When using testosterone cypionate vs propionate observed the following side effects, which disappeared either alone or after discontinuation of the drug: gastrointestinal tract (about 2%): soft stools or diarrhea, nausea, vomiting, stomatitis, glossitis, taste disturbance (less than 1%) .
Hematological changes (about 2%): eosinophilia, leukopenia; less frequently (<1%): granulocytopenia, hemolytic anemia, thrombocytosis, thrombocytopenia, increased thromboplastin and prothrombin time. Described isolated cases of agranulocytosis (<500 cells / ul), most of which occurred after 10 days of treatment and the application of a cumulative dose of 20 g or more. Skin reactions (about 1%): rash, allergic dermatitis, itching, hives, swelling of individual cases serious adverse reactions (exudative erythema multiforme (Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell’s syndrome)).
Other (rarely observed): headache and dizziness, precipitation of the calcium salt of ceftriaxone in the gallbladder with the corresponding symptoms, pancreatitis, increased liver activity enzymes, alkaline phosphatase, hyperbilirubinemia, oliguria, increase in the concentration of serum creatinine, mycosis of the genital tract, vaginitis, fever, chills, sweating, hot flashes, hypersensitivity pneumonitis, bronchospasm, epistaxis, hematuria, jaundice, decreased prothrombin time, seizure, heart rate, serum sickness, and anaphylactic or anaphylactoid reactions. We describe the very rare cases of pseudomembranous colitis, and bleeding disorders, as well as the formation of stones in the kidneys, mainly in children older than 3 years treated either large daily doses of drug ( > 80 mg / kg per day) or cumulative doses greater than 10 g, and also had additional risk factors (fluid intake restriction, bed rest, etc.). The formation of stones in the kidney may be asymptomatic or manifest itself clinically, can lead to kidney failure and is reversible after discontinuation of therapy Rocephin. Local reactions (very rare): Phlebitis following intravenous administration. It can be avoided by injecting the drug slowly over 2-4 minutes. Intramuscular injection without lidocaine is painful.
If overdose, hemodialysis and peritoneal dialysis does not reduce the concentration of the drug. No specific testosterone cypionate vs propionate antidote. Overdose Treatment – symptomatic.
Interaction with other drugs
With simultaneous use of large doses of Rocephin and potent diuretics (eg, furosemide), renal dysfunction was observed. Instructions that Rocephin increases renal toxicity of aminoglycosides, no. Drinking alcohol after administration of Rocephin is not accompanied disulfiramopodobnyh reaction. Ceftriaxone does not contain group, which could cause ethanol intolerance and bleeding that is inherent in some other cephalosporins. Probenecid does not affect the excretion of Rocephin.
Bacteriostatic antibiotics reduce the bactericidal effect of ceftriaxone.
With In vitro, was found antagonism between chloramphenicol and ceftriaxone.
Rocephin should not be added to infusion solutions containing calcium, for example, testosterone cypionate vs propionate solution and Hartmann. Ceftriaxone is incompatible and should not be confused with amsacrine, vancomycin, fluconazole and aminoglycosides. Influence on laboratory tests results in the rare cases when Rocephin treatment in patients with false-positive results may be observed Coombs test. Like other antibiotics, Rocephin can give a false positive result on samples galactosemia. False positive results may be obtained in the determination of glucose in urine, so during treatment if necessary Rocephin glucosuria need only determine enzymatic method.
As with other cephalosporins, even with careful history can not exclude the possibility of an anaphylactic shock. In patients with hypersensitivity to penicillin should be aware of the possibility of cross-allergic reactions.
As with the treatment of other antibacterial agents, superinfection may develop.
In patients with renal insufficiency usually does not require dose adjustment thanks to a double elimination pathway of ceftriaxone (through the kidney and liver). It is recommended to periodically determine the concentration of drug in the blood.
In patients with renal hepatic insufficiency daily dose of Rocephin should not exceed 2 g without monitoring the concentration of drug in the blood.
In patients treated with Rocephin, describe rare cases of changes in prothrombin time. Patients with a deficiency of vitamin K (impaired synthesis, malnutrition) may require monitoring of prothrombin time during therapy and the appointment of vitamin K (10 mg / week) with an increase in prothrombin time prior to or during therapy.
After using ceftriaxone, usually in doses exceeding standard recommended when the gallbladder ultrasound examination reveals shadows mistaken for stones. They are precipitates of calcium salt of ceftriaxone which disappear after the completion or discontinuation changes rarely produce any symptoms, but in such cases, only conservative treatment is recommended. If these phenomena are accompanied by a clinical simptomatikoi, the decision to cancel the drug is at the discretion of the attending physician.
Patients receiving testosterone cypionate vs propionate described rare cases of pancreatitis develop, possibly due to biliary obstruction. Most of these patients have previously had risk factors of stagnation in the biliary tract, for example, the earlier therapy, severe illness and total parenteral nutrition. At the same time we can not exclude the role of starter, formed under the influence of Rocephin, precipitates in the biliary tract in the development of pancreatitis.
Caution must be exercised in the appointment of Rocephin newborns with hyperbilirubinemia. Rocephin should not be used in newborns, especially premature who have a risk of developing bilirubin encephalopathy.
Long-term treatment should regularly monitor the blood picture.
Release form and packing powder for solution for intramuscular injection of 250 mg, 500 mg, 1 g Package : 250 mg, 500 mg or 1 g of ceftriaxone in a glass vial (glass hydrolytic class 1 L $), rubber stoppers of butyl rubber, crimped aluminum caps and closed by a plastic cover. in 2 ml (for Rocephin 250 mg or 500 mg) or 3.5 ml (for Rocephin 1 g) lidocaine / o ampoules made in accordance with ISO 9187, of glass of hydrolytic class 1 EP hermetically sealed. On vial with a solvent there is a point at the tip of colors- blue vial – two rings -. Blue and green 1 vial with 1 vial of solution of lidocaine 1% and instructions for use are placed in a cardboard box.