Oncef Special Precautions

This drug is administered with caution to the following patients: Patients with history of drug allergy.
Patients oneself or whose parents, sisters or brothers are prone to suffer from allergic symptoms such as bronchial asthma, exanthema, urticaria, etc.
Patients with severe renal disorder (as the plasma concentration in maintained for a long period of time, decreased dosage or increased interval between treatments are required).
Patients with poor oral ingestion or parenteral nutrition patients, elderly patients, with poor general conditions (cautious monitoring is required since vitamin K deficiency may occur).
In order to prevent appearance of the resistant microorganisms, susceptibility should be determined and treatment should be continued only for the minimum period of time required.
In order to predict side effects such as shock, etc., patient history should be taken in detail and skin reaction test should be performed.
Emergency measures have to be available in preparation for concurrence of shock (if anaphylactic shock occurs intravenous epinephrine has to be followed by a glucocorticoid injection), and even after measures taken the patient should be observed cautiously in stable condition.
It is desirable to perform laboratory test (hepatic function, renal function, blood etc.) at regular intervals during treatment.
Shadows which have been mistaken of gallstones have been detected on sonograms of the gallbladder, usually following doses higher than the standard recommended dose. These shadows are, however, precipitates of calcium ceftriaxone which disappear on completion or discontinuation of ceftriaxone therapy. Rarely, these findings have been associated with symptoms, in symptomatic cases, conservative nonsurgical management is recommended. Discontinuation of ceftriaxone treatment in symptomatic case should be at the discretion of clinician.
In the case of overdosage, drug concentration would not be reduced by hemodialysis or peritoneal dialysis.
Ceftriaxone is not reported to have side effects on a persons ability to drive vehicles or operate machinery.
Interference with laboratory test: Caution is required because a false positive reaction for glucosuria test that uses Benedict's and Fehling's solution, clinical test except testape reaction might occur.
Caution is required because it is positive to the direct Coombs test.
Ceftriaxone, like other antibiotics, may results in false-positive tests for galactosemia.
Precaution on Application: As vascular pain, venous thrombosis, flushing, nausea, vomiting may rarely occur by large intravenous dose, caution should be taken on preparation of injectable solution, site of injection, method of administration, etc., and injection should be given as slowly as possible (I.V. injection).
Ceftriaxone should be used immediately after reconstitution. Particularly, caution is required when dissolving in glutathione or high concentration amino acids solution.
Use in Pregnancy & Lactation: Ceftriaxone is passed through placental barrier.
As safety in human pregnancy has not been established, women who are pregnant or considering pregnancy should be administered only if therapeutic benefits justifies the possible risks.
As ceftriaxone is excreted in the breast milk at low concentrations, caution is advised in nursing mothers.
Use in Children: Safety and effectiveness of this drug in neonates, infants and children have been established.
Studies have shown that ceftriaxone, like some other cephalosporins, can displace bilirubin from serum albumin. Special caution should be exercised on the development of bilirubin encephalopathy when considering ceftriaxone for hyperbilirubinemic neonates, especially premature.
Use in Elderly: It is recommended that a very cautious dosage schedule and careful observation be adopted in elderly patients.
Generally elderly person have low biological function. Therefore adverse reaction is prone to occur more frequently.
In elderly patients, bleeding tendency due to Vitamin K deficiency may occur.