Zeftrax S Special Precautions

Although transient elevations of blood urea nitrogen and serum creatinine have been observed at the recommended dosages, the nephrotoxic potential of Ceftriaxone is similar to that of other cephalosporins.
Ceftriaxone is excreted via both biliary and renal excretion. Therefore, patients with renal failure normally require no adjustment in dosage when usual doses of Ceftriaxone are administered but concentrations of the drug in the serum should be monitored periodically. If evidence of accumulation exist, dosage should be decreased accordingly. Dosage adjustment should not be necessary in patients with hepatic dysfunction and significant renal disease, dosage should not exceed 2 mg daily without close monitoring of serum concentration. Alterations in prothrombin times have occurred rarely in patients treated with Ceftriaxone. Patients with impaired vitamin K synthesis or low vitamin K stores (e.g. chronic hepatic disease and malnutrition) may require monitoring of prothrombin time during treatment. Vitamin K administration (10 mg weekly) may be necessary if the prothrombin time is prolonged before or during therapy. Prolonged use of Ceftriaxone may result in overgrowth of non-susceptible organism. Careful observation of the patient is essential. It should be prescribed with caution in individuals with a history of gastrointestinal, especially colitis.