Ceftriaxone Oral Formulation Availability
Ceftriaxone is NOT available in an oral pill, tablet, or capsule formulation for clinical use—it must be administered by intramuscular (IM) or intravenous (IV) injection only. 1
Why No Oral Formulation Exists
Ceftriaxone cannot be absorbed adequately from the gastrointestinal tract when taken orally, which is why all approved formulations are injectable. 1 The drug achieves complete absorption only following IM administration, with peak plasma concentrations occurring 2-3 hours after injection. 1
Oral Alternative: Cefixime
If you need an oral cephalosporin with similar coverage, cefixime 400 mg orally is the standard substitute recommended by the CDC. 1
Important Limitations of Cefixime vs. Ceftriaxone:
- Cefixime provides lower and less sustained bactericidal levels than ceftriaxone 125 mg IM 1
- Cefixime monotherapy shows higher failure rates (5.8%) compared to ceftriaxone-based regimens (1.8%) for pharyngeal gonorrhea 1
- Cefixime has limited efficacy for pharyngeal gonorrhea and should not be used as first-line therapy 2
Clinical Context for Oral Conversion:
In severe upper urinary tract infections, sequential therapy (IV ceftriaxone for 4 days followed by oral cefixime) has been studied with reasonable success, though this approach excludes patients with underlying urological or vascular conditions. 3
Research on Experimental Oral Formulations
While experimental enteric-coated tablet formulations have been developed in research settings with promising bioavailability (~80% in rabbits), these are NOT commercially available or FDA-approved for clinical use. 4 These remain investigational only. 4, 5
Clinical Bottom Line
Do not prescribe or dispense ceftriaxone as an oral medication. 1 All clinical guidelines from the CDC, American Heart Association, and other major societies specify ceftriaxone for IV or IM use exclusively. 1 If a patient requires oral therapy, prescribe cefixime or another appropriate oral cephalosporin instead—but recognize that efficacy will be inferior for serious infections. 1