ceftriaxone and Tracelyte double electrolytes Interactions

Interactions between ceftriaxone and Tracelyte double electrolytes (intravenous electrolyte solution)

ceftriaxone and intravenous electrolyte solution (Major Drug-Drug)

CONTRAINDICATED: Coadministration of ceftriaxone with calcium-containing solutions, even via different infusion lines, may cause precipitation of ceftriaxone-calcium salt. There have been cases of fatal reactions involving the presence of these precipitates in the lung and kidneys of both term and premature neonates. In some cases, separate infusion lines and times of administration of ceftriaxone and calcium-containing solutions were used. Although there have been no reports to date of intravascular or pulmonary precipitations in patients other than neonates, the potential for interaction should be considered in any patient regardless of age.

MANAGEMENT: Ceftriaxone must not be mixed or administered simultaneously with calcium-containing intravenous solutions (e.g., parenteral nutrition infusions), even via different infusion lines at different sites. Ceftriaxone and intravenous calcium-containing solutions should not be administered within 48 hours of each other in any patient. Some experts (e.g., Health Canada) recommend that they not be administered intravenously within 5 days of each other in neonates and infants less than 10 weeks old. These interval recommendations are based on the presumed length of time it takes for most of a ceftriaxone dose to clear from circulation (i.e., approximately five half-lives), and the longer interval for younger patients is based on the prolonged elimination half-life of ceftriaxone in these patients. No data or recommendations are available for concomitant use of intravenous ceftriaxone and oral calcium-containing products or intramuscular ceftriaxone and calcium-containing products (IV or oral).