How Much Lidocaine To Mix With Rocephin?
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Answers ( 3 )
Mix Ceftriaxone IM with Lidocaine for Less Pain
Ceftriaxone is a broad-spectrum antibiotic that is frequently administered intramuscularly (IM) in emergency medicine. However, these injections hurt — A LOT! Can we do anything to minimize the pain?
Give ceftriaxone IM with lidocaine
Ceftriaxone for IM use can be diluted with lidocaine 1% [1]:
Ceftriaxone 250 mg vial – mix with 0.9 mL of lidocaine 1% = 250 mg/mL
Ceftriaxone 1000 mg vial – mix with 2.1 mL of lidocaine 1% = 350 mg/mL
What do the patients say?
In a double-blind crossover study [2], patients receiving IM ceftriaxone diluted with lidocaine 1% experienced 50% less pain compared to using sterile water for injection as a diluent. Using a 100 mm visual analog scale shortly after the shot, patients rated lidocaine-ceftriaxone pain as 25 mm compared to 50 mm for water-ceftriaxone. There was significant pain relief sustained up to 1 hour later.
Do not use calcium-containing diluents, such as Ringer’s or Hartmann’s solutions, to reconstitute Rocephin vials or further dilute a reconstituted vial for IV administration because a precipitate can form. When Rocephin is mixed with calcium-containing solutions in the same IV administration line, precipitation of ceftriaxone-calcium can occur.