Topic: Ceftriaxone IV push -have you done it? Have you diluted it yourself?
Rumigirl
Frequent Contributor (1K+ posts)
Member # 15091
posted
Has anyone done ceftriaxone (generic Rocephin) as an IV push? How was it---any more side-effects?
And have you diluted the ceftriaxone yourself? How was that? Any problems? The pharmacist at the Surgical supply company says it's not a problem, but at Infuserve, they don't recommend it.
My insurance company may not cover it any more (I'm going into my third month), and it's $300 per month cheaper to do the IV push and to mix it up myself---$640 per month vs $940 per month! I don't know how I"m going to afford it either way, but I have to, as I have just now finally seen the first improvement I've had in 3 1/2 years of aggressive treatment (mostly non-abx for most of that time).
If they deny it, which sounds most likely, I'm going to doggedly appeal it, but that doesn't guarantee anything.
To complicate matters, I could get it mixed in an IV push form at Infuserve for the same price as unmixed at my current Surgical supply company. BUT, if the insurance company reverses a denial on appeal, I will probably have trouble getting reimbursed from what I would pay at Infuserve, which isn't in-network, and doesn't submit to insurance themselves.
Posts: 3771 | From around | Registered: Mar 2008
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CD57
Frequent Contributor (1K+ posts)
Member # 11749
posted
I got my IV pushes (2g) from Infuserve, in 20ml syringe. It came premixed. I would infuse very slowly. The pharmacist there told me to do it over at least half an hour.
I LOVE that place, they are so great. And you won't find better prices.
Posts: 3528 | From US | Registered: Apr 2007
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Rumigirl
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Thank you, CD57.
Up for more replies.
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kgg
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Member # 5867
posted
We did Rocephin IV push over 20 minutes with my son when he was 20. He tolerated it well.
Best, Karen
Posts: 1688 | From Maine | Registered: Jun 2004
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Rumigirl
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Member # 15091
posted
Karen,
Did you dilute it yourselves, or did it come premixed? Thank you.
Posts: 3771 | From around | Registered: Mar 2008
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posted
should be infused over 30 min. I'll just leave it as that.
however, good documentation on your progress and positive reponse will help ins. cont. to approve it. IV comp. i am using had pt. on it 4 yrs before starting denying tx. And for lyme
when i called them about my IV start up and all i said for rocephin and dose and she said " for what, lyme? " i was very suprised !! they understand the importance of the documentation needed. so does my home health nurse...who i trained yrs ago...
-------------------- i am not a Dr. any info is only for education, suggestion or to think/research. please do not mis-intuprest as diagnostic or prescriptive, only trying to help. **
dx in 08:lyme, rmsf, bart, babs, and m.pneumonia. Posts: 422 | From TX | Registered: Oct 2008
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posted
I mix the ceftriaxone manually for IV drip now, but I would be concerned about an IV push without a syringe pump.
Mixing the ceftriaxone is really simple, the hardest part is getting the transfer pin fully into the vial - they really fit tight. There have been times that it took me a lot of effort to get the pin seated if it was off center - and I am 200lb grown man without Lyme.
I am unsure of how much money can be saved with a push vs. drip - most of the things you need are exactly the same - flushes, med in vial, admin tubing, etc. Infusion time is probably about the same - 20-40 minutes is what I hear most commonly.
I guess you could do a hand push with a 20ml syringe connected directly to the luer lock, but I would not recommend it.
Posts: 263 | From Capital Region, NY, USA | Registered: Jun 2008
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Keebler
Honored Contributor (25K+ posts)
Member # 12673
posted
-
I have never done this as IV drip or IV push but was hoping - and preparing for the treatment - years ago.
I had been instructed that it should be a drip, very slow - over an hour - so as to protect the gallbladder. Even with the protective RX that is nearly required for the gallbladder -- any faster -- or more concentrated - and the gallbladder could be overwhelmed and more prone to an attack.
This is what I was told about 6 or 7 years ago by a nurse who had been through IV tx herself. The mort dilute the solution and the longer drip time was much safer.
So, be sure to ask your doctor about the best protection for your gallbladder, Rx and the timing and dilution of this. And, if a push is the only way you can do this, others seem to have done okay with slower and more diluted approaches.
posted
My husband started on push but he had alot of itching so we made the push last longer and longer. We eventually switched to IV gravity pole so we could do it over an hour (itching didn't go away though).
Posts: 984 | From San Diego | Registered: Nov 2006
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posted
My husband did his first month of IV Rocephin as a drip, and 2 more months as a push. I was very nervous about switching from drip to push, but it was actually easier, and there was no difference in his tolerance.
We were also instructed to do the push over 30 minutes. Using a stopwatch helped.
Our syringes were pre-mixed.
My husband took Ursadiol (generic Actigall) to protect his gall bladder during Rocephin treatment. He also supplemented with shark liver oil to help his white blood count, as this can drop with Rocephin.
Hope this helps. Best of luck with it!
Viva
Posts: 532 | From southeast US | Registered: Oct 2005
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kgg
Frequent Contributor (1K+ posts)
Member # 5867
posted
We received the syringes pre-mixed.
Best, Karen
Posts: 1688 | From Maine | Registered: Jun 2004
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Rumigirl
Frequent Contributor (1K+ posts)
Member # 15091
posted
Hmm, tcw, that sounds difficult, getting the pin into the vial to mix it myself.
Although I would rather not do the IV push, and certainly not the mixing, the price difference is over $300 per month.
And, if I go with the premixed syringes with Infuserve, if insurance denies, but reverses it on appeal, I will probably have difficulty getting reimbursed out of network.
Oxford is keeping me on hold about their decision. I find it unsconscionable that they can deny treatment, when I've been sick so long, and I'm finally starting to get some relief!
I'm praying for a good outcome, but I understand that it's rare. Thanks to the IDSA!
Posts: 3771 | From around | Registered: Mar 2008
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Rumigirl
Frequent Contributor (1K+ posts)
Member # 15091
posted
Well, I heard today that my insurance did deny further treatment, saying, "it's experimental, not the standard of care." Infuriating!
The insurance companies got just what they wanted from the IDSA!
So now it's the IV pushes, either premixed from Infuserve or to be mixed by me from the surgical company I've been dealing with (so I could get reimubursed better, if they reverse the denial on appeal).
Posts: 3771 | From around | Registered: Mar 2008
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posted
My doctor told me about Infuserve, but what is the surgical supply co you are talking about? I need to get all the info I can before I agree to start the rocephin.
Thank you!!
Posts: 847 | From upstateNY | Registered: Dec 2007
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posted
I did a push for 5 months and mixed it all myself without any problems. My dosages was 2g, diluted with sterile saline solution in a 60cc leur-lock syringe, pushed over 20-40 minutes. In the end this was a lot cheaper than any other options I knew about, at least.
The worst of it was the first couple weeks because I was brain dead and pretty weak when I started-- not the sort of thing that makes this easier since there are a few more steps when you mix it and it takes some hand strength to fill the syringes. But once I was in the routine it was, well, routine.
If you want some more advice you can PM me. Good Luck!
Posts: 36 | From Corvallis, OR | Registered: Jul 2008
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posted
I have a PICC line, and do the push. I mix it myself; it is so, so easy. I have had both premixed and not, and there really is no difference in my opinion. And $300. is $300.! Hope all goes well for you.
Posts: 374 | From United States | Registered: Nov 2008
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