DURICEF
Clinical safety rating: caution
Comprehensive clinical and safety monograph for DURICEF (DURICEF).
Cephalosporin antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), disrupting peptidoglycan cross-linking.
| Metabolism | Cefadroxil is primarily excreted unchanged by the kidneys via glomerular filtration and tubular secretion; minimal hepatic metabolism. |
| Excretion | Primarily renal (80-90% unchanged via glomerular filtration and tubular secretion); <10% biliary/fecal. |
| Half-life | 1.5-2 hours (prolonged to 20-30 hours in severe renal impairment; dosing adjustment required for CrCl <50 mL/min). |
| Protein binding | 10-20% (primarily albumin). |
| Volume of Distribution | 0.2-0.4 L/kg (indicates distribution primarily into extracellular fluid; low tissue penetration). |
| Bioavailability | Oral: ~95% (cefadroxil is well absorbed; food delays but does not reduce absorption). |
| Onset of Action | Oral: within 30-60 minutes (time to peak serum concentration 1-2 hours). |
| Duration of Action | 6-12 hours (bactericidal activity persists above MIC; dosing every 12 hours in normal renal function). |
| Molecular Weight | 363.39 |
| Action Class | Cephalosporins: 1st generation |
| Brand Substitutes | Duroxyl 250mg Tablet, Troydrox 250mg Tablet, Codroxil 250mg Tablet, Brotzu 250mg Tablet, Drocef Kid 250mg Tablet |
500 mg to 1 g orally once or twice daily.
| Dosage form | CAPSULE |
| Renal impairment | CrCl 30-50 mL/min: 500 mg every 12 hours; CrCl 10-29 mL/min: 500 mg every 24 hours; CrCl <10 mL/min: 500 mg every 36 hours. |
| Liver impairment | No dosage adjustment required for hepatic impairment. |
| Pediatric use | 30 mg/kg/day orally in divided doses every 12 hours; maximum 1 g/day. |
| Geriatric use | Dose should be adjusted based on renal function; consider reduced initial dose and monitor renal status. |
| 1st trimester | Limited human data; animal studies show no evidence of harm. Generally considered safe if clearly needed. |
| 2nd trimester | No known teratogenic risk; use if clinically indicated. |
| 3rd trimester | No known risks, but use near delivery may affect neonatal gut flora; theoretical risk of kernicterus in premature infants. |
Clinical note
Comprehensive clinical and safety monograph for DURICEF (DURICEF).
| Placental transfer | Cefadroxil crosses the placenta with fetal serum levels approximately 10-20% of maternal levels. |
| Breastfeeding | Cefadroxil is excreted into breast milk in small amounts. It is generally considered compatible with breastfeeding, but monitor for possible diarrhea or allergic reaction in the infant. |
| Lactation Rating |
■ FDA Black Box Warning
None.
| Serious Effects |
Hypersensitivity to cefadroxil or other cephalosporinsPrevious immediate-type hypersensitivity reaction to penicillins or other beta-lactams (cross-reactivity)
| Precautions | Hypersensitivity reactions (including anaphylaxis) in patients with penicillin allergy, Clostridium difficile-associated diarrhea (CDAD), Prolonged use may result in superinfection with non-susceptible organisms, Dosage adjustment required in renal impairment, Seizures may occur with high doses or renal failure |
| Food/Dietary | DURICEF absorption is not significantly affected by food, but administration with food may help reduce gastrointestinal disturbances. No specific dietary restrictions required. |
Loading safety data…
| L2 (Probably Compatible) |
| Teratogenic Risk | FDA Pregnancy Category B. No evidence of teratogenicity in animal studies. Inadequate human data in first trimester; cephalosporins are generally considered low risk. Crosses placenta with detectable fetal concentrations. No documented teratogenic effects from inadvertent exposure. |
| Fetal Monitoring | Monitor maternal renal function and signs of hypersensitivity. Periodic CBCs in prolonged therapy. Fetal growth and well-being per routine prenatal care; no additional specialized monitoring required. |
| Fertility Effects | No known adverse effects on human fertility or reproductive performance based on animal studies and limited human data. |
| Clinical Pearls | DURICEF (cefadroxil) is a first-generation cephalosporin with a longer half-life (1.5-2 hours) compared to cephalexin, allowing once- or twice-daily dosing. It is effective against streptococci, staphylococci (including penicillinase-producing strains, but not MRSA), and some gram-negative bacilli (E. coli, P. mirabilis, Klebsiella). Dose adjustment required for CrCl <50 mL/min. Contraindicated in immediate hypersensitivity to cephalosporins and serious penicillin allergy. May cause false-positive urine glucose tests with copper-reducing methods (Clinitest) but not with glucose oxidase methods (Clinistix). Avoid concurrent use with warfarin due to increased INR. |
| Patient Advice | Take exactly as prescribed; complete the full course even if symptoms improve. · This medication may be taken with or without food; take with food if stomach upset occurs. · Do not take if you have ever had a severe allergic reaction to penicillin or cephalosporins. · Report signs of allergic reaction: rash, hives, difficulty breathing, swelling of face or throat. · May cause diarrhea; if severe or bloody, contact your doctor before taking any anti-diarrheal. · If you have kidney problems, your dose may need adjustment; inform your doctor of all medical conditions. · Avoid concurrent use with warfarin (blood thinner) without close monitoring. |