Effect of food on absorption of cefpodoxime proxetil oral suspension in adults

Abstract

The effect of a high-fat meal on absorption of a 200-mg dose of cefpodoxime proxetil oral suspension was evaluated in 20 healthy, male volunteers in a randomized, two-way crossover study. The concentrations of cefpodoxime in plasma and in urine were determined by sensitive and specific high-performance liquid chromatography methods. The area under the plasma drug concentration-time curve, time to peak concentration, and urinary excretion of cefpodoxime were significantly greater (P Յ 0.05) after administration of cefpodoxime proxetil oral suspension with food than under fasting conditions. However, the difference in the areas under the curve between fed and fasted treatments was only 11%, and application of the two one-sided tests procedure showed bioequivalence between treatments for this parameter. The slight increase in the extent of drug absorption and the slower rate of absorption which results when cefpodoxime proxetil is given with food are unlikely to be of clinical importance.

Cefpodoxime Concentrations in Human Serum and Oral Tissues Following a Single Oral Administration of Cefpodoxime Proxetil

“…The distribution of cefpodoxime concentrations in dental follicle is shown in (11,12). In the present study, the mean peak serum concentration of cefpodoxime was 3.07 ± 0.96 μg/mL and occurred at 3 hours after dosing with cefpodoxime proxetil.…”

“…Higher plasma levels were produced when cefpodoxime proxetil was taken with food or when a low gastric pH was present (11)(12)(13).…”

Pharmacokinetics of Antibacterial Agents in the Elderly: The Body of Evidence

“…Achievement of free concentration targets associated with efficacy was in most circumstances equivalent, suggesting no negative association with the fed state [113] Cefaclor Cmax decreased, Tmax delayed, but no AUC changes were reported for cefaclor granule and cefaclor suspension under fed state supposing effective use regardless of meal [114] Cefuroxime axetil Positive food effect on absorption with AUC in fed state greater than in the fasted state, suggesting postprandial administration be more effective [109] Cefpodoxime proxetil Achievement of proper Cmax and MIC values was reported in non-fasting patients. In the elderly patients, the absorption is approximately 30% lower compared to younger patients [115][116][117] Azithromycin Capsules have delayed disintegration under fed state, resulting in the extended gastric residence and gastric degradation of azithromycin, thus capsules should be taken only in the fasted state. Tablets can be used regardless of meal [118] Clindamycin The extent to systemic exposure was affected by the delay in absorption in the fed state, suggesting optimal dosing is in the fasted state [119] Linezolid A slight decrease in Cmax, and delay in Tmax were observed in fed state, with no effect on AUC, suggesting effective use regardless of meal [120] Ofloxacin Cmax and AUC were greater in the fasted state, significant decrease of absorption was observed with aluminum co-administration [121] Ciprofloxacin Cmax and AUC were greater in the fasted state, significant decrease of absorption was observed with aluminum co-administration.…”

Drug-Food Interactions: The Influence on the Patient’s Therapeutic Plan

“…However, by increasing their lipophilicity, their aqueous solubility was reduced, thus being classified in group IV of the BCS (Biopharmaceutical Classification System). The higher the dose of CP prescribed, the greater the benefit of taking it with a meal [39,40].…”