Trade Names:Rocephin- Injection, powder for solution 250 mg (3.6 mEq of sodium/g)- Injection, powder for solution 500 mg (3.6 mEq of sodium/g)- Injection, powder for solution 1 g (3.6 mEq of sodium/g)- Injection, powder for solution 2 g (3.6 mEq of sodium/g)- Injection, powder for solution 10 g (3.6 mEq of sodium/g)
Trade Names:CefTRIaxONE- Injection 1 g (3.6 mEq of sodium/g)- Injection 2 g (3.6 mEq of sodium/g)
Inhibits mucopeptide synthesis in bacterial cell wall.
Ceftriaxone is completely absorbed. T max is 2 to 3 h.
Vd is 5.78 to 13.5 L. Ceftriaxone is 85% to 95% protein bound.
33% to 67% is excreted in urine as unchanged drug and the remainder in feces; half-life is 5.8 to 8.7 h. Plasma Cl is 0.58 to 1.45 L/h. Renal Cl is 0.32 to 0.73 L/h.
No dosage adjustment needed.Hepatic Function Impairment
No dosage adjustment needed.
Acute bacterial otitis media ( Rocephin ); treatment of infections of lower respiratory tract, skin and skin structures, bone and joint, and urinary tract; treatment of pelvic inflammatory disease, intra-abdominal infections, gonorrhea ( Rocephin ), meningitis, and septicemia caused by susceptible microorganisms; preoperative prophylaxis.
Neurologic complications, arthritis, and carditis associated with Lyme disease in patients refractory to penicillin G.
Hypersensitivity to cephalosporins; neonates (28 days of age or younger); concomitant use with calcium-containing IV solutions, including continuous calcium-containing infusions, such as parenteral nutrition in neonates.
Ceftriaxone for injection and dextrose injection ( CefTRIaxONE ) is intended for IV administration only. Ceftriaxone sodium ( Rocephin ) may be administered IV or IM.Acute Otitis MediaChildren
IM A single dose of 50 mg/kg (max, 1 g) is recommended.Pediatric MeningitisChildren
IV CefTRIaxONE or IV/IM Rocephin : Recommended initial dose is 100 mg/kg (max, 4 g), followed by 100 mg/kg/day (max, 4 g/day) for 7 to 14 days.Skin or Skin Structure InfectionsChildren
IV/IM CefTRIaxONE IV or Rocephin IV/IM : Recommended daily dosage is 50 to 75 mg/kg once a day or in equally divided doses twice daily (max, 2 g/day).Surgical ProphylaxisAdults
IV CefTRIaxONE or IV/IM Rocephin : 1 g as a single dose 30 min to 2 h before surgery.Uncomplicated Gonococcal InfectionsAdults
IM 250 mg as single dose.Miscellaneous InfectionsAdults
IV CefTRIaxONE or IV/IM Rocephin : Usual adult daily dosage is 1 to 2 g once a day or in equally divided doses twice daily, depending on the type and severity of infection (max, 4 g/day).Children
IV CefTRIaxONE : Recommended daily dose is 50 to 75 mg/kg IV once a day or in divided doses every 12 h (max, 2 g/day). IV/IM Rocephin : Recommended daily dose is 50 to 75 mg/kg IV/IM in divided doses every 12 h (max, 2 g/day).Acute Bacterial Otitis Media, Persistent/Treatment Failure (off-label)Children
IM/IV 50 mg/kg/ IM or IV (not to exceed 1 g) daily for 3 days.Pelvic Inflammatory Disease (mild to moderate) (off-label)Adults
IM 250 mg given IM as a single dose with doxycycline 100 mg orally twice daily for 14 days, with or without metronidazole 500 mg orally twice daily for 14 days.Uncomplicated Gonococcal Infections (off-label)Adults
IM 125 mg given IM as a single dose.
Store unactivated unit at 59° to 86°F. Following reconstitution, product must be used within 24 h if stored at room temperature or within 7 days if stored under refrigeration.Rocephin
Store sterile powder at temperatures not exceeding 77°F. Protect from light. After reconstitution, protection from normal light is not necessary. Depending on the diluent, product must be used within 1 to 2 days if stored at room temperature or within 3 to 10 days if stored under refrigeration.
Increased risk of nephrotoxicity.Anticoagulants (eg, heparin, warfarin)
Risk of bleeding may be increased.Cyclosporine
Elevated cyclosporine levels with increased risk of toxicity may occur.
Other antimicrobial drugs.
None well documented.
Eosinophilia (6%); thrombocytosis (5%); leukopenia (2%).
Elevated ALT and AST (3%); elevated BUN (1%).
Induration/tightness/warmth (17%); induration/pain/tenderness (1%).
Fatal ceftriaxone-calcium precipitates in lung and kidneys of neonates.
Periodically measure plasma levels of the drug in patients with impaired renal function. If evidence of drug accumulation is present, adjust the dose accordingly. In patients with both hepatic function impairment and renal disease, closely monitor ceftriaxone plasma concentrations. Monitor PT in patients with impaired vitamin K synthesis or low vitamin K stores.Adverse reactions
Monitor patient for GI, skin, and general body adverse reactions and signs of superinfection. Instruct patient to inform health care provider if noted and significant, and to immediately report severe diarrhea, diarrhea containing blood or pus, or severe abdominal cramping.Response to therapy
Monitor patient's response to therapy.
Category B .
Excreted in breast milk.
Cephalosporins may accumulate in newborns.
Reactions range from mild to life-threatening. Administer drug with caution to penicillin-sensitive patients because of possible cross-reactivity.
No dosage adjustment is needed in patients with renal failure who are receiving usual doses of ceftriaxone.
No dosage adjustment is needed in patients with hepatic function impairment; however, in patients with both hepatic function impairment and renal disease, the dosage should not exceed 2 g daily without close monitoring of serum concentrations.
May result in bacterial or fungal overgrowth of nonsusceptible microorganisms.
Because of the possibility of precipitation of ceftriaxone calcium, do not administer ceftriaxone and a calcium-containing IV solution simultaneously. In patients other than neonates, ceftriaxone and calcium-containing solutions may be administered sequentially if the infusion lines are flushed with a compatible fluid between infusions.
Alterations in PT may occur.
Consider in patients in whom diarrhea develops.
Sonographic abnormalities in the gallbladder, with symptoms of gallbladder disease, have been reported.
May include the adverse reactions listed, but of a more severe nature.
Copyright © 2009 Wolters Kluwer Health.