Cefonicid Sodium

(BANM, USAN, rINNM)
Synonyms: Cefonicid sódico; Cefonicide sodique; Céfonicide Sodique; Cefonicidum natricum; Natrii Cefonicidum; SKF-D-75073-Z 2 ; SKF-D75073-Z (cefonicid monosodium). 7-[(R)-Mandelamido]-3-(1sulphomethyl-1H-tetrazol-5-ylthiomethyl)-3-cephem-4-carboxylic acid, disodium salt.
Cyrillic synonym: Натрий Цефоницид.

💊 Chemical information

Chemical formula: C18H16N6Na2O8S3 = 586.5.
CAS — 61270-58-4 (cefonicid); 61270-78-8 (cefonicid disodium); 71420-79-6 (cefonicid monosodium).
ATC — J01DC06.
ATC Vet — QJ01DC06.

Pharmacopoeias.

In US.

USP 31

(Cefonicid Sodium). A white to off-white solid. Freely soluble in water, in sodium chloride 0.9%, and in glucose 5%; very slightly soluble in dehydrated alcohol; soluble in methyl alcohol. pH of a 5% solution in water is between 3.5 and 6.5. Store in airtight containers.

💊 Adverse Effects and Precautions

As for Cefalotin Sodium. Cefonicid contains a substituted N-methylthiotetrazole sidechain, a structure associated with hypoprothrombinaemia.

Effects on the blood.

References.
1. Riancho JA, et al. Life-threatening bleeding in a patient treated with cefonicid. Ann Intern Med 1995; 123: 472–3.

Effects on the liver.

References.
1. Famularo G, et al. Eosinophilic hepatitis associated with cefonicid therapy. Ann Pharmacother 2001; 35: 1669–71.

Sodium content.

Each g of cefonicid sodium contains about 3.4 mmol of sodium.

💊 Interactions

As for Cefamandole.

💊 Antimicrobial Action

Cefonicid sodium has an antimicrobial action and pattern of resistance similar to those of cefamandole, although it is generally less active against Gram-positive cocci.

💊 Pharmacokinetics

Cefonicid is given parenterally as the sodium salt. Peak plasma concentrations ranging from 67 to 126 micrograms/mL have been achieved 1 to 2 hours after a 1-g intramuscular dose. Cefonicid is more than 90% bound to plasma proteins. It has a plasma half-life of about 4.5 hours, which is prolonged in patients with renal impairment. Therapeutic concentrations of cefonicid have been reported in a wide range of body tissues and fluids. Up to 99% of a dose of cefonicid is excreted unchanged in the urine within 24 hours. Probenecid reduces excretion of cefonicid.

💊 Uses and Administration

Cefonicid is a second-generation cephalosporin antibacterial used similarly to cefamandole in the treatment of susceptible infections and for surgical infection prophylaxis. It is given as the sodium salt by deep intramuscular injection, or intravenously by slow injection over 3 to 5 minutes or by infusion. Doses are expressed in terms of the equivalent amount of cefonicid; 1.08 g of cefonicid sodium is equivalent to about 1 g of cefonicid. The usual dose is cefonicid 1 g once daily. For uncomplicated urinary-tract infections, a dose of 500 mg once daily is recommended; up to 2 g once daily has been given in severe infections. More than 1 g should not be injected intramuscularly into a single site. For surgical infection prophylaxis, a single dose of 1 g given 1 hour before surgical incision is usually sufficient, but may be given daily for a further 2 days in prosthetic arthroplasty or openheart surgery.
1. Saltiel E, Brogden RN. Cefonicid: a review of its antibacterial activity, pharmacological properties and therapeutic use. Drugs 1986; 32: 222–59.

Administration in renal impairment.

For patients with renal impairment a loading dose equivalent to cefonicid 7.5 mg/kg is recommended, followed by reduced maintenance doses according to the creatinine clearance and the severity of the infection. A dose supplement is not required after dialysis.

💊 Preparations

USP 31: Cefonicid for Injection.

Proprietary Preparations

Belg.: Monocid†; Israel: Monocef; Ital.: Abiocef†; Auricid†; Bacid†; Biocil; Bioticic; Cefobacter; Cefodie; Cefoger†; Cefok; Cefoplus; Cefosporin†; Chefir; Clastidin†; Daycef; Delsacid†; Diespor; Emidoxin; Epicef†; Fonexel†; Fonicef†; Fonicid; Fonisal†; Framecef; Ipacid†; Krucef; Lampocef†; Lisa; Maxid; Microcid†; Modicef; Modiem; Monobios; Monobiotic; Monocid†; Necid; Nokid; Pantacid†; Parecid; Praticef; Raikocef; Renbiocid†; Rocid†; Silvercef†; Sintocef; Sofarcid; Unicid†; Valecid; Port.: Monocid; Spain: Monocid; Unidie; USA: Monocid†.
Published January 04, 2019.