Summary

Commonly reported side effects of cefuroxime include: diarrhea. Continue reading for a comprehensive list of adverse effects.

Applies to cefuroxime: oral powder for suspension, oral tablet. Other dosage forms:

• powder for solution

Serious side effects of Cefuroxime

Along with its needed effects, cefuroxime may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking cefuroxime:

More common

• Chills
• diarrhea
• fever
• general feeling of illness or discomfort
• headache
• itching of the vagina or genital area
• pain during sexual intercourse
• rigidity
• sweating
• thick, white vaginal discharge with no odor or with a mild odor

Less common

• Black, tarry stools
• chest pain
• cough
• loose stools
• painful or difficult urination
• shortness of breath
• sore throat
• sores, ulcers, or white spots on the lips or in the mouth
• swollen glands
• unusual bleeding or bruising
• unusual tiredness or weakness

Rare

• Back, leg, or stomach pains
• bladder pain
• bleeding gums
• bloody or cloudy urine
• body aches or pain
• burning while urinating
• dark urine
• difficulty with breathing
• ear congestion
• fast, pounding, or irregular heartbeat or pulse
• frequent urge to urinate
• general body swelling
• loss of appetite
• loss of voice
• lower back or side pain
• nasal congestion
• nausea or vomiting
• nosebleeds
• pain or tenderness around the eyes and cheekbones
• pale skin
• pink or red urine
• sneezing
• stuffy or runny nose
• swelling of the joints
• swollen glands
• tightness of chest or wheezing
• white or brownish vaginal discharge
• white patches in the mouth or throat or on the tongue
• white patches with diaper rash
• yellowing of the eyes or skin

Incidence not known

• Blistering, peeling, or loosening of the skin
• bloody, black, or tarry stools
• clay-colored stools
• cough or hoarseness
• coughing up blood
• decrease in urine output or decrease in urine-concentrating ability
• feeling of discomfort
• fever with or without chills
• general feeling of tiredness or weakness
• high fever
• hives
• increased menstrual flow or vaginal bleeding
• joint or muscle pain
• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• light-colored stools
• paralysis
• prolonged bleeding from cuts
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• red or black, tarry stools
• red or dark brown urine
• red skin lesions, often with a purple center
• red, irritated eyes
• seizures
• swollen lymph glands
• swollen or painful glands
• unpleasant breath odor
• upper right abdominal or stomach pain
• vomiting of blood

Other side effects of Cefuroxime

Some side effects of cefuroxime may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

• Bad, unusual, or unpleasant (after) taste
• change in taste
• diaper rash

Rare

• Abdominal or stomach cramps
• acid or sour stomach
• belching
• bloated
• difficulty with moving
• excess air or gas in the stomach or intestines
• flushing or redness of the skin
• full feeling
• gas in the stomach
• heartburn
• indigestion
• irritability
• irritation or soreness of the mouth
• itching skin
• muscle pain or stiffness
• muscle spasm of the neck
• passing gas
• restlessness
• sleepiness or unusual drowsiness
• stomach discomfort, upset, or pain
• swelling of the tongue
• thirst
• trouble sitting still
• unusually warm skin
• watering of the mouth and drooling
• weight loss

Incidence not known

• Hives or welts
• redness of the skin

For Healthcare Professionals

Applies to cefuroxime: injectable powder for injection, intravenous solution, oral powder for reconstitution, oral tablet.

General

This drug was generally well tolerated. The side effects most commonly reported with the parenteral formulation have included neutropenia, eosinophilia, transient liver enzyme/bilirubin elevations, and injection site reactions. The side effects most commonly reported with the oral formulations have included Candida overgrowth, eosinophilia, headache, dizziness, gastrointestinal disturbances, and transient liver enzyme elevations.^[Ref]

Gastrointestinal

Common (1% to 10%): Diarrhea/loose stools, nausea/vomiting, abdominal pain, nausea

Uncommon (0.1% to 1%): Abdominal cramps, flatulence, indigestion, mouth ulcers, swollen tongue, dyspepsia, gastrointestinal (GI) infection, ptyalism/excess salivation, GI disturbance, vomiting

Frequency not reported: Abdominal discomfort, dry mouth, Clostridioides difficile-associated diarrhea

Postmarketing reports: GI disturbances (including diarrhea, nausea, vomiting, abdominal pain), pseudomembranous colitis

Cephalosporin-class:

-Frequency not reported: Vomiting, abdominal pain, colitis^[Ref]

The onset of pseudomembranous colitis symptoms has been reported during or after antibacterial therapy.^[Ref]

Hepatic

Common (1% to 10%): Transient increase in AST, transient increase in ALT, transient increase in liver enzyme levels

Uncommon (0.1% to 1%): Transient increase in bilirubin

Postmarketing reports: Hepatic dysfunction, hepatitis, cholestasis, jaundice (mainly cholestatic)

Cephalosporin-class:

-Frequency not reported: Hepatic dysfunction (including cholestasis)^[Ref]

Nervous system

Common (1% to 10%): Headache, dizziness

Uncommon (0.1% to 1%): Sleepiness, somnolence, hyperactivity

Postmarketing reports: Seizures, encephalopathy^[Ref]

Cephalosporin-class antibiotics (including this drug) have been associated with seizures, especially in patients with renal dysfunction when the dose was not reduced.^[Ref]

Hypersensitivity

Common (1% to 10%): Delayed hypersensitivity reaction

Uncommon (0.1% to 1%): Hypersensitivity reactions (including rash, pruritus, urticaria)

Rare (0.01% to 0.1%): Severe hypersensitivity reactions

Frequency not reported: Serum sickness

Postmarketing reports: Anaphylaxis, serum sickness-like reaction^[Ref]

Delayed hypersensitivity reaction to this drug has been reported in 2.9% of patients with history of delayed hypersensitivity to penicillin (but not a cephalosporin).

Rare cases of severe hypersensitivity reactions (including erythema multiforme, toxic epidermal necrolysis [exanthematic necrolysis], drug fever, serum sickness-like reaction, anaphylaxis, Stevens-Johnson syndrome) have been reported.^[Ref]

Hematologic

Common (1% to 10%): Eosinophilia, decreased hemoglobin and hematocrit, neutropenia, decreased hemoglobin concentration

Uncommon (0.1% to 1%): Positive Coombs test, leukopenia, thrombocytopenia

Frequency not reported: Autoimmune granulocytopenia, increased coagulation time

Postmarketing reports: Hemolytic anemia, pancytopenia, increased prothrombin time

Cephalosporin-class:

-Frequency not reported: Aplastic anemia, hemolytic anemia, hemorrhage, prolonged prothrombin time, pancytopenia, agranulocytosis, positive Coombs test^[Ref]

Profound leukopenia has sometimes been profound with oral therapy.^[Ref]

Renal

Acute renal failure has been reported. Renal function improved after this drug was stopped, and deteriorated upon rechallenge.^[Ref]

Frequency not reported: Increased BUN, increased creatinine, decreased CrCl, acute renal failure

Postmarketing reports: Renal dysfunction, interstitial nephritis (including reversible fever, azotemia, pyuria, eosinophilia)

Cephalosporin-class:

-Frequency not reported: Toxic nephropathy^[Ref]

Genitourinary

Common (1% to 10%): Vaginitis

Uncommon (0.1% to 1%): Vulvar itch, dysuria, vaginal candidiasis, vaginal discharge, vaginal itch, urethral pain/bleeding, kidney pain, urinary tract infection, vaginal irritation

Cephalosporin-class:

-Frequency not reported: Vaginitis (including vaginal candidiasis)^[Ref]

Dermatologic

A case of occupational contact dermatitis due to cephalosporin allergy has been reported in a nurse who prepared cephalosporin solutions for administration to patients. The dermatitis resolved after the nurse stopped preparing the solutions.^[Ref]

Common (1% to 10%): Diaper/nappy rash

Uncommon (0.1% to 1%): Rash, urticaria/hives, pruritus, erythema

Rare (0.01% to 0.1%): Erythema multiforme, toxic epidermal necrolysis (exanthematic necrolysis), Stevens-Johnson syndrome

Frequency not reported: Acute generalized exanthematous pustulosis

Postmarketing reports: Angioedema/angioneurotic edema, urticaria, toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme, cutaneous vasculitis

Beta-lactam antibiotics:

-Frequency not reported: Severe cutaneous adverse reactions (including Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms [DRESS], acute generalized exanthematous pustulosis)^[Ref]

Metabolic

Uncommon (0.1% to 1%): Anorexia

Cephalosporin-class:

-Frequency not reported: Urine glucose false positive^[Ref]

Other

Common (1% to 10%): Transient increase in LDH, transient increase in alkaline phosphatase, Candida overgrowth, dislike of taste

Uncommon (0.1% to 1%): Chest pain/tightness, chills, thirst, viral illness, candidiasis, fever

Rare (0.01% to 0.1%): Drug fever

Frequency not reported: C difficile overgrowth, disulfiram reaction^[Ref]

Respiratory

Uncommon (0.1% to 1%): Shortness of breath, sinusitis, cough, upper respiratory infection^[Ref]

Musculoskeletal

Uncommon (0.1% to 1%): Muscle cramps, muscle stiffness, muscle spasm of the neck, lockjaw-type reaction, joint swelling, arthralgia^[Ref]

Cardiovascular

Uncommon (0.1% to 1%): Tachycardia

Frequency not reported: Kounis syndrome type I variant

Postmarketing reports: Acute myocardial ischemia (with or without myocardial infarction)^[Ref]

A 90-year-old man, with no history of coronary artery disease, diabetes mellitus, hypertension, or hyperlipidemia, was administered 750 mg cefuroxime axetil IM for urinary tract infection. About 10 minutes after the injection, the patient developed chest pain and pruritic skin rashes. Kounis syndrome type I variant was diagnosed secondary to the drug. Five days after stopping the drug, the patient's symptoms had resolved.

Acute myocardial ischemia (with or without myocardial infarction) has occurred as part of an allergic reaction.^[Ref]

Local

Common (1% to 10%): Injection site reactions (including pain, thrombophlebitis), thrombophlebitis with IV administration, phlebitis, transient pain at injection site

Frequency not reported: Pain at IM injection site^[Ref]

Immunologic

Common (1% to 10%): Jarisch-Herxheimer reaction^[Ref]

Psychiatric

Uncommon (0.1% to 1%): Irritable behavior