Dicephin
Generic Name
Ceftriaxone
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| dicephin 2 gm injection | ৳ 301.00 | N/A |
Description
Overview of the medicine
Ceftriaxone is a broad-spectrum third-generation cephalosporin antibiotic used to treat various bacterial infections.
Uses & Indications
Dosage
Adults
Usual adult dose is 1-2 gm once daily intravenously or intramuscularly. In severe infections, doses up to 4 gm daily may be used.
Elderly
No specific dose adjustment is generally necessary for elderly patients unless severe renal or hepatic impairment is present.
Renal_impairment
Dosage adjustment may be necessary in severe renal impairment (creatinine clearance <10 mL/min) with concomitant hepatic dysfunction. No adjustment needed for moderate renal impairment.
How to Take
Administer deep intramuscularly or intravenously. For intravenous administration, infuse slowly over 30 minutes (for IV infusion) or over 2-4 minutes (for IV push). Reconstitute powder with appropriate diluent.
Mechanism of Action
Inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), leading to bacterial cell lysis and death.
Pharmacokinetics
Onset
Rapid, typically within 30 minutes for IV administration.
Excretion
Excreted unchanged via both renal (approx. 33-67%) and biliary (approx. 35-50%) routes.
Half life
Approximately 6-9 hours in adults, allowing for once-daily dosing.
Absorption
Rapidly and completely absorbed after intramuscular (IM) administration; intravenous (IV) administration provides immediate and complete bioavailability.
Metabolism
Partially metabolized in the liver; primarily converted to inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to ceftriaxone, any other cephalosporins, or to penicillin antibiotics.
- Neonates with hyperbilirubinemia, especially premature neonates.
- Concurrent intravenous calcium-containing solutions in neonates (due to risk of precipitation).
Drug Interactions
Warfarin
May increase the anticoagulant effect of warfarin, requiring close monitoring of INR.
Aminoglycosides
Increased risk of nephrotoxicity when co-administered, especially in patients with pre-existing renal impairment.
Oral Contraceptives
May reduce the efficacy of oral contraceptives; advise use of alternative birth control methods.
Calcium-containing solutions
Contraindicated in neonates due to precipitation risk. In other age groups, administer sequentially with flushing.
Storage
Store the powder for injection at room temperature (20°C to 25°C), protect from light. After reconstitution, the solution is stable for 24 hours at room temperature or 48 hours when refrigerated (2°C to 8°C).
Overdose
In case of overdose, symptomatic and supportive treatment should be provided. There is no specific antidote. Hemodialysis and peritoneal dialysis are generally not effective for removing Ceftriaxone.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have shown no evidence of harm to the fetus, but adequate and well-controlled studies in pregnant women are lacking. Excreted in breast milk in small amounts; use with caution during lactation, monitor infants for diarrhea, candidiasis.
Side Effects
Contraindications
- Hypersensitivity to ceftriaxone, any other cephalosporins, or to penicillin antibiotics.
- Neonates with hyperbilirubinemia, especially premature neonates.
- Concurrent intravenous calcium-containing solutions in neonates (due to risk of precipitation).
Drug Interactions
Warfarin
May increase the anticoagulant effect of warfarin, requiring close monitoring of INR.
Aminoglycosides
Increased risk of nephrotoxicity when co-administered, especially in patients with pre-existing renal impairment.
Oral Contraceptives
May reduce the efficacy of oral contraceptives; advise use of alternative birth control methods.
Calcium-containing solutions
Contraindicated in neonates due to precipitation risk. In other age groups, administer sequentially with flushing.
Storage
Store the powder for injection at room temperature (20°C to 25°C), protect from light. After reconstitution, the solution is stable for 24 hours at room temperature or 48 hours when refrigerated (2°C to 8°C).
Overdose
In case of overdose, symptomatic and supportive treatment should be provided. There is no specific antidote. Hemodialysis and peritoneal dialysis are generally not effective for removing Ceftriaxone.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have shown no evidence of harm to the fetus, but adequate and well-controlled studies in pregnant women are lacking. Excreted in breast milk in small amounts; use with caution during lactation, monitor infants for diarrhea, candidiasis.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture when stored under recommended conditions.
Availability
Hospitals, Clinics, Pharmacies
Approval Status
Approved by regulatory authorities worldwide
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated Ceftriaxone's efficacy and safety in treating a wide range of bacterial infections across various patient populations.
Lab Monitoring
- Complete Blood Count (CBC) with differential
- Renal function tests (e.g., serum creatinine, BUN)
- Liver function tests (e.g., ALT, AST, bilirubin)
- Coagulation parameters (e.g., PT/INR, especially with concurrent warfarin)
- Culture and sensitivity tests to confirm pathogen and susceptibility
Doctor Notes
- Always obtain appropriate bacterial cultures and perform susceptibility tests prior to initiating therapy with Ceftriaxone.
- Monitor patients for signs of superinfection, especially Clostridium difficile-associated diarrhea, during and after treatment.
- Exercise caution when administering to patients with a history of penicillin allergy, as cross-reactivity can occur.
- Adjust dosage carefully in patients with severe concomitant renal and hepatic impairment.
Patient Guidelines
- It is crucial to complete the full course of treatment as prescribed by your doctor, even if symptoms improve earlier.
- Report any unusual side effects, severe diarrhea, or signs of allergic reaction (e.g., rash, swelling, difficulty breathing) immediately.
- Do not stop treatment abruptly without consulting your healthcare provider.
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
Missed Dose Advice
If a dose is missed, administer it as soon as remembered. If it is almost time for the next scheduled dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Ceftriaxone may cause dizziness or lightheadedness in some individuals. Patients should be cautioned against driving or operating machinery until they know how the medication affects them.
Lifestyle Advice
- Maintain good personal hygiene to prevent the spread of infection.
- Stay hydrated by drinking plenty of fluids unless advised otherwise by your doctor.
- Avoid alcohol consumption during treatment as it may exacerbate side effects, though direct interactions are minimal.
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