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Brand Name :
Fetroja
(United States) [Available]Synonyms :
cefiderocol 
Class :
Cephalosporins, Other
Brand Name :
Fetroja
(United States) [Available]Synonyms :
cefiderocol 
Class :
Cephalosporins, Other
Dosage Forms & Strengths Â
Injection, lyophilized powder of reconstitution Â
1g Â
Pyelonephritis: Â
2 g IV given every 8hrs for 7-14 days Â
Urinary Tract Infection: Â
2 g IV given every 8hrs for 7-14 days Â
Nosocomial Pneumonia: Â
2 g IV given every 8hrs for 7-14 days Â
Renal Dose Adjustments: Â
2 g IV every 6hrs CrCl at least 120 ml per minute 
1.5 g IV every 8hrs estimated CrCl 30 to 59 ml per minute 
1 g IV every 8hrs estimated CrCl 15 to 29 ml per minute 
0.75 g IV every 12hrs estimated CrCl less than 15 ml per minute without intermittent hemodialysis Â
Liver Dose Adjustments: Â
No adjustment recommended Â
 Â
2
g
Intravenous (IV)
every 8 hrs
7 - 14
days
2
g
Intravenous (IV)
every 8 hrs
7 - 14
days
2
g
Intravenous (IV)
every 8 hrs
7 - 14
days
Dose Adjustments
Renal Dose Adjustments:
2 g IV every 6hrs CrCl at least 120 ml per minute
1.5 g IV every 8hrs estimated CrCl 30 to 59 ml per minute
1 g IV every 8hrs estimated CrCl 15 to 29 ml per minute
0.75 g IV every 12hrs estimated CrCl less than 15 ml per minute without intermittent hemodialysis
Liver Dose Adjustments:
No adjustment recommended
may enhance the serum concentration of each other when combined
may enhance the serum concentration of each other when combined
may enhance the serum concentration of each other when combined
may enhance the serum concentration of each other when combined
may enhance the serum concentration of each other when combined
may diminish the rate of excretion leading to a higher serum level
may diminish the rate of excretion leading to a higher serum level
may diminish the rate of excretion leading to a higher serum level
may diminish the rate of excretion leading to a higher serum level
may diminish the rate of excretion leading to a higher serum level
may diminish the rate of excretion leading to a higher serum level
may diminish the rate of excretion leading to a higher serum level
may diminish the rate of excretion leading to a higher serum level
may diminish the rate of excretion leading to a higher serum level
may diminish the rate of excretion leading to a higher serum level
when both drugs are combined, there may be a reduced blood level of berotralstat  
when both drugs are combined, there may be an increased risk of seizures   
when both drugs are combined, there may be a reduced blood level of butorphanol  
may diminish the rate of excretion which results in higher serum level
may diminish the rate of excretion which results in higher serum level
may diminish the rate of excretion which results in higher serum level
may diminish the rate of excretion which results in higher serum level
may diminish the rate of excretion which results in higher serum level
when both drugs are combined, there may be a reduced blood level of acalabrutinib  
when both drugs are combined, there may be an increased risk of seizures  
when both drugs are combined, there may be an increased risk or severity of adverse effects  
when both drugs are combined, there may be an increased risk or severity of adverse effects  
when both drugs are combined, there may be an increased risk or severity of adverse effects  
cephalosporins increase the effect of anticoagulation of vitamin K antagonists
cephalosporins increase the effect of anticoagulation of vitamin K antagonists
cephalosporins increase the effect of anticoagulation of vitamin K antagonists
cephalosporins increase the effect of anticoagulation of vitamin K antagonists
cephalosporins increase the effect of anticoagulation of vitamin K antagonists
may enhance the nephrotoxic effect of aminoglycosides
may enhance the nephrotoxic effect of aminoglycosides
may enhance the nephrotoxic effect of aminoglycosides
may enhance the nephrotoxic effect of aminoglycosides
may enhance the nephrotoxic effect of aminoglycosides
they increase the effect of nephrotoxicity of aminoglycosides
neomycin/polymyxin B/bacitracin topical
they increase the effect of nephrotoxicity of aminoglycosides
It may enhance the risk of adverse effects when combined with Barbiturates
It may enhance the risk of adverse effects when combined with Barbiturates
It may enhance the risk of adverse effects when combined with Barbiturates
It may enhance the risk of adverse effects when combined with Barbiturates
It may enhance the risk of adverse effects when combined with Barbiturates
may diminish the rate of excretion which results in higher serum level
may diminish the rate of excretion which results in higher serum level
may diminish the rate of excretion which results in higher serum level
may diminish the rate of excretion which results in higher serum level
may diminish the rate of excretion which results in higher serum level
cephalosporins increase the nephrotoxicity of aminoglycosides
cephalosporins increase the nephrotoxicity of aminoglycosides
cephalosporins increase the nephrotoxicity of aminoglycosides
cephalosporins increase the nephrotoxicity of aminoglycosides
cephalosporins increase the nephrotoxicity of aminoglycosides
it increases the nephrotoxicity of cephalosporins
it increases the concentration of cephalosporins in the serum
may increase the nephrotoxic effect
may enhance the adverse/toxic effect of rifampin
It may enhance the risk of adverse effects when combined with Cephalosporins
may increase the nephrotoxic effect of cephalosporins
neomycin/polymyxin B/bacitracin topical
may increase the nephrotoxic effect of cephalosporins
may increase the anticoagulant effect of cephalosporins
may increase the anticoagulant effect of cephalosporins
may increase the anticoagulant effect of cephalosporins
may increase the anticoagulant effect of cephalosporins
may increase the anticoagulant effect of cephalosporins
when both drugs are combined, there may be an increased risk of seizures 
Cefiderocol works by attaching itself to penicillin-binding proteins (PBPs), blocking the formation of the bacterial cell wall, and killing the cell.Â
Cefiderocol can be actively transported into bacterial cells via iron channels in the outer cell membrane, such as those that are expressed by the PiuA gene in P. aeruginosa or the cirA and fiu genes in E. coli, once it has coupled to ferric iron.Â
Adverse drug reactions: Â
Frequency defined Â
>10% Â
Elevated liver tests Â
Hypokalemia Â
1-10% Â
Increased ALT Â
increased GGT Â
increased AST Â
abnormal hepatic function Â
Hypomagnesemia Â
Diarrhea Â
vomiting Â
nausea Â
constipation Â
Frequency not defined Â
Cholelithiasis Â
cholecystitis Â
gallbladder pain Â
Cholestasis Â
Decreased appetite Â
hypocalcemia Â
fluid overload Â
hyperkalemia Â
Abdominal pain Â
dry mouth Â
stomatitis Â
C difficile-associated diarrhea Â
oral candidiasis Â
NoneÂ
Contraindication:Â
Severe hypersensitivityÂ
Caution:Â
Increased Mortality in Certain PatientsÂ
Use in Severe InfectionsÂ
Hypersensitivity ReactionsÂ
Clostridioides difficile-Associated DiarrheaÂ
Pregnancy warnings:   Â
Breastfeeding warnings:Â
Pregnancy Categories:     Â
Â
It penetrates the outer membrane of Gram-negative bacteria by chelating iron and using bacterial iron absorption mechanisms.Â
The primary target of cefiderocol’s effectiveness has been aerobic Gram-negative bacteria.Â
Cefiderocol also binds and inhibits PBP1a, 1b, 2, and 4, however these molecules are less potent than PBP3 and should therefore have a smaller impact on the antibacterial action of cefiderocol.Â
The reconstituted solution must be diluted in the proper infusion solution before being used for intravenous infusion.Â
When solution and container allow, visually check parenteral medication products for discoloration and particle debris before administering.Â
Administration though intravenous infusion only and infuse over 3 hours.Â
Patient Information Leaflet Â
Generic Name: Cefiderocol (Rx) Â
Pronounced: SEF-i-DER-oh-kolÂ
Why do we use Cefiderocol?Â
A complex urinary tract infection, with or without pyelonephritis is treated with cefiderocol.Â
It is used for treatment of hospital-acquired and ventilator-associated bacterial pneumonia caused by susceptible Gram-negative microorganisms.Â
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