Drug Interactions between calcium gluconate and ceftriaxone
This report displays the potential drug interactions for the following 2 drugs:
- calcium gluconate
- ceftriaxone
Interactions between your drugs
cefTRIAXone calcium gluconate
Applies to: ceftriaxone and calcium gluconate
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 as well as infants up to 1 year of age. In some cases, separate infusion lines and times of administration of ceftriaxone and calcium-containing solutions were used. There have been no reports to date of intravascular or pulmonary precipitations in older patients. Two in vitro studies, one using adult plasma and the other neonatal plasma from umbilical cord blood, were conducted with varying ceftriaxone and calcium concentrations to assess the potential for precipitation when ceftriaxone and calcium-containing products are mixed in vials and in infusion lines. The results suggest that ceftriaxone-calcium precipitation occurs at a lower calcium concentration in neonatal plasma than in adult plasma.
MANAGEMENT: Ceftriaxone must not be mixed or administered simultaneously with intravenous calcium-containing solutions (e.g., Ringer's or Hartmann's solution; parenteral nutrition containing calcium) via a Y-site in any patient regardless of age. Concomitant use of ceftriaxone and intravenous calcium-containing products (or within 48 hours of each other) is considered contraindicated in neonates 28 days of age or younger, even when administered via different infusion lines at different sites. Ceftriaxone should not be used in neonates if they are receiving, or are expected to receive, calcium-containing intravenous products. In patients older than 28 days, ceftriaxone and calcium-containing products may be administered sequentially, provided the infusion lines are thoroughly flushed between infusions with a compatible fluid. 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).
References (4)
- (2002) "Product Information. Rocephin (ceftriaxone)." Roche Laboratories
- Canadian Vigilance program (2008) Notice to hospitals: Health Canada issued important safety informatin on ceftriaxone. Association of ceftriaxone with fatal outcome when administered intravenously with calcium-containing solutions. http://www.hc-sc.gc.ca/dhp-mps/alt_formats/hpfb-dgpsa/p
- Bradley JS, Wassel RT, Lee L, Nambiar S (2009) "Intravenous ceftriaxone and calcium in the neonate: assessing the risk for cardiopulmonary adverse events." Pediatrics, 123, e609-13
- CDER. Center for Drug Evaluation and Research. FDA. U.S. Food and Drug Admninistration (2009) Information for health care professionals: ceftriaxone (marketed as Rocephin and its generics). http://www.fda.gov/cder/drug/InfoSheets/HCP/ceftriaxone042009HCP.htm
Drug and food interactions
calcium gluconate food
Applies to: calcium gluconate
ADJUST DOSING INTERVAL: Administration with food may increase the absorption of calcium. However, foods high in oxalic acid (spinach or rhubarb), or phytic acid (bran and whole grains) may decrease calcium absorption.
MANAGEMENT: Calcium may be administered with food to increase absorption. Consider withholding calcium administration for at least 2 hours before or after consuming foods high in oxalic acid or phytic acid.
References (6)
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Canadian Pharmacists Association (2006) e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink
- Cerner Multum, Inc. "Australian Product Information."
- Agencia Española de Medicamentos y Productos Sanitarios Healthcare (2008) Centro de información online de medicamentos de la AEMPS - CIMA. https://cima.aemps.es/cima/publico/home.html
- Mangels AR (2014) "Bone nutrients for vegetarians." Am J Clin Nutr, 100, epub
- Davies NT (1979) "Anti-nutrient factors affecting mineral utilization." Proc Nutr Soc, 38, p. 121-8
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
See also
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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