2. DOSAGE AND ADMINISTRATION • Adults: 400 mg daily ( 2.1 ) • Children: 8 mg/kg/day ( 2.2 ) 2.1 Adults The recommended dose of cefixime is 400 mg daily. This may be given as a 400 mg tablet or capsule daily or the 400 mg tablet may be split and given as one half tablet every 12 hours. For the treatment of uncomplicated cervical/urethral gonococcal infections, a single oral dose 400 mg is recommended. The capsule and tablet may be administered without regard to food. In the treatment of infections due to Streptococcus pyogenes , a therapeutic dosage of cefixime should be administered for at least 10 days. 2.2 Pediatric Patients (6 months or older) The recommended dose is 8 mg/kg/day of the suspension. This may be administered as a single daily dose or may be given in two divided doses, as 4 mg/kg every 12 hours. Note: A suggested dose has been determined for each pediatric weight range. Refer to Table 1. Ensure all orders that specify a dose in milliliters include a concentration, because Cefixime for oral suspension is available in two different concentrations (100 mg/5 mL, 200 mg/5 mL). Table 1. Suggested doses for pediatric patients PEDIATRIC DOSAGE CHART Doses are suggested for each weight range and rounded for ease of administration Cefixime for Oral Suspension Cefixime Chewable Tablet 100 mg/ 5mL 200 mg/ 5mL Patient Weight (kg) Dose/Day (mg) Dose/Day (mL) Dose/Day (mL) Dose 5 to 7.5* 50 2.5 -- -- 7.6 to 10* 80 4 2 -- 10.1 to 12.5 100 5 2.5 1 tablet of 100 mg 12.6 to 20.5 150 7.5 4 1 tablet of 150 mg 20.6 to 28 200 10 5 1 tablet of 200 mg 28.1 to 33 250 12.5 6 1 tablet of 100 mg and 1 tablet of 150 mg 33.1 to 40 300 15 7.5 2 tablets of 150 mg 40.1 to 45 350 17.5 9 1 tablet of 150 mg and 1 tablet of 200 mg 45.1 or greater 400 20 10 2 tablets of 200 mg *The preferred concentrations of oral suspension to use are 100 mg/5 mL or 200 mg/5 mL for pediatric patients in these weight ranges. Children weighing more than 45 kg or older than 12 years should be treated with the recommended adult dose. Cefixime Chewable Tablets must be chewed or crushed before swallowing. Otitis media should be treated with the chewable tablets or suspension. Clinical trials of otitis media were conducted with the chewable tablets or suspension, and the chewable tablets or suspension results in higher peak blood levels than the tablet when administered at the same dose. Therefore, the tablet or capsule should not be substituted for the chewable tablets or suspension in the treatment of otitis media. [ See CLINICAL PHARMACOLOGY ( 12.3 )]. In the treatment of infections due to Streptococcus pyogenes , a therapeutic dosage of cefixime should be administered for at least 10 days. 2.3 Renal Impairment Cefixime for oral suspension may be administered in the presence of impaired renal function. Normal dose and schedule may be employed in patients with creatinine clearances of 60 mL/min or greater. Refer to Table 2 for dose adjustments for adults with renal impairment. Neither hemodialysis nor peritoneal dialysis removes significant amounts of drug from the body. Table 2: Doses for Adults with Renal Impairment Renal Dysfunction Cefixime for Oral Suspension Tablet Chewable Tablet Creatinine Clearance (mL/min) 100 mg/ 5mL 200 mg/ 5mL 400 mg 200 mg Dose/Day (mL) Dose/Day (mL) Dose/Day Dose/Day 60 or greater Normal Dose Normal Dose Normal Dose Normal Dose 21 to 59* OR renal hemodialysis 13 6.5 Not Appropriate Not Appropriate 20 or less OR continous peritoneal dialysis 8.6 4.4 0.5 tablet 1 tablet * The preferred concentration of oral suspension to use is 200 mg/5 mL for patients with this renal dysfunction 2.4 Reconstitution Directions for Oral Suspension Strength Bottle Size Reconstitution Directions 100 mg/5 mL and 200 mg/5 mL 100 mL To reconstitute, suspend with 68 mL water. Method: Tap the bottle several times to loosen powder contents prior to reconstitution. Add approximately half the total amount of water for reconstitution and shake well. Add the remainder of water and shake well. 100 mg/5 mL and 200 mg/5 mL 75 mL To reconstitute, suspend with 51 mL water. Method: Tap the bottle several times to loosen powder contents prior to reconstitution. Add approximately half the total amount of water for reconstitution and shake well. Add the remainder of water and shake well. 100 mg/5 mL and 200 mg/5 mL 50 mL To reconstitute, suspend with 34 mL water. Method: Tap the bottle several times to loosen powder contents prior to reconstitution. Add approximately half the total amount of water for reconstitution and shake well. Add the remainder of water and shake well. After reconstitution, the suspension may be kept for 14 days either at room temperature, or under refrigeration, without significant loss of potency. Keep tightly closed. Shake well before using. Discard unused portion after 14 days.