Ceftriaxone
/api/v1/drug/ceftriaxoneMechanism of action
Sourced from openFDAMechanism-of-action class: Enzyme Inhibitors.
Indications
Sourced from openFDA- Before instituting treatment with ceftriaxone, appropriate specimens should be obtained for isolation of the causative organism and for determination of its susceptibility to the drug. Therapy may be instituted prior to obtaining results of susceptibility testing.
Contraindications
Sourced from openFDA- Hypersensitivity Ceftriaxone for injection is contraindicated in patients with known hypersensitivity to ceftriaxone, any of its excipients or to any other cephalosporin. Patients with previous hypersensitivity reactions to penicillin and other beta lactam antibacterial agents may be at greater risk of hypersensitivity to ceftriaxone (see Warnings – Hypersensitivity Reactions ).contraindicated
Dosage & administration
Sourced from openFDACeftriaxone may be administered intravenously or intramuscularly. Do not use diluents containing calcium, such as Ringer’s solution or Hartmann’s solution, to reconstitute ceftriaxone vials or to further dilute a reconstituted vial for IV administration because a precipitate can form. Precipitation of ceftriaxone-calcium can also occur when ceftriaxone is mixed with calcium-containing solutions in the same IV administration line. Ceftriaxone 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 and calcium-containing solutions may be administered sequentially of one another if the infusion lines are thoroughly flushed between infusions with a compatible fluid (see WARNINGS ). There have been no reports of an interaction between ceftriaxone and oral calcium-containing products or interaction between intramuscular ceftriaxone and calcium-containing products (IV or oral). Neonates Hyperbilirubinemic neonates, especially prematures, should not be treated with ceftriaxone for injection. Ceftriaxone is contraindicated in premature neonates (see CONTRAINDICATIONS ). Ceftriaxone is contraindicated in neonates (≤ 28 days) if they require (or are expected to require) treatment with calcium-containing IV solutions, including continuous calcium-containing infusions such as parenteral nutrition because of the risk of precipitation of ceftriaxone-calcium (see CONTRAINDICATIONS ).
Warnings & precautions
Sourced from openFDAHypersensitivity Reactions Before therapy with ceftriaxone for injection is instituted, careful inquiry should be made to determine whether the patient has had previous hypersensitivity reactions to cephalosporins, penicillins and other beta-lactam agents or 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 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 vials or to further dilute a reconstituted vial for IV administration because a precipitate can form. Precipitation of ceftriaxone-calcium can also occur when ceftriaxone is mixed with calcium-containing solutions in the same IV administration line. Ceftriaxone must not be administered simultaneously with calcium-containing IV solutions, including continuous calcium-containing infusions such as parenteral nutrition via a Y-site.
Adverse reactions
Sourced from openFDACeftriaxone is generally well tolerated. In clinical trials, the following adverse reactions, which were considered to be related to ceftriaxone therapy or of uncertain etiology, were observed: Local Reactions Pain, induration and tenderness was 1% overall. Phlebitis was reported in <1% after IV administration. The incidence of warmth, tightness or induration was 17% (3/17) after IM administration of 350 mg/mL and 5% (1/20) after IM administration of 250 mg/mL. General Disorders and Administration Site Conditions Injection site pain (0.6%) Hypersensitivity Rash (1.7%). Less frequently reported (<1%) were pruritus, fever or chills. Infections and Infestations Genital fungal infection (0.1%) Hematologic Eosinophilia (6%), thrombocytosis (5.1%) and leukopenia (2.1%). Less frequently reported (<1%) were anemia, hemolytic anemia, neutropenia, lymphopenia, thrombocytopenia and prolongation of the prothrombin time. Blood and Lymphatic Disorders Granulocytopenia (0.9%), coagulopathy (0.4%) Gastrointestinal Diarrhea/loose stools (2.7%). Less frequently reported (<1%) were nausea or vomiting, and dysgeusia. The onset of pseudomembranous colitis symptoms may occur during or after antibacterial treatment (see WARNINGS ). Hepatic Elevations of aspartate aminotransferase (AST) (3.1%) or alanine aminotransferase (ALT) (3.3%). Less frequently reported (<1%) were elevations of alkaline phosphatase and bilirubin. Renal Elevations of the BUN (1.2%). Less frequently reported (<1%) were elevations of creatinine and the presence of casts in the urine.
Use in specific populations
Sourced from openFDAPregnancy Teratogenic Effects 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, this drug 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 intravenously administered ceftriaxone, 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 or less.
Overdosage
Sourced from openFDACeftriaxone overdosage has been reported in patients with severe renal impairment. Reactions have included neurological outcomes, including encephalopathy, seizures, myoclonus, and non-convulsive status epilepticus. In the event of overdosage, discontinue ceftriaxone for injection therapy and provide general supportive treatment (see DOSAGE AND ADMINISTRATION , WARNINGS and PRECAUTIONS ). In the case of overdosage, drug concentration would not be reduced by hemodialysis or peritoneal dialysis. There is no specific antidote. Treatment of overdosage should be symptomatic.
Approval history
Sourced from openFDA- Apr 20, 2005NDANDA050796B Braun
- May 3, 2005ANDAANDA065204Sandoz Inc
- May 9, 2005ANDAANDA065169Sandoz
- May 17, 2005ANDAANDA065168Sandoz
- Aug 23, 2005ANDAANDA065224Baxter Hlthcare
- Jan 10, 2008ANDAANDA065342Hikma Farmaceutica
- Jul 24, 2008ANDAANDA065329Acs Dobfar
- Jul 24, 2008ANDAANDA065328Acs Dobfar
FAERS reports
- 1Off Label Use3,81710%
- 2Drug Ineffective3,4529.2%
- 3Pyrexia2,0075.4%
- 4Acute Kidney Injury1,7664.7%
- 5Dyspnoea1,5454.1%
- 6Condition Aggravated1,5264.1%
- 7Pneumonia1,3033.5%
- 8Vomiting1,2193.3%
- 9Nausea1,2093.2%
- 10Drug Interaction1,1343.0%
- 11Diarrhoea1,1042.9%
- 12Drug Reaction With Eosinophilia And Systemic Symptoms1,0662.8%
- 13Rash1,0532.8%
- 14Sepsis1,0532.8%
- 15Hypotension9852.6%
Literature
Recent PubMed references pinned to Ceftriaxone as a MeSH major topic. Citations link to pubmed.ncbi.nlm.nih.gov.
- Extensively drug-resistant (XDR) Neisseria gonorrhoeae cured with ceftriaxone 2 g intravenous monotherapy in Croatia, March 2026.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2026 · Juzbašić T, Nemeth Blažić T, Volarević N, et al.PMID 42212421DOI 10.2807/1560-7917.ES.2026.31.21.2600422
- Physiologically Based Pharmacokinetic Modeling and Pharmacodynamic Target Attainment Analysis for Ceftriaxone Dosing in Pregnant Women: Model Development and Clinical Applications.Journal of clinical pharmacology · 2026 · Chen X, Lin ZPMID 42130310DOI 10.1002/jcph.70205
- Ceftriaxone has a similar effect on astrocytic and neuronal GLT-1 distribution after mild traumatic brain injury.Biochemical and biophysical research communications · 2026 · Naumenko Y, Olifirov B, Yuryshynets I, et al.PMID 42127518DOI 10.1016/j.bbrc.2026.153895
- Ceftriaxone for methicillin-susceptible Staphylococcus aureus bloodstream infections is associated with increased short-term mortality: a systematic review and meta-analysis.Annals of medicine · 2026 · Maraolo AE, Nobile M, Gentile I, et al.PMID 42112603DOI 10.1080/07853890.2026.2667672
- Reinfection and ceftriaxone tolerance in a clinical case of recurrent gonorrhoea: a case report supported by in vitro and in vivo models.Frontiers in cellular and infection microbiology · 2026 · Kanesaka I, Abdellati S, Vanbaelen T, et al.PMID 42112458DOI 10.3389/fcimb.2026.1720396
- Emergence of Ceftriaxone-Resistant Neisseria gonorrhoeae penA-60-Carrying Strains, Thailand, 2025.Emerging infectious diseases · 2026 · Kittiyaowamarn R, Sangprasert P, Girdthep N, et al.PMID 42103068DOI 10.3201/eid3206.251860
- Ceftriaxone versus cefotaxime: a scoping review of resistance selection, Clostridioides difficile risk, economic implications and environmental impacts.Infectious diseases now · 2026 · Raphaël É, Huynh S, Blez D, et al.PMID 42013917DOI 10.1016/j.idnow.2026.105278
- Zinc-dependent modulation of ceftriaxone killing in tolerant Neisseria gonorrhoeae.FEMS microbiology letters · 2026 · Kanesaka I, Kenyon C, Manoharan-Basil SS, et al.PMID 42008107DOI 10.1093/femsle/fnag047
Clinical trials
The 10 most recently updated of 273 ClinicalTrials.gov registrations naming Ceftriaxone as an intervention. Registration is not evidence of efficacy or safety — reference crosswalk only.
- Short-course Antibiotics vs Standard Course Antibiotics in Patients With CholangitisCompleted · Interventional · 410 enrolled · Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)NCT05750966updated 2026-06-11
- Efficacy of Temocillin Compared to Standard of Care in the Treatment of Neisseria Gonorrhoeae InfectionsNot yet recruiting · Phase 3 · Interventional · 360 enrolled · Assistance Publique - Hôpitaux de ParisNCT07631364updated 2026-06-08
- Prophylactic Antibiotics in the Endoscopic Secondary Prevention of Cirrhotic Patients With Varices: a Retrospective StudyCompleted · Observational · 480 enrolled · Second Affiliated Hospital, School of Medicine, Zhejiang UniversityNCT07616466updated 2026-06-01
- STeroids and Enhanced Spectrum Antibiotics for the Treatment of Patients in Africa With Refractory SepsisNot yet recruiting · Phase 3 · Interventional · 344 enrolled · University of VirginiaNCT07332325updated 2026-06-01
- Prophylactic Antibiotics in Endoscopic Secondary Prevention of Gastroesophageal Variceal BleedingCompleted · Interventional · 226 enrolled · Second Affiliated Hospital, School of Medicine, Zhejiang UniversityNCT06437964updated 2026-05-27
- Study of the Pharmacokinetics of CeftriaxoneTerminated · Observational · 12 enrolled · University Hospital, RouenNCT07169097updated 2026-05-26
- Optimizing the Diagnostic Approach to Cephalosporin Allergy TestingRecruiting · Phase 2 · Interventional · 300 enrolled · Massachusetts General HospitalNCT06406114updated 2026-05-26
- Ceftriaxone for Post-Treatment Lyme DiseaseWithdrawn · Phase 1 · Phase 2 · Interventional · 0 enrolled · Hackensack Meridian HealthNCT06785402updated 2026-05-18
- Postoperative Antibiotic Management Duration Following Surgery for Intravenous Drug Abuse (IVDA) Endocarditis (OPTIMAL)Terminated · Phase 4 · Interventional · 5 enrolled · West Virginia UniversityNCT05156437updated 2026-05-05
- Antimicrobial Prophylaxis for Skin Colonization With Propionibacterium Acnes in Primary Open Shoulder SurgeryRecruiting · Interventional · 88 enrolled · Université de MontréalNCT02996656updated 2026-05-01
Structural analogs
Ranked by 2D fingerprint (Tanimoto) similarity over PubChem structures. Structural proximity only — not a claim of therapeutic equivalence.
Frequently asked questions
- How does Ceftriaxone work?
- Mechanism-of-action class: Enzyme Inhibitors.
- What is Ceftriaxone used for?
- According to FDA labeling, Ceftriaxone carries indications including: Before instituting treatment with ceftriaxone, appropriate specimens should be obtained for isolation of the causative organism and for determination of its susceptibility to the drug. Therapy may be instituted prior to obtaining results of susceptibility testing.. This is a reference summary of labeled uses, not medical advice or a treatment recommendation.
- What class of drug is Ceftriaxone?
- Ceftriaxone is classified as Third-generation cephalosporins, Cephalosporin Antibacterial, Enzyme Inhibitors, Decreased Cell Wall Synthesis & Repair.
- What are the contraindications for Ceftriaxone?
- Ceftriaxone labeling lists contraindications including: Hypersensitivity Ceftriaxone for injection is contraindicated in patients with known hypersensitivity to ceftriaxone, any of its excipients or to any other cephalosporin. Patients with previous hypersensitivity reactions to penicillin and other beta lactam antibacterial agents may be at greater risk of hypersensitivity to ceftriaxone (see Warnings – Hypersensitivity Reactions ).. Always consult the full prescribing information and a clinician.
ceftriaxone is illustrative MVP content compiled from public sources. pharmacopeia is for educational and informational use only and is not a substitute for professional medical advice.