What happens if I overdose Ceftriaxone 1000mg?
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include muscle spasms; seizures.
Proper storage of Ceftriaxone 1000mg:
Ceftriaxone 1000mg is usually handled and stored by a health care provider. If you are using Ceftriaxone 1000mg at home, store Ceftriaxone 1000mg as directed by your pharmacist or health care provider. Keep Ceftriaxone 1000mg, as well as needles and syringes, out of the reach of children and away from pets.
Overdose of Ceftriaxone 1000mg in details
In the case of overdose, nausea, vomiting and diarrhea can occur. Ceftriaxone 1000mg concentration can not be reduced by hemodialysis or peritoneal dialysis.
There is no specific antidote. Treatment is symptomatic.
What should I avoid while taking Ceftriaxone 1000mg?
Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.
Ceftriaxone 1000mg warnings
Hypersensitivity Reactions
Before therapy with Ceftriaxone 1000mg is instituted, careful inquiry should be made to determine whether the patient has had previous hypersensitivity reactions to cephalosporins, penicillins and other beta-lactam agentsor other drugs. This product should be given cautiously to penicillin and other beta-lactam agent-sensitive patients. Antibacterial drugs should be administered with caution to any patient who has demonstrated some form of allergy, particularly to drugs. Serious acute hypersensitivity reactions may require the use of subcutaneous epinephrine and other emergency measures.
As with all beta-lactam antibacterial agents, serious and occasionally fatal hypersensitivity reactions (i.e., anaphylaxis) have been reported. In case of severe hypersensitivity reactions, treatment with Ceftriaxone 1000mg must be discontinued immediately and adequate emergency measures must be initiated.
Interaction With Calcium-Containing Products
Do not use diluents containing calcium, such as Ringer's solution or Hartmann's solution, to reconstitute Ceftriaxone 1000mg vials or to further dilute a reconstituted vial for IV administration because a precipitate can form. Precipitation of Ceftriaxone 1000mg-calcium can also occur when Ceftriaxone 1000mg is mixed with calcium-containing solutions in the same IV administration line. Ceftriaxone 1000mg must not be administered simultaneously with calcium-containing IV solutions, including continuous calcium-containing infusions such as parenteral nutrition via a Y-site. However, in patients other than neonates, Ceftriaxone 1000mg 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 1000mg-calcium.
Clostridium Difficile -Associated Diarrhea
Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including Ceftriaxone 1000mg, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile.
C. difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents.
If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated.
Hemolytic Anemia
An immune mediated hemolytic anemia has been observed in patients receiving cephalosporin class antibacterials including Ceftriaxone 1000mg. Severe cases of hemolytic anemia, including fatalities, have been reported during treatment in both adults and children. If a patient develops anemia while on Ceftriaxone 1000mg, the diagnosis of a cephalosporin associated anemia should be considered and Ceftriaxone 1000mg stopped until the etiology is determined.
What should I discuss with my healthcare provider before taking Ceftriaxone 1000mg?
Do not use Ceftriaxone 1000mg in a child without a doctor's advice, and never give more than the child's prescribed dose. Ceftriaxone 1000mg injection can be dangerous when given to a newborn baby with any intravenous medicines that contain calcium, including total parental nutrition (TPN). Ceftriaxone 1000mg should never be used in a premature baby, or in any newborn baby who has jaundice.
You should not use Ceftriaxone 1000mg if you are allergic to Ceftriaxone 1000mg or to other cephalosporin antibiotics, such as:
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cefaclor (Raniclor);
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cefadroxil (Duricef);
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cefazolin (Ancef);
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cefdinir (Omnicef);
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cefditoren (Spectracef);
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cefpodoxime (Vantin);
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cefprozil (Cefzil);
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ceftibuten (Cedax);
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cefuroxime (Ceftin);
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cephalexin (Keflex); or
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cephradine (Velosef).
To make sure Ceftriaxone 1000mg is safe for you, tell your doctor if you have:
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an allergy to any drugs (especially penicillins);
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kidney disease (or if you are on dialysis);
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liver disease;
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diabetes;
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gallbladder disease;
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a stomach or intestinal disorder such as colitis;
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poor nutrition; or
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a condition for which you take a blood thinner (warfarin, Coumadin, Jantoven).
Ceftriaxone 1000mg is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
Ceftriaxone 1000mg can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
Ceftriaxone 1000mg precautions
General: Prescribing B Braun Ceftriaxone 1000mg in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.
Although transient elevations of blood urea nitrogen (BUN) and serum creatinine have been observed, at the recommended dosages, the nephrotoxic potential of Ceftriaxone 1000mg sodium is similar to that of other cephalosporins.
Ceftriaxone 1000mg is excreted via both biliary and renal excretion. Therefore, patients with renal failure normally require no adjustment in dosage when usual doses of B Braun Ceftriaxone 1000mg are administered, but concentrations of drug in the serum should be monitored periodically. If evidence of accumulation exists, dosage should be decreased accordingly.
Dosage adjustments should not be necessary in patients with hepatic dysfunction; however, in patients with both hepatic dysfunction and significant renal disease, B Braun Ceftriaxone 1000mg dosage should not exceed 2 g daily without close monitoring of serum concentrations.
Alterations in prothrombin times have occurred rarely in patients treated with Ceftriaxone 1000mg sodium. Patients with impaired vitamin K synthesis or low vitamin K stores (eg, chronic hepatic disease and malnutrition) may require monitoring of prothrombin time during B Braun Ceftriaxone 1000mg treatment. Vitamin K administration (10 mg weekly) may be necessary if the prothrombin time is prolonged before or during therapy.
Prolonged use of B Braun Ceftriaxone 1000mg may result in overgrowth of nonsusceptible organisms. Careful observation of the patient is essential. If superinfection occurs during therapy, appropriate measures should be taken.
B Braun Ceftriaxone 1000mg should be prescribed with caution in individuals with a history of gastrointestinal disease, especially colitis.
There have been reports of sonographic abnormalities in the gallbladder of patients treated with Ceftriaxone 1000mg sodium; some of these patients also had symptoms of gallbladder disease. These abnormalities appear on sonography as an echo without acoustical shadowing suggesting sludge or as an echo with acoustical shadowing which may be misinterpreted as gallstones. The chemical nature of the sonographically detected material has been determined to be predominantly a Ceftriaxone 1000mg-calcium salt. The condition appears to be transient and reversible upon discontinuation of Ceftriaxone 1000mg sodium and institution of conservative management. Therefore, B Braun Ceftriaxone 1000mg should be discontinued in patients who develop signs and symptoms suggestive of gallbladder disease and/or the sonographic findings described previously.
Cases of pancreatitis, possibly secondary to biliary obstruction, have been reported rarely in patients treated with Ceftriaxone 1000mg sodium. Most patients presented with risk factors for biliary stasis and biliary sludge (preceding major therapy, severe illness, total parenteral nutrition). A cofactor role of Ceftriaxone 1000mg-related biliary precipitation cannot be ruled out.
The elimination of Ceftriaxone 1000mg is not altered by probenecid.
As with other cephalosporins, anaphylactic shock cannot be ruled out even if a thorough patient history is taken.
As with other dextrose-containing solutions, B Braun Ceftriaxone 1000mg should be prescribed with caution in patients with overt or known subclinical diabetes mellitus or carbohydrate intolerance for any reason.
If administration is controlled by a pumping device, care must be taken to discontinue pumping action before the container runs dry or air embolism may result.
Use only if solution is clear and container and seals are intact.
Information for Patients: Patients should be counseled that antibacterial drugs including B Braun Ceftriaxone 1000mg should only be used to treat bacterial infections. They do not treat viral infections (eg, the common cold). When B Braun Ceftriaxone 1000mg is prescribed to treat a bacterial infection, patients should be told that although it is common to feel better early in the course of therapy, the medication should be taken exactly as directed. Skipping doses or not completing the full course of therapy may decrease the effectiveness of the immediate treatment and increase the likelihood that bacteria will develop resistance and will not be treatable by B Braun Ceftriaxone 1000mg or other antibacterial drugs in the future.
Diarrhea is a common problem caused by antibiotics which usually ends when the antibiotic is discontinued. Sometimes after starting treatment with antibiotics, patients can develop watery and bloody stools (with or without stomach cramps and fever) even as late as ≥2 months after having taken the last dose of the antibiotic. If this occurs, patients should contact their physician as soon as possible.
Carcinogenicity: Considering the maximum duration of treatment and the class of the compound, carcinogenicity studies with Ceftriaxone 1000mg in animals have not been performed. The maximum duration of animal toxicity studies was 6 months.
Mutagenicity: Genetic toxicology tests included the Ames test, a micronucleus test and a test for chromosomal aberrations in human lymphocytes cultured in vitro with Ceftriaxone 1000mg. Ceftriaxone 1000mg showed no potential for mutagenic activity in these studies.
Impairment of Fertility: Ceftriaxone 1000mg produced no impairment of fertility when given IV to rats at daily doses up to 586 mg/kg/day approximately 20 times the recommended clinical dose of 2 g/day.
Use in pregnancy: Teratogenic Effects: Pregnancy Category B. Reproductive studies have been performed in mice and rats at doses up to 20 times the usual human dose and have no evidence of embryotoxicity, fetotoxicity or teratogenicity. In primates, no embryotoxicity or teratogenicity was demonstrated at a dose approximately 3 times the human dose.
There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproductive studies are not always predictive of human response, B Braun Ceftriaxone 1000mg should be used during pregnancy only if clearly needed.
Nonteratogenic Effects: In rats, in the Segment I (fertility and general reproduction) and Segment III (perinatal and postnatal) studies with IV administered Ceftriaxone 1000mg, no adverse effects were noted on various reproductive parameters during gestation and lactation, including postnatal growth, functional behavior and reproductive ability of the offspring, at doses of ≤586 mg/kg/day.
Use in lactation: Low concentrations of Ceftriaxone 1000mg are excreted in human milk. Caution should be exercised when B Braun Ceftriaxone 1000mg is administered to a nursing woman.
Use in children: B Braun Ceftriaxone 1000mg in the Duplex container is designed to deliver a 1 or 2 g dose of Ceftriaxone 1000mg. To prevent unintentional overdose, B Braun Ceftriaxone 1000mg should not be used in pediatric patients who require less than the full adult dose of Ceftriaxone 1000mg.
Safety and effectiveness of B Braun Ceftriaxone 1000mg in neonates, infants and pediatric patients have been established for the dosages described in the Dosage & Administration. In vitro studies have shown that Ceftriaxone 1000mg, like some other cephalosporins, can displace bilirubin from serum albumin. B Braun Ceftriaxone 1000mg should not be administered to hyperbilirubinemic neonates, especially prematures.
Use in the
Elderly: Of the total number of subjects in clinical studies of Ceftriaxone 1000mg sodium, 32% were ≥60 years. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out.
The pharmacokinetics of Ceftriaxone 1000mg were only minimally altered in geriatric patients compared to healthy adult subjects and dosage adjustments are not necessary for geriatric patients with Ceftriaxone 1000mg dosages up to 2 g/day.
No dosage adjustment is necessary for patients with impairment of renal or hepatic function; however, blood levels should be monitored in patients with severe renal impairment (eg, dialysis patients) and in patients with both renal and hepatic dysfunctions.
What happens if I miss a dose of Ceftriaxone 1000mg?
Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.
References
- DailyMed. "CEFTRIAXONE SODIUM: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- DrugBank. "ceftriaxone". http://www.drugbank.ca/drugs/DB01212 (accessed September 17, 2018).
- MeSH. "Anti-Bacterial Agents". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology
