How do I reconstitute Rocephin (ceftriaxone) 1g?

Reconstitution of Rocephin (Ceftriaxone) 1g

For intramuscular administration, reconstitute the 1g vial with 3.6 mL of diluent to achieve a 250 mg/mL concentration, or with 2.1 mL to achieve a 350 mg/mL concentration; for intravenous administration, reconstitute with 9.6 mL of appropriate diluent to achieve a 100 mg/mL concentration. 1

Intramuscular (IM) Reconstitution

Diluent Options:

• Sterile Water for Injection 1
• 0.9% Sodium Chloride Solution 1
• 5% Dextrose Solution 1
• Bacteriostatic Water with 0.9% Benzyl Alcohol 1
• 1% Lidocaine Solution (without epinephrine) 1

Reconstitution Steps:

• Inject the appropriate volume of diluent into the vial 1
• Shake the vial thoroughly to form a solution 1
• Withdraw entire contents of vial into syringe to equal total labeled dose 1
• For the 1g vial: use 3.6 mL diluent for 250 mg/mL concentration, or 2.1 mL for 350 mg/mL concentration 1

Administration Technique:

• Inject well within the body of a relatively large muscle 1
• Aspirate to avoid unintentional injection into a blood vessel 1

Intravenous (IV) Reconstitution

Diluent Options:

• Sterile Water for Injection 1
• 0.9% Sodium Chloride Solution 1
• 5% Dextrose Solution 1
• 10% Dextrose Solution 1

Reconstitution Steps:

• Add 9.6 mL of appropriate IV diluent to the 1g vial 1
• This yields approximately 100 mg/mL concentration 1
• Withdraw entire contents and dilute to desired concentration (10-40 mg/mL recommended) with appropriate IV diluent 1
• Administer by infusion over 30 minutes in adults 1

Critical Warnings

Do NOT use diluents containing calcium (such as Ringer's solution or Hartmann's solution) to reconstitute ceftriaxone, as particulate formation can result 1

Incompatibilities to avoid:

• Vancomycin, amsacrine, aminoglycosides, and fluconazole are incompatible with ceftriaxone in admixtures 1
• Do not physically mix with or piggyback into solutions containing other antimicrobial drugs 1
• If administering with other drugs, give sequentially with thorough flushing of IV lines between administrations 1

Stability After Reconstitution

IM solutions remain stable:

• At room temperature (25°C): 2 days for most diluents, 24 hours for bacteriostatic water and lidocaine 1
• Refrigerated (4°C): 10 days for sterile water, saline, and dextrose; 3 days for bacteriostatic water and lidocaine 1

IV solutions (10-40 mg/mL) remain stable:

• At room temperature: 2 days 1
• Refrigerated: 10 days for most diluents 1

Storage note: Store unreconstituted powder at 20-25°C (68-77°F) and protect from light 1. After reconstitution, protection from normal light is not necessary, and solution color ranges from light yellow to amber 1.