Maxipime (cefepime HCl)

Cefepime is commercially available as cefepime hydrochloride, which is monohydrated; dosage is expressed in terms of cefepime, calculated on the anhydrous basis.

In patients with renal impairment (i.e., creatinine clearance of 60 mL/minute or less), doses and/or frequency of administration of cefepime should be modified in response to the degree of renal impairment, severity of the infection, and susceptibility of the causative organism.

The manufacturers recommend that adults with creatinine clearance of 60 mL/minute or less (not receiving hemodialysis) receive the same initial dose of cefepime recommended for patients with normal renal function followed by a maintenance dosage of cefepime based on the patient's measured or estimated creatinine clearance. (See Table 1 and Table 2.)

Table 1. Maintenance Dosage for Treatment of Infections in Adults with Renal Impairment

Creatinine Initial dose: 500 Initial dose: 1 g Initial dose: 2 g Clearance mg (mL/minute) 30-60 500 mg every 24 h 1 g every 24 h 2 g every 24 h 11-29 500 mg every 24 h 500 mg every 24 h 1 g every 24 h <11 250 mg every 24 h 250 mg every 24 h 500 mg every 24 h

Table 2. Maintenance Dosage for Empiric Therapy in Febrile Neutropenic Adults with Renal Impairment

Creatinine Clearance (mL/minute) Initial Dose: 2 g 30-60 2 g every 12 h 11-29 2 g every 24 h <11 1 g every 24 h

The manufacturers recommend that adults undergoing hemodialysis receive an initial 1-g dose of cefepime on day 1, then 500 mg once daily thereafter for the treatment of infections or 1 g once daily for empiric therapy of presumed bacterial infections in febrile neutropenic patients. The manufacturers also recommend that the daily dose be given at the same time of day whenever possible; on hemodialysis days, the dose should be given after the procedure.

Adults undergoing continuous ambulatory peritoneal dialysis (CAPD) should receive the usual cefepime dose every 48 hours.

Data regarding use of cefepime in pediatric patients with impaired renal function are not available. Because the pharmacokinetics of cefepime are similar in pediatric and adult patients, the manufacturers recommend that dosage modifications proportional to those recommended for adults be used in pediatric patients with impaired renal function.

Since pharmacokinetics of cefepime appear not to be altered in patients with hepatic impairment, the manufacturers state that dosage adjustments are not necessary in such patients.

No dosing information is available for this tab.

No dosing information is available for this tab.

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There is no enhanced messaging for this drug.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

There is no enhanced messaging for this drug.

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

There are no moderate contraindications for this drug.

There is no enhanced messaging for this drug.

There are no severe adverse reactions for this drug.

There are no less severe adverse reactions for this drug.

No enhanced messaging available.

No enhanced messaging available.

Reproduction studies in rats, rabbits, or mice using cefepime dosages approximately 1.6 times or 0.3 times, or equal to the recommended maximum human dosage (calculated on a mg/m2 basis), respectively, have not revealed evidence of teratogenicity or embryotoxicity. There are no adequate and controlled studies using cefepime in pregnant women or during labor and delivery, and the drug should be used during pregnancy only when clearly needed.

Cefepime is distributed into milk in low concentrations following parenteral administration, and the drug should be used with caution in nursing women.

No enhanced messaging available.