How Long Does 1 Shot Of Rocephin Last?

How many hours does ceftriaxone last

Abstract – In human subjects, ceftriaxone exhibits an exceptionally long elimination half-life (5.8 to 8.7 hours) and a small degree of nonlinearity in its pharmacokinetics which can be ignored in its clinical applications. Thirty-three to 67 percent of a dose is excreted in the urine as unchanged drug, and the remainder is secreted in the bile and ultimately is found in the feces as microbiologically inactive compounds.

Ceftriaxone is rapidly and completely absorbed following intramuscular administration. Multiple dosing of ceftriaxone with doses ranging from 0.5 to 2 g at 12- or 24-hour intervals by intravenous and intramuscular routes resulted in 15 to 36 percent accumulation of ceftriaxone in plasma and no change in its elimination half-life.

The volume of distribution and the plasma clearance of ceftriaxone in pediatric patients were threefold greater than those in adults, and ceftriaxone penetrated the inflamed meninges of infants and children with bacterial meningitis. Small changes in the pharmacokinetics of ceftriaxone in elderly subjects or patients with renal or hepatic dysfunction are such that dose adjustments should not be necessary with a ceftriaxone dosage up to 2 g per day.

How often can I get a Rocephin shot

How to use Rocephin Vial. This medication is given by injection into a muscle or vein as directed by your doctor, usually once or twice daily. The dosage is based on your medical condition and response to treatment. Drink plenty of fluids while using this medication unless your doctor directs you otherwise.

Is Rocephin a strong antibiotic

What is Rocephin? – Rocephin is a cephalosporin (SEF a low spor in) antibiotic,, It works by fighting bacteria in your body. Rocephin is used to treat many kinds of bacterial infections, including severe or life-threatening forms such as E. coli, pneumonia, or meningitis, Rocephin is also used to prevent infection in people having certain types of surgery.

Is one shot of Rocephin enough for gonorrhea?

Gonorrhea can be cured with the right treatment. CDC recommends a single dose of 500 mg of intramuscular ceftriaxone.

Does ceftriaxone work immediately

It takes seven days for the medicine to cure gonorrhea. If you have sex during those first seven days you can still pass the infection on to your sex partners and you can also get re-infected yourself.

How does Rocephin make you feel?

Nausea, vomiting, pain in your upper stomach that spreads to your back; pale or yellowed skin, dark colored urine; new or worsening breathing problems (wheezing, feeling short of breath); a blood cell disorder-headache, chest pain, dizziness, weakness, severe tingling or numbness; or.

What bacteria is killed by Rocephin?

Action – Ceftriaxone is a broad spectrum antibiotic from the cephalosporin family. It is a known as a third generation cephalosporin, and is active against a number of bacteria not killed by first or second generation cephalosporins. Ceftriaxone kills bacteria by interfering with production of proteins important for their cell walls.

• It is active against a number of important and well-known organisms including: – Staphylococcus aureus (but not MRSA) – E.
• Coli – Neisseria meningitidis (meningococcus) – N.
• Gonorrhoeae (cause of gonorrhoea) Ceftriaxone also kills some important causative organisms of respiratory tract infections, Haemophilus influenzae, Streptococcus pneumoniae and Klebsiella pneumoniae.

Some strains of Pseudomonas aeruginosa, the bug that causes dangerous hospital infections, are also killed. A number of other bacteria responsible for a wide range of infections are also susceptible to Ceftriaxone.

Why is ceftriaxone given only once daily

Abstract – Twenty-six children received a single daily intravenous dose of ceftriaxone, 50 mg/kg, for a variety of bacterial infections including abscess (5), cellulitis (5), periorbital cellulitis (5), bacteremia without focus (4), osteomyelitis (2), pneumonia (2), pyelonephritis (2) and otitis media (1).

Organisms isolated from infectious foci were Staphylococcus aureus (9), Streptococcus pneumoniae (6), Streptococcus pyogenes (3), Escherichia coli (2); and Haemophilus influenzae type b, nontypable H. influenzae, Group B streptococcus, Pasteurella multocida, Haemophilus parainfluenzae and satelliting streptococcus (1 each).

Microbiologic cure was achieved in 20 of 22 (91%) infections and clinical cure in 25 of 26 (96%). Fifteen possible adverse reactions occurred in 34 patients evaluable for drug safety; most were mild and self-limited. Neutropenia developed in two patients necessitating discontinuation of ceftriaxone in one, followed by prompt resolution.

When does ceftriaxone peak

Ceftriaxone was completely absorbed following IM administration with mean maximum plasma concentrations occurring between 2 and 3 hours post-dose.

Can ceftriaxone be given twice a day

My Account Area – 1. Name of the medicinal product Ceftriaxone 2g Powder for solution for injection/infusion 2. Qualitative and quantitative composition Each bottle contains ceftriaxone sodium equivalent to 2g of ceftriaxone. Excipient with known effect Each gram of ceftriaxone contains approximately 82mg (3.6mmol) of sodium.

For the full list of excipients, see section 6.1 3. Pharmaceutical form Powder for solution for injection or infusion (Powder for injection/infusion). White to pale yellow crystalline powder.4. Clinical particulars 4.1 Therapeutic indications Ceftriaxone is indicated in the treatment of the following infections in adults and children including term neonates (from birth): Bacterial Meningitis Community acquired pneumonia Hospital acquired pneumonia Acute otitis media Intra-abdominal infections Complicated urinary tract infections (including pyelonephritis) Infections of bones and joints Complicated skin and soft tissue infections Gonorrhoea Syphilis Bacterial endocarditis Ceftriaxone may be used: For treatment of acute exacerbations of chronic obstructive pulmonary disease in adults For treatment of disseminated Lyme borreliosis (early (stage II) and late (stage III)) in adults and children including neonates from 15 days of age.

For Pre-operative prophylaxis of surgical site infections In the management of neutropenic patients with fever that is suspected to be due to a bacterial infection In the treatment of patients with bacteraemia that occurs in association with, or is suspected to be associated with, any of the infections listed above Ceftriaxone should be co-administered with other antibacterial agents whenever the possible range of causative bacteria would not fall within its spectrum (see section 4.4).

• Consideration should be given to official guidance on the appropriate use of antibacterial agents.4.2 Posology and method of administration Posology The dose depends on the severity, susceptibility, site and type of infection and on the age and hepato-renal function of the patient.
• The doses recommended in the tables below are the generally recommended doses in these indications.

In particularly severe cases, doses at the higher end of the recommended range should be considered. Adults and children over 12 years of age (≥ 50 kg)

In documented bacteraemia, the higher end of the recommended dose range should be considered. ** Twice daily (12 hourly) administration may be considered where doses greater than 2 g daily are administered. Indications for adults and children over 12 years of age (≥ 50 kg) that require specific dosage schedules: Acute otitis media A single intramuscular dose of Ceftriaxone 1-2 g can be given. Limited data suggest that in cases where the patient is severely ill or previous therapy has failed, Ceftriaxone may be effective when given as an intramuscular dose of 1-2 g daily for 3 days. Pre-operative prophylaxis of surgical site infections 2 g as a single pre-operative dose. Gonorrhoea 500 mg as a single intramuscular dose. Syphilis The generally recommended doses are 500 mg-1 g once daily increased to 2 g once daily for neurosyphilis for 10-14 days. The dose recommendations in syphilis, including neurosyphilis, are based on limited data. National or local guidance should be taken into consideration. Disseminated Lyme borreliosis (early and late ) 2 g once daily for 14-21 days. The recommended treatment durations vary and national or local guidelines should be taken into consideration. Paediatric population Neonates, infants and children 15 days to 12 years of age (< 50 kg) For children with bodyweight of 50 kg or more, the usual adult dosage should be given.

In documented bacteraemia, the higher end of the recommended dose range should be considered. ** Twice daily (12 hourly) administration may be considered where doses greater than 2 g daily are administered. Indications for neonates, infants and children 15 days to 12 years (< 50 kg) that require specific dosage schedules: Acute otitis media For initial treatment of acute otitis media, a single intramuscular dose of Ceftriaxone 50 mg/kg can be given. Limited data suggest that in cases where the child is severely ill or initial therapy has failed, Ceftriaxone may be effective when given as an intramuscular dose of 50 mg/kg daily for 3 days. Pre-operative prophylaxis of surgical site infections 50-80 mg/kg as a single pre-operative dose. Syphilis The generally recommended doses are 75-100 mg/kg (max 4 g) once daily for 10-14 days. The dose recommendations in syphilis, including neurosyphilis, are based on very limited data. National or local guidance should be taken into consideration. Disseminated Lyme borreliosis (early and late ) 50–80 mg/kg once daily for 14-21 days. The recommended treatment durations vary and national or local guidelines should be taken into consideration. Neonates 0-14 days Ceftriaxone is contraindicated in premature neonates up to a postmenstrual age of 41 weeks (gestational age + chronological age).

In documented bacteraemia, the higher end of the recommended dose range should be considered. A maximum daily dose of 50 mg/kg should not be exceeded. Indications for neonates 0-14 days that require specific dosage schedules: Acute otitis media For initial treatment of acute otitis media, a single intramuscular dose of Ceftriaxone 50 mg/kg can be given. Pre-operative prophylaxis of surgical site infections 20-50 mg/kg as a single pre-operative dose. Syphilis The generally recommended dose is 50 mg/kg once daily for 10-14 days. The dose recommendations in syphilis, including neurosyphilis, are based on very limited data. National or local guidance should be taken into consideration. Duration of therapy The duration of therapy varies according to the course of the disease. As with antibiotic therapy in general, administration of ceftriaxone should be continued for 48 – 72 hours after the patient has become afebrile or evidence of bacterial eradication has been achieved. Older people The dosages recommended for adults require no modification in older people provided that renal and hepatic function is satisfactory. Patients with hepatic impairment Available data do not indicate the need for dose adjustment in mild or moderate liver function impairment provided renal function is not impaired. There are no study data in patients with severe hepatic impairment (see section 5.2). Patients with renal impairment: In patients with impaired renal function, there is no need to reduce the dosage of ceftriaxone provided hepatic function is not impaired. Only in cases of preterminal renal failure (creatinine clearance < 10 ml/min) should the ceftriaxone dosage not exceed 2 g daily. In patients undergoing dialysis no additional supplementary dosing is required following the dialysis. Ceftriaxone is not removed by peritoneal- or haemodialysis. Close clinical monitoring for safety and efficacy is advised. Patients with severe hepatic and renal impairment In patients with both severe renal and hepatic dysfunction, close clinical monitoring for safety and efficacy is advised. Method of administration Intramuscular administration 2g ceftriaxone should be dissolved in 7.0ml of 1% Lidocaine Injection BP. The solution should be administered by deep intramuscular injection. Intramuscular injections should be injected well within the bulk of a relatively large muscle and not more than 1 g should be injected at one site. Dosages greater than 1g should be divided and injected at more than one site. As the solvent used is lidocaine, the resulting solution should never be administered intravenously (see section 4.3). The information in the Summary of Product Characteristics of lidocaine should be considered. Intravenous administration Ceftriaxone can be administered by intravenous infusion over at least 30 minutes (preferred route) or by slow intravenous injection over 5 minutes. Intravenous intermittent injection should be given over 5 minutes preferably in larger veins. Intravenous doses of 50 mg/kg or more in infants and children up to 12 years of age should be given by infusion. In neonates, intravenous doses should be given over 60 minutes to reduce the potential risk of bilirubin encephalopathy (see section 4.3 and 4.4). Intramuscular administration should be considered when the intravenous route is not possible or less appropriate for the patient. For doses greater than 2 g intravenous administration should be used. Ceftriaxone is contraindicated in neonates (≤ 28 days) if they require (or are expected to require) treatment with calcium-containing intravenous solutions, including continuous calcium-containing infusions such as parenteral nutrition, because of the risk of precipitation of ceftriaxone-calcium (see section 4.3). Diluents containing calcium, (e.g. Ringer's solution or Hartmann's solution), should not be used to reconstitute ceftriaxone vials or to further dilute a reconstituted vial for intravenous administration because a precipitate can form. Precipitation of ceftriaxone-calcium can also occur when ceftriaxone is mixed with calcium-containing solutions in the same intravenous administration line. Therefore, ceftriaxone and calcium-containing solutions must not be mixed or administered simultaneously (see sections 4.3, 4.4 and 6.2). For pre-operative prophylaxis of surgical site infections, ceftriaxone should be administered 30-90 minutes prior to surgery. For instructions on reconstitution of the medicinal product before administration, see section 6.6.4.3 Contraindications Hypersensitivity to ceftriaxone, or to any other cephalosporin. History of severe hypersensitivity (e.g. anaphylactic reaction) to any other type of beta-lactam antibacterial agent (penicillins, monobactams and carbapenems). Ceftriaxone is contraindicated in: • Premature neonates up to a postmenstrual age of 41 weeks (gestational age + chronological age)* • Full-term neonates (up to 28 days of age): - with hyperbilirubinaemia, jaundice, or who are hypoalbuminaemic or acidotic because these are conditions in which bilirubin binding is likely to be impaired* - if they require (or are expected to require) intravenous calcium treatment, or calcium-containing infusions due to the risk of precipitation of a ceftriaxone-calcium salt (see sections 4.4, 4.8 and 6.2 ). * In vitro studies have shown that ceftriaxone can displace bilirubin from its serum albumin binding sites leading to a possible risk of bilirubin encephalopathy in these patients. Contraindications to lidocaine must be excluded before intramuscular injection of ceftriaxone when lidocaine solution is used as a solvent (see section 4.4). See information in the Summary of Product Characteristics of lidocaine, especially contraindications. Ceftriaxone solutions containing lidocaine should never be administered intravenously.4.4 Special warnings and precautions for use Hypersensitivity reactions As with all beta-lactam antibacterial agents, serious and occasionally fatal hypersensitivity reactions have been reported (see section 4.8). In case of severe hypersensitivity reactions, treatment with ceftriaxone must be discontinued immediately and adequate emergency measures must be initiated. Before beginning treatment, it should be established whether the patient has a history of severe hypersensitivity reactions to ceftriaxone, to other cephalosporins or to any other type of beta-lactam agent. Caution should be used if ceftriaxone is given to patients with a history of non-severe hypersensitivity to other beta-lactam agents. Severe cutaneous adverse reactions (Stevens Johnson syndrome or Lyell's syndrome/toxic epidermal necrolysis) and drug reaction with eosinophilia and systemic symptoms (DRESS)) which can be life-threatening or fatal have been reported in association with ceftriaxone treatment; however, the frequency of these events is not known (see section 4.8). Jarisch-Herxheimer reaction (JHR) Some patients with spirochete infections may experience a Jarisch-Herxheimer reaction (JHR) shortly after ceftriaxone treatment is started. JHR is usually a self – limiting condition or can be managed by symptomatic treatment. The antibiotic treatment should not be discontinued if such reaction occurs.' Interaction with calcium containing products Cases of fatal reactions with calcium-ceftriaxone precipitates in lungs and kidneys in premature and full-term neonates aged less than 1 month have been described. At least one of them had received ceftriaxone and calcium at different times and through different intravenous lines. In the available scientific data, there are no reports of confirmed intravascular precipitations in patients, other than neonates, treated with ceftriaxone and calcium-containing solutions or any other calcium-containing products. In vitro studies demonstrated that neonates have an increased risk of precipitation of ceftriaxone-calcium compared to other age groups. In patients of any age ceftriaxone must not be mixed or administered simultaneously with any calcium-containing intravenous solutions, even via different infusion lines or at different infusion sites. However, in patients older than 28 days of age ceftriaxone and calcium-containing solutions may be administered sequentially one after another if infusion lines at different sites are used or if the infusion lines are replaced or thoroughly flushed between infusions with physiological salt-solution to avoid precipitation. In patients requiring continuous infusion with calcium-containing total parenteral nutrition (TPN) solutions, healthcare professionals may wish to consider the use of alternative antibacterial treatments which do not carry a similar risk of precipitation. If the use of ceftriaxone is considered necessary in patients requiring continuous nutrition, TPN solutions and ceftriaxone can be administered simultaneously, albeit via different infusion lines at different sites. Alternatively, infusion of TPN solution could be stopped for the period of ceftriaxone infusion and the infusion lines flushed between solutions (see sections 4.3, 4.8, 5.2 and 6.2). Paediatric population Safety and effectiveness of Ceftriaxone in neonates, infants and children have been established for the dosages described under Posology and Method of Administration (see section 4.2). Studies have shown that ceftriaxone, like some other cephalosporins, can displace bilirubin from serum albumin. Ceftriaxone is contraindicated in premature and full-term neonates at risk of developing bilirubin encephalopathy (see section 4.3). Immune mediated haemolytic anaemia An immune mediated haemolytic anaemia has been observed in patients receiving cephalosporin class antibacterials including Ceftriaxone (see section 4.8). Severe cases of haemolytic anaemia, including fatalities, have been reported during Ceftriaxone treatment in both adults and children. If a patient develops anaemia while on ceftriaxone, the diagnosis of a cephalosporin - associated anaemia should be considered and ceftriaxone discontinued until the aetiology is determined. Long term treatment During prolonged treatment complete blood count should be performed at regular intervals. Colitis/Overgrowth of non-susceptible microorganisms Antibacterial agent-associated colitis and pseudo-membranous colitis have been reported with nearly all antibacterial agents, including ceftriaxone, and may range in severity from mild to life-threatening. Therefore, it is important to consider this diagnosis in patients who present with diarrhoea during or subsequent to the administration of ceftriaxone (see section 4.8). Discontinuation of therapy with ceftriaxone and the administration of specific treatment for Clostridium difficile should be considered. Medicinal products that inhibit peristalsis should not be given. Superinfections with non-susceptible micro-organisms may occur as with other antibacterial agents. Severe renal and hepatic insufficiency In severe renal and hepatic insufficiency, close clinical monitoring for safety and efficacy is advised (see section 4.2). Interference with serological testing Interference with Coombs tests may occur, as Ceftriaxone may lead to false-positive test results. Ceftriaxone can also lead to false-positive test results for galactosaemia (see section 4.8). Non-enzymatic methods for the glucose determination in urine may give false-positive results. Urine glucose determination during therapy with Ceftriaxone should be done enzymatically (see section 4.8). The presence of ceftriaxone may falsely lower estimated blood glucose values obtained with some blood glucose monitoring systems. Please refer to instructions for use for each system. Alternative testing methods should be used if necessary. Sodium This medicinal product contains 165mg sodium per 2g vial, equivalent to 8.3% of the WHO recommended maximum daily intake of 2 g sodium for an adult. Antibacterial spectrum Ceftriaxone has a limited spectrum of antibacterial activity and may not be suitable for use as a single agent for the treatment of some types of infections unless the pathogen has already been confirmed (see section 4.2). In polymicrobial infections, where suspected pathogens include organisms resistant to ceftriaxone, administration of an additional antibiotic should be considered. Use of lidocaine In case a lidocaine solution is used as a solvent, ceftriaxone solutions must only be used for intramuscular injection. Contraindications to lidocaine, warnings and other relevant information as detailed in the Summary of Product Characteristics of lidocaine must be considered before use (see section 4.3). The lidocaine solution should never be administered intravenously. Biliary lithiasis When shadows are observed on sonograms, consideration should be given to the possibility of precipitates of calcium ceftriaxone. Shadows, which have been mistaken for gallstones, have been detected on sonograms of the gallbladder and have been observed more frequently at ceftriaxone doses of 1 g per day and above. Caution should be particularly considered in the paediatric population. Such precipitates disappear after discontinuation of ceftriaxone therapy. Rarely precipitates of calcium ceftriaxone have been associated with symptoms. In symptomatic cases, conservative nonsurgical management is recommended and discontinuation of ceftriaxone treatment should be considered by the physician based on specific benefit risk assessment (see section 4.8). Biliary stasis Cases of pancreatitis, possibly of biliary obstruction aetiology, have been reported in patients treated with Ceftriaxone (see section 4.8). Most patients presented with risk factors for biliary stasis and biliary sludge e.g. preceding major therapy, severe illness and total parenteral nutrition. A trigger or cofactor of Ceftriaxone-related biliary precipitation cannot be ruled out. Renal lithiasis Cases of renal lithiasis have been reported, which is reversible upon discontinuation of ceftriaxone (see section 4.8). In symptomatic cases, sonography should be performed. Use in patients with history of renal lithiasis or with hypercalciuria should be considered by the physician based on specific benefit risk assessment. Encephalopathy Encephalopathy has been reported with the use of ceftriaxone (see section 4.8), particularly in elderly patients with severe renal impairment (see section 4.2) or central nervous system disorders. If ceftriaxone-associated encephalopathy is suspected (e.g. decreased level of consciousness, altered mental state, myoclonus, convulsions), discontinuation of ceftriaxone should be considered.4.5 Interaction with other medicinal products and other forms of interaction Calcium-containing diluents, such as Ringer's solution or Hartmann's solution, should not be used to reconstitute Ceftriaxone vials or to further dilute a reconstituted vial for intravenous administration because a precipitate can form. Precipitation of ceftriaxone-calcium can also occur when ceftriaxone is mixed with calcium-containing solutions in the same intravenous administration line. Ceftriaxone must not be administered simultaneously with calcium-containing intravenous solutions, including continuous calcium-containing infusions such as parenteral nutrition via a Y-site. However, in patients other than neonates, ceftriaxone and calcium-containing solutions may be administered sequentially of one another if the infusion lines are thoroughly flushed between infusions with a compatible fluid. In vitro studies using adult and neonatal plasma from umbilical cord blood demonstrated that neonates have an increased risk of precipitation of ceftriaxone-calcium (see sections 4.2, 4.3, 4.4, 4.8 and 6.2). Concomitant use with oral anticoagulants may increase the anti-vitamin K effect and the risk of bleeding. It is recommended that the International Normalised Ratio (INR) is monitored frequently and the posology of the anti-vitamin K drug adjusted accordingly, both during and after treatment with ceftriaxone (see section 4.8). There is conflicting evidence regarding a potential increase in renal toxicity of aminoglycosides when used with cephalosporins. The recommended monitoring of aminoglycoside levels (and renal function) in clinical practice should be closely adhered to in such cases. In an in-vitro study antagonistic effects have been observed with the combination of chloramphenicol and ceftriaxone. The clinical relevance of this finding is unknown. There have been no reports of an interaction between ceftriaxone and oral calcium-containing products or interaction between intramuscular ceftriaxone and calcium-containing products (intravenous or oral). In patients treated with ceftriaxone, the Coombs' test may lead to false-positive test results. Ceftriaxone, like other antibiotics, may result in false-positive tests for galactosaemia. Likewise, non-enzymatic methods for glucose determination in urine may yield false-positive results. For this reason, glucose level determination in urine during therapy with ceftriaxone should be carried out enzymatically. No impairment of renal function has been observed after concurrent administration of large doses of ceftriaxone and potent diuretics (e.g. furosemide). Simultaneous administration of probenecid does not reduce the elimination of ceftriaxone.4.6 Fertility, pregnancy and lactation Pregnancy Ceftriaxone crosses the placental barrier. There are limited amounts of data from the use of ceftriaxone in pregnant women. Animal studies do not indicate direct or indirect harmful effects with respect to embryonal/foetal, perinatal and postnatal development (see section 5.3). Ceftriaxone should only be administered during pregnancy and in particular in the first trimester of pregnancy if the benefit outweighs the risk. Breastfeeding Ceftriaxone is excreted into human milk in low concentrations but at therapeutic doses of ceftriaxone no effects on the breastfed infants are anticipated. However, a risk of diarrhoea and fungal infection of the mucous membranes cannot be excluded. The possibility of sensitisation should be taken into account. A decision must be made whether to discontinue breast-feeding or to discontinue/abstain from ceftriaxone therapy, taking into account the benefit of breast feeding for the child and the benefit of therapy for the woman. Fertility Reproductive studies have shown no evidence of adverse effects on male or female fertility.4.7 Effects on ability to drive and use machines During treatment with ceftriaxone, undesirable effects may occur (e.g. dizziness), which may influence the ability to drive and use machines (see section 4.8). Patients should be cautious when driving or operating machinery.4.8 Undesirable effects The most frequently reported adverse reactions for ceftriaxone are eosinophilia, leucopenia, thrombocytopenia, diarrhoea, rash, and hepatic enzymes increased. Data to determine the frequency of ceftriaxone ADRs was derived from clinical trials. The following convention has been used for the classification of frequency: Very common (≥ 1/10) Common (≥ 1/100 - < 1/10) Uncommon (≥ 1/1000 - < 1/100) Rare (≥ 1/10000 - < 1/1000) Not known (cannot be estimated from the available data)

a Based on post-marketing reports. Since these reactions are reported voluntarily from a population of uncertain size, it is not possible to reliably estimate their frequency which is therefore categorised as not known. b See section 4.4 Description of selected adverse reactions Infections and infestations Reports of diarrhoea following the use of ceftriaxone may be associated with Clostridium difficile, Appropriate fluid and electrolyte management should be instituted (see section 4.4). Ceftriaxone-calcium salt precipitation Rarely, severe, and in some cases, fatal, adverse reactions have been reported in pre-term and full-term neonates (aged < 28 days) who had been treated with intravenous ceftriaxone and calcium. Precipitations of ceftriaxone-calcium salt have been observed in lung and kidneys post-mortem. The high risk of precipitation in neonates is a result of their low blood volume and the longer half-life of ceftriaxone compared with adults (see sections 4.3, 4.4, and 5.2). Cases of ceftriaxone precipitation in the urinary tract have been reported, mostly in children treated with high doses (e.g. ≥ 80 mg/kg/day or total doses exceeding 10 grams) and who have other risk factors (e.g. dehydration, confinement to bed). This event may be asymptomatic or symptomatic, and may lead to ureteric obstruction and postrenal acute renal failure, but is usually reversible upon discontinuation of ceftriaxone (see section 4.4). Precipitation of ceftriaxone calcium salt in the gallbladder has been observed, primarily in patients treated with doses higher than the recommended standard dose. In children, prospective studies have shown a variable incidence of precipitation with intravenous application - above 30 % in some studies. The incidence appears to be lower with slow infusion (20 - 30 minutes). This effect is usually asymptomatic, but the precipitations have been accompanied by clinical symptoms such as pain, nausea and vomiting in rare cases. Symptomatic treatment is recommended in these cases. Precipitation is usually reversible upon discontinuation of ceftriaxone (see section 4.4). Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.4.9 Overdose In overdose, the symptoms of nausea, vomiting and diarrhoea can occur. Ceftriaxone concentrations cannot be reduced by haemodialysis or peritoneal dialysis. There is no specific antidote. Treatment is symptomatic.5. Pharmacological properties 5.1 Pharmacodynamic properties Pharmacotherapeutic group: Antibacterials for systemic use, Third-generation cephalosporins ATC code: J01DD04 Mechanism of action Ceftriaxone inhibits bacterial cell wall synthesis following attachment to penicillin binding proteins (PBPs). This results in the interruption of cell wall (peptidoglycan) biosynthesis, which leads to bacterial cell lysis and death. Resistance Bacterial resistance to ceftriaxone may be due to one or more of the following mechanisms: • hydrolysis by beta-lactamases, including extended-spectrum beta-lactamases (ESBLs), carbapenemases and Amp C enzymes that may be induced or stably derepressed in certain aerobic Gram-negative bacterial species. • reduced affinity of penicillin-binding proteins for ceftriaxone. • outer membrane impermeability in Gram-negative organisms. • bacterial efflux pumps. Susceptibility testing Breakpoints Minimum inhibitory concentration (MIC) breakpoints established by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) are as follows:

a. Susceptibility inferred from cefoxitin susceptibility.b. Susceptibility inferred from penicillin susceptibility.c. Isolates with a ceftriaxone MIC above the susceptible breakpoint are rare and, if found, should be re-tested and, if confirmed, should be sent to a reference laboratory.d.

• Breakpoints apply to a daily intravenous dose of 1 g x 1 and a high dose of at least 2 g x 1.
• Clinical efficacy against specific pathogens The prevalence of acquired resistance may vary geographically and with time for selected species and local information on resistance is desirable, particularly when treating severe infections.

As necessary, expert advice should be sought when the local prevalence of resistance is such that the utility of ceftriaxone in at least some types of infections is questionable.

All methicillin-resistant staphylococci are resistant to ceftriaxone. + Resistance rates >50% in at least one region % ESBL producing strains are always resistant 5.2 Pharmacokinetic properties Absorption Intramuscular administration Following intramuscular injection, mean peak plasma ceftriaxone levels are approximately half those observed after intravenous administration of an equivalent dose. The maximum plasma concentration after a single intramuscular dose of 1 g is about 81 mg/l and is reached in 2 – 3 hours after administration. The area under the plasma concentration-time curve after intramuscular administration is equivalent to that after intravenous administration of an equivalent dose. Intravenous administration After intravenous bolus administration of ceftriaxone 500 mg and 1 g, mean peak plasma ceftriaxone levels are approximately 120 and 200 mg/l respectively. After intravenous infusion of ceftriaxone 500 mg, 1 g and 2 g, the plasma ceftriaxone levels are approximately 80, 150 and 250 mg/l respectively. Distribution The volume of distribution of ceftriaxone is 7 – 12 l. Concentrations well above the minimal inhibitory concentrations of most relevant pathogens are detectable in tissue including lung, heart, biliary tract/liver, tonsil, middle ear and nasal mucosa, bone, and in cerebrospinal, pleural, prostatic and synovial fluids. An 8 – 15 % increase in mean peak plasma concentration (C max ) is seen on repeated administration; steady state is reached in most cases within 48 – 72 hours depending on the route of administration. Penetration into particular tissues Ceftriaxone penetrates the meninges. Penetration is greatest when the meninges are inflamed. Mean peak ceftriaxone concentrations in CSF in patients with bacterial meningitis are reported to be up to 25 % of plasma levels compared to 2 % of plasma levels in patients with uninflamed meninges. Peak ceftriaxone concentrations in CSF are reached approximately 4-6 hours after intravenous injection. Ceftriaxone crosses the placental barrier and is excreted in the breast milk at low concentrations (see section 4.6). Protein binding Ceftriaxone is reversibly bound to albumin. Plasma protein binding is about 95 % at plasma concentrations below 100 mg/l. Binding is saturable and the bound portion decreases with rising concentration (up to 85 % at a plasma concentration of 300 mg/l). Biotransformation Ceftriaxone is not metabolised systemically; but is converted to inactive metabolites by the gut flora. Elimination Plasma clearance of total ceftriaxone (bound and unbound) is 10 – 22 ml/min. Renal clearance is 5 – 12 ml/min.50 – 60 % of ceftriaxone is excreted unchanged in the urine, primarily by glomerular filtration, while 40 – 50 % is excreted unchanged in the bile. The elimination half-life of total ceftriaxone in adults is about 8 hours. Patients with renal or hepatic impairment In patients with renal or hepatic dysfunction, the pharmacokinetics of ceftriaxone are only minimally altered with the half-life slightly increased (less than two fold), even in patients with severely impaired renal function. The relatively modest increase in half-life in renal impairment is explained by a compensatory increase in non-renal clearance, resulting from a decrease in protein binding and corresponding increase in non-renal clearance of total ceftriaxone. In patients with hepatic impairment, the elimination half-life of ceftriaxone is not increased, due to a compensatory increase in renal clearance. This is also due to an increase in plasma free fraction of ceftriaxone contributing to the observed paradoxical increase in total drug clearance, with an increase in volume of distribution paralleling that of total clearance. Older people In older people aged over 75 years the average elimination half-life is usually two to three times that of young adults. Paediatric population The half-life of ceftriaxone is prolonged in neonates. From birth to 14 days of age, the levels of free ceftriaxone may be further increased by factors such as reduced glomerular filtration and altered protein binding. During childhood, the half-life is lower than in neonates or adults. The plasma clearance and volume of distribution of total ceftriaxone are greater in neonates, infants and children than in adults. Linearity/non-linearity The pharmacokinetics of ceftriaxone are non-linear and all basic pharmacokinetic parameters, except the elimination half-life, are dose dependent if based on total drug concentrations, increasing less than proportionally with dose. Non-linearity is due to saturation of plasma protein binding and is therefore observed for total plasma ceftriaxone but not for free (unbound) ceftriaxone. Pharmacokinetic/pharmacodynamic relationship As with other beta-lactams, the pharmacokinetic-pharmacodynamic index demonstrating the best correlation with in vivo efficacy is the percentage of the dosing interval that the unbound concentration remains above the minimum inhibitory concentration (MIC) of ceftriaxone for individual target species (i.e. %T > MIC).5.3 Preclinical safety data There is evidence from animal studies that high doses of ceftriaxone calcium salt led to formation of concrements and precipitates in the gallbladder of dogs and monkeys, which proved to be reversible. Animal studies produced no evidence of toxicity to reproduction and genotoxicity. Carcinogenicity studies on ceftriaxone were not conducted.6. Pharmaceutical particulars 6.1 List of excipients None 6.2 Incompatibilities Based on literature reports, ceftriaxone is not compatible with amsacrine, vancomycin, fluconazole and aminoglycosides. Solutions containing ceftriaxone should not be mixed with or added to other agents except those mentioned in section 6.6. In particular, diluents containing calcium, (e.g. Ringer’s solution, Hartmann’s solution) should not be used to reconstitute ceftriaxone or to further dilute a reconstituted bottle for IV administration because a precipitate can form. Ceftriaxone must not be mixed or administered simultaneously with calcium containing solutions including total parenteral nutrition (see section 4.2, 4.3, 4.4 and 4.8). If treatment with a combination of another antibiotic with Ceftriaxone is intended, administration should not occur in the same syringe or in the same infusion solution.6.3 Shelf life Unopened –3 years. For reconstituted solution, chemical and physical in-use stability has been demonstrated for 24 hours at 25 o C and for four days at 2-8°C. From a microbiological point of view, once opened, the product should be used immediately. If not used immediately, in-use storage times and conditions prior to use are the responsibility of the user and would normally not be longer than 24 hours at 2-8°C, unless reconstitution has taken place in controlled and validated aseptic conditions.6.4 Special precautions for storage Unopened: Do not store above 25°C. Keep the bottles in the outer carton. After reconstitution: Store at 2-8°C, see section 6.3 for complete storage instructions.6.5 Nature and contents of container Ceftriaxone is supplied in moulded Type II 50 ml clear glass infusion bottles, closed with a Type I rubber stopper uncoated/coated in Omniflex and sealed with an aluminium/plastic cap. The bottles are packed in boxes of 1 and 10 bottles. Not all pack sizes may be marketed.6.6 Special precautions for disposal and other handling 1g vial – Concentrations for the intravenous injection: approximately 100 mg/ml, 1g vial – Concentrations for the intravenous infusion: approximately 50 mg/ml 2g vial – Concentrations for the intravenous injection or intravenous infusion: approximately 50 mg/ml (Please refer to section 4.2 for further information). Reconstitution Table

1 For Intravenous injection, 1g ceftriaxone is dissolved in 10ml of Water for Injections. The injection should be administered over 5 minutes, directly into the vein or via the tubing of an intravenous infusion.2 Dosages greater than 1g should be divided and injected at more than one site.

• These approximate available volume and approximate displacement volume values are when reconstituted using Water for Injections.
• The use of freshly prepared solutions is recommended.
• For storage conditions of the reconstituted medicinal product, see section 6.3.
• Ceftriaxone should not be mixed in the same syringe with any drug other than 1% Lidocaine Injection BP (for intramuscular injection only).

*Ceftriaxone is compatible with several commonly used intravenous infusion fluids e.g. Sodium Chloride Intravenous Infusion BP, 5% or 10% Glucose Intravenous Infusion BP, Sodium Chloride and Glucose Intravenous Infusion BP (0.45% sodium chloride and 2.5% glucose), Dextran 6% in Glucose Intravenous Infusion BP 5%, isotonic hydroxyethylstarch 6-10% infusions and Water for Injections.

The reconstituted solution should be clear. Do not use if particles are present. Ceftriaxone sodium when dissolved in Water for Injections Ph Eur forms a pale yellow to amber solution. Variations in the intensity of colour of the freshly prepared solutions do not indicate a change in potency or safety.

For single use only. Discard any unused contents.7. Marketing authorisation holder Wockhardt UK Ltd Ash Road North Wrexham LL13 9 UF United Kingdom 8. Marketing authorisation number(s) PL 29831/0033 9. Date of first authorisation/renewal of the authorisation Date of first authorisation: 13 October 2007 10.

Can Rocephin make you sleepy?

What side effects may I notice from receiving this medication? – Side effects that you should report to your care team as soon as possible:

Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat Confusion Drowsiness Gallbladder problems—severe stomach pain, nausea, vomiting, fever Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet Kidney stones—blood in the urine, pain or trouble passing urine, pain in the lower back or sides Low red blood cell count—unusual weakness or fatigue, dizziness, headache, trouble breathing Pancreatitis—severe stomach pain that spreads to your back or gets worse after eating or when touched, fever, nausea, vomiting Seizures Severe diarrhea, fever Unusual weakness or fatigue

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

Diarrhea

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Is one shot of Rocephin enough for chlamydia?

What antibiotics are used to treat chlamydia and gonorrhea?

From the 2015 Sexually Transmitted Disease (STD) guidelines, the CDC recommends treatment for a gonorrhea-chlamydia coinfection with () 1 gram given orally in a single dose, plus () 250 mg given intramuscularly as first-line therapy.As dual therapy, ceftriaxone and azithromycin should be administered together on the same day, preferably at the same time, and under direct observation by a health care provider.Co-infection of with can be found commonly in the community setting.

: What antibiotics are used to treat chlamydia and gonorrhea?

Does Rocephin have to be given 24 hours apart

How should I use this medication? – To treat bacterial infections, the recommended dose and dosing schedule of ceftriaxone varies according to the specific infection being treated, the response to therapy, and other medications or treatments being used.

The dose administered is also based on age, body size, and kidney and liver function. For moderate to severe infections in adults, the dose ranges from 1 g to 2 g daily given once every 24 hours or divided into 2 equal doses and given every 12 hours. For uncomplicated gonorrhea in adults, one dose of 250 mg is injected into a muscle.

For children 12 years of age and under, the dose is based on body weight and is given every 12 hours. The maximum daily dose for adults and children is 4 g. The duration of treatment depends on the type of infection and usually ranges from 4 to 14 days.

Some infections require only one dose while others require treatment for several weeks. Ceftriaxone is injected into a vein or into a muscle by a health care professional under the supervision of your doctor. Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications.

If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor. It is important to take this medication exactly as prescribed by your doctor. Store this medication (as unmixed vials) at room temperature, protect it from light, and keep it out of the reach of children.

How do I know if ceftriaxone is working?

pronounced as (sef try ax’ one) Ceftriaxone injection is used to treat certain infections caused by bacteria such as gonorrhea (a sexually transmitted disease), pelvic inflammatory disease (infection of the female reproductive organs that may cause infertility), meningitis (infection of the membranes that surround the brain and spinal cord), and infections of the lungs, ears, skin, urinary tract, blood, bones, joints, and abdomen.

1. Ceftriaxone injection is also sometimes given before certain types of surgery to prevent infections that may develop after the operation.
2. Ceftriaxone injection is in a class of medications called cephalosporin antibiotics.
3. It works by killing bacteria.
4. Antibiotics such as ceftriaxone injection will not work for colds, flu, or other viral infections.Using antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.

Ceftriaxone injection comes as a powder to be mixed with liquid, or as a premixed product, to be injected intravenously (into a vein) over a period of 30 or 60 minutes.Ceftriaxone injection can also be given intramuscularly (into a muscle). It is sometimes given as a single dose and sometimes given once or twice a day for 4-14 days, depending on the type of infection being treated.

You may receive ceftriaxone injection in a hospital or doctor’s office, or you may administer the medication at home. If you will be receiving ceftriaxone injection at home, your healthcare provider will show you how to use the medication. Be sure that you understand these directions, and ask your healthcare provider if you have any questions.

You should begin to feel better during the first few days of your treatment with ceftriaxone injection. If your symptoms do not improve or get worse, call your doctor. If you will be using more than one dose of ceftriaxone injection, use the medication until you finish the prescription, even if you feel better.

1. If you stop using ceftriaxone injection too soon or skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.
2. Ceftriaxone injection is also sometimes used to treat sinus infections, endocarditis (infection of the heart lining and valves), chancroid (genital sores caused by bacteria), Lyme disease (an infection that is transmitted by tick bites that may cause problems with the heart, joints, and nervous system), relapsing fever (an infection that is transmitted by tick bites that causes repeated episodes of fever), shigella (an infection that causes severe diarrhea), typhoid fever (a serious infection that is common in developing countries), salmonella (an infection that causes severe diarrhea), and Whipple’s disease (a rare infection that causes serious problems with digestion).

Ceftriaxone injection is also sometimes used to prevent infection in certain penicillin-allergic patients who have a heart condition and are having a dental or upper respiratory tract (nose, mouth, throat, voice box) procedure, patients who have fever and are at high risk for infection because they have very few white blood cells, close contacts of someone who is sick with meningitis, and in people who have been sexually assaulted or who have been bitten by humans or animals.

What is the strongest antibiotic ever

Vancomycin 3.0 is one of the most potent antibiotics ever created. It is used to treat conditions like methicillin-resistant Staphylococcus aureus-induced meningitis, endocarditis, joint infections, and bloodstream and skin infections.

Is Rocephin toxic to kidneys

What about a person undergoing hemodialysis? – Dosing also matters if people with renal failure are undergoing hemodialysis — a procedure that filters the blood, removing any accumulated substances and drugs. For example, doctors may choose to administer certain intravenous antibiotics, such as cefazolin (Ancef), after a dialysis session.

confusionseizuresuncontrollable twitching or jerking of a muscle group

When fluoroquinolone antibiotics accumulate in the bloodstream, people may experience:

ruptured tendonstingling, numbness, or pain in the fingertips and toesmental health side effects

Aminoglycosides can cause side effects that affect the ear, such as:

balance issues problems with coordinationimpaired hearing

Sometimes combining two antibiotics, such as piperacillin-tazobactam (Zosyn) and vancomycin (Firvanq), causes drug interactions in people with renal failure. These drug interactions further damage the kidneys. Antibiotics are not the only drugs that require specific attention in people with renal failure.

• Many different drugs pass through the kidneys and can accumulate if a person has renal failure.
• Renal disease may change the concentration and effect of a drug in the body, which can affect a person’s response to it.
• For example, higher drug concentrations can lead to more side effects.
• Certain medical conditions can further complicate prescribing of antibiotics and other drugs for people with renal failure.

Doctors consider the following factors:

avoidance of nephrotoxic drugs, such as NSAIDs and aminoglycosides, when possiblewhether the person is a smokerwhether the person has other conditions, such as:

unmanaged diabetesdehydration hypertensionhigh levels of lipids, or fats (hyperlipidemia)high levels of phosphates (hyperphosphatemia)

If there is an underlying issue, doctors should resolve or account for it before prescribing any new medications. Renal failure can have different effects on drugs but will often lead to accumulations and possible toxicities. Infections are common in people with renal failure.

Some antibiotics are contraindicated in some people with renal failure. Most antibiotics require dose or frequency adjustments for people with renal failure. Doctors will prescribe medications on an individual basis. This depends on many factors, including the severity of the renal disease, the specific infection, any underlying conditions a person has, and the potential side effects of the medication.

People can still experience side effects with certain antibiotics, so talking with a doctor about any concerns may be beneficial.

Why wait 7 days after gonorrhea treatment?

When can I have sex again after my gonorrhea treatment? – Wait seven days after finishing all medicine before having sex. You and your sex partner(s) should avoid having sex until you have each completed treatment and your symptoms are gone. This will help prevent you and your partner(s) from giving or getting gonorrhea again.

How fast is gonorrhea cured after shot?

How long does it take for the infection to go away? It takes 7 days. both you and your partner(s) increases risk of rein- fection (getting gonorrhea again) for you and your partner(s). vaginal, anal, and/or oral sex.

Is one shot of Rocephin enough for chlamydia?

What antibiotics are used to treat chlamydia and gonorrhea?

From the 2015 Sexually Transmitted Disease (STD) guidelines, the CDC recommends treatment for a gonorrhea-chlamydia coinfection with () 1 gram given orally in a single dose, plus () 250 mg given intramuscularly as first-line therapy.As dual therapy, ceftriaxone and azithromycin should be administered together on the same day, preferably at the same time, and under direct observation by a health care provider.Co-infection of with can be found commonly in the community setting.

: What antibiotics are used to treat chlamydia and gonorrhea?

How many shots of Rocephin should I take for a UTI?

How should I use this medication? – To treat bacterial infections, the recommended dose and dosing schedule of ceftriaxone varies according to the specific infection being treated, the response to therapy, and other medications or treatments being used.

The dose administered is also based on age, body size, and kidney and liver function. For moderate to severe infections in adults, the dose ranges from 1 g to 2 g daily given once every 24 hours or divided into 2 equal doses and given every 12 hours. For uncomplicated gonorrhea in adults, one dose of 250 mg is injected into a muscle.

For children 12 years of age and under, the dose is based on body weight and is given every 12 hours. The maximum daily dose for adults and children is 4 g. The duration of treatment depends on the type of infection and usually ranges from 4 to 14 days.

Some infections require only one dose while others require treatment for several weeks. Ceftriaxone is injected into a vein or into a muscle by a health care professional under the supervision of your doctor. Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications.

If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor. It is important to take this medication exactly as prescribed by your doctor. Store this medication (as unmixed vials) at room temperature, protect it from light, and keep it out of the reach of children.

What is 1 gram of Rocephin used for?

Ceftriaxone is used to treat a wide variety of bacterial infections. This medication belongs to a class of drugs known as cephalosporin antibiotics. It works by stopping the growth of bacteria.

How many units is 1 gram of Rocephin

In our office, we bill 1 gram as 4 units. We bill it out in increments of 250 mg as 1 unit.