Loracarbef

These indications are based on manufacturer information for both originator and generic products. For product specific registered indications, please refer to product specific manufacturer information

Registered South African indications:

• Otitis media caused by S. pneumoniae, H. influenzae, M.(B.) catarrhalis or S. pyogenes
• Acute bronchitis and acute exacerbations of chronic bronchitis caused by S. pneumoniae, H. influenzae or M.(B.) catarrhalis
• Pneumonia caused by S. pneumoniae or H. influenzae
• Acute maxillary sinusitis caused by S. pneumoniae, H. influenzae or M.(B.) catarrhalis
• Pharyngitis and tonsillitis caused by S. pyogenes
• Uncomplicated lower urinary tract infections (cystitis) caused by E. coli
• Uncomplicated pyelonephritis caused by E. coli
• Skin and skin structure infections caused by S. aureus or S. pyogenes

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Hypersensitivity to cephalosporins
• Pregnancy
• Breastfeeding
• Severe renal impairment (CrCl< 30ml/min)
• Infants < 6 months

Cautions

• Breastfeeding
• Mild to moderate renal impairment
• Hepatic impairment
• Prolonged use
• History of colitis

Forms avail. in SA and covered in this monograph: cap

Infections caused by: Gram-positive aerobic cocci (excluding enterococci and methicillin-resistant staphylococci); Gram-negative aerobic organisms (including E. coli, H. influenzae, Moraxella catarrhalis); Some anaerobes (including Peptostreptococcus)

General dosing range

• Oral (cap): 200-400mg, 12hrly

Specific doses based on individual indications

Please note that the dosages below should be used in combination with regional guidelines, taking into account local antibiotic sensitivities

Pharyngitis
Tonsillitis
Skin infections

• Oral (cap): 200mg, 12hly (Manufacturer recommendation)

Sinusitis
Pneumonia
Uncomplicated pyelonephritis

• Oral (cap): 400mg, 12hrly (Manufacturer recommendation)

Uncomplicated cystitis

• Oral (cap): 200mg, dly (Manufacturer recommendation)

Bronchitis

• Oral (tab): 200-400mg, 12hrly (Manufacturer recommendation)

Should be administered on an empty stomach

In the treatment of otitis media, sinusitis, and S. pyogenes infections, Loracarbef should be administered for at least 10 days (Manufacturer recommendation)

In the treatment of pneumonia and pyelonephritis, Loracarbef should be administered for at least 14 days (Manufacturer recommendation)

Paed. forms avail. in SA and covered in this monograph: sus

Infections caused by: Gram-positive aerobic cocci (excluding enterococci and methicillin-resistant staphylococci); Gram-negative aerobic organisms (including E. coli, H. influenzae, Moraxella catarrhalis); Some anaerobes (including Peptostreptococcus)

Specific doses based on individual indications

Please note that the dosages below should be used in combination with regional guidelines, taking into account local antibiotic sensitivities

Pharyngitis
Tonsillitis
Skin infections

• Oral (sus): 15mg/kg/day, in 2 divided doses (Manufacturer recommendation)

Acute otitis media

• Oral (sus): 30mg/kg/day, in 2 divided doses (Manufacturer recommendation)

Should be administered on an empty stomach

In the treatment of otitis media, sinusitis, and S. pyogenes infections, Loracarbef should be administered for at least 10 days (Manufacturer recommendation)

In the treatment of pneumonia and pyelonephritis, Loracarbef should be administered for at least 14 days (Manufacturer recommendation)

See additional prescribing points

Pregnancy

• Contraindicated

Breastfeeding

• Contraindicated

Renal Impairment

• Mild to moderate: Caution; dose adjustment recommended  
• Severe: Contraindicated

Hepatic Impairment

• Caution; no information available

Elderly

• No dose adjustment recommended

Central Nervous System Disorders

• Headache
• Somnolence
• Nervousness
• Insomnia
• Dizziness
• Seizures

Cardiovascular Disorders

• Vasodilatation

Gastrointestinal Disorders

• Diarrhoea
• Nausea and vomiting
• Abdominal pain
• Anorexia

Hepatobiliary Disorders

• Elevated transaminases
• Elevated alkaline phosphatase
• Cholestasis

Genitourinary Disorders

• Elevated urea 
• Elevated creatinine
• Vaginitis
• Vaginal moniliasis
• Renal dysfunction
• Toxic nephropathy

Endocrine and Metabolic Disorders

• Elevated lactic dehydrogenase

Skin and Subcutaneous Tissue Disorders

• Rash
• Urticaria
• Pruritus
• Erythema multiforme
• Stevens-Johnson syndrome
• Toxic epidermal necrolysis

Immune, Blood and Lymphatic System Disorders

• Hypersensitivity reactions
• Transient thrombocytopenia
• Leucopenia
• Eosinophilia
• Anaphylaxis
• Prolongation of prothrombin time
• Aplastic anaemia
• Haemolytic anaemia
• Agranulocytosis
• Fever
• Pancytopenia
• Neutropenia

Probenecid

None routine

Administration directions

• To reconstitute, invert bottle and tap to loosen powder
• Add 30ml of water divided into two portions to the dry mixture in the bottle
• Shake well after each addition

Paediatric dosing

Loracarbef inhibits bacterial cell wall synthesis by binding to essential target proteins in the bacterial cell wall.

Spectrum of activity: Gram-positive aerobic cocci (excluding enterococci and methicillin-resistant staphylococci); Gram-negative aerobic organisms (including E. coli, H. influenzae, Moraxella catarrhalis); Some anaerobes (including Peptostreptococcus)

Capsule 200mg

• Lorabid (Pharmacare) originator

Suspension (per 5ml) 100mg

• Lorabid 100 P (Pharmacare) originator

Suspension (per 5ml) 200mg

• Lorabid 200 P (Pharmacare) originator