Mode of Excretion of Faropenem
Faropenem is primarily excreted renally, with the drug eliminated predominantly unchanged through the kidneys.
Primary Excretion Pathway
- Renal excretion is the dominant route for faropenem elimination, as evidenced by its dialyzability profile in hemodialysis patients 1
- The drug demonstrates measurable removal during hemodialysis sessions, with approximately 2% of faropenem removed from the body during a single HD session, confirming its renal elimination pathway 1
- Dialyzer clearance of faropenem was measured at 14.9 ± 6.8 mL/min per m² with an elimination fraction of 20.4 ± 9.9% during hemodialysis 1
Clinical Implications for Renal Impairment
- Dose adjustment is necessary in patients with significant renal dysfunction, as the kidneys serve as the primary elimination route 1
- In hemodialysis patients, plasma faropenem concentrations decreased from 4.8 ± 2.5 µg/mL before HD to 2.8 ± 1.0 µg/mL at the end of the HD session, demonstrating renal-dependent clearance 1
- Despite dialyzability, the relatively low removal rate (2% per session) suggests that supplemental dosing after hemodialysis may not be required for the standard 200 mg twice daily regimen 1
Practical Dosing Considerations
- The standard dosing regimen of faropenem 200 mg twice daily maintains therapeutic concentrations above the MIC₅₀ for major pathogens (0.015-2 µg/mL) even in hemodialysis patients 1
- No additional dosing at the end of hemodialysis sessions was needed to maintain clinical efficacy in infected HD patients 1
- The drug demonstrated effective clinical outcomes in both 3-day and 7-day treatment regimens for acute uncomplicated cystitis, with the 7-day regimen showing superior microbiological eradication rates (66.7% vs 58.9%) 2