Parenteral Manual

CefTRIAXone sodium

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Original Date: 
August 2005
Revised Date: 
December 2019
  • Third generation cephalosporin for treatment of susceptible strains of bacteria 
  • Long half-life (8 hours) makes it suitable for outpatient therapy of other infections
  • Has been recommended as current outpatient therapy of choice for all forms of gonorrhea (active against penicillinase-producing strains of N. gonorrhea)
Reconstitution and Stability: 




1,000 mg

9.6 mL

100 mg/mL

2,000 mg

19.2 mL

100 mg/mL

10,000 mg

95 mL

100 mg/mL

  • Store unreconstituted vial at room temperature, protect from light
  • Reconstituted vial and solution for IV use stable 3 days room temperature, 10 days refrigerated
  • Solution colour ranges from light yellow to amber, depending on length of storage
  • May precipitate but goes back into solution at room temperature

    For IM use
    * Dilute 1000 mg vial with 1.8 mL lidocaine 1% or 2000 mg vial with 3.6 mL lidocaine 1% for 500 mg/mL. Stable 24 hours at room temperature or 72 hours refrigerated


- Solutions Compatible:  dextrose up to D10W, 0.9% NS, dextrose-saline combinations

- Additives/Above Cassette Compatible: lidocaine 1% (without epinephrine) for IM injection

- Y-site Compatible:  Intralipid 20% , morphine, potassium chloride

Incompatible: calcium, fluconazole, vancomycin, aminoglycoside antibiotics: administration of beta lactam and aminoglycoside antibiotics should be separated.
No calcium or calcium-containing IV medications (ie. TPN and Lactated Ringers) should be given simultaneously  via a Y-site.  In term patients that are older than one month (excluding  neonates), ceftriaxone and calcium containing solutions may be administered sequentially of one another if the infusions lines are thoroughly flushed between infusions with a compatible fluid.


(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)


YES, deep into large muscle
Usual dilution: 500 mg/mL- diluted with 1% lidocaine (without epinephrine)

IV Direct

Yes.  Max 2 g/dose IV direct

Usual dilution: 100 mg/mL

Infusion time: 3-5 minutes

IV Intermittent Infusion YES - preferred
Usual dilution: 100 mg/mL
Infusion time: 10-30 minutes
IV Continuous Infusion NO

(For neonatal dosages, refer to Neonatal IV Drug Manual.)


- Contraindicated until child is term plus 1 month of age

  • 50 - 100 mg/kg/day IV divided Q 12 - 24H (Max 2 g/dose)

- Meningitis:  refer to CHEO Meningitis (Bacterial) Treatment Guidelines

At 0 hours - loading dose of 100 mg/kg/dose (Max 2 g/dose),

At 12 hours -  another loading dose of 100 mg/kg /dose

At 24 hours - start 100 mg/kg/day IV divided Q12H (Max 2 g/dose or 4 g/day)                     

-  Uncomplicated Gonorrhea

  •  250 mg IM as a single dose



  • 1-2 g IM/IV  Q 12-24 hours (Max 2 g/dose)
Potential hazards of parenteral administration: 
  • Hypersensitivity reactions: rash, pruritus, bronchospasm, anaphylaxis
  • Possible cross-sensitivity with other beta-lactam antibiotics (ie. penicillins, cephalosporins)
  • Local reactions at injection site:  pain, induration and tenderness, thrombophlebitis
  • Gastrointestinal:  diarrhea, nausea, vomiting
  • Laboratory abnormalities:  eosinophilia, thrombocytosis, transient elevations in hepatic enzymes, BUN or serum creatinine
  • Sodium content is 3.6 mmol/g of ceftriaxone
  • Not necessary to reduce dose except where renal and hepatic insufficiency co-exist
  • Monitor CBC with differential, renal and hepatic function tests, PT

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