20 to 50     : Dose as in normal renal function
10 to 20     : Dose as in normal renal function
<10           : Dose as in normal renal function Maximum 2 g daily
DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD                :Not dialysed. Dose as in GFR <10 mL/min
HD                     :Not dialysed. Dose as in GFR <10 mL/min
HDF/high flux   :Unknown dialysability. Dose as in GFR <10 mL/min
CAV/VVHD      :Unknown dialysability. 2 g every 12–24 hours1CVVhd/HDFLikely dialysability. 2 g every 12–24 hours1
IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugs
Anticoagulants: effects of coumarins may be enhanced
Ciclosporin: may cause increased ciclosporin levels
ADMINISTRATION
Reconstition
Bolus 250 mg: IV – 5mL water for injection; IM – 1 mL 1% lidocaine hydrochloride
Bolus 1 g: IV – 10 mL water for injection; IM – 3.5 mL 1% lidocaine hydrochloride
Infusion: 2 g in 40 mL of calcium-free solution, e.g. sodium chloride 0.9%, glucose 5%
Incompatible with calcium containing solutions, e.g. Hartmann’s, Ringer’s
Route
IV, IM, SC
Rate of Administration
Bolus: over 2–4 minutes Infusion: over at least 30 minutes
Comments
Doses of 50 mg/kg or over should be given by slow IV infusion
For IM injection: doses greater than 1 g should be divided and injected at more than one site
OTHER INFORMATION
Calcium ceftriaxone has appeared as a precipitate in urine, or been mistaken as gallstones in patients receiving higher than recommended doses
Contains 3.6 mmol sodium per gram of ceftriaxone
Information from the company shows that the bioavailability of SC administration is equivalent to IV. The maximum amount able to be given in a single SC injection is 500 mg dissolved in 2 mL lidocaine 1%. Administration was said to be tolerable