What is the recommended dose of lidocaine to mix with Rocephin (Ceftriaxone) for intramuscular (IM) injection?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: June 4, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Research

For intramuscular injection of Rocephin (ceftriaxone), it is recommended to reconstitute the medication with 1% lidocaine hydrochloride solution without epinephrine, using 3.5 mL of 1% lidocaine solution per 1 gram of ceftriaxone powder, as supported by the most recent study 1.

Key Considerations

  • The use of lidocaine as a diluent for ceftriaxone is crucial for reducing injection pain, which is a significant concern for patients receiving intramuscular injections of this antibiotic.
  • The recommended dose of lidocaine to mix with Rocephin (Ceftriaxone) for intramuscular (IM) injection is based on the most recent and highest quality study available, which provides the best evidence for clinical practice.
  • When preparing the injection, it is essential to ensure complete dissolution of the ceftriaxone powder in the lidocaine solution by gently swirling the vial until the solution is clear.
  • The resulting solution should be administered immediately into a large muscle mass, such as the gluteus maximus or lateral thigh, to minimize discomfort and ensure effective delivery of the antibiotic.

Important Safety Considerations

  • Lidocaine should only be used for IM administration of ceftriaxone and never for intravenous use, as this can lead to serious adverse effects.
  • Before using lidocaine as a diluent, it is crucial to ensure that the patient has no history of hypersensitivity to local anesthetics of the amide type, as this can increase the risk of an allergic reaction.
  • The lidocaine helps reduce injection pain by temporarily numbing the area, making the administration more tolerable for patients who require this antibiotic via the intramuscular route, as demonstrated in studies such as 2 and 3.

Clinical Implications

  • The use of lidocaine as a diluent for ceftriaxone can improve patient comfort and adherence to treatment, which is essential for effective management of infections.
  • Clinicians should be aware of the recommended dose and administration guidelines for lidocaine and ceftriaxone to ensure safe and effective use of these medications, as supported by studies such as 4 and 5.
  • Further research may be necessary to confirm the optimal dose and administration guidelines for lidocaine and ceftriaxone, but current evidence supports the use of 3.5 mL of 1% lidocaine solution per 1 gram of ceftriaxone powder, as reported in 1.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.