Cefixime Administration with Food
Cefixime does not need to be taken with food and can be administered with or without meals. 1
Pharmacokinetic Evidence
The FDA drug label clearly states that cefixime tablets and suspension are approximately 40-50% absorbed whether administered with or without food 1. While food slightly delays the time to maximal absorption by approximately 0.8 hours, it does not significantly affect the overall drug absorption or peak serum concentrations 1.
Key pharmacokinetic findings:
- Bioavailability remains unchanged with or without food, maintaining approximately 50% absolute bioavailability 2
- Peak serum concentrations are not affected by food intake 1, 3
- Area under the curve (AUC) values remain similar in fed versus fasted states 3
- Time to peak concentration increases by approximately 1 hour when taken with food, but this delay is not clinically significant 3
Clinical Implications
A well-designed crossover study in 20 healthy volunteers demonstrated that both intrasubject and intersubject variability were minimal (less than 12% and 33% respectively) regardless of whether cefixime was taken in fasted or fed states 3. The terminal elimination half-life showed only a negligible difference between fed (3.6 hours) and fasted (3.5 hours) conditions 3.
Practical administration guidance:
- Patients may take cefixime with or without meals based on personal preference 1, 2
- No dosage adjustment is needed when switching between fed and fasted administration 3
- Food may help reduce gastrointestinal side effects in some patients, though this is not specifically required 1
Important Caveat
While food does not affect absorption, doxycycline (which may be co-administered with cefixime for certain infections) should be taken with 8 ounces of fluid and with food to reduce gastrointestinal intolerance and esophageal irritation 4. This distinction is important when cefixime is prescribed as part of combination therapy for gonococcal infections 4, 5.