Ceftriaxone 500mg Vial Reconstitution
For intramuscular injection, reconstitute the 500mg vial with 1.8 mL of diluent to achieve a 250 mg/mL concentration, or with 1.0 mL to achieve a 350 mg/mL concentration. 1
Reconstitution Procedure
Step-by-Step Instructions
- Inject the appropriate volume of diluent into the vial and shake thoroughly to form a solution 1
- Withdraw the entire contents of the vial into a syringe to equal the total labeled dose 1
- After reconstitution, each 1 mL of solution contains approximately 250 mg or 350 mg equivalent of ceftriaxone, depending on the diluent volume used 1
Diluent Volume Options for 500mg Vial
| Concentration | Diluent Volume |
|---|---|
| 250 mg/mL | 1.8 mL |
| 350 mg/mL | 1.0 mL |
Acceptable Diluents for IM Reconstitution
The following diluents are compatible for intramuscular preparation:
- 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) - This option may reduce injection discomfort 2, 1, 3
Critical Considerations
Pain Reduction Strategy
- Using 1% lidocaine solution as the diluent may significantly reduce the discomfort associated with intramuscular ceftriaxone injection 2
- Clinical experience demonstrates that lidocaine reconstitution is well tolerated by patients receiving intramuscular ceftriaxone 3
Injection Technique
- Inject well within the body of a relatively large muscle 1
- Aspirate before injection to avoid unintentional injection into a blood vessel 1
Stability After Reconstitution
Once reconstituted for IM use at 250 mg/mL or 350 mg/mL concentration:
- Stable for 24 hours at room temperature (25°C) when using Bacteriostatic Water or 1% Lidocaine 1
- Stable for 2 days at room temperature when using Sterile Water, 0.9% Sodium Chloride, or 5% Dextrose 1
- Stable for 3 days when refrigerated (4°C) for all listed diluents 1
Common Pitfalls to Avoid
- Do not use diluents containing calcium (such as Ringer's solution or Hartmann's solution), as particulate formation can result 1
- The 350 mg/mL concentration is not recommended for the 250mg vial since it may not be possible to withdraw the entire contents 1
- Protect the powder from light during storage, though protection from normal light is not necessary after reconstitution 1
- Discard unused portions after the stability time periods listed above 1