Ceftriaxone Does Not Have an Oral Formulation
Ceftriaxone is only available for intravenous (IV) or intramuscular (IM) administration—there is no FDA-approved oral form of this antibiotic. 1
Route of Administration
Ceftriaxone is administered exclusively by injection (IV or IM), as it is not absorbed adequately from the gastrointestinal tract when taken orally 2
Multiple guidelines consistently describe ceftriaxone as "for intravenous (IV) or intramuscular (IM) administration" without any mention of oral formulations 1
The drug achieves complete absorption following IM administration, with peak plasma concentrations occurring 2-3 hours after injection 1
Oral Alternatives to Ceftriaxone
When oral therapy is needed, cefixime is the recommended oral alternative that provides similar (though not identical) antimicrobial coverage:
Cefixime 400 mg orally is the standard oral cephalosporin substitute for ceftriaxone in conditions like gonorrhea 1
Cefixime has an antimicrobial spectrum similar to ceftriaxone, but provides lower and less sustained bactericidal levels than ceftriaxone 125 mg IM 1
Other oral third-generation cephalosporins include cefpodoxime proxetil (a structural analog of ceftriaxone) and cefdinir 1
Clinical Context: Sequential IV-to-Oral Therapy
In severe infections requiring initial parenteral therapy, switching from IV ceftriaxone to oral cefixime after 4 days has been studied successfully in upper urinary tract infections 3
This sequential approach (ceftriaxone IV followed by cefixime oral) achieved clinical cure rates of 74.3% compared to 81% with continued ceftriaxone 3
Experimental Oral Formulations
Research has explored enteric-coated oral tablet formulations of ceftriaxone using biopolymers and permeation enhancers, achieving approximately 80% oral bioavailability in animal studies 4
However, no such formulation is commercially available or FDA-approved for clinical use 4
Key Clinical Pitfall
Do not confuse ceftriaxone with oral cephalosporins. If a patient requires oral therapy, prescribe cefixime or another appropriate oral cephalosporin rather than attempting to find an oral ceftriaxone formulation that does not exist. 1