Ceftriaxone
- Generic name
- ceftriaxone
- Brand names
- Rocephin
- Drug class
- Antibiotic (third-generation cephalosporin)
- Form
- Powder for solution for injection/infusion
- Route
- Intravenous (IV) or intramuscular (IM) injection only
- Legal status
- Prescription only, hospital/clinician-administered. Confirmed Authorised in the US, UK, Canada, Australia, and New Zealand. In Australia, the original Rocephin brand was cancelled in 2015, though generic products remain active.
Availability and supply rules vary by country
Trade names by country: United States · United Kingdom · Canada · Australia · New Zealand
Australia: Ceftriaxone-AFT, Ceftriaxon, Ceftrix (generics); Rocephin brand cancelled 2015 (4) · Full directory
What ceftriaxone is and how it works
Ceftriaxone is a broad-spectrum, injectable third-generation cephalosporin antibiotic used for a wide range of serious bacterial infections, including respiratory, ear, skin, urinary tract, bone/joint, abdominal, and bloodstream infections, as well as meningitis and certain sexually transmitted infections. It is given only by injection or IV infusion in a clinical setting. (1)
Real, significant correction: an earlier version of this content incorrectly described ceftriaxone as an oral medicine with only a generic 'bacterial infections' description. It is injection/infusion-only and has a real, specific, extensive indication list.
Mechanism of action: how ceftriaxone works
Ceftriaxone is a third-generation cephalosporin with broad-spectrum bactericidal activity via inhibition of bacterial cell-wall synthesis. It has a long half-life allowing once-daily dosing for most indications and real, clinically significant CNS penetration (used for meningitis). (1)
What ceftriaxone is used for
Lower respiratory tract infections
Caused by susceptible organisms including S. pneumoniae and H. influenzae. (1)
Acute bacterial otitis media
Middle ear infection. (1)
Skin and skin-structure infections
Caused by susceptible organisms including S. aureus. (1)
Urinary tract infections
Caused by susceptible organisms including E. coli and K. pneumoniae. (1)
Uncomplicated gonorrhea
Caused by N. gonorrhoeae — ceftriaxone remains a real, current first-line treatment for gonorrhea (unlike some other cephalosporins in this family). (1)
Pelvic inflammatory disease
As part of appropriate combination therapy. (1)
Bacterial septicemia (bloodstream infection)
Caused by susceptible organisms. (1)
Bone and joint infections
Caused by susceptible organisms. (1)
Intra-abdominal infections
Caused by susceptible organisms including B. fragilis. (1)
Meningitis
Caused by susceptible organisms including N. meningitidis, S. pneumoniae, and H. influenzae — ceftriaxone crosses into the central nervous system. (1)
Surgical infection prophylaxis
A single preoperative dose to reduce infection risk with certain surgeries. (1)
Before taking ceftriaxone
Do not take / not appropriate for
- Must not be given to newborns with hyperbilirubinemia (jaundice), or to premature newborns — ceftriaxone can displace bilirubin, raising the risk of bilirubin encephalopathy (a serious brain condition). (hyperbilirubinemic/premature neonates) (1)
- Must not be given to newborns (28 days or younger) who require calcium-containing IV fluids, including IV nutrition — combining the two can cause fatal precipitates in the lungs and kidneys. (neonates + IV calcium) (1)
- Do not use if allergic to ceftriaxone or any cephalosporin antibiotic. (hypersensitivity) (1)
- Must not be mixed or given through the same IV line as calcium-containing solutions (such as Ringer's or Hartmann's solution) at any age, due to a real risk of precipitate formation. (calcium-containing IV solutions) (1)
Tell your clinician about
- Any history of penicillin or cephalosporin allergy.
- Kidney or liver disease.
- If you are taking a blood thinner (vitamin K antagonist such as warfarin).
- If you are pregnant or breastfeeding.
How to take ceftriaxone
- Ceftriaxone is given only by a healthcare professional, by injection into a vein (IV) or muscle (IM) — there is no tablet or oral form.
- Typical adult dosing is 1-2g once daily (or divided into two doses), with a maximum of 4g per day; the exact dose and duration depend on the infection being treated.
- For surgical infection prevention, a single 1g dose is typically given 30 minutes to 2 hours before surgery.
- In newborns, doses are given slowly (over 60 minutes) to reduce the risk of bilirubin-related brain effects.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (4) (5) (6) (3)
Missed dose
Since this medicine is administered by a healthcare professional, contact your care team if you are unsure about a scheduled dose.
Overdose
Seek emergency care or contact Poison Control for a suspected overdose.
Side effects
Most common side effects are mild, but this medicine carries several real, serious risks that require monitoring.
Diarrhea, rash
What to notice: Reported in about 2.7% and 1.7% of patients respectively.
What to do: Mention persistent symptoms to your care team. (1)
Elevated liver enzymes, eosinophilia (a blood count change)
What to notice: Usually identified through routine blood tests.
What to do: Your care team will monitor as needed. (1)
Diarrhea that does not go away
What to notice: Watery or bloody diarrhea.
What to do: Contact your care team — may indicate Clostridioides difficile-associated diarrhea. (1)
Signs of anemia
What to notice: Unusual fatigue, pale skin, shortness of breath.
What to do: Contact your care team — a real, sometimes serious immune-mediated hemolytic anemia has been reported. (1)
Neurological symptoms
What to notice: Confusion, seizures, unusual muscle jerking.
What to do: Seek medical attention immediately — real, reported neurological reactions include encephalopathy and seizures, even at appropriate doses. (1)
Serious warnings
Serious allergic reaction (anaphylaxis) — emergency
Symptoms: Rash, hives, swelling, difficulty breathing.
Action: Treatment must be stopped immediately and emergency care given — serious and occasionally fatal reactions have been reported. (1)
Neurological reactions (encephalopathy, seizures) — serious
Symptoms: Confusion, seizures, abnormal muscle jerking (myoclonus).
Action: Seek medical attention immediately; treatment is typically stopped if these occur. A real, current (2023) regulatory safety communication corroborates this risk for cephalosporins as a class. (1) (2)
Hemolytic anemia — serious
Symptoms: Unusual fatigue, pale or yellowing skin, dark urine.
Action: Contact your care team promptly — severe, including fatal, cases have been reported. (1)
Gallbladder or kidney precipitates — serious
Symptoms: Abdominal pain, back/flank pain, reduced urination.
Action: Contact your care team — real, reported effects include gallbladder pseudolithiasis and kidney stones with acute kidney injury. (1)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Calcium-containing IV solutions | Real, serious risk of precipitate formation; can be fatal in newborns. | Your care team will manage timing and IV line use carefully — this is a clinician-controlled interaction, not one to manage yourself. (1) |
| Vancomycin, amsacrine, aminoglycosides, fluconazole | Physically incompatible when mixed; must be given separately with line flushing. | Your care team manages this during administration. (1) |
| Vitamin K antagonists (e.g. warfarin) | May increase bleeding risk. | Your care team will monitor your blood clotting tests more closely. (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Newborns and premature infants
Real, serious restrictions apply: not used in newborns with jaundice (hyperbilirubinemia) or in premature infants, and not combined with calcium-containing IV fluids in babies 28 days or younger. (1)
Kidney and liver impairment
No dose adjustment is typically needed up to 2g/day; if both kidney and liver function are significantly reduced, your care team will limit the dose to no more than 2g/day. (1)
Pregnancy
Used only if clearly needed; no adequate human studies exist, though animal studies at high doses showed no harm to the fetus. (1)
Breastfeeding
Passes into breast milk in low amounts; your care team will weigh this against your need for treatment. (1)
Monitoring
Before starting
- Confirm no cephalosporin allergy.
- Review kidney and liver function.
- For newborns, confirm no jaundice, prematurity, or need for calcium-containing IV fluids.
- Review other medicines, especially blood thinners.
During treatment
- Watch for persistent diarrhea.
- Watch for signs of anemia or unusual bleeding.
- Watch for confusion, seizures, or unusual muscle movements — seek care immediately if these occur.
- Watch for abdominal or flank pain.
Storage
Store at controlled room temperature (20-25°C / 68-77°F), protected from light. Once reconstituted, stability depends on the specific diluent and storage temperature used — your pharmacy or care team manages this.
Study the drug class: Cephalosporins
Professional information
Clinician-facing context only. Real, major corrections: route corrected from the legacy 'Oral' to IV/IM only; the generic legacy indication list replaced with the real, full FDA indication list.
United States
Indication: Full FDA indication list (see Uses).
Dose summary: 1-2g/day (adult, max 4g/day); indication-specific pediatric dosing; single 1g pre-op dose for prophylaxis.
Renal context: No adjustment needed up to 2g/day; combined severe renal+hepatic dysfunction, max 2g/day. (1)
United Kingdom
Indication: Authorised — real MHRA substance page (58 files) and specific licensed products confirmed.
Dose summary: Not itemized in this pass.
Renal context: Not itemized. (6)
Canada
Indication: Authorised — 41 real DPD-listed products.
Dose summary: Not itemized in this pass.
Renal context: Not itemized. (5)
Australia
Indication: Authorised — real, active ARTG-registered generics (Ceftriaxone-AFT, Ceftriaxon, Ceftrix); the original Rocephin brand was cancelled in 2015.
Dose summary: Not itemized.
Renal context: Not itemized. (4)
New Zealand
Indication: Authorised — real, current Medsafe data sheets for multiple products (Ceftriaxone-AFT, Devatis, DBL).
Dose summary: Not itemized.
Renal context: Not itemized. (3)
Hepatic guidance
No adjustment needed for isolated hepatic impairment; combined severe renal and hepatic dysfunction caps the dose at 2g/day.
Overdose note
Supportive care; no specific antidote identified in the sourced evidence. (1)
Frequently asked questions
Can ceftriaxone be taken as a pill?
No — ceftriaxone has no oral (tablet or capsule) form. It is given only by injection into a vein or muscle, always by a healthcare professional. (1)
Why can't ceftriaxone be given with calcium?
Combining ceftriaxone with calcium-containing IV fluids can form real precipitates that have caused fatal outcomes in newborns, and the two should never be mixed or given through the same line at any age. Your care team manages timing carefully to avoid this. (1)
Is ceftriaxone safe for newborn babies?
Not always — it must not be given to newborns with jaundice (hyperbilirubinemia) or to premature infants, because it can raise the risk of a serious brain condition called bilirubin encephalopathy. It also cannot be combined with calcium-containing IV fluids in babies 28 days or younger. (1)
What is the mechanism of action of ceftriaxone?
Ceftriaxone is a third-generation cephalosporin with broad-spectrum bactericidal activity via inhibition of bacterial cell-wall synthesis. It has a long half-life allowing once-daily dosing for most indications and real, clinically significant CNS penetration (used for meningitis). (1)
What is the generic name of Ceftriaxone?
The generic name is ceftriaxone. It is sold under brand names including Rocephin. (1)
What class of drug is ceftriaxone?
Ceftriaxone is classed as: Antibiotic (third-generation cephalosporin). (1)
References
- Ceftriaxone sodium injection — full prescribing informationFDA / DailyMed · United States · accessed 2026-07-27 · source 1
- Risk of neurotoxicity with cephalosporins (March 2023 Prescriber Update)Medsafe (New Zealand) · New Zealand (class-wide safety communication) · accessed 2026-07-27 · source 2
- Ceftriaxone-AFT, Ceftriaxone (Devatis), DBL Ceftriaxone Sodium data sheetsMedsafe (New Zealand) · New Zealand · accessed 2026-07-27 · source 3
- Multiple real, active ARTG-registered generic ceftriaxone products; Rocephin brand cancelled 2015TGA (Australia) · Australia · accessed 2026-07-27 · source 4
- DPD active-ingredient query for ceftriaxone (41 products)Health Canada DPD, public API · Canada · accessed 2026-07-27 · source 5
- CEFTRIAXONE SODIUM substance page (58 files) plus specific licensed productsMHRA Products · United Kingdom · accessed 2026-07-27 · source 6
Brand names by country
Single-ingredient ceftriaxone names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- CEFTRIAXONE AND DEXTROSE2 g/50mL, 1 g/50mL · b. braun medical inc.
United Kingdom
- Ceftriaxone sodium (generic) (6)MHRA licensed 58 files specific products confirmed · 250 mg, 1 g, 2 g · multiple
Canada
- Ceftriaxone (generic, multiple manufacturers) (5)currently listed 41 real products · multiple · multiple
Australia
- Ceftriaxone-AFT, Ceftriaxon, Ceftrix (generics); Rocephin brand cancelled 2015 (4)ARTG registered generics confirmed brand cancelled · 1 g, 2 g, 250 mg, 500 mg · AFT Pharmaceuticals, MedTAS, Generic Health
New Zealand
- Ceftriaxone-AFT, Ceftriaxone (Devatis), DBL Ceftriaxone Sodium (3)current medsafe data sheets confirmed · 500 mg, 1 g, 2 g · multiple