Medications
Cefotetan
Cefotetan is a cephalosporin (cephamycin) antibiotic given by injection or infusion in a clinic or hospital to treat bacterial infections of the urinary tract, lungs, skin, female reproductive organs, abdomen, and bones and joints, and to prevent infection around certain surgeries. It works by blocking bacterial cell wall building, which kills the bacteria.
How Medicare covers it
Part D formulary aggregation carried exactly (the packaged listing figures). Cefotetan is normally clinician-administered (IV or IM), and Part A applies during a covered inpatient stay; the CMS Part B spending file carries no cefotetan J-code row, so no Part B basis is claimed from that file.
| Coverage details | |
|---|---|
| Part B status | No cefotetan row in the CMS Part B Spending by Drug HCPCS file (RY26, data through 2024) — no J-code basis is claimed from that file; the Part D aggregation is carried exactly and Part A applies during a covered inpatient stay. |
| Medicare Advantage | Most Medicare Advantage plans that include drug coverage (MAPD plans) use the same formulary-and-tier system; the plan's own drug list decides coverage and copay — check the plan's formulary. |
| Medicare Supplement (Medigap) | Medicare Supplement (Medigap) plans sold today do not include prescription drug coverage; drug coverage comes from Part D or an MAPD plan. |
What it treats
Treatment of infections caused by susceptible bacteria: urinary tract infections; lower respiratory tract infections; skin and skin structure infections; gynecologic infections; intra-abdominal infections; and bone and joint infections. It is also used before surgery (prophylaxis) to reduce certain postoperative infections in clean-contaminated or potentially contaminated surgery, such as cesarean section, abdominal or vaginal hysterectomy, transurethral surgery, biliary tract surgery, and gastrointestinal surgery. It has no activity against Chlamydia trachomatis — if that organism is a suspected cause of pelvic inflammatory disease, added antichlamydial coverage is needed.
What it is for, in depth
Cefotetan is a clinician-administered antibiotic, so it fits in hospital and clinic care rather than at-home treatment: culture specimens are taken before therapy to identify the organism and its susceptibilities, treatment may start before results return and is then adjusted, and for confirmed or suspected sepsis or other serious infection with an unidentified organism it may be combined with an aminoglycoside (given separately, never mixed). It covers the packaged infection sites — urinary tract, lower respiratory tract, skin and skin structure, gynecologic, intra-abdominal, and bone and joint infections — plus one-time surgical prophylaxis. It comes only as 1 g and 2 g single-dose powder vials for IV or IM use after mixing.
How it works
Cefotetan is a bactericidal, broad-spectrum cephamycin antibiotic. It kills bacteria by blocking bacterial cell wall synthesis, and it keeps working in the presence of some beta-lactamase enzymes (both penicillinases and cephalosporinases) that gram-negative and gram-positive bacteria use to resist antibiotics.
How it is taken
It comes as a dry powder in single-dose vials equal to 1 g or 2 g of cefotetan, mixed into solution and given into a vein or a large muscle by a health care provider. The usual adult dosage is 1 g or 2 g every 12 hours, set by the infection site and severity (for example, urinary tract infections may use 500 mg every 12 hours or 1–2 g every 24 hours; severe infections 2 g every 12 hours; life-threatening infections 3 g every 12 hours, with a maximum of 6 g a day). For surgical prophylaxis, 1 g or 2 g is given into a vein once, 30 to 60 minutes before surgery (for cesarean section, as soon as the cord is clamped). People with poor kidney function get the usual dose less often (every 24 or 48 hours) or at reduced amounts. The IV route is preferred for bloodstream infection, severe or life-threatening infection, or poor-risk patients. The label states no fixed course length and no missed-dose rule.
Common side effects
In clinical studies, stomach and bowel symptoms occurred in 1.5% of patients — most often diarrhea (1 in 80) and nausea (1 in 700); pseudomembranous colitis was also reported. Blood lab changes occurred in 1.4% (including raised eosinophils, a positive direct Coombs test, and raised platelets; agranulocytosis, hemolytic anemia, lowered white cells and platelets, and prolonged prothrombin time with or without bleeding were also reported). Liver enzyme rises occurred in 1.2%, and allergic reactions in 1.2% (most often rash, 1 in 150, and itching; anaphylaxis and hives were also reported). Local effects were under 1% (vein inflammation at the injection site and discomfort). Raised BUN and creatinine, and fever, were also reported.
Serious warnings
Serious allergic reactions: cross-allergy among beta-lactam antibiotics is documented and can occur in up to 10% of patients with a history of penicillin allergy — if a reaction occurs, the drug is stopped and serious reactions may need epinephrine, oxygen, IV fluids, antihistamines, steroids, and airway care. Immune-mediated hemolytic anemia, including fatal cases, has been reported with cefotetan at a risk at least 3 times higher than with other cephalosporins — if anemia develops within 2 to 3 weeks after a dose, cephalosporin-associated anemia should be considered and the drug stopped until the cause is found. Clostridioides difficile diarrhea, from mild diarrhea to fatal colitis, is reported with nearly all antibacterials and can occur more than 2 months after treatment. Cefotetan can lower prothrombin activity and cause bleeding — the risk is higher with poor kidney or liver function, poor nutrition, in older patients, and in patients with cancer; prothrombin time is monitored and vitamin K given as needed. Drinking alcohol within 72 hours after a cefotetan dose can cause a disulfiram-like reaction (flushing, sweating, headache, fast heartbeat) — patients should be cautioned about alcoholic beverages after receiving cefotetan.
Who should be careful
Cefotetan is contraindicated in patients with a known allergy to the cephalosporin group of antibiotics and in patients who have had cephalosporin-associated hemolytic anemia. Use with caution in people with a history of gastrointestinal disease, especially colitis; long use can cause overgrowth of organisms the drug does not kill. Pregnancy Category B — no adequate, well-controlled studies in pregnant women; use in pregnancy only if clearly needed. Cefotetan passes into human milk in very low amounts — use caution when nursing. Safety and effectiveness in children are not established. The drug is substantially cleared by the kidney, so older patients and those with poor kidney function need careful dose selection and possibly kidney monitoring.
Major interactions
Cefotetan is often given together with an aminoglycoside antibiotic for serious infections, but kidney toxicity may be increased — kidney function should be watched carefully, and cefotetan solutions must never be mixed in the same injection as aminoglycoside solutions; they are given separately. Cefotetan can cause false-positive urine glucose results with Clinitest, Benedict's, or Fehling's solution (enzyme-based glucose tests should be used instead), and high concentrations can falsely raise creatinine readings by the Jaffe reaction.
Why it is in its tier
The most common Part D tier for this drug in the CMS data is Tier 4, the non-preferred brand tier — higher coinsurance. Cefotetan is a generic injectable antibiotic. It has no row in the CMS Part D Drug Spending Dashboard data through 2024, so there is no dashboard average-cost figure for it. It is listed by 3,902 of 5,495 Part D plans (71.01%), and 92.98% of listing plans place it on Tier 4. It has no dashboard average-cost figure (see the dashboard note in this package). The tier shown is the most common one across plans. Individual plans vary, so check your own plan's drug list for your exact cost.
What official patient guides say
MedlinePlus says cefotetan injection is used to treat certain infections caused by bacteria and before surgery to prevent infections, and that antibiotics like cefotetan will not work for colds, flu, or other viral infections. It comes as a powder to be added to fluid and injected into a vein or a large muscle (a premixed IV product also exists), given every 12 or 24 hours; it may be received in a hospital or given at home after a health care provider shows how to use it, and it should be used until the prescription is finished even if you feel better. If you miss a dose, use it as soon as you remember it — but if it is almost time for the next dose, skip the missed dose and keep your regular schedule; do not use a double dose. Your health care provider will tell you how to store your medication.
Part D formulary coverage
| Formulary summary | |
|---|---|
| Most common tier | 4 |
| Plans listing this drug | 3902 |
| Total Part D plans | 5495 |
| Share of plans listing it | 71.01 |
| Formularies listing it | 115 |
| Tier | Plans |
|---|---|
| Tier 1 | 41 plans |
| Tier 2 | 220 plans |
| Tier 3 | 3 plans |
| Tier 4 | 3628 plans |
| Tier 6 | 10 plans |
Source: CMS Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files — Monthly file 2026-10-15 (plan year 2027), file 2027_20261008.zip (data.cms.gov dataset ed1496ea-23e7-41f1-9292-172fa842ccfb): basic drugs formulary file + plan information file, both dated 20261031 inside the zip; downloaded and aggregated 2026-10-30. Medication RxCUI sets for the expansion queue resolved from the CMS file itself and name-verified via the NLM RxNav (RxNorm) API (ops/medications/data/expansion_uncovered_names.json).
What you pay
| With Medicare Part D | |
|---|---|
| Most common tier | Tier 4 |
| Typical copay | $55 — half of plans charge between $55 and $55 |
| Typical coinsurance | 28.0% of the price |
| Based on | 3576 plans that cover this drug · 2027 plan year |
A tier is not a price; what you pay depends on your plan, pharmacy, and benefit stage; Extra Help or Medicaid can lower it further.
Sources: CMS Plan Benefit Package + formulary data; CMS NADAC · Checked 2026-11-07
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- Cefixime (Suprax and others)
- Cefoxitin
- Cefpodoxime (Vantin and others)
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Companies covering this drug
3,902 plans from 268 companies list this drug on a formulary for 2027. Search by company or plan name, or filter by tier. Cost sharing is the plan's published amount for this drug's tier in the initial coverage stage (1-month retail supply), where the plan publishes it; a blank means the plan does not publish it.
| Company | Plan | Tier | Copay | Coinsurance |
|---|
A tier is not a price; what you pay depends on your plan, pharmacy, and benefit stage; Extra Help or Medicaid can lower it further.
Coverage and costs change. Drug lists (formularies), tiers, and copays can change during the year and differ by plan. Always check with your insurance company or plan directly to confirm what is covered and what you will pay.
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