LORABID
Clinical safety rating: caution
Comprehensive clinical and safety monograph for LORABID (LORABID).
LORABID (loracarbef) is a beta-lactam antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), leading to cell lysis and death.
| Metabolism | Loracarbef is not metabolized; it is eliminated unchanged primarily by renal excretion via glomerular filtration and tubular secretion. |
| Excretion | Renal: 75-85% unchanged; biliary/fecal: 15-25% (partly as active metabolites) |
| Half-life | Terminal elimination half-life: 6-8 hours (prolonged to 12-15 hours in moderate renal impairment, CrCl 30-50 mL/min) |
| Protein binding | 75-80% bound to serum albumin |
| Volume of Distribution | 0.3-0.5 L/kg (high tissue penetration, including respiratory secretions, bile, and bone) |
| Bioavailability | Oral: 75-85% (fasting); IM: 90-100% |
| Onset of Action | Oral: 1-2 hours (peak serum concentrations); IM: 30-60 minutes; IV: immediate |
| Duration of Action | 12 hours (twice-daily dosing for susceptible infections; extended to 24 hours in severe renal impairment) |
Loracarbef 200-400 mg orally every 12 hours for 7-14 days.
| Dosage form | FOR SUSPENSION |
| Renal impairment | CrCl 30-49 mL/min: 200-400 mg every 24 hours; CrCl 10-29 mL/min: 200 mg every 24 hours; CrCl <10 mL/min: 200 mg every 48 hours. |
| Liver impairment | No dose adjustment required for hepatic impairment. Use caution in severe hepatic disease. |
| Pediatric use | Children ≥6 months: 15 mg/kg/day orally divided every 12 hours. Maximum 400 mg/day. |
| Geriatric use | Adjust dose based on renal function. Monitor for gastrointestinal effects. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for LORABID (LORABID).
| Breastfeeding | Excreted in breast milk in low concentrations; M/P ratio 0.2. Considered compatible with breastfeeding, but monitor infant for diarrhea, candidiasis, and allergic reactions. |
| Teratogenic Risk | No evidence of teratogenicity in animal studies; limited human data in first trimester. FDA Pregnancy Category B. Avoid in third trimester due to risk of kernicterus in neonates from bilirubin displacement. |
| Fetal Monitoring |
■ FDA Black Box Warning
No FDA black box warnings.
| Serious Effects |
["Hypersensitivity to loracarbef, other cephalosporins, or any component of the formulation.","Known hypersensitivity to penicillins (potential cross-sensitivity)."]
| Precautions | ["Hypersensitivity reactions, including anaphylaxis, have been reported.","Clostridium difficile-associated diarrhea (CDAD) may occur.","Renal impairment: dose adjustment required for creatinine clearance <50 mL/min.","Prolonged use may result in superinfection.","Caution in patients with history of gastrointestinal disease, particularly colitis."] |
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| No specific fetal monitoring required. Monitor maternal liver function and renal function during prolonged therapy. |
| Fertility Effects | No known adverse effects on fertility in animal or human studies. |