Cefuroxime sodium is available in vials containing 750 mg and 1.5 g of cefuroxime as the sodium salt.3567
For intravenous administration, the 750-mg and 1.5-g vials should be reconstituted with 8.3 and 16 mL, respectively, of sterile water for injection to yield a solution with an approximate cefuroxime concentration of 90 mg/mL.3567
For intramuscular administration, the 750-mg vial only should be reconstituted with 3 mL of sterile water for injection to yield a suspension with an approximate cefuroxime concentration of 225 mg/mL.3567 The suspension should be dispersed with shaking before the dose is withdrawn.3567
pH
The pH of freshly reconstituted solutions ranges from 6 to 8.5.3567
Osmolality
The osmolality of cefuroxime sodium (Glaxo) diluted to a cefuroxime concentration of 30 mg/mL in dextrose 5% was determined to be 315 mOsm/kg and in sodium chloride 0.9% was determined to be 314 mOsm/kg. At a cefuroxime concentration of 50 mg/mL, the osmolality was determined to be 329 mOsm/kg in dextrose 5% and 335 mOsm/kg in sodium chloride 0.9%.1375
The following maximum cefuroxime concentrations were recommended to achieve osmolalities suitable for peripheral infusion in fluid-restricted patients:1180
| Diluent | Maximum Concentration (mg/mL) | Osmolality (mOsm/kg) |
|---|---|---|
| Dextrose 5% | 76 | 568 |
| Sodium chloride 0.9% | 68 | 541 |
| Sterile water for injection | 137 | 489 |
Sodium Content
Cefuroxime sodium (Teligent) vials contain approximately 2.4 mEq (54.2 mg) of sodium per gram of cefuroxime.3567
Trade Name(s)
Kefurox, Zinacef
Cefuroxime sodium is administered by deep intramuscular injection, by direct intravenous injection over 3 to 5 minutes directly into the vein or into the tubing of a running infusion solution, by intermittent intravenous infusion, or by continuous intravenous infusion.3567 The manufacturer recommends temporarily discontinuing any other solutions infusing at the same site when administering the drug by Y-site infusion.3567
Intact vials of cefuroxime sodium should be stored at 15 to 30°C and protected from light.3567 The drug is present as a white to off-white powder.3567 Solutions may range in color from light yellow to amber, depending on the concentration and diluent used.3567 Cefuroxime sodium powder and solutions and suspensions prepared from cefuroxime sodium tend to darken, depending on storage conditions, without affecting their potency.3567
The reconstituted suspension for intramuscular injection and solution for intravenous administration prepared as directed are stable for 24 hours at room temperature and 48 hours refrigerated at 5°C.3567
pH Effects
The pH of maximum stability is in the range of 4.5 to 7.3.712
Freezing Solutions
Solutions of cefuroxime prepared as directed by reconstituting 750-mg or 1.5-g vials and immediately adding the reconstituted solution to 50 or 100 mL of sodium chloride 0.9% or dextrose 5% in a compatible container are stable for 6 months at -20°C.3567 The manufacturer states that frozen solutions should be thawed at room temperature; the use of water baths or microwaves for force thawing is not recommended.3567 Following thawing at room temperature, the solutions are stable for 24 hours at room temperature or 7 days under refrigeration.3567 Thawed solutions should not be refrozen.3567
Minibags of cefuroxime sodium in dextrose 5% or sodium chloride 0.9% were frozen at -20°C for up to 35 days and subsequently thawed at room temperature and in a microwave oven with care taken that the thawed solution temperature never exceeded 25°C. No significant differences in cefuroxime concentrations occurred between the thawing methods.1192
Cefuroxime sodium (Glaxo) diluted to cefuroxime concentrations of 30 and 60 mg/mL in sterile water for injection in polyvinyl chloride (PVC) portable infusion pump reservoirs (Pharmacia Deltec) and glass vials exhibited a 4% loss after 30 days at -20°C. Subsequent storage for 4 days at 3°C resulted in about a 10% loss in the PVC bags and a 4% loss in the glass vials.1581
Cefuroxime sodium diluted to a cefuroxime concentration of 15 mg/mL (i.e., 1.5 g/100 mL) in dextrose 5% in polyolefin bags was reported to be physically and chemically stable for 98 days stored at -20°C. Less than 10% drug loss occurred upon microwave thawing and subsequent refrigerated storage for 18 to 21 days.2592
Cefuroxime sodium (Panpharma) diluted to a cefuroxime concentration of 10 mg/mL in sodium chloride 0.9% and stored in polypropylene syringes (Becton Dickinson) protected from light at -20°C was stable for 365 days.3271
Cefuroxime sodium (Pfizer) prepared at a cefuroxime concentration of 1.5 g in 11 mL in sterile water for injection in syringes (Becton Dickinson) was stored frozen at -22 to -18°C for 60 days in the dark followed by thawing at room temperature (20 to 24°C) and additional storage at room temperature for 24 hours with approximately 10 hours exposure to light.3895; 3896 3.4% loss of drug was noted in samples assayed immediately after thawing and 7.4% loss in samples that were stored for an additional 24 hours at room temperature.3895
Syringes
Cefuroxime sodium (Panpharma) diluted to a cefuroxime concentration of 10 mg/mL in sodium chloride 0.9% and stored in polypropylene syringes (Becton Dickinson) protected from light at 5°C and 25°C with 60% relatively humidity was stable for 21 days and 9 hours, respectively.3271
Cefuroxime sodium (GlaxoSmithKline) diluted to a cefuroxime concentration of 90 mg/mL in sodium chloride 0.9% was stored as 50 mL in 50-mL polypropylene syringes.3566 Syringes stored at 2 to 8°C protected from light demonstrated less than 4% loss in theoretical concentration in 14 days with no significant change in physical appearance.3566 Syringes stored at 20 to 25°C both protected from and exposed to light demonstrated less than 10% loss in 2 days; syringes stored without light protection underwent a more intense yellowing in color than did those protected from light.3566 Syringes stored at 38 to 42°C protected from light exhibited losses of more than 40% of theoretical concentration after as little as 1 day.3566 pH of the solutions was not measured.3566
Ambulatory Pumps
Cefuroxime sodium (Glaxo) diluted to cefuroxime concentrations of 22.5 and 45 mg/mL in sterile water for injection in PVC portable infusion pump reservoirs (Pharmacia Deltec) exhibited a 4 to 6% loss in 8 hours and an 11 to 12% loss in 16 hours at 30°C. No loss occurred in 7 days at 3°C.1581
Central Venous Catheter
Cefuroxime sodium (Glaxo Wellcome) diluted to a cefuroxime concentration of 10 mg/mL in dextrose 5% was found to be compatible with the ARROWg+ard Blue Plus (Arrow International) chlorhexidine-bearing triple-lumen central catheter. Essentially complete delivery of the drug was found with little or no drug loss occurring. Furthermore, chlorhexidine delivered from the catheter remained at trace amounts with no substantial increase due to the delivery of the drug through the catheter.2335
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