Sodium Content of Cefepime
Cefepime contains approximately 73 mg (3.2 mEq) of sodium per gram of cefepime activity.
Pharmaceutical Formulation Details
The sodium content in cefepime is clinically relevant because:
- Each gram of cefepime contains approximately 73 mg of sodium 1
- This translates to approximately 3.2 mEq of sodium per gram of cefepime 1
- The sodium is present as part of the L-arginine formulation used to stabilize the cefepime molecule 1
Clinical Implications
Dosing Considerations for Sodium Load
When prescribing cefepime, calculate total sodium exposure based on the dosing regimen:
- Standard dosing of 2 g every 8-12 hours delivers 146-219 mg (6.4-9.6 mEq) of sodium per day 2
- Higher doses of 2 g every 8 hours (6 g daily) provide approximately 438 mg (19.2 mEq) of sodium daily 2
- Pediatric dosing at 100-150 mg/kg/day results in proportionally lower sodium loads 3
Patient Populations Requiring Monitoring
The sodium content warrants particular attention in:
- Patients with heart failure where sodium restriction is critical 1
- Patients with renal impairment who may have difficulty excreting sodium loads 1, 4
- Patients on fluid restriction where cumulative sodium from multiple medications matters 1
- Critically ill ICU patients receiving multiple sodium-containing medications and fluids 2
Practical Considerations
- The sodium content of cefepime is relatively modest compared to some other beta-lactams like piperacillin-tazobactam 1, 5
- For most patients without significant cardiac or renal disease, the sodium load from cefepime is clinically insignificant 4, 5
- In patients requiring strict sodium restriction (<2 g/day), account for the 146-438 mg daily sodium contribution from standard cefepime regimens 1