Ancef

Name: Ancef

Side Effects of Ancef

Serious side effects have been reported with Ancef. See the “Drug Precautions” section.

Common side effects of Ancef include nausea, vomiting, diarrhea, and stomach cramps.

This is not a complete list of Ancef side effects. Ask your doctor or pharmacist for more information.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Ancef Food Interactions

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Ancef, there are no specific foods that you must exclude from your diet when receiving this medication.

Ancef Dosage

Take Ancef exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The Ancef dose your doctor recommends will be based on:

  • the condition being treated
  • other medical conditions you have
  • other medications you are taking
  • how you respond to this medication
  • your kidney function
  • your weight
  • your age

The recommended dosing range for Ancef (cefazolin) in adults is 250 mg to 1500 grams given every 2 to 4 hours. The dose may be decreased if you have a decrease in kidney function.

The recommended dosing range for Ancef (cefazolin) in children is 25 mg/kg/day to 100 mg/kg/day divided into 3 or 4 equal doses. The dose may be decreased if you have a decrease in kidney function.

Ancef Overdose

Ancef is usually administered by a healthcare provider in a medical setting making it unlikely for an overdose to occur. However, if overdose is suspected, seek emergency medical attention.

Interactions for Ancef

Specific Drugs and Laboratory Tests

Drug

Interaction

Comments

Nephrotoxic Drugs

Potential for increased risk of nephrotoxicitya

Avoid concomitant use of nephrotoxic agents (e.g., aminoglycosides, colistin, polymyxin B, vancomycin) if possiblea

Probenecid

Decreased renal clearance and increased concentrations of cefazolin100

Tests for glucose

Possible false-positive reactions in urine glucose tests using Clinitest, Benedict’s solution, or Fehling’s solution100

Use glucose tests based on enzymatic glucose oxidase reactions (e.g., Clinistix)100

Advice to Patients

  • Advise patients that antibacterials (including cefazolin) should only be used to treat bacterial infections; they do not treat viral infections (e.g., the common cold).100 115 116 117 119

  • Importance of completing full course of therapy, even if feeling better after a few days.100 115 116 117 119

  • Advise patients that skipping doses or not completing the full course of therapy may decrease effectiveness and increase the likelihood that bacteria will develop resistance and will not be treatable with cefazolin or other antibacterials in the future.100 115 116 117 119

  • Advise patients that diarrhea is a common problem caused by anti-infectives and usually ends when the drug is discontinued.115 116 117 119 Importance of contacting a clinician if watery and bloody stools (with or without stomach cramps and fever) occur during or as late as 2 months or longer after the last dose.115 116 117 119

  • Importance of discontinuing cefazolin and informing clinician if an allergic reaction occurs.100 115 116 117 119

  • Importance of informing clinicians of existing or contemplated therapy, including prescription and OTC drugs.100 115 116 117 119

  • Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.100 115 116 117 119

  • Importance of informing patients of other important precautionary information. (See Cautions.)

Ancef Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Rare
  • Bluish color
  • changes in skin color
  • pain
  • swelling of the foot or leg
  • tenderness
Incidence not known
  • Abdominal or stomach cramps or tenderness
  • back, leg, or stomach pains
  • black, tarry stools
  • bleeding gums
  • blistering, peeling, or loosening of the skin
  • bloating
  • blood in the urine or stools
  • bloody or cloudy urine
  • chest pain
  • chills
  • clay-colored stools
  • cloudy urine
  • cough
  • coughing up blood
  • dark urine
  • decrease in urine output or decrease in urine-concentrating ability
  • decreased frequency or amount of urine
  • diarrhea
  • diarrhea, watery and severe, which may also be bloody
  • difficult or painful urination
  • difficulty with breathing or swallowing
  • dizziness
  • excessive muscle tone
  • fast heartbeat
  • feeling of discomfort
  • fever
  • general body swelling
  • general tiredness and weakness
  • headache
  • hives
  • increased blood pressure
  • increased menstrual flow or vaginal bleeding
  • increased thirst
  • inflammation of the joints
  • itching
  • itching of the vagina or genital area
  • joint or muscle pain
  • light-colored stools
  • loss of appetite
  • lower back or side pain
  • muscle aches or stiffness
  • muscle tension or tightness
  • nausea or vomiting
  • nosebleeds
  • pain during sexual intercourse
  • pain, warmth, or burning in the fingers, toes, and legs
  • pale skin
  • paralysis
  • pinpoint red spots on the skin
  • problems with vision or hearing
  • prolonged bleeding from cuts
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • rash
  • red irritated eyes
  • red or black, tarry stools
  • red or dark brown urine
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • restlessness
  • seizures
  • skin rash
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • stomach cramps
  • sudden decrease in the amount of urine
  • swelling of the face, fingers, or lower legs
  • swollen lymph glands
  • swollen or painful glands
  • thick, white vaginal discharge with no odor or with a mild odor
  • tightness in the chest
  • trouble sitting still
  • troubled breathing
  • unpleasant breath odor
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • unusual weight loss
  • upper right abdominal pain
  • vomiting
  • vomiting of blood
  • weight gain
  • wheezing
  • yellowing of the eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known
  • Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
  • hives or welts
  • redness of the skin
  • sore mouth or tongue
  • weight loss
  • white patches in the mouth, tongue, or throat

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Warnings

BEFORE THERAPY WITH Ancef IS INSTITUTED, CAREFUL INQUIRY SHOULD BE MADE TO DETERMINE WHETHER THE PATIENT HAS HAD PREVIOUS HYPERSENSITIVITY REACTIONS TO CEFAZOLIN, CEPHALOSPORINS, PENICILLINS, OR OTHER DRUGS. IF THIS PRODUCT IS GIVEN TO PENICILLIN-SENSITIVE PATIENTS, CAUTION SHOULD BE EXERCISED BECAUSE CROSS-HYPERSENSITIVITY AMONG BETA-LACTAM ANTIBIOTICS HAS BEEN CLEARLY DOCUMENTED AND MAY OCCUR IN UP TO 10% OF PATIENTS WITH A HISTORY OF PENICILLIN ALLERGY. IF AN ALLERGIC REACTION TO Ancef OCCURS, DISCONTINUE TREATMENT WITH THE DRUG. SERIOUS ACUTE HYPERSENSITIVITY REACTIONS MAY REQUIRE TREATMENT WITH EPINEPHRINE AND OTHER EMERGENCY MEASURES, INCLUDING OXYGEN, IV FLUIDS, IV ANTIHISTAMINES, CORTICOSTEROIDS, PRESSOR AMINES, AND AIRWAY MANAGEMENT, AS CLINICALLY INDICATED.

Pseudomembranous colitis has been reported with nearly all antibacterial agents, including cefazolin, and may range in severity from mild to life-threatening. Therefore, it is important to consider this diagnosis in patients who present with diarrhea subsequent to the administration of antibacterial agents.

Treatment with antibacterial agents alters the normal flora of the colon and may permit overgrowth of clostridia. Studies indicate that a toxin produced by Clostridium difficile is a primary cause of “antibiotic-associated colitis”.

After the diagnosis of pseudomembranous colitis has been established, therapeutic measures should be initiated. Mild cases of pseudomembranous colitis usually respond to drug discontinuation alone. In moderate to severe cases, consideration should be given to management with fluids and electrolytes, protein supplementation, and treatment with an oral antibacterial drug clinically effective against C. difficile colitis.

Dosing & Uses

Dosage Forms & Strengths

powder for injection

  • 500mg
  • 1g
  • 2g
  • 10g
  • 20g
  • 100g
  • 300g

Moderate-to-Severe Infections

0.5-1 g IV q6-8hr

Mild Infections With Gram-Positive Cocci

250-500 mg IV q8hr

Mild-to-Moderate Cholecystitis

1-2 g IV q8hr for 4-7 days

Uncomplicated Urinary Tract Infection

1 g IV q12hr

Preparation for Surgery

Prophylaxis against infection

Preoperatively: 1-2 g IV/IM ≤60 minutes before procedure (may be repeated in 2-5 hours intraoperatively)

Postoperatively: 0.5-1 g IV q6-8hr for 24 hours

Surgical infection

  • Cardiac procedures, hysterectomy, oral or pharyngeal procedures, craniotomy, joint replacement, thoracic procedures, arterial procedures, amputation, traumatic wounds; high-risk esophageal, gastroduodenal, or biliary tract procedures: 1-2 g IV
  • Colorectal procedures: 1-2 g IV plus metronidazole 0.5 g IV
  • High-risk cesarean section, 2nd trimester abortion: 1 g IV
  • Ophthalmic procedures: 100 mg subconjunctivally

Endocarditis

  • 1 g IV/IM 30-60 minutes before procedure
  • American Heart Association (AHA) guidelines: Endocarditis prophylaxis recommended only for high-risk patients

Bacterial Keratitis (Off-label)

1 drop instilled into affected eye(s) q1-2hr; typically alternated every other hour with antibiotic providing gram-negative coverage (eg, tobramycin)

Extemporaneous compounded fortified cefazolin 50 mg/mL

  • Dilute 500 mg parenteral cefazolin powder in sterile water to form 10 mL solution
  • Store refrigerated; preparation expires in 7 days

Dosing Modifications

Renal impairment

  • CrCl 35-54 mL/min: Give full dose at intervals >8hr
  • CrCl 10-35 mL/min: Give therapeutic dose q12hr
  • CrCl ≤10 mL/min: Give therapeutic dose q24hr

Hepatic impairment

  • Not studied

Dosing Considerations

Susceptible organisms

  • Streptococcus pneumoniae, Klebsiella, Haemophilus influenzae, Staphylococcus aureus, group A beta-hemolytic streptococcus, Escherichia coli, Proteus mirabilis, Enterobacter (some strains)

Dosage Forms & Strengths

powder for injection

  • 500mg
  • 1g
  • 2g
  • 10g
  • 20g
  • 100g
  • 300g

Infections With Gram-Positive Cocci

Neonates (7 days,
  • >7 days, >2 kg: 60 mg/kg/day IV/IM divided q8hr
  • Infants & children

    • 25-100 mg/kg/day IV/IM divided q6-8hr; not to exceed 6 g/day

    Endocarditis

    Prophylaxis

    50 mg/kg IV/IM ≤30-60 minutes before procedure; not to exceed 1 g  

    AHA guidelines: Endocarditis prophylaxis recommended only for high-risk patients

    Community-Acquired Pneumonia

    >3 months and children: 150 mg/kg/day IV/IM divided q8hr (moderate to severe infections, methicillin susceptible S.Aureus preferred

    Dosing Considerations

    Cefazolin 2 g for Injection USP and Dextrose Injection USP is not recommended for use in pediatric patients; to avoid unintentional overdose, 1 g cefazolin for Injection USP and dextrose Injection USP should only be used in pediatric patients who require entire contents of 1 g dose and not any fraction of it

    There are no dosing recommendations for pediatric patients for perioperative prophylaxis or for pediatric patients with renal impairment

    Adverse Effects

    Frequency Not Defined

    Anorexia

    Diarrhea

    Eosinophilia

    Fever

    Increased transaminases

    Leukopenia

    Nausea and vomiting

    Neutropenia

    Oral candidiasis

    Pain at injection site

    Phlebitis

    Pseudomembranous colitis

    Seizure

    Stevens-Johnson syndrome

    Thrombocytopenia

    Thrombocytosis

    Transient elevation of hepatic enzymes

    Vaginitis

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