Latebreakers: Calcium not to be given with Rocephin

Cases occurred in both term and premature neonates. Hyperbilirubinemic neonates, especially those who are premature, should not be treated with ceftriaxone,

Labeling revisions for ceftriaxone (Rocephin, Roche) for injection have been made following reports of calcium-ceftriaxone precipitates in the lungs and kidneys, leading to fatal reactions. Cases occurred in both term and premature neonates. Hyperbilirubinemic neonates, especially those who are premature, should not be treated with ceftriaxone, and the drug must not be mixed or administered simultaneously or within 48 hours of calcium-containing solutions or products, even when different infusion lines are being used. The updated information has been added to the Contraindications, Warnings, Precautions, Adverse Reactions, and Dosage and Administration sections of the prescribing information.