ceftriaxone (Rocephin)

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Introduction

Tradename: Rocephin. 3rd generation cephalosporin.

Indications

Contraindications

pregnancy category = b

safety in lactation = ?

Dosage

Powder for injection: 250 & 500 mg, 1 & 2 g

Pharmacokinetics

elimination via kidney

elimination via liver

1/2life = 6-9 hours

protein binding = 94 % <70 ug/mL

protein binding = 84 % 300 ug/mL

protein binding = 58 % 600 ug/mL

elimination by hemodialysis = -

elimination by peritoneal dialysis = -

Antimicrobial activity

Gram positive

Gram negative

Anaerobes

Adverse effects

Drug interactions

  • Ca+2 & Ca+2-containing solutions or products[8][9] cases of fatal reactions with Ca+2-ceftriaxone precipitates in the lungs & kidneys in both term & premature neonates
  • Ca+2-containing solutions or products must not be administered within 48-hours of the last administration of ceftriaxone
  • ceftriaxone & Ca+2-containing products may be used concomitantly in patients >28 days of age[10]

Test interactions

Laboratory

Mechanism of action

inhibition of bacterial cell wall synthesis

More general terms

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Harrison's Principles of Internal Medicine, 13th ed. Companion Handbook. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1995, pg 162
  3. Clinical Guide to Laboratory Tests, 3rd edition, NW Tietz ed, WB Saunders, Philadelphia, 1995
  4. Sanford Guide to antimicrobial therapy 1997
  5. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  6. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  7. 7.0 7.1 Prescriber's Letter 14(6): 2007 Ceftriaxone Dose for Community-Acquired Pneumonia (CAP) Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=230608&pb=PRL (subscription needed) http://www.prescribersletter.com
  8. 8.0 8.1 FDA MedWatch http://www.fda.gov/medwatch/safety/2007/safety07.htm#Rocephin
  9. 9.0 9.1 Prescriber's Letter 14(10): 2007 Rocephin (Ceftriaxone) and Calcium interaction Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=231005&pb=PRL (subscription needed) http://www.prescribersletter.com
  10. 10.0 10.1 FDA MedWatch http://www.fda.gov/medwatch/safety/2009/safety09.htm#Ceftriaxone
  11. 11.0 11.1 11.2 11.3 11.4 Deprecated Reference
  12. 12.0 12.1 Pardo I, Pierre-Jean M, Bouzille G et al Safety of subcutaneous versus intravenous ceftriaxone administration in older patients: A retrospective study. J Am Geriatr Soc. 2024 Apr;72(4):1060-1069. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38348519 PMID: https://www.ncbi.nlm.nih.gov/pubmed/38348519 https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/jgs.18786

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