CEFUROXIME REIG JOFRE 250 mg POWDER AND SOLVENT FOR INJECTABLE SOLUTION

2. What you need to know before you use Cefuroxima Reig Jofre

Do not use Cefuroxima:

• or to any of the other ingredients of this medicine (listed in section 6).
• if you have ever had a severe allergic reaction (hypersensitivity) to any other type of beta-lactam antibiotic (penicillins, monobactams, and carbapenems).
• if you have ever developed a severe skin rash or peeling of the skin, blisters, and/or mouth ulcers after treatment with cefuroxima or any other cephalosporin antibiotic.

Consult your doctor beforestarting treatment with cefuroxima; if you think this may affect you, you should not be given Cefuroxima Reig Jofre.

Warnings and precautions

You should be aware of certain symptoms such as allergic reactions and gastrointestinal disorders, such as diarrhea, while receiving cefuroxima. This will reduce the risk of possible complications. See ("Symptoms to which you should pay attention") in section 4. If you have had an allergic reaction to other antibiotics, such as penicillin, you may also be allergic to Cefuroxima.

Severe skin reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms (DRESS), have been reported with cefuroxima treatment. Seek medical attention immediately if you notice any of the symptoms related to these severe skin reactions described in section 4.

If you need a blood or urine test

Cefuroxima may affect the results of sugar tests in urine and blood tests (Coombs test). If you are having tests:

Tell the person taking the samplethat you are taking cefuroxima.

Using Cefuroxima Reig Jofre with other medicines

Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines.

Some medicines may affect how cefuroxima works, or make it more likely that you will have side effects. These include:

• aminoglycoside antibiotics,
• "water pills" (diuretics), such as furosemide,
• probenecid,
• oral anticoagulants.

Consult your doctorif you think this may affect you. You may need additional checks to monitor kidney function while taking cefuroxima.

Contraceptive pill

Cefuroxima may reduce the effectiveness of the contraceptive pill. If you are taking the contraceptive pill while being treated with cefuroxima, you should also use barrier contraceptive methods(such as condoms). Ask your doctor for advice.

Pregnancy, breastfeeding, and fertility

Tell your doctor before being treated with cefuroxima:

• if you are pregnant, think you may be pregnant, or plan to become pregnant,
• if you are breastfeeding.

Your doctor will weigh the benefits of being treated with cefuroxima against the risks to your child.

Driving and using machines

Do not drive or use machinery if you do not feel well.

Cefuroxima Reig Jofre contains sodium:

A 250 mg vial of cefuroxima Reig Jofre contains 14 mg (0.59 mmol) of sodium, so it is considered "essentially sodium-free".

Two 250 mg vials of Cefuroxima Reig Jofre contain 28 mg (1.12 mmol) of sodium, which should be taken into account in patients on low-sodium diets.

3. How to use Cefuroxima Reig Jofre

Cefuroxima is usually administered by a doctor or nurse. It can be administered by injection directly into a vein or into a muscle.

The usual dose

Your doctor will decide what dose of cefuroxima is right for you, based on: the severity and type of infection, if you are being treated with other antibiotics, your weight and age, and how well your kidneys are working.

Newborns (0-3 weeks)

For every kilogram of the newborn's weight, they will be given 30 to 100 mg of cefuroxima per day, divided into two or three doses.

Infants (over 3 weeks) and children

For every kilogram of the infant's or child's weight, they will be given 30 to 100 mg of cefuroxima per day, divided into three or four doses.

Adults and adolescents

750 mg to 1,500 mg of cefuroxima per day, divided into two, three, or four doses. The maximum dose is 6 g per day.

Patients with kidney problems

If you have a kidney problem, your doctor may change your dose. Consult your doctorif you are affected by this problem.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Symptoms to which you should pay attention

A small number of people who received cefuroxima had a severe allergic reaction or a potentially serious skin reaction. The symptoms of these reactions include:

• severe allergic reaction. The signs include skin rash with itching, swelling, sometimes of the face or mouth, causing difficulty breathing,
• skin rash, which can cause blistering, looking like small targets(dark spot in the center surrounded by a lighter area, with a dark ring around the edge),
• widespread skin rashwith blistering and peeling of the skin. (These can be symptoms of Stevens-Johnson syndromeor toxic epidermal necrolysis),
• fungal infectionsin rare cases, medicines like cefuroxima can cause an overgrowth of fungi (Candida) in the body, which can lead to fungal infections (such as thrush). This side effect is more likely to occur if you have been treated with cefuroxima for a long time.
• generalized rash, high body temperature, and swollen lymph nodes (DRESS or drug hypersensitivity syndrome).
• chest pain in the context of allergic reactions, which can be a symptom of allergy-induced heart attack (Kounis syndrome).

Contact a doctor or nurse immediately if you experience any of these symptoms.

Common side effects

May affect up to 1 in 10 people:

• pain at the injection site, swelling, and redness along the vein.

Contact your doctorif you suffer from any of these symptoms.

Common side effects that may appear in blood tests:

• increase in some substances (enzymes) produced by the liver,
• changes in white blood cell count (neutropeniaor eosinophilia),
• low levels of red blood cells (anemia).

Uncommon side effects

May affect up to 1 in 100 people:

• skin rash, itching, hives (urticaria),
• diarrhea, nausea, stomach pain.

Contact your doctorif you suffer from any of these symptoms.

Uncommon side effects that may appear in blood tests:

• low levels of white blood cells (leukopenia),
• increase in bilirubin (a substance produced by the liver),
• positive Coombs test.

Other side effects

Other side effects have occurred in a very small number of people, but their exact frequency is unknown:

• fungal infections,
• high temperature (fever),
• allergic reactions,
• inflammation of the colon (large intestine), causing diarrhea, usually with blood and mucus,
• stomach pain,
• inflammation in the kidneys and blood vessels,
• rapid destruction of red blood cells (hemolytic anemia),
• skin rash, which can cause blistering, looking like small targets (dark spot in the center surrounded by a lighter area, with a dark ring around the edge) erythema multiforme.

Contact your doctorif you suffer from any of these symptoms.

Side effects that may appear in blood tests:

• decrease in the number of platelets in the blood (cells that help the blood to clot – thrombocytopenia),
• increase in blood urea nitrogen and serum creatinine levels.

Reporting of side effects

If you experience any side effects, talk to your doctor, pharmacist, or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly through the Spanish Medicines and Healthcare Products Agency's website: https://www.notificaRAM.es. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storage of Cefuroxima Reig Jofre

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the carton after EXP.

The expiry date refers to the last day of the month shown.

Store below 30°C.

Store the vial in the outer packaging to protect it from light.

For the storage conditions of the reconstituted powder, see "INFORMATION FOR HEALTHCARE PROFESSIONALS" at the end of the leaflet.

Medicines should not be disposed of via wastewater or household waste. Return any unused medicine to a pharmacy for proper disposal. If you are unsure, ask your pharmacist how to dispose of medicines no longer required. This will help protect the environment.

6. Contents of the pack and other information

Composition of Cefuroxima Reig Jofre:

The active substance is cefuroxime sodium.

Each 250 mg vial contains Reig Jofre 267.37 mg of cefuroxime sodium, equivalent to 250 mg of cefuroxime.

The solvent ampoule contains water for injections.

Appearance of Cefuroxima Reig Jofre and contents of the pack

Cefuroxime sodium is a white or pale yellow powder.

It is presented in 10 ml type II glass vials, closed with a gray bromobutyl rubber stopper and sealed with a "flip-off" cap.

Ampoule of type I glass containing 2 ml of water for injection.

Pack of 1 vial and 1 solvent ampoule.

Marketing authorization holder and manufacturer

Marketing authorization holder

Laboratorio Reig Jofré, S.A.

Gran Capitán 10, 08970 Sant Joan Despí

Barcelona (Spain)

Manufacturer

Laboratorio Reig Jofré, S.A.

Jarama 111, Polígono Industrial, Toledo

45007 Toledo

Date of last revision of this leaflet:May 2023

Detailed and up-to-date information on this medicine is available on the website of the Spanish Agency for Medicines and Healthcare Products (AEMPS) http://www.aemps.gob.es/

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INFORMATION FOR HEALTHCARE PROFESSIONALS

Instructions for reconstitution

For single use only. Discard unused solution.

Intramuscular use

Add 1 ml of water for injections to cefuroxime 250 mg powder for solution for injection (see Table "Volumes of addition and concentrations of the solution, which may be useful when fractionated doses are required").

Gently shake to obtain an opaque suspension.

Intravenous use

Dissolve in water for injections using at least 2 ml for cefuroxime 250 mg. Gently shake to obtain a clear solution.

Table Volumes of addition and concentrations of the solution, which may be useful when fractionated doses are required

** The resulting volume of the cefuroxime solution in the reconstitution medium is increased by the displacement factor of the drug resulting in the listed concentrations in mg/ml.

Compatibility

Cefuroxime sodium is compatible with aqueous solutions containing up to 1% lidocaine hydrochloride.

The stability of cefuroxime sodium in sodium chloride 0.9% solution for injection and in glucose 5% solution for injection is not affected by the presence of sodium hydrocortisone phosphate.

Storage of cefuroxime injectable:

Store below 30°C.

Store the vial in the outer packaging to protect it from light.

Reconstituted solution: From a microbiological point of view, the product should be used immediately after reconstitution. If not used immediately, the in-use storage times and conditions are the responsibility of the user and normally should not exceed 8 hours at 25°C and 24 hours in the refrigerator (between 2°C and 8°C), unless the reconstitution has been carried out in controlled and validated conditions.

Incompatibilities

Solutions containing cefuroxime should not be mixed with or added to solutions containing other products that are not those mentioned above (see "Compatibility").

Cefuroxime powder for solution for injection should not be mixed in the same syringe with aminoglycoside antibiotics.

The pH of sodium bicarbonate injection at 2.74% p/v significantly affects the color of the solutions, and therefore, this solution is not recommended for the dilution of cefuroxime powder for solution for injection.