Zolibac Injection
Cefazolin
1gm
Square Pharmaceuticals PLC.
| Pack size | 1's Pack |
|---|---|
| Dispensing mode | |
| Source | |
| Agent | |
| Retail Price | 200.00 AED |
Available as:
Indications
Zolibac Injection is used for:
Infections With Gram-Positive Cocci, Mild-to-Moderate Cholecystitis, Uncomplicated Urinary Tract Infection, Prophylaxis against surgical infection, Endocarditis, Community-Acquired Pneumonia
Adult Dose
Parenteral
Susceptible infections
Adult:
Mild: 0.25-0.5 g 8 hourly.
Moderate to severe: 0.5-1 g 6-8 hourly.
Severe, life-threatening: 1-1.5 g 6 hourly. Max: 12 g daily.
All doses to be given by deep IM inj, slow IV inj over 3-5 min, or intermittent or continuous IV infusion.
Mild Infections With Gram-Positive Cocci
250-500 mg IV q8hr
Mild-to-Moderate Cholecystitis
1-2 g IV q8hr for 4-7 days
Uncomplicated Urinary Tract Infection
1 g IV q12hr
Preparation for Surgery
Prophylaxis against infection
Preoperatively: 1-2 g IV/IM ?60 minutes before procedure (may be repeated in 2-5 hours intraoperatively)
Postoperatively: 0.5-1 g IV q6-8hr for 24 hours
Surgical infection
Cardiac procedures, hysterectomy, oral or pharyngeal procedures, craniotomy, joint replacement, thoracic procedures, arterial procedures, amputation, traumatic wounds; high-risk esophageal, gastroduodenal, or biliary tract procedures: 1-2 g IV
Colorectal procedures: 1-2 g IV plus metronidazole 0.5 g IV
High-risk cesarean section, 2nd trimester abortion: 1 g IV
Ophthalmic procedures: 100 mg subconjunctivally
Endocarditis
1 g IV/IM 30-60 minutes before procedure
American Heart Association (AHA) guidelines: Endocarditis prophylaxis recommended only for high-risk patients
Child Dose
Parenteral
Susceptible infections
Child: >1 yr 25-50 mg/kg daily in 3 or 4 divided doses to be given by deep IM inj, slow IV inj over 3-5 min, or intermittent or continuous IV infusion.
Max: 100 mg/kg daily in divided doses for severe infections.
Infections With Gram-Positive Cocci
Neonates (<28 days)
<7 days: 40 mg/kg/day IV/IM divided q12hr
>7 days, <2 kg: 40 mg/kg/day IV/IM divided q12hr
>7 days, >2 kg: 60 mg/kg/day IV/IM divided q8hr
Infants & children
25-100 mg/kg/day IV/IM divided q6-8hr; not to exceed 6 g/day
Endocarditis
Prophylaxis
50 mg/kg IV/IM ?30-60 minutes before procedure; not to exceed 1 g
AHA guidelines: Endocarditis prophylaxis recommended only for high-risk patients
Community-Acquired Pneumonia
>3 months and children: 150 mg/kg/day IV/IM divided q8hr (moderate to severe infections, methicillin susceptible S.Aureus preferred
Renal Dose
Renal impairment:
CrCl (ml/min) Dosage Recommendation
<10 Half the usual dose 18-24 hrly.
11-34 Half the usual dose 12 hrly.
35-54 Usual dose at intervals of at least 8 hr.
Administration
IV Preparation
Reconstitute 500 mg or 1 g with 2 mL or 2.5 mL SWI, respectively, to provide solutions containing approximately 225 or 330 mg/mL
IV push: Further dilute in approximately 5 mL of SWI or according to manufacturer's directions
Infusion: Dilute reconstituted 500 mg or 1 g solution in 50-100 mL NS or D5W
IM Preparation
Reconstitute 500 mg or 1 g with 2 mL or 2.5 mL SWI, respectively, to provide solutions containing approximately 225 or 330 mg/mL
IV Administration
IV push
Administer directly into vein, and infuse over 3-5 minutes or slowly into tubing of compatible IV infusion solution
IM Administration
Inject deep into large muscle mass
Contra Indications
Hypersensitivity to cephalosporins.
Precautions
Hypersensitivity Reactions: Cross-hypersensitivity may occur in up to 10% of patients with a history of penicillin allergy. If an allergic reaction occurs, discontinue the drug.
Clostridioides difficile-associated diarrhea (CDAD): May range from mild diarrhea to fatal colitis. Evaluate if diarrhea occurs.
Prothrombin Activity: May be associated with a fall in prothrombin activity. Prothrombin time should be monitored in patients at risk and exogenous vitamin K was administered as indicated
Pregnancy-Lactation
Pregnancy
Available data from published prospective cohort studies, case series and case reports over several decades with cephalosporin use, including cefazolin, in pregnant women have not established a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes; drug crosses the placenta
Animal data
Animal reproduction studies with rats, mice and rabbits administered cefazolin during organogenesis at doses 1 to 3 times maximum recommended human dose (MRHD) did not demonstrate adverse developmental outcomes; in rats subcutaneously administered cefazolin prior to delivery and throughout lactation, there were no adverse effects on offspring at a dose approximately 2 times the MRHD
Lactation
Data from published literature report that cefazolin is present in human milk, but not expected to accumulate in a breastfed infant; there are no data on effects of drug on breastfed child or on milk production
Developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed child from drug or from the mother’s underlying condition
Interactions
May enhance the anticoagulant effect of vit K antagonists (e.g. warfarin).
May diminish the therapeutic effect of Na picosulfate, BCG and typhoid vaccine.
May decrease the protein binding of fosphenytoin and phenytoin.
Probenecid may decrease renal tubular secretion of cefazolin, resulting in increased and prolonged blood levels.
May increase the nephrotoxic effects of aminoglycosides.
Contraindicated (0)
Serious (12)
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Adverse Effects
Side effects of Cefazolin :
Frequency Not Defined
Anorexia
Diarrhea
Eosinophilia
Fever
Increased transaminases
Leukopenia
Nausea and vomiting
Neutropenia
Oral candidiasis
Pain at injection site
Phlebitis
Pseudomembranous colitis
Seizure
Stevens-Johnson syndrome
Thrombocytopenia
Thrombocytosis
Transient elevation of hepatic enzymes
Vaginitis
Potentially Fatal: Anaphylaxis, pseudomembranous colitis.
Mechanism of Action
Cefazolin binds to 1 or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.
Note
Zolibac 1gm Injection manufactured by Square Pharmaceuticals PLC.. Its generic name is Cefazolin. Zolibac is availble in Bangladesh.
Farmaco BD drug index information on Zolibac Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.