Topcef-250 mg Injection can be administered either intravenously (IV) or intramuscularly (IM). For IM administration, reconstitute the powder with sterile water for injection, lidocaine solution, or an appropriate diluent. Deep IM injection into a large muscle is recommended. For IV administration, reconstitute and dilute further, then administer slowly over 30 minutes (for adults) or 60 minutes (for neonates and infants). Always check the manufacturer's specific instructions for reconstitution and dilution.

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 units, which are crucial for the integrity and rigidity of the bacterial cell wall, leading to cell lysis and bacterial death.

• •Hypersensitivity to ceftriaxone, any other cephalosporin, or any component of the formulation.
• •Patients with a history of severe hypersensitivity reaction to any other type of beta-lactam antibacterial agent (e.g., penicillins, monobactams, carbapenems).
• •Neonates with hyperbilirubinemia, especially premature neonates, because ceftriaxone can displace bilirubin from serum albumin binding sites, potentially increasing the risk of kernicterus.
• •Concurrent use with calcium-containing intravenous solutions in neonates (≤28 days of age) due to the risk of precipitation of ceftriaxone-calcium in the lungs and kidneys.

Store the dry powder vial below 30°C in a dry place, protected from light and moisture. Do not freeze. After reconstitution, the solution should be used immediately. If not used immediately, store refrigerated (2°C to 8°C) for a specific period (e.g., 24 hours), as per manufacturer's instructions, and discard any unused portion.

In cases of overdose with ceftriaxone, symptoms are generally an exaggeration of known side effects, such as gastrointestinal disturbances, neurological effects (seizures), and hypersensitivity reactions. Treatment should be symptomatic and supportive. There is no specific antidote. Hemodialysis and peritoneal dialysis are generally not effective in removing ceftriaxone from the body.

Pregnancy Category B. Studies in animals have not shown 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 low concentrations in breast milk. Caution should be exercised when administered to a nursing mother; monitor for potential adverse effects on the infant (e.g., diarrhea, candidiasis).