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). |
| 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 | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for DURICEF (DURICEF).
| Breastfeeding | Excreted into breast milk in low concentrations. M/P ratio approximately 0.1. Considered compatible with breastfeeding; monitor infant for diarrhea, rash, or thrush. |
| 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 |
■ FDA Black Box Warning
None.
| Serious Effects |
["Known hypersensitivity to cephalosporins or any component of the formulation","Serious immediate-type hypersensitivity reaction to penicillins (e.g., anaphylaxis) due to cross-sensitivity risk"]
| 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"] |
Loading safety data…
| 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. |