Pregnancy is always a special situation where every action or side effect of the drug varies when compared to a situation of a non-pregnant patient. It is not only because the pregnant woman's metabolism differs due to the hormonal and other changes happened to her, but also because every medicine or its metabolite passes to the baby and shows its action there. The only thing is, be cautious, attentive and well supervised when you take any single drug in pregnancy. The interactions can vary in pregnancy, and the dosage may differ as well. Strict supervision of the Physician is mandatory.
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Ceftriaxone crosses the placenta. Pregnancy was found to influence the single dose pharmacokinetics of Ceftriaxone when administered prior to delivery (Popović 2007). The pharmacokinetics of Ceftriaxone following multiple doses in the third trimester are similar to those of nonpregnant patients (Bourget 1993). Ceftriaxone is recommended for use in pregnant women for the treatment of gonococcal infections, Lyme disease, and may be used in certain situations prior to vaginal delivery in women at high risk for endocarditis (consult current guidelines) (ACOG 120, 2011; CDC [Workowski 2015]; Wormser 2006).
Ceftriaxone breastfeeding
When a drug is taken when the patient is breast feeding, a part of the drug is secreted in her breast milk and is passed to the baby. The dosage of the medicine to mother and baby are different, and many drugs actions are side effects when you take them without a disease, and what if you the baby takes them without a disease? What if the drug is contraindicated in newborns, infants or children? So, breastfeeding is a very alarming situation when the mother is on medications. Ask your Physician or Pediatrician about the effect of the drug on the baby and how much is excreted in breast milk and if it harms the baby!
Use is considered acceptable; caution is recommended. -UK: A decision should be made to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother and the benefit of breastfeeding for the child. Excreted into human milk: Yes (small amounts) Comments: -The effects in the nursing infant are unknown; low levels in milk not expected to cause harmful effects in the nursing infant. -This drug is considered compatible with breastfeeding by the American Academy of Pediatrics.
After 1 g IM or IV on day 3 postpartum to 20 women, peak milk levels averaged about 0.7 and 0.5 mg/L, respectively, at about 4 hours after the dose. Levels decreased very slowly over 24 hours with half-lives of 13 to 17 hours. Amounts in milk correspond to infant dose of about 0.5% of the maternal weight-adjusted dose. With usual doses, only a few mg of this drug expected to be ingested per day by the infant. Disruption of infant's gastrointestinal flora (resulting in diarrhea or thrush) reported occasionally with cephalosporins; such effects have not been adequately evaluated. Risk of diarrhea and mucous membrane fungal infections cannot be excluded; possible sensitization should be considered.
See references
References for pregnancy information
Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
Heikkila A, Erkkola R "Review of beta-lactam antibiotics in pregnancy - the need for adjustment of dosage schedules." Clin Pharmacokinet 27 (1994): 49-62
TGA. Therapeutic Goods Administration. Australian Drug Evaluation Committee "Prescribing medicines in pregnancy: an Australian categorisation of risk of drug use in pregancy. Available from: URL: http://www.tga.gov.au/docs/pdf/medpreg.pdf." ():
Donders GGG "Treatment of sexually transmitted bacterial diseases in pregnant women." Drugs 59 (2000): 477-85
Ramus RM, Sheffield JS, Mayfield JA, Wendel GD Jr "A randomized trial that compared oral cefixime and intramuscular Ceftriaxone for the treatment of gonorrhea in pregnancy." Am J Obstet Gynecol 185 (2001): 629-32
Royal Australian College of General Practicioners (RACGP), the Pharmaceutical Society of Australia (PSA), the Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists (ASCEPT) "Australian Medicines Handbook. Available from: URL: https://www.amh.net.au/"
References for breastfeeding information
Cerner Multum, Inc. "Australian Product Information." O 0
Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
Briggs GG, Freeman RK, Yaffe SJ.. "Drugs in Pregnancy and Lactation. 5th ed." Baltimore, MD: Williams & Wilkins (1998):
Royal Australian College of General Practicioners (RACGP), the Pharmaceutical Society of Australia (PSA), the Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists (ASCEPT) "Australian Medicines Handbook. Available from: URL: https://www.amh.net.au/"
Kafetzis DA, Brater DC, Fanourgakis JE, et al "Ceftriaxone distribution between maternal blood and fetal blood and tissues at parturition and between blood and milk postpartum." Antimicrob Agents Chemother 23 (1983): 870-3
United States National Library of Medicine "Toxnet. Toxicology Data Network. Available from: URL: http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT." ([cited 2013 -]):
Committee on Drugs, 1992 to 1993 "The transfer of drugs and other chemicals into human milk." Pediatrics 93 (1994): 137-50
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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).
PubMed Health. "Rocephin: This section provide the link out information of drugs collectetd in PubMed Health. ". http://www.ncbi.nlm.nih.gov/pubmedhe... (accessed September 17, 2018).
Human Metabolome Database (HMDB). "Ceftriaxone: The Human Metabolome Database (HMDB) is a freely available electronic database containing detailed information about small molecule metabolites found in the human body.". http://www.hmdb.ca/metabolites/HMDB0... (accessed September 17, 2018).
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