loracarbef, Lorabid

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Pharmacy Author:

Omudhome Ogbru, PharmD

Omudhome Ogbru, PharmD

Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

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Medical and Pharmacy Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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GENERIC NAME: loracarbef

BRAND NAME: (Lorabid: This brand no longer is available in the U.S.)

DRUG CLASS AND MECHANISM: Loracarbef is a synthetic (man-made) oral antibiotic in the cephalosporin family of antibiotics. The cephalosporin family includes cephalexin (Keflex), cefaclor (Ceclor), cefuroxime (Zinacef), cefpodoxime (Vantin), cefprozil (Cefzil), and many injectable antibiotics. Like other cephalosporins, loracarbef stops bacteria from multiplying by preventing bacteria from forming the walls that surround them. The walls are necessary to protect bacteria from their environment and to keep the contents of the bacterial cell together; bacteria cannot survive without a cell wall. Loracarbef is effective against a wide variety of bacteria such as Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenzae, E. coli, and many others. Loracarbef was approved in December 1991.

PRESCRIPTION: Yes

GENERIC AVAILABLE: No

PREPARATIONS: Capsules: 200 and 400 mg. Suspension: 100 and 200 mg/5 ml.

STORAGE: Tablets and oral suspension may be stored at room temperature, 59° to 86°F (15° to 30°C) in a tightly closed container.

PRESCRIBED FOR: Loracarbef is effective against susceptible bacteria responsible for infections of the middle ear, tonsils, throat, larynx (laryngitis), bronchi (bronchitis), and sinuses as well as pneumonia. It also is used for treating urinary tract and skin infections.

DOSING: The recommended dose for adults is 200-400 mg every 12 hours.

DRUG INTERACTIONS: Probenecid (Benemid) may increase the concentration of loracarbef in the blood by decreasing excretion of loracarbef by the kidney. This interaction is sometimes used to enhance the effect of cephalosporins.

PREGNANCY: Safe use during pregnancy has not been established.

NURSING MOTHERS: Safe use in nursing mothers has not been established.

SIDE EFFECTS: Loracarbef is generally well tolerated, and side effects are usually transient. More common side effects include nausea, abdominal pain, vomiting, skin rash, abnormal liver tests, vaginitis, itching, headaches, and dizziness.

Loracarbef should be avoided by patients with a known allergy to other cephalosporin antibiotics. Since loracarbef is chemically related to penicillin, an occasional patient can have an allergic reaction (sometimes even life threatening anaphylaxis) to both medications. Treatment with loracarbef and other antibiotics can alter the normal bacteria flora of the colon and permit overgrowth of the bacterium, Clostridium difficile, in the colon. This may lead to inflammation of the colon known as C. difficile or pseudo-membranous colitis. Patients who develop pseudo-membranous colitis as a result of antibiotic treatment can experience diarrhea, abdominal pain, fever, and sometimes even shock.

Reference: FDA Prescribing Information

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