Exephin IV (1gm/vial)

Exephin IV is an antibiotic belonging to the cephalosporin group, which is used to treat bacterial infections in your body. It is effective in infections of the brain (e.g., meningitis), lungs (e.g., pneumonia), ear, urinary tract, skin & soft tissues, bones & joints, blood and heart. Exephin IV is also used to prevent infections during surgery. It fights the infection by killing the bacteria. This helps to improve your symptoms and cure the underlying infection. It is given as a drip (intravenous infusion) or as an injection directly into a vein or a muscle under the supervision of a healthcare professional. Your doctor will decide the correct dose for you. This medicine will be given to you regularly at evenly spaced intervals as per the schedule prescribed by your doctor. Do not skip any doses and finish the full course of treatment even if you feel better. Stopping the medicine too early may lead to the returning or worsening of infection. The most common side effects of this medicine include diarrhea, rash, and changes in liver function tests and blood cell counts. Some people may develop temporary redness or pain at the site of injection. These side effects are usually mild but let your doctor know if they bother you or do not go away. Before taking it, you should let your doctor know if you are allergic to any antibiotics or have any kidney or liver problems. You should also let your healthcare team know all other medicines you are taking as they may affect, or be affected by this medicine. Pregnant and breastfeeding women should consult their doctor before using it.

Uses of Exephin IV

• Bacterial infections

Side effects of Exephin IV

Common

• Abnormal liver function tests
• Diarrhea
• Rash

How to use Exephin IV

Your doctor or nurse will give you this medicine. Kindly do not self administer.

How Exephin IV works

Exephin IV is an antibiotic. It kills the bacteria by preventing them from forming the bacterial protective covering (cell wall) which is needed for them to survive.

What if you forget to take Exephin IV?

If you miss a dose of Exephin IV, please consult your doctor.

Quick Tips

• Your doctor has prescribed Exephin IV to cure your infection and improve your symptoms.
• Do not skip any doses and finish the full course of treatment even if you feel better. Stopping it early may make the infection harder to treat.
• Discontinue Exephin IV and inform your doctor immediately if you get a rash, itchy skin, swelling of face and mouth, or have difficulty in breathing.
• Diarrhea may occur as a side effect but should stop when your course is complete. Inform your doctor if it does not stop or if you find blood in your stools.

Brief Description

Indication

Pneumonia, Meningitis, Acute otitis media, Lyme disease, Typhoid fever, Otitis media, Pelvic inflammatory disease, Septicemia, Skin and Skin-Structure Infections, Gonorrhea, Respiratory tract infections, Urinary tract infections, Bone and Joint Infections, Chlamydia infection, Surgical Prophylaxis

Administration

IV/IM Administration IV: Infuse intermittently over 30 minutes IM: Inject deep into large muscle mass

Adult Dose

Susceptible infections IV/IM 1-2 g/day, up to 4 g/day for severe infections. Intra-abdominal Infections Complicated, mild-to-moderate, community acquired: 1-2 g/day IV in single daily dose or divided q12hr for 4-7 days, in combination with metronidazole Meningitis 2 g IV q12hr for 7-14 days Acute Uncomplicated Pyelonephritis 1-2 g IV qDay Typhoid fever 2 g IV once daily for 14 days. Surgical Prophylaxis Prophylaxis of surgical infection 1 g IV 0.5-2 hours before procedure Uncomplicated Gonococcal Infections Uncomplicated gonococcal infection of pharynx, cervix, urethra, or rectum: ceftriaxone 250 mg IM once plus azithromycin 1 g PO once (preferred) or alternatively, doxycycline 100 mg PO q12hr for 7 days Pelvic Inflammatory Disease 250 mg IM as single dose with doxycycline, with or without metonidazole for 14 days

Child Dose

Children: IV, IM: 50–75 mg/kg/day, max 2 g/day q24h 50 mg/kg, max 1 g, 1–3 doses IM for AOM q24h 100 mg/kg/day for meningitis, max 4 g/day q12h

Renal Dose

Renal impairment: CrCl (ml/min) <10 Max: 2 g daily.

Contraindication

Hypersensitivity to cephalosporins; hyperbilirubinaemic neonates. Do not use calcium or calcium-containing solutions or products with or within 48 hr of ceftriaxone administration due to risk of calcium-ceftriaxone precipitate formation.

Mode of Action

Ceftriaxone binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.

Precaution

History of penicillin allergy; severe renal impairment; pregnancy and lactation; superinfection. Lactation: Drug enters breast milk in low concentrations; use with caution

Side Effect

>10% Induration after IM injection (5-17%) 1-10% Eosinophilia (6%),Thrombocytosis (5%),Diarrhea (3%),Elevated hepatic transaminases (3%),Leukopenia (2%),Rash (2%),Increased blood urea nitrogen (BUN) (1%),Induration at IV site (1%),Pain (1%) <1% Agranulocytosis,Anaphylaxis,Anemia,Basophilia,Bronchospasm,Candidiasis,Chills,Diaphoresis,Dizziness,Dysgeusia,Flushing,Gallstones,Glycosuria,Headache,Hematuria,Hemolytic anemia,Increased alkaline phosphatase or bilirubin,Increased creatinine,Jaundice,Leukocytosis,Lymphocytosis,Lymphopenia,Monocytosis,Nausea,Neutropenia,Phlebitis,Prolonged or decreased prothrombin time (PT),Pruritus,Renal stones,Serum sickness,Thrombocytopenia,Urinary casts,Vaginitis,Vomiting

Pregnancy Category Note

Pregnancy category: B Lactation: Drug enters breast milk in low concentrations; use with caution

Interaction

May increase nephrotoxicity of aminoglycosides. May diminish therapeutic effect of BCG, typhoid vaccine, Na picosulfate. May increase anticoagulant effect of vit K antagonists (e.g. warfarin). May increase serum level w/ probenecid. Potentially Fatal: Admin w/ Ca-containing IV soln may cause precipitation of a crystalline material in the lungs and kidneys.