Formulation in Pharmacy Practice   2nd Edition

CEFUROXIME
 
 
Cefuroxime axetil is an ester of cefuroxime which is well absorbed orally and then hydrolysed to active cefuroxime.  A suspension is commercially available in some countries.  The injectable form, cefuroxime sodium, is poorly absorbed if given orally.  Cefuroxime axetil has an extremely bitter and unpleasant taste which is difficult to mask.  This is a particular problem in paediatric patients who cannot swallow whole tablets or when small doses are required.

Attempts can be made to mask the unpleasant taste by dispersing the tablet in fruit juice or flavoured milk.  The drug is stable in apple juice for 24 hours and for at least two hours in orange juice, grape juice or chocolate milk.1  It is recommended that such dispersions are prepared immediately prior to administration.

Pramar et al2 studied the stability of cefuroxime axetil in suspensions compounded from tablets.
Suspensions of 10mg per mL were prepared in the following bases.
  1. Simple syrup with 0.1% sodium benzoate and citric acid to pH 3.3
  2. As (i) with citrate buffer added to pH 5.5
  3. Freshly prepared syrup (sucrose 85% w/v in water) - pH 6.8
The cefuroxime axetil in these suspensions is stable for up to 28 days when stored under refrigeration.  Less viscous suspensions without sugars showed unacceptable dose variation.

REFERENCES
  1. St Claire R.L., Caudill W.L.  The stability of cefuroxime axetil in beverages (letter) Am J Hosp Pharm 1989; 46(2): 256.
  2. Pramar Y., Das Gupta V., Bethea C., Zerai T.  Stability of cefuroxime axetil in suspensions.J Clin Pharm Ther 1991; 16(5): 341-4.

 
Formulation in Pharmacy Practice
2nd Edition