Roche and the FDA have informed healthcare professionals of fatal reactions with calcium-ceftriaxone precipitates in the lungs and kidneys in both term and preterm neonates. This occurs when Rocephin (ceftriaxone) is used concomitantly with calcium or calcium-containing solutions.

Hyperbilirubinemic neonates, especially in preterm infants, should not be treated with ceftriaxone. Ceftriaxone should not be mixed or administered simultaneously with calcium-containing solutions or products (e.g. Ringerss) even via different infusion lines. Also, calcium-containing solutions or products must not be administered with 48 hours of the last administration of ceftriaxone.