Velosef

Velosef,

trademark for a cephalosporin antibiotic (cephradine).

---

cephradine

Nicef (UK), Velosef

Pharmacologic class: First-generation cephalosporin

Therapeutic class: Anti-infective

Pregnancy risk category B

Action

Interferes with bacterial cell-wall synthesis, causing cell to rupture and die. Active against many gram-positive bacteria; shows limited activity against gram-negative bacteria.

Availability

Capsules: 250 mg, 500 mg

Oral suspension: 125 mg/5 ml, 250 mg/5 ml

⊘Indications and dosages

➣ Respiratory, skin, and other infections

Adults: 250 to 1,000 mg P.O. q 6 to 12 hours. For severe or chronic infection, dosage may be increased up to 1 g q 6 hours.

Children older than age 9 months: 25 to 50 mg/kg/day P.O. q 6 hours in divided doses. For otitis media, usual dosage is 75 to 100 mg/kg/day P.O. q 6 to 12 hours in divided doses.

Dosage adjustment

• Renal impairment

Contraindications

• Hypersensitivity to cephalosporins or penicillin

Precautions

Use cautiously in:
• renal impairment, phenylketonuria
• history of GI disease
• debilitated or emaciated patients
• elderly patients
• pregnant or breastfeeding patients.

Administration

• Give drug with food if it causes GI upset.

Route	Onset	Peak	Duration
P.O.	Rapid	1-2 hr	6-12 hr

Adverse reactions

CNS: headache, lethargy, paresthesia, syncope, seizures

CV: hypotension, vasodilation, palpitations, chest pain, phlebitis, thrombophlebitis

EENT: hearing loss, scleral yellowing

GI: nausea, vomiting, constipation, abdominal cramps, oral candidiasis, pseudomembranous colitis

GU: vaginal candidiasis, nephrotoxicity

Hematologic: anemia, lymphocytosis, eosinophilia, bleeding tendency, leukopenia, bone marrow depression, hypoprothrombinemia, neutropenia, thrombocytopenia, agranulocytosis

Hepatic: hepatomegaly

Musculoskeletal: joint pain

Respiratory: dyspnea

Skin: rash, maculopapular and erythematous urticaria, yellow skin discoloration

Other: chills, fever, edema, allergic reactions including anaphylaxis, serum sickness

Interactions

Drug-drug. Aminoglycosides, loop diuretics: increased risk of nephrotoxicity

Probenecid: increased cephradine blood level

Drug-diagnostic tests. Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, bilirubin, blood urea nitrogen, creatinine, eosinophils, lactate dehydrogenase, lymphocytes: increased levels

Coombs' test: false-positive result (especially in neonates whose mothers received drug before delivery)

Granulocytes, neutrophils, white blood cells: decreased counts

Patient monitoring

• Assess for signs and symptoms of serious adverse reactions, including hypersensitivity, jaundice, and bleeding.
• Monitor liver and kidney function test results.

Patient teaching

• Tell patient to take drug with full glass of water.
☞ Instruct patient to immediately report severe diarrhea, abdominal pain, or vomiting.
☞ Advise patient to stop taking drug and contact prescriber immediately if rash occurs.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

---

Velosef®

Cephradine, see there