Medscape April 14, 2009 — Ceftriaxone Can Be Administered With Calcium -Containing Products in Certain Patients Ceftriaxone can now be administered concomitantly with calcium-containing products in patients older than 28 days but remains contraindicated in neonates, the US Food and Drug Administration (FDA) announced today. The announcement updates a previous recommendation that ceftriaxone and calcium-containing products should not be administered within 48 hours of one another, regardless of patient age. The FDA requested that the manufacturer of ceftriaxone conduct in vitro studies to investigate whether ceftriaxone-calcium precipitates when ceftriaxone and calcium-containing products are mixed in vials and in infusion lines, according to an alert from MedWatch, the FDA's safety information and adverse event reporting program. Studies were conducted in plasma from adults and neonates at normal and greater than physiologic concentrations. According to the FDA's information for healthcare professionals, ceftriaxone and calcium-containing products may be used concomitantly in patients older than 28 days using precautionary steps because "the risk of precipitation is low in this population." Precautionary steps include sequential administration in patients older than 28 days provided that the infusion lines are thoroughly flushed between infusions with a compatible fluid. In addition, ceftriaxone must not be administered simultaneously with intravenous calcium-containing solutions via a Y-site in any age group. --

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