Simplicef
SIMPLICEF (cefpodoxime proxetil)
FULL PRESCRIBING INFORMATION: CONTENTS*
- SIMPLICEF DESCRIPTION
- INDICATION
- SIMPLICEF DOSAGE AND ADMINISTRATION
- SIMPLICEF CONTRAINDICATIONS
- WARNINGS
- PRECAUTIONS
- SIMPLICEF ADVERSE REACTIONS
- CLINICAL PHARMACOLOGY
- EFFECTIVENESS
- ANIMAL SAFETY
- STORAGE INFORMATION
- HOW SUPPLIED
- PRINCIPAL DISPLAY PANEL - 100 mg Tablet Bottle Label
- PRINCIPAL DISPLAY PANEL - 200 mg Tablet Bottle Label
FULL PRESCRIBING INFORMATION
For Oral Use In Dogs Only
CAUTION: Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian.
SIMPLICEF DESCRIPTION
Cefpodoxime proxetil is an orally administered, extended spectrum, semi-synthetic cephalosporin antibiotic. The chemical name is: (+/-)-1-Hydroxyethyl(+)-(6R,7R)-7-[2-(2-amino-4-thiazolyl) glyoxylamido]-3-methoxymethyl)-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylate, 72-(Z)-(Omethyloxime), isopropyl carbonate (ester) [87239-81-4].
Cefpodoxime proxetil Chemical Structure:
Cefpodoxime proxetil is a prodrug; its active metabolite is cefpodoxime. All doses of SIMPLICEF (cefpodoxime proxetil) tablets are expressed in terms of the active cefpodoxime moiety. SIMPLICEF is available as:
100 mg Tablet, each reddish-orange, elliptical, scored tablet contains cefpodoxime proxetil equivalent to 100 mg of cefpodoxime.
200 mg Tablet, each light orange, round rectangle, scored tablet contains cefpodoxime proxetil equivalent to 200 mg of cefpodoxime.
INDICATION
SIMPLICEF tablets are indicated for the treatment of skin infections (wounds and abscesses) in dogs caused by susceptible strains of Staphylococcus intermedius, Staphylococcus aureus, Streptococcus canis (group G, β hemolytic), Escherichia coli, Pasteurella multocida, and Proteus mirabilis.
SIMPLICEF DOSAGE AND ADMINISTRATION
Dose range: The dose range of SIMPLICEF (cefpodoxime proxetil) tablets is 5-10 mg/kg (2.3-4.5 mg/lb) body weight, administered orally, once a day. The dose may be given with or without food. The determination of dosage for any particular patient must take into consideration such factors as the severity and nature of the infection, the susceptibility of the causative organisms, and the integrity of the patient's host-defense mechanisms. Obtain a sample of the pathogenic organism for culture and sensitivity testing prior to beginning antimicrobial therapy. Once results become available, continue with appropriate therapy.
Duration: SIMPLICEF tablets should be administered once daily for 5-7 days or for 2-3 days beyond the cessation of clinical signs, up to a maximum of 28 days. Treatment of acute infections should not be continued for more than 3-4 days if no response to therapy is seen.
Dosing Charts: For daily oral administration of SIMPLICEF at 5 mg/kg (Table 1) and 10 mg/kg (Table 2).
Weight of Dog (lbs) | ||||||
---|---|---|---|---|---|---|
Daily Dose | 22 | 44 | 66 | 88 | 132 | |
No. of 100 mg tablets | 0.5 | 1 | 1.5 | 1 | ||
No. of 200 mg tablets | 1 | 1 |
Weight of Dog (kgs) | ||||||
---|---|---|---|---|---|---|
Daily Dose | 10 | 20 | 30 | 40 | 60 | |
No. of 100 mg tablets | 0.5 | 1 | 1.5 | 1 | ||
No. of 200 mg tablets | 1 | 1 |
Weight of Dog (lbs) | ||||||
---|---|---|---|---|---|---|
Daily Dose | 11 | 22 | 44 | 66 | 88 | 132 |
No. of 100 mg tablets | 0.5 | 1 | 1 | |||
No. of 200 mg tablets | 1 | 1 | 2 | 3 |
Weight of Dog (kgs) | ||||||
---|---|---|---|---|---|---|
Daily Dose | 5 | 10 | 20 | 30 | 40 | 60 |
No. of 100 mg tablets | 0.5 | 1 | 1 | |||
No. of 200 mg tablets | 1 | 1 | 2 | 3 |
SIMPLICEF CONTRAINDICATIONS
Cefpodoxime proxetil is contraindicated in dogs with known allergy to cefpodoxime or to the β-lactam (penicillins and cephalosporins) group of antibiotics.
WARNINGS
Not for human use. Keep this and all drugs out of reach of children. Antimicrobial drugs, including penicillins and cephalosporins, can cause allergic reactions in sensitized individuals. To minimize the possibility of allergic reactions, those handling such antimicrobials, including cefpodoxime, are advised to avoid direct contact of the product with the skin and mucous membranes.
PRECAUTIONS
The safety of cefpodoxime proxetil in dogs used for breeding, pregnant dogs, or lactating bitches has not been demonstrated. As with other cephalosporins, cefpodoxime proxetil may occasionally induce a positive direct Coombs' test.
SIMPLICEF ADVERSE REACTIONS
A total of 216 dogs of various breeds and ages ranging from 2 months to 15 years were included in the field study safety analysis. The following table shows the number of dogs displaying each clinical observation.
Clinical Observation | SIMPLICEF (n=118) |
Active Control (n=98) |
---|---|---|
Vomiting | 2 | 4 |
Diarrhea | 1 | 1 |
Increased water drinking | 0 | 2 |
Decreased appetite | 1 | 1 |
To report a suspected adverse reaction call 1-888-963-8471.
To request a material safety data sheet (MSDS) for SIMPLICEF tablets, call 1-888-963-8471.
CLINICAL PHARMACOLOGY
Pharmacokinetics/Pharmacodynamics: Cefpodoxime proxetil is a prodrug that is absorbed from and de-esterified in the gastrointestinal tract to its active metabolite, cefpodoxime. Following oral administration to fasting Beagles, oral bioavailability was 63.1 ± 5.3%.
Figure 1. Canine Plasma Concentration of Cefpodoxime After a Single Oral Dose of 10 mg/kg Cefpodoxime Proxetil Tablets
Cefpodoxime is distributed in the body with an apparent volume of distribution of 151 ± 27 mL/kg. Like other β-lactam antibiotics, cefpodoxime is eliminated from the body primarily in the urine, with an apparent elimination half-life of approximately 5-6 hours after oral administration. This is similar to the 4.7 hour apparent elimination half-life observed after intravenous dosing. Following intravenous administration of 10 mg/kg, the average total body clearance (ClB) was 22.7 ± 4.19 mL/hr/kg.
PK Parameter | Unit | Tablet (SD) |
---|---|---|
AUC0-∞ | mcg∙hr/mL | 145 (77.6) |
AUC0-LOQ | mcg∙hr/mL | 142 (77.5) |
Maximum concentration (Cmax) | mcg/mL | 16.4 (11.8) |
Terminal plasma elimination half-life (t1/2,z) | hr | 5.61 (1.15) |
Time of maximum concentration (tmax) | hr | 2.21 (0.542) |
Mean residence time (MRT0-∞) | hr | 9.21 (1.97) |
Microbiology: Like other β-lactam antibiotics, cefpodoxime exerts its inhibitory effect by interfering with bacterial cell wall synthesis. This interference is primarily due to its covalently binding to the penicillin-binding proteins (PBPs) (i.e. transpeptidase and/or carboxypeptidase), which are essential for synthesis of the bacterial cell wall. Therefore, cefpodoxime is bactericidal. Cefpodoxime is stable in the presence of many common β-lactamase enzymes. As a result, many organisms resistant to other β-lactam antibiotics (penicillins and some cephalosporins) due to the production of β-lactamases may be susceptible to cefpodoxime.
Cefpodoxime has a broad spectrum of clinically useful antibacterial activity that includes staphylococci, streptococci, and Gram-negative species (including Pasteurella, Escherichia, and Proteus). The compound is not active against most obligate anaerobes, Pseudomonas spp., or enterococci. The minimum inhibitory concentrations (MICs) for cefpodoxime against Gram-positive and Gram-negative pathogens isolated from canine skin infections (wounds and abscesses) in a 2002 U.S. field study are presented in Table 5. All MICs were determined in accordance with the National Committee for Clinical Laboratory Standards (NCCLS). Appropriate quality control (QC) ranges for in vitro susceptibility testing are presented in Table 6.
Organism |
# of Isolates | MIC50 | MIC90 | Range |
---|---|---|---|---|
Staphylococcus intermedius | 118 | 0.12 | 0.50 | 0.12->32.0 |
Streptococcus canis (group G, β hemolytic) | 33 | ≤0.03 | ≤0.03 | ≤0.03 |
Escherichia coli | 41 | 0.25 | 0.50 | 0.12->32.0 |
Pasteurella multocida | 32 | ≤0.03 | ≤0.03 | ≤0.03-0.12 |
Proteus mirabilis | 14 | ≤0.03 | 0.06 | ≤0.03-0.06 |
Staphylococcus aureus | 19 | 2.0 | 2.0 | 0.12-2.0 |
QC ATCC strain | KB Disk Diffusion Method | Broth Micro-dilution Method | |
---|---|---|---|
Drug concentration | Zone diameter | MIC | |
Escherichia coli 25922 | 10 mcg | 23-28 mm |
0.25-1 mcg/mL |
Staphylococcus aureus 25923 | 10 mcg | 19-25 mm |
|
Staphylococcus aureus 29213 | 1-8 mcg/mL |
||
Streptococcus pneumoniae 49619 | 10 mcg | 28-34 mm |
0.03-0.12 mcg/mL |
EFFECTIVENESS
The clinical effectiveness of SIMPLICEF (cefpodoxime proxetil) was established in a multi-location (23 site) field study. In this study, 216 dogs with infected wounds or abscesses were treated with either SIMPLICEF (n=118) once daily at 5 mg/kg (2.3 mg/lb) body weight or with a active control antibiotic (n=98) administered twice daily for 5-7 days. In this study, SIMPLICEF was considered noninferior to the active control (88.7% versus 88.4% respectfully) in the treatment of canine skin infections (wounds and abscesses) caused by susceptible strains of Staphylococcus intermedius, Staphylococcus aureus, Streptococcus canis (group G, β hemolytic), Escherichia coli, Pasteurella multocida, and Proteus mirabilis.
ANIMAL SAFETY
In target animal safety studies, cefpodoxime was well tolerated at exaggerated daily oral doses of 100 mg/kg/day (10 times the maximum label dose) for 13 weeks in adult dogs and for 28 days in puppies (18- 23 days of age). Therefore, once daily administration of cefpodoxime oral tablets at the maximum labeled dose of 10 mg/kg for up to 28 days was shown to be safe in adult dogs and puppies.
Blood dyscrasia including neutropenias, may be seen following high doses of cephalosporins. Cephalosporin administration should be discontinued in such cases.
STORAGE INFORMATION
Store tablets at controlled room temperature 20° to 25°C (68° to 77°F). Replace cap securely after each opening.
HOW SUPPLIED
SIMPLICEF tablets are available in the following strengths (cefpodoxime equivalent), colors, and sizes:
100 mg (reddish-orange, elliptical, scored, debossed with 5228)
Bottles of 100
Bottles of 250
200 mg (light orange, round rectangle, scored, debossed with 5229)
Bottles of 100
Bottles of 250
NADA # 141-232, Approved by FDA
Manufactured by:
Sandoz
Kundl, Austria
Product of India
Distributed by:
Zoetis Inc.
Kalamazoo, MI 49007
Revised June 2013
46104787
PRINCIPAL DISPLAY PANEL - 100 mg Tablet Bottle Label
SIMPLICEF®
(cefpodoxime proxetil)
100 mg
100 TABLETS
Antimicrobial For Oral Use
in Dogs Only
Caution: Federal (USA) law
restricts this drug to use by
or on the order of a licensed
veterinarian.
NADA# 141-232, Approved by FDA
zoetis
PRINCIPAL DISPLAY PANEL - 200 mg Tablet Bottle Label
SIMPLICEF®
(cefpodoxime proxetil)
200 mg
100 TABLETS
Antimicrobial For Oral Use
in Dogs Only
Caution: Federal (USA) law
restricts this drug to use by
or on the order of a licensed
veterinarian.
NADA# 141-232, Approved by FDA
zoetis
Simplicefcefpodoxime proxetil TABLET
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Simplicefcefpodoxime proxetil TABLET
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