Cefrag

Cefrag Uses, Dosage, Side Effects, Food Interaction and all others data.

Cefrag is a sterile, semisynthetic, broad-spectrum, 3rd generation cephalosporin antibiotic for intravenous or intramuscular administration. The bactericidal activity of Cefrag results from inhibition of cell wall synthesis. Cefrag has a high degree of stability in the presence of beta-lactamases both penicillinases and cephalosporinases of gram-negative and gram- positive bacteria.

Cefrag is a cephalosporin/cephamycin beta-lactam antibiotic used in the treatment of bacterial infections caused by susceptible, usually gram-positive, organisms. Cefrag has in vitro activity against gram-positive aerobic, gram-negative aerobic, and anaerobic bacteria. The bactericidal activity of ceftriaxone results from the inhibition of cell wall synthesis and is mediated through ceftriaxone binding to penicillin-binding proteins (PBPs). Cefrag is stable against hydrolysis by a variety of beta-lactamases, including penicillinases, and cephalosporinases and extended-spectrum beta-lactamases. However, resistance to ceftriaxone usually occurs through beta-lactamase hydrolysis, altered PBPs, or reduced bacterial cell permeability. Cefrag should not be mixed with or giving in the same IV line as diluents/products containing calcium as they may cause ceftriaxone to precipitate. Cefrag use may also cause biliary sludge or gallbladder pseudolithiasis.

Trade Name Cefrag
Availability Prescription only
Generic Ceftriaxone
Ceftriaxone Other Names Ceftriaxona, Ceftriaxone, Ceftriaxonum, Rocephin
Related Drugs amoxicillin, doxycycline, diclofenac ophthalmic, ciprofloxacin, cephalexin, metronidazole, azithromycin, clindamycin, dexamethasone ophthalmic, levofloxacin
Type
Formula C18H18N8O7S3
Weight Average: 554.58
Monoisotopic: 554.04605704
Protein binding

Ceftriaxone is 95% protein bound.

Groups Approved
Therapeutic Class Third generation Cephalosporins
Manufacturer
Available Country Italy
Last Updated: September 19, 2023 at 7:00 am
Cefrag
Cefrag

Uses

Cefrag is used for the treatment of the following infections when caused by susceptible organisms:

Lower Respiratory Tract Infections caused by Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella pneumoniae, E. coli, Enterobacter aerogenes, Proteus mirabilis, Serratia marcescens.

Acute Bacterial Otitis Media caused by Streptococcus pneumoniae, Haemophilus influenzae (including beta-lactamase producing strains), Moraxella catarrhalis (including beta-lactamase producing strains).

Skin and Skin Structure Infections caused by Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pyogenes, Viridans group streptococci, E. coli, Enterobacter cloacae, Klebsiella oxytoca, Klebsiella pneumoniae, Proteus mirabilis, Morganella morganii, Pseudomonas aeruginosa, Serratia marcescens, Acinetobacter calcoaceticus, Bacteroides fragilis, Peptostreptococcus species.

Urinary Tract Infections (complicated and uncomplicated) caused by E. coli, Proteus mirabilis, Proteus vulgaris, Morganella morganii, Klebsiella pneumoniae.

Uncomplicated Gonorrhea (cervical, urethral, pharyngial and rectal) caused by Neisseria gonorrhoeae, including both penicillinase- and nonpenicillinase-producing strains, and pharyngeal gonorrhea caused by nonpenicillinase-producing strains of Neisseria gonorrhoeae.

Pelvic Inflammatory Disease caused by Neisseria gonorrhoeae.

Bacterial Septicemia caused by Staphylococcus aureus, Streptococcus pneumoniae, E. coli, Haemophilus influenzae, Klebsiella pneumoniae.

Bone and Joint Infections caused by Staphylococcus aureus, Streptococcus pneumoniae, E. coli, Proteus mirabilis, Klebsiella pneumoniae, Enterobacter species.

Intra-abdominal Infections caused by E. coli, Klebsiella pneumoniae, Bacteroides fragilis, Clostridium species, Peptostreptococcus species.

Meningitis caused by Haemophilus influenzae, Neisseria meningitidis, Streptococcus pneumoniae. Cefrag has also been used successfully in a limited number of cases of meningitis and shunt infection caused by Staphylococcus epidermidis and E. coli.

Surgical Prophylaxis: The preoperative administration of a single 1 gm dose of Cefrag may reduce the incidence of postoperative infections in patients undergoing surgical procedures classified as contaminated or potentially contaminated.

Cefrag is also used to associated treatment for these conditions: Arthritis gonococcal, Bacterial Endocarditis, Bacterial Infections, Bacterial Sepsis, Bacterial Sinusitis, Bone and Joint Infections, Brain abscess, Chancroid, Community Acquired Pneumonia (CAP), Conjunctivitis gonococcal neonatal, Epididymitis, Epiglottitis, Gonococcal infection of pharynx, Gonococcal pelvic inflammatory disease, Intra-Abdominal Infections, Lower respiratory tract infection bacterial, Lyme Neuroborreliosis, Meningitis, Bacterial, Ophthalmia neonatorum due to gonococcus, Postoperative Infections, Prosthetic Joint Infection, Salmonella Typhi Infection, Septic Arthritis, Shigellosis, Skin and Subcutaneous Tissue Bacterial Infections, Syphilis, Vulvovaginitis gonococcal, Whipple Disease, Bacterial otitis media, Complicated Bacterial Urinary Tract Infections, Susceptible Bacterial Infections, Uncomplicated Gonorrhea, Uncomplicated Urinary tract infection bacterial

How Cefrag works

Cefrag works by inhibiting the mucopeptide synthesis in the bacterial cell wall. The beta-lactam moiety of ceftriaxone binds to carboxypeptidases, endopeptidases, and transpeptidases in the bacterial cytoplasmic membrane. These enzymes are involved in cell-wall synthesis and cell division. Binding of ceftriaxone to these enzymes causes the enzyme to lose activity; therefore, the bacteria produce defective cell walls, causing cell death.

Dosage

Cefrag dosage

Generally, Cefrag should be taken once or equally devided twice a day for 4-14 days. Cefrag therapy should be continued for at least 2 days after the sign and symptoms of infection have disappeared.

The usual duration of therapy is 4 to 14 days; in complicated infections longer therapy may be required. No dosage adjustment is required for patients with renal or hepatic impairment.

Use the solution immediately after reconstitution of powder.

Side Effects

Generally Cefrag is well tolerated. However, few side effects including nausea, vomiting, diarrhea, dizziness and fever may occur.

Toxicity

Cefrag overdose may increase the risk of urolithiasis and subsequent post-renal acute renal failure (PARF). Other symptoms of overdose unavailable in the literature. However, they are likely similar to the adverse effects of the medication. If overdose of ceftriaxone occurs, treat with symptomatic and supportive treatment, as ceftriaxone levels will not be reduced by dialysis.

Precaution

Cefrag should be administered with caution to individuals with a history of gastrointestinal disease, particularly colitis.

Interaction

May increase nephrotoxicity of aminoglycosides. May diminish therapeutic effect of BCG, typhoid vaccine, Na picosulfate. May increase anticoagulant effect of vit K antagonists (e.g. warfarin). May increase serum level with probenecid.

Food Interaction

No interactions found.

Volume of Distribution

The apparent volume of distribution of an intravenous or intramuscular dose in healthy patients is 5.78 to 13.5 L. The volume of distribution of an intravenous or intramuscular dose in septic patients is 6.48 to 35.2 L. Cefrag has good enough CSF penetration to be used as an effective treatment of bacterial meningitis.

Elimination Route

Cefrag is only given as an injection, either intramuscularly or intravenously. Cefrag is less than 1% bioavailable if given orally.

Half Life

The elimination half-life of ceftriaxone is 5.8-8.7 hours. The half-life of ceftriaxone in the middle ear fluid has been estimated to be 25 hours.

Clearance

The plasma clearance of ceftriaxone in healthy adults receiving a 0.15-3g dose is 0.58 to 1.45 L/hour. The renal clearance of ceftriaxone is 0.32 to 0.73 L/hour. In intensive care unit patients, ceftriaxone's total drug clearance was 0.96L/h (0.55-1.28 L/h), and unbound drug clearance was 1.91 L/h (1.46-6.20 L/h).

Elimination Route

Cefrag is primarily eliminated in the urine (33-67%). The remainder is eliminated through secretion in the bile and removed from the body via the feces.

Pregnancy & Breastfeeding use

Pregnancy: The safety of Cefrag in the treatment of infections during pregnancy has not been established. Cefrag should only be used during pregnancy if the likely benefit outweighs the potential risk to the fetus and/or the mother.

Lactation: Cefrag is excreted in breast milk at low concentrations. Therefore, caution should be exercised when Cefrag is administered to a nursing mother.

Contraindication

Cefrag should not be given to patients with a history of hypersensitivity to cephalosporin antibiotics. It is contraindicated in premature infants during the first 6 weeks of life. Its safety in human pregnancy has not been established. Cefrag is contraindicated in neonates 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.

Acute Overdose

There is no specific antidote. Treatment of over dosage should be symptomatic.

Storage Condition

Store below 25°C, protected from light & moisture. Use reconstituted solutions immediately.

Reconstituted solutions are stable for 6 hours at room temperature and for 24 hours at 2°-8°C. It should not be mixed in the same syringe with any drug other than 1% Lidocaine Hydrochloride injection BP (for IM injection only).

Innovators Monograph

You find simplified version here Cefrag

Cefrag contains Ceftriaxone see full prescribing information from innovator Cefrag Monograph, Cefrag MSDS, Cefrag FDA label

FAQ

What is Cefrag used for?

Cefrag is used to treat certain kinds of bacterial infections. It will not work for colds, flu, or other viral infections.Cefrag is a cephalosporin antibiotic.

What are the common side effects of Cefrag?

Common side effects of Cefrag include:

  • rash,
  • diarrhea,
  • nausea,
  • vomiting,
  • upset stomach,
  • blood clots,
  • dizziness,
  • headache,
  • pain or swelling in your tongue,
  • a lump where the medicine was injected,
  • sweating,
  • vaginal itching or discharge,
  • vaginal yeast infection,
  • anemia,
  • changes in taste, or
  • flushing.

How safe is Cefrag?

FDA alert states that generally, fatalities have been associated with simultaneous administration of Cefrag and calcium-containing products.administration of the two products at different times and via different infusion lines has also been fatal.

Who should not take Cefrag?

A type of blood disorder where the red blood cells burst called hemolytic anemia. Liver problems. disease of the gallbladder. Severe renal impairment.

Is Cefrag safe during pregnancy?

At first ,Cefrag is not harmful for pregnant women.The U.S. Food and Drug Administration (FDA) considers Cefrag a pregnancy Category B medicine, which means that it has not been studied in pregnant women. However, when studied in pregnant animals, Cefrag showed no negative effects on unborn babies.

What are the benefits of Cefrag?

Cefrag is used to treat many kinds of bacterial infections, including severe or life-threatening forms such as E. coli, pneumonia, or meningitis.Cefrag is also used to prevent infection in people having certain types of surgery.

Is Cefrag safe during breastfeeding?

Cefrag is acceptable in nursing mothers.

Can I take Cefrag without food?

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Cefrag, there are no specific foods that you must exclude from your diet when receiving this medication.

Which foods should be avoided during treatment with Cefrag?

Foods that must be avoided while on antibiotic treatment include grapefruit, foods rich in calcium.

Can I drink alcohol after taking Cefrag?

It is best not to drink alcohol for up to 48 hours after the injection.

How many days should Cefrag injection be taken?

It is sometimes given as a single dose and sometimes given once or twice a day for 4-14 days, depending on the type of infection being treated.

How long can I take Cefrag?

Cefrag is sometimes given for up to 14 days. Read and carefully follow any Instructions for Use provided with your medicine.

Can I drive after taking Cefrag ?

Cefrag can cause dizziness. If you feel dizzy, do not drive or use any tools or machines.

How does Cefrag work in the body?

Cefrag works by interfering with the formation of bacterial cell walls. Cefrag impairs the bonds that hold the bacterial cell wall together, which allows holes to appear in the cell walls.

Where is Cefrag injected?

Cefrag is injected into a muscle or as an infusion into a vein (IV).

Can I take Cefrag without food?

In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Cefrag, there are no specific foods that you must exclude from your diet when receiving this medication.

*** Taking medicines without doctor's advice can cause long-term problems.
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