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Pulmocef (Ceftin)
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Pulmocef

Pulmocef (generic name: cefuroxime axetil; brand names include: Zinacef / Bacticef / Cefasun / Cefudura / Cefuhexal / Cefurax / Cefutil / Cetil / Froxime / Elobact / Oraxim / Zinnat) belongs to a group of medicines known as cephalosporin antibiotics. Pulmocef is used to treat various bacterial infections including infections of the throat, lungs and ears; skin and skin structure infections; and urinary tract infections. Pulmocef is also used to treat uncomplicated gonorrhea and Lyme disease.

Other names for this medication:
Altacef, Cefakind, Ceftin, Ceftum, Cefuroxime, Oratil, Stafcure, Supacef, Zinacef, Zocef

Similar Products:
Lorabid, Cefotan, Cefzil, Lorabid Pulvules, Mefoxin, Raniclor

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Also known as:  Ceftin.

Description

Pulmocef eye drops and eye ointment are used to treat bacterial eye infections. Eye infections are a common cause of conjunctivitis. In conjunctivitis, your eye becomes inflamed, feels gritty, and may water more than usual. The white of your eye may look red, and your eyelids can become swollen and stuck together with a discharge when you wake up in the morning. Only one eye may be infected to begin with, but it often spreads to both eyes.

Most cases of infective conjunctivitis clear within a few days without treatment. For more severe infections, or for infections which do not clear on their own, an antibiotic eye drop or ointment such as Pulmocef can be helpful.

Pulmocef works by helping to kill the bacteria which are causing the infection. It is available on prescription. You can also buy the drops and the ointment from a pharmacy, without a prescription, if it is for conjunctivitis in an adult or a child over 2 years of age. Do not use Pulmocef eye drops or ointment for a child under 2 years old, unless it has been prescribed by a doctor.

Dosage

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

You may take Pulmocef tablets with or without meals.

Pulmocef oral suspension (liquid) must be taken with food.

Shake the oral liquid well just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

If you switch from using the tablet form to using the oral suspension (liquid) form of Pulmocef, you may not need to use the same exact dosage in number of milligrams. The medication may not be as effective unless you use the exact form and strength your doctor has prescribed.

Use this medication for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated. Pulmocef will not treat a viral infection such as the common cold or flu.

This medication can cause you to have false results with certain medical tests, including urine glucose (sugar) tests. Tell any doctor who treats you that you are using Pulmocef.

Overdose

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include seizure (black-out or convulsions).

Storage

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) away from moisture and heat. Keep container tightly closed. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Pulmocef are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

Contact your doctor right away if stomach pain or cramps, severe diarrhea, or bloody stools occur during treatment or within several months after treatment with Pulmocef. Do not treat diarrhea without first checking with your doctor.

The tablet and oral suspension forms of Pulmocef are not equivalent. Do not substitute one for the other.

Pulmocef only works against bacteria; it does not treat viral infections (eg, the common cold).

Be sure to use Pulmocef for the full course of treatment. If you do not, the medicine may not clear up your infection completely. The bacteria could also become less sensitive to this or other medicines. This could make the infection harder to treat in the future.

Long-term or repeated use of Pulmocef may cause a second infection. Tell your doctor if signs of a second infection occur. Your medicine may need to be changed to treat this.

Diabetes patients - Pulmocef may cause the results of some tests for urine glucose to be wrong. Ask your doctor before you change your diet or the dose of your diabetes medicine.

Hormonal birth control (eg, birth control pills) may not work as well while you are using Pulmocef. To prevent pregnancy, use an extra form of birth control (eg, condoms).

Lab tests, including liver function, kidney function, and complete blood cell count, may be performed while you use Pulmocef. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Pulmocef should not be used in children younger 3 months; safety and effectiveness in these children have not been confirmed.

Pregnancy and breast-feeding: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Pulmocef while you are pregnant. Pulmocef is found in breast milk. Do not breastfeed while taking Pulmocef.

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In these studies and among the patients eligible for analysis, microbiologically proven S. pneumoniae pneumonia occurred in 170 of the patients treated with levofloxacine and in 140 treated with the comparator. Bacteriemia was evidenced in 51/170 of the levofloxacin-treated patients (30%) and in 45/140 (32%) of the comparator-treated patients. At treatment end, clinical success rate was 93.5% (159/170) for levofloxacin and 90.7% (127/140) for comparators. S. pneumoniae eradication rate was comparable for levofloxacin (94.9%) and comparators (95.3%). In patients with bacteriemia, the clinical success rate was 86.2% (44/51) for levofloxacin and 84.4% (38/45) for comparators.

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The acute otitis media is a frequent infantile disease and, in 80% of cases, a bacterial strain can be isolated from the otorrhoea. Haemophilus influenzae and Streptococcus pneumoniae are the two major species isolated from auricular exudate, and represent two thirds of all isolated strains, with the others comprising Staphylococcus aureus, Branhamella catarrhalis, Pseudomonas aeruginosa, Enterobacteriaceae and corynebacteria. The treatment of this disease is based principally on beta-lactams (aminopenicillins, cephalosporins) administered by the oral route. Cefuroxime is a cephalosporin which is absorbed via the digestive tract in the form of cefuroxim-axetil. The activity of this compound was studied against 210 strains isolated from otorrhoea, collected from children who presented an acute otitis media during the first half of 1989. These strains were: 112 strains of H. influenzae, of which 23 produced a beta-lactamase; 21 strains of Streptococcus pneumoniae; 3 strains of Streptococcus pyogenes; 10 strains of Branhamella catarrhalis of which 9 produced a beta-lactamase; 18 strains of S. aureus; 14 strains of Enterobacteriaceae, and 32 strains of corynebacteria. The minimal inhibitory concentration (MIC) of cefuroxime-axetil was measured by dilution in agar. The MICs of cefuroxime against H. influenzae were low and similar (MIC 50 = 1 mg/l; MIC 90 = 1 mg/l) regardless of whether the strain secreted a beta-lactamase. Overall, 90% and 98% of the 210 strains tested here were inhibited by 1 and 4 mg/l of cefuroxime respectively. These results show that the antibacterial spectrum of cefuroxime-axetil appears to be ideally suited to the bacterial strains isolated from acute otitis media.

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The antimicrobial spectrum and in vitro potency of the most frequently prescribed orally administered cephalosporins (cefaclor, cefdinir, cefpodoxime, cefprozil, cefuroxime axetil, cephalexin) and amoxicillin/clavulanate are reviewed. These beta-lactam agents have been widely used in the outpatient arena for the treatment of community-acquired respiratory tract and other mild-to-moderate infections. The data presented here were obtained from critical review articles on each of these compounds. Cephalexin and cefaclor were among the least potent and had the narrowest antimicrobial spectrums against the pathogens evaluated. In contrast, cefdinir, cefpodoxime, cefprozil, and cefuroxime were highly active against penicillin-susceptible Streptococcus pneumoniae and retained some activity against penicillin-intermediate strains, whereas amoxicillin/clavulanate was the most active against S. pneumoniae, including most penicillin nonsusceptible strains. Amoxicillin/clavulanate and cefdinir were the most potent compounds against methicillin (oxacillin)-susceptible Staphylococcus aureus, whereas cefpodoxime was the most potent compound against Haemophilus influenzae. Amoxicillin/clavulanate, cefdinir, and cefpodoxime were also active against Moraxella catarrhalis, including beta-lactamase-producing strains. In summary, orally administered "3rd-generation" or extended spectrum cephalosporins exhibited more balanced spectrums of activity against the principal bacterial pathogens responsible for outpatient respiratory tract and other infections when compared with other widely used oral cephalosporins of earlier generations or amoxicillin alone.

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We studied 97 patients with a clinical history of nonimmediate reactions to a penicillin and a positive patch test result to at least 1 of the penicillins tested. All patients also underwent patch testing with several cephalosporins. Patients with a negative patch test to a cephalosporin underwent test dosing in order to assess tolerability.

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Antimicrobial agents play an important role in the treatment of patients with acute otitis media and otitis media with effusion (OME). The study was undertaken to determine the concentrations of cefuroxime in the blood and middle ear effusions (MEE) of children between 6 and 12 years of age with acute otitis media and chronic OME after a single oral dose administration of cefuroxime axetil, the ester prodrug of cefuroxime. Cefuroxime axetil (250 mg) was administered 2 to 6 hours before either myringotomy for acute otitis media or myringotomy and tube insertion for chronic OME. Blood samples and middle ear aspirates were obtained from 31 children and the samples were analyzed by high performance liquid chromatography. Cefuroxime was recovered in measurable concentrations in all serum samples and in 15 (79%) of the 19 MEE specimens analyzed. No correlation was seen between cefuroxime MEE concentrations and effusion type, bacteriology or serum concentrations. This study shows that cefuroxime does penetrate into MEE when OME is present and that therapeutic concentrations can be achieved in some patients.

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An in-vitro model was shown to be capable of simulating a cefuroxime serum profile equivalent to that observed in human volunteer studies, following a single dose of 250 mg cefuroxime axetil. The model was used to carry out kill kinetic studies and showed cefuroxime to lyse the four bacterial test strains, time of onset of lysis being related to the sensitivity of the respective organisms. The more sensitive Staphylococcus aureus and Haemophilus influenzae strains were subject to a higher absolute kill and showed no regrowth over the duration of the simulated serum profile. In contrast, Proteus mirabilis and Escherichia coli showed regrowth after 4 and 5 h respectively. The kill kinetic profiles of the respective organisms are discussed in relation to the pharmacokinetic analysis of the cefuroxime serum profile.

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In this double-blind, randomized, multicentered, parallel-group study, patients received once-daily cefdinir 600 mg, twice-daily cefdinir 300 mg, or twice-daily cefuroxime axetil 250 mg for 10 days. Primary efficacy measures were microbiologic eradication rate, by pathogen and by patient, and clinical response rate, by patient.

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(1) Macrolides are an alternative to beta-lactam agents for treating uncomplicated community-acquired pneumonia, acute exacerbations of chronic bronchitis, sinusitis and throat infections. The choice of macrolides is based mainly on the risk of interactions, which is lowest with spiramycin. (2) Telithromycin is a macrolide antibiotic derived from erythromycin. It was first marketed in France in 2002, for the above indications. (3) Telithromycin is no more effective than the antibiotics with which it has been compared, namely amoxicillin and clarithromycin in non life-threatening pneumonia; amoxicillin-clavulanate and cefuroxime axetil in acute exacerbations of chronic bronchitis and acute sinusitis; and clarithromycin and phenoxymethylpenicillin (penicillin V) in pharyngotonsillitis. (4) In clinical trials, telithromycin was not more effective than comparator antibiotics on infections thought to be due to pneumococcal strains resistant to penicillin and/or erythromycin. Cases of erythromycin cross-resistance have been observed. (5) The adverse effects of telithromycin are the same as those of other macrolides, mainly gastrointestinal disturbances, headache, dizziness, and hepatotoxicity. Telithromycin also carries a risk of torsades de pointes, and seems to cause more visual problems than other macrolides. (6) Telithromycin inhibits cytochrome P450 isoenzymes, so there is a high risk of drug interactions. (7) In practice, spiramycin remains the standard option when a macrolide is indicated for the treatment of common ENT and pulmonary infections.

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Telithromycin, the first approved ketolide antibiotic, was developed to treat community-acquired respiratory tract infections, including acute bacterial maxillary sinusitis (ABMS). A previously published study showed that a 5-day course of 800 mg telithromycin once daily is as effective as a 10-day course in the treatment of ABMS.

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Since the 90% CI for AUClast and Cmax ratios were within the 80-125% interval proposed by the US FDA, it was concluded that cefuroxime axetil (test formulation, 250 mg/5 mL suspension) was bioequivalent to a reference formulation under fed conditions, for both the rate and extent of absorption.

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Gatifloxacin has an extended spectrum of antibacterial activity and provides better coverage of Gram-positive Flagyl Dosage For Cats organisms (e.g. S. pneumoniae) than some older fluoroquinolones. The drug has favourable pharmacokinetic properties, is administered once daily and is at least as well tolerated as other fluoroquinolones. Gatifloxacin is a useful addition to the fluoroquinolones currently available for use in the clinical setting and has an important role in the management of adult patients with various bacterial infections. As with other fluoroquinolones, careful control of gatifloxacin usage in the community is important in order to prevent the emergence of bacterial resistance and thus preserve the clinical value of this agent.

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We sought to evaluate the possibility of using alternative cephalosporins in subjects with cephalosporin allergy who especially Clavam Syrup Side Effects require them.

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In this double-blind, randomized, multicentered, parallel-group study, patients received once-daily cefdinir 600 mg, twice- Bactrim Tablet For Dogs daily cefdinir 300 mg, or twice-daily cefuroxime axetil 250 mg for 10 days. Primary efficacy measures were microbiologic eradication rate, by pathogen and by patient, and clinical response rate, by patient.

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A total of 88 patients (93%) completed follow-up. Patients recorded their symptoms, work assessment, and compliance during the 3-week treatment phase. Patients receiving fluticasone achieved a significantly higher rate of clinical success than patients receiving placebo (93.5% vs 73.9%; P =.009). Patients treated with fluticasone improved significantly more rapidly (median of 6.0 days to clinical success) vs patients in the Cefakind Syrup Dose placebo group (median of 9.5 days; P =.01).

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The pharmacokinetic parameters of cefixime were Antirobe Aquadrops Dosage Cats determined in healthy volunteers following oral administration of 200 mg cefixime as tablet, syrup and dry suspension, respectively. All three galenic formulations showed reliable absorption. Mean peak plasma concentrations amounted to 2.4-3.4 mg/l and were reached after 3.3-3.5 h. Mean terminal half-lives were 2.9-3.1 h. The mean areas under the plasma concentration-time curves ranged between 18 and 26 mg/l.h; 18-24% of the dose administered were recovered unchanged in the urine. The best bioavailability was obtained with the dry suspension followed by the tablet and the syrup. With respect to the ester pro-drug cephalosporins, cefuroxime axetil, cefetamet pivoxyl and cefotiam hexetil, cefixime exhibits higher plasma half-life and area under the curve as well as, comparable absolute bioavailability but consistently lower urinary recovery which indicates higher non-renal clearance.

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Ninety-three children from four pediatric practices, with clinical and bacteriologic evidence of acute Group A beta-hemolytic streptococcal pharyngitis (GABHS) randomly received cefuroxime axetil (60 cases) or phenoxymethyl penicillin (33 cases). Cefuroxime axetil was given twice daily (125 mg). Phenoxymethyl penicillin was given three times daily (250 mg). The treatment groups were similar. Throat cultures were routine 2 to 7 days after the start of therapy and 2 days and 14 days after the end of therapy. The bacterial cure rates were 85 percent (51/60) for cefuroxime axetil, and 88 percent (29/33) for phenoxymethyl penicillin treated Omnicef Oral Suspension Cost patients. Clinical results were comparable in both treatment groups. It was concluded that cefuroxime axetil given twice daily is as effective as phenoxymethyl penicillin given three times daily in producing bacteriologic eradication and clinical symptomatic improvement in children with GABHS.

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The effect of food on the pharmacokinetics of cefuroxime axetil was studied. Twelve healthy male subjects were included in this study. They were given single oral 500 mg doses of cefuroxime axetil alone or with food based on a balanced two-way crossover design. Plasma cefuroxime concentrations were assayed by the high performance liquid chromatographic method. When the drug was given alone, the area under the curve (AUC) was 15.77 +/- 4.12 mg*h/L, Cmax was 4.20 +/- 1.05 mg/L, Tmax was 2.36 +/- 0.84 h, T1/2 was 1.56 +/- 0.26 h, and Clinsol Gel Company Name Clp/F was 34.13 +/- 10.39 L/h; 45.12 +/- 9.59% of the dose was recovered in the urine within 24 hours, and the renal clearance was 12.58 +/- 4.41 L/h. When the drug was given with food, the corresponding AUC was 23.46 +/- 4.57 mg*h/L, Cmax was 7.10 +/- 1.41 mg/L, Tmax was 2.04 +/- 1.32 h, T1/2 was 1.40 +/- 0.23 h, and Clp/F was 21.93 +/- 5.18 L/h; the 24-hour urinary recovery was 69.33 +/- 6.13% and the renal clearance was 12.58 +/- 2.99 L/h. The above pharmacokinetic parameters obtained from the two regimens were compared by two-way ANOVA corrected for the change-over effect. No significant difference was found for Tmax, T1/2 or renal clearance (p > 0.05). Higher AUC, Cmax, urinary recovery and lower Clp/F values were observed for the regimen with food (p < 0.05). The plasma drug concentrations resulting from the regimen with food were higher throughout the 12-hour sampling period when compared to the regimen without food.(ABSTRACT TRUNCATED AT 250 WORDS)

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A total of 945 isolates were recovered. E. coli accounted for 71.4% of isolates; other gram-negative bacilli for 20.2% and gram-positive cocci for 8.4%. The percentages of E. coli isolates susceptible to ampicillin, cotrimoxazole, norfloxacin and ciprofloxacin, phosphomycin, cefuroxime, and cefuroxime-axetil were 40.5, 74.7, 91.6, 97.8, 98.1 and 75.9, respectively. Isolates with cefotaxime MIC higher than 0.5 mg/l were not detected. Significant differences were observed (p < 0.01) for susceptibilities recorded in 1992 and 1995 for amoxycillin/clavulanic acid, cefazolin, and the four quinolones. The antibiotics with the best in vitro activity against Cefixime Tablets Dose the remaining gram-negative bacilli were norfloxacin and ciprofloxacin (98% of susceptible isolates), gentamicin (97%) and cefotaxime (95%).

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Cefditoren exhibited enhanced in vitro activity against the most common uropathogens in the outpatient setting, representing an alternative Azithromycin 800 Mg oral treatment option in patients with risk factors for resistance to first-line antibiotics.

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