Can You Give Oral Ceftriaxone?
No, ceftriaxone cannot be given orally because it is not adequately absorbed from the gastrointestinal tract and must be administered exclusively by intravenous (IV) or intramuscular (IM) injection. 1
Why Oral Administration Is Not Possible
- Ceftriaxone lacks adequate gastrointestinal absorption, which is why it has only been developed and approved for parenteral (IV/IM) administration. 1
- The drug achieves complete absorption only following IM administration, with peak plasma concentrations occurring 2-3 hours after injection. 1
- All clinical guidelines and drug references specify ceftriaxone for IV or IM use only, with no mention of oral formulations. 2, 1, 3
Oral Alternative: Cefixime
If you need an oral cephalosporin with similar spectrum to ceftriaxone, prescribe cefixime 400 mg orally instead. 1
- Cefixime is the standard oral third-generation cephalosporin substitute recommended by the CDC for conditions like gonorrhea when oral therapy is appropriate. 1
- However, cefixime provides lower and less sustained bactericidal levels compared to ceftriaxone 125 mg IM, making it less effective for serious infections. 1
- For pharyngeal gonorrhea specifically, cefixime monotherapy has shown higher failure rates (5.8%) compared to ceftriaxone-based regimens (1.8%). 2
Clinical Implications
- Do not confuse ceftriaxone with oral cephalosporins when prescribing—they are fundamentally different in their route of administration. 1
- For serious infections requiring ceftriaxone's superior pharmacokinetics (long half-life allowing once-daily dosing, high tissue penetration), parenteral administration is mandatory. 3, 4, 5
- The long serum half-life of ceftriaxone (7-8 hours) allows once-daily dosing for most adults and every 12 hours in children, which is an advantage over other third-generation cephalosporins. 3, 4, 5
Experimental Formulations
- While research has explored enteric-coated oral tablet formulations of ceftriaxone using permeation enhancers and pH modulators, achieving approximately 80% bioavailability in animal studies, no oral formulation is currently approved or available for clinical use. 6