1. What Zinoxime is and what it is used for 
Zinoxime is indicated for the treatment of the infections listed below in adults and children, including neonates (from birth).
- Community acquired pneumonia.
- Acute exacerbations of chronic bronchitis.
- Complicated urinary tract infections, including pyelonephritis.
- Soft-tissue infections: cellulitis, erysipelas and wound infections.
- Intra-abdominal infections. 
- Prophylaxis against infection in gastrointestinal (including oesophageal), orthopaedic, cardiovascular, and gynaecological surgery (including caesarean section).
In the treatment and prevention of infections in which it is very likely that anaerobic organisms will be encountered, cefuroxime should be administered with additional appropriate antibacterial agents.

2. Before you are given Zinoxime
Do not use Zinoxime
- If you are allergic (hypersensitive) to penicillin, any other antibiotics or any of the other ingredients.
- If you suffer from acute porphyria.
Take special care with Zinoxime if you
- Have kidney problems
- Are pregnant, think you may be pregnant, planning a family or breast-feeding.
Taking other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
Take care if you are taking any of the following medicines:
- Diuretics (water tablets).
- Probenecid (a drug used to treat gout).
- Anti-coagulants (medicines used to prevent blood clots).
- Oestrogens (oral contraceptives).
- Oral typhoid vaccine.
Pregnancy and breast-feeding
Ask your doctor or pharmacist for advice before taking any medicine.

3. How Zinoxime is given
Posology
Table 1. Adults and children ≥ 40 kg

Table 2. Children < 40 kg

Renal impairment
Cefuroxime is primarily excreted by the kidneys. Therefore, as with all such antibiotics, in patients with markedly impaired renal function it is recommended that the dosage of Zinoxime should be reduced to compensate for its slower excretion.
Table 3. Recommended doses for Zinoxime in renal impairment

Hepatic impairment
Cefuroxime is primarily eliminated by the kidney. In patients with hepatic dysfunction this is not expected to affect the  pharmacokinetics of cefuroxime.
Method of administration
Zinoxime should be administered by intravenous injection over 
a period of 3 to 5 minutes directly into a vein or via a drip tube or infusion over 30 to 60 minutes, or by deep intramuscular injection.
Intramuscular injections should be injected well within the bulk of a relatively large muscle and not more than 750 mg should be injected at one site. For doses greater than 1.5 g intravenous administration should be used. 
Reconstitution for injection:
The 750 mg IM injection: Mix the contents of one vial using 3 ml Sterile Water for injection to make an opaque suspension.
The 750 mg IV injection: Dissolve the contents of one vial using 6 ml Sterile Water for injection to form a clear, pale yellow to light brown colored solution.
The 1.5 g IV injection: Dissolve the contents of one vial using 15 ml Sterile Water for injection to form a clear, pale yellow to light brown colored solution.
If you are given more Zinoxime than you should
The following reactions and symptoms have been seen when very high doses of Zinoxime have been given by mistake or if large amounts of the medicine are accidentally swallowed: Irritation of the brain and shaking fits (convulsion).

4. Possible side effects
Like all medicines, Zinoxime can cause side-effects, although not everybody gets them.
If any of the following rare side effects occur, contact your doctor immediately.
Rare side effects include:
- Severe allergic reaction including puffiness of the eyelids, face or lips or swelling or redness of the tongue.
- Severe skin rash resembling burns and covering the whole body.
- Severe patchy skin rash also affecting eyes, nose, genitals and stomach, with headache, fever and joint pains.
- Severe diarrhea, and/or bloody diarrhoea which needs special treatment.
- Shortness of breath.
- Reduction in blood cell count.
- Anemia (resulting in tiredness, increased awareness of your heartbeat, dizziness and fainting).
- Liver problems or jaundice (yellowing of the skin).
- Kidney problems (indicated by a change in the frequency of urination, inability to urinate or pain on urination).
The following side-effects have been linked to this treatment:
- Skin rash or itchy skin.
- Unusual pains in the joints or difficulty in using muscles.
- Fever.
- Headache.
- Dizziness.
- Feeling of being too active.
- Nervousness.
- Disturbed sleep.
- Confusion.
- Diarrhea or change in bowel movements.
- Feeling or being sick.
- Pain in the stomach or chest.
- Pain at the site of injection.
Some bacteria may be resistant to cefuroxime. In these cases, your doctor may stop treatment with Zinoxime and change to a different antibiotic.
If any of the side-effects get serious or if you notice any side-effects not listed in this leaflet, please tell your doctor or pharmacist.

5. How to store Zinoxime
Keep out of reach of children.
Store below 30°C.
Keep contents in the carton until consumed.
After Reconstitution:
The reconstituted suspension or solution is stable for 24 hours at temperature below 30°C and 48 hours in a refrigerator (2-8°C).
After Dilution: 
The diluted solution for infusion should not be store longer than 6 hours at room temperature and 24 hours refrigerated between (2 – 8°C).
For single use only. Any remaining unused solution after reconstitution and dilution should be discarded.
From a microbiological point of view, the reconstituted and diluted solution should be used immediately. If not used immediately, in-use storage conditions are the responsibility of the user. 
Do not use beyond the expiry date or if the product shows any signs of deterioration.