Generic Name: piperacillin and tazobactam (pi PER a sil in and tay zoe BAK tam)
Brand Names: Zosyn

What is Zosyn?

Zosyn contains a combination of piperacillin and tazobactam. Piperacillin and tazobactam are penicillin antibiotics that fight bacteria in the body.

Zosyn is used to treat many different infections caused by bacteria, such as urinary tract infections, bone and joint infections, severe vaginal infections, stomach infections, skin infections, and pneumonia.

Zosyn is sometimes given together with other antibiotics.

Zosyn may also be used for purposes not listed in this medication guide.

Important information

You should not use Zosyn if you are allergic to piperacillin or tazobactam or to any other penicillin antibiotic, such as amoxicillin (Amoxil, Augmentin, Dispermox, Moxatag), ampicillin (Principen, Unasyn), dicloxacillin (Dycill, Dynapen), oxacillin (Bactocill), ticarcillin (Timentin), or penicillin (Bicillin L-A, PC Pen VK, Pfizerpen), and others.

Before using Zosyn tell your doctor if you have kidney disease, a bleeding or blood clotting disorder, low levels of potassium in your blood, cystic fibrosis, a history of allergies, if you are on a low-salt diet, or if you are allergic to a cephalosporin antibiotic such as cefdinir (Omnicef), cefprozil (Cefzil), cefuroxime (Ceftin), cephalexin (Keflex), and others.

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Use Zosyn for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Zosyn will not treat a viral infection such as the common cold or flu.

Zosyn may cause bleeding, especially in people with kidney disease or using certain medicines. Tell your doctor if you are using any medication to prevent blood clots such as alteplase (Activase), bivalirudin (Angiomax), clopidogrel (Plavix), dabigatran (Pradaxa), dipyridamole (Persantine, Aggrenox), enoxaparin (Lovenox), fondaparinux (Arixtra), heparin, tenecteplase (TNKase), ticlopidine (Ticlid), tinzaparin (Innohep), warfarin (Coumadin, Jantoven), and others.

Before using Zosyn

You should not use Zosyn if you are allergic to piperacillin and tazobactam or to any penicillin antibiotic (amoxicillin, ampicillin, Augmentin, dicloxacillin, oxacillin, penicillin, ticarcillin, and others).

To make sure Zosyn is safe for you, tell your doctor if you have:

  • kidney disease (or if you are on dialysis);

  • a bleeding or blood clotting disorder;

  • an electrolyte imbalance such as low levels of potassium in your blood;

  • cystic fibrosis;

  • a history of any type of allergy;

  • if you are on a low-salt diet; or

  • if you are allergic to a cephalosporin antibiotic such as cefdinir (Omnicef), cefprozil (Cefzil), cefuroxime (Ceftin), cephalexin (Keflex), and others.

FDA pregnancy category B. Zosyn is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

See also: Pregnancy and breastfeeding warnings (in more detail)

Piperacillin and tazobactam can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I use Zosyn?

Zosyn is injected into a vein through an IV. You may be shown how to use an IV at home. Do not self-inject this medicine if you do not understand how to give the injection and properly dispose of used needles, IV tubing, and other items used to inject the medicine.

Zosyn is usually given for 7 to 10 days, depending on the infection being treated. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Zosyn must be mixed with a liquid (diluent) before using it. If you are using the injections at home, be sure you understand how to properly mix and store the medication.

Prepare your dose only when you are ready to give an injection. Do not use if the medicine has changed colors or has particles in it. Call your pharmacist for new medicine.

If you use Zosyn long-term, you may need frequent medical tests at your doctor's office.

Use a disposable needle only once, then throw away in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

Use this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Zosyn will not treat a viral infection such as the common cold or flu.

This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using Zosyn.

Store unmixed Zosyn and the liquid diluent at cool room temperature.

Medicine mixed in an IV bag must be used within 24 hours if you keep it at room temperature.

Mixed medicine in an infusion pump must be used within 12 hours if you keep it at room temperature.

Mixed medication in an IV bag can also be stored in the refrigerator for up to 7 days. Do not freeze. Throw away any unused mixture that has not been used within that time.

What happens if I miss a dose?

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.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid?

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.

Zosyn side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Zosyn: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • diarrhea that is watery or bloody;

  • pale or yellowed skin, dark colored urine, fever, confusion or weakness;

  • rapid heart rate, feeling light-headed or short of breath, trouble concentrating;

  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

  • dry mouth, increased thirst, confusion, increased urination, muscle pain or weakness, fast heart rate, fainting;

  • fever, chills, body aches, flu symptoms;

  • blisters or ulcers in your mouth, red or swollen gums, trouble swallowing;

  • seizure (convulsions); or

  • severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common Zosyn side effects may include:

  • nausea, vomiting, stomach pain or upset;

  • constipation, mild diarrhea;

  • headache, dizziness, agitation;

  • runny nose;

  • anxiety, sleep problems (insomnia);

  • skin rash or itching;

  • pain, swelling, or other irritation where the injection was given; or

  • vaginal itching or discharge.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Zosyn?

Zosyn may cause bleeding, especially in people who have kidney disease or use certain medicines. Tell your doctor if you are using any medication to prevent blood clots, such as:

  • heparin or warfarin (Coumadin);

  • argatroban, bivalirudin, dabigatran, fondaparinux, lepirudin, rivaroxaban;

  • abciximab, eptifibatide, tirofiban;

  • dalteparin, enoxaparin, tinzaparin;

  • anagrelide, cilostazol, clopidogrel, dipyridamole, eltrombopag, oprelvekin, prasugrel, romiplostim, ticagrelor, ticlopidine; or

  • alteplase, reteplase, tenecteplase, urokinase.

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Zosyn, especially:

  • methotrexate; or

  • probenecid.

These lists are not complete. Other drugs may interact with Zosyn, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about Zosyn.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Zosyn only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2014 Cerner Multum, Inc. Version: 3.02. Revision Date: 2014-01-03, 4:47:38 PM.

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