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Pharmacological action: Cefixime, like other Cephalosporins has a bactericidal action resulting from the inhibition of cell wall synthesis. Cefixime is highly stable in the presence of beta-lactamase enzymes. Cefixime binds with high affinity to penicillin – binding proteins in the bacterial cell wall, thus interfering with peptidoglycan synthesis. Peptidoglycan is a heteropolymeric structure that provides the cell wall with mechanical stability. The final stage in the synethesis of peptidoglycan involves the completion of the cross-linking. The terminal glycine residue of  the petaglycine bridge is linked to the forth residue of the pentapeptide, the transpeptidase enzyme that performs this step in inhibited by cephalosporins and penicillins. As a result the bacterial cell wall is weakened, and the cell swells and then ruptures. Cefixime is bactericidal against a broad spectrum of bacteria at easily achievable plasma concentrations. Pharmacokinetics: Only 40 to 50% of an oral dose of cefixime is absorbed from the gastrointestinal tract, whether taken before or after meals, although the rate of absorption may be decreased in the presence of food. Absorption is fairly slow; peak plasma concentrations of 2 to 3 micrograms/mL and 3.7 to 4.6 micrograms/mL have been reported between 2 and 6 hours after single doses of 200 and 400 mg, respectively. The plasma half-life is usually about 3 to 4 hours and may be prolonged when there is renal impairment. About 65% of cefixime is bound to plasma proteins. Information on the distribution of cefixime in body tissues and fluids is limited. It crosses the placenta. Relatively high concentrations may be achieved in bile and urine. About 20% of an oral dose (or 50% of an absorbed dose) is excreted unchanged in the urine within 24 hours. Up to 60% may be eliminated by nonrenal mechanisms; there is no evidence of metabolism but some is probably excreted into the faeces from bile. It is not substantially removed by dialysis.

Each chewable tablet contains: Cefixime USP as trihydrate eq. to Anhydrous Cefixime - 400 mg

Cefixime is used for the treatment of acute otitis media, pharyngitis and tonsillitis, respiratory tract infections (acute bronchitis, acute exacerbations of chronic bronchitis), or urinary tract infections

Cefixime is contraindicated in individuals who are hypersensitive to the drug or other cephalosporins and should be used with caution in individuals who are hypersensitive to penicillins

Изменения данных лабораторных исследований: лейкоцитоз, базофилия, анемия, лейкопения, нейтропения, лимфопения, тромбоцитопения/тромбоцитоз, гранулоцитопения, повышение активности печеночных трансаминаз и ЩФ, уменьшение/увеличение протромбинового времени, гиперкреатининемия, глюкозурия, гипербилирубинемия, повышение содержания мочевины. Пищеварительные расстройства: спазмы в желудке, диарея, боль в животе, диспепсия, стоматит, тошнота, метеоризм, рвота, дисбактериоз, кандидоз рта, глоссит, желтуха, холестаз, гепатит, псевдомембранозный колит. Метаболические расстройства: анорексия. Неврологические расстройства: гиперактивность, головная боль, дисфория, головокружение. Отоларингологические расстройства: потеря слуха. Дыхательные расстройства: диспноэ. Мочеполовые расстройства: ОПН, тубулоинтерстициальный нефрит, гематурия, генитальный зуд, монилиаз, вагинит. Иммунные расстройства: проявления аллергии (зуд, эритема, крапивница, сыпь, ангионевротический отек, бронхоспазм, анафилактический шок), реакции, подобные сывороточной болезни, медикаментозная сыпь, DRESS, лихорадка, медикаментозная лихорадка, артралгия, синдром Стивенса — Джонсона, синдром Лайелла. Общие: слабость, повышение потоотделения, утомляемость, воспаление слизистых оболочек.

Precautions for Aspartame: Aspartame must be avoided by people with the genetic condition phenylketonuri (PKU) as Aspartame cleaves into Phenylalanine. Adverse reactions : Most of the adverse reactions observed in clinical trials were of a mild and transient nature. The most commonly seen reactions were: skin rash, fever, urticaria, pruritis, erythema multiforme, Steven-Johnson syndrome, eosinophilia, leucopenia, genital pruritis, vaginitis, candidiasis, anaphylaxis, superinfection, haemolytic anaemia, diarrhoea, dyspepsia, flatulence, abdominal pain, pseudomembranous colitis, and transient elevation of SGOT, SGPT, alkaline phosphatase, BUN and creatinine.  Interactions : Antacids : Administration of an antacid containing aluminum hydroxide and magnesium hydroxide either simultaneously with or 2 hours before or after a single 400-mg oral dose of cefixime has no clinically important effects on the pharmacokinetics of the anti-infective agent. Anticoagulants : Increased prothrombin time (with or without bleeding) may occur following concomitant use of cefixime with an anticoagulant (e.g., warfarin). Carbamazepine : Concomitant administration of cefixime and carbamazepine may result in increased plasma carbamazepine concentrations. Carbamazepine concentrations should be monitored if the drug is used concomitantly with cefixime. Nifedipine : Concomitant administration of cefixime and nifedipine increases oral bioavailability of cefixime as a result of higher peak plasma concentrations and area under the plasma concentration-time curve (AUC). Probenecid : Although specific information is unavailable, concomitant administration of probenecid reportedly increases peak serum concentrations and the AUC of cefixime and decreases renal clearance and volume of distribution of the drug.

If acute overdosage of cefixime occurs, the stomach should be emptied by gastric lavage. Cefixime is not removed in clinically important quantities by hemodialysis or peritoneal dialysis.

Cefixime chewable tablets should be chewed before swallowing. The prescribed dose may be administered without regard to meals.  Adult Dosage : The recommended adult dosage is 200mg-400mg daily accordance to the severity of infection given either as a single dose or in two divided doses. Pediatric Dosage : Children older than 12 years of age or those weighing more than 50 kg may receive the usual adult dosage of cefixime.

Store at temperature 15- 30°C. Store in a dry place, Protect from light.