Ceftrix
Generic Name
Ceftriaxone 250 mg Injection
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| ceftrix 250 mg injection | ৳ 90.27 | N/A |
Description
Overview of the medicine
Ceftriaxone is a broad-spectrum, third-generation cephalosporin antibiotic used to treat a variety of bacterial infections. It is administered via injection and is effective against many Gram-positive and Gram-negative bacteria.
Uses & Indications
Dosage
Adults
For uncomplicated gonorrhea: 250 mg as a single IM dose. For other serious infections, typical dosage is 1-2 g administered once daily or in two divided doses. Maximum daily dose is 4 g.
Elderly
No dosage adjustment is generally required unless there is severe renal or hepatic impairment. Monitor renal function.
Renal_impairment
No dosage reduction is required for mild to moderate renal impairment. For severe impairment (creatinine clearance < 10 mL/min) or patients undergoing dialysis, careful monitoring of ceftriaxone plasma concentrations is recommended.
How to Take
Ceftrix-250-mg-injection is administered either intravenously (IV) as a slow injection over 2-4 minutes or as an infusion over 30 minutes, or intramuscularly (IM) into a large muscle mass. It should be reconstituted with an appropriate diluent (e.g., sterile water for injection, lidocaine solution for IM).
Mechanism of Action
Ceftriaxone exerts its bactericidal effect by inhibiting bacterial cell wall synthesis. It binds to penicillin-binding proteins (PBPs), which interferes with the peptidoglycan synthesis necessary for the integrity of the bacterial cell wall.
Pharmacokinetics
Onset
Rapid, with peak plasma concentrations achieved within 2-3 hours after IM injection and immediately after IV administration.
Excretion
Approximately 50-60% excreted via the kidneys (glomerular filtration and tubular secretion) and 40-50% via the bile and feces.
Half life
Approximately 6-9 hours (can be prolonged in neonates, elderly, and those with severe renal/hepatic impairment).
Absorption
Rapidly and completely absorbed after intramuscular (IM) administration. Intravenous (IV) administration provides 100% bioavailability.
Metabolism
Not extensively metabolized; primarily eliminated by gut flora to inactive metabolites. About 33-67% is excreted unchanged.
Side Effects
Contraindications
- Hypersensitivity to ceftriaxone, any other cephalosporin, or to any of the excipients.
- Patients with a history of severe hypersensitivity reactions to any other type of beta-lactam antibacterial agent (e.g., penicillins, monobactams, carbapenems).
- Neonates (≤ 28 days) with hyperbilirubinemia, particularly those who are premature.
- Neonates (≤ 28 days) who require or are expected to require treatment with intravenous calcium-containing solutions due to the risk of ceftriaxone-calcium precipitation in lungs and kidneys.
Drug Interactions
Alcohol
No disulfiram-like reaction (unlike some other cephalosporins).
Probenecid
Does not affect ceftriaxone excretion, unlike other cephalosporins.
Aminoglycosides
Enhanced antibacterial activity when used together, but potential for increased nephrotoxicity (kidney toxicity).
Oral Anticoagulants
May increase the anticoagulant effect and the risk of bleeding. Regular monitoring of coagulation parameters is recommended.
Calcium-containing solutions
Concomitant use is contraindicated in neonates due to risk of precipitation. In other age groups, infuse ceftriaxone and calcium-containing solutions sequentially, flushing the line between infusions.
Storage
Store the unreconstituted powder below 30°C (preferably 15-30°C) in a dry place, protected from light. Keep out of reach of children.
Overdose
In case of overdose, symptoms may include nausea, vomiting, diarrhea, and central nervous system disturbances. Treatment is largely symptomatic and supportive. Hemodialysis or peritoneal dialysis will not enhance the elimination of ceftriaxone.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have shown no evidence of fetal harm, but adequate and well-controlled studies in pregnant women are lacking. It should be used during pregnancy only if clearly needed. Ceftriaxone is excreted in breast milk in low concentrations; caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Hypersensitivity to ceftriaxone, any other cephalosporin, or to any of the excipients.
- Patients with a history of severe hypersensitivity reactions to any other type of beta-lactam antibacterial agent (e.g., penicillins, monobactams, carbapenems).
- Neonates (≤ 28 days) with hyperbilirubinemia, particularly those who are premature.
- Neonates (≤ 28 days) who require or are expected to require treatment with intravenous calcium-containing solutions due to the risk of ceftriaxone-calcium precipitation in lungs and kidneys.
Drug Interactions
Alcohol
No disulfiram-like reaction (unlike some other cephalosporins).
Probenecid
Does not affect ceftriaxone excretion, unlike other cephalosporins.
Aminoglycosides
Enhanced antibacterial activity when used together, but potential for increased nephrotoxicity (kidney toxicity).
Oral Anticoagulants
May increase the anticoagulant effect and the risk of bleeding. Regular monitoring of coagulation parameters is recommended.
Calcium-containing solutions
Concomitant use is contraindicated in neonates due to risk of precipitation. In other age groups, infuse ceftriaxone and calcium-containing solutions sequentially, flushing the line between infusions.
Storage
Store the unreconstituted powder below 30°C (preferably 15-30°C) in a dry place, protected from light. Keep out of reach of children.
Overdose
In case of overdose, symptoms may include nausea, vomiting, diarrhea, and central nervous system disturbances. Treatment is largely symptomatic and supportive. Hemodialysis or peritoneal dialysis will not enhance the elimination of ceftriaxone.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have shown no evidence of fetal harm, but adequate and well-controlled studies in pregnant women are lacking. It should be used during pregnancy only if clearly needed. Ceftriaxone is excreted in breast milk in low concentrations; caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years for unreconstituted powder. Reconstituted solution should be used immediately or stored for a limited time as per manufacturer's instructions.
Availability
Hospitals, Clinics, Retail Pharmacies
Approval Status
Approved (Globally and in Bangladesh)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Ceftriaxone has undergone extensive clinical trials demonstrating its efficacy and safety in treating various bacterial infections across different patient populations, leading to its widespread use.
Lab Monitoring
- Complete blood count (CBC) if prolonged therapy is anticipated.
- Renal and hepatic function tests (e.g., creatinine, BUN, liver enzymes) in patients with pre-existing impairment or during prolonged treatment.
- Prothrombin time (PT) or International Normalized Ratio (INR) for patients on anticoagulants or with vitamin K deficiency.
Doctor Notes
- Crucial to differentiate between true allergic reaction and non-allergic adverse effects when assessing penicillin cross-reactivity.
- Monitor for signs of C. difficile infection, especially in patients developing prolonged diarrhea.
- Caution advised in patients with significant hepatic or renal impairment, although dose adjustment may not be strictly necessary for mild-moderate cases. Consider therapeutic drug monitoring in severe cases.
- Advise patients about potential for injection site pain and methods to minimize discomfort.
- Strictly contraindicated with calcium-containing IV solutions in neonates due to risk of fatal precipitation.
Patient Guidelines
- It is crucial to complete the full course of treatment as prescribed by the doctor, even if symptoms improve, to prevent resistance and recurrence of infection.
- Report any severe or persistent side effects, especially severe diarrhea, rash, or breathing difficulties, to your healthcare provider immediately.
- Ensure proper hydration during treatment.
- Do not self-administer; this medicine must be given by a healthcare professional.
Missed Dose Advice
If a dose is missed, it should be administered as soon as remembered, unless it is almost time for the next scheduled dose. In that case, skip the missed dose and continue with the regular dosing schedule. Do not double the dose to make up for a missed one.
Driving Precautions
Ceftriaxone may cause dizziness in some patients. Patients should be advised to exercise caution when driving or operating machinery until they are aware of how the medication affects them.
Lifestyle Advice
- Maintain good hygiene to prevent further spread of infection.
- Avoid sharing needles or any injection equipment.
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