Cefixime Uses, Dosage, Side Effects & Precautions

Cefixime is the generic name of an oral antibiotic from the cephalosporin group. It is prescribed for selected bacterial infections and is a prescription medicine in India.

Many companies sell it under their own brand names, as tablets, dispersible tablets and dry syrup. The active ingredient is the same, but strength, form and price are not.

What Is Cefixime?

Cefixime is a cephalosporin antibiotic, and MedlinePlus[1] explains that it works by killing bacteria.

The WHO Model List[2] describes cefixime as a third generation cephalosporin. DailyMed[3] describes it as a semisynthetic cephalosporin antibacterial taken by mouth.

In India, cefixime is a Schedule H1 drug. A study in JAC Antimicrobial Resistance[4] names it among the Schedule H1 cephalosporins, which may be sold only on a registered medical practitioner’s prescription.

What Is the Cefixime Mechanism of Action?

Cefixime stops bacteria from building their cell walls. The DailyMed label states that, as with other cephalosporins, its bactericidal action results from inhibition of cell wall synthesis.

The cefixime mechanism of action is aimed at bacteria, and MedlinePlus states that the medicine will not work for colds, flu or other viral infections.

What Is Cefixime Used For?

Cefixime is used for certain bacterial infections. MedlinePlus lists bronchitis, gonorrhoea, and infections of the ears, throat, tonsils and urinary tract.

The DailyMed tablet label lists uncomplicated urinary tract infections, pharyngitis and tonsillitis, flare-ups of chronic bronchitis and uncomplicated gonorrhoea. It restricts use to infections proven or strongly suspected to be bacterial.

The WHO list names it as a second-choice treatment for gonococcal infection and for infectious gastroenteritis or colitis. These cefixime uses come from US and WHO sources. They answer what is cefixime used for in those settings, not the approved indications of any Indian product.

Is Cefixime for Throat Infection a First Choice?

No. The DailyMed label for cefixime oral suspension[5] notes that penicillin is the usual drug of choice for infections caused by Streptococcus pyogenes.

That label still lists pharyngitis and tonsillitis among its uses, from six months of age. The tablet label states that treatment of Streptococcus pyogenes infections should continue for at least 10 days. Whether cefixime for throat infection is appropriate is a decision for a doctor.

Popular Brands Containing Cefixime

Several cefixime brands are sold in India. The company names below are those shown on the Medkart listing for each pack.

Brand Name	Active Ingredient	Available Strengths / Forms*	Manufacturer / Company
Taxim-O	Cefixime	200 mg tablets, 400 mg tablets	Alkem Laboratories Limited
Cefix	Cefixime	100 mg tablets, 200 mg tablets	Cipla Pharmaceutical Company Limited
Zifi	Cefixime	200 mg tablets	FDC India Limited
Cadixim	Cefixime	200 mg tablets	Zydus Lifesciences Limited
Milixim	Cefixime	200 mg tablets	Glenmark Pharmaceuticals Limited
Omnicef O	Cefixime	200 mg tablets	Aristo Pharmaceuticals Private Limited
Mahacef	Cefixime	Dry syrup	Mankind Pharma Limited

Examples of listed strengths and forms, not a complete catalogue. Product ranges can change.

Which Strengths and Forms Are Available?

The WHO list gives tablets of 200 mg and 400 mg and an oral liquid at 100 mg per 5 ml. The DailyMed suspension label adds a liquid at 200 mg per 5 ml.

Medkart’s listings for cefixime 100 mg, cefixime 200 mg and cefixime 400 mg show tablets, dispersible tablets and dry syrup among the forms stocked.

A strength such as cefixime 200 mg describes the amount of active ingredient in that product. It is product information, not a dosing instruction.

How Is Cefixime Dosage Decided?

There is no single cefixime dosage that fits every prescription. The infection, age, weight, kidney function and the product all come into it.

The DailyMed tablet label gives 400 mg a day for adults, as one dose or as half a tablet every 12 hours. Children over 45 kg or older than 12 years receive the adult amount under that label.

For children aged six months and over, the suspension label gives 8 mg per kg per day. It says ear infections should be treated with the chewable tablets or suspension.

For uncomplicated gonorrhoea, the tablet label gives a single 400 mg dose. It calls for a dose adjustment when creatinine clearance falls below 60 ml per minute. A prescriber decides the amount and length of any course.

What Are the Common Cefixime Side Effects?

Stomach and bowel effects are the most common cefixime side effects. The DailyMed label reports diarrhoea in 16% of people in clinical trials, nausea in 7% and loose stools in 6%.

MedlinePlus also lists vomiting, gas and heartburn, and the label adds headaches, dizziness, skin rashes and hives among other reported reactions.

MedlinePlus lists serious symptoms that need prompt medical attention, including:

Watery or bloody stools
Rash or hives
Difficulty breathing
Swelling of the face, throat, tongue, lips or eyes
Fever or other signs of infection

The DailyMed label warns that serious allergic reactions, including shock and deaths, have been reported.

What Precautions and Interactions Need Checking?

Allergy, kidney disease and pregnancy are among the situations to raise before treatment starts.

Situation	What to do
Allergy to antibiotics	The DailyMed label states that cefixime must not be used by anyone with a known allergy to it or to other cephalosporins. MedlinePlus advises telling the doctor about any such allergy.
Kidney disease	MedlinePlus lists kidney disease among the conditions to raise with the doctor. The DailyMed label sets lower doses for reduced kidney function.
Bowel disease or colitis	MedlinePlus advises mentioning any stomach or intestinal disease, particularly colitis, before starting.
Liver disease	MedlinePlus lists liver disease among the conditions the doctor should know about.
Pregnancy	The DailyMed label states that published data have not shown a consistent link between cephalosporin use and major birth defects. MedlinePlus advises telling the doctor about a pregnancy.
Breastfeeding	The DailyMed label notes that cefixime is present in animal milk and that no human data are available.
Phenylketonuria	MedlinePlus says the chewable tablets contain aspartame, which forms phenylalanine.

Cefixime can interact with some medicines, and the DailyMed label warns that it may raise carbamazepine levels. It may also increase prothrombin time and bleeding risk with warfarin.

MedlinePlus states that it may make hormonal contraceptives less effective, and advises another form of birth control during treatment. Anyone on regular medicines should check with a pharmacist first.

Why Does Antibiotic Resistance Matter?

Cefixime belongs to a group the WHO flags for higher resistance potential, and the WHO list places it among the Watch group antibiotics.

The WHO’s 2019 AWaRe classification announcement[6] describes Watch antibiotics as having higher resistance potential. The group includes most of the highest priority critically important antimicrobials.

The DailyMed label warns that skipping doses or not finishing the course may raise the chance that bacteria become resistant.

The JAC Antimicrobial Resistance study states that Schedule H1 was largely intended to regulate newer antimicrobials such as third and fourth generation cephalosporins. It reports a sharp, sustained fall in their use after March 2014.

Generic Cefixime Vs Brand-Name Cefixime

Generic and branded cefixime contain the same active ingredient. The US FDA[7] states that a generic matches the brand-name medicine on active ingredient, strength, dosage form and route, and is bioequivalent to it.

That is the U.S. FDA standard, and an India-specific regulatory source is needed before making the same claim about an Indian product.

Products can still differ in manufacturer, inactive ingredients, appearance and price. The same active ingredient and strength alone do not prove that two products are interchangeable, so a doctor or pharmacist should confirm any switch.

Buy or Compare Cefixime Tablets on Medkart

Medkart lists cefixime tablets and dry syrup from several manufacturers, all marked as prescription items. The listings show these packs as in-store items, and the store locator shows Medkart pharmacies. Medkart highlights WHO-GMP certified medicines on its home page.

The medicines index lists what is available. The details a reader can compare on Medkart’s medicine comparison tool include:

Active ingredient
Strength
Dosage form
Manufacturer
Pack size
Current price

Any cefixime alternative suggested by the tool should be discussed with a doctor or pharmacist before a prescribed medicine is changed.

Key Takeaways

Cefixime is a third generation cephalosporin antibiotic that kills bacteria by blocking cell wall synthesis.
Cefixime uses include selected urinary, throat, ear and chest infections and gonorrhoea, but not viral illnesses.
For throat infection caused by Streptococcus pyogenes, the US label names penicillin as the usual drug of choice.
A strength such as cefixime 200 mg is product information, not an instruction about how much to take.
Cefixime dosage depends on the infection, age, weight and kidney function, and is set by a prescriber.
Diarrhoea is the most frequently reported of the cefixime side effects in US clinical trials.
Warfarin, carbamazepine and hormonal contraceptives are among the medicines to check with a pharmacist.
Cefixime is a WHO Watch group antibiotic and a Schedule H1 drug in India, so it needs a prescription.

FAQs: Common Questions About Cefixime

Q. Is cefixime a penicillin?

No. Cefixime belongs to the cephalosporin family, a different group of antibiotics. Even so, the DailyMed label warns that cross-sensitivity may occur in up to 10% of patients with a history of penicillin allergy. That history should be shared with the prescriber before a course begins.

Q. What happens if a dose of cefixime is missed?

It depends on how close the next dose is. MedlinePlus says a forgotten dose should be taken once remembered, unless the next one is almost due, when it is skipped. It advises against doubling up to make up for it.

Q. Can cefixime be taken with or without food?

Yes, either way. The DailyMed tablet label says the tablet may be given without regard to food. MedlinePlus adds that chewable tablets must be chewed completely, and that the liquid should be shaken well before each dose.

Q. Can diarrhoea start after a cefixime course has finished?

Yes. The DailyMed label explains that antibiotics alter the normal flora of the colon, which can allow C. difficile to overgrow. It warns that watery or bloody stools can appear two or more months after the last dose, and these should be reported to a doctor.

Q. Does cefixime affect urine tests?

Yes. The DailyMed label reports false-positive urine ketone results with nitroprusside tests, and false-positive urine glucose results with Clinitest, Benedict’s or Fehling’s solution. MedlinePlus advises people with diabetes to use Clinistix or TesTape for urine sugar checks during treatment.

Q. Is there a cefixime alternative if one brand is unavailable?

Yes, often, because Medkart lists many brands made with the same active ingredient and strength. The choice of substitute still belongs to a doctor or pharmacist, who can check form and suitability. Only the prescriber can judge whether a different antibiotic suits the infection.

References

Medical disclaimer: This article provides general information and does not replace advice from a doctor or pharmacist. Cefixime is a prescription antibiotic listed in Schedule H1 in India. Brands with the same composition should only be substituted under the guidance of a healthcare professional or pharmacist because product details and approved indications can differ.

Cefixime: Uses, Dosage, Side Effects & Precautions