Inoxon
Generic Name
Ceftriaxone
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
Variant | Unit Price | Strip Price |
---|---|---|
inoxon 1 gm injection | ৳ 160.00 | N/A |
Description
Overview of the medicine
Ceftriaxone is a broad-spectrum third-generation cephalosporin antibiotic used to treat various bacterial infections, including severe and life-threatening ones. It is administered parenterally, primarily via intravenous or intramuscular routes.
Uses & Indications
Dosage
Adults
Usually 1-2 gm once daily (or in two equally divided doses) intravenously or intramuscularly depending on the severity and type of infection. In severe cases, up to 4 gm/day may be given.
Elderly
No specific dose adjustment is generally needed for elderly patients unless there is severe renal or hepatic impairment. Close monitoring of adverse effects is recommended.
Renal_impairment
No dose adjustment is needed for renal impairment up to a creatinine clearance of 15 mL/min. For severe renal impairment or in patients undergoing dialysis, careful monitoring of drug levels and consideration of dose reduction may be necessary.
How to Take
For intravenous (IV) administration, reconstitute the powder with an appropriate diluent (e.g., Sterile Water for Injection, 0.9% Sodium Chloride Injection) and infuse over 30 minutes. For intramuscular (IM) administration, reconstitute with 1% Lidocaine HCl solution and inject deep into a large muscle mass (e.g., gluteus maximus). Do not administer IV calcium-containing solutions simultaneously with ceftriaxone, especially in neonates.
Mechanism of Action
Ceftriaxone inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs) located inside the bacterial cell wall. This binding prevents the cross-linking of peptidoglycan chains, which is essential for maintaining the integrity and rigidity of the bacterial cell wall, leading to cell lysis and bacterial death.
Pharmacokinetics
Onset
Within 2-3 hours of administration for clinical effect.
Excretion
Approximately 50-60% of the dose is excreted unchanged via renal excretion, and 35-40% via biliary and fecal excretion. This dual excretion pathway allows for its use in patients with moderate renal or hepatic impairment without significant dose adjustment.
Half life
Approximately 6-9 hours in adults, allowing for once-daily dosing.
Absorption
Rapidly and completely absorbed after intramuscular (IM) administration, reaching peak plasma concentrations within 2-3 hours. Intravenous (IV) administration provides 100% bioavailability.
Metabolism
Not extensively metabolized in the liver; primarily eliminated unchanged. A small portion is converted to an inactive metabolite by intestinal microflora.
Side Effects
Contraindications
- Hypersensitivity to ceftriaxone, any other cephalosporin, or any component of the formulation.
- History of severe hypersensitivity reactions (e.g., anaphylaxis) to any other beta-lactam antibiotic (e.g., penicillin).
- Neonates (≤28 days old) with hyperbilirubinemia, especially premature neonates, due to the risk of bilirubin encephalopathy.
- Neonates (≤28 days old) receiving intravenous calcium-containing solutions or products due to the risk of precipitation.
Drug Interactions
Anticoagulants
Ceftriaxone may enhance the anticoagulant effect of vitamin K antagonists (e.g., warfarin), increasing the risk of bleeding. Close monitoring of INR is advised.
Aminoglycosides
Synergistic effect against some bacteria, but do not mix in the same syringe or IV line due to potential inactivation.
Oral Contraceptives
May reduce the efficacy of oral contraceptives. Advise additional non-hormonal contraception during treatment and for 7 days after.
IV Calcium-containing solutions
Contraindicated in neonates; in other age groups, administer sequentially with flushing between infusions to avoid precipitation.
Loop Diuretics (e.g., Furosemide)
Concomitant use with high doses of loop diuretics may increase the risk of nephrotoxicity, although this is rare.
Storage
Store the dry powder vials at a controlled room temperature, below 30°C (86°F), protected from light and moisture. Reconstituted solutions are stable for a limited time (e.g., 6 hours at room temperature or 24 hours under refrigeration) depending on the diluent used and manufacturer's instructions; always use freshly prepared solutions when possible.
Overdose
In cases of overdose, symptoms may include nausea, vomiting, diarrhea, and potentially neurological disturbances such as seizures. There is no specific antidote. Treatment is supportive and symptomatic. Hemodialysis or peritoneal dialysis is generally not effective in removing ceftriaxone from the body.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have shown no evidence of fetal harm, but there are no adequate and well-controlled studies in pregnant women. Ceftriaxone should be used during pregnancy only if clearly needed and the potential benefits outweigh the potential risks to the fetus. It is excreted in breast milk in low concentrations; caution should be exercised when Inoxon is administered to a nursing woman.
Side Effects
Contraindications
- Hypersensitivity to ceftriaxone, any other cephalosporin, or any component of the formulation.
- History of severe hypersensitivity reactions (e.g., anaphylaxis) to any other beta-lactam antibiotic (e.g., penicillin).
- Neonates (≤28 days old) with hyperbilirubinemia, especially premature neonates, due to the risk of bilirubin encephalopathy.
- Neonates (≤28 days old) receiving intravenous calcium-containing solutions or products due to the risk of precipitation.
Drug Interactions
Anticoagulants
Ceftriaxone may enhance the anticoagulant effect of vitamin K antagonists (e.g., warfarin), increasing the risk of bleeding. Close monitoring of INR is advised.
Aminoglycosides
Synergistic effect against some bacteria, but do not mix in the same syringe or IV line due to potential inactivation.
Oral Contraceptives
May reduce the efficacy of oral contraceptives. Advise additional non-hormonal contraception during treatment and for 7 days after.
IV Calcium-containing solutions
Contraindicated in neonates; in other age groups, administer sequentially with flushing between infusions to avoid precipitation.
Loop Diuretics (e.g., Furosemide)
Concomitant use with high doses of loop diuretics may increase the risk of nephrotoxicity, although this is rare.
Storage
Store the dry powder vials at a controlled room temperature, below 30°C (86°F), protected from light and moisture. Reconstituted solutions are stable for a limited time (e.g., 6 hours at room temperature or 24 hours under refrigeration) depending on the diluent used and manufacturer's instructions; always use freshly prepared solutions when possible.
Overdose
In cases of overdose, symptoms may include nausea, vomiting, diarrhea, and potentially neurological disturbances such as seizures. There is no specific antidote. Treatment is supportive and symptomatic. Hemodialysis or peritoneal dialysis is generally not effective in removing ceftriaxone from the body.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have shown no evidence of fetal harm, but there are no adequate and well-controlled studies in pregnant women. Ceftriaxone should be used during pregnancy only if clearly needed and the potential benefits outweigh the potential risks to the fetus. It is excreted in breast milk in low concentrations; caution should be exercised when Inoxon is administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture. Always refer to the expiration date printed on the product packaging.
Availability
Pharmacies, Hospitals
Approval Status
Approved by FDA/DGDA
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Ceftriaxone has undergone extensive clinical trials since its development, establishing its efficacy and safety profile in treating a broad spectrum of bacterial infections across various patient populations, including children and adults. These trials have supported its widespread use as a standard antibiotic.
Lab Monitoring
- Renal function (BUN, creatinine) in patients with pre-existing renal impairment or during prolonged high-dose therapy.
- Liver function tests (ALT, AST, bilirubin) periodically, especially in patients with hepatic impairment or during prolonged treatment.
- Complete blood count (CBC) with differential, particularly during extended therapy to monitor for hematological abnormalities.
Doctor Notes
- Prior to initiation of therapy, ascertain whether the patient has had previous hypersensitivity reactions to cephalosporins, penicillins, or other drugs.
- Consider performing culture and susceptibility testing to identify the causative organism and its susceptibility to ceftriaxone. Therapy may be initiated before results are available.
- Monitor for signs and symptoms of C. difficile-associated diarrhea if patients develop diarrhea during or after treatment.
- In neonates, co-administration with calcium-containing intravenous solutions is absolutely contraindicated. In older patients, administer sequentially and flush lines thoroughly.
Patient Guidelines
- It is crucial to complete the entire course of Inoxon as prescribed by your doctor, even if your symptoms improve sooner, to prevent recurrence and development of antibiotic resistance.
- Report any unusual or severe side effects, especially persistent diarrhea, rash, or difficulty breathing, to your healthcare provider immediately.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs, herbal supplements, and vitamins, to avoid potential drug interactions.
- Avoid concurrent use of intravenous calcium-containing solutions without consulting your doctor, especially if the patient is a neonate.
Missed Dose Advice
If a dose of Inoxon injection is missed, it should be administered as soon as remembered. However, if it is almost time for the next scheduled dose, skip the missed dose and resume the regular dosing schedule. Do not administer a double dose to make up for a missed one.
Driving Precautions
Inoxon may cause dizziness or lightheadedness in some individuals. Patients should be advised to exercise caution when driving or operating machinery until they know how the medication affects them.
Lifestyle Advice
- Maintain good hydration by drinking plenty of fluids, especially if experiencing diarrhea, to prevent dehydration.
- Avoid alcohol consumption during the course of treatment, as it may exacerbate certain side effects or mask symptoms of adverse reactions.
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