Monocef (Ceftriaxone Sodium)
Also sold as: Monocef, Rocephin, Cefaxone, Oframax, Ceftrimax
Pregnancy
Cat B
Lactation
Safe
Schedule
H
Forms
Injection 250mg, 500mg, 1g, 2g vials (IV/IM) +1
Indications
- Community-acquired pneumonia (CAP) — hospital-grade
- Meningitis (bacterial)
- Septicaemia
- Typhoid fever (complicated)
- Intra-abdominal infections
- Gonorrhea (uncomplicated)
- Surgical prophylaxis
- Pelvic inflammatory disease (PID)
- Lyme disease
Adult Dosing
Most infections
1-2 g IV/IM once daily
7-14 days
Meningitis
2 g IV every 12 hours
10-14 days
Gonorrhea (uncomplicated)
500 mg IM single dose
Add azithromycin 1g PO for co-treatment
Surgical prophylaxis
1-2 g IV single dose
30-60 min before incision
Typhoid (severe)
2 g IV once daily
10-14 days
Pediatric Dosing
Meningitis: 100 mg/kg/day divided every 12 hours. AVOID in neonates with hyperbilirubinemia (displaces bilirubin from albumin). Do NOT reconstitute with calcium-containing solutions in neonates.
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| CrCl > 10 mL/min | No adjustment |
| CrCl < 10 mL/min / Hemodialysis | Max 2 g/day; do not exceed |
Hepatic Adjustment
No adjustment if renal function normal; dose cap 2 g/day if both hepatic + renal impairment
Pregnancy & Lactation
Pregnancy: Category B
Generally safe; used for gonorrhea, Lyme disease, and severe infections in pregnancy.
Lactation: Safe
Low levels in breast milk; compatible with breastfeeding.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Calcium-containing IV solutions (including Ringer's lactate) | FATAL PRECIPITATION in neonates — never mix; avoid co-infusion in adults within 48 hours | Major |
| Warfarin | Increased anticoagulant effect | Moderate |
| Aminoglycosides (amikacin, gentamicin) | Synergistic antibacterial activity — separate infusions | Minor |
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Side Effects
Common
- Injection site pain/phlebitis
- Diarrhea
- Nausea
- Rash
- Eosinophilia
Serious / Discontinue If
- Biliary sludge/cholelithiasis (prolonged use)
- Hemolytic anemia
- C. difficile colitis
- Anaphylaxis
- Ceftriaxone-calcium precipitation (neonates)
Contraindications
- Cephalosporin hypersensitivity
- Neonatal hyperbilirubinemia (>28 days only with caution)
- Concurrent calcium IV in neonates
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Monocef 1g | Aristo | Vial ₹65 |
| Cefaxone 1g | Alkem | Vial ₹58 |
| Oframax 1g | Ranbaxy (Sun) | Vial ₹72 |
| Ceftrimax 1g | Cipla | Vial ₹70 |
Monitoring Required
- Renal function (prolonged therapy)
- CBC (hemolysis)
- Gallbladder ultrasound if prolonged >14 days
- LFT
Patient Counseling Points
- Hospital/clinic administration only — IV or IM injection
- Report any rash, swelling, or difficulty breathing after injection
- Diarrhea during or after treatment — report to doctor
- Complete the prescribed course even if feeling better
Stop Googling drug references mid-consultation
EasyClinic auto-flags Monocef interactions, renal cutoffs, and pregnancy warnings the moment you write the prescription. Built-in safety net for every Indian doctor.
Clinically reviewed by: Dr. Sanjay Mehta, MD (Internal Medicine), Senior Consultant
Last reviewed: 2026-04-01
References
- BNF — Ceftriaxone
- WHO Meningitis Treatment Guidelines
- IAP STGs 2024
- CDC STI Treatment Guidelines 2021