What is the contraindication of ceftriaxone?

KindProteinOrganismHumansPharmacological action

Unknown

Inhibitor

General FunctionSodium-independent organic anion transmembrane transporter activitySpecific FunctionInvolved in the renal elimination of endogenous and exogenous organic anions. Functions as organic anion exchanger when the uptake of one molecule of organic anion is coupled with an efflux of one ...Gene NameSLC22A6Uniprot IDQ4U2R8Uniprot NameSolute carrier family 22 member 6Molecular Weight61815.78 Da

1. Takeda M, Babu E, Narikawa S, Endou H: Interaction of human organic anion transporters with various cephalosporin antibiotics. Eur J Pharmacol. 2002 Mar 8;438(3):137-42. [Article]
2. Jung KY, Takeda M, Shimoda M, Narikawa S, Tojo A, Kim DK, Chairoungdua A, Choi BK, Kusuhara H, Sugiyama Y, Sekine T, Endou H: Involvement of rat organic anion transporter 3 (rOAT3) in cephaloridine-induced nephrotoxicity: in comparison with rOAT1. Life Sci. 2002 Mar 8;70(16):1861-74. [Article]
3. Jariyawat S, Sekine T, Takeda M, Apiwattanakul N, Kanai Y, Sophasan S, Endou H: The interaction and transport of beta-lactam antibiotics with the cloned rat renal organic anion transporter 1. J Pharmacol Exp Ther. 1999 Aug;290(2):672-7. [Article]

What Is Ceftriaxone and How Does It Work?

Ceftriaxone is used to treat a wide variety of bacterial infections. Ceftriaxone belongs to a class of drugs known as cephalosporin antibiotics. It works by stopping the growth of bacteria.

Ceftriaxone is not recommended for use in newborns with high blood bilirubin levels and premature infants due to increased risk of side effects. Ask the doctor or pharmacist for details.

Ceftriaxone may also be used before dental procedures in people with certain heart conditions (such as artificial heart valves) to help prevent serious infection of the heart (bacterial endocarditis).

Ceftriaxone is available under the following different brand names: Rocephin.

What Are Dosages of Ceftriaxone?

Dosages of Ceftriaxone:

Adult and Pediatric Dosage Forms and Strengths

Injectable solution

Powder for injection

• 250 mg
• 500 mg
• 1 g
• 2 g
• 10 g (adult only)
• 100 g (adult only)

Dosage Considerations – Should be Given as Follows:

Intra-abdominal Infections

• Complicated, mild-to-moderate, community-acquired: 1-2 g/day intravenously (IV) in single daily dose or divided every 12 hours for 4-7 days, in combination with metronidazole

Acute Bacterial Otitis Media

• Adult: 50 mg/kg intramuscularly (IM) once
• Persistent or treatment failures: 50 mg/kg intravenously/intramuscularly (IV/IM) for 3 days
• Pediatric: 50 mg/kg IM in single-dose; not to exceed 1 g

Pelvic Inflammatory Disease

• 250 mg intramuscularly (IM) as a single dose with doxycycline, with or without metronidazole for 14 days

Septic/toxic Shock (Off-label)

• 2 g intravenously (IV) once daily; with clindamycin for toxic shock

Skin and Soft Necrotizing Infection (Off-label)

• Due to Aeromonas hydrophilia: 1-2 g intravenously (IV) once/day in combination with doxycycline
• Due to Vibrio vulnificus; 1 g IV once/day in combination with doxycycline
• Continue treatment until further debridement is not necessary, the clinical improvement observed, and the patient is afebrile for 48-72 hours
• Children over 12 years: 1-2 g/day intravenously/intramuscularly (IV/IM) in a single daily dose or divided every 12 hours for 7-14 days, depending on type and severity of infection

Severe Acute Bacterial Rhinosinusitis (Off-label)

• Infection requiring hospitalization: 1-2 g intravenously (IV) every 12-24 hours for 5-7 days

Prosthetic Joint Infection

• 2 g intravenously (IV) every 24 hours for 2-6 weeks; continue treatment until clinical improvement is observed and the patient is afebrile for 48-72 hours

Meningitis

• Adult: 2 g intravenously (IV) every 12 hours for 7-14 days
• Pediatric: 100 mg/kg/day intravenously/intramuscularly (IV/IM) in single daily dose or divided every 12 hours for 7-14 days; not to exceed 4 g/day
• Serious Infections Other Than Meningitis, Pediatric
• 50-75 mg/kg/day intravenously/intramuscularly (IV/IM) divided every 12 hours for 7-14 days

Acute Uncomplicated Pyelonephritis

• 1-2 g intravenously (IV) once/day

Surgical Prophylaxis

Prophylaxis of surgical infection

• 1 g intravenously (IV) 0.5-2 hours before the procedure

Uncomplicated Gonococcal Infections

Adult: Uncomplicated gonococcal infection of pharynx, cervix, urethra, or rectum: ceftriaxone 250 mg intramuscularly (IM) once plus azithromycin 1 g orally once (preferred) or alternatively, doxycycline 100 mg orally every 12 hours for 7 days

Centers for Disease Control (CDC) Sexually Transmitted Diseases (STD) guidelines: MMWR Recommendations Rep. June 5, 2015:64(RR3);1-137

Sexual assault

• Prophylaxis of sexually transmitted diseases (STDs) such as gonorrhea after sexual assault per CDC guidelines includes the following 3-drug regimen:
  • Ceftriaxone 250 mg intramuscularly (IM) once, PLUS
  • Azithromycin 1 g orally once, PLUS
  • Metronidazole or tinidazole 2 g orally once
  • If alcohol has been recently ingested or emergency contraception is provided, metronidazole or tinidazole can be taken by the victim at home rather than as directly observed therapy to avoid drug interactions

Pediatric:

Neonates

• Ophthalmia neonatorum: 25-50 mg/kg intravenously/intramuscularly (IV/IM) once; not to exceed 125 mg
• Disseminated gonococcal infections and gonococcal scalp abscesses: 25-50 mg/kg/day IV/IM in single daily dose for 7 days; if meningitis is documented, treat for 10-14 days
• Prophylaxis for infants of mothers with gonococcal infection: 25-50 mg/kg IV/IM once; not to exceed 125 mg

Children

• Less than 45 kg with uncomplicated gonococcal vulvovaginitis, cervicitis, urethritis, pharyngitis, or proctitis: 125 mg intramuscularly (IM) once
• Less than 45 kg with bacteremia or arthritis: 50 mg/kg/day intravenously/intramuscularly (IV/IM) in single daily dose for 7 days; daily dose not to exceed 1 g
• Greater than 45 kg with bacteremia or arthritis: 50 mg/kg/day IM/IV in single daily dose for 7 days
• Greater than 45 kg: 1-2 g intravenously (IV) every 12 hours

Other Gonococcal Infections (Off-label)

• Gonococcal conjunctivitis: 1 g intramuscularly (IM) once
• Disseminated gonococcal infection: 1 g/day intravenously/intramuscularly (IV/IM); continued for at least 24-48 hours after improvement is observed, then continued with cefixime 400 mg orally every 12 hours to complete at least 1 week of therapy
• Gonococcal endocarditis: 1-2 g intravenously (IV) every 12 hours for 4 weeks
• Gonococcal meningitis: 1-2 g IV every 12 hours for 10-14 days
• Acute epididymitis: 250 mg IM once with doxycycline

Epiglottis, Pediatric (Off-label)

• 100 mg/kg/day intravenously (IV) on first day; follow with 50 mg/kg on day 2 or 75 mg/kg once/day for 10-14 days

Acute Epididymitis, Pediatric (Off-label)

• Children over 8 years and greater than 45 kg: 250 mg intramuscularly (IM) once with concomitant doxycycline regimen

Dosing Considerations

Susceptible organisms

• Anaerobic cocci, Bacteroides fragilis, Borrelia burgdorferi, Clostridium spp, Enterobacter spp, Escherichia coli, Haemophilus influenzae, Klebsiella spp, Morganella morganii, Neisseria gonorrhoeae, Neisseria meningitides, Proteus mirabilis, Providencia rettgeri, Pseudomonas spp, Serratia spp, Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes

CEFTRIAXONE - INJECTION

(SEF-trye-AX-one)

COMMON BRAND NAME(S): Rocephin

USES: Ceftriaxone is used to treat a wide variety of bacterial infections. This medication belongs to a class of drugs known as cephalosporin antibiotics. It works by stopping the growth of bacteria.This drug is not recommended for use in newborns with high blood bilirubin levels and premature infants due to increased risk of side effects. Ask the doctor or pharmacist for details.

HOW TO USE: This medication is given by injection into a muscle or vein as directed by your doctor, usually once or twice daily. The dosage is based on your medical condition and response to treatment. Drink plenty of fluids while using this medication unless your doctor directs you otherwise.If you are using this medication at home, learn all preparation and usage instructions from your health care professional. Avoid mixing ceftriaxone with IV fluids that have calcium in them (such as Ringer's solution, Hartmann's solution, parenteral nutrition-TPN/PPN). Consult your pharmacist for details about the safe use of IV calcium products in infants, children, and adults (see Precautions section). Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.If you are using the frozen pre-mixed solution, thaw the bag at room temperature or in the refrigerator. If the bag is thawed in the refrigerator, let it sit at room temperature at least 1 hour before using. Do not thaw by putting in a water bath or microwaving. After thawing, shake well and squeeze the bag to check for leaks. Discard solution if the bag leaks. Do not re-freeze the solution after thawing.For the best effect, use this antibiotic at evenly spaced times. To help you remember, use this medication at the same time(s) every day.Continue to use this medication for the full time prescribed, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection.Tell your doctor if your condition lasts or gets worse.

SIDE EFFECTS: Swelling, redness, or pain at the injection site may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: easy bruising/bleeding, unusual tiredness, symptoms of gallbladder disease (such as stomach/abdominal pain, nausea, vomiting), signs of kidney problems (such as change in the amount of urine), pink/bloody/dark urine, painful/frequent urination, back/side pain, yellowing eyes/skin, uncontrollable movements, confusion, seizures.This medication may rarely cause a severe intestinal condition due to a bacteria called C. difficile. This condition may occur during treatment or weeks to months after treatment has stopped. Tell your doctor right away if you develop: diarrhea that doesn't stop, abdominal or stomach pain/cramping, blood/mucus in your stool.If you have these symptoms, do not use anti-diarrhea or opioid products because they may make symptoms worse.Use of this medication for prolonged or repeated periods may result in oral thrush or a new yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.If ceftriaxone is mixed with a numbing medication (such as lidocaine) before injection into a muscle, it may rarely cause a serious blood problem (methemoglobinemia). Get medical help right away if you have any very serious side effects, including: pale/gray/blue skin, fast heartbeat, shortness of breath.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before using ceftriaxone, tell your doctor or pharmacist if you are allergic to it; or to other antibiotics (such as penicillins, other cephalosporins); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: gallbladder disease, kidney disease, liver disease, stomach/intestinal diseases (such as colitis).Do not give any products by vein that contain calcium (including IV solutions such as Ringer's solution, Hartmann's solution, parenteral nutrition-TPN/PPN) to a newborn less than 1 month old who is receiving this medication. Doing so can cause serious problems in the vital organs.Ceftriaxone may cause live bacterial vaccines (such as typhoid vaccine) to not work well. Tell your health care professional that you are using ceftriaxone before having any immunizations/vaccinations.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Tell your doctor if you are pregnant before using this medication.This medication passes into breast milk in small amounts and is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: calcium-containing IV fluids.This medication may interfere with certain lab tests (such as certain urine glucose tests), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: seizures.

NOTES: Do not share this medication with others.Lab and/or medical tests (such as complete blood count, kidney function tests) should be done while you are using this medication. Keep all medical and lab appointments.

MISSED DOSE: It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Do not double the dose to catch up.

STORAGE: Consult the product instructions and your pharmacist for storage details. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Information last revised January 2022. Copyright(c) 2022 First Databank, Inc.

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.