Suprax
In brief
- Suprax (cefixime) is a prescriptionâonly medicine in the UK.
- Suprax (cefixime) is used to treat bacterial infections such as uncomplicated urinary tract infections, otitis media, pharyngitis/tonsillitis, acute bronchitis and uncomplicated gonorrhoea. It is a thirdâgeneration cephalosporin antibiotic that works by inhibiting bacterial cellâwall synthesis through binding to penicillinâbinding proteins.
- Usual adult dosage: 400 mg once daily or 200 mg every 12 hours; for certain indications a single 400 mg dose may be used (eg, uncomplicated gonorrhoea). Paediatric dosing: approximately 8 mg/kg once daily or 4 mg/kg every 12 hours (depending on formulation and age); typical treatment courses are 5â10 days. Reduce dose by about 50% if creatinine clearance is below 60 mL/min; not recommended for infants under 6 months without specialist advice.
- Administered orally as tablets, capsules, chewable tablets or as an oral suspension (powder for reconstitution) for paediatric use.
- Many people begin to notice symptomatic improvement within 24â48 hours of starting therapy, though some symptoms may take longer to resolve; if no improvement is seen within 48â72 hours, seek medical review.
- The clinical effect is generally maintained with onceâdaily dosing (400 mg) for 24 hours; the elimination halfâlife is roughly 3â4 hours in adults, so treatment is typically continued for 5â10 days depending on the infection.
- There is no specific contraindication to moderate alcohol consumption reported for cefixime, but alcohol may worsen gastrointestinal side effects and slow recoveryâavoiding alcohol while unwell and while taking antibiotics is advisable.
- The most common side effect is diarrhoea (including loose or frequent stools); other common effects include abdominal pain, flatulence, nausea and rash. Serious but rare reactions include severe allergic reactions, StevensâJohnson syndrome and Clostridioides difficile colitis.
- Would you like to try Suprax without a prescription?
Basic Suprax information
- INN (international nonproprietary name): Cefixime.
- ATC code: J01DD08.
- Forms and strengths: 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 (Rx).
Legal status and availability in the UK
In our online pharmacy, Suprax is available without a prescription, with discreet delivery to the United Kingdom in 9â21 days.
Clinical effectiveness in the UK
People often want to know how quickly Suprax works in NHS practice.
Within NHS practice cefixime shows consistent clinical benefit for specific bacterial infections when used per guidance.
Common responsive conditions include uncomplicated UTI, paediatric otitis media, and select respiratory infections where oral thirdâgeneration coverage is indicated.
Symptoms of infections that respond to cefixime usually improve within 48â72 hours.
Treatment failures are recorded when resistance is present or when the drug is used for an incorrect indication.
Side effects are mainly mild gastrointestinal upset, occasional rash and rare severe hypersensitivity.
Clinician notes emphasise renal function checks in older patients and dose adjustment guidance, specifically reducing dose by 50% if creatinine clearance is less than 60 mL/min.
Indications and expanded uses
Patients ask whether Suprax is suitable for common infections seen in primary care.
MHRA and national formularies list cefixime primarily for systemic bacterial infections where an oral thirdâgeneration cephalosporin is appropriate.
Common MHRA/NHS uses include uncomplicated urinary tract infections, acute otitis media, pharyngitis and selected respiratory infections.
Cefixime is also used as a single 400 mg dose in some gonorrhoea presentations, where local STI guidance permits.
Typical adult regimens are 400 mg once daily or 200 mg twice daily, with paediatric weightâbased dosing of approximately 8 mg/kg once daily.
Offâlabel uses in UK practice are limited and typically reserved for patients with severe penicillin allergy who still require cephalosporin coverage or for specific outpatient scenarios under consultant oversight.
Avoid empirical use for viral upper respiratory infections.
| Indication | Usual adult dose | Paediatric dose | Typical duration |
|---|---|---|---|
| Uncomplicated UTI | 400 mg once daily or 200 mg twice daily | 8 mg/kg once daily or 4 mg/kg twice daily | 5â7 days |
| Otitis media | 400 mg once daily | 8 mg/kg once daily | 5â10 days |
| Pharyngitis/tonsillitis | 400 mg once daily | 8 mg/kg once daily | 5â10 days |
| Gonorrhoea (singleâdose therapy where indicated) | 400 mg single dose | â | Single dose |
Composition and brand landscape
People sometimes wonder whether Suprax is different from generic cefixime.
The active ingredient is cefixime, a thirdâgeneration cephalosporin (ATC J01DD08).
Suprax is a recognised brand name; generic cefixime is also made by manufacturers such as Egis, Krka and Teva.
Available forms include tablets (commonly 400 mg), chewable tablets (100 mg/200 mg), capsules and paediatric oral suspensions (100 mg/5 mL and 200 mg/5 mL).
Packaging varies between blister packs for tablets and bottles for suspensions.
Storage guidance is standard: tablets at 15â30°C and reconstituted suspension refrigerated and used within 14 days.
| Form | Strengths | Supplier |
|---|---|---|
| Tablets | 400 mg | Generic suppliers (various manufacturers) |
| Chewable tablets | 100 mg, 200 mg | Generic suppliers |
| Oral suspension | 100 mg/5 mL, 200 mg/5 mL | Generic suppliers |
- INN vs brand: INN is cefixime; Suprax is a brand name used internationally.
- WHO essential medicines list: Cefixime is included, reflecting its clinical importance.
Contraindications and special precautions
Before supplying Suprax pharmacists must screen for allergy and highârisk features.
Absolute contraindications include known severe hypersensitivity to cefixime, other cephalosporins or formulation excipients.
A history of severe penicillin allergy should raise caution because of potential crossâreactivity.
Highârisk groups include elderly patients with reduced renal function, pregnant people and infants under six months where safety is not established.
Reduce dose by about 50% if creatinine clearance is below 60 mL/min.
Use with caution in patients with a history of gastrointestinal disease, particularly inflammatory bowel disease, because of the risk of C. difficile superinfection.
Monitor for severe cutaneous adverse reactions and advise immediate review if rash or systemic symptoms develop.
- Screening checklist: known cephalosporin or severe penicillin allergy; current renal impairment; under six months of age; pregnancy or breastfeeding; history of colitis or C. difficile.
- Lifestyle advice: no formal driving restriction, but avoid driving if dizziness occurs; avoid excessive alcohol while unwell.
Dosage guidelines
Patients commonly ask whether they should take Suprax once or twice daily.
Standard NHSâaligned adult dosing is 400 mg once daily or 200 mg twice daily for most indications.
A single 400 mg dose is used for certain uncomplicated gonorrhoea presentations where guidance allows.
Paediatric dosing is typically 8 mg/kg once daily or 4 mg/kg every 12 hours for children aged six months to 12 years.
Suspension formulations of 100 mg/5 mL and 200 mg/5 mL are preferred for children for dose accuracy.
For renal impairment reduce the dose by 50% if creatinine clearance is under 60 mL/min, and monitor renal function in elderly patients.
Typical durations range from 5 to 10 days depending on the indication, except singleâdose regimens where applicable.
If a dose is missed, take it as soon as remembered unless the next dose is near; do not double up.
| Indication | Adult dose | Paediatric dose | Duration |
|---|---|---|---|
| Uncomplicated UTI | 400 mg once daily or 200 mg twice daily | 8 mg/kg once daily | 5â7 days |
| Otitis media | 400 mg once daily | 8 mg/kg once daily | 5â10 days |
| Gonorrhoea | 400 mg single dose | â | Single dose |
Interactions overview
Patients often worry about food, alcohol and other medicines with Suprax.
Cefixime has relatively few pharmacokinetic interactions compared with many antibiotics.
Absorption is best on an empty stomach, although many patients take it with food without major issues.
No disulfiramâlike interaction with alcohol is documented, but alcohol may exacerbate gastrointestinal side effects.
Concurrent use with other nephrotoxic agents calls for renal monitoring.
Coâadministration with some bacteriostatic antibiotics may be antagonistic in vitro, so check local guidance before combining.
Yellow Card reports and UK pharmacovigilance note that broadâspectrum antibiotic combinations can increase the risk of C. difficile.
Review all patient medicines for anticoagulants and oral contraceptives, and advise patients to report unexpected bleeding or contraceptive concerns.
| Drug class | Interaction | Clinical action |
|---|---|---|
| Nephrotoxic agents | Increased renal risk | Monitor renal function; adjust dose if required |
| Bacteriostatic antibiotics | Potential in vitro antagonism | Avoid combination unless clinically justified |
| Alcohol | No major PK interaction | Advise to avoid excess alcohol while unwell |
Comparable medicines and preferences
Clinicians weigh cefixime against alternatives when choosing empirical or targeted therapy.
Common alternatives in NHS practice include cefpodoxime, cefuroxime and amoxicillin/clavulanate.
Choice depends on suspected pathogen, local AMR patterns and patient allergy history.
Cefixime advantages include oral thirdâgeneration coverage, onceâdaily dosing options and convenient paediatric suspensions.
Downsides include a broader spectrum than narrowâspectrum agents and stewardship concerns given resistance pressures.
For gonorrhoea, many UK STI services now favour dual or susceptibilityâguided therapy rather than empirical oral cefixime alone.
- Pros: effective oral option for specific infections; convenient dosing; WHOâlisted medicine.
- Cons: broader spectrum raises AMR concerns; limited activity against some resistant Enterobacterales.
| Situation | Preferred alternative | Rationale |
|---|---|---|
| Suspected pathogen covered by a narrowâspectrum agent | Amoxicillin | Less broad spectrum, stewardship advantage |
| Penicillin allergy needing an oral cephalosporin | Cefuroxime or cefpodoxime (caseâbyâcase) | Consider allergy crossâreactivity and local guidance |
FAQ
- Is Suprax the same as cefixime?
Yes, Suprax is a brand name; the active ingredient is cefixime.
- Can children take Suprax suspension?
Yes, paediatric oral suspensions are available in 100 mg/5 mL and 200 mg/5 mL strengths with weightâbased dosing of about 8 mg/kg once daily, but not recommended under six months.
- Do I need a prescription?
Yes, cefixime is a prescriptionâonly medicine in the UK; obtain this from a GP, urgent care service or via electronic prescription to a pharmacy.
- What if I miss a dose or vomit after taking it?
Take a missed dose as soon as you remember unless the next dose is due soon; do not double up.
If vomiting occurs within one hour of dose, contact your prescriber for advice.
Guidelines for proper use
Pharmacists regularly counsel patients on safe and effective antibiotic use.
Confirm the indication and allergy history, especially penicillin and cephalosporin reactions, before dispensing.
Verify renal function in elderly patients and advise dose adjustment if creatinine clearance is under 60 mL/min.
Explain the dosing schedule, storage and reconstitution steps for suspensions.
Advise patients to refrigerate reconstituted suspension and discard after 14 days.
Emphasise adherence and the importance of completing the prescribed course even if symptoms improve.
Advise prompt medical review for severe rash, breathing difficulty or bloody diarrhoea.
Signpost NHS 111 and the NHS App for triage and the MHRA Yellow Card scheme for adverseâevent reporting.
- Pharmacist quickâcheck: confirm indication; check allergies; review current medicines; show reconstitution and storage; document counselling.
- Patient leaflet points: dose and timing; what to do for missed doses; storage; warning signs to seek help.
Delivery across the United Kingdom
| City | Region | Delivery Time |
|---|---|---|
| London | England | 9â21 days |
| Birmingham | England | 9â21 days |
| Manchester | England | 9â21 days |
| Glasgow | Scotland | 9â21 days |
| Liverpool | England | 9â21 days |
| Leeds | England | 9â21 days |
| Sheffield | England | 9â21 days |
| Newcastle Upon Tyne | England | 9â21 days |
| Bristol | England | 9â21 days |
| Cardiff | Wales | 9â21 days |
| Belfast | Northern Ireland | 9â21 days |
| Nottingham | England | 9â21 days |
| Plymouth | England | 9â21 days |
