Suprax
In brief
- Cefixime (Suprax) is a prescription-only medicine (POM) in the UK.
- Suprax (cefixime) is a third‑generation cephalosporin antibiotic used to treat bacterial infections such as uncomplicated urinary tract infections, otitis media, pharyngitis/tonsillitis, gonorrhoea and acute bronchitis; it works by inhibiting bacterial cell‑wall synthesis through binding to penicillin‑binding proteins, causing bacterial cell death.
- Usual dosage: Adults — 400 mg once daily or 200 mg every 12 hours (single 400 mg dose may be used for uncomplicated gonorrhoea); Children (≥6 months) — approximately 8 mg/kg once daily or 4 mg/kg every 12 hours (use appropriate chewable tablet or suspension strengths); reduce dose by about 50% if creatinine clearance is <60 mL/min; not established for infants under 6 months.
- Form of administration: oral — tablets (400 mg), capsules (400 mg), chewable tablets (100 mg, 200 mg) and oral suspension (100 mg/5 mL, 200 mg/5 mL).
- Onset time: bactericidal activity begins shortly after the first dose, but clinical symptom improvement is usually noticed within 48–72 hours.
- Duration of action: plasma half‑life is about 3–4 hours; drug concentrations are sustained sufficiently for once‑daily dosing in many regimens; typical treatment courses last 5–10 days (single dose for specific indications like gonorrhoea).
- Alcohol warning: no specific disulfiram‑like interaction is reported with cefixime, but avoid alcohol as it can worsen gastrointestinal side effects and hinder recovery.
- The most common side effect is diarrhoea.
- Would you like to try Suprax without a prescription?
Legal status and availability in the UK
Suprax (cefixime) is a prescription-only medicine (POM) in the UK.
In our online pharmacy, Suprax is available without a prescription, with discreet delivery to the United Kingdom in 9–21 days.
Basic Suprax information
- INN (international nonproprietary name): Cefixime.
- Brand names available in the United Kingdom: Suprax; generic cefixime.
- ATC code: J01DD08.
- Forms and dosages: Tablets 400 mg; capsules 400 mg; chewable tablets 100 mg and 200 mg; oral suspension 100 mg/5 mL and 200 mg/5 mL.
- OTC / Rx classification: Prescription-only medicine (POM)
Availability
Suprax (cefixime) is supplied by UK pharmacies against a prescription in 400 mg tablets, chewable strengths and paediatric suspensions. Generic cefixime is also available.
Product basics: what Suprax is and how it works
INN, class and mechanism
Cefixime is the International Nonproprietary Name for Suprax.
It is a third-generation systemic cephalosporin with ATC code J01DD08.
Cefixime works by inhibiting bacterial cell-wall synthesis through binding to penicillin-binding proteins.
This action produces bactericidal effects against a range of Gram-negative and some Gram-positive pathogens.
Forms and standard strengths
Available forms include tablets and capsules at 400 mg strength, chewable tablets at 100 mg and 200 mg, and oral suspensions at 100 mg/5 mL and 200 mg/5 mL.
Chewable tablets and flavoured suspensions are useful paediatric options to improve adherence.
Indications and typical regimens
Common adult indications and dosing
Cefixime is indicated for uncomplicated urinary tract infections, otitis media, pharyngitis/tonsillitis, and acute bronchitis when a bacterial cause is likely.
It is also used as a single 400 mg dose for uncomplicated gonorrhoea (cervical or urethral infection).
Standard adult dosing is 400 mg once daily or 200 mg twice daily, depending on clinical judgement and formulation.
Treatment duration usually ranges from 5 to 10 days according to the indication and severity.
Paediatric dosing overview
Children aged 6 months to 12 years typically receive 8 mg/kg once daily or 4 mg/kg every 12 hours.
Chewable tablets and suspension formulations help with adherence and accurate dosing.
Safety and efficacy are not established for children under 6 months and the medicine should be avoided in that age group.
| Indication | Adult dose | Paediatric dose | Typical duration |
|---|---|---|---|
| Uncomplicated UTI | 400 mg once daily or 200 mg q12h | 8 mg/kg once daily or 4 mg/kg q12h | 5–7 days |
| Otitis media | 400 mg once daily | 8 mg/kg once daily | 5–10 days |
| Pharyngitis/tonsillitis | 400 mg once daily | 8 mg/kg once daily | 5–10 days |
| Gonorrhoea | 400 mg single dose | Not applicable | Single dose |
Manufacturers
Suprax is marketed under the Suprax brand and as generic cefixime. Manufacturers include Lupin, Aurobindo, Cipla, Dr Reddy’s, Teva and Krka.
In the UK, exact brand availability varies by supplier.
Legal classification in the UK
Cefixime is a prescription-only medicine (POM) in the UK and should be dispensed on presentation of a valid prescription.
MHRA-registered generics are normally available.
Dosing adjustments: renal and hepatic considerations
Renal impairment and elderly
Reduce the cefixime dose by 50% when creatinine clearance is under 60 mL/min.
Elderly patients do not have a routine dose change but frequently need renal monitoring due to age-related decline in clearance.
Specialist advice is needed for severe impairment.
Hepatic impairment and special populations
No specific hepatic dose adjustment is reported, but monitor patients with severe hepatic dysfunction.
Cefixime should be used in pregnancy only if clearly indicated and after risk–benefit assessment.
Children under 6 months are not recommended to receive cefixime because safety and efficacy are not established in that age group.
How to take Suprax
Practical administration instructions
Oral cefixime may be taken with or without food, and doses should be taken at consistent times each day.
For paediatric suspensions, reconstitute exactly as the manufacturer instructs, shake well before use and measure doses with an oral syringe for accuracy.
Complete the full prescribed course even if symptoms improve early to reduce resistance risk.
Missed dose and overdose guidance
If a dose is missed, take it as soon as remembered unless the next dose is imminent; do not double up to make up a missed dose.
In case of suspected overdose, management is supportive; contact NHS 111, or 999 in an emergency.
Contraindications, precautions and drug interactions
Absolute and relative contraindications
Absolute contraindication is known severe hypersensitivity to cefixime, other cephalosporins, or any excipients in the formulation.
A history of a severe penicillin allergy is a relative contraindication due to potential cross-reactivity and warrants careful assessment.
Patients with severe gastrointestinal disease, especially a history of colitis, need caution because of the risk of Clostridioides difficile superinfection.
Interactions and monitoring
Interactions are limited, but co-administration with nephrotoxic agents requires renal monitoring.
Patients on oral anticoagulants may need INR monitoring if clinically relevant interactions are suspected.
Side effects, severity and reporting
Common and less common adverse effects
Common side effects include diarrhoea, abdominal pain, flatulence, nausea and headache.
Rash and pruritus may occur and more serious but rare events include anaphylaxis, Stevens-Johnson syndrome, blood dyscrasias and C. difficile colitis.
New rashes or significant gastrointestinal symptoms should be reported promptly.
Management and Yellow Card reporting
Stop the medicine and seek urgent care if there are signs of a severe allergic reaction such as breathing difficulty, swelling or severe skin lesions.
Less severe side effects can usually be managed symptomatically, but prescribers should be informed of persistent problems.
Suspected adverse drug reactions should be reported via the MHRA Yellow Card scheme and the prescriber notified.
- Triage guidance: mild diarrhoea and nausea — monitor and advise hydration; severe diarrhoea, blood in stools or dehydration — seek urgent medical assessment.
Alternatives to Suprax
Situational choices
Comparable oral cephalosporins include cefpodoxime and cefuroxime, while amoxicillin/clavulanate (Augmentin) is a commonly used alternative with a different spectrum.
Choice depends on local resistance patterns, allergy history, site of infection and dosing convenience.
Cefixime offers once-daily dosing options and reasonable community pathogen coverage but may be less active than some alternatives for particular organisms.
Resistance and stewardship
Antimicrobial stewardship requires targeted use only for likely bacterial infections and culture-directed therapy where possible.
| Agent | Typical spectrum | Dosing frequency |
|---|---|---|
| Cefixime (Suprax) | Gram-negative, some Gram-positive | Once or twice daily |
| Cefuroxime | Broader in some Gram-positive infections | Twice daily |
| Amoxicillin/clavulanate | Broad-spectrum including beta-lactamase producers | Twice daily |
Paediatric guidance for carers
Formulations, dosing and administration aids
Use the suspension formulations 100 mg/5 mL or 200 mg/5 mL and chewable tablets 100 mg or 200 mg for child-friendly dosing.
Doses are weight-based. Use an oral syringe for exact measurements and shake the suspension well before each dose.
Safety notes for children
Children under 6 months should not receive cefixime as safety and efficacy have not been established in that age group.
Common paediatric side effects include diarrhoea and mild rash; keep up fluid intake and seek review if symptoms persist.
Seek urgent advice for severe diarrhoea, signs of dehydration, high fever or any suspected allergic reaction.
Renal impairment and elderly: dose adjustment
Dosing chart and monitoring
Dosing rule: creatinine clearance (CrCl) ≥60 mL/min — standard dosing; CrCl <60 mL/min — reduce dose by 50%.
Dialysis dosing requires specialist advice and individual assessment.
| Renal function | Recommended action |
|---|---|
| CrCl ≥60 mL/min | Standard adult/paediatric dosing |
| CrCl <60 mL/min | Reduce dose by 50% or follow renal dosing chart |
| On dialysis | Seek specialist nephrology advice |
Storage and disposal
Correct storage and shelf‑life
Tablets and capsules should be stored at room temperature between 15–30°C and protected from moisture.
Unreconstituted suspensions may be stored at room temperature, but once reconstituted refrigerate and discard any unused medicine after 14 days.
Disposal
Unused antibiotics should be returned to a pharmacy for safe disposal rather than thrown away or stockpiled at home. Do not flush them.
Delivery across the United Kingdom
| City | Region | Delivery Time |
|---|---|---|
| London | Greater London | 9–21 days |
| Birmingham | West Midlands | 9–21 days |
| Manchester | Greater Manchester | 9–21 days |
| Glasgow | Scotland | 9–21 days |
| Leeds | West Yorkshire | 9–21 days |
| Cardiff | Wales | 9–21 days |
| Belfast | Northern Ireland | 9–21 days |
| Newcastle | Tyne and Wear | 9–21 days |
| Southampton | South East | 9–21 days |
| Plymouth | South West | 9–21 days |
| Norwich | East of England | 9–21 days |
| Exeter | South West | 9–21 days |
| Stoke-on-Trent | Staffordshire | 9–21 days |
| Hull | East Yorkshire | 9–21 days |
