Cefpodoxime
VANTIN
What it isPBP-inhibiting third-generation oral cephalosporin prodrug; respiratory, skin, and urinary infections.
Why this oneBroader Gram-negative cover than the earlier oral cephalosporins with twice-daily dosing.
What limits itIt needs food and gastric acid for absorption, so PPIs and antacids reduce it. No pseudomonal or MRSA cover.
FDA-approved for
- respiratory, skin and urinary bacterial infections
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Pharyngitis/tonsillitis | Adults/adolescents ≥12 y | 100 mg q12h ×5–10 days | 100 mg q12h | |
| Acute community-acquired pneumonia | Adults/adolescents ≥12 y | 200 mg q12h ×14 days | 200 mg q12h | |
| Acute exacerbation of chronic bronchitis | Adults/adolescents ≥12 y | 200 mg q12h ×10 days | 200 mg q12h | |
| Uncomplicated gonorrhea; rectal gonococcal (women) | Adults/adolescents ≥12 y | 200 mg single dose | 200 mg single dose | |
| Skin/skin-structure infection | Adults/adolescents ≥12 y | 400 mg q12h ×7–14 days | 400 mg q12h | |
| Acute maxillary sinusitis | Adults/adolescents ≥12 y | 200 mg q12h ×10 days | 200 mg q12h | |
| Uncomplicated UTI | Adults/adolescents ≥12 y | 100 mg q12h ×7 days | 100 mg q12h |
Renal Severe impairment (CrCl <30 mL/min): extend dosing interval to q24h. Hemodialysis: 3 times/week after dialysis
Hepatic No adjustment needed
Instructions
- Administer tablets orally with food to enhance absorption
Cautions
- Hypersensitivity/anaphylaxis; cross-reactivity in penicillin-allergic patients
- Pseudomembranous colitis/CDAD
- Seizures reported with cephalosporins in renal impairment
Adverse reactions
- Diarrhea (7%, dose-related), nausea, abdominal pain, headache
- Vaginal/vulvovaginal fungal infections
- Rare: Stevens-Johnson syndrome, toxic epidermal necrolysis, anaphylactic shock, acute liver injury
Pregnancy Not teratogenic/embryocidal in animals; no adequate human studies — use only if clearly needed
Lactation Undefined
NO BOXED WARNINGS
Principal riskHypersensitivity; needs food and acid for absorption
Cost, est. cash$5–$150/month
Generic entry2002
Classes and tags
Clinical profile
Legacy pregnancy categoryB
Defining liabilityAllergy, gastrointestinal effects and agent-specific renal, hepatic, hematologic or interaction risks.
Mechanism of action: Cefpodoxime ballicule
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Memory aids: mascots and interaction avatars
beta lactam ring