Cefpodoxime Proxetil
Cefpodoxime proxetil
Also known as: Simplicef · Vantin · Banan · Biocef · Cefodox · Cepodem · Garia · Instana · Kelbium · Orelox · Otreon · Podomexef · CS-807 · R-3763 · U-76252 · U-76253
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| For susceptible skin infections | 5-10 mg/kg PO once daily | PO | q24h | 5-7 days or 2-3 days beyond 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. | 🌎 NA |
- For susceptible skin infections: May be given with or without food.
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| For susceptible skin and soft tissue infections | 5 mg/kg PO q12h or 10 mg/kg PO once daily | PO | q12h or q24h | — | 🌎 NA |
- For susceptible skin and soft tissue infections: Extrapolated from human dosage.
Horses
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Foals (neonates) with bacterial infections | 10 mg/kg PO q6-12 hours | PO | q6-12h | — | 🌎 NA |
- Foals (neonates) with bacterial infections: Additional studies required to confirm clinical efficacy and safety.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Cefpodoxime proxetil is an oral, third-generation cephalosporin antibiotic used primarily in veterinary medicine for the treatment of susceptible bacterial infections, particularly skin infections in dogs.
- Prodrug Formulation: The esterified "proxetil" component enhances lipid solubility and gastrointestinal absorption. Once absorbed, it is rapidly hydrolyzed in the intestinal wall to the active metabolite, cefpodoxime.
- Spectrum of Activity: Highly effective against Gram-positive organisms like Staphylococcus pseudintermedius, Staphylococcus aureus, and Streptococcus canis, as well as many Gram-negative Enterobacteriaceae (e.g., E. coli, Proteus mirabilis, Pasteurella multocida, and Klebsiella).
- Clinical Pearl: It is notably ineffective against Pseudomonas aeruginosa, Enterococcus spp., anaerobes, and methicillin-resistant Staphylococcus (MRSA/MRSP). Its once-daily dosing in dogs makes it highly convenient for owners, improving compliance compared to first-generation cephalosporins like cephalexin.
Mechanism of action
Cefpodoxime is a bactericidal antibiotic that disrupts bacterial cell wall synthesis.
- It binds to specific Penicillin-Binding Proteins (PBPs) located inside the bacterial cell wall.
- Inhibition of PBPs → prevents the cross-linking of peptidoglycan chains → weakens the bacterial cell wall.
- This structural instability → osmotic pressure changes → cell lysis and death.
- As a third-generation cephalosporin, it exhibits increased stability against many bacterial beta-lactamase enzymes compared to earlier generations.
Safety & warnings
Contraindications
- Hypersensitivity to cefpodoxime or other cephalosporins
Adverse effects
- Inappetence
- Diarrhea
- Vomiting
- Hypersensitivity reactions
- Positive direct Coombs' test
- Blood dyscrasias (rare, following high doses)
Precautions
Renal Impairment: Because cefpodoxime is excreted by the kidneys, dosages and/or dosage frequency may need to be adjusted in patients with significantly diminished renal function.
Seizure Disorders: Use with caution in patients with a history of seizure disorders.
Laboratory Interference:
- May cause false-positive urine glucose determinations when using cupric sulfate solution (Benedict's Solution, Clinitest). Glucose oxidase tests are unaffected.
- May cause false-positive results in nitroprusside tests for urinary ketones.
Breeding/Pregnancy: Safety in breeding, pregnant, or lactating dogs has not been demonstrated. Use only when clearly indicated.
Drug interactions
Potentially additive nephrotoxicity (controversial). In vitro synergy exists, but do not mix together in the same syringe/fluid.
Drugs that increase stomach pH may decrease the absorption of cefpodoxime.
Drugs that increase stomach pH may decrease the absorption of cefpodoxime.
Competitively blocks tubular secretion of cephalosporins, increasing serum levels and half-lives.
Drugs that increase stomach pH may decrease the absorption of cefpodoxime.
Monitoring
- Clinical efficacy (resolution of infection)
- Adverse GI effects
Pharmacokinetics
Half-life
Absorption
Cefpodoxime proxetil is a prodrug. After single oral doses (10 mg/kg) to fasted dogs, bioavailability is approximately 63%. In humans, it is 40-50% absorbed; food alters the rate but not the extent of absorption.
Distribution
Volume of distribution in dogs is 150 mL/kg. Penetrates most tissues well. In foals, levels in synovial and peritoneal fluids are similar to serum, but no drug was detected in the CSF.
Metabolism
Hydrolyzed in vivo in the intestinal wall from the inactive proxetil ester to the active antibiotic, cefpodoxime.
Elimination
Eliminated in both the urine and feces. Serum half-life may be prolonged in patients with impaired renal function.
Overdose
Cephalosporin overdoses are unlikely to cause significant problems. The most likely signs of acute toxicity or overdose are gastrointestinal disturbances (vomiting, diarrhea, inappetence). Supportive care should be provided if necessary.
Available products
Formulations
- Tablets
- Granules for oral suspension
Veterinary
- Cefpodoxime Proxetil Tablets: 100 mg & 200 mg; Simplicef (Pfizer)
Human-labeled
- Cefpodoxime Proxetil Oral Tablets: 100 mg & 200 mg; Vantin (Pharmacia & Upjohn), generic
- Cefpodoxime Proxetil Granules for Suspension, Oral: 50 mg/5 mL & 100 mg/5 mL in 50 mL, 75 mL & 100 mL bottles; Vantin (Pharmacia & Upjohn), generic
Regulatory status
No regulatory data for: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Tablets and unreconstituted powder should be stored at 20-25°C in well-closed containers. After reconstitution, the oral suspension should be stored in the refrigerator and discarded after 14 days.
Client information
- Administration: Can be given with or without food. If your pet vomits after taking it on an empty stomach, try giving it with a small meal.
- Completion of Therapy:
Important: Always complete the entire prescription as directed by your veterinarian, even if your pet seems completely healed. Stopping early can lead to resistant bacterial infections.
- Side Effects: Generally well-tolerated. Watch for mild stomach upset, such as decreased appetite, vomiting, or diarrhea. Contact your vet if these are severe.
- Storage: Keep tablets at room temperature in a tightly closed container. If using the liquid suspension, keep it refrigerated and throw away any unused portion after 14 days.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.