What happens if I overdose Pipertaz?
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local ( ), or emergency room immediately.
Proper storage of Pipertaz:
Pipertaz is usually handled and stored by a health care provider. If you are using Pipertaz at home, store Pipertaz as directed by your pharmacist or health care provider. Keep Pipertaz out of the reach of children and away from pets.
Overdose of Pipertaz in details
There have been postmarketing reports of overdose with Pipertaz. The majority of those events experienced, including nausea, vomiting, and diarrhea, have also been reported with the usual recommended dosages. Patients may experience neuromuscular excitability or convulsions if higher than recommended doses are given intravenously (particularly in the presence of renal failure).
Treatment should be supportive and symptomatic according the patient's clinical presentation. Excessive serum concentrations of either Pipertaz or Tazobactam (Pipertaz) may be reduced by hemodialysis. Following a single 3.375 g dose of Pipertaz, the percentage of the Pipertaz and Tazobactam (Pipertaz) dose removed by hemodialysis was approximately 31% and 39%, respectively.
What should I avoid while taking Pipertaz?
Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.
Pipertaz warnings
Hypersensitivity Adverse Reactions
Serious and occasionally fatal hypersensitivity (anaphylactic/anaphylactoid) reactions (including shock) have been reported in patients receiving therapy with Pipertaz. These reactions are more likely to occur in individuals with a history of penicillin, cephalosporin, or carbapenem hypersensitivity or a history of sensitivity to multiple allergens. Before initiating therapy with Pipertaz, careful inquiry should be made concerning previous hypersensitivity reactions. If an allergic reaction occurs, Pipertaz should be discontinued and appropriate therapy instituted.
Severe Cutaneous Adverse Reactions
Pipertaz may cause severe cutaneous adverse reactions, such as Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms, and acute generalized exanthematous pustulosis. If patients develop a skin rash they should be monitored closely and Pipertaz discontinued if lesions progress.
Hematologic Adverse Reactions
Bleeding manifestations have occurred in some patients receiving β-lactam drugs, including Pipertaz. These reactions have sometimes been associated with abnormalities of coagulation tests such as clotting time, platelet aggregation and prothrombin time, and are more likely to occur in patients with renal failure. If bleeding manifestations occur, Pipertaz should be discontinued and appropriate therapy instituted.
The leukopenia/neutropenia associated with Pipertaz administration appears to be reversible and most frequently associated with prolonged administration.
Periodic assessment of hematopoietic function should be performed, especially with prolonged therapy, ie, ≥ 21 days.
Central Nervous System Adverse Reactions
As with other penicillins, patients may experience neuromuscular excitability or convulsions if higher than recommended doses are given intravenously (particularly in the presence of renal failure).
Electrolyte Effects
Pipertaz contains a total of 2.84 mEq (65 mg) of Na+ (sodium) per gram of Pipertaz in the combination product. This should be considered when treating patients requiring restricted salt intake. Periodic electrolyte determinations should be performed in patients with low potassium reserves, and the possibility of hypokalemia should be kept in mind with patients who have potentially low potassium reserves and who are receiving cytotoxic therapy or diuretics.
Clostridium difficile Associated Diarrhea
Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including Pipertaz, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile.
C. difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibacterial drug use. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents.
If CDAD is suspected or confirmed, ongoing antibacterial drug use not directed against C. difficile may need to be discontinued. Appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated.
Development of Drug-Resistant Bacteria
Prescribing Pipertaz in the absence of a proven or strongly suspected bacterial infection is unlikely to provide benefit to the patient and increases the risk of development of drug-resistant bacteria.
What should I discuss with my healthcare provider before taking Pipertaz?
Some medical conditions may interact with Pipertaz. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have cystic fibrosis, bowel inflammation, bleeding problems, congestive heart failure, or kidney problems
- if you are on dialysis, or if you have a history of severe diarrhea or bowel problems due to an antibiotic
- if you are on a salt-restricted diet or have low blood potassium levels
Some MEDICINES MAY INTERACT with Pipertaz. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Chemotherapy or diuretics (eg, furosemide, hydrochlorothiazide) because the risk of side effects, such as low blood potassium levels, may be increased
- Probenecid because it may increase the risk of Pipertaz's side effects
- Anticoagulants (eg, warfarin), heparin, methotrexate, or nondepolarizing muscle relaxants (eg, vecuronium) because the risk of their side effects may be increased by Pipertaz
- Aminoglycosides (eg, tobramycin) or oral contraceptives (birth control pills) because their effectiveness may be decreased by Pipertaz
This may not be a complete list of all interactions that may occur. Ask your health care provider if Pipertaz may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
Pipertaz precautions
Serious and occasionally fatal hypersensitivity (anaphylactoid) reactions have been reported in patients on penicillin therapy, including those receiving Pipertaz, a thorough inquiry about patient's previous hypersensitivity reactions is important. Serious anaphylactoid reactions require emergency treatment with epinephrine. Oxygen, IV steroids and airway management including intubation should also be administered as indicated.
Pseudomembranous colitis has been reported with nearly all antibacterial agents and may range in severity from mild to life-threatening. It is important to consider this diagnosis in patients who present with diarrhea following administration of antibacterial agents.
Superinfection with fungal or bacterial pathogens may develop with prolonged use. Bleeding has been reported in some patients receiving β-lactam antibiotics, including Pipertaz, it is advised that Pipertaz be discontinued immediately when bleeding occurs and appropriate therapy be initiated.
A higher incidence of fever and rash in patients with cystic fibrosis has also occurred with Pipertaz.
Carcinogenicity, Mutagenicity & Impairment of Fertility: Fertility/Reproduction: Reproduction studies have been performed in rats and have revealed no evidence of impaired fertility when Pipertaz is given at a dose similar to the maximum recommended human daily dose based on body surface area.
Use in pregnancy: (Pregnancy Category B): Teratology studies have been performed in mice and rats and have revealed no harmful effects on the fetus when Pipertaz was administered at a dose 1-2 times and 2-3 times the human dose of Pipertaz and Tazobactam (Pipertaz), respectively, based on body surface area.
However, there are no adequate and well-controlled studies that evaluated the combination of Pipertaz or monotherapy with Pipertaz in pregnant women. Pipertaz should only be used during pregnancy when clearly needed.
Use in lactation: Pipertaz is excreted at low concentrations in human milk while Tazobactam (Pipertaz) concentrations in human milk have not been studied.
Exercise caution when Pipertaz is administered to breastfeeding women.
Use in children: Pipertaz is used to treat serious abdominal infections in children 2-12 years. However, it is not recommended in the treatment of abdominal infections in children <2 years.
Use in the
Elderly: Patients >65 years do not have an increased risk of developing adverse effects solely because of age. However, the dosage should be adjusted in the presence of renal insufficiency.
What happens if I miss a dose of Pipertaz?
Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.
References
- DrugBank. "Tazobactam". http://www.drugbank.ca/drugs/DB01606 (accessed September 17, 2018).
- DrugBank. "piperacillin". http://www.drugbank.ca/drugs/DB00319 (accessed September 17, 2018).
- MeSH. "beta-Lactamase Inhibitors". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology
