Cefuroxime (oral)
Pronunciation: se-fyoor-OX-eem.
- Generic name
- cefuroxime axetil
- Brand names
- Ceftin, Zinnat
- Drug class
- Cephalosporin antibiotic
- Form
- Tablet; oral suspension (granules for reconstitution)
- Route
- By mouth (oral)
- Legal status
- Prescription-only antibiotic
Supply Rules Vary
Trade names by country: United States · United Kingdom · Canada · Australia
Australia: Zinnat (4) · Full directory
What cefuroxime axetil is and how it works
Cefuroxime axetil is an oral cephalosporin antibiotic used to treat a range of bacterial infections including pharyngitis, otitis media, sinusitis, bronchitis, skin infections, urinary tract infections, uncomplicated gonorrhea, and early Lyme disease. It is ineffective against viral infections like colds or flu. (1) (2)
The specific infection, dose, and treatment duration are determined by a health professional. Cefuroxime axetil tablets and oral suspension are not interchangeable; use the exact product prescribed. A prescriber must confirm eligibility, infection type, age, and weight.
Mechanism of action: how cefuroxime axetil works
Cefuroxime axetil is an oral prodrug of cefuroxime, a second-generation cephalosporin that inhibits bacterial cell wall synthesis. It is stable to many beta-lactamases. (2) (1)
What cefuroxime axetil is used for
Pharyngitis / Tonsillitis (including acute streptococcal)
Cefuroxime axetil is indicated for treatment of pharyngitis and acute streptococcal tonsillitis in adults; pediatric use and exact course length vary by country label (e.g., from 3 months of age with a 5-10 day course per UK labeling). Confirm current local label for exact age and duration. (2) (3)
Otitis media and sinusitis
Cefuroxime axetil is indicated for acute otitis media and acute bacterial sinusitis in applicable patients. (2)
Bronchitis and other lower respiratory tract infections
Cefuroxime axetil may be used for acute bacterial exacerbations of chronic bronchitis and other suitable lower respiratory tract infections. (2)
Skin and skin-structure infections
Cefuroxime axetil is indicated for treatment of certain skin and skin-structure infections in appropriate patients. (2)
Urinary tract infections (UTIs)
Cefuroxime axetil is indicated for treatment of urinary tract infections in appropriate patients; the prescriber determines whether a specific infection is within the approved scope of use. (2)
Uncomplicated gonorrhea
Cefuroxime axetil may be used as a single-dose treatment for uncomplicated gonorrhea, per the prescriber's regimen and the current local label. (2) (1)
Early Lyme disease (tick-borne)
Cefuroxime axetil is indicated for treatment of early Lyme disease in adults and select pediatric patients. A Jarisch-Herxheimer reaction may occur after starting treatment. (2) (1)
Before taking cefuroxime axetil
Do not take / not appropriate for
- Do not take cefuroxime axetil if you have a known severe allergy (e.g. anaphylaxis) to cefuroxime, other cephalosporins, or any ingredient in the formulation. If you have a severe penicillin allergy, tell the prescriber before starting; cross-reactivity is possible, and the prescriber will decide whether cefuroxime is appropriate. (all products) (2)
- Do not take cefuroxime axetil for a viral infection such as a cold or flu. (all indications) (1)
Tell your clinician about
- Any allergies to cephalosporins, penicillins, or other medicines.
- Any history of gastrointestinal, kidney, or liver disease.
- Current pregnancy, plans for pregnancy, or breastfeeding.
- All current medicines, including hormonal contraceptives, antacids, H2-blockers, probenecid, and any other prescribed or OTC products.
- If you are diabetic, because cefuroxime can interfere with some urine glucose tests; use Clinistix or TesTape instead.
How to take cefuroxime axetil
- Take cefuroxime axetil tablets by mouth exactly as prescribed; frequency and duration depend on the specific infection and the current local label.
- Swallow tablets whole; do not crush or chew them due to a very bitter taste. For patients who cannot swallow tablets, the prescriber may consider the oral suspension (but note: tablets and suspension are NOT interchangeable on a milligram basis).
- Cefuroxime axetil can be taken with or without food.
- Complete the full prescribed course even if you feel better. Stopping early can lead to treatment failure and resistant bacteria.
- Space antacids (containing magnesium or aluminum) by 1-2 hours from cefuroxime axetil dosing; ask the prescriber or pharmacist about timing with H2-blockers.
- Cefuroxime may reduce the effectiveness of combined oral contraceptives; ask the prescriber or pharmacist about additional or alternative contraception during treatment.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4)
Missed dose
Follow the product instructions for missed doses, or ask the prescriber or pharmacist. Do not double the dose.
Overdose
In case of overdose, call the local poison control centre (US: 1-800-222-1222 or poisonhelp.org) immediately. Seizures may occur. Call 911 if the person collapses, has a seizure, or has trouble breathing. (1)
Side effects
The most common side effects involve the digestive system. Serious allergic reactions and severe diarrhea (including C. difficile-associated colitis) can occur.
Diarrhea
What to notice: Loose or watery stools.
What to do: Report persistent or severe diarrhea, especially if it contains blood or mucus, to a health professional. Do not treat without medical advice as it could be C. difficile colitis. (2)
Nausea and vomiting
What to notice: Feeling sick or being sick.
What to do: Take with food to reduce gastrointestinal upset. If vomiting prevents retaining the dose, contact the prescriber. (1) (2)
Vaginitis
What to notice: Vaginal itching or discharge.
What to do: Inform the prescriber. (2)
Jarisch-Herxheimer reaction (when treating Lyme disease)
What to notice: Fever, chills, aches, and sometimes skin rash shortly after starting antibiotic treatment for Lyme disease.
What to do: Contact the prescriber promptly if this occurs; it is a known reaction and does not usually mean an allergy. (2)
Severe or persistent diarrhea
What to notice: Watery or bloody stools, with or without stomach cramps, fever.
What to do: Contact the prescriber immediately. Do not take anti-diarrheal medicines unless directed by a health professional. (1) (2)
Signs of infection or blood disorder
What to notice: Fever, unusual bruising or bleeding, severe tiredness.
What to do: Seek medical assessment promptly. (1)
Serious warnings
Anaphylaxis / Severe allergic reaction — emergency
Symptoms: Difficulty breathing, swelling of the face, lips, tongue, or throat, hives/urticaria, severe rash, itching, hoarseness, throat tightness, faintness, or a feeling of impending doom.
Action: Seek emergency medical help immediately; a clinician or emergency service will decide whether cefuroxime needs to be stopped. Call 911 (US) or 999 (UK) or go to the nearest emergency room. Anaphylaxis can be fatal. (1) (2)
C. difficile-associated diarrhea (colitis) — seek_medical_attention
Symptoms: Watery or bloody stools, stomach cramps, fever, persistent diarrhea that may occur weeks after stopping the antibiotic.
Action: Contact your prescriber immediately. Do not treat diarrhea with anti-diarrheal medicines unless directed by a health professional. (2)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Combined oral contraceptives | Cefuroxime may reduce the effectiveness of combined oral contraceptives by affecting gut flora, reducing oestrogen reabsorption. | Ask the prescriber or pharmacist about additional or alternative contraception during and after treatment. (1) (3) |
| Antacids (magnesium- or aluminum-containing) and H2-blockers (e.g. cimetidine, famotidine, ranitidine) | These can reduce the absorption of cefuroxime axetil. | Separate antacid dosing by at least 1-2 hours; ask the prescriber or pharmacist about timing with H2-blockers. (2) |
| Probenecid | Probenecid can increase cefuroxime levels by reducing its elimination. | Coadministration is not recommended. (2) |
Pregnancy, breastfeeding, kidney/liver function, age
Children and adolescents
Cefuroxime axetil is indicated for children from 3 months of age (per UK SmPC) and for select pediatric patients (per US label). Tablets and suspension are not interchangeable on a milligram basis. The prescriber must confirm the exact dose based on age and weight. (2) (3)
Pregnancy and breastfeeding
Animal studies have not shown adverse developmental effects. Cefuroxime appears in breast milk at levels estimated below 1% of an adult dose. Consult your doctor before taking cefuroxime if you are pregnant, planning to become pregnant, or breastfeeding. (2)
Diabetes
Cefuroxime can cause false-positive results with some urine glucose tests that use copper-reduction methods (e.g., Benedict's solution, Clinitest). Use glucose tests that are based on glucose oxidase (e.g., Clinistix, TesTape) during treatment. (1)
Kidney or liver impairment
Inform the prescriber if you have kidney or liver disease. Cefuroxime is renally cleared; dose adjustment may be needed for patients with reduced kidney function. No specific thresholds were retrieved from the available sources. The prescriber must determine the appropriate dose. (1)
Monitoring
Before starting
- Confirm the diagnosis and appropriate indication for cefuroxime axetil.
- Obtain a detailed allergy history, particularly for cephalosporins and penicillins.
- Assess renal function (dose adjustment may be required in renal impairment; no specific thresholds retrieved from available sources).
- Review all concurrent medications for potential interactions, especially hormonal contraceptives, antacids, H2-blockers, and probenecid.
- Inform diabetic patients about possible interference with urine glucose tests and advise use of glucose oxidase tests.
During treatment
- Monitor for signs of allergic reaction, especially during the first few doses.
- Monitor for diarrhea that could indicate C. difficile colitis.
- Encourage completing the full prescribed course, even if symptoms improve.
Storage
Store in the original container, tightly closed, out of reach of children. Keep at room temperature (controlled room temperature 20-25°C or 68-77°F, with excursions permitted to 15-30°C). Protect from heat, moisture, and light. Do not store in the bathroom. For the oral suspension, follow the storage instructions for the reconstituted product provided by the pharmacist; usually store in the refrigerator but do not freeze, and discard any unused portion after the stated period.
Study the drug class: Cephalosporins
Professional information
Clinician-facing context only. Use the current local indication, dosing table, and product-specific guidance.
United States and United Kingdom (see notes for country-specific figures)
Indication: Any cefuroxime axetil use
Dose summary: Adults (13+): 250-500 mg twice daily for 7-20 days depending on infection type; single 1000 mg dose for uncomplicated gonorrhea. Pediatric: 250 mg twice daily when able to swallow tablets; not for use in children who cannot swallow tablets unless using suspension (but note: tablets and suspension are not interchangeable on a milligram basis). Duration ranges 5-10 days per UK label, 5-20 days per US label. These are context-only summary values; the current local label must be consulted for precise dosing.
Renal context: Renal impairment: Cefuroxime is renally cleared. Dose adjustment is necessary for reduced creatinine clearance, but no specific numeric thresholds or tables were retrieved from the available sources. The clinician must consult the current local product information and published guidelines. This page does not provide a specific creatinine-clearance adjustment. (2) (3)
Hepatic guidance
Use local product information and specialist judgement; this page does not provide impairment-specific dosing for hepatic impairment. No data were retrieved from the available sources for hepatic impairment.
Overdose note
Overdose may lead to seizures. Immediate consultation with a poison control centre is recommended. Supportive care and seizure management should be provided as needed. (2) (1)
Frequently asked questions
Can I take cefuroxime with food?
Yes. Cefuroxime can be taken with or without food. Taking it with food may help reduce stomach upset. (1) (2)
Can I crush or chew cefuroxime tablets?
No. Swallow tablets whole. Crushing or chewing releases the very bitter taste. If you have difficulty swallowing tablets, talk to your prescriber; they may consider the oral suspension (but note that the tablet and suspension are not interchangeable on a milligram basis). (1)
Can cefuroxime affect birth control?
It may reduce the effectiveness of combined oral contraceptives by affecting gut flora and oestrogen reabsorption. Ask the prescriber or pharmacist about additional or alternative contraception during and after treatment. (1) (3)
If I am treating Lyme disease with cefuroxime, what is a Jarisch-Herxheimer reaction?
It is a known reaction that can occur when antibiotics are started for Lyme disease. Symptoms include fever, chills, muscle aches, and sometimes a rash. It is not an allergic reaction. Contact your prescriber if it occurs. (2)
What is the mechanism of action of cefuroxime axetil?
Cefuroxime axetil is an oral prodrug of cefuroxime, a second-generation cephalosporin that inhibits bacterial cell wall synthesis. It is stable to many beta-lactamases. (2) (1)
References
- Cefuroxime: MedlinePlus Drug InformationMedlinePlus, U.S. National Library of Medicine · United States · accessed 2026-07-23 · source 1
- Cefuroxime Axetil tablet, film coated — prescribing informationU.S. National Library of Medicine DailyMed / FDA-sourced label · United States · accessed 2026-07-23 · source 2
- Zinnat Tablets 250 mg — Summary of Product Characteristics (Sandoz Limited)electronic Medicines Compendium (UK) · United Kingdom · accessed 2026-07-23 · source 3
- ZINNAT cefuroxime 250mg (as axetil) tablet blister pack — ARTG 47621Therapeutic Goods Administration · Australia · dated 1994-02-24 · accessed 2026-07-23 · source 4
Brand names by country
Single-ingredient cefuroxime axetil names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Ceftin (2)current regulator label · 125 mg, 250 mg, 500 mg tablets; oral suspension · See current FDA/DailyMed listing
United Kingdom
- Zinnat (3)current licensed product lower confidence source · 125 mg, 250 mg tablets · Sandoz Limited · Source verification is search-result-confirmed, not a live-opened EMC page this session; re-verify with a live fetch before publication.
Canada
- CEFTIN -
- CEFTIN - PWS
Australia
- Zinnat (4)current register product lower confidence source · 250 mg tablet · Aspen Pharmacare Australia Pty Ltd · Source verification is search-result-confirmed, not a live-opened TGA page (domain has repeatedly timed out this session); re-verify with a live fetch before publication.