Dicephin
Generic Name
Ceftriaxone 1 gm Injection
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| dicephin 1 gm injection | ৳ 190.60 | N/A |
Description
Overview of the medicine
Dicephin 1 gm Injection contains Ceftriaxone, a third-generation cephalosporin antibiotic. It is a broad-spectrum antibiotic used to treat a wide range of bacterial infections by inhibiting bacterial cell wall synthesis. It is administered parenterally, primarily via intravenous or intramuscular route.
Uses & Indications
Dosage
Adults
Usual adult dose is 1-2 gm once daily (every 24 hours), administered intravenously (IV) or intramuscularly (IM). In severe cases, up to 4 gm daily.
Elderly
No specific dose adjustment is generally required for elderly patients with normal renal and hepatic function.
Renal_impairment
No dosage adjustment is generally required for patients with mild to moderate renal impairment. For severe renal impairment or dialysis, close monitoring is advised, but significant dose reduction is usually not needed.
How to Take
Dicephin 1 gm injection can be administered either intravenously (IV) or intramuscularly (IM). For IV administration, it should be diluted and infused over 30 minutes. For IM administration, it should be injected deep into a large muscle mass. The contents of the vial should be reconstituted with an appropriate diluent (e.g., sterile water for injection, lidocaine for IM).
Mechanism of Action
Ceftriaxone is a bactericidal antibiotic that acts by inhibiting bacterial cell wall synthesis. It binds to penicillin-binding proteins (PBPs) located in the bacterial cytoplasmic membrane, thereby interfering with the transpeptidation step of peptidoglycan synthesis, which is crucial for maintaining the integrity of the bacterial cell wall.
Pharmacokinetics
Onset
Rapid onset of action, typically within minutes of IV administration.
Excretion
Approximately 33-67% excreted unchanged in urine, and the remainder is excreted in bile as inactive metabolites or unchanged drug.
Half life
Approximately 5.8 to 8.7 hours in healthy adults, allowing for once-daily dosing.
Absorption
Rapidly and completely absorbed after intramuscular (IM) administration, achieving peak plasma concentrations within 2-3 hours. Intravenous (IV) administration provides immediate peak levels.
Metabolism
Minimal hepatic metabolism; primarily eliminated largely unchanged.
Side Effects
Contraindications
- Hypersensitivity to ceftriaxone or other cephalosporins.
- History of severe hypersensitivity reactions (e.g., anaphylaxis) to any other type of beta-lactam antibacterial agent (e.g., penicillins, monobactams, carbapenems).
- Neonates with hyperbilirubinemia, especially premature neonates, due to the risk of bilirubin encephalopathy.
- Concomitant use with calcium-containing IV solutions in neonates (≤ 28 days of age).
Drug Interactions
Aminoglycosides
May have synergistic effects against certain organisms, but should be administered separately to avoid chemical incompatibility.
Oral Anticoagulants
May enhance the anticoagulant effect of vitamin K antagonists (e.g., warfarin), requiring increased monitoring of INR and dose adjustment.
Calcium-containing solutions
Concomitant use is contraindicated in neonates due to the risk of fatal ceftriaxone-calcium precipitation. In other age groups, calcium and ceftriaxone should not be mixed or administered simultaneously through the same IV line.
Loop Diuretics (e.g., furosemide)
Can increase the risk of nephrotoxicity when co-administered, although not a strong interaction.
Storage
Store the dry powder vial at room temperature (below 30°C) and protect from light and moisture. After reconstitution, the solution should be used immediately or stored for a limited time (e.g., 6 hours at room temperature or 24 hours at 2-8°C, depending on the diluent and concentration) as per manufacturer's instructions.
Overdose
In case of overdose, symptoms may include nausea, vomiting, diarrhea, and convulsions in severe cases. Management is primarily 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 harm to the fetus. However, there are no adequate and well-controlled studies in pregnant women. 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 or other cephalosporins.
- History of severe hypersensitivity reactions (e.g., anaphylaxis) to any other type of beta-lactam antibacterial agent (e.g., penicillins, monobactams, carbapenems).
- Neonates with hyperbilirubinemia, especially premature neonates, due to the risk of bilirubin encephalopathy.
- Concomitant use with calcium-containing IV solutions in neonates (≤ 28 days of age).
Drug Interactions
Aminoglycosides
May have synergistic effects against certain organisms, but should be administered separately to avoid chemical incompatibility.
Oral Anticoagulants
May enhance the anticoagulant effect of vitamin K antagonists (e.g., warfarin), requiring increased monitoring of INR and dose adjustment.
Calcium-containing solutions
Concomitant use is contraindicated in neonates due to the risk of fatal ceftriaxone-calcium precipitation. In other age groups, calcium and ceftriaxone should not be mixed or administered simultaneously through the same IV line.
Loop Diuretics (e.g., furosemide)
Can increase the risk of nephrotoxicity when co-administered, although not a strong interaction.
Storage
Store the dry powder vial at room temperature (below 30°C) and protect from light and moisture. After reconstitution, the solution should be used immediately or stored for a limited time (e.g., 6 hours at room temperature or 24 hours at 2-8°C, depending on the diluent and concentration) as per manufacturer's instructions.
Overdose
In case of overdose, symptoms may include nausea, vomiting, diarrhea, and convulsions in severe cases. Management is primarily 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 harm to the fetus. However, there are no adequate and well-controlled studies in pregnant women. 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 24-36 months from the date of manufacture when stored under recommended conditions. Reconstituted solution has a shorter shelf life.
Availability
Hospitals, Clinics, Pharmacies
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Ceftriaxone has undergone extensive clinical trials demonstrating its efficacy and safety across various bacterial infections in both adult and pediatric populations. Ongoing research continues to explore its role in new indications and resistant pathogens.
Lab Monitoring
- Periodic monitoring of complete blood count (CBC) with differential for prolonged therapy.
- Monitoring of renal and hepatic function, especially in patients with pre-existing impairment or prolonged treatment.
- Coagulation parameters (INR, prothrombin time) in patients receiving concomitant anticoagulants.
Doctor Notes
- Crucial for severe infections, including hospital-acquired infections, where resistance to other antibiotics is suspected.
- Always inquire about previous allergic reactions to cephalosporins or penicillins before administration.
- Avoid concomitant use with calcium-containing IV solutions, especially in neonates.
- Monitor for signs of superinfection or C. difficile-associated diarrhea, particularly with prolonged therapy.
Patient Guidelines
- Complete the entire course of medication as prescribed by your doctor, even if you start feeling better.
- Do not stop the injection prematurely, as this can lead to antibiotic resistance and recurrence of infection.
- Report any severe side effects like severe diarrhea, allergic reactions, or unusual bleeding/bruising to your doctor immediately.
- Inform your healthcare provider about all your current medications, including over-the-counter drugs and herbal supplements.
Missed Dose Advice
If a dose of Dicephin Injection is missed, contact your doctor or nurse as soon as possible to reschedule. It is important to complete the full course of treatment to prevent the infection from returning.
Driving Precautions
Dicephin may cause dizziness in some individuals. If you experience dizziness or visual disturbances, avoid driving or operating machinery until you know how the medicine affects you.
Lifestyle Advice
- Maintain good hygiene to prevent further spread of infection.
- Stay well-hydrated throughout the treatment period.
- Avoid alcohol during treatment, as it may exacerbate some side effects (though not directly interacting with ceftriaxone).
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