Possible Interaction: Ceftriaxone and Calcium Supplement

“DiscussionConcomitant administration of intravenous ceftriaxone and calcium-containing solutions should be avoided in neonates.”

“ Ceftriaxone binds with calcium ions and forms insoluble biliary sludge in the gallbladder.”

“Several cases of life-threatening reaction due to cephalosporin have been reported.…--7 Some of the reactions have been related to rapid administration of intravenous ceftriaxone coincidentally … a calcium solution.5,6 In another case caused by cefazidime7 an …-mediated mechanism was suggested, but it could not be demonstrated.”

“Objective In September 2007, the FDA issued an alert recommending that ceftriaxone and calcium-containing solutions should not be administered to any patient within 48 h of each other.”

“Our results are the first to demonstrate that ceftriaxone has the potential to significantly increase urinary excretion of calcium , which may be linked to ceftriaxone-related urolithiasis or sludge.”

“In response to reports of … UK has warned that ceftriaxone … calcium-containing solutions and is contraindicated entirely in neonates.2 Draft guidelines on the management of meningococcal disease by The National … caution against use in the under 3-month age group.3 We performed an anonymised postal survey from …”

“In July 2007, the U.S. Food and Drug Administration (FDA) issued a MedWatch alert regarding a potentially deadly drug interaction between ceftriaxone and calcium or calcium-containing products.[1][1] The warning, which advised against administration of these products within 48 hours of each other,”

“The concurrent use of intravenous ceftriaxone and calcium-containing solutions in the newborn and young infant may result in a life-threatening adverse drug reaction.”

“This report describes and summarizes the reported cases that led to safety concerns regarding the concurrent administration of intravenous ceftriaxone and calcium in this age group.”

“BACKGROUND Isolated reports of neonatal and infant deaths associated with ceftriaxone-calcium precipitation in the lungs and kidneys … a recommendation from the US FDA in June 2007 advising that in patients of all ages, calcium-containing solutions should not be administered simultaneously or … 48 h of the last ceftriaxone ….”

“ Ceftriaxone binds calcium in the biliary tract, forming biliary sludge or stones.”