7 Suprax Side Effects You Should Know About

Suprax (cefixime) is an antibiotic medication used for many types of bacterial infections. A few examples include urinary tract infections, ear infections, and some sexually transmitted infections. Suprax works by killing the bacteria that cause these infections. It’s FDA approved for use in adults and children ages 6 months and older.

Suprax is part of a group of antibiotics known as cephalosporins. It’s available as a capsule, chewable tablet, and oral liquid. The capsule and oral liquid are available as brand-name and generic products. The chewable tablet is brand-name only. 

Like all antibiotics, Suprax has possible side effects to be aware of. Some are usually mild, like diarrhea or nausea. But others can be more serious and may require immediate medical attention. Below, we’ll discuss seven of the most common Suprax side effects. But keep in mind, this isn’t a complete list. If you have further questions about Suprax side effects, talk to your healthcare provider. 

1. Diarrhea

Diarrhea is the most common Suprax side effect. It’s defined as having loose, watery stools that occur more than 3 times a day. In clinical studies, diarrhea occurred in up to 16% of people taking Suprax. 

Thankfully, diarrhea from Suprax usually resolves after you finish the antibiotic. In the meantime, make sure to drink plenty of fluids. This can help prevent dehydration from diarrhea. And talk to your healthcare provider about over-the-counter (OTC) antidiarrheal medications. Products like loperamide (Imodium A-D) or Pepto-Bismol (bismuth subsalicylate) may help when needed. Or they may recommend changing to a different antibiotic with a lower risk of diarrhea. 

If you experience bothersome diarrhea from Suprax, let your provider know. Diarrhea can be a sign of an infection called Clostridioides difficile (C. diff) associated diarrhea (CDAD). C. diff can happen with nearly any antibiotic. Along with watery diarrhea, other symptoms that might indicate C. diff include fever and abdominal cramps. And it can happen even after you’ve finished taking an antibiotic (up to 2 months later).

More serious symptoms of C. diff include dehydration, sepsis, and swelling of the colon. If you need Suprax for a long time or have recently used other antibiotics, CDAD may be more likely.

Treatment for C. diff infection usually includes stopping your antibiotic right away. Your provider may also prescribe specific antibiotics to treat C. diff. These include oral vancomycin (Vancocin), metronidazole (Flagyl), or fidaxomicin (Dificid). While probiotics may help prevent C. diff, they aren’t recommended for an active C. diff infection.

2. Nausea

Nausea is another common gastrointestinal (GI) side effect of Suprax. About 7% of people taking Suprax report nausea. 

Suprax can be taken with or without food, but taking it with food may help lessen nausea. It may also help to eat smaller meals frequently throughout the day. When you eat, choosing bland foods — such as low-fat dairy products, white bread and crackers, and peanut butter — might also help. 

If your nausea continues to bother you, talk to your healthcare provider. They might recommend OTC medications to help manage nausea. Examples include Dramamine (dimenhydrinate) or Bonine (meclizine). 

3. Stomach upset

Stomach pain and indigestion are other possible side effects of Suprax. Just like with nausea, eating a bland diet may help. Or, your healthcare provider may recommend OTC antacids. Examples include Tums (calcium carbonate) or Rolaids (calcium carbonate/magnesium hydroxide).

Gas may also occur with Suprax. To help with gas, try eating slower and avoid being “on the go” while you’re eating. Having smaller (but frequent) meals throughout the day can also relieve gas. Taking a short walk after eating can also help. OTC medications like simethicone (Gas-X) can also improve gas symptoms.

4. Allergic reactions

Cephalosporins can cause a range of allergic reactions. The most common allergic reaction to cephalosporins is a skin rash. But these antibiotics can also cause a range of other reactions. These often show up within minutes to hours of taking the antibiotic, and may include:

• Hives

• Itchy skin

• Angioedema (swelling under the skin)

• GI symptoms, like diarrhea or throwing up

• Wheezing or difficulty breathing

• Anaphylaxis (a medical emergency that requires immediate care)

In some cases, allergic reactions can happen days to weeks after taking cephalosporins like Suprax. This reaction could present as a mild, itchy skin rash. Or it could be a more severe reaction, including drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome and Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN). DRESS and SJSJ/TEN are rare but potentially life-threatening reactions. They require immediate medical attention.

Stop Suprax and contact your provider if you start to experience signs of an allergic reaction after starting Suprax. Your provider will likely switch you to another antibiotic. And if you have any serious symptoms, like trouble breathing, swelling in your face, or blisters on your skin, call 911 or seek emergency care. 

Before starting Suprax, let your healthcare provider know if you’ve had an allergic reaction to any cephalosporin or penicillin antibiotic in the past. A prior allergic reaction to these antibiotics makes it more likely to have a reaction to Suprax. 

5. Higher risk of bleeding

Cephalosporins may make it more likely to experience bleeding. But not all cephalosporins are equally risky. Suprax is thought to have less bleeding risk than other cephalosporins. 

Still, it’s important to talk to your healthcare provider before starting Suprax. Together, you can determine if you’re at high risk for bleeding with Suprax. Certain risk factors can make you more likely to experience bleeding, including:

• Using anticoagulant medications, like warfarin (Coumadin, Jantoven), apixaban (Eliquis), or rivaroxaban (Xarelto)

• Using antiplatelet medications, like clopidogrel (Plavix), ticagrelor (Brilinta), or aspirin

• A history of liver or kidney problems

• A history of bleeding problems

• Poor nutrition

If you have any of these risk factors, you may need close monitoring for bleeding with Suprax. Signs of abnormal bleeding include unexplained bruising, blood in the stool, and blood in the urine. If you experience any of these signs, let your healthcare provider know immediately. 

6. High Suprax levels in people with kidney problems

The kidneys do most of the work to remove Suprax from the body. But if your kidneys don’t work as well as they should, Suprax can build up in the body and cause side effects. 

Before starting Suprax, let your healthcare provider know if you have a history of kidney problems or if you’re on dialysis. In these situations, your healthcare provider may lower your dose of Suprax. And they may monitor your kidney function more closely while you’re taking Suprax. 

7. Antibiotic resistance

Antibiotic resistance happens when an antibiotic becomes ineffective against a bacteria it’s supposed to treat. It’s a process that can occur over time.

Antibiotic resistance can happen when antibiotics are used ineffectively. For example, taking an antibiotic at too low a dose or for too little time can lead to antibiotic resistance. This makes it less likely that the antibiotic will work to kill the bacteria. If this happens, bacteria can become antibiotic-resistant, and will be harder to kill in the future. 

If your healthcare provider prescribes Suprax, you can help avoid antibiotic resistance by making sure you take the full course of Suprax. Don’t stop taking it early, even if you start to feel better. Stopping antibiotics early makes it more likely that some bacteria still remains, and it can become stronger and more resistant to Suprax in the future. 

It’s also important to only use Suprax when your provider recommends it. Even if you have Suprax at home, don’t take it without talking to your provider first. They’ll make sure that your infection is one that can be treated by Suprax.

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Written by:

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP, has over a decade of experience as a pharmacist, professor, and researcher. She was a full-time clinical professor in the pharmacy practice department at D’Youville School of Pharmacy before subsequently joining the faculty of the pharmacy practice department at the University at Buffalo School of Pharmacy and Pharmaceutical Sciences.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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