Dicephin
Generic Name
Ceftriaxone 250 mg Injection
Manufacturer
Generic Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| dicephin 250 mg injection | ৳ 100.30 | N/A |
Description
Overview of the medicine
Ceftriaxone is a broad-spectrum cephalosporin antibiotic used to treat various bacterial infections including respiratory tract infections, skin and soft tissue infections, urinary tract infections, and meningitis.
Uses & Indications
Dosage
Adults
General adult dosage for serious infections: 1-2 g once daily, intravenously or intramuscularly. In severe cases, up to 4 g once daily. For uncomplicated gonorrhea: 250 mg as a single IM dose.
Elderly
No specific dose adjustment is needed based on age alone; monitor renal and hepatic function.
Renal_impairment
No dosage adjustment needed for mild to moderate impairment. For severe renal impairment (creatinine clearance <10 mL/min), dosage should not exceed 2 g daily.
How to Take
For IM administration, reconstitute with lidocaine 1% solution and inject deeply into a large muscle. For IV administration, reconstitute with sterile water for injection and administer slowly over 30 minutes. Do not mix with calcium-containing solutions.
Mechanism of Action
Ceftriaxone inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), leading to bactericidal activity and cell lysis.
Pharmacokinetics
Onset
Rapid onset, typically within 2-3 hours after IM administration, immediate after IV administration.
Excretion
Approximately 50-60% excreted unchanged via the kidneys and 40-50% via biliary/fecal route.
Half life
Approximately 6-9 hours (longer in neonates and elderly).
Absorption
Rapid and complete absorption after intramuscular (IM) administration, immediate after intravenous (IV) administration. High bioavailability.
Metabolism
Partially metabolized to inactive metabolites in the liver. About 35-65% excreted unchanged.
Side Effects
Contraindications
- Hypersensitivity to ceftriaxone, other cephalosporins, or penicillin.
- Neonates with hyperbilirubinemia, especially premature neonates.
- Neonates (≤28 days old) receiving calcium-containing IV solutions.
Drug Interactions
Aminoglycosides
Synergistic antibacterial effect may occur, but separate administration is recommended due to potential chemical incompatibility.
Oral anticoagulants
May increase the anticoagulant effect (e.g., warfarin), leading to increased bleeding risk.
Calcium-containing solutions
Concomitant use with IV calcium-containing solutions is contraindicated in neonates and should be avoided in all patients within 48 hours of ceftriaxone administration due to precipitation risk.
Loop diuretics (e.g., Furosemide)
Increased risk of nephrotoxicity with concomitant use, especially in patients with pre-existing renal impairment.
Storage
Store powder below 30°C in a dry place, protected from light. Reconstituted solution should be used immediately or stored for a limited time as per manufacturer's instructions (e.g., 6 hours at room temperature, 24 hours refrigerated).
Overdose
In case of overdose, symptomatic and supportive treatment should be administered. Hemodialysis or peritoneal dialysis is not effective for removing ceftriaxone from the body.
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. Use during pregnancy only if clearly needed. Ceftriaxone is excreted in low concentrations into breast milk; use with caution in breastfeeding mothers.
Side Effects
Contraindications
- Hypersensitivity to ceftriaxone, other cephalosporins, or penicillin.
- Neonates with hyperbilirubinemia, especially premature neonates.
- Neonates (≤28 days old) receiving calcium-containing IV solutions.
Drug Interactions
Aminoglycosides
Synergistic antibacterial effect may occur, but separate administration is recommended due to potential chemical incompatibility.
Oral anticoagulants
May increase the anticoagulant effect (e.g., warfarin), leading to increased bleeding risk.
Calcium-containing solutions
Concomitant use with IV calcium-containing solutions is contraindicated in neonates and should be avoided in all patients within 48 hours of ceftriaxone administration due to precipitation risk.
Loop diuretics (e.g., Furosemide)
Increased risk of nephrotoxicity with concomitant use, especially in patients with pre-existing renal impairment.
Storage
Store powder below 30°C in a dry place, protected from light. Reconstituted solution should be used immediately or stored for a limited time as per manufacturer's instructions (e.g., 6 hours at room temperature, 24 hours refrigerated).
Overdose
In case of overdose, symptomatic and supportive treatment should be administered. Hemodialysis or peritoneal dialysis is not effective for removing ceftriaxone from the body.
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. Use during pregnancy only if clearly needed. Ceftriaxone is excreted in low concentrations into breast milk; use with caution in breastfeeding mothers.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date, check product label for specific expiry.
Availability
Available in hospitals and pharmacies
Approval Status
Approved by relevant authorities (e.g., DGDA)
Patent Status
Generic available (off-patent)
WHO Essential Medicine
YesClinical Trials
Ceftriaxone has been extensively studied in numerous clinical trials since its introduction, demonstrating efficacy and safety across various bacterial infections in diverse patient populations.
Lab Monitoring
- Complete blood count (CBC) with differential, especially with prolonged therapy.
- Renal function tests (e.g., serum creatinine, BUN).
- Liver function tests (e.g., AST, ALT, bilirubin).
- Coagulation parameters (e.g., PT/INR) in patients at risk of bleeding.
Doctor Notes
- Always obtain a thorough patient history regarding allergies, especially to beta-lactam antibiotics.
- Monitor for signs of C. difficile-associated diarrhea, especially with prolonged use.
- Exercise caution when administering to neonates, particularly those with hyperbilirubinemia or receiving calcium-containing solutions.
- Adjust dose in patients with severe renal or hepatic impairment.
Patient Guidelines
- Complete the full course of medication even if symptoms improve.
- Report any severe allergic reactions immediately to your doctor.
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
- Avoid alcohol during treatment, as some cephalosporins can cause a disulfiram-like reaction.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
This medicine may cause dizziness in some patients. If you experience dizziness, avoid driving or operating machinery.
Lifestyle Advice
- Maintain good hydration during treatment.
- Avoid self-medication.
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