AHFS Class:

8:12.06.16 Fourth Generation Cephalosporins

Generic Name

• Cefepime Hydrochloride-Enmetazobactam (CAS Registry Number: 123171-59-5)
• Cefepime Hydrochloride-Enmetazobactam (CAS Registry Number: 1001404-83-6)

The fixed combination of cefepime hydrochloride-enmetazobactam is available as a powder in preservative-free single-dose vials containing 2.5 g (the equivalent of 2 g of cefepime plus enmetazobactam 0.5 g).³⁹⁹³ Each vial also contains L-arginine 1.414 g.³⁹⁹³

Reconstitute each 2.5-g vial with 10 mL of sodium chloride 0.9%, dextrose 5%, or dextrose 2.5% in sodium chloride 0.45% withdrawn from a 250-mL infusion bag to yield a 0.2-g/mL concentrated solution (cefepime 0.16 g/mL plus enmetazobactam 0.04 g/mL) in a final volume of approximately 13 mL.³⁹⁹³ Mix gently to dissolve.³⁹⁹³ The reconstituted solution is a concentrate; the appropriate dose should be immediately diluted in the same 250-mL infusion bag from which the diluent was removed.³⁹⁹³ Both reconstitution and dilution should be made with the same type of infusion solution.³⁹⁹³

The manufacturer's instructions for preparing various doses of cefepime hydrochloride-enmetazobactam from the reconstituted concentrate are as follows:³⁹⁹³

For a 2.5-g dose (cefepime 2 g plus enmetazobactam 0.5 g), withdraw the entire contents of 1 vial (i.e., approximately 13 mL).

For a 1.25-g dose (cefepime 1 g plus enmetazobactam 0.25 g), withdraw 6.5 mL.

For a 0.625-g dose (cefepime 0.5 g plus enmetazobactam 0.125 m), withdraw 3.3 mL.

All doses should be added to the 250-mL infusion bag from which the solution used for reconstitution was withdrawn.

Equivalency

In cefepime hydrochloride-enmetazobactam, cefepime hydrochloride 2.3 g is equivalent to 2 g of cefepime.³⁹⁹³

Trade Name(s)

Exblifep

Cefepime hydrochloride-enmetazobactam is administered by intravenous infusion, generally over 2 hours.³⁹⁹³ An infusion time of 4 hours may be recommended in some patients depending on renal function.³⁹⁹³

Intact vials should be stored at 2 to 8°C in the carton to protect from light; temperature excursions from 15 to 25°C permitted.³⁹⁹³

Cefepime hydrochloride-enmetazobactam is a white to off-white powder that forms a clear to yellowish solution upon reconstitution and dilution.³⁹⁹³

Diluted solutions may be stored at 2 to 8°C for up to 4 hours.³⁹⁹³ Administration of the diluted solution must be completed within 6 hours of dilution.³⁹⁹³

Solution Compatibility

For a list of references cited in the text of this monograph, search the monograph titled References.

ASHP^® Injectable Drug Information^TM. Selected Revisions March 31, 2024. © Copyright, 2025. American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.