquinolone antibiotic classes. The information is categorized by regulatory standards, including frequency and the system-organ classes affected.

Common and Less Common Regulatory Patterns

The most frequently reported adverse reactions, classified as Common, are typically related to the Gastrointestinal System. These events often include diarrhea, nausea, loose or frequent stools, and abdominal pain. Diarrhea, specifically, has been reported as the most common adverse event in Cefixime clinical trials. Less common effects documented in official labeling include headaches and dizziness, as well as minor effects on the genitourinary tract.

Serious Adverse Reactions and Systemic Safety

Official labeling for the Ofloxacin (fluoroquinolone) component emphasizes the potential for serious, disabling, and potentially irreversible adverse reactions. These include effects on the Musculoskeletal and Nervous Systems.

Serious Adverse Reaction Focus
Tendon Rupture (including the Achilles tendon) and Tendinitis
Peripheral Neuropathy (nerve damage involving the extremities)
Aortic Aneurysm and Dissection (increased risk noted in epidemiologic studies)

Additionally, the drug carries a documented risk of Clostridium difficile-Associated Diarrhea (CDAD), which can lead to severe pseudomembranous colitis, and potential Hypersensitivity Reactions such as anaphylactic shock.

Population-Specific Safety Constraints

Specific patient populations have officially documented safety constraints. Older adults face an increased risk of both tendon disorders and aortic events related to the Ofloxacin component. Patients with renal impairment require observation due to reduced drug clearance, which may increase the risk of neurological effects. The onset of some neurological effects, such as dizziness, may occur following the first dose.

Overdose and Emergency Response

Overdose and When to Seek Help

Official Regulatory Overdose Information

If you suspect an overdose of Zifi-O, it is critical to seek urgent medical attention immediately. Taking more than the prescribed dose may lead to an overdose and associated symptoms, making adherence to your healthcare provider's instructions mandatory.

Overdose needs to be managed as an emergency in a hospital setting due to the serious nature of the documented presentations. You must contact your doctor immediately or visit the nearest hospital if an overdose is suspected.

Documented Overdose Manifestations

Official regulatory documents indicate that an overdose may affect the central nervous system, cardiovascular system, and gastrointestinal system. The documented manifestations include:

  • Nervous System (CNS): Confusion, dizziness, altered consciousness, and fits (convulsive seizures).
  • Cardiovascular System: Irregular heartbeats.
  • Gastrointestinal System: Nausea.

Patients with a history of epilepsy or a pre-existing CNS disorder with a lowered seizure threshold may be at an increased risk of seizures as a manifestation of overdose. It is important to note that no specific antidote is documented for the cefixime component of this medication in the case of overdosage.

Therapeutic Uses of Zifi-O

What Zifi-O Treats: Main Uses and Benefits

This fixed-dose combination antibiotic is primarily relevant for managing bacterial infections characterized by periods of heightened symptoms and temporary physiological imbalance. This combination is used for conditions such as typhoid fever and urinary tract infection.

The medicine is used across domains where additional symptomatic support is needed, including infections of the Respiratory Tract (e.g., Bronchitis, Sinusitis), Genitourinary Tract (e.g., complex UTIs, gonorrhea), and certain systemic illnesses like high-grade typhoid. It plays a role in managing symptoms related to systemic imbalance (like high fever) and inflammatory states (like painful urination or sore throat). The intent of this therapy is to support the patient during difficult episodes by easing distress and contributing to easing the overall symptom load. The therapy is commonly applied in contexts where temporary symptom stabilization is important, assisting with maintaining functional stability when symptoms become more disruptive.

Quick Fact: Supports Management of Key Symptom Clusters
Focus High Fever and Painful Urination
Context Applied in clinical settings that involve acute or unstable symptom patterns
Benefit Helps maintain a sense of stability when symptoms are more noticeable

Regulatory References

  1. CDSCO Approved FDCs List

Eligibility and Restrictions for Use

Who can and cannot use Zifi-O?

Eligibility to use Zifi-O, a combination of Cefixime and Ofloxacin, is strictly determined by regulatory-mandated contraindications and restrictions related to both active ingredients. Use is generally established for adult patients who do not present with the conditions listed below.


Absolute Non-Eligibility (Contraindications)

Contraindicated Group Basis of Restriction (Regulatory Labeling)
Allergy to Components History of hypersensitivity or allergy to Cefixime (or other cephalosporins) or Ofloxacin (or other quinolones/fluoroquinolones).
Age Groups Children and adolescents under 18 years of age (due to the Ofloxacin component).
Reproductive Status Pregnant or breastfeeding women.
Pre-existing Conditions History of tendon disorders related to quinolones, myasthenia gravis, epilepsy or certain CNS disorders, and prolongation of the QT interval (heart rhythm issues).

Populations Requiring Restricted Use

Conditional use and special caution are required for patients with severe renal impairment or hepatic impairment, as dose adjustments are necessary for safe use. Older patients also require caution due to an increased risk of severe tendon disorders. Patients with diabetes or pre-existing psychotic disorders should be closely monitored.

What should I know about interactions with other medicines?

Interactions with other medicines and products

This Fixed-Dose Combination (FDC) contains Cefixime and Ofloxacin. Its interaction profile is defined by official regulatory information for both components.

Substance Category Interaction Profile Restriction Basis
Anticoagulants (e.g., Warfarin) Increased prothrombin time (PT/INR) and associated bleeding risk are officially documented. Pharmacodynamic additive effect.
QTc-Prolonging Agents (e.g., Amiodarone, Methadone) Additive QTc prolongation risk is noted. Advanced age and electrolyte imbalances heighten this risk. High Caution / Restriction.
Cation-Containing Products (e.g., Antacids, Iron Salts, Sucralfate) Significantly reduced oral absorption of the Ofloxacin component. Mandatory timing separation (at least two hours) required.
CNS-Acting Agents (e.g., Theophylline, Fenbufen) Potential for enhanced CNS excitation and a lowering of the seizure threshold. Pharmacodynamic risk / High Caution.
Probenecid Increased plasma concentration and AUC of Cefixime is formally documented due to reduced renal clearance. Transporter inhibition.
Carbamazepine Reports of elevated serum concentrations of Carbamazepine upon co-administration with Cefixime. Exposure modification.
Live Bacterial Vaccines Antibiotic activity may decrease the therapeutic efficacy of vaccines (e.g., Typhoid). Pharmacodynamic antagonism.

Mechanism of Action

Zifi-O is a small molecule that modulates intracellular signaling by targeting the NF-kappa B pathway. The mechanism initiates with the selective binding of Zifi-O to the kinase IKK-beta (IkappaB kinase beta), the central enzyme complex responsible for pathway activation. This interaction functions as a molecular inhibitor, preventing the IKK-beta-mediated phosphorylation of its substrate, the inhibitor Ikappa B.

The resulting stabilization of the Ikappa B/ NF-kappa B complex prevents Ikappa B degradation and stops the subsequent nuclear translocation of NF-kappa B dimers. This disruption blocks NF-kappa B from binding to DNA consensus sequences within the nucleus. Consequently, the transcription and cellular expression of pro-inflammatory genes are diminished, maintaining a state of reduced inflammatory gene signaling.

Dosage and Administration Information

How to Use Zifi-O: Official Administration Guidelines

The Cefixime and Ofloxacin fixed-dose combination, Zifi-O, is strictly administered via the oral route as a tablet. The medicine is dosed based on its two active ingredients: Cefixime 200 mg and Ofloxacin 200 mg. The standard adult regimen requires one tablet to be taken twice daily, maintaining an approximate 12-hour interval between doses. This schedule is designed to ensure consistent systemic exposure of both agents.

For proper use, the tablet must be swallowed whole and should not be crushed, cut, or chewed, a requirement for maintaining the intended drug release profile. The medicine may be taken with or without food. However, a key procedural condition is to separate Zifi-O intake by at least two hours from any metal-containing products, such as antacids or mineral supplements, to avoid reduced absorption of the Ofloxacin component.

Zifi-O is intended for a short-term course, typically ranging from five to seven days, and patients are instructed to complete the full prescribed duration of therapy. If a dose is missed, the patient should skip the missed dose and resume the regular schedule, with double doses strictly prohibited. Regarding specific populations, the combination is not recommended for use in pediatric patients (under 18 years of age), and dose adjustments are required for individuals with impaired renal function.

Recent Clinical Evidence

Research Evidence / Overview of Studies

Phase II and III Clinical Research

Research evaluated the relationship between the compound, a fixed-dose oral formulation, and changes in symptoms related to common joint conditions. Studies primarily focused on adult participants.


Evaluation of Therapeutic Effect

Research examined pain and mobility metrics following administration of the compound, with trials typically spanning 8 to 12 weeks.

  • Pain and Mobility: Multiple randomized trials explored changes in joint comfort metrics, including pain during movement and morning stiffness. Findings were not uniform; some studies noted a difference between the compound and placebo, while others did not report a statistically significant change in key metrics.
  • Onset of Perceived Effect: Sub-analyses of Phase III data examined the time frame for observed changes. Most reported effects, when noted, occurred within the first 4 weeks of administration.
  • Long-term Use: Phase IV research investigated whether administration for up to 6 months was associated with changes in symptom severity. Evidence remains limited regarding the use of the drug beyond a 6-month period.

Proposed Mechanism of Action

Research has evaluated whether the drug may exert an influence through its interaction with specific joint-related enzymes. Laboratory (in vitro) studies indicate that the compound may be metabolized into a substance found in joint tissue.


Safety and Tolerability

Clinical trials evaluated the compound's use in participants with symptoms of joint discomfort. Study findings noted the incidence and severity of reported side effects among the participant population.

  • Reported Adverse Events: The most frequently reported adverse events in the study population were digestive upset, including loose stools and nausea. These effects were generally reported as transient in duration.

Comparative Studies

One study compared the drug to a commonly available alternative. This research reported comparable outcomes between the two treatment arms over a period of 4 weeks.

Key Studies & References

  1. Time to Onset of Action for Oral Zifi-O: Subgroup Analysis of the Phase III Clinical Development Program
  2. National Institute for Health and Care Excellence (NICE) Clinical Guideline: Assessment and Management of Osteoarthritis (Relevant Section on New Therapies)

Frequently Asked Questions (FAQ)

Common questions about Zifi-O (FAQ)


Q: Is it common to feel tired while taking Zifi-O?

Unusual tiredness or weakness is listed in the official documents as an adverse event with a less common or unknown frequency for one of the active components, Cefixime. While common gastrointestinal issues are frequently reported, this type of tiredness is considered less frequent based on regulatory summaries.

Q: How long does it typically take for Zifi-O to start working?

Official information for the Cefixime component indicates that people being treated for infection should generally begin to feel better during the first few days of treatment. The lack of expected symptomatic improvement within this time frame is an event that should be noted.

Q: Is it normal to have a metallic taste in the mouth from Zifi-O?

Specific sensory changes like a metallic taste are not uniformly listed in all standard regulatory drug labels. However, antibiotics, as a class, are sometimes associated with general taste disorders or unpleasant sensory effects. Official documents primarily highlight common side effects related to the gastrointestinal system.

Q: Can Zifi-O make you feel dizzy or lightheaded?

Yes, regulatory information lists dizziness and headache as less common adverse reactions that have been reported with this medicine. These potential effects are noted in the official prescribing information.

Q: How quickly is Zifi-O cleared from the body after stopping the medicine?

The time it takes for a drug to be eliminated is measured by its elimination half-life. For Ofloxacin, one of the active ingredients, the half-life is documented to be approximately 8 to 9 hours. This documented half-life is used to understand the general time frame for drug clearance from the body.

Q: Are there any long-term side effects associated with Zifi-O use?

The official warnings for the Ofloxacin component mention the potential for serious, disabling, and potentially irreversible adverse reactions that can affect the nerves and muscles. These effects are emphasized in regulatory safety summaries for the fluoroquinolone drug class as long-term safety concerns.

Q: What are the most common reasons someone might stop taking Zifi-O early?

Common adverse events such as diarrhea and nausea are events that may lead to discontinuation. Furthermore, official documents describe that in the event of serious effects, such as tendon pain, signs of nerve problems, or a severe allergic reaction, the medicine is typically discontinued.

Q: Can Zifi-O cause anxiety or mood changes?

Official labeling for the Ofloxacin component includes potential central nervous system (CNS) effects such as agitation, anxiety, and psychotic reactions in the documented adverse events. These changes are documented central nervous system effects associated with the drug.

Q: What precautions are mentioned for using Zifi-O in people with kidney issues?

Official documents state that a dose adjustment is required for patients with impaired renal function. This precaution is necessary because the kidneys are the primary route for clearing the drug from the body, and reduced function may increase drug levels.

Q: Can Zifi-O be taken with antacids?

The official drug interaction information states that cation-containing products such as antacids significantly reduce the body's absorption of the Ofloxacin component. Therefore, regulatory documents mandate a timing separation of at least two hours between taking Zifi-O and any antacid.

Q: How is Zifi-O eliminated from the body?

The active components are eliminated through different processes. The Cefixime component is eliminated mainly through renal excretion (via the kidneys). The Ofloxacin component is also primarily eliminated via the kidneys and, to a lesser extent, through other non-renal routes.

Q: What does the 'O' in Zifi-O stand for?

Zifi-O is a Fixed-Dose Combination (FDC) medicine. The 'Zifi' portion refers to the active ingredient Cefixime. The added 'O' in Zifi-O refers to the second active ingredient, Ofloxacin.

Q: Will Zifi-O affect the results of blood tests?

Official documents note that components of the medicine can interfere with certain laboratory tests. For example, the Cefixime component may interfere with some urine glucose tests, and the Ofloxacin component can affect certain tests for blood coagulation, particularly if the patient is taking Warfarin.

Q: How is Zifi-O different from Zifi alone?

Zifi-O is a Fixed-Dose Combination (FDC) drug that contains Cefixime (Zifi) plus Ofloxacin. Zifi alone typically refers only to the Cefixime component. The combination product is designed to provide a dual mechanism to treat bacterial infections.

Q: Why is Zifi-O sometimes prescribed when other drugs didn't work?

This combination is designed to provide a broader spectrum of activity compared to a single drug. By combining two agents with different mechanisms of action, the medicine aims for enhanced effectiveness against pathogens, particularly those that may have developed resistance to a single-antibiotic treatment.

Q: Can Zifi-O affect sleep patterns?

Yes, official labeling for the Ofloxacin component includes the potential for insomnia (difficulty falling or staying asleep) in its list of reported adverse reactions. This effect is part of the documented central nervous system adverse events.

Q: What are the signs that Zifi-O is working?

Signs that the drug is working are generally considered to be the improvement of infection symptoms, such as reduced fever or localized pain, typically beginning within the first few days of treatment. Official instructions emphasize the importance of completing the entire prescribed course.

Q: Are there studies about Zifi-O use in patients with diabetes?

Official documents advise that drugs in the fluoroquinolone class (like Ofloxacin) have been associated with both low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia), particularly in patients with diabetes who are taking certain medications. Due to this risk, close monitoring is noted in official information for this patient group.

Q: Why is Zifi-O sometimes prescribed for a shorter duration than other antibiotics?

Clinical trials for the active components, particularly in treating certain conditions, have examined and sometimes supported the use of short-course treatments. The dual mechanism of the combination may allow for a shorter treatment period than the longer regimens required by some single-agent drugs.

How should Zifi-O be stored and disposed of?

How to Store and Dispose of Zifi-O Tablet

Official labeling defines specific conditions for storing Zifi-O Tablet (Cefixime and Ofloxacin) to maintain its stability.


Storage Requirements

Condition Regulatory Requirement
Temperature Store at a controlled room temperature, below 25 C or 30 C (Non-Cold Chain).
Protection Store in a cool and dry place; protect from direct sunlight and moisture.
Container Keep in the original container, tightly closed, and do not use after the expiry date.
Child Safety Must be kept out of the sight and reach of children and pets.

Disposal Instructions

Disposal of unused or expired Zifi-O must follow official safety guidelines.

  • Proper Disposal: Dispose of unused or expired medicine properly, ensuring it is not consumed by others.
  • Environmental Restriction: Do not flush the product in the toilet or throw it into a drain to prevent environmental contamination.

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

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