Ceftriaxone Renal Dosing Adjustment
Ceftriaxone requires no dosage adjustment for renal failure when usual doses are used. [1] Ceftriaxone is not removed by peritoneal- or hemodialysis, so no post-dialysis supplemental dose is required. [1]
Normal Renal Function
Ceftriaxone should be dosed using the usual regimen for the indication. [1] Dosage adjustments are not required in patients with renal failure when usual doses are administered. [1]
Moderate Renal Impairment (Creatinine Clearance 10–49 mL/min)
Ceftriaxone dosing should follow the usual regimen for the indication without renal dose adjustment. [1] Renal failure generally does not require dosage adjustment when usual doses are used. [1]
Severe Renal Failure (Creatinine Clearance <10 mL/min)
Ceftriaxone dosing should follow the usual regimen for the indication without renal dose adjustment. [1] In preterminal renal failure (creatinine clearance <10 mL/min), the ceftriaxone dosage should not exceed 2 g daily. [2]
Intermittent Hemodialysis
Ceftriaxone is not removed by hemodialysis. [1] No additional supplementary dosing is required following dialysis. [1]
Continuous Renal Replacement Therapy (CRRT)
Ceftriaxone is not removed to a clinically significant extent by dialysis, and no post-dialysis supplemental dosing is required following dialysis. [1] Renal replacement does not mandate a routine ceftriaxone dose reduction based on the available labeling guidance. [1]
Dose-Safety Limitations
When both hepatic dysfunction and significant renal disease are present, caution is required and the ceftriaxone dosage should not exceed 2 g daily. [1] In preterminal renal failure (creatinine clearance <10 mL/min), ceftriaxone dosage should not exceed 2 g daily. [2]