Aminoglycosides: In case of concomitant administration of cephalosporins and aminoglycosides there has been reported an increased risk of oto- and nephrotoxicity. Dose adjustment may be necessary.
Furthermore, these medicinal products must be administered separately to avoid physicochemical incompatibility between Ceftriaxone and the aminoglycoside.
Bacteriostatic antibiotics, such as chloramphenicol and tetracycline, may antagonize the activity of Ceftriaxone, especially in acute infections accompanied by rapid proliferation of micro-organisms. Simultaneous use of Ceftriaxone and bacteriostatic antibiotics is, therefore, not recommended.
Probenecid: Contrary to other cephalosporins, probenecid does not impede tubular secretion of Ceftriaxone.
Oral contraceptives: Ceftriaxone may adversely affect the efficacy of hormonal contraceptives. Consequently, it is advisable to use supplementary non-hormonal contraceptive measures.
Other: Laboratory-diagnostic tests: The Coombs test may be false-positive in rare cases during treatment with Ceftriaxone. Non-enzymatic methods for glucose determinations in urine may yield false-positive results. For this reason, urine glucose determination during therapy with Ceftriaxone should be carried out enzymatically. Ceftriaxone may lead to false-positive results of galactose determination in blood. The Ceftriaxone molecule does not contain the N-methylthio-tetrazole substituent which has been associated with a disulfiram-like effect when alcohol is taken during therapy with certain cephalosporins.
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