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Rocephin (ceftriaxone) Disease Interactions

There are 8 disease interactions with Rocephin (ceftriaxone):


Ceftriaxone (Includes Rocephin) ↔ Hyperbilirubinemia

Severe Potential Hazard, High plausibility

Applies to: Hyperbilirubinemia

Hyperbilirubinemic neonates, especially premature, should not be treated with ceftriaxone for injection. Studies have shown that ceftriaxone can displace bilirubin from its binding to serum albumin, leading to possible risk of bilirubin encephalopathy in these patients.


Antibiotics (Includes Rocephin) ↔ Colitis

Moderate Potential Hazard, Moderate plausibility

Applies to: Colitis/Enteritis (Noninfectious)

Pseudomembranous colitis has been reported with most antibacterial agents and may range in severity from mild to life-threatening, with an onset of up to two months following cessation of therapy. Antibiotic therapy can alter the normal flora of the colon and permit overgrowth of Clostridium difficile, whose toxin is believed to be a primary cause of antibiotic- associated colitis. The colitis is usually characterized by severe, persistent diarrhea and severe abdominal cramps, and may be associated with the passage of blood and mucus. The most common culprits are clindamycin, lincomycin, the aminopenicillins (amoxicillin, ampicillin), and the cephalosporins. Therapy with broad-spectrum antibiotics and other agents with significant antibacterial activity should be administered cautiously in patients with a history of gastrointestinal diseases, particularly colitis. There is some evidence that pseudomembranous colitis, if it occurs, may run a more severe course in these patients and that it may be associated with flares in their underlying disease activity. The offending antibiotic(s) should be discontinued if significant diarrhea occurs during therapy. Stool cultures for Clostridium difficile and stool assay for C. difficile toxin may be helpful diagnostically. A large bowel endoscopy may be considered to establish a definitive diagnosis in cases of severe diarrhea.


  1. Moriarty HJ, Scobie BA "Pseudomembranous colitis in a patient on rifampicin and ethambutol." N Z Med J 04/23/80 (1980): 294-5
  2. Thomas E, Mehta JB "Pseudomembranous colitis due to oxacillin therapy." South Med J 77 (1984): 532-3
  3. Harmon T, Burkhart G, Applebaum H "Perforated pseudomembranous colitis in the breast-fed infant." J Pediatr Surg 27 (1992): 744-6
View all 47 references

Ceftriaxone (Includes Rocephin) ↔ Gallbladder Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease, Gallbladder Disease, Biliary Obstruction

Ceftriaxone can precipitate in the gallbladder. Sonographic abnormalities and symptoms of gallbladder disease have been reported. Therapy with ceftriaxone should be administered cautiously in patients with preexisting disease of the gallbladder, biliary tract, or liver. Serial abdominal ultrasonography may be appropriate during therapy. The drug should be discontinued in patients who develop signs and symptoms suggestive of gallbladder disease while being treated with ceftriaxone.


  1. Zinberg J, Chernaik R, Coman E, Rosenblatt R, brandt LJ "Reversible symptomatic biliary obstruction associated with ceftriaxone pseudolithiasis." Am J Gastroenterol 86 (1991): 1251-4
  2. Meyboom RH, Kuiper H, Jansen A "Ceftriaxone and reversible cholelithiasis." BMJ 297 (1988): 858
  3. Kirejczyk WM, Crowe HM, Mackay IM, Quintiliani R, Cronin EB "Disappearing "gallstones": biliary pseudolithiasis complicating ceftriaxone therapy." Am J Roentgenol 159 (1992): 329-30
View all 7 references

Ceftriaxone (Includes Rocephin) ↔ Pancreatitis

Moderate Potential Hazard, Moderate plausibility

Applies to: Biliary Obstruction

Cases of pancreatitis, possibly secondary to biliary obstruction, have been reported rarely in patients treated with ceftriaxone. 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-related biliary precipitation cannot be ruled out.


Ceftriaxone (Includes Rocephin) ↔ Prothrombin Time Alterations

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease, Vitamin K Deficiency, Malnourished

Alterations in prothrombin times have rarely occurred in patients treated with ceftriaxone. Patients with impaired vitamin K synthesis or low vitamin K stores, such a patients with chronic hepatic disease and malnutrition, require monitoring of prothrombin time during treatment. Vitamin K administration (10 mg per week) might be needed if prothrombin time is prolonged before or during therapy.


Ceftriaxone (Includes Rocephin) ↔ Renal/Liver Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease, Renal Dysfunction, Biliary Obstruction

Ceftriaxone is eliminated by both renal and hepatobiliary excretion. At usual dosages (i.e. 1 to 2 g/day), adjustments are generally not necessary in either renal or hepatobiliary impairment. However, serum drug concentrations should be monitored periodically, and the dosage decreased accordingly if drug accumulation occurs. In patients with both hepatic and severe renal impairment, ceftriaxone dosage should not exceed 2 grams per day without close monitoring of serum concentrations.


  1. Stoeckel K, Koup JR "Pharmacokinetics of ceftriaxone in patients with renal and liver insufficiency and correlations with a physiologic nonlinear protein binding model." Am J Med 77 (1984): 26-32
  2. Garcia RL, Santivanez V, Battilana CA "Single-dose pharmacokinetics of ceftriaxone in patients with end-stage renal disease and hemodialysis." Chemotherapy 34 (1988): 261-6
  3. Pollock AA, Tee PE, Patel IH, Spicehandler J, Simberkoff MS, Rahal JJ "Pharmacokinetic characteristics of intravenous ceftriaxone in normal adults." Antimicrob Agents Chemother 22 (1982): 816-23
View all 15 references

Cephalosporins (Includes Rocephin) ↔ Liver Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

Cases of hepatitis have been reported with the use of certain cephalosporins. Transient rise in SGOT, SGPT, and alkaline phosphatase levels have also been observed. Caution and monitoring is recommended when these agents are prescribed to patients with hepatic disorders.


Cephalosporins (Includes Rocephin) ↔ Seizure Disorders

Moderate Potential Hazard, Moderate plausibility

Applies to: Seizures

Several cephalosporins have been implicated in triggering seizures, particularly in patients with renal impairment when the dosage was not reduced. If seizures occur with drug therapy, the drug should be discontinued. Anticonvulsant therapy can be given if clinically indicated. Monitor patients with preexisting seizure disorders.

Rocephin (ceftriaxone) drug Interactions

There are 51 drug interactions with Rocephin (ceftriaxone)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

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