From the Guidelines
To prepare ceftriaxone 500mg for intramuscular injection, first gather the medication vial, sterile diluent (typically 2mL of sterile water for injection or 1% lidocaine without epinephrine), a syringe, and appropriate needles. Reconstitute the ceftriaxone powder by injecting the diluent into the vial, then gently roll or swirl the vial until the powder is completely dissolved - do not shake vigorously. Once dissolved, withdraw the entire solution into your syringe and change to a new needle (typically 21-23 gauge, 1-1.5 inches long) for administration. Select an appropriate injection site such as the ventrogluteal or vastus lateralis muscle, clean the site with alcohol, and inject the medication deep into the muscle using the Z-track technique to minimize leakage and pain. Ceftriaxone should be administered slowly for IM injections. The reconstituted solution appears clear to yellowish and should be used within 24 hours if stored at room temperature or within 3 days if refrigerated. Using 1% lidocaine as a diluent can help reduce the pain associated with ceftriaxone injection, as this medication is known to cause significant discomfort when administered intramuscularly due to its high pH and osmolality 1.
Some key points to consider when preparing ceftriaxone for IM injection include:
- Using sterile technique to minimize the risk of infection
- Avoiding vigorous shaking of the vial to prevent introducing air into the solution
- Administering the medication slowly to reduce discomfort
- Using the Z-track technique to minimize leakage and pain
- Considering the use of 1% lidocaine as a diluent to reduce pain associated with the injection 1.
It's also important to note that ceftriaxone is a broad-spectrum cephalosporin antibiotic, and its use should be guided by current clinical guidelines and antimicrobial stewardship principles to minimize the risk of resistance and adverse effects 1.
In terms of specific administration guidelines, the dose and frequency of ceftriaxone administration will depend on the specific clinical indication and patient population, and should be guided by current clinical guidelines and evidence-based recommendations 1.
Overall, the preparation and administration of ceftriaxone for IM injection requires careful attention to detail and adherence to sterile technique and clinical guidelines to minimize the risk of adverse effects and ensure optimal patient outcomes.
From the FDA Drug Label
DIRECTIONS FOR USE Intramuscular Administration: Reconstitute ceftriaxone powder with the appropriate diluent (see COMPATIBILITY AND STABILITY). Inject diluent into vial, shake vial thoroughly to form solution Withdraw entire contents of vial into syringe to equal total labeled dose. Vial Dosage Size Amount of Diluent to be Added 250 mg 0.9 mL — 500 mg 1.8 mL 1 mL ... As with all intramuscular preparations, ceftriaxone should be injected well within the body of a relatively large muscle; aspiration helps to avoid unintentional injection into a blood vessel.
To prepare ceftriaxone 500mg for Intramuscular (IM) injection, reconstitute the ceftriaxone powder with the appropriate diluent. For a 500mg dose, add 1.8 mL of diluent to the vial, then shake the vial thoroughly to form a solution. Withdraw the entire contents of the vial into a syringe, and inject well within the body of a relatively large muscle. 2
From the Research
Preparation of Ceftriaxone 500mg for IM Injection
To prepare ceftriaxone 500mg for intramuscular (IM) injection, the following steps can be considered:
- Ceftriaxone can be administered intramuscularly, and its pharmacokinetics and tolerance have been studied in humans after single-dose intramuscular administration in water and lidocaine diluents 3.
- The use of 1% lidocaine as a diluent does not alter the elimination parameters or bioavailability of intramuscularly administered ceftriaxone, and it reduces the intensity and frequency of pain at the injection site 3.
- Ceftriaxone is rapidly and completely absorbed following intramuscular administration, with 33 to 67 percent of a dose excreted in the urine as unchanged drug 4.
Reconstitution and Administration
- Ceftriaxone can be reconstituted with lidocaine to reduce pain at the injection site, and this combination is well tolerated by patients 5, 3.
- The pharmacokinetic profile of ceftriaxone in humans exhibits an exceptionally long elimination half-life, allowing for once-daily administration 4.
- Intramuscular administration of ceftriaxone results in serum and pleural fluid concentrations that are well above the MIC90 of most common respiratory pathogens, indicating good penetration into extracellular spaces 6.