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Ceftriaxone im and iv difference for passing bbb and neurological lyme

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Posted 7/24/2024 2:08 AM (GMT -5)
I just wanted to learn if there is a difference between im and iv ceftriaxone in terms of treating lyme disease. Since in Turkey there is no lyme, docs are pretty incompetant so I can only take im one they are scared to give iv one for some reason. I have seen some articles that there is not much diff between both but they were not specifically about lyme disease. So I wanted to ask this community if you know it.
Posted 7/24/2024 6:11 AM (GMT -5)
i have not looked into it specifically - but in terms of general principles
both IM and IV will bypass the gut and first pass metabolism in the liver - which are the main causes of increased effectiveness with IV drugs vs oral ( oral drugs are reduced by the gut and then by the liver before entering the general blood circulation) so i would expect IV and IM to be similar in this respect

IM will disperse into the system more slowly than IV - as it needs to diffuse through tissue - but this is not necessary a problem as it produces a longer peak of drug concentration
once in the blood - the interaction with the BBB will be the same - regardless of route of administration

one point i am not aware of is if you can dose sufficient ceftriaxone via IM
oral doses are often 2g / day - and i would expect IV/IM doses to be the same

i am not sure if its possible to give 2g as an IM shot - that would lead to a lot of discomfort i would have thought ?
Posted 7/24/2024 11:53 AM (GMT -5)
2g a day can be given by IM

but - they give it in 4 injections each of 2ml infusions and use 1% lidocaine in the infusions to manage the discomfort.

paper said...
i.m. injections were well tolerated. We believe two factors
are responsible for this favorable result. The importance of
reconstituting ceftriaxone with 1% lidocaine for use in i.m.
injections needs to be emphasized. This ploy allowed for
comfortable administration, which was accepted even by initially skeptical patients.
In addition, 2 ml was the maximum volume administered. Although this required two and
four injections, respectively, for the 1- and 2-g doses, we
believe this approach minimizes discomfort. In this experience, local pain or symptoms after i.m. injection was a rare occurrence.

.

source
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC175886/pdf/aac00088-0169.pdf
Posted 7/25/2024 3:20 AM (GMT -5)
I used to take Ceftriaxone 2gm IM shots. I would reconstitute it with a bit less water because it was a lot of shots and a lot of volume. I would have taken IV but it is hard to put an IV in yourself, so ended up going IM for a short while. It worked for sure but seemed no stronger die off than 500mg Cefuroxime .
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